Please select the eligibility criteria that correspond to the clinical trial below.
Title: N/A
Brief Summary: A recent meta-analysis that included over 29.000 individuals found that the odds ratio (OR) of individuals with high brain reserve compared to low was 0.54 (p \< 0.0001), a risk decrease of 46%. Among the factors that influence cognitive reserve, mentally stimulating activities was the most robust factor after controlling for education, age, occupation and other potential confounds. The brain reserve effect was sustained over a median longitudinal follow-up of 7 years. It would be interesting to detect whether a complex cognitive training could show similar effects on the cognitive abilities of patients with mild Alzheimer's disease (AD) and mild cognitive impairment (MCI) as it has been reported in previous studies based on mentally stimulating activities analysis.

The hypothesis is that a complex cognitive training alters the neural networks in both subject groups and this alteration is associated with improvement or stabilization of cognitive and non-cognitive function.

The investigator will perform a complex cognitive training program. Twenty patients with mild AD and twenty four patients with MCI will be recruited in this study. The patients will be randomised in control- and treatment groups.Additionally indirect effects on non-cognitive functions will be evaluated in caregivers of the patients.

The investigators expect that the cognitive and non-cognitive abilities will be changed during the cognitive training. The investigators also expect differences between treatment and control groups.


Options:
A: Inclusion Criteria:

* Male or female patients aged ≥ 55 years, fulfilling criteria of the National Institute of Neurological and Communicative Disease and Stroke (NINCDS) and the Alzheimer's Disease and Related Disorders Association (ADRDA) for the diagnosis of clinically probable AD or Petersen's criteria of mild cognitive impairment (MCI)
* No evidence for other psychiatric axis I disorders according to DSM-IV criteria
* No uncontrolled arterial hypertension or diabetes mellitus
* No history of drug/alcohol abuse
* Cholinesterase inhibitors or Memantine must have been in a stabile doses at least 2 moths in AD subject group prior to the Baseline
* The patient is able to provide written informed consent to participate in the study. If, at investigator's discretion, a patient is considered not to be capable to give legal consent, then written consent must also be obtained from the patient's legally acceptable representative.

Exclusion Criteria:

* Evidence for other psychiatric axis I disorders according to DSM-IV criteria
* Uncontrolled arterial hypertension or diabetes mellitus
* History of drug/alcohol abuse
* No ability to participate and no willing to give informed consent and comply with the study restrictions
B: 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
C: Inclusion Criteria:

* Male/Female 55-90 years old.
* Montreal Cognitive Assessment score ≤27
* Preserved Instrumental Activities of Daily Living (based on Lawton-Brody Instrumental Activities of Daily Living Sale)

Exclusion Criteria:

* Dementia (i.e., Mini-Mental Examination score \<24 or self-reported physician diagnosis)
* Major Depression (\>=16 on the Center for Epidemiologic Studies - Depression Scale combined with clinical judgment by primary study physician)
* Other neurological or psychiatric disorders
* Recent history of severe cardiovascular conditions
* Significant orthopedic conditions
* Have blood pressure \>180/100 mmHg or \<100/60 mmHg
* Unable to comprehend questionnaire material/study procedures
D: Inclusion Criteria:

1. able to follow instruction,
2. clinical dementia rating (CDR) = 0.5 or 1,
3. self- or informant-reported memory or cognitive complaint, and
4. able to perform activities of daily living (Barthel Index ≥ 70).

Exclusion Criteria:

1. recent myocardial infarction,
2. heart failure,
3. recent heart surgery,
4. severe asthma,
5. concomitant with other neurological disorders, or
6. joint deformity that might prevents them performing exercise or cognitive training.

Answer: A