Fallers, Mild Cognitive Impairment
Conditions
Keywords
Biomarker, Cognitive impairment, Gait abnormality, Older Adults, Exercise
Brief summary
The effectiveness of conventional exercise, tai chi chuan and health education/usual physical activity over a 6-month intervention period in improving primary outcomes and secondary outcomes in older mild cognitive impairment adults will be compared. Third, whether changes in serum levels of the brain-derived neurotrophic factor (BDNF), insulin-like growth factor (IGF)-1, and vascular endothelial growth factor (VEGF) and expression of the apolipoprotein E (APOE) ε4 allele parallel changes in gait characteristics and cognitive functions after the intervention will be examined.
Interventions
BEHAVIORALExercise
Each session will last 60 min, consisting of 10 min of warm-up, 45 min of exercise, and a 5-min cool-down.
Sponsors
National Health Research Institutes, Taiwan
Taipei Medical University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Intervention model description
A pragmatic, single-blinded, randomized controlled trial with three arms will be conducted to investigate the effectiveness of conventional exercise and tai chi chuan, compared to health education/usual physical activity.
Eligibility
Sex/Gender
ALL
Age
65 Years to 100 Years
Healthy volunteers
Yes
Inclusion criteria
* At least 65 years old * Had an emergency department visit due to a fall at least 3 months prior to the baseline assessment (assuming a full recovery time from a fall to be 3 months) * Can ambulate independently * Has mild cognitive impairment
Exclusion criteria
* Do not live in a community setting * Cannot ambulate independently and communicate with researchers * Have a major unstable cardiopulmonary disease (e.g., ischemic chest pain, shortness of breath, recurrent syncopal episodes, orthopnea, paroxysmal nocturnal dyspnea, palpitations, or tachycardia) * Have a contraindication to physical exercise (e.g., severe osteoarthritis or severe pulmonary hypertension)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Gait characteristics | 12 months | Performance on six gait characteristics (velocity, cadence, stride length, swing time, stride length variability, and swing time variability) will be measured with a 6-m electronic walkway of GAITRite. |
| Global cognition | 12 months | Global cognition will be assessed using the Mini-Mental State Examination (MMSE). The MMSE comprises 11 questions, and the score ranges 0\ 30, with lower scores indicating poorer global cognition. |
| Serum levels of BDNF | 12 months | Serum BDNF concentrations will be assessed. |
| Serum levels of IGF-1 | 12 months | Serum IGF-1 concentrations will be assessed. |
| Serum levels of VEGF | 12 months | Serum VEGF concentrations will be assessed. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Tinetti balance | 12 months | The Tinetti balance score ranges 0\ 26, with a higher score indicating a better balance ability. |
| Fear of falling | 12 months | Fear of falling will be assessed using the Falls Efficacy Scale (FES) test. |
| Mobility | 12 months | The timed up and go test requires subjects to rise from a standard chair, walk a distance of 3 m, turn, walk back to the chair, and sit down. The time to complete the timed up and go will be recorded. |
| Muscle strength | 12 months | Grip strength will be assessed via a handgrip dynamometer and measured in kilograms of isometric force. |
| Falls | 12 months | number of falls and multiple falls |
| Depressive symptoms | 12 months | Depressive symptoms will be assessed using the 15-item Geriatric Depression Scale (GDS). |
Countries
Taiwan
Contacts
Primary ContactMau-Roung Lin, Professor
Outcome results
None listed