Randomized Trial of Exercise and Social Interaction in a Community-Based Sample of Non-Demented Chinese Elders
Condition: Cognitive Impairment; Dementia; Mild Cognitive Impairment; Alzheimer Disease
MeSH terms: Alzheimer Disease; Dementia; Cognitive Dysfunction
Study type: Interventional

Summary: 
      A pilot randomized clinical trial was conducted in a random sample of 120 non-demented
      Chinese elders (ages 60-79) living in a defined community in Shanghai, China to compare the
      effects of interventions (fast walking, Tai Chi, group intellectual discussion) to no
      intervention with respect to change in cognition and whole brain volume determined by
      repeated neuropsychological batteries and MRI scans. Aims included determining the
      feasibility of recruiting and retaining a random sample of people age 60+ for such a trial as
      well as collection of preliminary data on the efficacy of the interventions. The long-term
      goal of this research program is to determine whether sustained physical and/or mental
      exercise interventions are efficacious in delaying the onset of dementia and to understand
      the role and mechanisms of brain growth in this process.
    

Detailed description: 
      Physical exercise has been shown to increase brain volume and improve cognition in randomized
      trials of non-demented elderly. Although greater social engagement was found to reduce
      dementia risk in observational studies, randomized trials of social interventions have not
      been reported. A representative sample of 120 elderly from Shanghai, China was randomized to
      four groups (Tai Chi, Walking, Social Interaction, No Intervention) for 40 weeks. Two MRI's
      were obtained, one before the intervention period, the other after. A neuropsychological
      battery was administered at baseline, 20 weeks and 40 weeks. Comparison of changes in brain
      volumes in intervention groups with the No Intervention group were assessed by t-tests.
      Time-intervention group interactions for neuropsychological measures were evaluated with
      repeated-measures mixed models.
    

Intervention name(s): Fast walking; Tai Chi; Intellectual stimulation; Contact and testing only
Intervention type(s): Other; Other; Other; Other
Intervention description(s): Participants assigned to this group met with two group leaders three times per week in the morning in Jing An Park and were encouraged to walk quickly around a 400 meter circular route. Each session consisted of 10 minutes of warm-up stretching, 30 minutes of brisk walking, and 10 minutes of cool-down exercises. Prior to the first session, each participant was given a pedometer with their name on it. They were asked to take 100 steps and the sensitivity and positioning of the pedometer was adjusted to assure accurate measurement. At the termination of each session, the pedometers were collected and the number of steps taken by each participant at that session recorded. A record of the number of steps taken for every participant at each session over the 40 week period was maintained.; Participants assigned to this group met with a Tai Chi master and assistant three times per week in the morning in Jing An Park or at a nearby gymnasium depending on weather conditions. Each session included 20 min of warm-up exercises (lower back and hamstring stretching, gentle calisthenics, and balance training), 20 min of Tai Chi practice, and 10 min of cool-down exercises.; Participants assigned to this group met with a group leader and an assistant for one hour three times a week in the morning at the neighborhood community center. Although direction was initially given regarding subjects for discussion, the participants decided on their own to organize and select topics themselves.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: magnetic resonance imaging; cognition; Tai Chi; physical exercise; mental exercise; intervention trial; prevention; dementia; Alzheimer disease; mild cognitive impairment