Yoga, Aerobic and Stretching Exercise Effects on Neurocognition

Study Overview
=================
Brief Summary
-----------------
The investigators propose to conduct a 6-month 3-arm randomized controlled exercise trial among older adults to compare the efficacy of yoga with aerobic exercise and stretching-toning exercises on cognitive function, brain structure and function, cardiorespiratory fitness, functional fitness, and inflammatory and molecular markers. Using a single-blind, three arm randomized control trial, 168 older adults ages 55-79 will be assigned to either: a Hatha yoga group, an aerobic exercise group or an active stretching and toning control group. The groups will engage in hour-long group exercise sessions 3x/week. A comprehensive neurocognitive test battery, brain imaging, cardiovascular fitness test, and a blood draw will take place at baseline; end of the 6-month intervention, and at 12-month follow-up. The proposed work will examine the relationship between yoga training and improved cognitive functioning as well as identify neurobiological correlates as potential mechanisms of action through which yoga training exerts its effect on cognitive function. COVID-19 Precautions: Due to COVID-19, all exercise sessions will be conducted live via Zoom video-conferencing such that 1/3rd of the participants in each group will exercise in person with the research staff at UIUC campus once a week while the remaining 2/3rd will tune in via Zoom

Official Title
-----------------
Yoga, Aerobic and Stretching Exercise Effects on Neurocognitive Performance: A Randomized Controlled Trial

Conditions
-----------------
Aging, Cognitive Decline

Intervention / Treatment
-----------------
* Behavioral: Physical Activity


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: 55-79 years of age at study enrollment TICS-M score of 32 or higher No current or past diagnosis of mild cognitive impairment or dementias Low-active (≤ 2 days of 30 minutes of structured exercise/week) Physician's consent to participate in VO2max testing and the exercise program Ambulatory Absence of health conditions that may be exacerbated by exercise Good or corrected vision and hearing No MRI contraindications (e.g. metal or implanted devices in the body) Right-handed Intention to remain in the Champaign-Urbana area over the study duration Exclusion Criteria: Below 55 or above 79 years of age at study enrollment TICS-M score of 31 or lower Current or past diagnosis of mild cognitive impairment or dementias High-active (3 or more days of 30 minutes of structured exercise/week) Physician's non-consent to participate in VO2max testing and the exercise program Non-ambulatory (use of wheelchairs or walkers) Presence of health conditions that may be exacerbated by exercise Poor vision and hearing MRI contraindications (e.g. metal or implanted devices in the body) Left-handed Plans to travel outside of Champaign-Urbana area during the study

Ages Eligible for Study
-----------------
Minimum Age: 55 Years
Maximum Age: 79 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Yoga Group<br>Participants will be led through a beginner yoga course taught by a certified yoga instructor. Classes will meet three times a week for 60 minutes over the 6 month study duration. Sessions will focus on yoga postures, breathing, and meditative practices and may utilize mats, blocks, belts, and blankets. | Behavioral: Physical Activity<br>* 3 sessions per week, 60 minutes per session for 6 months<br>|
| Experimental: Aerobic Group<br>Trained exercise instructors will lead participants through an aerobic group exercise class. Sessions will begin with a 15-20 minute aerobics class and increase in duration over the 6 months capping off at 40-minutes per session. The prescribed intensity will be 50-60% of the maximum heart rate reserve for weeks one to six and 60-75% for the remainder of the program. | Behavioral: Physical Activity<br>* 3 sessions per week, 60 minutes per session for 6 months<br>|
| Active Comparator: Stretching Toning Group<br>Participants randomized to this group will meet three times a week for an hour-long structured group exercise session. This group will perform stretching and toning exercises using resistance bands, balance disks, and exercise mats. | Behavioral: Physical Activity<br>* 3 sessions per week, 60 minutes per session for 6 months<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in cognitive function | A comprehensive neuropsychological battery (part of the NIH toolbox) will be used that assesses different domains of cognitive function, including working memory, attention and executive function. | Baseline, 6 months, 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in brain structure | MRI will be used to measure brain volume. | Baseline, 6 months, 12 months | 
| Change in brain function | Functional MRI will be used to measure changes in brain activity during resting state. | Baseline, 6 months, 12 months |