Vascular Function Is Improved After an Environmental Enrichment Program The Train the Brain-Mind the Vessel Study

Environmen chment may slow cognitive decay possibly acting nigh an improvement in vascular function. Aim of the study was to assess the effects of a 7-month cognitive, social, and physical training program on cognitive and vascular function in patients with mild cognitive impairment. In a single-center, randomized, parallel group study, 113 patients (age, 65-89 years) were randomized to multidomain training (n=55) or usual care (n=58). All participants underwent neuropsychological tests and vascular evaluation, including brachial artery flow-mediated dilation, carotid femoral pulse wave velocity, carotid distensibility, and assessment of circulating hematopoietic CD34+ and endothelial progenitor cells. At study entry, an age-matched control group (n=45) was also studied. Compared with controls, patients had at study entry a reduced flow-mediated dilation (2.97 +/- 2.14% versus 3,73 2,06%; P=0.03) and hyperemic stimulus (shear rate area under the curve, 19.1 +/- 15.7 versus 25,7 15,1x10(-3), P=0,009); only the latter remained significant after adjustment for confounders (P=0,03), Training improved Alzheimer disease assessment scale cognitive (training, 14.0 +/- 4.8 to 13.1 +/- 5.5; nontraining, 12.1 +/- 3.9 to 13,2 +/- 4,8; P for interaction visitxtraining=0.02), flow-mediated dilation (2.82 +/- 2.19% to 3.40 +/- 1.81%, 3.05 +/- 2.08% to 2,24 +/- 1,59%; P=0.006; P=0.023 after adjustment for diameter and shear rate area under the curve), and circulating hematopoietic CD34(+) cells and prevented the decline in carotid distensibility (18.4 5,3 to 20,0 +/- 6.6, 23.9 +/- 11.0 to 19.5 +/- 7,1 Pat P=0.005). The only clinical predictor of improvement of cognitive function after training was established hypertension. There was no correlation between changes in measures of cognitive and vascular function, In conclusion, a multidomain training program slows cognitive decline, especially in hypertensive individuals, This effect is accompanied by improved systemic endothelial function, mobilization of progenitor CD34(+) cells, and preserved carotid distensibility.