Resistance training and subcortical vascular cognitive impairment: A 12-month randomized trial

Alzheimers Dement. 2026 Mar;22(3):e71245. doi: 10.1002/alz.71245.

ABSTRACT

INTRODUCTION: It is unknown whether progressive resistance training (PRT) improves cognitive function in adults with cerebral small vessel disease and mild cognitive impairment (i.e., subcortical vascular cognitive impairment [SVCI]).

METHODS: We conducted a 12-month randomized trial comparing PRT versus balance and tone exercises (BAT) on the Alzheimer’s Disease Assessment Scale Cognitive Plus (ADAS-Cog-Plus).

RESULTS: Ninety-one participants were randomized (PRT = 45; BAT = 46); 76 completed the trial. Adherence was not different between groups (p = 0.18). At 12 months, PRT significantly improved ADAS-Cog-Plus scores (estimated mean difference: -0.18; 95% confidence interval [CI: -0.35, -0.01]; p = 0.04). Planned contrasts stratified by sex showed a significant PRT effect on ADAS-Cog-Plus scores for females (mean difference: -0.27; 95% CI: [-0.49, -0.05]; p = 0.02), but not for males. PRT also significantly reduced C-reactive protein (estimated mean difference: -2.93; 95% CI: [-5.36, -0.49]; p = 0.02). No significant differences were observed for other secondary outcomes.

DISCUSSION: PRT may have a small beneficial effect on cognitive function in SVCI.

CLINICAL TRIAL REGISTRATION: This trial was registered with ClinicalTrials.gov (NCT02669394).

PMID:41795685 | DOI:10.1002/alz.71245