Village Interactive Training and Learning Study
Condition: Aged
Study type: Interventional

Summary: 
      The purpose of this research study is to help scientists and health care providers learn more
      about preventing dementia and brain disease in older adults. There is an urgent need to
      develop strategies to prevent or slow down memory loss and brain function decline in the
      elderly.

      In this study, the investigators hope to learn how physical exercise and a brain training
      program work together to improve thinking and memory in older adults. Specifically, these
      aims include:

        -  Learning whether physical activities (like biking or treadmill walking or Wii Fit games)
           will help improve the benefits of a brain training program. Based on preliminary results
           and that in the literature, the investigators anticipate greater cognitive benefits in
           the Exercise + Cognitive training groups than the Cognitive Training alone group.

        -  To determine whether the benefits of adding exercise will occur quickly or develop more
           gradually over time. The investigators suspect that a major benefit of exercise
           pre-dosing will occur by the 12th week of the program.

        -  To examine whether Wii-Fit exercise games cause similar effects on brain training as
           traditional exercise programs such as biking or walking. Although several recent studies
           have raised questions about the true aerobic benefit of exergames such as Wii-Fit Plus,
           other evidence suggests that these weaker aerobic benefits may be offset by the greater
           novelty and interest level afforded by exergames.
    

Detailed description: 
      Research Participants take part in a 16 week Wellness Program, which includes either
      traditional physical exercise with brain training(Group A), Wii exergaming with brain
      training(Group B) or brain training alone (Group C). Participants are randomly assigned to
      groups.

      A comprehensive battery of neuropsychological tests, surveys and assessments are given prior
      to start of the intervention, at completion of the 16 weeks, and again 3 months post
      completion.

      The program involves 4 days of physical activity each week for groups A & B. The physical
      exercise/activity portion will involve warm up stretching and then either Group A-traditional
      exercise (like riding a stationary recumbent bicycle or walking on a treadmill), Group B-
      playing Nintendo Wii Exergames with a television based video game, or Group C- NO exercise at
      all.

      Every 4th week the 16 week intervention period, all participants in all three groups will
      also complete 80 minutes of brain training activities each day of the week. This is in
      addition to the previously assigned physical activity for Groups A & B. The brain training
      regimen consists of Posit Science Insight computer based brain games.

      The Insight program consists of five different modules that focus on visual processing,
      attention, and memory. Each of the modules are described below:

        1. Bird Safari: This module involves identifying and ordering simple visual stimuli that
           flash on a screen. The goal is to improve ability to respond quickly to visual stimuli
           and to segment rapidly changing visual pictures.

        2. Jewel Diver: This module involves tracking objects as they become hidden by distractors.
           The goal is to improve ability of visual system to rapidly identify and discriminate
           objects in the visual periphery.

        3. Master Gardener: This module involves visual working memory and matching pairs of
           pictures.

        4. Road Tour: This is a simulated driving exercise that involves divided attention to
           oncoming cars and road signs. The goal is to improve ability of visual system to
           continuously track multiple objects against a field of distractors.

        5. Sweep Seeker: In this exercise, participants identify complex moving visual stimuli. The
           goal is to improve rapid, sequential eye movements to salient visual targets, process
           relevant information and then make rapid decisions to identify, discriminate and
           classify targets.

      Questionnaires regarding the participants mood before and after the brain training weekly are
      administered. In addition, brief questionnaires on attention and memory are given to measure
      thinking and memory progress.
    

Intervention name(s): Exercise; Exergames; Cognitive Training
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Participants will do physical activity that raises heart rate to a target heart rate (THR)zone which is pre-calculated using the Karvonen Formula:
(THR={(max. heart rate- rest heart rate) x %intensity} + resting heart rate
Participants begin exercise regimen starting at 50% THR for intensity and gradually increase by 5% up to a maximum of 75% THR.
Activity duration begins at 10 mins./day and increases 5 mins. every week following to a maximum of 40 mins. Polar Heart Rate monitors are used to measure THR and save resulting data.; Participants experience Wii Video Games in a standardized format, beginning with 15 mins of seated play per day on week one, and then increasing 5 mins./week on each week following up to a maximum of 40mins. of play.
Participants are made aware of the Target Heart Rate Zone for the week, but are not required to reach that zone during play. The THR is calculated by the Karvonen Formula:
THR={(max. heart rate- rest heart rate) x %intensity} + resting heart rate
Polar Heart Rate monitors are used to measure THR and save resulting data.; Posit Science INSIGHT program games are used for all cognitive training. Participants are exposed to (2) forty minute game sessions per day, for the cognitive training weeks #4,8,12,16.
INSIGHT Assessments are done at baseline, the start of each training week and at week 28.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Cognitive Training; Aging; Seniors