Cognition and Neuroplasticity Sedentary Adults After 8 Weeks of Aerobic Exercise

The investigators will quantify cognitive improvements following moderate to high intensity
aerobic exercise intervention (participant will choose between treadmill, elliptical or
stationary bike). Each participant will engage in 60 minute daily sessions delivered 3
times/week for 8 consecutive weeks (a total of 24 sessions). The investigators will determine
the relationship between cognitive improvements and TMS neuroplasticity. The cognitive
domains explored will be: 1) Visuomotor processing speed and cognitive flexibility/task
switching; 2) Response inhibition, mental flexibility, and attentional control; 3) Attention
and working memory; 4) List Learning and Memory; and 5) Semantic Verbal Fluency. The
investigators will also explore the effect modification of BDNF levels and BDNF allelic
status, and APOE4 status on cognitive response after exercise.

Inclusion Criteria:

- age ≥ 55years

- no clinically detectable cognitive impairment (MoCA score ≥ 26 and Clinical Dementia
Rating (CDR) score of 0)

- low activity level (individuals who do not engage in regular exercise, or currently
exercise once a week or less)

- primary language is English

Exclusion Criteria:

- any unstable medical condition (i.e.: uncontrolled hypertension or uncontrolled
diabetes)

- medical contraindication to physical exercise

- contraindication to TMS Neuroplasticity testing, as per the TMS Safety Guidelines.13

- History of fainting spells of unknown or undetermined etiology that might constitute
seizures

- History of seizures, diagnosis of epilepsy, history of abnormal (epileptiform) EEG or
family history of treatment resistant epilepsy

- Any current history of a psychiatric illness

- No medication is an absolute exclusion from TMS. Medications will be reviewed by the
Principal Investigator and a decision about inclusion will be made based on the
following:

- The subject's past medical history, drug dose, history of recent medication changes or
duration of treatment, and combination with other Central Nervous System (CNS) active
drugs.

- The published TMS guidelines review medications to be considered with TMS.

- Any metal in the brain, skull or elsewhere unless approved by the responsible MD

- Any medical devices (i.e. Cardiac pacemaker, deep brain stimulator, medication
infusion pump, cochlear implant, vagal nerve stimulator)

- Intracranial lesion

- Substance abuse or dependence within the past six months

- Pregnant women

- Vulnerable populations such as prisoner's

- People unable to consent themselves

- Subjects who, in the Investigator's opinion might not be suitable for the study