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Will physical activity impact people who have vascular cognitive impairment problems? This was the question that triggered a randomised clinical trial that lasted almost 2 years and has been promoting the practice of physical activity among people with vascular cognitive impairment. Vascular cognitive impairment is characterised by the difficulty in making decisions, retardation, diminishing initiative and attention deficit. Since memory is usually spared at the beginning of the disease, this pathology is under-diagnosed.

This is a research work led by Neurologist and Professor Ana Verdelho, who relies on the collaboration of a multidisciplinary team with physicians, physiologists and neurophysiologists who check all the procedures. The team is integrated into Professor José Ferro's laboratory, based at the Faculty of Medicine and at the João Lobo Antunes iMM, with funding from the Foundation for Science and Technology (FCT).

Mariana Borges (exercise physiologist) and Mário Rodrigues (neuropsychologist) applied for a research grant and are now working on this project. Every day, they follow the different steps of a study that has six months of intervention followed by six months of long-term observation.



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The aim of all this is to try to evaluate the benefits of physical activity in the population affected by vascular cognitive impairment.

Currently with about seventy participants, the study is in the recruitment phase, and one of the objectives is to obtain a sample that allows drawing firm conclusions. Usually, the candidates are selected by physicians, but they can also be chosen through the lectures (in senior universities, for example) that the study has been disseminating, offering the participants a feasible physical intervention plan at no charge.

If the patients meet the inclusion criteria - patients with proven cerebral pathology, with or without strokes, non-dependent, without dementia criteria and without limitations to physical activity - they may then visit the office to find out more about the study and give their consent to the collection of clinical variables. It is at this point that they meet Mário Rodrigues, Neuropsychologist, who does the neuropsychological evaluation of all the cognitive variables, as well as Mariana Borges, Exercise Physiologist, who does the physical evaluation and applies the exercise intervention plan.

Using an accelerometer to count the steps and monitor the person's rhythm on a daily basis, they study how long the person does light, moderate and vigorous physical activity for a week, and then they make a personalised calculation. Based on each person's profile, but always in accordance with the stipulated protocol, Mariana Borges adapts the physical activities according to specific needs. The objective is to make an initial balance of induced activities after six months, obtaining information on whether there is cognitive and physical impact.

All the examinations and costs inherent to the research are assumed by the group, which has established partnerships with Hospital da Luz to perform MRI scans at zero, six and twelve months of study. The walks take place in the University Stadium. In this way, they intend to protect and delay the cognitive decline that can happen in ageing, by vascular interference.

But while there are proven physical improvements, are there any improvements at the cognitive level? This is a road that still needs to be travelled.

Now it is important for this research group to receive more people so that they can continue with their screening and randomisation, but they know that the fact that the patients have to go to the research centre, by their own means, may limit some volunteers. After the intervention and over six months, the patients are given autonomy to decide what activity they will do at home; by doing this, they want to understand if the patients' life habits will change, and that is the reason why they are very careful not to manipulate motivations.

The recruitment of new patients will end this year, followed by the follow up Until then, there will always be people coming and going, in a process that is naturally based on rotation. As this is a multicentric study, there is also some work being developed in Porto, albeit in an early stage.

Once the research is over, Mariana and Mário are planning to start their PhDs. Mário Rodrigues wants to follow research in the area of dementias and, simultaneously, work in psychology and clinical neuropsychology of intervention, while Mariana Borges will prescribe exercise to people with pathologies.

For all those who may belong to the group that is considered a significant sample, we list the requirements for those who want to participate and be referenced. There's still time!

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• Inclusion criteria: patients with vascular pathology in the image, with or without strokes (age over 18 years), non-dependent, without dementia criteria and without limitations to physical activity


• Diagnosis: Vascular cognitive impairment (retardation, decreased initiative, memory complaints, difficulty in making decisions, slow walking)


• Exclusion criteria: Alzheimer's, dementia and contraindication for physical activity

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AFIVASC Contacts

afisvasc@gmail.com

91 338 89 18

Joana Sousa

Editorial Team