Nanna Aue Sobol

Moderate-to-High Intensity Physical Exercise in Patients with Alzheimer's Disease: A Randomized Controlled Trial

BACKGROUND Studies of physical exercise in patients with Alzheimers disease (AD) are few and results have been inconsistent. OBJECTIVE To assess the effects of a moderate-to-high intensity aerobic exercise program in patients with mild AD. METHODS In a randomized controlled trial, we recruited 200 patients with mild AD to a supervised exercise group (60-min sessions three times a week for 16 weeks) or to a control group. Primary outcome was changed from baseline in cognitive performance estimated by Symbol Digit Modalities Test (SDMT) in the intention-to-treat (ITT) group. Secondary outcomes included changes in quality of life, ability to perform activities of daily living, and in neuropsychiatric and depressive symptoms. RESULTS The ITT analysis showed no significant differences between intervention and control groups in change from baseline of SDMT, other cognitive tests, quality of life, or activities of daily living. The change from baseline in Neuropsychiatric Inventory differed significantly in favor of the intervention group (mean: -3.5, 95% confidence interval (CI) -5.8 to -1.3, p = 0.002). In subjects who adhered to the protocol, we found a significant effect on change from baseline in SDMT as compared with the control group (mean: 4.2, 95% CI 0.5 to 7.9, p = 0.028), suggesting a dose-response relationship between exercise and cognition. CONCLUSIONS This is the first randomized controlled trial with supervised moderate-to-high intensity exercise in patients with mild AD. Exercise reduced neuropsychiatric symptoms in patients with mild AD, with possible additional benefits of preserved cognition in a subgroup of patients exercising with high attendance and intensity.

The Effects of High-Intensity versus Low-Intensity Resistance Training on Leg Extensor Power and Recovery of Knee Function after ACL-Reconstruction

Objective. Persistent weakness is a common problem after anterior cruciate ligament- (ACL-) reconstruction. This study investigated the effects of high-intensity (HRT) versus low-intensity (LRT) resistance training on leg extensor power and recovery of knee function after ACL-reconstruction. Methods. 31 males and 19 females were randomized to HRT (n = 24) or LRT (n = 26) from week 8–20 after ACL-reconstruction. Leg extensor power, joint laxity, and self-reported knee function were measured before and 7, 14, and 20 weeks after surgery. Hop tests were assessed before and after 20 weeks. Results. Power in the injured leg was 90% (95% CI 86–94%) of the noninjured leg, decreasing to 64% (95% CI 60–69%) 7 weeks after surgery. During the resistance training phase there was a significant group by time interaction for power (P = 0.020). Power was regained more with HRT compared to LRT at week 14 (84% versus 73% of noninjured leg, resp.; P = 0.027) and at week 20 (98% versus 83% of noninjured leg, resp.; P = 0.006) without adverse effects on joint laxity. No other between-group differences were found. Conclusion. High-intensity resistance training during rehabilitation after ACL-reconstruction can improve muscle power without adverse effects on joint laxity.

Effect of aerobic exercise on physical performance in patients with Alzheimer's disease

Knowledge about the feasibility and effects of exercise programs to persons with Alzheimers disease is lacking. This study investigated the effect of aerobic exercise on physical performance in community‐dwelling persons with mild Alzheimers disease.

Associations between physical function, dual-task performance and cognition in patients with mild Alzheimer's disease

Objective: Alzheimers disease (AD) causes a gradual decline in cognition, limitations of dual-tasking and physical function leading to total dependence. Hence, information about the interaction between physical function, dual-task performance and cognition may lead to new treatment strategies with the purpose of preserving function and quality of life. The objective of this study was to investigate the associations between physical function, dual-task performance and cognition in community-dwelling patients with mild AD. Methods: Baseline results from 185 participants (50–90 years old) in the single blinded multicenter RCT ‘ADEX’ (Alzheimers disease: the effect of physical exercise) were used. Assessments included tests of physical function: 400-m walk test, 10-m walk test, Timed Up and Go test and 30-s chair stand test; dual-task performance, i.e., 10-m walk while counting backwards from 50 or naming the months backwards; and cognition, i.e., Mini Mental State Examination, Symbol Digit Modalities Test, the Stroop Color and Word Test, and Lexical verbal fluency test. Results: Results in the 30-s chair stand test correlated significantly with all tests of cognition (r = .208–.242) while the other physical function tests only randomly correlated with tests of cognition. Results in the dual-task counting backwards correlated significantly with results in all tests of cognition (r = .259–.388), which accounted for 7%–15% of the variation indicating that a faster time to complete dual-task performance was associated with better cognitive performance. Conclusion: The evidence of the associations between physical function, dual-task performance and cognition is important when creating new rehabilitation interventions to patients with mild AD.

