Concurrent Aerobic Exercise and Cognitive Training to Prevent Alzheimer's in at-risk Older Adults

同时进行有氧运动和认知训练可预防高危老年人的阿尔茨海默病

• 批准号: 10696409
• 负责人: Olu Olofinboba
• 金额: $ 81.14万
• 依托单位: MOAI TECHNOLOGIES, LLC
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10696409
• 关键词: Address; Adherence; Aerobic; Aerobic Exercise; Affect; Alzheimer' s Disease; Alzheimer' s disease risk; American; Attention; Behavior Therapy; Biological Markers; Blood; Businesses; COVID-19 pandemic; Clinical Trials; Clinical Trials Design; Cognition; Cognitive; Combined Modality Therapy; Communities; Dementia; Disease; Dose; Double-Blind Method; Elderly; Environment; Epidemic; Exercise; Habilitation; Home; Impaired cognition; Individual; Intervention; Laboratories; Liquid substance; Measures; Minnesota; Modeling; Outcome; Participant; Performance; Personal Satisfaction; Persons; Pharmaceutical Preparations; Phase; Populations at Risk; Prevention strategy; Preventive Medicine; Psyche structure; Randomized; Rehabilitation therapy; Reporting; Research Project Grants; Risk; Science; Small Business Innovation Research Grant; Technology; Testing; Therapeutic; Time; Travel; Universities; Update; Work; arm; cognitive task; cognitive training; combat; commercialization; community setting; cost; cost effective treatment; design; efficacy evaluation; exercise training; exergame; experience; flexibility; improved; innovation; intervention delivery; neuroprotection; novel; pharmacologic; preference; preservation; prevent; primary outcome; processing speed; programs; satisfaction; secondary outcome; telerehabilitation; therapy design; usability; user-friendly; virtual environment; virtual reality

Project Summary/Abstract Alzheimer’s disease (AD) affects more than six million Americans currently and is projected to affect 14 million at a cost of $1.2 trillion in 2050. Despite its tremendous impacts and the limited influence of pharmacological therapies, attention has been brought to non-pharmacological interventions as promising therapeutic strategies for the prevention of cognitive decline. Aerobic exercise and cognitive training, particularly when in combination represent important behavioral interventions for cognition in persons at risk for AD. Both preventative medicine therapies are cost-effective strategies and aim to preserve the mental abilities, daily living performance, and cognitive well-being of individuals in the early stages of the disease. The proposed project will build on findings from the Phase II pilot where the feasibility and efficacy of Virtual Reality Cognitive Training (VRCT) combined with concurrent aerobic cycling (Exergame) was demonstrated in a clinical trial. This clinical trial was conducted utilizing a supervised intervention model, which is important for demonstrating preliminary feasibility and efficacy, but has limitations for addressing real-world feasibility and sustainability. Currently, the top two reported barriers for participation in community or facility-based, preventive medicine therapies such as exercise and cognitive training include burdens of travel or time commitment. Recently, advancements in technology have allowed for home-based (asynchronous) telerehabilitation interventions such as exercise training to be utilized as a supplement or replacement to conventional, synchronous rehabilitation programs. Although telerehabilitation is a growing form of therapy, it has yet to be studied in persons at risk for AD or with Exergame therapy. In order for Exergames to be a sustainable preventive medicine approach to AD, its feasibility and efficacy in a home-based (asynchronous) setting is needed. In order to expand our reach and marketability of the Exergame and combat these participation barriers, the sustainability and efficacy of Exergames in a home-based environment must be addressed. In support of expanding the reach and marketability of the Exergame, the purpose of this project is to: 1) develop a fully-featured version of the VRCT aspect of the Exergame that can be installed and updated remotely in order to support home-based use and, 2) assess the feasibility, efficacy, and sustainability of the Exergame in a home-based, asynchronous telerehabilitation setting via a clinical trial. Once the fully-featured Exergame with remote installation and updating capacity has been completed, the clinical trial, using a 2:2 factorial design will randomize 104 community-dwelling older adults at risk of AD to one of four arms for 3 months: home-based (asynchronous) Exergames, supervised Exergame, home-based asynchronous aerobic exercise, or supervised aerobic exercise. This project is innovative as 1) it addresses barriers for the real world use of the Exergame, which will increase the reach and marketability of the product, and 2) the clinical trial uses gold standard laboratory, real world (“field”), and novel blood biomarker efficacy and sustainability assessments of the Exergames.

项目概要/摘要 阿尔茨海默病 (AD) 目前影响超过 600 万美国人，预计将影响 1,400 万美国人 到 2050 年，其成本将达到 1.2 万亿美元。尽管其影响巨大，而药理学的影响有限 疗法，非药物干预作为有前途的治疗策略受到关注 用于预防认知能力下降，特别是在结合有氧运动和认知训练时。 对 AD 风险人群的认知进行重要的行为干预 两种预防医学。 治疗是具有成本效益的策略，旨在保持心理能力、日常生活能力和 拟议的项目将以研究结果为基础。 第二阶段试点结合了虚拟现实认知训练（VRCT）的可行性和有效性 一项临床试验证明了同时有氧循环（Exergame）的效果。 利用监督干预模型进行，这对于证明初步有效性非常重要 和功效，但在解决现实世界的可行性和可持续性方面存在局限性。 报告参与基于社区或设施的预防性医学治疗障碍，例如 运动和认知训练包括旅行负担或时间投入。最近，在这方面取得了进展。 技术允许进行基于家庭（异步）的远程康复干预，例如锻炼 培训作为传统同步康复计划的补充或替代。 尽管远程康复是一种不断发展的治疗形式，但尚未在有 AD 风险或患有 AD 的人群中进行研究。 Exergame 疗法为了使 Exergames 成为 AD 的可持续预防医学方法，其 为了扩大我们的影响力和有效性，需要在家（异步）环境中实现可行性和有效性。 Exergame 的适销性并克服这些参与障碍、可持续性和有效性 必须解决家庭环境中的运动游戏问题，以支持扩大影响范围和范围。 Exergame 的市场化，该项目的目的是： 1）开发 VRCT 的全功能版本 Exergame 的一个方面可以远程安装和更新，以支持家庭使用， 2) 评估在家中异步锻炼游戏的可行性、有效性和可持续性 通过临床试验进行远程康复设置，功能齐全的 Exergame 具有远程安装和功能。 容量更新已完成，临床试验采用2:2析因设计将随机化104 社区居住的老年人有 AD 风险，四臂之一持续 3 个月：家庭（异步） Exergames、Exergame、家庭异步有氧运动或有人监督的有氧运动 该项目具有创新性，因为 1) 它解决了 Exergame 在现实世界中使用的障碍，这将 增加产品的覆盖面和适销性，2) 临床试验使用金标准实验室，真实 世界（“现场”），以及 Exergames 的新型血液生物标志物功效和可持续性评估。