Exercise training improves cognition and fatigue in older adults with multiple sclerosis
Photo by Tony Woodhead / Unsplash
Key Takeaway
Consider exercise training as a potential intervention for improving cognition and fatigue in older adults with MS, but recognize the evidence is preliminary.
This Phase-Ib randomized controlled trial investigated the effects of home-based exercise training in older adults with multiple sclerosis. A total of 51 participants were randomized to either exercise training (aerobic and resistance) or an active control (stretching) for 16 weeks. The study assessed secondary outcomes including cognition, symptoms, and quality of life.
Results showed statistically significant improvements in the exercise group for executive function, processing speed, fatigue, and health-related quality of life, with effect sizes (Cohen's d) ranging from 0.48 to 0.66 (p < 0.05). The control group showed no significant changes. The exercise group included 20 participants and the control group 16.
Safety and tolerability data were not reported, and the study did not specify a primary outcome. Limitations include the small sample size and preliminary nature of the evidence. The study was home-based, which may enhance feasibility but also limits generalizability.
These findings suggest that exercise training may offer cognitive and symptomatic benefits for older adults with MS, but clinicians should interpret the results cautiously given the early-phase design and lack of safety data. Larger, more definitive trials are needed before practice changes.
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View Original Abstract ↓
BACKGROUND: Older adults with multiple sclerosis (MS) experience co-occurring effects of aging and disease progression, resulting in worsening cognition, symptoms, and quality of life (QOL). There is limited research examining approaches for improving those outcomes in older adults with MS.
OBJECTIVES: We examined the efficacy of a 16-week home-based exercise training program for improving secondary study outcomes of cognition, symptoms, and QOL in older adults with MS.
METHODS: This phase-Ib, randomized controlled trial (RCT) included 51 participants (60.5±6.6 years, 78% females) who were randomized into exercise training (aerobic and resistance) or active control (stretching) conditions. Participants completed laboratory assessments before and after the 16-week programs. Cognitive function was measured using the NIH Toolbox Cognitive Battery. Symptoms of fatigue, depression, anxiety, and pain were assessed using the Fatigue Severity Scale, Modified Fatigue Impact Scale, Hospital Anxiety and Depression Scale, and Short-form McGill Pain Questionnaire, respectively. QOL was measured by the 29-item Multiple Sclerosis Impact Scale and the 36-Item Short Form Health Survey.
RESULTS: Forty-one participants (80.4 %) completed the conditions, with outcome data obtained from 20 exercise and 16 control participants. There were statistically significant improvements in executive function, processing speed, fatigue, and health-related QOL in the exercise group (p < 0.05, d = 0.48-0.66). No significant changes were observed in the control group (p>0.05).
CONCLUSIONS: We provide preliminary evidence on the benefits of exercise training for improving cognition, reducing fatigue impact, and enhancing QOL in older adults with MS who had moderate disability.
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