title: Aerobic exercise and vascular cognitive impairment: A randomized controlled trial.
abstract: OBJECTIVE
  To assess the efficacy of a progressive aerobic exercise training program on cognitive and everyday function among adults with mild subcortical ischemic vascular cognitive impairment (SIVCI).
  
  
  METHODS
  This was a proof-of-concept single-blind randomized controlled trial comparing a 6-month, thrice-weekly, progressive aerobic exercise training program (AT) with usual care plus education on cognitive and everyday function with a follow-up assessment 6 months after the formal cessation of aerobic exercise training. Primary outcomes assessed were general cognitive function (Alzheimer's Disease Assessment Scale-Cognitive subscale [ADAS-Cog]), executive functions (Executive Interview [EXIT-25]), and activities of daily living (Alzheimer's Disease Cooperative Study-Activities of Daily Living [ADCS-ADL]).
  
  
  RESULTS
  Seventy adults randomized to aerobic exercise training or usual care were included in intention-to-treat analyses (mean age 74 years, 51% female, n = 35 per group). At the end of the intervention, the aerobic exercise training group had significantly improved ADAS-Cog performance compared with the usual care plus education group (-1.71 point difference, 95% confidence interval [CI] -3.15 to -0.26, p = 0.02); however, this difference was not significant at the 6-month follow-up (-0.63 point difference, 95% CI -2.34 to 1.07, p = 0.46). There were no significant between-group differences at intervention completion and at the 6-month follow-up in EXIT-25 or ADCS-ADL performance. Examination of secondary measures showed between-group differences at intervention completion favoring the AT group in 6-minute walk distance (30.35 meter difference, 95% CI 5.82 to 54.86, p = 0.02) and in diastolic blood pressure (-6.89 mm Hg difference, 95% CI -12.52 to -1.26, p = 0.02).
  
  
  CONCLUSIONS
  This study provides preliminary evidence for the efficacy of 6 months of thrice-weekly progressive aerobic training in community-dwelling adults with mild SIVCI, relative to usual care plus education.
  
  
  BACKGROUND
  NCT01027858.
  
  
  METHODS
  This study provides Class II evidence that for adults with mild SIVCI, an aerobic exercise program for 6 months results in a small, significant improvement in ADAS-Cog performance.
authors.affiliation: Author affiliations are provided at the end of the article. teresa.ambrose@ubc.ca.
authors.forename: Teresa
authors.initials: T
authors.lastname: Liu-Ambrose
authors.affiliation: Author affiliations are provided at the end of the article.
authors.forename: John R
authors.initials: JR
authors.lastname: Best
authors.affiliation: Author affiliations are provided at the end of the article.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Davis
authors.affiliation: Author affiliations are provided at the end of the article.
authors.forename: Janice J
authors.initials: JJ
authors.lastname: Eng
authors.affiliation: Author affiliations are provided at the end of the article.
authors.forename: Philip E
authors.initials: PE
authors.lastname: Lee
authors.affiliation: Author affiliations are provided at the end of the article.
authors.forename: Claudia
authors.initials: C
authors.lastname: Jacova
authors.affiliation: Author affiliations are provided at the end of the article.
authors.forename: Lara A
authors.initials: LA
authors.lastname: Boyd
authors.affiliation: Author affiliations are provided at the end of the article.
authors.forename: Penelope M
authors.initials: PM
authors.lastname: Brasher
authors.affiliation: Author affiliations are provided at the end of the article.
authors.forename: Michelle
authors.initials: M
authors.lastname: Munkacsy
authors.affiliation: Author affiliations are provided at the end of the article.
authors.forename: Winnie
authors.initials: W
authors.lastname: Cheung
authors.affiliation: Author affiliations are provided at the end of the article.
authors.forename: Ging-Yuek R
authors.initials: GR
authors.lastname: Hsiung
mesh_terms: D000368:Aged; D001794:Blood Pressure; D001795:Blood Pressure Determination; D003071:Cognition; D060825:Cognitive Dysfunction / Q000503:physiopathology / Q000628:therapy*; D005081:Exercise Therapy / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D016037:Single-Blind Method; D016896:Treatment Outcome