The increasing interest in its therapeutic potential of hypoxia conditions has caused a debate about its most beneficial regimes. In this respect, the method of intermittent hypoxic-hyperoxic training (IHHT) was applied. It is hypothesized that, by replacing the normoxic time intervals with hyperoxic exposures (e.g., 30-40% oxygen), IHHT could achieve more beneficial effects compared to IHT. Despite promising findings that support these hypothesis16, 22, only a few studies have evaluated the therapeutic effects of IHHT in patients with cognitive impairments such as dementia. Bayer et al.23 have shown that up to six weeks of IHHT augments the effects of an multimodal training intervention in patients with mild to moderate dementia in terms of improvements in cognitive function and endurance performance. In a further pilot study by Serebrovska et al.24, the authors could demonstrate that three weeks of IHHT influence cognitive functions positively and thus might delay the manifestation of dementia-related biomarkers (amyloid beta) in patients with mild cognitive impairments (i.e. pre dementia status). However, a recent study has shown that adding IHHT to a multimodal training intervention did not provide additional improvements in geriatric patients.25 Hence, due to the limited and inconsistence evidence on the therapeutic effects of IHHT in patients with dementia and/or mild cognitive impairments, further investigations are warranted to validate the above-mentioned neuroprotective effects.
Under this context, our planned investigation is designed to study the utility of IHHT as an efficient non-pharmacological therapy to improve cognitive performance, physical functioning, socio-emotional parameters and to reduce cardiovascular and metabolic risk factors in patients with mild to moderate dementia.