Aging, Cognitive Decline, Elderly, Intervention Study, Physical Decline
Conditions
Keywords
Cognition, Physical Activity, Biological Aging, Intervention, Neuroscience, MRI, EEG, Biological Markers, Cost-benefit Analysis, Age-related Decline, Depression, Anxiety
Brief summary
Recent studies have shown promising cognitive and physical interventions aimed at slowing down ageing-related declines in quality of life, but they lack strong ecological validity (brief durations, unrealistic goals, no real-world application) and has yet to show robust evidence that such interventions are stable and suitable in the long-term. The investigators aim to examine whether these interventions can, over four years, significantly slow down the normal rate of ageing-related decline.
Detailed description
This is a longitudinal, controlled, cohort study. The overarching aim in this intervention study is three-fold: (1) to test hypotheses derived from ageing-related theories, (2) to provide robust measurable evidence both in the long-term and validate meaningful interventions, and (3) provide quantifiable cost-benefit ratio to suggested solutions. A cohort of Malaysian older adults will be recruited and assigned to one of the groups, either cognitive stimulation, physical activity, combined cognitive stimulation and physical activity, or non-intervention control.
Interventions
BEHAVIORALCognitive stimulation
The cognitive stimulation will comprise of psychoeducation, videogaming, book club and technology training workshop sessions. Participants will take part in weekly sessions that are an hour long each. For every six months, the participants will alternate between psychoeducation, videogaming, book club and technology training workshop sessions.
BEHAVIORALPhysical activity
The physical activity intervention will comprise of walking, Zumba, resistance exercise and aerobics sessions. Participants will take part in weekly sessions that are an hour long each. For every six months, the participants will alternate between walking, Zumba, resistance exercise and aerobics sessions until the end of intervention period.
Sponsors
Sunway University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
A cohort of older Malaysian adults will be recruited and assigned to one of the groups, either cognitive stimulation, physical activity, combined cognitive stimulation and physical activity, or non-intervention control.
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Malaysian older adults aged 60 and above who fulfil the following criteria will be recruited: Inclusion Criteria: * Healthy and this includes those seeking regular medical attention, * Have some form of mobility (ability to walk short distances at least 3m), * Able to communicate in at least one of the following languages: English, Malay, Mandarin, Tamil.
Exclusion criteria
* Older adults with a history of stroke, * Diagnosis of neurodegenerative diseases (such as Alzheimer's disease or Parkinson's) or psychiatric disorders, * Uncorrected auditory and/or visual impairments, * Currently on psychiatric medications, * Immobile, * Require full-time caregiver assistance, * With comprehension impediments from the assessment portion of this project, * A Montreal Cognitive Assessment (MoCA) score of \<13.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in cognitive scores | 4 years | Changes in cognitive scores will be evaluated using Montreal Cognitive Assessment (MoCA). Possible scores range from 0-30. Higher scores indicate less cognitive impairment. |
| Changes in electroencephalogram (EEG) | 4 years | Onset of neural responses to errors in the Go/No Go task will be evaluated using EEG. |
| Changes in structural magnetic resonance imaging (MRI) | 4 years | Relationship between Wisconsin Card Sorting Test performance and grey matter volume will be evaluated using structural MRI. |
| Cost-benefit analysis of intervention | 4 years | The economic benefits from the interventions will be evaluated and will cover three aspects: financial, productivity and health. |
| Changes in levels of human salivary lactoferrin | 4 years | Changes in levels of human salivary lactoferrin (ng/mL) will be measured using salivary Enzyme-Linked Immunosorbent Assay (ELISA) kits. Low levels of lactoferrin can potentially indicate higher risk for cognitive impairment. |
| Changes in levels of human salivary C-reactive proteins | 4 years | Changes in levels of human salivary C-reactive proteins (CRP, mg/L) will be measured using salivary Enzyme-Linked Immunosorbent Assay (ELISA) kits. High levels of CRP can indicate inflammation and its association with greater cognitive decline. |
| Changes in salivary telomere length | 4 years | Changes in salivary telomere length (T/S ratio) will be measured using quantitative PCR. A higher T/S ratio indicates better preservation of telomere length hence better preservation of cognition. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in depression scores | 4 years | Changes in depression scores will be measured using part of the Center for Epidemiologic Studies Depression Scale (CES-D). Possible scores range from 0-42. Higher scores indicating greater frequency of depressive experiences. |
| Changes in anxiety scores | 4 years | Changes in anxiety scores will be measured using part of the Form Y of the State-Trait Anxiety Inventory (STAI). Possible scores range from 6-24. Higher scores indicate greater anxiety. |
| Changes in body composition | Throughout study participation, up to 4 years | Changes in body composition will be measured using Bioelectrical Impedance Analysis (BIA), including parameters such as body fat percentage, muscle mass and visceral fat composition. |
| Changes in Body Mass Index (BMI) | Throughout study participation, up to 4 years | Changes in Body Mass Index (BMI, kg/m²) will be evaluated using participants' height and body weight measurements. |
| Changes in blood pressure | Throughout study participation, up to 4 years | Changes in systolic and diastolic blood pressure (mmHg) will be measured using a standard blood pressure monitoring device. |
| Changes in falls risk | Throughout study participation, up to 4 years | Changes in falls risk will be evaluated using the Falls Risk Assessment Tool (FRAT). Higher scores indicate greater risk of falls. |
| Changes in sarcopenia risk | Throughout study participation, up to 4 years | Changes in sarcopenia risk will be evaluated using the SARC-F questionnaire. Higher scores indicate greater risk of sarcopenia. |
| Changes in frailty status | Throughout study participation, up to 4 years | Changes in frailty status will be assessed using the Pictorial Fit-Frail Scale. Higher scores indicate greater frailty. |
Countries
Malaysia
Contacts
PRINCIPAL_INVESTIGATORYook Chin Chia Professor, Datin, Dr, MBBS, FRCP
Sunway University
STUDY_CHAIRTin Tin Su
Monash University
STUDY_CHAIRRozainee Khairudin
The National University of Malaysia
STUDY_CHAIRNur Ain Shahrier
Sunway University
STUDY_CHAIRAudrey Wei Ling Lim
Sunway University
Outcome results
None listed