Effects of Exercise on Urinary AD7c-NTP (Alzheimer-Associated Neuronal Thread Protein) Levels and Cognitive Function Among Active Korean Elderly: A Randomized Controlled Trial

J Alzheimers Dis. 2024;99(1):345-362. doi: 10.3233/JAD-230946.


Background: Alzheimer-associated neuronal thread protein (AD7c-NTP) has been demonstrated to have high diagnostic accuracy in differentiating Alzheimer's disease (AD) patients from healthy individuals. However, it is yet unclear whether exercise can lower the level of AD7c-NTP in urine among active Korean elderly.

Objective: To assess the effect of exercise on AD7c-ntp levels in urine and cognitive function among active Korean elderly.

Methods: In total, 40 Korean elderly (≥65 years) were divided into Active Control group (CG, n = 10), Aerobic exercise group (AG, n = 18), and combined Resistance/Aerobic exercise group (RAG, n = 12). A total of 12 weeks of exercise intervention was implemented. At week 0 and 12, cognitive performance (Korean Mini-Mental State Examination, Korean-Color Word Stroop test), grip strength, and body composition (muscle mass and body fat percentage) were measured. Also, a morning urine sample was obtained from each subject. The level of AD7c-NTP was measured using competitive enzyme-linked immunosorbent assay (ELISA).

Results: After 12 weeks of exercise intervention, there was a significant difference of AD7c-NTP levels between RAG and CG (p = 0.026), AG and CG (p = 0.032), respectively. Furthermore, the AD7c-NTP levels in urine showed negative correlation with K-MMSE scores (r = -0.390, p = 0.013) and grip strength (r = -0.376, p = 0.017), among all participants after exercise intervention.

Conclusions: This is the first study to investigate urine biomarker through exercise intervention. In future stuides, participants who have low cognitive function and low activity levels need to be recruited to observe more significant 'Exercise' effect.

Keywords: AD7C-NTP; Alzheimer’s disease; cognitive function; exercise; urine biomarker.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Alzheimer Disease / diagnosis
  • Alzheimer Disease / urine
  • Biomarkers / urine
  • Cognition* / physiology
  • Exercise Therapy / methods
  • Exercise* / physiology
  • Female
  • Humans
  • Male
  • Nerve Tissue Proteins / urine
  • Neuropsychological Tests
  • Republic of Korea


  • AD7c-NTP protein, human
  • Nerve Tissue Proteins
  • Biomarkers