Abstract INTRODUCTION It is unknown whether progressive resistance training (PRT) improves cognitive function in adults with cerebral small vessel disease and mild cognitive impairment (i.e., subcortical vascular cognitive impairment SVCI). METHODS We conducted a 12‐month randomized trial comparing PRT versus balance and tone exercises (BAT) on the Alzheimer's Disease Assessment Scale Cognitive Plus (ADAS‐Cog‐Plus). RESULTS Ninety‐one participants were randomized (PRT = 45; BAT = 46); 76 completed the trial. Adherence was not different between groups ( p = 0.18). At 12 months, PRT significantly improved ADAS‐Cog‐Plus scores (estimated mean difference: −0.18; 95% confidence interval CI: −0.35, −0.01; p = 0.04). Planned contrasts stratified by sex showed a significant PRT effect on ADAS‐Cog‐Plus scores for females (mean difference: −0.27; 95% CI: −0.49, −0.05; p = 0.02), but not for males. PRT also significantly reduced C‐reactive protein (estimated mean difference: −2.93; 95% CI: −5.36, −0.49; p = 0.02). No significant differences were observed for other secondary outcomes. DISCUSSION PRT may have a small beneficial effect on cognitive function in SVCI. CLINICAL TRIAL REGISTRATION This trial was registered with ClinicalTrials.gov (NCT02669394).
Liu‐Ambrose et al. (2026) studied this question.