Acute Exercise and the Cerebral Metabolic Response in Aging and Alzheimer's Disease (AEROBIC)

University of Kansas

Status: Completed

Conditions: Alzheimer Disease; Healthy Aging

Treatments: Behavioral: Aerobic Exercise

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT04299308

1R01AG062548-01A1 (U.S. NIH Grant/Contract)

STUDY00142140

Details and patient eligibility

About

The overall goal is to characterize the acute exercise response as it relates to brain glucose metabolism in aging and Alzheimer's Disease (AD). The study team will also examine lactate metabolism, relationships with cognition, and the effect of exercise intensity.

Full description

Aim 1: Compare the effects of acute, moderate intensity and acute, higher intensity exercise on cerebral glucose metabolism in nondemented (ND) elderly and AD subjects. ND (n=30) and AD (n=30) subjects will undergo a single bout of moderate intensity (45-55% HRR) or higher intensity (65-75% HRR) exercise to assess the effect of exercise intensity on acute change in brain glucose metabolism (rest to exercise). Investigators hypothesize that both moderate and high intensity exercise will elicit a drop in global brain glucose metabolism compared to quiet rest, but that the effect will be greater with higher intensity vs. moderate intensity exercise, and greater in ND subjects than in AD subjects.

Aim 2: Characterize the effect of both exercise intensities on acute biomarker response and cognition (memory and executive function) in ND and AD subjects. The acute biomarker response to exercise and the effect on cognition has not been examined in aged or AD cohorts. Investigators hypothesize that acute higher intensity exercise will elicit a greater blood lactate response (area under the curve, AUC) compared to acute moderate intensity exercise, and that this response will be greater in ND than in AD subjects. Investigators further hypothesize that lactate AUC will track negatively with change in cerebral glucose metabolism and cognitive performance. Although investigators will focus on lactate, they will also quantify additional exercise-related biomarkers.

Enrollment: 60 patients

Sex: All

Ages: 60+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Age 60 and older
• Stable medication doses (>1month)
• Post-menopausal
• Diagnosis of either Nondemented (CDR 0) or Probable AD (CDR 0.5 or 1 only)

Exclusion criteria

• Inability to provide consent
• Diagnosis of insulin-dependent (Type 1) Diabetes Mellitus
• Recent ischemic heart disease (<2 years)
• Diagnosis of an clinically significant chronic disease including cardiovascular disease (CVD), other metabolic diseases (e.g., thyroid), cancer, human immunodeficiency virus (HIV), or acquired immunodeficiency syndrome
• Excluded from or unable to complete an MRI scan
• Any Neurological disorders that have the potential to impair cognition or brain metabolism (e.g., Parkinson's disease, stroke defined as a clinical episode with neuroimaging evidence in an appropriate area to explain the symptoms).
• Clinically significant depressive symptoms that may impair cognition, abnormalities in B12, rapid plasma regain (RPR), or thyroid function that may impair cognition, use of psychoactive and investigational medications, and significant visual or auditory impairment

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

60 participants in 2 patient groups

Moderate Intensity Aerobic Exercise

Experimental group

Description:

45-55% of heart rat reserve (HHR) Low range = ((Max HR from Visit 1) - Resting HR ) \* 0.45 + Resting HR High range = ((Max HR from Visit 1) - Resting HR) \* 0.55 + Resting HR

Treatment:

Behavioral: Aerobic Exercise

High Intensity Aerobic Exercise

Experimental group

Description:

65-75% of heart rat reserve (HHR) Low range = ((Max HR from Visit 1) - Resting HR ) \* 0.65 + Resting HR High range = ((Max HR from Visit 1) - Resting HR) \* 0.75 + Resting HR

Treatment:

Behavioral: Aerobic Exercise