Exercise and Gotu Kola Extract to Ameliorate Tumor Necrosis Factor - Alpha, Quality of Life, and Executive Function in Cognitive Impairment Women

Increasing tumor necrosis factor-alpha (TNF-alpha) and decreasing quality of life (QoL) are associated with cognitive deterioration.Exercise and Gotu kola (Centella Asiatica) can improve memory and antiinflammation, but their combination has not yet been revealed.This study aimed to see how exercise and Gotu kola extract affected TNF-alpha, quality of life, and executive functions in women with cognitive impairment.This study used an experimental design with a control group with a 12-week pre and post-test in women with cognitive impairment.The Montreal Cognitive Assessment (MoCA) was used to screen for cognitive impairment.The participants in the study were 64 women with a mean age of 53.3 (4.8) years.The subjects were divided into four groups: Gotu kola/GK extract capsule (1x500 mg/day), exercises (2x75 minutes per week), a GK-exercise combination, and the control group.The WHO-QoL questionnaire was used to assess the quality of life.The Trail Making Test-B (TMT-B) was used to assess executive functions.The study found that Gotu kola might increase QoL in the physical domain (p=0.028)and environmental domain (p=0.016).Exercise and a GK-exercise combination could improve QoL: physical, psychological, social, and environmental domain (p<0.05).According to the Mann-Whitney test, the GK-exercise combination was the most helpful in enhancing TNF-alpha (Δ=-10.5;p=0.003),MoCA (∆= 4.6; p=<0.001), and TMT-B (Δ=-21.4;p=0.023).Discussion: Physical activity is one of the factors that can play a role in cognitive function through several mechanisms.To conclude, exercise, Gotu Kola, and their combination can effectively decrease inflammation and increase the quality of life and cognitive function in women with cognitive impairment.This study expected that exercise and Gotu Kola could be priority interventions in treating cognitive impairment.