Perimenopause, Subjective Cognitive Complaints
Conditions
Keywords
progressive resistance training, perimenopause
Brief summary
Perimenopause is now considered a possible risk factor for dementia and may contribute to the fact that 2/3 of those living with Alzheimer's disease are females. Indeed, research studies show that middle-aged females demonstrate significant declines in their thinking abilities and detrimental changes in their brains as they go through perimenopause. Thus, perimenopausal females need strategies to bolster their brain health. The World Health Organization strongly recommends physical activity interventions to reduce the risk of decline in thinking abilities. However, whether exercise can improve thinking abilities and brain health in perimenopausal females has not been examined. Our research aims to address this important knowledge gap in female brain health. We will study the effects of a 6-month resistance exercise training (e.g., lifting free weights, exercise with weight machine) program on thinking abilities in 50 physically inactive perimenopausal females, aged 40 to 55 years, who are experiencing difficulties with their thinking abilities. In addition to measuring thinking abilities, we will determine if exercise benefits muscle health, heart health, sleep quality, psychological well-being, menopausal symptoms, and quality of life. We will also explore how resistance exercise training improves thinking abilities as such information can lead to new discoveries and therapies for brain health in females.
Detailed description
1. PURPOSE: To determine if progressive resistance training (PRT) can improve cognitive outcomes compared to balance, flexibility, and tone (BAT) exercises in perimenopausal females aged 40-55 years with subjective cognitive complaints. 2. HYPOTHESIS: At the end of the intervention, PRT will result in an increase in words recalled during the RAVLT 20-minute delay vs no improve in BAT. 3. JUSTIFICATION: The menopause transition (MT) negatively impacts cognitive function and the brain. The majority of perimenopausal females experiences cognitive difficulties and have subjective cognitive complaints (SCCs). Verbal episodic memory and processing speed are most negatively impacted by the MT. Cognitive and brain changes during the MT can significantly impact career and financial wellbeing. The MT is thus a critical window to intervene for female brain health. Exercise can reduce dementia risk factors and promote cognitive health. No published randomized controlled trials have examined the effect of exercise on cognitive outcomes in perimenopausal females. 4. OBJECTIVE: To determine if 26 weeks of 2x/week progressive resistance training (PRT) can improve verbal episodic memory performance on the Rey Auditory Verbal Learning Test (RAVLT) compared with balance, flexibility, and tone exercises (BAT) for physically inactive perimenopausal females aged 40-55. 5. RESEARCH DESIGN: A 26-week, assessor-blinded, two-arm, proof-of-concept trial with 50 physically inactive perimenopausal females, aged 40 to 55 years, with subjective cognitive complaints. Participants will be randomized 1:1 to PRT or BAT and measured at baseline, 13 weeks, and 26 weeks.
Interventions
BEHAVIORALProgressive Resistance Training
The sessions will occur in the Exercise Prescription Suite of the Centre for Aging SMART at VCH; this suite is a fully-equipped gym that includes treadmills, bikes, pneumatic resistance training equipment, and free weights. The training stimulus will initially be at 3 sets of 10-15 repetitions with proper form. At week 4, training intensity will progress from 60-82% of predicted 1 repetition maximum (RM) using the 8RM method. Every 4 weeks the 8RM test will be repeated.
BEHAVIORALBalance, Flexibility, and Tone Exercises
Each BAT session will be 1-hr in duration and consist of Pilates mat exercises, Yoga-based poses and breathing, Kegel exercises, stretches, and relaxation techniques (e.g., visualization).
Sponsors
University of British Columbia
Vancouver Coastal Health Research Institute
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
40 Years to 55 Years
Healthy volunteers
Yes
Inclusion criteria
* Are biological females, as assigned at birth * Are aged between 40 and 55 years * Had at least 1 menstrual period in the last 10 months * Are perimenopausal based on STRAW +10 Staging System, or answer "yes" to MQ6 questions of changes in periods, having hot flashes, or vaginal dryness, pain, or sexual concerns * Have an intact uterus * Have a Montreal Cognitive Assessment (MoCA) score \>26/30, indicating normal cognition * Have subjective cognitive complaints defined as responding "yes" to "Do you feel like your memory or thinking is becoming worse?" * Completed high school education * Read and speak English with acceptable visual and auditory acuity * Are able to safely engage in moderate-intensity PRT as indicated by the PAR-Q+; and * Are able to provide informed consent.
