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Cognitive function in elderly marathon runners: Cross-sectional data from the marathon trial (apsoem)

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Zusammenfassung

HINTERGRUND: Die kognitive Beeinträchtigung von älteren Menschen trägt zur Morbidität, Verlust der Lebensqualität und Beeinträchtigung der Arbeitsfähigkeit in alternden westlichen Gesellschaften bei. Strategien zur Erhaltung der kognitiven Fähigkeiten im hohen Alter stellen daher eine große Herausforderung für die Arbeitsmedizin dar. ZIEL: Festzustellen, ob intensives Ausdauertraining mit einer verbesserten kognitiven Leistungsfähigkeit verbunden ist, und ob brain-derived neurotrophic factor (BDNF) und insulin-like growth factor (IGF) durch Ausdauertraining erhöht werden. METHODIK: Aktive ältere Marathonläufer oder Radfahrer über 60 Jahre wurden angeworben und einer inaktiven Kontrollgruppe nach Alter, Geschlecht und Bildungsjahren gegenübergestellt. Nachdem laut Studienprotokoll Personen mit verschiedenen Krankheiten ausgeschlossen wurden, konnten 56 Athleten und 58 Kontrollpersonen für Folgeuntersuchungen herangezogen werden. Der Einfluss von Ausdauertraining auf kognitive Funktionen wurde durch die Vienna Neuropsychologische Testbatterie (VNTB) und die CERAD Testbatterie (Consortium to Establish a Registry for Alzheimer's Disease) gemessen. Andere relevante Ergebnisse waren die Werte der humoralen Wachstumsfaktoren (BDNF und IGF-1), Apo ε4 Carrierfrequenz und Selbsteinschätzungen. ERGEBNISSE: Die Leistung der älteren Marathongruppe war nur bei einer spezifischen kognitiven Aufgabe besser (beim Five Point Test, p = 0,04) und fast signifikant besser in einem zusätzlichen Test (NAI Stroop Test, p = 0,08). Weder BDNF noch IGF-1 hatten einen Bezug zur Dauer des täglichen Ausdauertrainings, und kein Unterschied wurde bei den Basalwerten dieser Wachstumsfaktoren in den Trainings- und Kontrollkohorten gefunden. Interessanterweise fanden wir auch signifikant reduzierte BDNF-Werte bei Personen mit Alzheimerkrankheit in der Familie trotz Beibehaltung der normalen kognitiven Leistung (p = 0,01). SCHLUSSFOLGERUNG: Diese Ergebnisse deuten darauf hin, dass umfassendes Ausdauertraining für die Erhaltung der kognitiven Funktionen von älteren Menschen nützlich sein könnte. Längsschnittdaten dieser prospektiven Kohortenstudie sind notwendig, um diese möglichen Auswirkungen auf Kognition zu bewerten. Zusätzlich zeigen unsere Daten, dass die nützlichen Auswirkungen von Ausdauertraining nicht mit der Hochregulation von Neurotrophinen wie BDNF und IGF-1 verbunden sind. Da wir reduzierte BDNF-Werte bei Personen mit einer positiven Familiengeschichte von Alzheimer fanden, vermuten wir, dass eine BDNF-Senkung einer kognitiven Beeinträchtigung vorausgehen könnte.

Summary

BACKGROUND: Cognitive impairment of the elderly contributes to morbidity, loss of quality of life, and impairment of work ability in aging western societies. Thus strategies to maintain cognitive function at an advanced age imply a great challenge to Occupational Medicine. AIM: To study whether intensive endurance exercise training is associated with better cognitive performance and increases brain-derived neurotrophic factor (BDNF) and insulin-like growth factor (IGF). METHODS: Active elderly marathon runners or bicyclists older than 60 years were recruited and matched with an inactive control group according to age, sex, and education years. After exclusion of various diseases according to the study protocol 56 athletes and 58 controls could be selected for follow-up studies. The influence of endurance training on cognitive function was assessed by the use of the Vienna Neuropsychological Test Battery and the CERAD test battery. Other relevant outcomes were the levels of BDNF, IGF-1, Apo e4 carrier state, and self-ratings. RESULTS: The elderly marathon group performed better only in one specific cognitive task (the Five Point Test, p = 0.04) and almost significantly better in one additional test (the NAI Stroop Test, p = 0.08). Neither BDNF nor IGF-1 was related to the duration of daily exercise and no differences in the basal levels of these humoral growth factors in the exercise and the control cohort were found. Interestingly, we also found significantly decreased BDNF levels in subjects with Alzheimer's disease in the family in spite of the maintained normal cognitive performance (p = 0.01). CONCLUSION: These results suggest that extensive endurance exercise training might be beneficial for maintaining cognitive function in elderly persons. Our data demonstrate that beneficial endurance training effects are not linked to the upregulation of the examined neurotrophins. Since we found reduced BDNF-levels in subjects with a positive family history of Alzheimer's disease, we speculate that BDNF-reduction might precede cognitive impairment.

