EXERT results: exercise shown to stall cognitive decline in patients with mild cognitive impairment

The Phase III, multicenter, randomized EXERT trial (NCT02814526) enrolled almost 300 patients to investigate the effects of regular exercise on brain function in previously sedentary older adults with mild cognitive impairment (MCI). Patients were randomized 1:1 to undertake moderate intensity aerobic training or stretching, balance, and range of motion (SBR) training for 18 months. For the first 12 month, exercise was supervised for 2 sessions per week and independent for 2 session per week. Laura Baker, PhD, Wake Forest University School of Medicine, Winston-Salem, NC, presents the topline results of the EXERT trial after 12 months. Surprisingly, neither the aerobic exercise nor the SBR arms showed decline from baseline on the ADAS-Cog-Exec at 12 months, assessed as the primary endpoint. Clinical Dementia Rating scale Sum of Boxes (CDR-SB) scores also showed no change. To try to understand these findings, the outcomes were compared to matched controls from the ADNI-1 longitudinal observation study. ADNI-1 MCI participants showed the expected 12-month decline on the ADAS-Cog-Exec. These findings suggest that both the aerobic training and SBR interventions may have prevented cognitive decline. The social support aspect of the intervention may have also contributed to the effects seen. Dr Baker shares her thoughts on these data and provides recommendations for patients with MCI. This interview took place at the Alzheimer's Association International Conference (AAIC) 2022 in San Diego, CA.