Please select the eligibility criteria that correspond to the clinical trial below.
Title: The Effects of Mental Activity and Exercise on Cognitive Function in Older Adults Who Self-Report a Recent Decline in Memory or Thinking
Brief Summary: The primary objective of this study is to conduct a randomized, controlled trial to determine whether engaging in mental activity or exercise, either alone or in combination, improves cognitive function in non-demented, inactive older adults who self-report a recent decline in memory or thinking. In addition, we, the researchers at the University of California, San Francisco, plan to seek funding to follow subjects over time to determine whether these interventions are associated with changes in rate of cognitive decline or risk of dementia after the intervention period has ended.


Options:
A: Inclusion Criteria:

* Age 70 to 85 years
* Summary score between 88 (80 for less than 8 years of education) and 95 on the Modified Mini-Mental Exam
* Sedentary lifestyle, i.e., not actively participating in a formal exercise program within the past 3 months (defined as 30 minutes or more of formal exercise at least once a week; brisk walks will be considered formal exercise, leisurely walks will not)
* Fluency in standard American English (to limit staffing and translation costs in this pilot)
* Willingness to be randomized to any of the four intervention conditions

Exclusion Criteria:

* Failure to provide the name of a personal physician
* Living in a nursing home; persons living in assisted or independent housing will not be excluded
* Unable to communicate because of severe hearing loss or speech disorder
* Severe visual impairment, which would preclude completion of the assessments and/or intervention
* Neurologic disease, e.g. Alzheimer's (or other types of dementia), stroke that required hospitalization, Parkinson's, multiple sclerosis, amyotrophic lateral sclerosis, or prior diagnosis of mild cognitive impairment (MCI)
* Abnormal functioning based on the modified Telephone Interview for Cognitive Status (less than 30)
* Positive screen for MCI or dementia
* Scores greater than or equal to 1.5 standard deviations below normal on memory and non-memory domain tests (speed of processing, and verbal fluency)
* Severe rheumatologic or orthopedic diseases, e.g., awaiting joint replacement, active inflammatory disease
* Terminal illness with life expectancy less than 8 months, as determined by a physician
* Severe pulmonary disease, e.g., on home oxygen or chronic steroids
* Severe cardiac disease, including New York Health Association Class III or IV congestive heart failure, clinically significant aortic stenosis, history of cardiac arrest which required resuscitation, use of a cardiac defibrillator, or uncontrolled angina
* Other significant co-morbid disease that would impair ability to participate in the exercise-based intervention, e.g. renal failure on hemodialysis, severe or acute psychiatric disorder (e.g. bipolar disorder or major depression, schizophrenia), excessive alcohol use (more than 14 drinks per wk); persons with managed depression (on stable dosage for at least 3 months) will not be excluded
* Baseline Geriatric Depression Scale score greater than 6
* Other significant factors that may affect the ability for cognitive training, including a history of head trauma resulting in a loss of consciousness, current use of benzodiazepines, hypnotic or anticholinergic agents, and current use of cognitive enhancing prescription or investigational medications (e.g., donepezil, selegiline, tacrine)
* Member of household is already enrolled
* Lives distant from the study site or is planning to move out of the area in next 3 years or leave the area for more than 3 months during the next year
* History of participation in a cognitive program in the last 2 years (includes research studies involving memory training)
* Myocardial infarction, coronary artery bypass graft, or valve replacement within past 6 months
* Serious conduction disorder (e.g., 3rd degree heart block), uncontrolled arrhythmia
* Pulmonary embolism or deep venous thrombosis within past 6 months
* Stroke, hip fracture, hip or knee replacement, or spinal surgery within past 4 months
* Receiving physical therapy for gait, balance, or other lower extremity training
* Severe hypertension, e.g., systolic blood pressure over 160 mmHg, diastolic blood pressure over 110 mmHg
* Other temporary intervening events, such as sick spouse, bereavement, or recent move
* Participation in another intervention trial; participation in an observational study may be permitted
* Inability to commit to intervention schedule requirements
B: Inclusion Criteria:

1. Age range between 60-70 years old
2. Clinical Dementia Rating (CDR) of 0.5\*
3. Geriatric Depression Scale (GDS) of 9 and below
4. Mini-Mental State Examination of 24 and above\*
5. Chinese ethnicity
6. Literate in English and/or Chinese
7. Able to travel to study site independently

   * In the case of conflicting CDR and MMSE scores, MMSE scores will supersede CDR scores.

Exclusion Criteria:

1. Any known neuropsychiatric disorders (such as epilepsy or mental retardation)
2. Involvement in another research study (aside from SLAS)
C: Inclusion Criteria:

* Age \> 64
* Self-report of recent decline in memory or thinking
* Low/no physical activity (\<2 days/week for \<30 minutes/session of moderate intensity activity over past 3 months)
* Low/no computer mental activity (\<2 days/week for \<30 minutes/session over past 3 months)
* Fluent in English
* Willingness to perform study activities

Exclusion Criteria:

* Evidence of dementia (based on self-report, physician diagnosis or score \< 19 on Telephone Interview for Cognitive Status)
* Significant central nervous system disorder (Parkinson's disease, multiple sclerosis, ALS \[Lou Gerig's disease\])
* Major, current psychiatric disorder (major depressive disorder, schizophrenia, bipolar disorder, post-traumatic stress disorder, obsessive-compulsive disorder, psychiatric hospitalization in past 20 years)
* Major central nervous system event (stroke, transient ischemic attack/mini-stroke, seizure, or traumatic brain injury that has left a residual deficit)
* Significant heart disease (severe congestive heart failure, severe aortic stenosis, cardiac arrest, uncontrolled angina)
* Significant lung disease (requiring supplemental oxygen or oral or injected steroids)
* Other condition that would make participation potentially dangerous (cancer requiring treatment in past 3 years, severe arthritis, history of cardiac defibrillation, dialysis)
* Lack of physician approval
* Severe hearing or visual impairment
* History of learning disability
* Starting prescription medication to enhance cognitive function (e.g., memantine, aricept)
* Dependent in any basic activity of daily living (eating, dressing, bathing, toileting, getting out of bed/chair)
* History of alcohol abuse/heavy alcohol use
* History of drug abuse/heavy drug use
* Currently enrolled in another research study
* Fibromyalgia or tremor severe enough to prevent use of a computer mouse
* Planning to travel \> 4 exercise class days during study period
* Behaviors during screening or baseline visit that, in the judgement of research staff, are likely to present significant problems (e.g., uncooperative, anger, inappropriate physical contact)
* Unable to perform neuropsychological evaluations
* Unable to complete consent process
D: Inclusion Criteria:

* aged 60-77 years
* dementia Risk Score 6 points or more
* fulfillment of at least one of the following CERAD criteria: i) MMSE: 20-26 points ii) word list memory task (3x10 words): 19 words or less iii) delayed recall: 75% or less

Exclusion Criteria:

* malignant diseases
* dementia
* substantial cognitive decline
* major depression
* symptomatic cardiovascular disease
* revascularisation within 1 year
* severe loss of vision, hearing or communicative ability
* other conditions inhibiting from safe engagement in the prescribed intervention as judged by the study physician
* other conditions preventing from cooperation as judged by the study physician

Answer: C