Exercise Trial for Alzheimer's Disease

Study Overview
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Brief Summary
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Exercise Trial for Alzheimer's Disease(EXTRA) is a pilot randomized clinical trial involving a physcial activity program versus a healthy lifestyle program, with one year follow-up in 30 non-disabled, community-dwelling persons, age 65 and older.

Detailed Description
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Alzheimer's disease (AD) occurs in 1 in 7 individuals over 65, and 1 in 2 individuals over 85. While the progression of AD is extremely variable, it is generally established that AD subjects will move from having compromised function in socail and work settings, to requiring institutionalization and/or intensive management within 10 years of initial clinical diagnosis. A randomized controlled piot trial is needed to provide information regarding exercies effects on individuals with mild to moderate Alzheimer's disease. Exercise Trial for Alzheimer's Disease (EXTRA) is a pilot randomized controlled trial designed to compare a moderate-intesity physical activity program to a healthy lifestyle health education program in 30 older adults with mild to moderate Alzheimer's Disease. These individuals will be followed for 1 year. This trial will provide pilot evidence regarding whether physical activity is effective and practical for individuals with AD. The effects of an exercise intervention on halting, slowing, or reversing the cognitive effects of AD will be assessed with pilot data and potentially provide support for a larger trial in the future.

Official Title
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Exercise Trial for Alzheimer's Disease (EXTRA)

Conditions
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Alzheimer's Disease

Intervention / Treatment
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* Behavioral: Healthy Lifestyle Program
* Behavioral: Physical Activity Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 65 years and older must be planning to reside in the area for 1 year summary scor of greater than or equal to 3 on the Short Physical Performance Battery (SPPB) have mild to moderate AD defined by a score of 12-24 on the Mini-Mental Status Examination (MMSE). Diagnosis of probable AD from site physician utilizing the following criteria: Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) criteria for Dementia of Alzheimer's Type, National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS/ADRDA) Criteria for Probable Alzheimer's Disease, and Hachinski Ischemic Score is less than or equal to 4 sedentary lifestyle which is operationally defined as spending less than 20 minutes a week in the past month getting regular physical activity. must be willing to give informed consent, be willing to be randomized to either physical activity or health lifestyle intervention, and to follow the protocol for the group to which they have been assigned Exclusion Criteria: unable or unwilling to give informed consent or accept randomization in either study group current diagnosis of schizophreniz, other psychotic disorders, or bipolar disorder current consumption of more than 14 alcoholic drinks per week plans to relocate to out of the study area within the next year or plans to be out of the study area for more than 6 weeks in the next year score of greater than 3 on SPPB another member of the household is a participant in they study residence too far from the intervention site difficulty in communication with study personnel due to speech or hearing problems MMSE less than 12 or greater than 24 currently enrolled in another randomized trial involving lifestyle or phamaceutical interventions other medical, psychiatric, or behavioral factors that in the judgement of the Principal Investigator may interfere with study participation or the ability to follow the intervention protocol

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Healthy Lifestyle Program<br>The purpose of the healthy lifestyle group is to control for general levels of staff and participant time and attention, in addition to general secular and seasonal effects that could influence the outcomes of interest. | Behavioral: Healthy Lifestyle Program<br>* The healthy lifestyle program includes upper body stretching and educational workshops. The purpose of this group is to control for general levels of staff and participant time and attention, in addition to general secular and seasonal effects that could influence the outcomes of interest. The rational for this placebo exercise activity is that it helps foster adherence to this arm of the study and increases the perceived benefit of the healthy lifestyle program to the participants without directly affecting the study outcomes.<br>|
| Active Comparator: Physical Activity Intervention<br>The physical activity program includes aerobic, strenth, flexibility and balance training. | Behavioral: Physical Activity Intervention<br>* The physical activity intervention consists of a general weekly physical activity goal of 150 minutes. This is consistent with the public health message from the Surgeon General's report that moderate physical activity should be performed for 30 minutes on most if not all days of the week (150-210 total minutes). This goal is approached in a progressive manner over the course of the trial.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effect of exercise on cognitive decline | The primary hypothesis is that exercise will decrease the congnitive decline in activities of daily living, in the subjects with Alzheimer's Disease. | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measuring the effects of exercise on depression, metabolic indices, and changes in overall function. | The secondary hypothesis is that exercise will decrease the level of depression, improve multiple metabolic indices, and improve function in subjects with Alzheimer's Disease. | 6 months | 
| Evidence based feasibility for conducting exercise interventions in the Alzheimer's Disease population. | The third hypothesis is that well controlled exercise interventions can be successfully implemented in subjects with Alzheimer's Disease. | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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exercise, intervention, Alzheimer's Disease, physical activity