Evidence map›Paper›PMID 40271888›Full record

Trial reportAlzheimer's & dementia : the journal of the Alzheimer's Association2025

Effects of exercise on cognition and Alzheimer's biomarkers in a randomized controlled trial of adults with mild cognitive impairment: The EXERT study.

Laura D Baker, Judy A Pa, Jeffrey A Katula, Vahan Aslanyan, David P Salmon, Diane M Jacobs, Elizabeth A Chmelo, Heather Hodge, Rosemary Morrison, Genevieve Matthews and 17 more

Abstract readRandomized Controlled TrialMulticenter StudyClinical Trial, Phase III
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
  5. Review
  6. Review
  7. Review
  8. Review
  9. Review
  10. The landscape of dementia in India: Prevalence, risk factors, and opportunities ahead.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Review
  11. Article
  12. Article
  13. Review
  14. Review
  15. Review
  16. Review
  17. Review
  18. Article
  19. Observational
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors.

Laura D BakerDepartment of Internal Medicine-Geriatrics, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA.
Judy A PaAlzheimer's Disease Cooperative Study, University of California, La Jolla, California, USA.
Jeffrey A KatulaDepartment of Health and Exercise Science, Wake Forest University, Winston Salem, North Carolina, USA.
Vahan AslanyanDepartment of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
David P SalmonAlzheimer's Disease Cooperative Study, University of California, La Jolla, California, USA.
Diane M JacobsAlzheimer's Disease Cooperative Study, University of California, La Jolla, California, USA.
Elizabeth A ChmeloDepartment of Internal Medicine-Geriatrics, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA.
Heather HodgeYMCA of the USA, Chicago, Illinois, USA.
Rosemary MorrisonAlzheimer's Disease Cooperative Study, University of California, La Jolla, California, USA.
Genevieve MatthewsAlzheimer's Disease Cooperative Study, University of California, La Jolla, California, USA.
James BrewerAlzheimer's Disease Cooperative Study, University of California, La Jolla, California, USA.
Youngkyoo JungDepartment of Radiology, Medical Physics, University of California Davis Health, Davis, California, USA.
Robert A RissmanDepartment of Physiology and Neurosciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Curtis TaylorAlzheimer's Disease Cooperative Study, University of California, La Jolla, California, USA.
Gabriel C LégerAlzheimer's Disease Cooperative Study, University of California, La Jolla, California, USA.
Karen MesserHerbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA.
A Carol EvansAlzheimer's Disease Cooperative Study, University of California, La Jolla, California, USA.
Ozioma C OkonkwoDepartment of Medicine, Division of Geriatrics and Gerontology, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Aladdin H ShadyabHerbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA.
Jingjing ZouAlzheimer's Disease Cooperative Study, University of California, La Jolla, California, USA.
Sheila JinAlzheimer's Disease Cooperative Study, University of California, La Jolla, California, USA.
Ronald G ThomasAlzheimer's Disease Cooperative Study, University of California, La Jolla, California, USA.
Jin ZhangMoors Cancer Center, University of California San Diego, La Jolla, California, USA.
Andrea Z La CroixHerbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA.
Carl W CotmanShiley-Marcos Alzheimer's Disease Research Center, University of California San Diego, La Jolla, California, USA.
Howard H FeldmanAlzheimer's Disease Cooperative Study, University of California, La Jolla, California, USA.
EXERT Study Group

Funding

TRIAL OF VALPROATE TO ATTENUATE THE PROGRESSION OF ADU01AG010483 · NIA · UNIVERSITY OF ROCHESTER · PI AISEN, PAUL S. · 1991 to 2012
$116.2M
RECRUITMENT COREU19AG010483 · NIA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI FELDMAN, HOWARD · 2013 to 2020
$80.6M
UCSD Shiley-Marcos Alzheimer's Disease Research Center P30P30AG062429 · NIA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Steven Dyal Edland · 2019 to 2026
$34.9M
Vascular Contributions to Dementia and Genetic Risk Factors for Alzheimer's DiseaseP01AG052350 · NIA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Daniel A Nation, ARTHUR W TOGA · 2016 to 2026
$28.4M
USCADRC Diversity Supplement PachicanoP30AG066530 · NIA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI HELENA Chang CHUI, ARTHUR W TOGA · 2020 to 2026
$27.8M
Wake Forest University School of Medicine Alzheimer's Disease Research CenterP30AG072947 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI SUZANNE CRAFT · 2021 to 2026
$24.3M
Wake Forest Alzheimer's Disease Core CenterP30AG049638 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI RAPP, STEPHEN R · 2016 to 2020
$12.2M
Multi-omic Investigation of Exercise Effects in Mild Cognitive ImpairmentR01AG058644 · NIA · UNIVERSITY OF CALIFORNIA-IRVINE · PI MAPSTONE, MARK · 2018 to 2021
$2.0M
Brain Research Foundation ECD-2014-01NIA NIH HHS AG058644NIA NIH HHS P01 AG052350NIA NIH HHS P30 AG049638NIA NIH HHS P30AG049638NIA NIH HHS P30 AG062429NIA NIH HHS P30 AG066530NIA NIH HHS P30 AG072947NIA NIH HHS R01 AG058644NIA NIH HHS U01 AG010483NIA NIH HHS U19 AG010483NIA NIH HHS U19AG010483-25
6 · The paper itself

Abstract

introductionThe EXERT study (Exercise in Adults with Mild Memory Problems) was a Phase 3, multicenter, randomized controlled trial that examined effects of exercise on cognition and other measures of brain health in sedentary older adults with amnestic mild cognitive impairment (MCI).

methodsParticipants were randomized to moderate-high intensity aerobic training (AX) or low-intensity stretching/balance/range of motion (SBR) for 18 months. Exercise was supervised for the first 12 months. Assessments were administered at baseline and every 6 months. The primary outcome was a global cognitive composite.

resultsA total of 296 participants were enrolled, and intervention adherence was high (supervised session attendance: AX = 81%, SBR = 87%). Intervention effects on cognition did not differ for AX and SBR (regression = -0.078, standard error [SE] = 0.074; p = 0.3). Notably, there was no 12 month  cognition decline for either group, and mean 12 month  hippocampal volume loss for both groups was low at 0.51%. DISCUSSION: Exercise intensity did not differentially affect cognitive trajectory. Intervention delivery was successful (high adherence) and cognition remained stable over 12 months  for both MCI groups, an association that warrants further study. HIGHLIGHTS: Exercise in Adults with Mild Memory Problems (EXERT) was a large multisite randomized controlled trial of moderate-high intensity aerobic training versus lower-intensity flexibility and balance exercise in sedentary older adults with amnestic mild cognitive impairment (MCI). A sensitive and validated measure of global cognitive function, the Alzheimer's Disease Assessment Scale-Cognition supplemented with tests of executive function (ADAS-Cog-Exec), was used to assess intervention efficacy with 12 months of supervised exercise. There was no intervention group difference on the 12-month cognitive trajectory of the ADAS-Cog-Exec. Intervention delivery was successful (high adherence), and cognition remained stable over 12 months for both exercise groups. Regular supported moderate-high or lower-intensity exercise may stall decline in adults with amnestic MCI, but further investigation is needed.

Indexed as

Alzheimer DiseaseCognitionCognitive DysfunctionExerciseExercise TherapyAgedAged, 80 and overBiomarkersFemaleHumansMaleMiddle AgedNeuropsychological TestsTreatment OutcomeBiomarkersAlzheimer'sbrain MRIclinical trialcognitionexercisemild cognitive impairmentmultisitenonpharmacological intervention

Identifiers

PMID40271888
PMCPMC12019696

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.