Body and Brain Exercise for Older Adults With Memory Complaints

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's127 enrolled

Overview

The purpose of this study is to investigate whether an exercise class with a cognitive (or brain) training component was more effective than a usual combined aerobic and resistance exercise class for older adults with cognitive complaints (such as concerns about changes in memory or thinking skills). It is hypothesized that the group randomized to the exercise class that includes additional brain training will have greater improvements in brain health.

Older adults with self-reported cognitive complaints (CCs) may be at increased risk for the development of Alzheimer's disease and dementia. Cognitive decline in older adults, particularly reduced memory and executive function is associated with functional decline, institutionalization, and increased health care costs. Similarly, cardiovascular risk factors have been associated with cognitive and functional impairment in aging. Aerobic exercise has been shown to improve vascular function and blood flow in the brain's prefrontal cortex. In turn, resistance training can produce functional changes within distinct cortical regions during the encoding and recall of association tasks and has been shown to increase circulating neural growth factors (i.e., a proposed mechanism by which cognition may be preserved or improved in old age). Recent evidence also suggests that cognitive training may improve the cognitive performance of older adults. Therefore, we will investigate the impact of a combined exercise program (multi-modality exercise; M2) compared to a combined exercise program with a cognitive component (multi-modality, mind-motor exercise; M4) on cognition, cognitive-motor, mobility, neural functioning and vascular outcomes in older adults with cognitive complaints. Community-based exercise programs for older adults provide widespread access, are relatively inexpensive, and provide opportunities for social interaction. The primary purpose of this study is to compare the effects of the M2 and M4 exercise programs on brain health. This study will also examine the effects of the different exercise programs on cardiovascular risk factors and mobility. In a subset of participants, cognitive-motor and neural functioning outcomes will be examined.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Conditions

Cognitive Ability, General

Interventions

Multi-modal exerciseBEHAVIORAL

Community-based group exercise classes following Canadian Centre for Activity and Aging exercise guidelines. Exercise classes consist of 5 min warm-up, 20 min aerobic exercise, 5 min aerobic cool-down, 10 min full-body resistance exercise, 5 min stretching (total 45 min)

Mind-Motor ExerciseBEHAVIORAL

Square Step Exercise involves mimicking a stepping pattern demonstrated by an instructor. The stepping patterns become progressively difficult and involve forward, backward, lateral and diagonal movements on a 250cm long mat with 25cm square grids (15 min).

Balance and range of motion exercisesBEHAVIORAL

Community-based group exercise designed to improve balance and range of motion of the joints (15 min)

Eligibility

Sex: ALLMin age: 55 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * aged 55 years or older * self-reported cognitive complaint (defined as answering yes to the question "Do you feel like your memory or thinking skills have gotten worse recently?). * independent on instrumental activities of daily living Exclusion Criteria: * Probable Dementia (i.e., diagnosis OR Mini-Mental State Examination score \<24) * Other neurological conditions or major psychiatric disorders (i.e., Parkinson's disease; bipolar disorder) * Previous history of severe cardiovascular conditions (i.e., myocardial infarction or stroke \<1-year ago; end stage congestive heart failure; end stage renal disease) * Severe sensory impairment (i.e., blind) * Significant orthopedic conditions (i.e., severe osteoarthritis) * Clinical depression (determined via \>=16 on the Center for Epidemiologic Studies - Depression Scale AND review by primary study physician) * Have blood pressure \>180/100 mmHg or \<100/60 mmHg * Unable to comprehend questionnaire material * Any other factors that could potentially limit ability to fully participate in the intervention

Locations (1)

Gymnasium

Woodstock, Ontario, Canada

Outcomes

Primary Outcomes

Composite score from Cambridge Brain Sciences Cognitive Battery - 12 tasks

To assess global cognitive function

Time frame: 6 months

Secondary Outcomes

Composite score from Cambridge Brain Sciences Cognitive Battery - 12 tasks

To assess global cognitive function

Time frame: 12 months

Gait variability (stride time) under dual-task conditions

Gait variability is the stride-to-stride fluctuations of the way someone walks and will be calculated as the coefficient of variation of step length (SD/mean x100). Measured with GAITRite system.

Time frame: 6 & 12 months

Gait variability (stride time) under single-task conditions

Gait variability is the stride-to-stride fluctuations of the way someone walks and will be calculated as the coefficient of variation of step length (SD/mean x100). Measured with GAITRite system.

Time frame: 6 & 12 months

Gait velocity (speed) under dual-task conditions

Average walking speed (gait velocity) measured with the GAITRite system

Time frame: 6 & 12 months

Gait velocity (speed) under single-task conditions

Average walking speed (gait velocity) measured with the GAITRite system

Time frame: 6 & 12 months

Step length (average) under dual-task conditions

Mean step length calculated from GAITRite system

Time frame: 6 & 12 months

Data from ClinicalTrials.gov

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