Exclusion criteria
* Are engaged in regular PRT (i.e., 2x/week) in the prior three months * Are diagnosed with cognitive impairment or dementia of any type * Are at high risk for cardiac complications during exercise * Have clinically important peripheral neuropathy or severe musculoskeletal or joint disease that impairs mobility * Are taking medications that negatively affect cognitive function, such as anticholinergics, major tranquilizers, and anticonvulsants * Have a BMI \<15 or anorexia nervosa; g) had surgical menopause * Had endometrial ablation that resulted in the loss of menstruation * Have polycystic ovarian syndrome * Currently undergoing chemo * Are using estrogen-containing contraception in the last 12 months * Had premature ovarian failure; or * Are already enrolled in a drug or exercise trial
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rey Auditory Verbal Learning Test (RAVLT) | Baseline, 13 weeks, 26 weeks | The RAVLT is a valid, reliable, and widely-used instrument of verbal episodic memory and learning, with normative values. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| NIH TB Cognitive Battery - Flanker Test | Baseline, 13 weeks, 26 weeks | A measure of executive functions |
| NIH TB Cognitive Battery - Dimensional Change Card Sort Test | Baseline, 13 weeks, 26 weeks | A measure of executive functions |
| NIH TB Cognitive Battery - Picture Sequence Memory Test | Baseline, 13 weeks, 26 weeks | A measure of visual episodic memory |
| NIH TB Cognitive Battery - List Sorting Test | Baseline, 13 weeks, 26 weeks | A measure of working memory |
| NIH TB Cognitive Battery - Pattern Comparison Processing Speed Test | Baseline, 13 weeks, 26 weeks | A measure of processing speed |
| Everyday Memory Questionnaire | Baseline, 13 weeks, 26 weeks | A subjective measure of memory failure in everyday life |
| Muscle strength of quads | Baseline, 13 weeks, 26 weeks | Muscle strength measure by isokinetic dynamometer |
| Peripheral QCT of the tibia | Baseline, 13 weeks, 26 weeks | A measure of bone and muscle health |
| Blood pressure | Baseline, 13 weeks, 26 weeks | Blood pressure - systolic and diastolic |
| Lipid panel | Baseline, 26 weeks | Lipid levels |
| Hemoglobin A1-C | Baseline, 26 weeks | Average blood sugar levels |
| C-reactive protein | Baseline, 26 weeks | Measure of inflammation |
| Health resource utilization | Baseline, 13 weeks, 26 weeks | Cost of health resource used |
| Carotid-femoral pulse wave velocity | Baseline, 13 weeks, 26 weeks | Arterial stiffness |
| Pittsburgh Sleep Quality Index | Baseline, 13 weeks, 26 weeks | Subjective sleep quality |
| Actigraph | Baseline, 13 weeks, 26 weeks | Using actigraphy data, quantify sleep quality (e.g., duration, efficiency, fragmentation). |
| Fatigue Severity Scale | Baseline, 13 weeks, 26 weeks | Subjective fatigue |
| PHQ-9 | Baseline, 13 weeks, 26 weeks | Depression severity |
| GAD-7 | Baseline, 13 weeks, 26 weeks | Generalized anxiety disorder |
| Menopause Rating Scale | Baseline, 13 weeks, 26 weeks | Menopause symptoms |
| EuroQol-5 Domain-5 Level | Baseline, 13 weeks, 26 weeks | Quality of life |
| International Physical Activity Questionnaire | Every 30 days over 26 weeks | Physical activity |
| DEXA | Baseline, 13 weeks, 26 weeks | Lean mass |
| Mediterranean-DASH Diet Intervention for Neurodegenerative Delay (MIND) Diet score | Baseline, 13 weeks, 26 weeks | Diet |
| Processing Speed by smartphone | Baseline, 13 weeks, 26 weeks | Processing Speed |
| Memory by smartphone | Baseline, 13 weeks, 26 weeks | Memory |
| Productivity Questionnaire | Baseline, 13 weeks, 26 weeks | Measure of work productivity |
| Brain-Derived Neurotrophic Factor | Baseline, 26 weeks | Neurotrophic Factor |
| IGF-1 | Baseline, 26 weeks | Neurotrophic Factor |
Countries
Canada
Contacts
CONTACTTeresa Liu-Ambrose, PhD
PRINCIPAL_INVESTIGATORTeresa Liu-Ambrose, PhD
University of British Columbia
Outcome results
None listed