Journal
NEUROLOGY
Volume 71, Issue 3, Pages 210-216Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/01.wnl.0000317094.86209.cb
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Funding
- NCRR NIH HHS [M01 RR023940-02, U54 RR021813-019003, M01 RR023940, P41 RR013642, M01RR023940, U54 RR021813-019002, U54 RR021813, U54 RR021813-019001, P41 RR013642-010004, M01 RR023940-01] Funding Source: Medline
- NIA NIH HHS [R03AG026374, AG026482, R21 AG026482, R03 AG026374, R21 AG029615] Funding Source: Medline
- NIMH NIH HHS [R01 MH071940-02, R01 MH071940-03, R01 MH71940, R01 MH071940-05, R01 MH071940, R01 MH071940-04] Funding Source: Medline
- NINDS NIH HHS [R01 NS039123-02, NS039123, K23NS058252, R01 NS039123, K23 NS058252, R01 NS039123-03, R01 NS039123-04] Funding Source: Medline
- PHS HHS [C76 HF00201] Funding Source: Medline
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Objective: To examine the correlation of cardiorespiratory fitness with brain atrophy and cognition in early-stage Alzheimer disease (AD). Background: In normal aging physical fitness appears to mitigate functional and structural age-related brain changes. Whether this is observed in AD is not known. Methods: Subjects without dementia (n = 64) and subjects with early-stage AD (n = 57) had MRI and standard clinical and psychometric evaluations. Peak oxygen consumption (VO2peak), the standard measure of cardiorespiratory fitness, was assessed during a graded treadmill test. Normalized whole brain volume, a brain atrophy estimate, was determined by MRI. Pearson correlation and linear regression were used to assess fitness in relation to brain volume and cognitive performance. Results: Cardiorespiratory fitness (VO2peak) was modestly reduced in subjects with AD (34.7 [5.0] mL/kg/min) vs subjects without dementia (38.1 [6.3] mL/kg/min, p = 0.002). In early AD, VO2peak was associated with whole brain volume (beta = 0.35, p = 0.02) and white matter volume (beta = 0.35, p = 0.04) after controlling for age. Controlling for additional covariates of sex, dementia severity, physical activity, and physical frailty did not attenuate the relationships. VO2peak was associated with performance on delayed memory and digit symbol in early AD but not after controlling for age. In participants with no dementia, there was no relationship between fitness and brain atrophy. Fitness in participants with no dementia was associated with better global cognitive performance (r = 0.30, p = 0.02) and performance on Trailmaking A and B, Stroop, and delayed logical memory but not after controlling for age. Conclusions: Increased cardiorespiratory fitness is associated with reduced brain atrophy in Alzheimer disease (AD). Cardiorespiratory fitness may moderate AD-related brain atrophy or a common underlying AD-related process may impact both brain atrophy and cardiorespiratory fitness.
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