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Background: In normal aging physical fitness appears to mitigate functional and structural age-related brain changes. Whether this is observed in AD is not known.

Methods: Subjects without dementia (n = 64) and subjects with early-stage AD (n = 57) had MRI and standard clinical and psychometric evaluations. Peak oxygen consumption (VO2peak), the standard measure of cardiorespiratory fitness, was assessed during a graded treadmill test. Normalized whole brain volume, a brain atrophy estimate, was determined by MRI. Pearson correlation and linear regression were used to assess fitness in relation to brain volume and cognitive performance.

Results: Cardiorespiratory fitness (VO2peak) was modestly reduced in subjects with AD (34.7 [5.0] mL/kg/min) vs subjects without dementia (38.1 [6.3] mL/kg/min, p = 0.002).

In early AD, VO2peak was associated with whole brain volume (beta = 0.35, p = 0.02) and white matter volume (beta = 0.35, p = 0.04) after controlling for age.

Controlling for additional covariates of sex, dementia severity, physical activity, and physical frailty did not attenuate the relationships.

VO2peak was associated with performance on delayed memory and digit symbol in early AD but not after controlling for age.

In participants with no dementia, there was no relationship between fitness and brain atrophy.

Fitness in participants with no dementia was associated with better global cognitive performance (r = 0.30, p = 0.02) and performance on Trailmaking A and B, Stroop, and delayed logical memory but not after controlling for age.

Conclusions:

• Increased cardiorespiratory fitness is associated with reduced brain atrophy in Alzheimer disease (AD).
• Cardiorespiratory fitness may moderate AD-related brain atrophy or a common underlying AD-related process may impact both brain atrophy and cardiorespiratory fitness.

Source: Neurology, July 2008; 71:210-216. [E-pub ahead of print] Burns JM, Cronk BB, Anderson HS, Donnelly JE, Thomas GP, Harsha A, Brooks WM, Swerdlow, RH. Departments of Neurology and Molecular & Integrative Physiology and Hoglund Brain Imaging Center, University of Kansas School of Medicine, Kansas City; Energy Balance Laboratory and Center for Physical Activity, Nutrition, and Weight Management University of Kansas, Schiefelbusch Institute for Lifespan Studies, Lawrence, Kansas. USA. [E-mail: jburns2@kumc.edu]