Brain and Cognitive Changes After Reasoning or Physical Training in Cognitively Normal Seniors
Condition: Hearing Impaired
MeSH terms: Deafness; Hearing Loss
Study type: Interventional

Summary: 
      Seniors 65 years of age and older represent one of the fastest growing segments of society
      with the population doubling within the next 25 years with dramatic rates of mental decline,
      costing society billions of dollars each year. The proposed research seeks to discover
      whether relatively short term mental or physical training can enhance gist reasoning,
      generalize to untrained cognitive areas and modify/strengthen brain function in areas
      susceptible to aging processes. To identify neuroprotective and non-pharmacological
      interventions to prevent mental decline and maximize cognitive brain health during the course
      of the adult lifespan has major public policy implications.
    

Detailed description: 
      Background: A significant potential exists to modify the structure and function of the aging
      human brain given intensive mental stimulation and physical activity. Age-related cognitive
      decline has consistently been identified on frontal lobe measures of executive control such
      as reasoning. Concomitantly, a greater vulnerability of frontal brain networks, which
      subserve executive control functions, has also been identified with aging. Preliminary
      evidence highlights the potential of reasoning training as well as physical training to
      modify and strengthen brain and cognitive function in seniors. Evidence from our lab
      indicates that frontally mediated, gist-based reasoning (defined as the ability to combine
      detail information to construct abstract meanings) offers a promising cognitive domain to
      train. Extracting gist meaning from the massive amount of incoming information is one of the
      most vital mental skills a healthy mind achieves. Purpose: This proposal is an innovative
      study to obtain data regarding the benefits of a (a) novel gist-based reasoning training
      program or (b) physical training on frontal-lobe mediated cognitive measures of executive
      control in cognitively normal seniors. The project will also employ newly developed (a) brain
      measures to chart changes in brain blood flow and connectivity combined with (b) a cognitive
      activation task specifically designed to measure brain regions engaged in gist reasoning
      versus detail processing. The project also examines shorter dose effects, i.e. after 6 weeks
      and 12 weeks, than previously examined as well as individual differences based on high and
      low performers for gist and physical training. Methods: 60 cognitively normal seniors between
      the ages of 60 and 75 years will be recruited for study and randomized into 1 of 3 groups.
      Each group will consist of 20 participants each: a reasoning-trained, a physical-trained and
      a wait-listed control group. Participants will be comprehensively screened to insure they are
      cognitively normal. Prior to intervention, participants' baseline gist and detail processing
      ability, battery of cognitive functions and fitness measures will be obtained. Structural and
      functional brain measures will also be obtained. Participants will undergo 12 weeks of
      gist-based training or physical training with measurement at midpoint, 6 weeks of training,
      endpoint 12 weeks of training and 4 weeks after training is completed. Training effects will
      be measured behaviorally in trained areas (reasoning & physical) and untrained cognitive
      areas. Additionally, structural and functional brain imaging will measure changes in cerebral
      blood flow, global and regional brain volume, white matter tracts, efficiency, activation
      patterns, and blood oxygenation with a particular focus on changes to frontal regions.
      Significance: The current study seeks to discover neuroprotective, nonpharmacological
      interventions that could prevent mental decline and strengthen cognitive brain health in
      seniors, with possible societal savings of billions of dollars. This will be one of the first
      training studies to explore short-term intensive reasoning and physical training, each
      documented as pivotal to cognitive brain health with the potential to strengthen frontal
      regions against the losses associated with aging.
    

Intervention name(s): SMART- Strategic Memory and Reasoning Training; Physical Exercise
Intervention type(s): Behavioral; Other
Intervention description(s): Teach people to filter out un necessary or unimportant details to enhance mental efficiency. This training will be done over 12 weeks for 3 hours each week.; The group with undergo 1 hour of aerobic exercise (at 50-70 % of the participants max oxygen intake) 3 times a week for 12 weeks.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Prevention
Keywords: Healthy Aging; Exercise; Cognition; Cognitive Training; Keeping healthy seniors as mentally efficient as possible