Protecting the Brain From Post-Stroke Cognitive Impairment and Dementia With Multimodal Exercise Training

The rates of cognitive decline and dementia after stroke are disproportionately high. Strategies that can protect the brain early after the stroke event could reduce the future risk of cognitive decline and dementia in these patients. Although physical exercise is usually recommended after stroke, there is very little information about the protective effect of exercise implemented in early stages of recovery as a potential protective measure against cognitive decline and dementia risk in these patients. This study will investigate the effect of a multimodal exercise intervention implemented early after the stroke event on cognition and on a selected group of markers that can predict cognitive decline and dementia risk.

Inclusion Criteria: * medically stable * have had a first-ever ischemic/hemorrhagic stroke confirmed by MRI/CT 0-6 months prior to participation. * Able to independently walk at least 10 meters (assistive devices permitted) and capable of following instructions will be required. Exclusion Criteria: * Diagnosed with dementia * Medications that impact cognition * Absolute contraindications to exercise or MRI scanning * Significant disability (modified Rankin score \>3) * Participants will be excluded if they have been engaged in a structured exercise training program outside their regular in/out-patient hospital rehabilitation since suffering the stroke. * Co-morbidities that preclude exercise participation, pain worsened with exercise, and communication (e.g., severe aphasia) or behavioral issues limiting safe participation will also be reasons for exclusion.