None listed
Conditions
Brief summary
AIM: The aim of this randomised controlled study is to investigate the impact, in older adults, of a novel aquatic exercise intervention which optimises the haemodynamic stimulus responsible for improvement in brain blood flow and function. HYPOTHESES: 1. A land-based walking program will improve brain blood flow and function in elderly subjects (>50yrs), relative to a matched but non-trained control group. 2. Water-based walking, involving elevated responses to the circulation when training in water will improve brain blood flow and function to a greater degree than land-walking. 3. Improvement in brain blood flow measures will be significantly related to changes in cognition, memory and clinical measures. RESEARCH DESIGN: The study is a randomised, single-blind controlled trial. METHODS: One hundred fifty healthy, insufficiently active individuals, aged 50 years and older, with subjective memory complaints will be recruited from the community. Participants will be randomised to either a land-based, water-based or non-exercise training group. The exercise groups will attend centre-based exercise sessions 3 times a week for 6 months. The control group will maintain their usual lifestyle and attend 4, one hour centre-based healthy ageing education sessions over the 6 months. Primary and secondary outcome measures will be assessed at baseline, 6 and 12 months. In addition the primary outcomes brain blood flow and peripheral vascular function will be assessed at week 12 during the 6-month exercise training period.
Interventions
Group 1: Land-based exercise training.
Participants will attend a centre-based program 3 times weekly for 1hour. Supervised land-based walking will be undertaken in surrounding parkland or on treadmills in a laboratory or gymnasium. Initial exercise intensity will be set individually according to results of a preliminary exercise test (i.e. 55-65%VO2peak) and regular measures of intensity (heart rate (HR) using a HR monitor and Rate of Perceived Exertion (RPE, Borg Scale) will be collected and
Group 1: Land-based exercise training. Participants will attend a centre-based program 3 times weekly for 1hour. Supervised land-based walking will be undertaken in surrounding parkland or on treadmills in a laboratory or gymnasium. Initial exercise intensity will be set individually according to results of a preliminary exercise test (i.e. 55-65%VO2peak) and regular measures of intensity (heart rate (HR) using a HR monitor and Rate of Perceived Exertion (RPE, Borg Scale) will be collected and recorded during each session to ensure compliance. Exercise intensity will be progressed throughout the 6-month program. Group 2: Water-based exercise training. Participants will attend a centre-based program 3 times weekly for 1hour per visit, and will participate in a water-walking program undertaken in a shallow heated 30x25m pool. The intensity of each session (55-65%VO2peak) will be matched to that undertaken by Group 1 using comparative oxygen uptake assessment as well as HR monitoring. The exercise-training program will be similarly progressed over the 6-month period.
Sponsors
University of Western Australia
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
50 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Healthy men Healthy post-menopausal women, (stable HRT included) Aged 50 years and over Memory complainer Inactive lifestyle (equal or less than 60 minutes/week moderate intensity exercise for at least 3 months) Non-smoker for at least 12 months Available for 12 –15 month duration Prepared to participate in an centre-based exercise program; complete 150 minutes of moderate physical activity per week (3x50 minutes/week). Systolic BP less than 160mmHg or Diastolic BP less than 100mmHg. (blood pressure lowering medication if on stable therapy medications and if the blood pressure is within the criteria) total cholesterol less than or equal to 7mmol/L (cholesterol lowering medication if on stable therapy)
Exclusion criteria
No medical details from General Practitioner (GP) Smoker (smoked in the last 12 months) Systolic BP greater than 160mmHg or Diastolic BP greater than 100mmHg Total cholesterol greater than 7mmol/L weekly alcohol intake greater than 280gm/week and/or drinking more than 40gms ethanol in one session? greater than 60 minutes/week of regular moderate (or higher) intensity exercise per week BMI greater than 40 kg/m2 Modified Telephone Interview Cognitive Status (Tics-M) less than 32 Geriatric Depression Scale- (GDS) greater than 6 Standardised Mini-Mental State Examination (sMMSE) - score less than 24 Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) greater than 1.5 SD below the age-related means for delayed memory index Diagnosis of mild cognitive impairment, dementia or Alzheimer’s disease Psychiatric medications such as cognitive enhancers or anti-epileptics, lithium Intermittent use of NSAIDS (non-steroidal anti-inflammatory drugs) not able to meet the requirement of moderate physical activity. Not confident of exercising in chest deep water Present or past history of : - ischemic heart disease (myocardial infarction, coronary artery disease) - angina - intermittent claudication - stroke - diabetes mellitus - persistent or frequent arrhythmias - atrial fibrillation (chronic and on warfarin) - regular medication for asthma or chronic obstructive airways disease - epilepsy/epilepsy medication - severe mental illness (anxiety, psychosis, schizophrenia) - liver disease - kidney disease - any joint, muscular or spinal disorders including arthritis that prohibits moderate exercise. - other serious illness medical conditions likely to compromise survival (cancer) Possible hospital admission or period of treatment/rehabilitation, in the next 6 months Not able to communicate in English. Simultaneous participation in another research study
Outcome results
None listed