Improving heart health may not be enough to protect against Alzheimer’s disease
Dr. Jeffrey Keller of Pennington Biomedical Research Center explores whether exercise and intensive cardiovascular risk reduction could improve cognitive function in older adults at risk for Alzheimer’s disease
In a recent study, researchers found that exercise and aggressive cardiovascular risk reduction successfully improved heart health, but these efforts did not produce measurable cognitive benefits over two years in older adults at risk for Alzheimer's disease.
In “Effects of Exercise and Intensive Vascular Risk Reduction on Cognitive Function in Older Adults - A Randomized Clinical Trial,” published in JAMA Neurology, researchers, including Dr. Jeffrey Keller of Pennington Biomedical Research Center, shared the results of the Risk Reduction for Alzheimer’s Disease (rrAD) study. They found that interventions that successfully improved cardiovascular health did not translate into measurable cognitive benefits over two years, highlighting a critical gap between vascular risk reduction and brain health.
“We improved the body, but not the brain,” said Dr. Keller, who leads the Institute for Dementia Research and Prevention at Pennington Biomedical. “We know that exercise and cardiovascular risk management are critical for overall health, but this study suggests they may not be enough on their own to improve cognitive function in older adults at risk for Alzheimer’s. Addressing a single set of risk factors, even aggressively, may not be sufficient, highlighting the need for more comprehensive approaches to dementia prevention.”
The multicenter study analyzed 480 participants between the ages of 60 and 85 who exhibited hypertension and had a family history of dementia and subjective cognitive decline. Over 24 months, the study tested whether exercise or vascular risk reduction via medications, or both, could improve cognitive function in older adults at risk for Alzheimer’s. The interventions included 160 minutes per week of moderate-to-vigorous exercise and a high-intensity statin. Participants were separated into four groups: one with exercise only, one with just medication intervention, one with both and a control group that received their usual care. They were then evaluated against the Preclinical Alzheimer Cognitive Composite (PACC), which produced standardized score units.
At the end of the study, researchers determined there were no significant differences between the groups for the primary outcome of cognition. Data showed there was only 0.1 standard deviation on the PACC score between the exercise and no exercise groups, and there was no score difference between the medication intervention and the groups not receiving the intervention.
In evaluating cardiovascular health, the data confirmed that the interventions with medications, including losartan and amlodipine, were successful in reducing blood pressure by an average of 13 points, 5 points more than those not receiving the medication intervention. The medication intervention group also saw a 24-point drop in LDL cholesterol, compared to a drop of 7 points for those not receiving the intervention.
Exercise and cardiovascular risk management are still essential for overall health in seniors. While the study data did indicate improvements to cardiovascular health, it also demonstrated that no meaningful cognitive benefit was observed. Researchers contend that this approach needs further study, and that a longer study duration or a multi-domain approach may result in a better understanding of how to prevent or delay cognitive decline.
In addition to Pennington Biomedical, this multicenter study included authors from Texas Health Presbyterian Hospital, University of Texas Southwestern Medical Center, University of Kansas Alzheimer’s Disease Research Center, University of Kentucky, University of Kansas, Michigan State University, Albert Einstein College of Medicine and Washington University in St Louis.
This project was funded by the National Institutes of Health (NIH R01 AG049749). Additional funding was from the Josephine Hughes Sterling Foundation.
About the Pennington Biomedical Research Center
The Pennington Biomedical Research Center is at the forefront of medical discovery as it relates to understanding the triggers of obesity, diabetes, cardiovascular disease, cancer and dementia. Pennington Biomedical has the vision to lead the world in promoting nutrition and metabolic health and eliminating metabolic disease through scientific discoveries that create solutions from cells to society. The Center conducts basic, clinical and population research, and is a campus in the LSU System.
