Aerobic Exercise and Cognitive Training in Older Adults
Condition: Sedentary Lifestyle
Study type: Interventional

Summary: 
      The purpose of this study is to examine the impact of a combined cognitive training and
      aerobic exercise intervention in sedentary older adults. It is hypothesized that the aerobic
      exercise will potentiate and increase the generalizability of the cognitive training.
      Importantly, this study will focus on older adults at-risk for mobility disability. This area
      is of particular importance considering a large percentage of adults are entering old age and
      therefore likely to suffer from age-related cognitive decline and mobility disability.

      To address the investigators' research question 60 adults (age 18-89) will be randomized to
      one of two 12 week intervention groups: 1) Cognitive Training alone (CT) or 2) Aerobic
      Exercise + Cognitive Training (AE+CT). The aerobic exercise arm of the study will follow the
      same format shown to improve a broad range of executive functions in older adults in previous
      research. The cognitive training arm will consists of a popular commercially-available brain
      fitness program that has demonstrated specific cognitive improvements and high adherence.
    

Detailed description: 
      Purpose: The purpose of this study is to examine the impact of a combined cognitive training
      and aerobic exercise intervention in sedentary older adults. Recent research demonstrated
      that older adults who participated in aerobic fitness training significantly increased their
      brain volume. Equally important, the demonstrated enhancement in brain size is related to
      improvement on specific cognitive tasks. For example, researchers demonstrated that 124 older
      adults randomly assigned to receive aerobic training experienced substantial improvement in
      cognitive performance tasks related to speed of processing and working memory. Similarly,
      neuroimaging studies showed that aerobically trained individuals increased brain activation
      during various cognitive tasks.

      A growing body of research also demonstrates the beneficial effects of cognitive training in
      later life to promote a healthy brain. For example, researchers demonstrated cognitive
      interventions targeting memory, reasoning and speed of processing were effective to improve
      brain function. Unfortunately, despite these promising findings, the generalizability of
      cognitive training is limited. For example, researchers showed cognitive training tasks
      designed to improve reasoning, memory, planning, spatial skills and attention in over 11,000
      participants demonstrated no transfer effects to untrained tasks, even when the tasks were
      closely related. The purpose of this study is to see if combing aerobic exercise and
      cognitive training can enhance the cognitive improvement of each. Specially, the
      investigators wish to determine if aerobic exercise done immediately before cognitive
      training can potentiate the improvement.

      The investigators hypothesized that the aerobic exercise will potentiate and increase the
      generalizability of the cognitive training. Importantly, this study will focus on older
      adults at-risk for mobility disability. This area is of particular importance considering a
      large percentage of adults are entering old age and therefore likely to suffer from
      age-related cognitive decline and mobility disability.

      Background: Currently the United States has over 23 million Veterans. Of this number, 39.1
      percent are over the age of 65 a number that will greatly increase as a large percent of the
      US population ages. Unfortunately, many of these individuals will suffer from some form of
      age-related cognitive decline and/or mobility disability. Significantly, declining mental
      health and mobility disability are primary components of the expected 25 percent growth in
      health care cost related to the aging crisis in America. And, despite the fact that the
      United States federal government spends $100 billion dollars annually to cure and/or treat
      cognitive impairments, successful strategies to improve these impairments remain elusive. The
      proposed research will substantially advance the development of treatments for cognitive and
      mobility impairment because the goals explore an intervention that may potentially have
      pervasive effects on US Veterans quality of life and well-being from a physical as well as a
      cognitive standpoint.

      Methods and Research Plan: To address the investigators' research question 60 adults (age
      18-89) will be randomized to one of two 12 week intervention groups: 1) Cognitive Training
      alone (CT) or 2) Aerobic Exercise + Cognitive Training (AE+CT). The aerobic exercise arm of
      the study will follow the same format shown to improve a broad range of cognitive functions
      in older adults in previous research. The cognitive training arm will consists of a popular
      commercially-available brain fitness program that has demonstrated specific cognitive
      improvements and high adherence.

      Baseline testing will consist of a battery of cognitive function that target verbal fluency,
      response inhibition, and working memory. Additionally, participant will undergo a structural
      and functional MRI. Participants will also be evaluated on their physical function as
      assessed by a 400 meter walk, balance tests, and questionnaires about their daily l
      functioning. And lastly, all participants will be assessed on their aerobic capacity and for
      visual outcomes and serum BDNF. Following the 12-week intervention all participants will be
      post tested in the same manner as the baseline testing.
    

Intervention name(s): Aerobic exercise + Cognitive Training Group; Cognitive training Only
Intervention type(s): Behavioral; Behavioral
Intervention description(s): stationary bicycling; 20 minutes of cognitive training using Mindfit program
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: Aging