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Reshaping the path of mild cognitive impairment by refining exercise prescription: a study protocol of a randomized controlled trial to understand the "what," "for whom," and "how" of exercise to promote cognitive function.
Trials. 2022 Sep 09; 23(1):766.T

Abstract

BACKGROUND

Targeted exercise training is a promising strategy for promoting cognitive function and preventing dementia in older age. Despite the utility of exercise as an intervention, variation still exists in exercise-induced cognitive gains and questions remain regarding the type of training (i.e., what), as well as moderators (i.e., for whom) and mechanisms (i.e., how) of benefit. Both aerobic training (AT) and resistance training (RT) enhance cognitive function in older adults without cognitive impairment; however, the vast majority of trials have focused exclusively on AT. Thus, more research is needed on RT, as well as on the combination of AT and RT, in older adults with mild cognitive impairment (MCI), a prodromal stage of dementia. Therefore, we aim to conduct a 6-month, 2 × 2 factorial randomized controlled trial in older adults with MCI to assess the individual effects of AT and RT, and the combined effect of AT and RT on cognitive function and to determine the possible underlying biological mechanisms.

METHODS

Two hundred and sixteen community-dwelling adults, aged 65 to 85 years, with MCI from metropolitan Vancouver will be recruited to participate in this study. Randomization will be stratified by biological sex and participants will be randomly allocated to one of the four experimental groups: (1) 4×/week balance and tone (BAT; i.e., active control); (2) combined 2×/week AT + 2×/week RT; (3) 2×/week AT + 2×/week BAT; or (4) 2×/week RT + 2×/week BAT. The primary outcome is cognitive function as measured by the Alzheimer's Disease Assessment Scale-Cognitive-Plus. Secondary outcomes include cognitive function, health-related quality of life, physical function, actigraphy measures, questionnaires, and falls. Outcomes will be measured at baseline, 6 months (i.e., trial completion), and 18 months (i.e., 12-month follow-up).

DISCUSSION

Establishing the efficacy of different types and combinations of exercise training to minimize cognitive decline will advance our ability to prescribe exercise as "medicine" to treat MCI and delay the onset and progression of dementia. This trial is extremely timely as cognitive impairment and dementia pose a growing threat to global public health.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02737878 . Registered on April 14, 2016.

Authors+Show Affiliations

Department of Physical Therapy, University of British Columbia (UBC), Vancouver, British Columbia, Canada. Djavad Mowafaghian Centre for Brain Health, UBC, Vancouver, British Columbia, Canada. Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.Department of Physical Therapy, University of British Columbia (UBC), Vancouver, British Columbia, Canada. Djavad Mowafaghian Centre for Brain Health, UBC, Vancouver, British Columbia, Canada. Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada. Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada. Department of Psychiatry, UBC, Vancouver, British Columbia, Canada.Faculty of Health Sciences, School of Kinesiology, Western University, London, Ontario, Canada. Brain and Mind Institute, Western University, London, Ontario, Canada.Djavad Mowafaghian Centre for Brain Health, UBC, Vancouver, British Columbia, Canada. Division of Neurology, UBC, Vancouver, British Columbia, Canada.School of Kinesiology, UBC, Vancouver, British Columbia, Canada.Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA.Department of Psychology, Northeastern University, Boston, MA, USA. Beckman Institute, University of Illinois, Urbana, IL, USA.Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA. Iowa Neuroscience Institute, University of Iowa, IA, Iowa City, USA.Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA. Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA. Neuroscience Research Institute, AdventHealth, Orlando, FL, USA.Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada. Social and Economic Change Laboratory, Faculty of Management, UBC-Okanagan, Kelowna, Canada.Faculty of Health Sciences, School of Kinesiology, Western University, London, Ontario, Canada.Department of Physical Therapy, University of British Columbia (UBC), Vancouver, British Columbia, Canada. Djavad Mowafaghian Centre for Brain Health, UBC, Vancouver, British Columbia, Canada.Department of Physical Therapy, University of British Columbia (UBC), Vancouver, British Columbia, Canada. Djavad Mowafaghian Centre for Brain Health, UBC, Vancouver, British Columbia, Canada. Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.Department of Physical Therapy, University of British Columbia (UBC), Vancouver, British Columbia, Canada. Djavad Mowafaghian Centre for Brain Health, UBC, Vancouver, British Columbia, Canada. Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.Department of Medicine, University of Montreal, Montreal, Quebec, Canada. Research Centre, Montreal Heart Institute, Montreal, Quebec, Canada. Research Center, Institut Universitaire de Geriatrie de Montréal, Montreal, Quebec, Canada.School of Population and Public Health, UBC, Vancouver, British Columbia, Canada. Providence Healthcare Research Institute, Centre for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada.Djavad Mowafaghian Centre for Brain Health, UBC, Vancouver, British Columbia, Canada. Department of Psychology, UBC, Vancouver, British Columbia, Canada.School of Graduate Psychology, Pacific University, Hillsboro, OR, USA.Department of Physical Therapy, University of British Columbia (UBC), Vancouver, British Columbia, Canada. Djavad Mowafaghian Centre for Brain Health, UBC, Vancouver, British Columbia, Canada. Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.Department of Physical Therapy, University of British Columbia (UBC), Vancouver, British Columbia, Canada. Djavad Mowafaghian Centre for Brain Health, UBC, Vancouver, British Columbia, Canada. Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.Department of Physical Therapy, University of British Columbia (UBC), Vancouver, British Columbia, Canada. teresa.ambrose@ubc.ca. Djavad Mowafaghian Centre for Brain Health, UBC, Vancouver, British Columbia, Canada. teresa.ambrose@ubc.ca. Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada. teresa.ambrose@ubc.ca.

