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AAIC 2022 | EXERT: why was strength/balance training as effective as cardio in preventing cognitive decline?

The Phase III, multi-site, 18-month EXERT trial (NCT02814526) examined the effects of regular aerobic exercise versus stretching, balance, and range of motion (SBR) training on brain function in 300 older adults with MCI. In both groups, ADAS-Cog-Exec and Clinical Dementia Rating scale Sum of Boxes (CDR-SB) scores showed no decline from baseline at 12 months. Laura Baker, PhD, Wake Forest University School of Medicine, Winston-Salem, NC, shares her thoughts on what could have caused these findings, when other trials have shown benefit of aerobic exercise over SBR training. Prof. Baker suggests that the longer trial duration in comparison to earlier studies may explain why both interventions showed beneficial effects. For the exercise to reverse the damage of a sedentary lifestyle and repair the dysfunctional systems must take time. Additionally, the volume of exercise may have an impact on outcomes. The higher intensity of exercise in the aerobic group may have allowed a cognitive benefit to be seen earlier, with the SBR training needing longer to have the same impact. The EXERT team now hope to look at brain atrophy in the intervention groups and the ADNI matched control cohort. This interview took place at the Alzheimer’s Association International Conference (AAIC) 2022 in San Diego, CA.