Resilience and Brain Health of Older Adults During the COVID-19 Pandemic (MEDEX-2)

Study Overview
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Brief Summary
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This project capitalizes on a natural experiment imposed by the COVID-19 pandemic in conjunction with an extensive set of cognitive, emotional, biological, and neuroimaging variables already collected at multiple time points in older adults participating in a clinical trial of exercise and mindfulness. This project will elucidate the effects of stress on cognitive function and emotional health in later life, including biological measures of Alzheimer Disease risk, stress, and aging, with the ultimate goal of discovering how to mitigate these effects, among older adults who have made and maintained a lifestyle change.

Official Title
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Resilience and Brain Health of Older Adults During the COVID-19 Pandemic (MEDEX-2)

Conditions
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Age-related Cognitive Decline

Intervention / Treatment
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* Behavioral: Mindfulness-Based Stress Reduction
* Behavioral: Exercise
* Behavioral: Mindfulness-Based Stress Reduction + Exercise
* Behavioral: Health Education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participated in the parent study, Protocol ID #201410093 Exclusion Criteria: Inability to safely continue classes or complete assessments, as per PI discretion

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: Factorial Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Mindfulness-Based Stress Reduction<br>Mindfulness-Based Stress Reduction (MBSR) as delivered in the parent study (Protocol ID #201410093) consisted of a brief introductory meeting, eight weekly 2.5-hour classes, and a retreat, followed by monthly booster sessions for approximately 15 months. Content included instruction in mindfulness meditation practices, gentle mindful movement, and exercises to enhance mindfulness in everyday life. For the current study, participants will continue monthly approximately 2.5 hour booster sessions covering similar content for the duration of the study. Participants will be encouraged to maintain daily formal meditative activities at home. | Behavioral: Mindfulness-Based Stress Reduction<br>* Mindfulness-Based Stress Reduction<br>|
| Experimental: Exercise<br>The exercise protocol in the parent study (Protocol ID #201410093) was optimal for improving aerobic fitness and insulin sensitivity in older adults, as well as improving strength and balance and reducing indices of frailty. It consisted of classes twice weekly for 6 months, building up to 1.5 hr, under the direct supervision of trained exercise instructors, followed by once weekly classes for 12 months. For the current study, participants will continue monthly approximately 1.5 hour classes focused on functional training for the duration of the study. Participants will be encouraged to continue between-session engagement in aerobic and resistance training activities at home. | Behavioral: Exercise<br>* Exercise<br>|
| Experimental: Mindfulness-Based Stress Reduction + Exercise<br>This condition will receive both MBSR and exercise as described. Participants in this condition will attend monthly sessions with encouragement to complete at-home mindfulness practice as well as at-home exercise for the duration of the study. | Behavioral: Mindfulness-Based Stress Reduction + Exercise<br>* Mindfulness-Based Stress Reduction + Exercise<br>|
| Active Comparator: Health Education<br>The health education control condition is based on a chronic disease self-management program developed at Stanford University and was used as an attentional control in the parent study (Protocol ID #201410093). This control intervention was designed to be time-equivalent to MBSR, with 8 weeks of 2.5 hour weekly group classes followed by monthly booster sessions for approximately 15 months. For the current study, participants will continue monthly approximately 1.5 hour sessions covering similar content for the duration of the study. | Behavioral: Health Education<br>* Health Education<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effects of the interventions on changes in cognitive performance | Test effects of mindfulness and exercise on changes in change in memory and cognitive control composites. | Approximately three years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Exercise, Mindfulness, Education, Elderly