Walking Interventions, Cognitive Remediation and Mild Cognitive Impairment

Study Overview
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Brief Summary
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The purpose of this study is to determine the effects of a coordinated intervention of cognitive remediation training (CRT) and walking intervention on cognition and gait in the elderly.

Detailed Description
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This is a single blind randomized study designed to understand the effects of different interventions, walking interventions and cognitive remediation in particular, towards cognition and gait in the elderly. The study uses a 4 arm approach consisting of 4 intervention groups, with each intervention lasting for 12 weeks. The investigators will investigate the effect of each intervention towards cognitive function and gait. All interventions will be conducted on site at the Pennington Biomedical Research Center, and will be focused on determining the effects of different combinations of walking, cognitive remediation, healthy living courses, and reading. Cognitive measures will include objective clinical measures related to dementia, and the gait analysis will include in clinic and free living measures related to falls.

Official Title
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Walking Interventions, Cognitive Remediation and Mild Cognitive Impairment

Conditions
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Cognitive Impairment

Intervention / Treatment
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* Behavioral: Cognitive Remediation Therapy Group
* Behavioral: Walking Intervention (WI) Group
* Behavioral: Combination Group
* Behavioral: Healthy Living Group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Men and women meeting all criteria listed below will be included in the study: Subjects between 65-85 years of age inclusive Subjects with Short Physical Performance Battery of 10 or greater Subjects averaging less than 5,000 steps per day Subjects with Mini Mental State Exam 25-28, inclusive Subjects with normal for age physical-neurological exam Subjects able to walk a city block without a walking aid Written Informed Consent obtained PRIOR to performing any study procedures Exclusion Criteria: Subjects with difficult walking due to pain or posture Subjects with difficulty in using computer due to significant visual and/or fine motor impairment Subjects with large weight loss (>15 Kilogram) in the last 12 months Subjects with geriatric depression scale > 9. Subjects with Malignancies in the past 5 years, with the exception of skin cancer therapeutically controlled Subjects with abnormal electrocardiogram results. These include: a resting heart rate below 40 bpm or above 100 bpm, previously unknown and/or untreated atrial fibrillation or flutter, evidence of a third degree A-V block, a previously undocumented left bundle branch block, S-T segment depression of greater than 2 mm, evidence of a previous MI, or any other findings that in the clinical judgment of the medical investigator preclude participation in an exercise intervention. Subjects with shortness of breath, exertional angina, uncontrolled high blood pressure or any other chronic medical condition deemed by the physician to preclude participation in an exercise intervention. Subjects with any other medical condition or disease that is life-threatening or that can interfere with, or be aggravated by, exercise. Subjects who currently smoke.

Ages Eligible for Study
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Minimum Age: 65 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

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


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Cognitive Remediation Therapy Group<br>30 minute Cognitive Remediation Therapy and 60 minute Healthy Living Class three time per week | Behavioral: Cognitive Remediation Therapy Group<br>* 30 min Cognitive Remediation Therapy + 60 Min Healthy Living class 3x week<br>|
| Experimental: Walking Intervention Group<br>60 minutes of walking and 30 minutes of reading stimulation three times a week | Behavioral: Walking Intervention (WI) Group<br>* 60 min Walking Intervention + 30 min low interface reading 3x week<br>|
| Experimental: Combination Group<br>30 minutes of Cognitive Remediation therapy and 60 minutes of walking three times a week | Behavioral: Combination Group<br>* 30 min Cognitive Remediation Therapy + 60 min Walking Intervention 3x week<br>|
| Experimental: Healthy Living Group<br>60 minute Healthy Living Class and 30 minutes of reading stimulation three times a week. | Behavioral: Healthy Living Group<br>* 60 Min Healthy Living class + 30 min low interface reading 3x week<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effects of interventions on cognition | Standard psychometric tests will be used to measure cognition | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effects of interventions on gait | Standard laboratory assessments and accelerometers will be used to measure gait. | 6 months |