Chronic endurance exercise training prevents aging-related cognitive decline in healthy older adults: a randomized controlled trial.

OBJECTIVE: To evaluate the effects of endurance exercise training (EET) on the cognitive status of healthy community-dwelling older adults. METHODS: A randomized controlled trial was conducted involving community-dwelling older adults from the town of Pianoro (northern Italy). We randomized 120 healthy subjects aged 65-74 years, both genders, to treatment (N = 60) and control (N = 60) groups. The treatment consisted of 12 months of supervised EET in a community gym, 3 h a week. All participants were assessed both at baseline and after 12 months on an intention-to-treat analysis. Cognitive status was assessed by one single test (Mini Mental State Examination, MMSE). Anthropometric indexes, routine laboratory measurements and C-reactive protein (CRP) were also assessed. RESULTS: The control group showed a significant decrease in MMSE score (mean difference -1.21, 95% CI -1.83/-0.60, p = 0.0002), which differed significantly (p = 0.02) from the treatment group scores (-0.21, 95% CI -0.79/0.37, p = 0.47). The odds ratio for the treated older adults to have a stable cognitive status after 1 year, as compared to the control group, was 2.74 (95% CI 1.16/6.48) after adjustment for age, gender, educational level and several other possible confounders. Blood pressure, body mass index, waist circumference and serum cholesterol did not differ significantly between the two groups, while CRP decreased only in the treatment group. CONCLUSIONS: A 12-month EET intervention may reduce the progression of age-related cognitive decline in healthy older adults.

Serum C3 is a stronger inflammatory marker of insulin resistance than C-reactive protein, leukocyte count, and erythrocyte sedimentation rate: comparison study in an elderly population.

OBJECTIVE: This study was performed to ascertain the relative relevance of some inflammatory markers in insulin resistance. RESEARCH DESIGN AND METHODS: Four inflammatory markers (leukocyte count, erythrocyte sedimentation rate [ESR], high-sensitivity C-reactive protein [CRP], and C3 complement) were assessed as possible determinants of the homeostasis model assessment (HOMA) index, together with the five elements of the metabolic syndrome (National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults [Adult Treatment Panel III] definition), total cholesterol, physical activity, and four indicators of adiposity (BMI, waist circumference, percent body fat, and hepatic steatosis) in an unselected population of 990 subjects aged 65-91 years (the Pianoro Study). RESULTS: In univariable analysis, C3, CRP, and leukocyte count, but not ESR, were significantly correlated with HOMA index. In multivariable analysis, C3 remained associated with insulin resistance with the highest partial R(2) value (0.049), independently of all other covariates. The other most significant (P < 0.0001) determinants of HOMA index were total cholesterol (inverse association, R(2) = 0.026), waist circumference (R(2) = 0.023), triglycerides (R(2) = 0.022), and hepatic steatosis (R(2) = 0.021) (R(2) = 0.450 for the whole model). The adjusted relative risks of having the metabolic syndrome for the subjects with inflammatory markers in the high tertile, with respect to those with lower values, were (prevalence ratio [95% CI]): 1.77 (1.41-2.22) for C3, 1.38 (1.12-1.70) for leukocyte count, 1.17 (0.94-1.46) for CRP, and 1.13 (0.91-1.40) for ESR. CONCLUSIONS: Of the four inflammatory markers simultaneously assessed in our elderly population, only C3 was strongly associated with insulin resistance, independently of the components of the metabolic syndrome and the main indexes of abdominal and general obesity.

Effects of weight loss and risk factor treatment in subjects with elevated serum C3, an inflammatory predictor of myocardial infarction.

BACKGROUND: Serum C3 is an inflammatory predictor of myocardial infarction and a covariate of fasting insulin and several endogenous risk factors. This study was performed to ascertain whether risk factor control may reduce elevated C3 concentrations. METHODS: After traditional risk factor and C3 assessment in 1100 unselected men aged 55-64 years, 238 men with persistently elevated C3 levels (>=1.19 g/l, high tertile) were randomised into 2 groups: 43 controls, who were referred to their general practitioner, and 195 subjects who were intensively treated with diet, and anti-hypertensive or antidiabetic drugs according to specific indications, without anti-dyslipidemic drugs. RESULTS: After three months in the treated subjects significant decrements of body weight, blood pressure, blood glucose and serum lipids were obtained, with stable C3 levels (while in controls a 3.3% increase occurred, P=0.02). The factors associated with a C3 decrement >5% were a high baseline C3 level, a recent acute inflammation, physical activity, belonging to the treated group, and a significant reduction in body weight, triglycerides or blood glucose. However, in multivariate analysis only an elevated baseline C3 (P<0.0001), a weight loss >2% (P=0.0009) and physical activity (P=0.02) remained independently associated with a C3 decrement >5% (R(2)=0.14). CONCLUSIONS: Only weight loss and physical activity, but not traditional risk factor lowering, could independently induce a significant C3 decrease. Thus, C3 elevation is associated with, but probably not caused by, traditional risk factors.