The promotion of physical activity for use in Alzheimer's disease prevention trials in adults with Down syndrome: Results from a 12-month randomized trial

IF 4.9 Q1 CLINICAL NEUROLOGY

Alzheimer''s and Dementia: Translational Research and Clinical Interventions Pub Date : 2025-06-12 DOI:10.1002/trc2.70115

Lauren T. Ptomey, Brian C. Helsel, Richard A. Washburn, Robert N. Montgomery, Ron Krebill, Jessica C. Danon, Joseph R. Sherman, Daniel Forsha, Amy Bodde, Amanda N. Szabo-Reed, Anna M. Gorczyca, Joseph E. Donnelly

{"title":"The promotion of physical activity for use in Alzheimer's disease prevention trials in adults with Down syndrome: Results from a 12-month randomized trial","authors":"Lauren T. Ptomey, Brian C. Helsel, Richard A. Washburn, Robert N. Montgomery, Ron Krebill, Jessica C. Danon, Joseph R. Sherman, Daniel Forsha, Amy Bodde, Amanda N. Szabo-Reed, Anna M. Gorczyca, Joseph E. Donnelly","doi":"10.1002/trc2.70115","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> INTRODUCTION</h3>\n \n <p>Alzheimer's disease (AD) is the leading cause of death in individuals with Down syndrome (DS). Participation in moderate-to-vigorous physical activity (MVPA) may prevent or delay the onset of AD. Therefore, we evaluated the potential effectiveness of a remotely delivered home-based group exercise (≈8/group) to increase daily MVPA and cardiorespiratory fitness in adults with DS to a level that may be associated with delaying AD in adults with DS.</p>\n </section>\n \n <section>\n \n <h3> METHODS</h3>\n \n <p>Adults with DS (<i>n</i> = 81, age ≈27 years 55% female) without dementia were randomized (2:2:1) to a 12-month intervention, which included 40-min exercise sessions scheduled once (remote low (RL), <i>n</i> = 32) or 3 times per week (remote high (RH), <i>n</i> = 34) plus twice monthly 20-min individual remotely delivered support/education sessions or to a control arm who attended twice monthly support/education sessions only (SE, <i>n</i> = 15). MVPA (minutes/day) was assessed by accelerometer, and cardiorespiratory fitness (VO<sub>2 Peak,</sub> mL/kg/min) was assessed using a maximal treadmill test</p>\n </section>\n \n <section>\n \n <h3> RESULTS</h3>\n \n <p>Participant retention at 12 months was 100%. Attendance at exercise and support/education sessions averaged ~85% and ~86%, respectively. Linear mixed modeling revealed no significant differences in change in MVPA from baseline to 12 months between the RH (10 min/day) and the RL arms (2 min/day, <i>p </i>= 0.06) or the RH and SE arms (1 min/day <i>p</i> = 0.13). The change in VO₂ <sub>Peak</sub> differed significantly between the RH (2.0 ± 4.6 mL/kg/min) and RL arms (−1.1 ± 3.0 mL/kg/min, <i>p</i> = 0.04) but not between the RH and SE arms (1.2 ± 5.3 mL/kg/min, <i>p </i>= 0.85).</p>\n </section>\n \n <section>\n \n <h3> DISCUSSION</h3>\n \n <p>Our results suggest that remotely delivered group exercise (3 times/week) in conjunction with twice-monthly support/education is feasible and may increase daily MVPA and cardiorespiratory fitness to a level that may be associated with improvements in health and cognitive parameters in adults with DS.</p>\n </section>\n \n <section>\n \n <h3> CLINICAL TRIALS REGISTRATION</h3>\n \n <p>This trial was approved by the Institutional Review Board at the University of Kansas Medical Center and was registered on clinicaltrials.gov (NCT04048759).</p>\n </section>\n \n <section>\n \n <h3> Highlights</h3>\n \n <div>\n <ul>\n \n <li>Evidence suggests that exercise may delay Alzheimer's disease (AD) in the general population, but its impact on adults with Down syndrome (DS) remains unknown.</li>\n \n <li>Adults attended remote exercise sessions either 1 or 3 times a week or received basic education about exercise.</li>\n \n <li>Those who attend exercise sessions 3 times a week increased their physical activity by 70 min per week.</li>\n \n <li>Those who attend exercise sessions 3 times a week improve their cardiorespiratory fitness.</li>\n \n <li>Remote exercise can be used in future AD prevention trials in adults with DS.</li>\n </ul>\n </div>\n </section>\n </div>","PeriodicalId":53225,"journal":{"name":"Alzheimer''s and Dementia: Translational Research and Clinical Interventions","volume":"11 2","pages":""},"PeriodicalIF":4.9000,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/trc2.70115","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Alzheimer''s and Dementia: Translational Research and Clinical Interventions","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/trc2.70115","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

INTRODUCTION

Alzheimer's disease (AD) is the leading cause of death in individuals with Down syndrome (DS). Participation in moderate-to-vigorous physical activity (MVPA) may prevent or delay the onset of AD. Therefore, we evaluated the potential effectiveness of a remotely delivered home-based group exercise (≈8/group) to increase daily MVPA and cardiorespiratory fitness in adults with DS to a level that may be associated with delaying AD in adults with DS.

