Exercise-Based Cardiac Rehabilitation Improves Cognitive Function Among CVD Patients

Abstract

Objective: Investigate the effects of cardiac rehabilitation (CR) exercise training on cognitive performance and if the changes are associated with alterations in prefrontal cortex (PFC) oxygenation among patients with cardiovascular disease (CVD). Design: A single group pre-post design. Setting: An outpatient CR program. Subjects: Twenty (15 male, 5 female; mean (SD) age 64.8 (11.6) yrs) patients from an outpatient CR program. Intervention: At least 18 individualized CR sessions (approximately 6 weeks). Main measures: Pre- and post-CR changes in cognitive performance (a measure of 5 constructs from the NIH Fluid Cognition test battery), left-PFC and right-PFC activation (measured using functional near-infrared spectroscopy (fNIRS)) and cardiorespiratory capacity (measured by a submaximal graded treadmill test). Results: Patients showed improvements in cardiorespiratory capacity and various cognitive constructs (processing speed, attention, executive function, and working memory scores). A significant increase in PFC oxygenation, primarily in the left-PFC region, occurred at post-CR test. Correlation analyses revealed negative associations between changes in cognition (executive function and fluid composite score) and PFC changes. The change in cardiorespiratory capacity was positively associated with the change in working memory score. Conclusions: CVD patients enrolled in CR showed significant improvements in multiple cognitive domains along with increased cortical activation. The negative associations between cognitive functioning and PFC oxygenation suggest an improved neural efficiency, which is identified as higher cognitive performance for a given (or reduced) amount of cortical activation