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References

  • Morbidity and Mortality Weekly Report (MMWR). Trends in aging – United States and worldwide. Morb Mortal Wkly Rep 2003;52:101–4,106

    Google Scholar 

  • Eurostat (2010) http://ec.europa.eu/eurostat (accessed 9 July 2010)

  • Lutz W, Sanderson W, Scherbov S. The coming acceleration of global population ageing. Nature 2008;451:716–9

    Article  CAS  PubMed  Google Scholar 

  • Giarini O, Liedke PM. Wie wir arbeiten werden. Der neue Bericht an den Club of Rome. Hamburg: Hoffmann und Campe; 1998

  • Rüdiger HW. Challenges to occupational medicine in a changing world of labour. Int Arch Occup Environ Health 2003;76:171–3

    PubMed  Google Scholar 

  • Ilmarinen JE. Aging workers. Occup Environ Med 2001;58:546–52

    Article  CAS  PubMed  Google Scholar 

  • Baltes PB, Singer T. Plasticity and the ageing mind: an exemplar of the bio-cultural orchestration of brain and behaviour. Eur Rev 2001;9: 59–76

    Article  Google Scholar 

  • West RL. An application of prefrontal cortex function theory to cognitive aging. Psychol Bull 1996;120:272–92

    Article  CAS  PubMed  Google Scholar 

  • Barnes DE, Yaffe K, Satariano WA, Tager IB. A longitudinal study of cardiorespiratory fitness and cognitive function in healthy older adults. J Am Geriatr Soc 2003;51:459–65

    Article  PubMed  Google Scholar 

  • Laurin D, Verreault R, Lindsay J, MacPherson K, Rockwood K. Physical activity and risk of cognitive impairment and dementia in elderly persons. Arch Neurol 2001;58:498–504

    Article  CAS  PubMed  Google Scholar 

  • Yaffe K, Barnes D, Nevitt M, Lui LY, Covinsky K. A prospective study of physical activity and cognitive decline in elderly women: women who walk. Arch Intern Med 2001;161:1703–8

    Article  CAS  PubMed  Google Scholar 

  • Larson EB, Wang L, Bowen JD, McCormick WC, Teri L, Crane P, et al. Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Ann Intern Med 2006;144:73–81

    PubMed  Google Scholar 

  • Britton A, Shipley M, Singh-Manoux A, Marmot MG. Successful aging: the contribution of early-life and midlife risk factors. J Am Geriatr Soc 2008;56:1098–105

    Article  PubMed  Google Scholar 

  • Psaltopoulou T, Kyrozis A, Stathopoulos P, Trichopoulos D, Vassilopoulos D, Trichopoulou A. Diet, physical activity and cognitive impairment among elders: the EPIC-Greece cohort (European Prospective Investigation into Cancer and Nutrition). Public Health Nutr 2008;11:1054–62

    Article  CAS  PubMed  Google Scholar 

  • Dorner T, Kranz A, Zettl-Wiedner K, Ludwig C, Rieder A, Gisinger C. The effect of structured strength and balance training on cognitive function in frail, cognitive impaired elderly long-term care residents. Aging Clin Exp Res 2007;19:400–5

    PubMed  Google Scholar 

  • Cassilhas RC, Viana VA, Grassmann V, Santos RT, Santos RF, Tufik S, et al. The impact of resistance exercise on the cognitive function of the elderly. Med Sci Sports Exerc 2007;39:1401–7

    Article  PubMed  Google Scholar 

  • Broe GA, Creasey H, Jorm AF, Bennett HP, Casey B, Waite LM, et al. Health habits and risk of cognitive impairment and dementia in old age: a prospective study on the effects of exercise, smoking and alcohol consumption. Aust NZ J Public Health 1998;22:621–3

    Article  CAS  Google Scholar 

  • Verghese J, Lipton RB, Katz MJ, Hall CB, Derby CA, Kuslansky G, et al. Leisure activities and the risk of dementia in the elderly. N Engl J Med 2003;348:2508–16

    Article  PubMed  Google Scholar 

  • Lachman ME, Neupert SD, Bertrand R, Jette AM. The effects of strength training on memory in older adults. J Aging Phys Act 2006;14:59–73

