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A randomized trial of 253 breast cancer survivors found greater improvements in attention among participants in a remotely coached exercise program than in a health and wellness program. Memory improved more in the exercise group at six months, but the difference was not present at 12 months; the trial found no significant group differences in its primary outcomes of processing speed and self-reported cognition.
Two studies published September 30 in the Journal of the National Cancer Institute report that a 12-month exercise program was associated with greater improvements in attention among breast cancer survivors, and with slower changes in markers of epigenetic aging. The randomized trial found no significant difference between the exercise and comparison groups in its two primary cognitive outcomes, processing speed and self-reported cognition; the findings do not establish that exercise caused the observed changes.
The trial enrolled 253 breast cancer survivors who had completed active treatment, reported low physical activity and experienced cognitive difficulties. Researchers randomly assigned participants to a remotely delivered exercise program or a health and wellness program. Both groups had regular contact with a health coach, but only the exercise group received coaching to increase activity. Participants in that group used fitness trackers and received individualized support toward a goal of 150 minutes of moderate-to-vigorous activity per week.
The exercise group increased its activity more than the comparison group. Both groups improved on all cognitive measures. Researchers found greater improvement in attention at six and 12 months in the exercise group. The exercise group also improved more in memory at six months, but that difference was no longer present at 12 months. There was no significant group difference in executive function, processing speed or self-reported cognition.
A companion analysis examined 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, researchers found slower changes in aging markers over the study period in the exercise group. The report said the comparison group showed nearly 10 months of epigenetic aging markers over the 12-month period, compared with about one month in the exercise group. These clocks estimate biological age from DNA methylation patterns; they do not measure chronological age.
Attention Gains and Daily Tasks
Attention helps people follow conversations, take in information and complete tasks. The study’s lead author, Sheri Hartman of UC San Diego, said sustained improvements in attention were encouraging, particularly because participants achieved them with a modest increase in activity. The findings may matter to survivors who report thinking difficulties after treatment, but the trial does not show that every survivor will benefit or that exercise will resolve cognitive symptoms.
The companion study adds a possible biological clue: participants with faster epigenetic aging across both groups tended to show less improvement in attention and worse self-reported cognition. That association does not show that epigenetic aging caused cognitive changes, or that slowing those markers produced the attention gains. The results point to questions for further research rather than a confirmed explanation for how exercise may affect thinking after cancer treatment.
A Trial After Active Treatment
Cognitive difficulties after breast cancer can involve attention, memory, processing speed and other aspects of thinking. The source report says researchers believe these problems may reflect a combination of treatment effects, inflammation, hormonal changes, fatigue and stress. Symptoms can persist after treatment and affect daily activities and quality of life. The trial focused on survivors who had completed active treatment and themselves reported both low activity and cognitive difficulties.
The comparison group received regular health coach contact through a wellness program, which allowed researchers to compare the exercise intervention with a program that also offered support. The studies came from the same randomized clinical trial, but the epigenetic analysis used only a subset of participants who provided blood samples. The reported results cover 12 months; they do not establish whether any cognitive differences last longer.
“Attention is central to our everyday activities. It helps us follow conversations, absorb information and complete tasks without making errors, so the sustained improvements we saw in this trial is particularly encouraging.”
— Sheri Hartman, lead author and UC San Diego professor
Questions Beyond Twelve Months
The studies do not establish whether exercise caused the attention gains or the slower changes in epigenetic aging markers. Nor do they show that changes in those markers directly explain any cognitive benefit. The memory difference observed at six months was not maintained at 12 months, and the trial found no significant differences between groups on its two primary outcomes.
The researchers say larger studies are needed to confirm the findings and clarify who may benefit, how much activity may be needed and whether effects persist. The source report does not provide longer-term follow-up, results beyond the participant groups described, or evidence that the program changes clinical care.
Larger Studies to Test Results
The researchers say further studies should test whether the findings hold in larger groups and whether epigenetic changes contribute directly to cognitive outcomes. They also plan to investigate which survivors are most likely to benefit and what level of activity may support lasting improvements. Until those questions are answered, the reported results describe outcomes in this trial over one year, not a guaranteed effect for individual survivors.
Key Questions
What did the exercise trial find?
Among 253 breast cancer survivors, those assigned to a remotely coached exercise program had greater improvements in attention at six and 12 months than participants in a health and wellness program. The trial found no significant group difference in processing speed or self-reported cognition.
Did exercise improve memory?
The exercise group improved more in memory at six months, but the difference was not maintained at 12 months. At that point, memory improvement was the same as in the comparison group.
What did the epigenetic study measure?
Researchers used two epigenetic clocks to estimate biological age from DNA methylation patterns in blood samples from 124 participants. The clocks measure aging markers, not the number of years a person has lived.
Do the findings prove exercise caused the changes?
No. The studies report differences associated with the exercise program, but they do not establish that exercise caused the cognitive or epigenetic changes, or that the aging markers directly produced cognitive effects.
What research is still needed?
The researchers say larger studies are needed to confirm the findings, assess how long any changes last, identify who is most likely to benefit and clarify the amount of activity involved.
Source: rss
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