Electronic Thesis and Dissertation Repository

Degree

Doctor of Philosophy

Program

Health and Rehabilitation Sciences

Supervisor

Robert J. Petrella

Abstract

Cardiovascular disease (CVD) risk factors contribute to neuropathological changes within regions of the brain that are involved with both cognitive and motor control processes, and have been identified as potentially modifiable dementia and gait dysfunction risk factors. Exercise training is a corner-stone treatment for vascular risk factor control, and evidence suggests that physical and cognitive training can benefit cognition and gait; however, the exercise training modality that can provide the greatest cognitive benefit remains elusive. Therefore, the purpose of this thesis was three-fold: (i) to determine whether CVD risk factors and gait were associated with cognitive functioning, (ii) to determine whether blood pressure dipping status was associated with cognitive and gait impairments in community-dwelling older adults, and iii) to examine the impact of a dual-task gait training and aerobic exercise (DAE) on cognition, gait, and vascular health. Cumulative CVD risk was an independent predictor of executive functioning. Cross-sectional differences in cognition and usual and dual-task gait were observed between older adults with preserved blood pressure dipping and non-dippers. Last, 26-weeks of DAE training improved cognition and usual and dual-task gait, and the improvements in cognition were maintained for at least 6 months after the exercise program. The management of traditional and novel CVD risk factors should be a primary aim of prevention strategies aimed at mitigating cognitive decline. Although DAE training can benefit cognition and gait, further work is required to unequivocally determine the efficacy of DAE training as a method to improve brain health in older adults without dementia.

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