Research findings could help identify Alzheimer's patients who will benefit from exercise

A novel study has discovered metabolites that predict which Alzheimer's patients are likely to see their symptoms improve with exercise therapy. These findings were unveiled today at the 71^st AACC Annual Scientific Meeting & Clinical Lab Expo, and could be used to develop a blood test to guide Alzheimer's treatment.

In the U.S., one out of every 3 seniors has Alzheimer's or another form of dementia when they die, and from 2000-2017, deaths from Alzheimer's soared by 145%. A major reason why the Alzheimer's mortality rate continues to climb is that there is currently no cure for the disease, or even a way to slow its progression. In the last several years, however, promising studies have shown that exercise enhances cognition in Alzheimer's patients and also reduces the accumulation of amyloid plaques in the brain, which are a physiological hallmark of the disease.

Numerous phase III clinical trials are now investigating exercise's efficacy as a treatment. Patient response to exercise therapy varies, though, which means that if exercise becomes an approved treatment for Alzheimer's, healthcare providers will also need a test to identify the patients who will benefit from it.

A team of researchers led by Danni Li, PhD, and Fang Yu, PhD, of the University of Minnesota in Minneapolis, has identified blood metabolites that could be used to predict cognitive response to exercise in Alzheimer's patients. To identify these metabolites, Li and Yu's team studied 26 patients from the FIT-AD Trial, which is a clinical trial investigating the effects of cycling on mild-to-moderate Alzheimer's disease. The researchers measured the levels of 188 metabolites in participants' blood before the trial began and after 12 months. At the same time points, the team tested patients' cognitive abilities using the Alzheimer's Disease Assessment Scale-Cognition tool.

The team then used statistical analysis to identify metabolites that increased or decreased in response to exercise and in association with cognitive improvements. Altogether, the researchers found that changes in the levels of two phospholipids (lysoPC a C18.2 and PC aa C40.6) and five amino acids (isoleucine, leucine, methionine, tyrosine, and valine) were associated with an improvement in Alzheimer's patients' cognitive abilities.

Exercise treatment is a very promising intervention for Alzheimer's patients and is even an effective treatment for cognitive impairment in patients without Alzheimer's. But we also know that not everyone responds to exercise in the same way, so we want to use this research to develop a test to see who is going to respond better to exercise treatment. This is in line with the model of precision medicine, and finding the right person who will respond to the right therapy."

Danni Li, PhD, University of Minnesota, Minneapolis

Ghaith Altawallbeh, PhD, a fellow at the University of Minnesota in Minneapolis, will present this work at the AACC Annual Scientific Meeting.