Science

Davangere P. Devanand, Arjun V. Masurkar, Thomas Wisniewski

Introduction: Mild to moderate exercise may decrease Alzheimer’s disease (AD) risk, but the effects of vigorous, regular physical exercise remain unclear.

Methods: Two patients with initial diagnoses of amnestic mild cognitive impairment (MCI) demonstrated positive AD biomarkers throughout 16 and 8 years of follow-up, with final diagnoses of mild AD and amnestic MCI, respectively.

Results: Patient 1 was diagnosed with amnestic MCI at age 64. Neuropsychologi- cal testing, magnetic resonance imaging (MRI), fluorodeoxyglucose–positron emission tomography (FDG-PET), amyloid imaging PET, and cerebrospinal fluid (CSF) biomark- ers during follow-ups remained consistent with AD. By age 80, progression was minimal with Montreal Cognitive Assessment (MoCA) 26 of 30. Patient 2 was diag- nosed with amnestic MCI at age 72. Neuropsychological testing, MRI, FDG-PET, and amyloid imaging PET during follow-ups remained consistent with AD. At age 80, MoCA was 27 of 30 with no clinical progression. Both patients regularly performed vigorous, regular exercise that increased after retirement/work reduction.

Discussion: Vigorous, regular exercise may slow disease progression in biomarker- positive amnestic MCI and mild AD.