Does manipulation of arterial shear stress enhance cerebrovascular function and cognition in the aging brain? Design, rationale and recruitment for the Preventia randomised clinical trial

Daniel J. Green, Kay L. Cox, Johanna C. Badcock, Philip N. Ainslie, Carmela Pestell, Barbara A. Maslen, Nicola T. Lautenschlager

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Cognitive and cerebrovascular declines are potentially life-changing conditions which are associated with a substantial healthcare burden worldwide. While pharmacological approaches for the prevention of cognitive decline have been largely ineffective, exercise programs may be able to delay or prevent cognitive decline in those at risk. One putative mechanism for the beneficial impacts of exercise on brain health involves improvement in cerebrovascular function. Exercise positively affects arterial structure and function in peripheral arteries and microvessels, but the impacts on brain vascular function are largely unknown. Water immersion increases brain blood flow and shear stress, a mechanism that improves artery health. We hypothesised that repeated water immersion may lead to adaptations which enhance cerebrovascular function and health in humans. Methods/design: 72 sedentary older adults (50 years and older) with subjective memory complaints were randomly assigned to a 24-week water-based or land-based walking program (designed to elicit differing stresses on blood vessels) or an education group. Measures of cerebral artery function and cognitive performance were assessed before and after the intervention, and again at 48 weeks to test for persistence of any benefits. Other outcomes included biochemistry, blood pressure, body composition and fitness. Discussion: Water-based versus land-based exercise elicit different haemodynamic responses and, consequently, distinct patterns of shear stress in arteries, including those supplying the brain. If the exercise programs prove beneficial, this will inform future strategies for the prevention of cerebrovascular decline in the ageing ‘healthy’ population.

Original languageEnglish
Pages (from-to)153-163
Number of pages11
JournalMental Health and Physical Activity
Volume15
DOIs
Publication statusPublished - 1 Oct 2018

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Cognition
Randomized Controlled Trials
Water
Arteries
Brain
Immersion
Blood Vessels
Health
Cerebral Arteries
Microvessels
Body Composition
Biochemistry
Walking
Hemodynamics
Pharmacology
Blood Pressure
Delivery of Health Care
Education
Population
Cognitive Dysfunction

Cite this

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abstract = "Background: Cognitive and cerebrovascular declines are potentially life-changing conditions which are associated with a substantial healthcare burden worldwide. While pharmacological approaches for the prevention of cognitive decline have been largely ineffective, exercise programs may be able to delay or prevent cognitive decline in those at risk. One putative mechanism for the beneficial impacts of exercise on brain health involves improvement in cerebrovascular function. Exercise positively affects arterial structure and function in peripheral arteries and microvessels, but the impacts on brain vascular function are largely unknown. Water immersion increases brain blood flow and shear stress, a mechanism that improves artery health. We hypothesised that repeated water immersion may lead to adaptations which enhance cerebrovascular function and health in humans. Methods/design: 72 sedentary older adults (50 years and older) with subjective memory complaints were randomly assigned to a 24-week water-based or land-based walking program (designed to elicit differing stresses on blood vessels) or an education group. Measures of cerebral artery function and cognitive performance were assessed before and after the intervention, and again at 48 weeks to test for persistence of any benefits. Other outcomes included biochemistry, blood pressure, body composition and fitness. Discussion: Water-based versus land-based exercise elicit different haemodynamic responses and, consequently, distinct patterns of shear stress in arteries, including those supplying the brain. If the exercise programs prove beneficial, this will inform future strategies for the prevention of cerebrovascular decline in the ageing ‘healthy’ population.",
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AU - Ainslie, Philip N.

AU - Pestell, Carmela

AU - Maslen, Barbara A.

AU - Lautenschlager, Nicola T.

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