None listed
Conditions
Brief summary
Evidence is now emerging to suggest that lifestyle factors, namely physical activity and cognitive stimulation could provide a cost-effective and relatively simple means of protecting the brain against age-related cognitive decline and dementia. This hypothesis can generally be described as a “use it or lose it” philosophy. However, it is unclear which forms, intensity and frequency of physical activity provide the most benefit. Similarly, the optimal level and form of cognitive stimulation remains to be determined. To date, very few intervention studies have demonstrated improvement through standardized tests of memory and cognition (neuropsychological tests) and none have used blood biomarkers as part of the assessment criteria. Therefore, this study is specifically designed to determine whether a home-based lifestyle intervention program, involving physical activity or cognitive stimulation alone, or in combination, can provide measurable improvements in cognition and AD-related blood biomarkers amongst the healthy, community-dwelling elderly. 200 male and female participants aged 60 to 85 will be recruited into 4 intervention groups: physical activity alone, cognitive stimulation alone, physical activity and cognitive stimulation combined or a control group. The intervention period for all of the groups will last for 16 weeks. Participants will be monitored closely throughout the intervention period and assessed at baseline (pre-intervention), during the intervention at 8 weeks and at 2 post-intervention time-points (16 and 52 weeks). The assessment criteria include a battery of neuropsychological and clinical tests and measurement of AD-related blood biomarkers. 20% of participants will undergo a brain imaging scan and body composition analysis to assess the effect of the intervention on brain activity and changes in fat and lean body mass. This project will provide greater insight into the mechanisms underlying the protective effect of physical activity and cognitive stimulation on brain function. The project will also directly assess and compare the efficacy of home-based intervention strategies on a wide range of parameters. Should the interventions prove successful, this study could then be expanded to include a greater number of participants and assess multiple strategies with the ultimate aim being the development of a public health strategy for the prevention/delay of cognitive decline.
Interventions
Arm 1 - Physical Activity - walking for 3 days a week for 60 minutes for 16 weeks; resistance training using ankle weights and gymsticks for 40-60 minutes per day for 2 days a week for 16 weeks. Training provided by exercise physiologists in the 60 minute group specific monthly meetings and at the time of their personal physical fitness assessment. The participants then performed these activities on their own at home.
As walking was considered to be the main component of exercise, a pedometer
Arm 1 - Physical Activity - walking for 3 days a week for 60 minutes for 16 weeks; resistance training using ankle weights and gymsticks for 40-60 minutes per day for 2 days a week for 16 weeks. Training provided by exercise physiologists in the 60 minute group specific monthly meetings and at the time of their personal physical fitness assessment. The participants then performed these activities on their own at home. As walking was considered to be the main component of exercise, a pedometer was given to each subject to record number of steps during the intervention period. Moreover, the Borg's scale was used to measure the level of perceived exertion for each participant. The intervention group recorded the Borg's scale in their daily logbooks as well as was assessed during their physical fitness assessments. Thus participants were advised in the 60-minute monthly group meeting for 4 months to gradually increase their activities based on the level of their perceived excretion. This gradual increase was recorded by exercise physiologist in the log book for the next four weeks at every monthly group meeting for each participant. Similar procedure of gradual increment from baseline was followed for resistance training exercises which was assessed using 1 Repetition Maximum (1RM). Arm 2 - Cognitive Stimulation - auditory and visual stimulation using computerized software programs - 60 minutes for 5 days a week for 16 weeks. The Brain fitness Program (Posit Science, USA) for auditory stimulation and the Insight program (Posit Science, USA) for visual stimulation was used for training. Half of the participants started with the auditory program for the first 8 weeks followed by the visual training program for the last 8 weeks and vice versa for the remaining participants in the group. Training and problem solving occurred in the 60 minute group specific monthly meetings for 4 months. The participants installed the software's and performed these exercises on their personal computers at home. Arm 3 - Combination of Arm 1 and Arm 2 Printed instructions handouts were given to all intervention groups explaining their respective physical/mental exercises. All the participants were monitored for their adherence in fortnightly phone calls, monthly group meetings and log books that recorded the intervention activities as well as routine lifestyle physical and mental activities for 16 weeks.
Sponsors
McCusker Alzheimer's Research Foundation
Study design
Allocation
Non-randomised trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
60 Years to 85 Years
Healthy volunteers
Yes
Inclusion criteria
1. Mini Mental State Examination (MMSE) greater than or equal to 24. 2. Personal physician fitness certificate stating that the participant is fit to take part in a home based physical exercise intervention program.
Exclusion criteria
1. Diagnosis of any type of dementia including AD. 2. Uncontrolled medical condition–physical or mental that could lead to difficulty complying with the protocol including history of myocardial infarction, unstable or severe cardiovascular disease including angina or congestive heart failure, schizophrenia, bipolar disorder, anxiety neurosis or depression. 3. Arthritis causing any disability or restricted movements.
Outcome results
None listed