Slowing cognitive decline in alpha-syn. through exercise

The so-called alpha-synucleinopathies (Parkinson`s disease, dementia with Lewy bodies, multisystem atrophy) are the second most common form of neurodegenerative disease after Alzheimer`s disease. It is expected that there will be more and more people with these diseases. By 2040, there will be more than 12 million worldwide. Acting out dreams during sleep (REM sleep behavior disorder) is often a sign of alpha- synucleinopathy in the early stages. This can develop within the next 20 years after diagnosis. In so-called alpha-synucleinopathies, the person not only loses their motor skills, but also their cognitive abilities. This significantly impairs social functions and quality of life. There are only a few treatment options for these cognitive disorders. That`s why you have to do something about it early on. If you exercise a lot, your brain stays fit for longer and the deterioration of nerve cells can be slowed down. Exercise also has a positive effect on healthy ageing. Studies show that exercise training can influence the disease in alpha-synucleinopathies. However, there are few studies on exercise training for people with Parkinson`s disease or dementia with Lewy bodies, and most of these focus on short- term interventions under the care of dedicated physiotherapists or other healthcare providers. When one is motor or cognitively impaired, it becomes more difficult to move. We therefore urgently need to redefine when and how to implement physical activity interventions. Executive functions (which help us plan tasks, organize, make decisions and control our behavior) are impaired early on when people act out dreams at night. Therefore, people with REM sleep behavior disorder are a very appropriate target group to study how lifestyle affects cognitive function. People with isolated REM sleep behavior disorder can use a cell phone app to promote their physical activity in everyday life and overcome limitations. This enables them to change their lifestyle in the long term and do more. We are conducting a study with more than 250 people with REM sleep behavior disorder. The study will run for one year. We are testing an app that is designed to improve cognitive abilities. To do this, we are testing the cognitive function of the participants remotely and examining imaging and blood- based markers of brain ageing. We are also testing the app, which combines the game principle with health, on healthy older people without risk characteristics for accelerated brain ageing. The study aims to show how more exercise has a positive effect on the brain and whether our approach is suitable for all people.