Grant: Travel Awards - Institute Community Support

PURPOSE: To examine whether the Framingham Cardiovascular Risk Profile Score (FCRP) moderates the effect of a 6-month progressive aerobic training program (AT) on executive function in older adults with vascular cognitive impairment. METHODS: This is a secondary analysis of a proof-of-concept RCT in 71 older adults, who were randomized to either a 6-month, thrice-weekly, AT program, or usual care (CON). At baseline and completion, three executive processes were measured: 1) response inhibition by Stroop Colour Word Test; 2) working memory by digit span backward test (DSB), and 3) set shifting by the Trail Making Test (B-A; TMT). Baseline cardiovascular risk (CVR) was calculated using the FCRP, and participants were classified as low risk (<20% FCRP score; LCVR) or high risk (>20% FCRP score; HCVR). A complete case analysis (n=57) was conducted by an analysis of covariance (ANCOVA) to evaluate between-group differences. Age, baseline Montreal Cognitive Assessment score, education, and baseline score for the outcome variable were entered as covariates. RESULTS: A significant interaction was found between FCRP and group (AT or CON) for the DSB (F(1,49)=4.67, p=0.03) and the TMT (F(1,50)=4.09, p=0.04). There was no significant interaction for the Stroop Test (F(1,48)=.802 p=.38). On the DSB test, AT improved performance compared to CON (3.74 vs. 2.75) in those with LCVR, while in those with HCVR, AT did not provide improvements compared to CON (2.97vs. 3.76). Similarly, for the TMT (B-A), AT improved performance compared to CON (52.66 vs. 80.12 in those with LCVR, while AT was not beneficial compared to CON in those with HCVR (98.80vs. 59.92). CONCLUSION: We found that CVR significantly moderates the efficacy of aerobic exercise on working memory and set shifting in older adults with vascular cognitive impairment. Our findings highlight the importance of intervening early in the disease course, when CVR may be lower, to reap maximum benefits of aerobic exercise.