Cerebral/Peripheral Vascular Reactivity and Neurocognition in Middle-Age Athletes

Introduction: Midlife vascular disease risk is associated with higher incidence of cognitive impairment in late life. Regular aerobic exercise improves vascular function, which in turn may translate into better cognitive function. The purpose of this study was to determine the associations among cardiorespiratory fitness, cerebral and peripheral vascular reactivity, and cognitive function in sedentary and endurance-trained middle-age adults. Methods: Thirty-two endurance-trained and 27 healthy sedentary participants ages 43-65 yr underwent measurements of maximal oxygen uptake (VO_2max), neurocognitive assessment, cerebrovascular reactivity to CO₂ (CVR), and brachial artery flow-mediated dilation (FMD). Results: There were no group differences in age, sex, education level, fasting blood glucose, and blood pressure. Compared with sedentary subjects, endurance-trained athletes demonstrated better cognitive performance on memory (z-score: -0.36 ± 1.11 vs 0.30 ± 0.76, P < 0.01), attention-executive function (z-score: -0.21 ± 0.53 vs 0.18 ± 0.72, P = 0.02), and total cognitive composite scores (z-score: -0.27 ± 0.63 vs 0.23 ± 0.57, P < 0.01). Furthermore, brachial FMD (4.70% ± 2.50% vs 7.13% ± 3.09%, P < 0.01) and CVR (4.19% ± 0.71%·mm Hg^-1 vs 4.69% ± 1.06%·mm Hg^-1, P = 0.052) were greater in endurance-trained individuals than in the sedentary subjects. Total cognitive composite scores showed a significant positive association with brachial FMD (r = 0.36, P < 0.01) and CVR (r = 0.30, P = 0.03). Finally, when brachial FMD and CVR were entered as covariates, fitness-related group differences in total cognitive composite score were significantly attenuated (all P > 0.05). Conclusion Endurance-trained middle-age adults demonstrated better cognitive performance, which may, at least in part, be mediated by their enhanced vascular function, including cerebral and endothelial-dependent vascular reactivity.