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A randomized trial of 253 breast cancer survivors found that a remotely coached exercise program was associated with greater improvements in attention than a health and wellness program. Memory improved more in the exercise group at six months, but the difference was not sustained at 12 months; a companion analysis found slower epigenetic aging markers in a subset of participants.
A 12-month exercise program was associated with greater improvements in attention among breast cancer survivors than a health and wellness program in a randomized trial of 253 participants, researchers reported Sept. 30 in the Journal of the National Cancer Institute. A companion analysis of blood samples from a subset also found slower epigenetic aging markers in the exercise group, though the studies do not establish that exercise caused the cognitive changes.
The trial enrolled survivors who had completed active treatment and reported both low physical activity and cognitive difficulties. Participants were randomly assigned either to a remotely delivered exercise program or to a health and wellness program. Both groups had regular contact with a health coach, but only the exercise group received coaching on physical activity. Participants in that group used fitness trackers and received individualized support to work toward 150 minutes of moderate-to-vigorous activity per week. They increased their activity more than participants in the comparison group.
Researchers found no significant difference between groups on the trial’s two primary outcomes: processing speed and self-reported cognition. The exercise group had greater improvements in attention at six and 12 months. It also showed a greater improvement in memory at six months, but that difference was not maintained at 12 months. The groups did not differ significantly in executive function. Both groups improved on all cognitive measures during the study.
The companion study analyzed blood samples from a randomly selected subset of 124 participants, collected at the start and at six- and 12-month follow-ups. Using two epigenetic clocks—tools that estimate biological age from DNA methylation patterns—the researchers found slower rates of epigenetic aging in the exercise group over the study period. At the start, participants’ estimated epigenetic ages averaged about 8.7 years older than their chronological ages. Over 12 months, the comparison group showed nearly 10 months of epigenetic aging markers, while the exercise group showed about one month, according to the report.
Attention Gains During Recovery
Cognitive difficulties after breast cancer treatment can affect everyday tasks, including following conversations, taking in information and completing work. The report says about one in three survivors experience such problems, which can involve attention, memory and processing speed and may persist after treatment. The trial’s attention results point to a possible way to support an aspect of thinking that matters in daily life.
The findings may interest survivors and clinicians because participants worked toward a practical activity target with remote coaching. However, the study does not show that exercise will improve cognition for every survivor, and it did not find a significant advantage on its primary outcomes. The companion aging results are biological markers, not proof that participants’ overall health or brain function aged more slowly.
How the Trial Was Set Up
The two studies came from the same randomized clinical trial, designed to test whether increasing physical activity could improve cognitive health after breast cancer treatment. The comparison program provided regular health coach contact without exercise coaching, allowing the researchers to compare the exercise program with a supported wellness program rather than with no contact.
Researchers say cognitive problems can arise from a combination of treatment effects, inflammation, hormonal changes, fatigue and stress. The study focused on survivors who already reported cognitive difficulties and low activity, so its results may not apply in the same way to all people treated for breast cancer.
“Attention is central to our everyday activities. It helps us follow conversations, absorb information and complete tasks without making errors.”
— Sheri Hartman, lead author and professor at UC San Diego
Limits of the Current Evidence
The trial found no significant group differences in processing speed, self-reported cognition or executive function, and the memory advantage observed at six months was absent at 12 months. Because both groups improved on cognitive measures, the results do not show that exercise alone accounts for all observed changes.
The companion study found an association between exercise assignment and slower epigenetic aging markers, but it does not establish that these changes directly caused the attention findings. The blood analysis included a subset of the trial, and the researchers say larger studies are needed to confirm the results and determine whether the biological changes contribute to cognitive benefits. The report does not establish which survivors are most likely to benefit or what activity level may sustain improvements over time.
Larger Studies to Test Benefits
The researchers say future studies should test the findings in larger groups, examine whether epigenetic aging changes directly contribute to cognitive outcomes, and track whether attention and memory improvements can be sustained. They also aim to identify who benefits most and how much activity may be needed. No further trial dates or milestones were specified in the report.
Key Questions
Did exercise improve every cognitive measure in the trial?
No. The exercise group improved more in attention at six and 12 months and in memory at six months. The memory difference was not sustained at 12 months, and researchers found no significant group differences in processing speed, self-reported cognition or executive function.
How many people took part?
The randomized trial included 253 breast cancer survivors. The companion blood-sample analysis included a randomly selected subset of 124 participants.
What exercise goal did participants receive?
The remotely coached program helped participants work toward 150 minutes of moderate-to-vigorous physical activity per week, using fitness trackers and individualized coaching.
Does the study prove exercise slows biological aging?
No. The companion study found slower changes in epigenetic aging markers in the exercise group over 12 months. Researchers say more work is needed to confirm the findings and determine how those markers relate to cognitive benefits.
Source: rss
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