The prevalence of dementia will double in the next three decades in the U.S.; effective treatment or prevention for dementia is urgently needed. The current exploratory project aims to evaluate and understand how the brain and cognition may improve after a 12-week intervention that combines brain training and aerobic exercise training to improve brain function, both in those with mild cognitive impairment (some with possible prodromal Alzheimer's disease) and with healthy aging. Findings from this pilot project will guide and refine the development of a future larger clinical trial that aligns with the goals of the National Alzheimer's Plan of Action (NAPA), especially regarding "Prevent and Effectively Treat Alzheimer's Disease (AD) by 2025.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
90
Progressive aerobic exercise
Adaptive cognitive training
Combine adaptive cognitive and progressive aerobic exercise training
University of Maryland Baltimore
Baltimore, Maryland, United States
RECRUITINGChanges in Brain structure measures
Changes in brain volume measures from T1-weighted images (volumes in mm3)
Time frame: At baseline and at 4 weeks after the corresponding training program.
Changes in brain cortical thickness measures
Changes in brain cortical thickness measures from T1-weighted images (thickness measures in mm)
Time frame: At baseline and at 4 weeks after the corresponding training program.
Changes in Brain microstructure measures
Changes in brain measures of diffused tensor imaging (diffusion coefficient in mm²/s)
Time frame: At baseline and at 4 weeks after the corresponding training program.
Changes in Brain blood flow from Arterial spin labeling magnetic resonance imaging (ASL-MRI) in milliliters/100 g/minutes
Changes in Brain blood flow from Arterial spin labeling magnetic resonance imaging (ASL-MRI) in milliliters/ 100 g/ minutes
Time frame: At baseline and at 4 weeks after the corresponding training program.
Changes in Brain Activation on functional MRI
Changes in functional MRI from blood oxygen level dependence (BOLD) contrast on fMRI (in percentage change)
Time frame: At baseline and at 4 weeks after the corresponding training program.
Changes in cognitive performance, emotions, and motor function based on NIH toolbox
Changes in cognitive performance, emotions, and motor function in raw scores measured by the NIH Toolbox® (reports will be generated as T scores, with higher T scores indicating better outcomes)
Time frame: At baseline and at 4 weeks after the corresponding training program.
Changes in executive function using the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A)
Changes in executive function using the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) (reports will be generated as T scores, with lower T scores indicating better outcomes and T scores higher than 65 indicating significant impairments in the executive function)
Time frame: At baseline and at 4 weeks after the corresponding training program.
Changes in Blood Bioenergetic Markers
Platelet mitochondrial respiration (OCR) and extracellular acidification rates (ECAR) will be evaluated to assess bioenergetic profiles in platelets isolated from whole blood of fasted participants. OCR will be measured using a Seahorse model XFe96 machine as the high throughput platform. Measurements of OCR/ECAR will be performed with the following modifications. Platelets will be isolated from whole blood with a Beckman Allegra model X-30R centrifuge. Platelets will be counted using a Nexcelom Bioscience Cellometer (Lawrence, MA) using Calcein acetoxymethyl (AM) ester dye to enable the seeding of 10,000,000 platelets per well.
Time frame: At baseline and at 4 weeks after the corresponding training program.
VO2peak
VO2peak will be used as the primary measure of aerobic capacity. Subjects will be asked to exercise to voluntary exhaustion during a treadmill test using a modified Bruce protocol. Oxygen (O2) consumption, carbon dioxide (CO2) production, and minute ventilation will be measured breath-by-breath using a metabolic cart and the average of the final two 20 second values of O2 consumption are VO2peak.
Time frame: At baseline and within one week after the corresponding training program.
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