Journal Article

Aerobic Exercise Reduces Carotid Artery Stiffness and Increases Cerebral Blood Flow

BOTTOM LINE 

Cognitive impairment and carotid artery stiffness characterize many older adults with HIV. A risk for Alzheimer’s disease may be poor blood flow to the brain. A study of the possible effect of one-year of aerobic exercise on carotid artery stiffness and cerebral blood flow in a group of older persons with mild cognitive impairment (19 competed the study) compared to a group doing stretches (29 completed) has been reported. Using various state of the art measurements before and after one-year completion of aerobic exercise, there was a significant decrease in the carotid artery stiffness and a significant increase in the cerebral perfusion compared to the control group.  Although there was no significant increase in cognitive performance, the authors feel this “proof of concept” study suggests that a larger and longer study can be justified to address the important question about artery stiffness, brain blood flow, effect of exercise, impact on cognitive performance and possibly the effect on Alzheimer’s disease.   Older adults with HIV are characterized as leading sedentary lives. There is a clear need for them to begin engaging regular aerobic routines.     

ABSTRACT

Background: Central arterial stiffness and brain hypoperfusion are emerging risk factors of Alzheimer's disease (AD). Aerobic exercise training (AET) may improve central arterial stiffness and brain perfusion.                    

Objective: To investigate the effects of AET on central arterial stiffness and cerebral blood flow (CBF) in patients with amnestic mild cognitive impairment (MCI), a prodromal stage of AD.

Methods: This is a proof-of-concept, randomized controlled trial that assigned 70 amnestic MCI patients into a 12-month program of moderate-to-vigorous AET or stretching-and-toning (SAT) intervention. Carotid β-stiffness index and CBF were measured by color-coded duplex ultrasonography and applanation tonometry. Total CBF was measured as the sum of CBF from both the internal carotid and vertebral arteries, and divided by total brain tissue mass assessed with MRI to obtain normalized CBF (nCBF). Episodic memory and executive function were assessed using standard neuropsychological tests (CVLT-II and D-KEFS). Changes in cardiorespiratory fitness were measured by peak oxygen uptake (VO2peak).

Results: Total 48 patients (29 in SAT and 19 in AET) were completed one-year training. AET improved VO2peak, decreased carotid β-stiffness index and CBF pulsatility, and increased nCBF. Changes in VO2peak were associated positively with changes in nCBF (r = 0.388, p = 0.034) and negatively with carotid β-stiffness index (r = -0.418, p = 0.007) and CBF pulsatility (r = -0.400, p = 0.014). Decreases in carotid β-stiffness were associated with increases in cerebral perfusion (r = -0.494, p = 0.003). AET effects on cognitive performance were minimal compared with SAT.

Conclusion: AET reduced central arterial stiffness and increased CBF which may precede its effects on neurocognitive function in patients with MCI.

Purpose of this Program: The AAHIVM, ACRIA and AGS (collectively, the “Sponsors,” “we” or “us”) are sponsors of this Website and through it seek to address the unique needs and challenges that older adults of diverse populations living with HIV face as they age. However, the information in this Website is not meant to supplant the advice provided in a doctor-patient relationship.

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