The Mediating Effect of Different Exercise Programs on the Immune Profile of Frail Older Women with Cognitive Impairment

Background: Frail individuals experience an accelerated immunosenescence, and exercise has been identified as a therapy to promote a better inflammatory environment. Objective: To analyze the effects of 28-weeks of two different exercise protocols on the functional fitness and immune profiles of institutionalized pre-frail and frail women with mild cognitive impairment. Methods: Participants residing in care homes (n-60, 81 +/- 7.84 years old) were randomized into three groups: a chair elastic band muscle-strength exercise (CSE, n=21; 81 +/- 4.79), a chair multimodal exercise (CME, n=20; 80 +/- 8.19), and a control non-exercise (CGne, n=19; 80 +/- 10.01). Both CME and CSE groups performed progressive circuit-training exercise sessions. The controls did not change their usual lifestyle. The Fried protocol and the Mini-Mental State Examination questionnaire were used to identify the frail subgroups and the participants with mild cognitive impairment. Data for anti and pro-inflammatory markers and physical fitness were analyzed pre and post-interventions. Results: After the intervention, a significant effect of time and time by group for sigA and time by group for IL-10 levels were found (p > 0.05). Within-group analysis showed a significant moderate decrease in the TNF-alpha to IL-10 ratio for the CME group and an increase in the controls (p > 0.05) and a slight reduction in the IL-6 and IL-1 beta concentrations. The controls showed a negative trend towards a decrease in physical fitness and a trend for increased levels in the pro-inflammatory markers IL-6 and IL-1 beta. Conclusion: The evidence regarding the use of systematic and moderate long-term exercise as therapy for promoting a better balance between pro- and anti-inflammatory environments and a decrease in the inflammatory index for the CME group were the most promising results from this study.