Efeito do exercício físico multimodal nos biomarcadores inflamatórios, nas funções cognitivas e na força muscular em idosos com doença de Alzheimer

Abstract

Alzheimer’s disease (AD) is a progressive neurodegenerative disease, it is the most commom cause of dementia. With the worldwide increase in the elderly population, AD has been the focus of research in many studies, among them the relation of disease with biomarkers, such inflammatory cytokines. Physical exercise has been considered a non-pharmacological tratment, and its chronic effects are able to attenuate inflammation levels, increase muscle strenght and improve cognition in the elderly. Considering this, the presenty study aimed to evaluate the effect of multimodal physical exercise (MPE) on inflammatory biomarkers, congnitive function and muscle strenght in elderly with AD. The sample consisted of 19 elderly with AD, in the mild and moderate stage of the disease, who were divided for convenience into two groups, 8 of them in the control group (CG), who followed their routine without participation in physical exercise programs for 12 weeks and 11 in the training group (TG), who performed a MPE program of 60 minutes, 3 times weekly, for 12 weeks. The groups were evaluated in two moments, pre and post 12 weeks. In the evaluation protocol, the following instruments were used: Clinical Dementia Rating Score (CDR), Modified Baecke Questionnaire (MBQ), Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB), Clock Drawing Test (CDT), Geriatric Depression Scale (GDS), Chair Stand Test (CST), Hand Grip Strenght (HGS) and Resistance test of superior members (RSM). Blood samples were also collected for the evaluation of inflammatory biomarkers (IL-6, IL-10 and TNF-α) and analyzed by ELISA. The MPE program was of moderate intensity, and each class session focused on different physical abilities, being aerobic capacity, and muscular strenght; aerobic capacity, agility and balance; muscular strenght, agility and balance. For characterization variables, the U Mann Whitney test was used to verify if there was any difference between the groups (TG and CG) at the pre-intervention moment. Data were analyzed by means of mean and standard deviation, using the U Mann Whitney test for intergroup comparisons and the Wilcoxon test for intragroup comparison. The study showed improvement of the executive functions presented in FAB (p≤0,05), strenght of lower limbs by the CST (p=0,006) and physical activity level by the QBM (p=0,007) in the TG, in addition a tendency in the MMSE and RSM (p≤0,08). The CG presented also showed improvement in CST (p=0,033). There wasno significant response in inflammatory biomarkers, and many elderly patients did not presente concentrations in the blood samples. According to the presente study, the MPE training improves the frontal cognitive functions, muscular strenght and physical activity level of the elderly with AD. No improvement in inflammatory biomarkers. It is importante to note that the test used to analysed the biomarkers was not able to detect TNF-α concentrations in any of the elderly with AD, and only a few detected IL-6 and IL-10.