Memory and Exercise Training Study in Older Adults With Subjective Memory Complaints
Condition: Memory Impairment
Study type: Interventional

Summary: 
      This pilot study is a first step in a rapidly growing area of clinical research to create the
      most effective means to combat age-related losses in cognitive function through preventive
      lifestyle strategies such as physical exercise and memory training. This study will develop
      innovative simultaneous exercise and memory training programs in non-demented volunteers with
      subjective memory complaints (controls or MCI). Our primary goal is to assess the cognitive
      impact of 4-week memory training programs done twice weekly: 1. during simultaneous aerobic
      exercise (SIM-AR-MET), 2. sequentially after aerobic exercise (SEQ-AR-MET), or 3. without
      aerobic exercise (replaced with sequential stretching and toning) (SEQ-ST-MET). The
      investigators will also measure potential metabolic (e.g., glucose, lipid panel) and
      molecular (serum BDNF) mediators of observed cognitive changes in a subset of participants
      (those at the UCLA CTRC/IPCN site).
    

Detailed description: 
      A total of 90 non-demented healthy older adult volunteers (age 60-75) with subjective memory
      complaints (controls or MCI) will be screened and enrolled into the study. The CTRC/IPCN site
      will enroll 30 subjects (10 in each group); the MPTF site will enroll 60 subjects (20 in each
      group). Baseline assessments will include neuropsychological testing of all study subjects.
      At UCLA CTRC/IPCN, baseline assessments will also include cardiorespiratory fitness, body
      composition, YMCA fitness tests, and blood-based markers of metabolism and plasticity. To
      control for total activity levels, all study subjects will wear continuous physical activity
      monitors (FitBit accelerometers) and keep exercise and cognitive activity logs during the
      entire study. All subjects (n = 90) will first complete a 1-week observational period to
      capture baseline activity levels. Subjects will then be randomized to one of three groups:
      SIM-AR-E&MT, SEQ-AR-E&MT, or SEQ-ST-MET (n = 30 per group). SIM-AR-MET and SEQ-AR-MET
      subjects will complete a 3-week exercise only 'ramp-up' period consisting of twice weekly
      1-hour sessions practicing stationary bicycling, improving cardiovascular fitness enough to
      complete the upcoming 4-weeks of MET sessions (described below), and practicing stretching
      and toning; SEQ-ST-MET subjects 3-week exercise only 'ramp-up' period will consist of an
      equal number of six stretching and toning sessions (no aerobic components). All 3 programs
      will then have two 2-hour sessions per week for 4 weeks. The SIM-AR-MET and SEQ-ST-MET
      subjects will do stretching/toning during the first hour; SEQ-AR-MET subjects will do aerobic
      cycling during the first hour. During the second half of the sessions, all 3 groups will
      first learn new memory training strategies while sedentary. SIM-AR-MET subjects will then
      practice the memory techniques while cycling while SEQ-AR-MET and SEQ-ST-MET subjects will
      practice the memory techniques while still sedentary. The three groups will have group
      specific exercise and memory training homework assignments, along with monitoring of activity
      and logging of cognitively enriching activities. The NP testing will be done again at the end
      of the 4 weeks of memory training classes for all study subjects. UCLA CTRC/IPCN subjects
      will have the additional testing done at baseline (e.g., blood-based markers, etc.).

      Consideration was given to having a purely observational 'wait-list' group, but in our
      experience with this population such groups have typically initiated greater levels of
      self-guided exercise and memory training in reaction to being put on a wait list.
      Alternatively, if no increase in activity or memory training is undertaken by wait list
      subjects, the investigators would not expect any differences in cognitive performance to be
      measurable within the brief 3 month total time frame of this initial study. The investigators
      also considered have a group do aerobic exercise immediately after memory training, but based
      on current literature, this combination seemed the least likely to impact memory
      synergistically. Thus, these two groups will be deferred for the pilot until later, larger
      studies can be done to confirm or refute these hypotheses. Similarly, while our primary aim
      assessing change in NP performance will be tested in all subjects, the pilot nature of the
      study prohibits testing of secondary aims in both sites. The academic medical center site
      will leverage the assistance of the UCLA CTRC/IPCN to accomplish preliminary testing of the
      secondary aims in 30 subjects, while the UCLA MPTF community site will test only the primary
      study aim of change in NP performance.
    

Intervention name(s): simultaneous aerobic exercise; sequential aerobic exercise; stretching and toning
Intervention type(s): Other; Other; Other
Intervention description(s): stationary bicycling at 65% of heart rate reserve for 30 minutes while receiving memory training.; stationary bicycling at 65% of heart rate reserve for 30 minutes followed by memory training.; anaerobic stretching and toning followed by memory training.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Health Services Research
Keywords: (An)aerobic exercise; memory training; cognitive benefits