Aerobic Exercise Improves Cognition for Older Adults with Glucose Intolerance, A Risk Factor for Alzheimer's Disease
Aerobic Exercise Improves Cognition for Older Adults with Glucose Intolerance, A Risk Factor for Alzheimer's Disease
复制标题
DOI：
10.3233/jad-2010-100768
复制
发表时间：
2010-01-01
影响因子：
4
通讯作者：
Craft, Suzanne
中科院分区：
文献类型：
--
作者：
Baker, Laura D.;Frank, Laura L.;Craft, Suzanne
葡萄糖调节受损是2型糖尿病（T2 DM）病理学的定义特征，与认知障碍和痴呆的风险增加有关。尽管有氧运动对身体健康的益处已被充分证明，但尚未对糖尿病前期和早期T2 DM相关的血糖调节不良的老年人进行运动对认知的影响进行研究。采用随机对照设计，28名成年人（57-83岁）符合2小时耐量试验标准的葡萄糖耐受不良完成了6个月的有氧运动或拉伸，作为对照。主要认知结果包括执行功能的测量（轨迹B、任务转换、Stroop、自我命令指向测试和言语流畅性）。其他结果包括记忆表现（故事回忆，列表学习），通过最大分级运动平板试验获得的心肺适应性测量，高胰岛素-正葡萄糖钳夹期间的葡萄糖处置，体脂和胰岛素，皮质醇，脑源性神经营养因子，胰岛素样生长因子-1，淀粉样蛋白β（A β（40）和A β（42））的空腹血浆水平。6个月的有氧运动改善了执行功能（MANCOVA，p = 0.04）、心肺适应性（MANOVA，p = 0.03）和胰岛素敏感性（p = 0.05）。在所有受试者中，6个月的心肺适应性变化和胰岛素敏感性呈正相关（p = 0.01）。对于A β（42），有氧组的血浆水平相对于对照组有下降趋势（p = 0.07）。我们的研究结果使用严格的控制方法表明，老年葡萄糖不耐症的成年人有氧运动的认知增强效果。虽然需要在更大的样本中进行复制，但我们的发现可能对越来越多的认知能力下降风险增加的成年人具有重要的治疗意义。
Impaired glucose regulation is a defining characteristic of type 2 diabetes mellitus (T2DM) pathology and has been linked to increased risk of cognitive impairment and dementia. Although the benefits of aerobic exercise for physical health are well-documented, exercise effects on cognition have not been examined for older adults with poor glucose regulation associated with prediabetes and early T2DM. Using a randomized controlled design, twenty-eight adults (57-83 y old) meeting 2-h tolerance test criteria for glucose intolerance completed 6 months of aerobic exercise or stretching, which served as the control. The primary cognitive outcomes included measures of executive function (Trails B, Task Switching, Stroop, Self-ordered Pointing Test, and Verbal Fluency). Other outcomes included memory performance (Story Recall, List Learning), measures of cardiorespiratory fitness obtained via maximal-graded exercise treadmill test, glucose disposal during hyperinsulinemic-euglycemic clamp, body fat, and fasting plasma levels of insulin, cortisol, brain-derived neurotrophic factor, insulin-like growth factor-1, amyloid-beta (A beta(40) and A beta(42)). Six months of aerobic exercise improved executive function (MANCOVA, p = 0.04), cardiorespiratory fitness (MANOVA, p = 0.03), and insulin sensitivity (p = 0.05). Across all subjects, 6-month changes in cardiorespiratory fitness and insulin sensitivity were positively correlated (p = 0.01). For A beta(42), plasma levels tended to decrease for the aerobic group relative to controls (p = 0.07). The results of our study using rigorous controlled methodology suggest a cognition-enhancing effect of aerobic exercise for older glucose intolerant adults. Although replication in a larger sample is needed, our findings potentially have important therapeutic implications for a growing number of adults at increased risk of cognitive decline.