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.

项目摘要/摘要 阿尔茨海默氏病（AD）目前影响超过600万美国人，预计将影响1400万 2050年的成本为1.2万亿美元。尽管其巨大影响和药品的影响有限 疗法，将注意力集中在非药理学干预措施中作为有希望的治疗策略 预防认知能力下降。有氧运动和认知训练，尤其是合并时 代表对有AD风险的人认知的重要行为干预措施。两者都预防医学 疗法是具有成本效益的策略，旨在保持心理能力，日常生活表现和 在疾病的早期阶段，个体的认知幸福感。拟议的项目将基于发现 从II期飞行员中，虚拟现实认知训练（VRCT）的可行性和效率结合在一起 在一项临床试验中证明了并发有氧循环（Exergame）。该临床试验是 使用监督干预模型进行的，这对于证明初步可行性很重要 和效率，但有解决现实世界可行性和可持续性的局限性。目前，前两名 报告了参与社区或基于设施的预防医学疗法的障碍 运动和认知训练包括旅行或时间承诺的伯恩斯。最近，进步 技术允许家庭基于家庭（异步）的电信干预措施，例如锻炼 培训将用作传统同步康复计划的补充或替代品。 尽管远离居民是一种增长的治疗形式，但它尚未在有AD的风险或与 Exergame疗法。为了使Exergames成为一种可持续的预防医学方法，其 需要在基于家庭的（异步）设置中的可行性和效率。为了扩大我们的影响力和 Exergame的销售性并打击这些参与障碍，可持续性和效率 必须解决基于家庭的环境中的电动机。支持扩大覆盖范围和 Exergame的可销售性，该项目的目的是：1）开发VRCT的功能齐全的版本 可以远程安装和更新的Exergame方面，以支持基于家庭的使用和 2）评估Exergame的可行性，效率和可持续性 通过临床试验设置远离居民设置。一旦带有远程安装的功能齐全的电动机， 更新能力已经完成，使用2：2阶乘设计的临床试验将随机分配104 居住的老年人有3个月的四个武器中有四个臂之一的风险：基于家庭（异步） Exergames，有监督的Exergame，基于家庭的异步有氧运动或有氧有氧运动 锻炼。该项目具有创新性，因为1）它解决了现实世界使用该活动的障碍，该障碍将 提高产品的覆盖范围和销售性，2）临床试验使用金标准实验室，真实 世界（“田野”），以及新型的血液生物标志物效率和Exergames的可持续性评估。