    PubMed  Google Scholar 

  • Oken BS, Zajdel D, Kishiyama S, Flegal K, Dehen C, Haas M, et al. Randomized, controlled, six-month trial of yoga in healthy seniors: effects on cognition and quality of life. Altern Ther Health Med 2006;12:40–7

    PubMed  Google Scholar 

  • Angevaren M, Aufdemkampe G, Verhaar HJ, Aleman A, Vanhees L. Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment. Cochrane Database Syst Rev 2008;CD005381

  • Colcombe S, Kramer AF. Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychol Sci 2003;14:125–30

    Article  PubMed  Google Scholar 

  • Angevaren M, Vanhees L, Wendel-Vos W, Verhaar HJ, Aufdemkampe G, Aleman A, et al. Intensity, but not duration, of physical activities is related to cognitive function. Eur J Cardiovasc Prev Rehabil 2007;14:825–30

    Article  PubMed  Google Scholar 

  • Schaaf MJ, Duurland R, de Kloet ER, Vreugdenhil E. Circadian variation in BDNF mRNA expression in the rat hippocampus. Brain Res Mol Brain Res 2000;75:342–4

    Article  CAS  PubMed  Google Scholar 

  • Haus E, Dumitriu L, Nicolau GY, Bologa S, Sackett-Lundeen L. Circadian rhythms of basic fibroblast growth factor (bFGF), epidermal growth factor (EGF), insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), cortisol, and melatonin in women with breast cancer. Chronobiol Int 2001;18:709–27

    Article  CAS  PubMed  Google Scholar 

  • Komulainen P, Pedersen M, Hanninen T, Bruunsgaard H, Lakka TA, Kivipelto M, et al. BDNF is a novel marker of cognitive function in ageing women: the DR's EXTRA Study. Neurobiol Learn Mem 2008;90:596–603

    Article  CAS  PubMed  Google Scholar 

  • Ploughman M. Exercise is brain food: the effects of physical activity on cognitive function. Dev Neurorehabil 2008; 11:236–40

    Article  PubMed  Google Scholar 

  • Böhm H, Bürklen R, Dienstl F, Ehrenböck G, Gaul W, Herbinger E, et al. Empfehlungen für eine standardisierte Ergometrie. Öst Ärzteztg 1978;33:333–44

    Google Scholar 

  • Lehrner J, Maly J, Gleiß A, Auff E, Dal-Bianco P. The Vienna Neuropsychological Test Battery (VNTB) for detecting dementia – standardization, norms, and validation. Psychologie in Österreich 2007;4 & 5:358–65

    Google Scholar 

  • Morris JC, Heyman A, Mohs RC, Hughes JP, van Belle G, Fillenbaum G, et al. The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer's disease. Neurology 1989;39:1159–65

    CAS  PubMed  Google Scholar 

  • Lehrner J, Gufler R, Guttmann G, Maly J, Gleiss A, Auff E, et al. Annual conversion to alzheimer disease among patients with memory complaints attending an outpatient memory clinic: the influence of amnestic mild cognitive impairment and the predictive value of neuropsychological testing. Wien Klin Wochenschr 2005;117:629–35

    Article  PubMed  Google Scholar 

  • Schmidt K, Metzler P. Wortschatztest (WST). Bern: Verlag Hans Huber; 1992

    Google Scholar 

  • Bullinger M, Kirchberger I. SF-36. Fragebogen zum Gesundheitszustand. Handanweisung. Göttingen: Hogrefe; 1998

    Google Scholar 

  • http://www.cure4you.dk/354/WHO-5_German.pdf

  • Hautzinger M, Bailer M, Worall H, Keller F. Beck-Depressions-Inventar (BDI). Bern: Huber; 1994

    Google Scholar 

  • Bach M, Nikolaus T, Oster P, Schlierf G. Depressionsdiagnostik im Alter – "Geriatric Depression Scale". Z Gerontol Geriatr 1995;28:42–6

    CAS  PubMed  Google Scholar 

  • Hindmarch I, Lehfeld H, Jongh P, Erzigkeit H. B-ADL. Skala zur Einschätzung der Alltagskompetenz. Göttingen: Hogrefe; 1999

    Google Scholar 

  • Mahon NE, Yarcheski A, Yarcheski TJ. Psychometric evaluation of the personal lifestyle questionnaire for adolescents. Res Nurs Health 2002;25:68–75

    Article  PubMed  Google Scholar 

  • Mahon NE, Yarcheski TJ, Yarcheski A. The revised Personal Lifestyle Questionnaire for early adolescents. West J Nurs Res 2003;25:533–47

    Article  PubMed  Google Scholar 

  • Petrella JR, Coleman RE, Doraiswamy PM. Neuroimaging and early diagnosis of Alzheimer disease: a look to the future. Radiology 2003;226:315–36

