Please select the eligibility criteria that correspond to the clinical trial below.
Title: Compensation Factors of Cognitive Ageing: Using Computer Technology to Reduce Cognitive Decline in Ageing
Brief Summary: The ageing of the population will inevitably lead to a growing number of older people living alone and in need of care. Given the high cost of geriatric care, a critical research issue is exploring ways to improve or maintain cognitive and functional status in old age. Unfortunately, it has been shown that training those specific cognitive processes most sensitive to ageing (such as speed of processing or working memory), produces only limited beneficial effects. However, research also suggests that factors such as cognitive engagement, physical activity and social context may act as more general modulators of cognitive decline. This project is a longitudinal study with experimental and control groups. It is inspired from the engagement model of cognitive optimization suggesting that a lifestyle marked by social and intellectual engagement may mitigate age-related declines on cognitive functioning. It uses new cutting-edge information computing technology (ICT) solutions to improve or simply maintain cognitive functions in the elderly. This research investigates how the treatment reduces the effects of cognitive age-related decline in executive control processes and episodic (explicit) memory using behavioral and imaging measures. The results will provide significant knowledge on the potential of new ICT technologies to delay, compensate, and even prevent common chronic problems experienced by the elderly population. The hypothesis is that cognitive training with video-games through ICT solutions will promote brain and mental health and independence. Ultimately, the objective is to contribute to the understanding of factors that help avoiding the (personal and economic) consequences of long-term care in geriatric institutions.


Options:
A: Inclusion criteria for patients with MCI

1. Patients fulfilling criteria for AMCI \[Petersen et al. 2001b\]:

   i. Memory impairment for age and education ii. No impairment in other cognitive domains iii. Normal social activities iv. Patient is not demented
2. For the other subtypes of MCI, cognitive impairment in one or more nonmemory domain
3. Sedentary lifestyle with no regular participation in physical exercise defined as two or three times a week for at least 20 minutes duration, or participation in active sport more than once a week, in the previous six months.
4. Willing and able to give informed consent.
5. Availability and access to safe exercise environments, such as paths or roads with sidewalks for walking or cycling.
6. At low risk from serious adverse effects from increased physical activity as indicated by performance on the revised Physical activity readiness questionnaire (PARQ).

Exclusion Criteria:

Exclusion criteria for patients with MCI

1. Type 1 (insulin dependent) diabetes mellitus.
2. Blood pressure of 160/100 mmHg or more.
3. Body weight more than 140% of ideal body weight.
4. Musculoskeletal or other medical problems preventing safe participation in regular moderate intensity exercise (65-77% of predicted maximum heart rate). This will include a resting tachycardia (heart rate above 100 bpm) and history of myocardial infarction or unstable angina within the last month.

Participants with modifiable exclusion criteria will be reconsidered after successful management. Patients will be referred for medical treatment prior to commencing exercise if indicated by the PARQ and the intervention will be guided by the PARmedX.

Participants taking medications affecting heart rate will need to be on a stable dosing regime for 3 months prior to commencing in order to control for potential spurious results on fitness measures caused by these treatments.
B: Inclusion Criteria:

* 50 years of age or older
* Patient of the FCC in Family Medicine or General Internal Medicine Clinic at UIHC
* No known memory problems

Exclusion Criteria:

* Significant vision impairments
* Lack of access to a computer or owns a MAC
* Lives more than 37 miles from the lab
* Traumatic Brain Injury or severe stroke
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:

* Mini-Mental State Examination (MMSE) score 26 or greater
* Global Deterioration Scale (GDS) score less than 5
* Independent living
* Normal or correct to normal vision and hearing

Exclusion Criteria:

* Diagnosis of dementia
* Planned move from study area
* Inability to complete study activities
* Scores lower than inclusion criteria requirements Communication problems.

Answer: D