Pub Type(s)

Clinical Trial Protocol
Journal Article

Language

eng

PubMed ID

36085237

Citation

Barha, Cindy K., et al. "Reshaping the Path of Mild Cognitive Impairment By Refining Exercise Prescription: a Study Protocol of a Randomized Controlled Trial to Understand the "what," "for Whom," and "how" of Exercise to Promote Cognitive Function." Trials, vol. 23, no. 1, 2022, p. 766.
Barha CK, Falck RS, Best JR, et al. Reshaping the path of mild cognitive impairment by refining exercise prescription: a study protocol of a randomized controlled trial to understand the "what," "for whom," and "how" of exercise to promote cognitive function. Trials. 2022;23(1):766.
Barha, C. K., Falck, R. S., Best, J. R., Nagamatsu, L. S., Hsiung, G. R., Sheel, A. W., Hsu, C. L., Kramer, A. F., Voss, M. W., Erickson, K. I., Davis, J. C., Shoemaker, J. K., Boyd, L., Crockett, R. A., Ten Brinke, L., Bherer, L., Singer, J., Galea, L. A. M., Jacova, C., ... Liu-Ambrose, T. (2022). Reshaping the path of mild cognitive impairment by refining exercise prescription: a study protocol of a randomized controlled trial to understand the "what," "for whom," and "how" of exercise to promote cognitive function. Trials, 23(1), 766. https://doi.org/10.1186/s13063-022-06699-7
Barha CK, et al. Reshaping the Path of Mild Cognitive Impairment By Refining Exercise Prescription: a Study Protocol of a Randomized Controlled Trial to Understand the "what," "for Whom," and "how" of Exercise to Promote Cognitive Function. Trials. 2022 Sep 9;23(1):766. PubMed PMID: 36085237.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reshaping the path of mild cognitive impairment by refining exercise prescription: a study protocol of a randomized controlled trial to understand the "what," "for whom," and "how" of exercise to promote cognitive function. AU - Barha,Cindy K, AU - Falck,Ryan S, AU - Best,John R, AU - Nagamatsu,Lindsay S, AU - Hsiung,Ging-Yuek Robin, AU - Sheel,A William, AU - Hsu,Chun Liang, AU - Kramer,Arthur F, AU - Voss,Michelle W, AU - Erickson,Kirk I, AU - Davis,Jennifer C, AU - Shoemaker,J Kevin, AU - Boyd,Lara, AU - Crockett,Rachel A, AU - Ten Brinke,Lisanne, AU - Bherer,Louis, AU - Singer,Joel, AU - Galea,Liisa A M, AU - Jacova,Claudia, AU - Bullock,Alexis, AU - Grant,Sofia, AU - Liu-Ambrose,Teresa, Y1 - 2022/09/09/ PY - 2022/07/15/received PY - 2022/08/30/accepted PY - 2022/9/9/entrez PY - 2022/9/10/pubmed PY - 2022/9/14/medline KW - Aerobic training KW - Biomarkers, Exercise KW - Cognition KW - Mild cognitive impairment KW - Mobility KW - Randomized controlled trial KW - Resistance training SP - 766 EP - 766 JF - Trials JO - Trials VL - 23 IS - 1 N2 - BACKGROUND: Targeted exercise training is a promising strategy for promoting cognitive function and preventing dementia in older age. Despite the utility of exercise as an intervention, variation still exists in exercise-induced cognitive gains and questions remain regarding the type of training (i.e., what), as well as moderators (i.e., for whom) and mechanisms (i.e., how) of benefit. Both aerobic training (AT) and resistance training (RT) enhance cognitive function in older adults without cognitive impairment; however, the vast majority of trials have focused exclusively on AT. Thus, more research is needed on RT, as well as on the combination of AT and RT, in older adults with mild cognitive impairment (MCI), a prodromal stage of dementia. Therefore, we aim to conduct a 6-month, 2 × 2 factorial randomized controlled trial in older adults with MCI to assess the individual effects of AT and RT, and the combined effect of AT and RT on cognitive function and to determine the possible underlying biological mechanisms. METHODS: Two hundred and sixteen community-dwelling adults, aged 65 to 85 years, with MCI from metropolitan Vancouver will be recruited to participate in this study. Randomization will be stratified by biological sex and participants will be randomly allocated to one of the four experimental groups: (1) 4×/week balance and tone (BAT; i.e., active control); (2) combined 2×/week AT + 2×/week RT; (3) 2×/week AT + 2×/week BAT; or (4) 2×/week RT + 2×/week BAT. The primary outcome is cognitive function as measured by the Alzheimer's Disease Assessment Scale-Cognitive-Plus. Secondary outcomes include cognitive function, health-related quality of life, physical function, actigraphy measures, questionnaires, and falls. Outcomes will be measured at baseline, 6 months (i.e., trial completion), and 18 months (i.e., 12-month follow-up). DISCUSSION: Establishing the efficacy of different types and combinations of exercise training to minimize cognitive decline will advance our ability to prescribe exercise as "medicine" to treat MCI and delay the onset and progression of dementia. This trial is extremely timely as cognitive impairment and dementia pose a growing threat to global public health. TRIAL REGISTRATION: ClinicalTrials.gov NCT02737878 . Registered on April 14, 2016. SN - 1745-6215 UR - https://www.unboundmedicine.com/medline/citation/36085237/Reshaping_the_path_of_mild_cognitive_impairment_by_refining_exercise_prescription:_a_study_protocol_of_a_randomized_controlled_trial_to_understand_the_"what"_"for_whom"_and_"how"_of_exercise_to_promote_cognitive_function_ DB - PRIME DP - Unbound Medicine ER -