Acute and chronic effects of exercise training on cognitive interference and health-related quality of life in patients with coronary artery disease

Abstract Background Patients with coronary artery disease (CAD) are at increased risk of cognitive decline, particularly in executive functions such as inhibitory control (1), and frequently report reduced health-related quality of life (2). Although current evidence is limited, emerging findings suggest that exercise-based cardiac rehabilitation is an effective non-pharmacological strategy with the potential to prevent cognitive decline, demonstrating acute and long-term benefits for cognitive function (3) as well as consistent improvements in quality of life (4). However, the acute and chronic effects of exercise on inhibitory control and quality of life in CAD remain poorly understood. Purpose To determine the acute and chronic impact of exercise training on cognitive interference and patient-reported quality of life in patients with coronary artery disease. Methods Twenty-four patients with CAD completed a cardiopulmonary exercise test (CPET) at baseline, and after 12-weeks program of aerobic exercise (post-intervention). Cognitive interference was assessed using a digital version of the Stroop test (5) administered immediately before and 15 min after each CPET to evaluate both acute (pre–post CPET) and chronic (baseline–post- intervention) effects. Health-related QoL was measured at the same time points using the MacNew questionnaire (6). Normality was assessed using the Shapiro–Wilk test. Acute and chronic changes in Stroop performance were analysed using repeated-measures ANOVA. Mean differences (MD) and 95% confidence intervals (95% CI) and effect size (η²p) were reported. As McNew scores were non-parametric, pre–post differences were analysed with the Friedman test, reporting Kendall’s W as effect size. Results Acute exercise elicited significant improvements across all Stroop conditions. Reaction times decreased in the congruent (MD = 104.3 ms; 95% CI 78.2, 130.5; p .001; η²p =.748), neutral (MD = 39.7 ms; 95% CI 0.7, 78.8; p = .046; η²p =.162), and incongruent conditions (MD = 142 ms; 95% CI 85.6, 198.3; p .001; η²p =.578), the latter showing the greatest improvement. Over 12 weeks, no significant baseline–post-intervention changes were observed in the congruent or neutral conditions. The incongruent condition showed a trend toward improved performance (chronic effect p = .162; MD = 42.21 ms; 95% CI –31.2, 115.6; η²p =.083). All MacNew dimensions demonstrated improvements after exercise program: emotional (p = .001; W =.524), physical (p = .001; W =.327), and social (p = .001; W =.614). Conclusions Acute exercise produced immediate enhancements in cognitive performance, most notably in cognitive interference. Although chronic effects on Stroop outcomes were modest, a trend toward reduced interference emerged over the 12-week program. All QoL dimensions improved after exercise program. Overall, aerobic exercise appears to confer immediate cognitive benefits and meaningful improvements in well-being in patients with CAD.