The investigators proposed research will establish whether combining aerobic exercise with cognitive challenges is feasible and effective in community dwelling older adults with early signs of cognitive impairment.
To determine the effects of dual-task aerobic exercise training on community dwelling older adults with early signs of cognitive impairment. We will compare an exercise intervention (E-I) versus an exercise control (E-C) group. Each week, both groups will accumulate a minimum of 120 minutes of exercise (target 150 minutes) from community-based group classes (50 minutes of aerobic exercise) and also complete 45 minutes of beginner-level Square Stepping Exercise (SSE). The E-I group will also answer cognitively challenging questions while doing SSE (dual-task training). This study will determine whether a combined multiple modality (primary component being aerobic exercise) and dual-task exercise program is both feasible and effective for improving cognitive and mobility status, as well as vascular compliance, in older adults who may be at risk for cognitive and mobility decline.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
44
Goal of 150 minutes of structured exercise/week; minimum of 120 minutes from CCAA classes/week. The 75-minute class includes: 5-minute warm-up; 25 minutes of AE (70-85% maximum heart rate); 5-minute cool-down; 20 minutes of strength training; 5 minutes of core strengthening; 5 minutes of balance training; and 10 minutes of stretching. The 60-minute program is identical except: 15 minutes total for all strength training (including core) and 5 minutes of stretching. Following CCAA classes, participants continue with dual-task gait training where they are required to walk on a special mat with a designated walking pattern (beginner level Square Stepping Exercise) while answering cognitively challenging questions.
Goal of 150 minutes of structured exercise/week; minimum of 120 minutes from CCAA classes/week. The 75-minute class includes: 5-minute warm-up; 25 minutes of AE (70-85% maximum heart rate); 5-minute cool-down; 20 minutes of strength training; 5 minutes of core strengthening; 5 minutes of balance training; and 10 minutes of stretching. The 60-minute program is identical except: 15 minutes total for all strength training (including core) and 5 minutes of stretching. Following CCAA classes, participants continue with gait training where they are required to walk on a special mat with a designated walking pattern (beginner level Square Stepping Exercise). This will not include any dual-task challenges.
Aging, Rehabilitation and Geriatric Care Research Center
London, Ontario, Canada
Global cognitive functioning
Four standardized domain-specific composite scores were averaged to create this standardized global cognitive functioning score (incorporates executive function, processing speed, verbal learning and memory, and verbal fluency.
Time frame: 26 weeks
Global cognitive functioning
Four standardized domain-specific composite scores were averaged to create this standardized global cognitive functioning score (incorporates executive function, processing speed, verbal learning and memory, and verbal fluency.
Time frame: 12 & 52 weeks
Executive Function/Mental Flexibility
Standardized scores from seconds to complete Trail Making Test Part A and Trail Making Test Part B averaged to create this standardized composite score
Time frame: 12, 26, and 52 weeks
Processing Speed
Standardized score from the Digit-Symbol Substitution Test (total correct responses)
Time frame: 12, 26 and 52 weeks
Verbal Learning and Memory
Standardized scores from Auditory Verbal Learning Test (number of words learned and number of words recalled) were averaged to create this standardized composite score
Time frame: 12, 26 and 52 weeks
Verbal Fluency
Standardized scores from semantic (number of animals) and phonemic (number of words starting with C) were averaged to create this standardized composite score
Time frame: 12, 26 and 52 weeks
Gait variability (step length) under dual-task conditions
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Gait variability is the stride-to-stride fluctuations of the way someone walks and will be calculated as coefficient of variation of step length (SD/mean x 100). Measured with GAITRite system.
Time frame: 12, 26 and 52 weeks
Gait variability (step length) under single-task conditions
Gait variability is the stride-to-stride fluctuations of the way someone walks and will be calculated as coefficient of variation of step length (SD/mean x 100). Measured with GAITRite system.
Time frame: 12, 26 and 52 weeks
Gait speed under dual-task conditions
Average walking speed measured with GAITRite system
Time frame: 12, 26 and 52 weeks
Gait speed under single-task conditions
Average walking speed measured with GAITRite system
Time frame: 12, 26 and 52 weeks
Double support (seconds and % gait cycle time) under dual-task conditions
Initial double support occurs from heel contact of one footfall to toe-off of the opposite footfall. Terminal double support occurs from opposite footfall heel strike to support footfall toe-off.Total double support is the sum of the initial double support added to the terminal double support. It is measured in seconds (sec) and also expressed as a percent of the Gait Cycle time for the same foot. Measured with GAITRite system
Time frame: 12, 26 and 52 weeks
Double support (seconds and % gait cycle time) under single-task conditions
Initial double support occurs from heel contact of one footfall to toe-off of the opposite footfall. Terminal double support occurs from opposite footfall heel strike to support footfall toe-off.Total double support is the sum of the initial double support added to the terminal double support. It is measured in seconds (sec) and also expressed as a percent of the Gait Cycle time for the same foot. Measured with GAITRite system
Time frame: 12, 26 and 52 weeks
Step length under dual-task conditions
Mean step length measured with GAITRite system
Time frame: 12, 26 and 52 weeks
Step length under single-task conditions
Mean step length measured with GAITRite system
Time frame: 12, 26 and 52 weeks
Carotid artery compliance
Measured from non-invasive vascular assessment with B-mode Ultrasound over the carotid artery (in the neck)
Time frame: 12, 26 and 52 weeks
Carotid artery Intima-media thickness (IMT)
Measured from non-invasive vascular assessment with B-mode Ultrasound over the carotid artery (in the neck)
Time frame: 12, 26 and 52 weeks
Ambulatory systolic blood pressure
Average systolic blood pressure over a 24-hour time frame
Time frame: 12, 26 and 52 weeks
Clinic systolic blood pressure
Average systolic blood pressure from final 2 (out of 3) readings
Time frame: 12, 26 and 52 weeks
Ambulatory diastolic blood pressure
Average diastolic blood pressure over a 24-hour time frame
Time frame: 12, 26 and 52 weeks
Clinic diastolic blood pressure
Average diastolic blood pressure from final 2 (out of 3) readings
Time frame: 12, 26 and 52 weeks
Total balance score
Total balance score calculated from the Fullerton Advanced Balance Scale
Time frame: 12, 26, and 52 weeks
Total Falls Self-Efficacy score
Total falls self-efficiacy score calculated from the Falls Self-Efficacy International (FES-I) scale
Time frame: 12, 26, and 52 weeks