Exercise Versus Cognitive Interventions for Elders at Risk for Dementia

对于有痴呆症风险的老年人来说，运动与认知干预

• 批准号: 7937900
• 负责人: DAVID LOEWENSTEIN
• 金额: $ 45.11万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7937900
• 关键词: Activities of Daily Living; Address; Affect; Age; Aging; American; Area; Arts; Biological; Biological Markers; Cognitive; Country; Data; Dementia; Diagnosis; Economics; Effectiveness; Elderly; Ensure; Exercise; Exhibits; Family; Grant; Head; Health Benefit; Hispanics; Home environment; Immune; Impaired cognition; Individual; Inflammatory; Inflammatory Response; Intervention; Investigation; Knowledge; Lipids; Measures; Memory; Not Hispanic or Latino; Outcome; Persons; Physical Endurance; Physical Fitness; Physical activity; Physiological; Pilot Projects; Population; Process; Public Health; Quality of life; Relative (related person); Risk; Speed; Testing; Training; United States; cognitive function; cognitive training; comparative effectiveness; comparative efficacy; effectiveness research; fitness; high risk; immune function; improved; inflammatory marker; mild neurocognitive impairment; older patient; peer; physical conditioning; post intervention; processing speed; programs; public health relevance; social

DESCRIPTION (provided by applicant): This application addresses Broad Challenge Area (05) Comparative Effectiveness Research, and Specific Challenge Topic 05-AG-104: Planning Grants and Pilot Studies for Comparisons of Management Strategies for Older Patients with Multiple Coexisting Conditions. As the population of the United States ages, there is an increased risk of cognitive impairment and physical deconditioning. Physical exercise has been shown to have physical and health benefits in the elderly and there is increasing evidence that systematic exercise programs may enhance cognitive function. In addition, cognitive exercise programs developed by our group and others have shown to be promising in enhancing cognitive function in older adults with cognitive impairment. There is a paucity of data, however, on the following: a) The extent to which exercise can benefit older adults with mild cognitive impairment (MCI) b) The comparative effectiveness of exercise and cognitive training among persons with MCI c) The possible advantages of combined exercise and cognitive interventions for MCI The proposed investigation will offer the unique opportunity to investigate exercise- and cognitive-related training changes at cognitive and physiological levels. The study will assess the impact of exercise training, cognitive training, and a combination of exercise and cognitive training on physical fitness, inflammatory and immunological biomarkers, and cognitive function among Hispanic and non-Hispanic older adults with MCI. This represents the first study of its type to compare the efficacy of state of the art non-pharmacological interventions in MCI. The study has significant potential to improve cognitive and physical status as well as quality of life in older adults with MCI. With the aging of the population, there is an increasing need to develop interventions that can optimize and maintain cognitive and physical health. Mild Cognitive Impairment (MCI) is characterized by cognitive decline confirmed by objective cognitive testing that is greater than would be expected for an individual's age but insufficient to merit a diagnosis of dementia. Over 5 million older adults in the United States have MCI and it is increasingly recognized that this condition may adversely affect the ability to manage higher order activities of daily living and reduce quality of life. Individuals with MCI are also at a considerably higher risk for progression to dementia than their non-MCI peers. Any approach that could reduce the cognitive consequences of MCI in older adults would have considerable economic and social benefits to afflicted individuals, their families, and the country at large. The proposed study will examine the comparative effectiveness of a physical exercise intervention, a cognitive exercise intervention, and a combined physical plus cognitive intervention in older adults with MCI. This study is unique in that ) it would be the first to conduct a head-to-head comparison of a Physical Exercise Intervention, a Cognitive Exercise Intervention, a Combined Physical plus Cognitive Exercise Intervention, and a no-intervention control condition among older adults with MCI; 2) a broad array of outcome variables will be examined including measures of cognitive functioning, physical endurance and fitness, biological activity (e.g., lipid profiles, immune and inflammatory response), and quality of life; 3) the interventions will be administered to Hispanic and non-Hispanic older adults to ensure broad applicability to older adults with MCI in the US; 4) the Combined PEI+CEI intervention will examine the possibility that the integration of the cognitive and the physical exercise intervention may result in greater effects than physical exercise or cognitive exercise alone. PUBLIC HEALTH RELEVANCE: The proposed investigation offers an empirical comparison of safe and non-invasive approaches that could improve the cognitive and physical health of older adults with MCI as well as their quality of life.

描述（由申请人提供）：本申请涉及广泛的挑战领域 (05) 比较有效性研究和具体挑战主题 05-AG-104：针对多种共存病症的老年患者的管理策略比较的规划拨款和试点研究。随着美国人口老龄化，认知障碍和身体机能失调的风险增加。体育锻炼已被证明对老年人的身体和健康有益，并且越来越多的证据表明系统的锻炼计划可以增强认知功能。此外，我们小组和其他人开发的认知锻炼计划已被证明有望增强患有认知障碍的老年人的认知功能。然而，以下方面的数据很少： a) 运动对患有轻度认知障碍 (MCI) 的老年人的益处 b) 运动和认知训练对 MCI 患者的比较效果 c) 可能的优势MCI 的运动和认知联合干预的研究拟议的调查将为在认知和生理水平上研究运动和认知相关的训练变化提供独特的机会。该研究将评估运动训练、认知训练以及运动和认知训练相结合对患有 MCI 的西班牙裔和非西班牙裔老年人的身体素质、炎症和免疫生物标志物以及认知功能的影响。这是同类研究中第一项比较最先进的非药物干预措施对 MCI 的疗效的研究。该研究对于改善患有 MCI 的老年人的认知和身体状况以及生活质量具有巨大的潜力。随着人口老龄化，越来越需要开发能够优化和维持认知和身体健康的干预措施。轻度认知障碍 (MCI) 的特点是通过客观认知测试证实认知能力下降，其程度高于个人年龄的预期，但不足以诊断为痴呆。在美国，超过 500 万老年人患有 MCI，人们越来越认识到这种情况可能会对管理日常生活中的高级活动的能力产生不利影响并降低生活质量。患有 MCI 的人发展为痴呆的风险也比非 MCI 的同龄人要高得多。任何能够减少老年人轻度认知障碍认知后果的方法都将为受影响的个人、他们的家庭和整个国家带来可观的经济和社会效益。拟议的研究将考察体育锻炼干预、认知锻炼干预以及体育加认知联合干预对患有轻度认知障碍 (MCI) 的老年人的比较效果。这项研究的独特之处在于）它将是第一个在老年人中对身体运动干预、认知运动干预、身体加认知运动联合干预以及无干预控制条件进行头对头比较的研究与MCI； 2) 将检查一系列广泛的结果变量，包括认知功能、身体耐力和健康、生物活动（例如血脂、免疫和炎症反应）以及生活质量的测量； 3) 这些干预措施将针对西班牙裔和非西班牙裔老年人进行，以确保其广泛适用于美国患有 MCI 的老年人； 4）PEI+CEI联合干预将考察认知与体育锻炼干预相结合可能比单独体育锻炼或认知锻炼产生更大效果的可能性。 公共卫生相关性：拟议的调查对安全和非侵入性方法进行了实证比较，这些方法可以改善患有 MCI 的老年人的认知和身体健康以及他们的生活质量。