Acknowledgements to Referees

N. Cicorella, Mantova, Italy R. Cifkova, Prague, Czech Republic R. Cohen, Providence, R.I., USA W.J. Culpepper, Baltimore, Md., USA C. Curioni, Petrópolis, Brazil L.M. de Lau, Rotterdam, The Netherlands V. Demarin*, Zagreb, Croatia M. Dennis, Edinburgh, UK J. de Pedro Cuesta, Madrid, Spain D.A. De Silva, Singapore, Singapore R. De Silva, Nugegoda, Sri Lanka E. De Valck, Brussels, Belgium Y. Doi, Wako, Japan P. Durai, Punjab, India M. Endziniene, Kaunas, Lithuania S. Evans, Springfield, Ill., USA F. Fang, Stockholm, Sweden W. Feng, Charleston, S.C., USA R. Fernandez-Ballestero, Madrid, Spain J.M. Ferro, Lisbon, Portugal J.L. Fisher, Columbus, Ohio, USA H. Flocas, Athens, Greece R.L. Folmer, Portland, Oreg., USA G. Franklin, Seattle, Wash., USA L. Fratiglioni, Stockholm, Sweden G.D. Friedman, Oakland, Calif., USA D. Frydecka, Wroclaw, Poland M.J. Futter, Cape Town, South Africa M. Giroud, Dijon, France W. Grisold, Wien, Austria F. Grodstein, Boston, Mass., USA Q.H. Guo, Shanghai, China W.A. Hauser*, New York, N.Y., USA P. Heuschmann, Münster, Germany R. Hilsabeck, Encino, Calif., USA M. Himle, Salt Lake City, Utah, USA B. Hocking, Camberwell, Vic., Australia E. Hogervorst, Loughborough, UK X. Huang, Hershey, Pa., USA G.G. Iuliano, Salerno, Italy J. Jirsch, Montréal, Qué., Canada L. Abdullah, Sarasota, Fla., USA S. Adamovich, Newark, N.J., USA A. Adem, Al Ain, United Arab Emirates H. Akiyuki*, Chiba, Japan T. Ala, Springfield, Ill., USA M. Alashari, Al Ain, United Arab Emirates S.M. Albert, Pittsburg, Pa., USA A. Ali, Kingston, Jamaica A. Alperovitch, Paris, France M. Alter, Wynnewood, Pa., USA L.-C. Alvaro*, Bilbao, Spain A. Anand, Chandigarh, India C. Armon, Springfield, Ill., USA V.V. Ashraf, Calicut, India A. Barber, Auckland, New Zealand S. Barker-Collo, Auckland, New Zealand L. Batistin, Padua, Italy L. Bayentin, Québec, Qué., Canada B. Baykan, Istanbul, Turkey E. Beghi*, Milano, Italy J. Benito-Leon*, Madrid, Spain J. Berciano, Santander, Spain D. Bereczki, Budapest, Hungary D. Berger, Cortland, N.Y., USA F. Bermejo-Pareja, Madrid, Spain N. Bharucha, Mumbai, India R. Biswas, Bhopal, India F. Bonvicini, Reggio Emilia, Italy G. Boysen*, Copenhagen, Denmark M. Brainin, Krems, Austria A.M. Brickman, New York, N.Y., USA R. Brouns, Antwerp, Belgium N. Cabral, Joinville, Brazil S.F. Cappa*, Milano, Italy A. Carolei, L’Aquila, Italy D. Carpenter, Rensselaer, N.Y., USA T.D. Carter, Melbourne, Vic., Australia J.M. Castellote Olivito, Madrid, Spain H. Chen, Research Triangle Park, N.C., USA A. Chio, Torino, Italy

Contents Vol. 41, 2013

223 3rd International Congress on Neurology and Epidemiology Abu Dhabi, UAE, November 21–23, 2013 Editors: Feigin, V.L. (Auckland); Saadah, M. (Abu Dhabi) (available online only) 221 Acknowledgements to Referees