The research enterprise at Pennington Biomedical includes over 600 employees within a network of 44 clinics and research laboratories, and 16 highly specialized core service facilities. Its scientists and physician/scientists are supported by research trainees, lab technicians, nurses, dietitians and other support personnel. Pennington Biomedical is a globally recognized state-of-the-art research institution in Baton Rouge, Louisiana. For more information, see www.pbrc.edu.
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In “Effects of Exercise and Intensive Vascular Risk Reduction on Cognitive Function in Older Adults - A Randomized Clinical Trial,” published in JAMA Neurology, researchers, including Dr. Jeffrey Keller of Pennington Biomedical Research Center, shared the results of the Risk Reduction for Alzheimer’s Disease (rrAD) study. They found that interventions that successfully improved cardiovascular health did not translate into measurable cognitive benefits over two years, highlighting a critical gap between vascular risk reduction and brain health.
“We improved the body, but not the brain,” said Dr. Keller, who leads the Institute for Dementia Research and Prevention at Pennington Biomedical. “We know that exercise and cardiovascular risk management are critical for overall health, but this study suggests they may not be enough on their own to improve cognitive function in older adults at risk for Alzheimer’s. Addressing a single set of risk factors, even aggressively, may not be sufficient, highlighting the need for more comprehensive approaches to dementia prevention.”
The multicenter study analyzed 480 participants between the ages of 60 and 85 who exhibited hypertension and had a family history of dementia and subjective cognitive decline. Over 24 months, the study tested whether exercise or vascular risk reduction via medications, or both, could improve cognitive function in older adults at risk for Alzheimer’s. The interventions included 160 minutes per week of moderate-to-vigorous exercise and a high-intensity statin. Participants were separated into four groups: one with exercise only, one with just medication intervention, one with both and a control group that received their usual care. They were then evaluated against the Preclinical Alzheimer Cognitive Composite (PACC), which produced standardized score units.
At the end of the study, researchers determined there were no significant differences between the groups for the primary outcome of cognition. Data showed there was only 0.1 standard deviation on the PACC score between the exercise and no exercise groups, and there was no score difference between the medication intervention and the groups not receiving the intervention.
In evaluating cardiovascular health, the data confirmed that the interventions with medications, including losartan and amlodipine, were successful in reducing blood pressure by an average of 13 points, 5 points more than those not receiving the medication intervention. The medication intervention group also saw a 24-point drop in LDL cholesterol, compared to a drop of 7 points for those not receiving the intervention.
Exercise and cardiovascular risk management are still essential for overall health in seniors. While the study data did indicate improvements to cardiovascular health, it also demonstrated that no meaningful cognitive benefit was observed. Researchers contend that this approach needs further study, and that a longer study duration or a multi-domain approach may result in a better understanding of how to prevent or delay cognitive decline.
In addition to Pennington Biomedical, this multicenter study included authors from Texas Health Presbyterian Hospital, University of Texas Southwestern Medical Center, University of Kansas Alzheimer’s Disease Research Center, University of Kentucky, University of Kansas, Michigan State University, Albert Einstein College of Medicine and Washington University in St Louis.
This project was funded by the National Institutes of Health (NIH R01 AG049749). Additional funding was from the Josephine Hughes Sterling Foundation.
About the Pennington Biomedical Research Center
The Pennington Biomedical Research Center is at the forefront of medical discovery as it relates to understanding the triggers of obesity, diabetes, cardiovascular disease, cancer and dementia. Pennington Biomedical has the vision to lead the world in promoting nutrition and metabolic health and eliminating metabolic disease through scientific discoveries that create solutions from cells to society. The Center conducts basic, clinical and population research, and is a campus in the LSU System.
The research enterprise at Pennington Biomedical includes over 600 employees within a network of 44 clinics and research laboratories, and 16 highly specialized core service facilities. Its scientists and physician/scientists are supported by research trainees, lab technicians, nurses, dietitians and other support personnel. Pennington Biomedical is a globally recognized state-of-the-art research institution in Baton Rouge, Louisiana. For more information, see www.pbrc.edu.
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