    Article  PubMed  Google Scholar 

  • Lehrl S, Fischer B (eds). Kurztest für cerebale Insuffizienz (c.I.-Test). Ebersberg: Vless; 1997

    Google Scholar 

  • Strittmatter WJ, Weisgraber KH, Huang DY, Dong LM, Salvesen GS, Pericak-Vance M, et al. Binding of human apolipoprotein E to synthetic amyloid beta peptide: isoform-specific effects and implications for late-onset Alzheimer disease. Proc Natl Acad Sci USA 1993;90:8098–102

    Article  CAS  PubMed  Google Scholar 

  • van Vliet P, Westendorp RG, Eikelenboom P, Comijs HC, Frolich M, Bakker E, et al. Parental history of Alzheimer disease associated with lower plasma apolipoprotein E levels. Neurology 2009;73:681–7

    Article  CAS  PubMed  Google Scholar 

  • Pontifex MB, Hillman CH, Polich J. Age, physical fitness, and attention: P3a and P3b. Psychophysiology 2009;46:379–87

    Article  PubMed  Google Scholar 

  • Liu-Ambrose T, Eng JJ, Boyd LA, Jacova C, Davis JC, Bryan S, et al. Promotion of the mind through exercise (PROMoTE): a proof-of-concept randomized controlled trial of aerobic exercise training in older adults with vascular cognitive impairment. BMC Neurol 2010;10:14

    Article  PubMed  Google Scholar 

  • Lange-Asschenfeldt C, Kojda G. Alzheimer's disease, cerebrovascular dysfunction and the benefits of exercise: from vessels to neurons. Exp Gerontol 2008;43:499–504

    Article  CAS  PubMed  Google Scholar 

  • Swain RA, Harris AB, Wiener EC, Dutka MV, Morris HD, Theien BE, et al. Prolonged exercise induces angiogenesis and increases cerebral blood volume in primary motor cortex of the rat. Neuroscience 2003;117:1037–46

    Article  CAS  PubMed  Google Scholar 

  • van Praag H, Kempermann G, Gage FH. Running increases cell proliferation and neurogenesis in the adult mouse dentate gyrus. Nat Neurosci 1999;2:266–70

    Article  CAS  PubMed  Google Scholar 

  • Chang HC, Yang YR, Wang SG, Wang RY. Effects of treadmill training on motor performance and extracellular glutamate level in striatum in rats with or without transient middle cerebral artery occlusion. Behav Brain Res 2009;205:450–5

    Article  CAS  PubMed  Google Scholar 

  • Beaumont E, Kaloustian S, Rousseau G, Cormery B. Training improves the electrophysiological properties of lumbar neurons and locomotion after thoracic spinal cord injury in rats. Neurosci Res 2008;62:147–54

    Article  PubMed  Google Scholar 

  • Berchtold NC, Castello N, Cotman CW. Exercise and time-dependent benefits to learning and memory. Neuroscience 2010;167:588–97

    Article  CAS  PubMed  Google Scholar 

  • Cotman CW, Berchtold NC. Exercise: a behavioral intervention to enhance brain health and plasticity. Trends Neurosci 2002;25:295–301

    Article  CAS  PubMed  Google Scholar 

  • Cotman CW, Engesser-Cesar C. Exercise enhances and protects brain function. Exerc Sport Sci Rev 2002;30:75–9

    Article  PubMed  Google Scholar 

  • Neeper SA, Gomez-Pinilla F, Choi J, Cotman CW. Physical activity increases mRNA for brain-derived neurotrophic factor and nerve growth factor in rat brain. Brain Res 1996;726:49–56

    Article  CAS  PubMed  Google Scholar 

  • Schiffer T, Schulte S, Hollmann W, Bloch W, Struder HK. Effects of strength and endurance training on brain-derived neurotrophic factor and insulin-like growth factor 1 in humans. Horm Metab Res 2009;41:250–4

    Article  CAS  PubMed  Google Scholar 

  • Fujimura H, Altar CA, Chen R, Nakamura T, Nakahashi T, Kambayashi J, et al. Brain-derived neurotrophic factor is stored in human platelets and released by agonist stimulation. Thromb Haemost 2002;87:728–34

    CAS  PubMed  Google Scholar 

  • Ziegenhorn AA, Schulte-Herbruggen O, Danker-Hopfe H, Malbranc M, Hartung HD, Anders D, et al. Serum neurotrophins – a study on the time course and influencing factors in a large old age sample. Neurobiol Aging 2007;28:1436–45