METHODS

Adults with DS (n = 81, age ≈27 years 55% female) without dementia were randomized (2:2:1) to a 12-month intervention, which included 40-min exercise sessions scheduled once (remote low (RL), n = 32) or 3 times per week (remote high (RH), n = 34) plus twice monthly 20-min individual remotely delivered support/education sessions or to a control arm who attended twice monthly support/education sessions only (SE, n = 15). MVPA (minutes/day) was assessed by accelerometer, and cardiorespiratory fitness (VO_{2 Peak,} mL/kg/min) was assessed using a maximal treadmill test

RESULTS

Participant retention at 12 months was 100%. Attendance at exercise and support/education sessions averaged ~85% and ~86%, respectively. Linear mixed modeling revealed no significant differences in change in MVPA from baseline to 12 months between the RH (10 min/day) and the RL arms (2 min/day, p = 0.06) or the RH and SE arms (1 min/day p = 0.13). The change in VO₂ _Peak differed significantly between the RH (2.0 ± 4.6 mL/kg/min) and RL arms (−1.1 ± 3.0 mL/kg/min, p = 0.04) but not between the RH and SE arms (1.2 ± 5.3 mL/kg/min, p = 0.85).

DISCUSSION

Our results suggest that remotely delivered group exercise (3 times/week) in conjunction with twice-monthly support/education is feasible and may increase daily MVPA and cardiorespiratory fitness to a level that may be associated with improvements in health and cognitive parameters in adults with DS.

CLINICAL TRIALS REGISTRATION

This trial was approved by the Institutional Review Board at the University of Kansas Medical Center and was registered on clinicaltrials.gov (NCT04048759).

Highlights

Evidence suggests that exercise may delay Alzheimer's disease (AD) in the general population, but its impact on adults with Down syndrome (DS) remains unknown.
Adults attended remote exercise sessions either 1 or 3 times a week or received basic education about exercise.
Those who attend exercise sessions 3 times a week increased their physical activity by 70 min per week.
Those who attend exercise sessions 3 times a week improve their cardiorespiratory fitness.
Remote exercise can be used in future AD prevention trials in adults with DS.

查看原文本刊更多论文

促进身体活动用于唐氏综合症成人阿尔茨海默病预防试验：一项为期12个月的随机试验结果

阿尔茨海默病（AD）是唐氏综合征（DS）患者死亡的主要原因。参加中高强度的体育活动（MVPA）可以预防或延缓AD的发病。因此，我们评估了远程递送的基于家庭的团体锻炼（≈8/组）的潜在有效性，以提高成人退行性椎体滑移患者的每日MVPA和心肺健康水平，使其达到可能与延迟成人退行性椎体滑移患者AD相关的水平。方法将无痴呆的DS成人（n = 81，年龄≈27岁，55%为女性）随机分为（2:2:1）组，进行为期12个月的干预，其中包括每周安排一次40分钟的锻炼（远程低（RL）， n = 32）或每周3次（远程高（RH）， n = 34），外加每月两次20分钟的个人远程支持/教育课程，或对照组每月只参加两次支持/教育课程（SE, n = 15）。通过加速计评估MVPA（分钟/天），使用最大跑步机测试评估心肺健康（VO2峰值，mL/kg/min）。结果参与者12个月的保留率为100%。参加锻炼和支持/教育课程的平均人数分别为85%和86%。线性混合模型显示，RH组（10分钟/天）和RL组（2分钟/天，p = 0.06）或RH组和SE组（1分钟/天p = 0.13）从基线到12个月的MVPA变化无显著差异。RH组（2.0±4.6 mL/kg/min）和RL组（- 1.1±3.0 mL/kg/min, p = 0.04）的VO 2峰值变化差异显著，但RH组和SE组（1.2±5.3 mL/kg/min, p = 0.85）之间无显著差异。我们的研究结果表明，远程团体运动（每周3次）与每月两次的支持/教育相结合是可行的，并且可以将每日MVPA和心肺健康提高到可能与DS成人健康和认知参数改善相关的水平。该试验由堪萨斯大学医学中心的机构审查委员会批准，并在clinicaltrials.gov上注册（NCT04048759）。有证据表明，运动可以延缓一般人群的阿尔茨海默病（AD），但其对唐氏综合症（DS）成人的影响尚不清楚。成年人每周参加1到3次远程锻炼课程，或接受有关锻炼的基本教育。那些每周参加3次锻炼的人每周的体力活动增加了70分钟。每周锻炼3次的人可以改善心肺健康。远程运动可用于未来成人退行性椎体滑移症的AD预防试验。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Alzheimer''s and Dementia: Translational Research and Clinical Interventions Medicine-Psychiatry and Mental Health

CiteScore

10.10

自引率

2.10%

发文量

134

审稿时长

10 weeks

期刊介绍： Alzheimer''s & Dementia: Translational Research & Clinical Interventions (TRCI) is a peer-reviewed, open access,journal from the Alzheimer''s Association®. The journal seeks to bridge the full scope of explorations between basic research on drug discovery and clinical studies, validating putative therapies for aging-related chronic brain conditions that affect cognition, motor functions, and other behavioral or clinical symptoms associated with all forms dementia and Alzheimer''s disease. The journal will publish findings from diverse domains of research and disciplines to accelerate the conversion of abstract facts into practical knowledge: specifically, to translate what is learned at the bench into bedside applications. The journal seeks to publish articles that go beyond a singular emphasis on either basic drug discovery research or clinical research. Rather, an important theme of articles will be the linkages between and among the various discrete steps in the complex continuum of therapy development. For rapid communication among a multidisciplinary research audience involving the range of therapeutic interventions, TRCI will consider only original contributions that include feature length research articles, systematic reviews, meta-analyses, brief reports, narrative reviews, commentaries, letters, perspectives, and research news that would advance wide range of interventions to ameliorate symptoms or alter the progression of chronic neurocognitive disorders such as dementia and Alzheimer''s disease. The journal will publish on topics related to medicine, geriatrics, neuroscience, neurophysiology, neurology, psychiatry, clinical psychology, bioinformatics, pharmaco-genetics, regulatory issues, health economics, pharmacoeconomics, and public health policy as these apply to preclinical and clinical research on therapeutics.