Stroehlein Julia K, Vieluf Solveig, Zimmer Philipp, Schenk Alexander, Oberste Max, Goelz Christian, van den Bongard Franziska, Reinsberger Claus
Department of Sports and Health, Institute of Sports Medicine, Paderborn University, Warburger Straße 100, 33098, Paderborn, Germany.
Department for Performance and Health, Institute for Sport and Sport Science, Technical University Dortmund, Otto-Hahn-Straße 3, 44227, Dortmund, Germany.
BMC Neurol. 2021 May 17;21(1):200. doi: 10.1186/s12883-021-02186-9.
Subjective Memory Complaints (SMC) in elderly people due to preclinical Alzheimer's Disease may be associated with dysregulation of the Kynurenine Pathway (KP), with an increase in neurotoxic metabolites that affect cognition. Golf is a challenging sport with high demands on motor, sensory, and cognitive abilities, which might bear the potential to attenuate the pathological changes of preclinical AD. This trial investigated the feasibility of learning to play golf for elderly with cognitive problems and its effects on cognitive functions and the KP.
In a 22-week single-blinded randomized controlled trial, elderly people with SMC were allocated to the golf (n = 25, 180 min training/week) or control group (n = 21). Primary outcomes were feasibility (golf exam, adherence, adverse events) and general cognitive function (Alzheimer's Disease Assessment Scale). Secondary outcomes include specific cognitive functions (Response Inhibition, Corsi Block Tapping Test, Trail Making Test), KP metabolites and physical performance (6-Minute-Walk-Test). Baseline-adjusted Analysis-of-Covariance was conducted for each outcome.
42 participants were analyzed. All participants that underwent the golf exam after the intervention passed it (20/23). Attendance rate of the golf intervention was 75 %. No adverse events or drop-outs related to the intervention occurred. A significant timegroup interaction (p = 0.012, F = 7.050, Cohen's d = 0.89) was found for correct responses on the Response Inhibition task, but not for ADAS-Cog. Moreover, a significant timegroup interaction for Quinolinic acid to Tryptophan ratios (p = 0.022, F = 5.769, Cohen's d = 0.84) in favor of the golf group was observed. An uncorrected negative correlation between attendance rate and delta Quinolinic acid to Kynurenic acid ratios in the golf group (p = 0.039, r=-0.443) was found as well.
The findings indicate that learning golf is feasible and safe for elderly people with cognitive problems. Preliminary results suggest positive effects on attention and the KP. To explore the whole potential of golfing and its effect on cognitive decline, a larger cohort should be studied over a longer period with higher cardiovascular demands.
The trial was retrospectively registered (2nd July 2018) at the German Clinical Trials Register ( DRKS00014921 ).
临床前阿尔茨海默病导致的老年人主观记忆障碍（SMC）可能与犬尿氨酸途径（KP）失调有关，神经毒性代谢产物增加会影响认知。高尔夫是一项对运动、感官和认知能力要求很高的挑战性运动，可能具有减轻临床前AD病理变化的潜力。本试验研究了认知有问题的老年人学习打高尔夫的可行性及其对认知功能和KP的影响。
在一项为期22周的单盲随机对照试验中，将有SMC的老年人分配到高尔夫组（n = 25，每周训练180分钟）或对照组（n = 21）。主要结局指标为可行性（高尔夫考试、依从性、不良事件）和一般认知功能（阿尔茨海默病评估量表）。次要结局指标包括特定认知功能（反应抑制、Corsi块点击测试、连线测验）、KP代谢产物和身体性能（6分钟步行试验）。对每个结局指标进行基线调整的协方差分析。
对42名参与者进行了分析。干预后参加高尔夫考试的所有参与者都通过了考试（20/23）。高尔夫干预的出勤率为75%。未发生与干预相关的不良事件或退出情况。在反应抑制任务的正确反应方面发现了显著的时间组交互作用（p = 0.012，F = 7.050，科恩d值 = 0.89），但在阿尔茨海默病评估量表认知部分（ADAS-Cog）方面未发现。此外，观察到喹啉酸与色氨酸比值存在显著的时间组交互作用（p = 0.022，F = 5.769，科恩d值 = 0.84），有利于高尔夫组。在高尔夫组中还发现出勤率与喹啉酸与犬尿烯酸比值的变化之间存在未校正的负相关（p = 0.039，r = -0.443）。
研究结果表明，学习高尔夫对认知有问题的老年人是可行且安全的。初步结果表明对注意力和KP有积极影响。为了探索高尔夫运动的全部潜力及其对认知衰退的影响，应该在更长的时间内对更大的队列进行研究，且对心血管系统有更高的要求。
该试验于2018年7月2日在德国临床试验注册中心（DRKS00014921）进行了回顾性注册。