    Article  CAS  PubMed  Google Scholar 

  • Vardy ER, Rice PJ, Bowie PC, Holmes JD, Grant PJ, Hooper NM. Increased circulating insulin-like growth factor-1 in late-onset Alzheimer's disease. J Alzheimers Dis 2007;12:285–90

    CAS  PubMed  Google Scholar 

  • Levinger I, Goodman C, Matthews V, Hare DL, Jerums G, Garnham A, et al. BDNF, metabolic risk factors, and resistance training in middle-aged individuals. Med Sci Sports Exerc 2008;40:535–41

    Article  PubMed  Google Scholar 

  • Peng S, Wuu J, Mufson EJ, Fahnestock M. Precursor form of brain-derived neurotrophic factor and mature brain-derived neurotrophic factor are decreased in the pre-clinical stages of Alzheimer's disease. J Neurochem 2005;93:1412–21

    Article  CAS  PubMed  Google Scholar 

  • Joyner MJ, Nose H. Physiological regulation linked with physical activity and health. J Physiol 2009;587:5525–6

    Article  CAS  PubMed  Google Scholar 

  • Kamphuis MH, Geerlings MI, Tijhuis MA, Giampaoli S, Nissinen A, Grobbee DE, et al. Physical inactivity, depression, and risk of cardiovascular mortality. Med Sci Sports Exerc 2007;39:1693–9

    Article  PubMed  Google Scholar 

  • Wonisch M, Berent R, Klicpera M, Laimer H, Marko C, Pokan R, et al. Praxisleitlinien ergometrie. Austrian J Cardiol Suppl 2008;A:3–17

    Google Scholar 

  • Lezak M. Neuropsychological assessment. New York: Oxford University Press; 1995

    Google Scholar 

  • Lehrner J, Gleiß A, Maly J, Auff E, Dal-Bianco P. Der Verbale Selektive Reminding Test (VSRT). Ein Verfahren zur Überprüfung verbaler Gedächtnisfunktionen. Neuropsychiatrie 2006;20:204–14

    Google Scholar 

  • Folstein M, Folstein S, McHugh P. MMST. Mini Mental Status Test. In: Fassung von J Kessler, Folstein S, Denzler P, editors Deutschsprachige. Weinheim: Beltz; 1990

  • Sunderland T, Hill JL, Mellow AM, Lawlor BA, Gundersheimer J, Newhouse PA, et al. Clock drawing in Alzheimer's disease. A novel measure of dementia severity. J Am Geriatr Soc 1989;37:725–9

    CAS  PubMed  Google Scholar 

  • Gatterer G. Alters-Konzentrations-Test (AKT). Göttingen: Hogrefe; 1990

    Google Scholar 

  • Tewes U. Hamburg-Wechsler-Intelligenztest für Erwachsene. Revision 1991 (HAWIE-R). Bern: Verlag Hans Huber; 1994

    Google Scholar 

  • Reitan R. Trail Making Test (TMT). Tucson: Reitan Neuropsychology Laboratory; 1979

  • Oswald W, Fleischmann U. Das Nürnberger-Alters-Inventar. Göttingen: Hogrefe; 1997

    Google Scholar 

  • Steiner M. Das alternde Gedächtnis: Grenzen und Perspektiven. Die MAC-Gedächtnisbatterie. Diplomarbeit Grund- und Integralwissenschaftliche Fakultät. Universität Wien, Wien; 1998

  • Regard M, Strauss E, Knapp P. Children's production on verbal and non-verbal fluency tasks. Percept Mot Skills 1982;55:839–44

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Unit of Occupational Medicine, Medical University of Vienna, Vienna, Austria

    Robert Winker & Ina Lukas

  2. Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria

    Thomas Perkmann & Helmut Haslacher

  3. Department of Psychology, Sigmund Freud Private University, Vienna, Austria

    Elisabeth Ponocny

  4. Department for Neurology, Medical University of Vienna, Vienna, Austria

    Johann Lehrner & Peter Dal-Bianco

  5. Institute for MRI Hernals, Vienna, Austria

    Dimiter Tscholakoff

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  1. Robert Winker
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  2. Ina Lukas
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  3. Thomas Perkmann
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Correspondence to Robert Winker.

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(apsoem): an Austrian prospective cohort study in cognitive function of elderly marathon-runners; Th is trial was registered with ClinicalTrials.gov, number NCT01045031.

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Winker, R., Lukas, I., Perkmann, T. et al. Cognitive function in elderly marathon runners: Cross-sectional data from the marathon trial (apsoem). Wien Klin Wochenschr 122, 704–716 (2010). https://doi.org/10.1007/s00508-010-1485-z

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