Please select the eligibility criteria that correspond to the clinical trial below.
Title: The Cognitive Benefits of Interactive Mental and Physical Exercise for Older Adults at Risk for or With Mild Cognitive Impairment (MCI)
Brief Summary: The purpose of this study is to clarify the benefits to brain health and thinking processes that result from different forms of exercise. This study will examine the effectiveness of cybercycling (virtual reality enhanced stationary cycling) for persons at risk for and with MCI, and compare this with the individual cognitive, behavioral, and physiological effects of physical and mental exercise alone. The Investigators hypothesis that cognitive benefit will be greatest for combined aerobic and cognitive exercise compared to physical and mental exercise alone.


Options:
A: Inclusion Criteria:

* age 50+
* able to pedal recumbent stationary bicycle
* available for regular exercise participation 3-5x/week for at least 6 months
* physician permission to exercise

Exclusion Criteria:

* unstable heart condition or other significant cardiovascular history (e.g,. stroke)
* meets criteria for Alzheimer's or other dementia
* significant history of other neurological disease (e.g., seizures, Parkinson's, etc.)
* physician denial to exercise
B: Inclusion criteria

1. Age ≥ 60 years,
2. Community dwelling, as defined by living at home without staying in long-term care facilities (e.g., nursing home) in the last 12 months, and
3. Cognitive frailty, as defined by co-existence of mild cognitive impairment and physical frailty,

   1. Mild cognitive impairment, measured by Montreal Cognitive Assessment (MoCA) ≤ 25 and Clinical Dementia Rating (CDR) = 0.5, and
   2. Frailty status from pre-frail to frail, measured by Fried Frailty Phenotype score ≥ 1.

Exclusion criteria

1. Diagnosed dementia, according to subjects' medical record, or
2. Probable dementia, as defined by MoCA ≤ 18, or
3. Mobility restriction, as defined by Modified Functional Ambulatory Classification (MFAC) \< Category 7 (i.e., Outdoor walker), or
C: Inclusion Criteria:

* age 50+
* able to participate in cycling
* physician permission

Exclusion Criteria:

* unstable heart condition
* physician denial
* neurological condition
D: INCLUSION CRITERIA:

Participants fulfilling all of the following inclusion criteria are eligible for the study:

* (1 = mNCD) clinical diagnosis of 'Mild Neurocognitive Disorder' according to the International Classification of Diseases 11th Revision (ICD-XI) or the Diagnostic and statistical manual of mental disorders (DSM-5®)) OR (2 = sMCI) patients screened for mild cognitive impairment (sMCI) according to the following criteria: (a) informant (i.e. healthcare professionals)-based suspicion of MCI confirmed by (b) an objective screening of MCI based on the German Version of the Quick Mild Cognitive Impairment Screen with (b1) a recommended cut-off score for cognitive impairment (MCI or dementia) of \< 62/100 (doi: 10.3233/JAD-161204), while (b2) not falling below the cut-off score for dementia (i.e. \< 45/100 (doi: 10.3233/JAD-161204)).
* German speaking
* able to stand at least for 10 min without assistance

EXCLUSION CRITERIA:

The presence of any of the following exclusion criteria will lead to exclusion of the participants:

* mobility impairments (i.e. gait, balance) that prevent experiment participation
* presence of additional, clinically relevant (i.e. acute and/or symptomatic) neurological disorders (i.e. epilepsy, stroke, multiple sclerosis, Parkinson's disease, brain tumors, or traumatic disorders of the nervous system)
* presence of any other unstable or uncontrolled diseases

Additional exclusion criteria will comprise of Covid-19 specific exclusion criteria (according to the Federal Office of Public Health). In case of Covid-19 specific exclusion criteria, participation in the study will only be allowed in case the treating physician provided written informed consent to allow participation in this study despite the presence of Covid-19 specific exclusion criteria. These Covid-19 specific exclusion criteria will include:

* high blood pressure (self-reported; systolic ≥ 140 mmHg and/or Diastolic ≥ 90 mmHg)
* Chronic respiratory condition
* uncontrolled type 2 Diabetes
* Condition or therapy that weakens the immune system
* unstable Cardiovascular Disease
* Cancer (present and/or under treatment)
* Serious obesity (BMI ≥ 40 kg/m2)

Answer: A