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This study examines the behavioral, molecular, and structural biomarkers of brain health that will allow for the stratification of individuals according to their "cognitive signature" and function. This study will randomize older adults into one of four interventions for a period of 12 months: 1) Aerobic Exercise, 2) Resistance Exercise, 3) Yoga Exercise, 4) Health Education (involves stretching and range of motion activities). This aims of this study will examine whether and how these different types of training interventions exert effects cognitive function, brain structure, biomarkers of brain health and cognition, and physical function.
Physical activity is increasingly recognized to play a role in maintenance of brain health and attenuation of physical decline associated with aging. While physical activity has been shown to gradually decline with increasing age, initiation of an exercise protocol attenuates declines in cognition associated with advancing age, including impaired neurogenesis as well as decreased attention and learning. These benefits may be attributed, at least in part, to physical activity's role in maintaining an anti-inflammatory phenotype, and several clinical observational studies performed in older adults have shown an inverse relationship between self-reported physical activity and inflammatory biomarkers. Pre-clinical studies have also revealed that exposing aged animals to circulating factors derived from young animal counterparts significantly improves cognitive function and promotes neurogenesis.
A major limitation of clinical studies investigating the effect of physical activity on cognitive function is that subjects display considerable variability in their responses to the intervention. There are likely to be multiple biological pathways by which physical activity influences brain structure and function, and the type of physical activity that may be effective for influencing these pathways is likely to vary greatly. A better mechanistic understanding of how different modes of physical activity may target varying regions of the brain and other aspects of aging is therefore warranted.
This study examines the behavioral, molecular, and structural biomarkers of brain health that will allow for the stratification of individuals according to their "cognitive signature" and function. This study will randomize older adults into one of four interventions for a period of 12 months: 1) Aerobic Exercise, 2) Resistance Exercise, 3) Yoga Exercise, 4) Health Education (involves stretching and range of motion activities).
This aims of this study will examine whether and how these different types of training interventions exert differential effects on potential pathways of cognition and function in aged individuals, and the role of baseline subject characteristics in mediating these responses. The specific aims are:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Aerobic Activity | Experimental | Moderate-intensity exercise aerobic exercise that involves participating in activities similar to brisk walking that increase heart rate and breathing rate, with activity progressing to 150 minutes per week. Activities other than brisk walking, such as dance, aerobics, swimming, cycling or other activities that increase heart rate and breathing rate to a moderate intensity that can be sustained for at least 10 minutes will also be encouraged. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision. |
|
| Resistance Training | Experimental | Resistance exercise that involves participating in activities similar to lifting weights that cause the participant to work specific muscles of your body, with activity progressing to 150 minutes per week. This can involve using weight training machines, elastic tubes that create resistance, or weights such a dumbbells. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision. |
|
| Yoga | Experimental | Yoga involves a series of movements and poses that are performed in a specific sequence that are adapted to your ability, with activity progressing to 150 minutes per week. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision. |
|
| Health Education |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Aerobic Activity | Behavioral | Moderate-intensity exercise aerobic exercise that involves participating in activities similar to brisk walking that increase heart rate and breathing rate, with activity progressing to 150 minutes per week. Activities other than brisk walking, such as dance, aerobics, swimming, cycling or other activities that increase heart rate and breathing rate to a moderate intensity that can be sustained for at least 10 minutes will also be encouraged. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision. |
| Measure | Description | Time Frame |
|---|---|---|
| Change from Baseline Brain Structure at 6 and 12 months | Measured used MRI and fMRI tasks. | Baseline, 6 months, 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Change from Baseline Functional Fitness at 3, 6, and 12 months | Assessed with the Short Physical Performance Battery | Baseline, 3 months, 6 months, 12 months |
| Change from Baseline Fitness at 3, 6, and 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Change from Baseline subjective well-being at 3, 6, and 12 months | Measured by the Satisfaction with Life Scale (SWLS) 5-item questionnaire | Baseline, 3 months, 6 months, 12 months |
| Change from Baseline Mood at 3, 6, and 12 months |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| John M. Jakicic, PhD | University of Pittsburgh | Principal Investigator |
| Fabrisia Ambrosio, PhD | University of Pittsburgh | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Pittsburgh | Pittsburgh | Pennsylvania | 15260 | United States |
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| ID | Term |
|---|---|
| D003072 | Cognition Disorders |
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D001519 | Behavior |
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| ID | Term |
|---|---|
| D015444 | Exercise |
| D055070 | Resistance Training |
| D015013 | Yoga |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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The outcome assessors will be masked to intervention assignment.
| Experimental |
This involves the participant receiving information regarding aspects of health that are important for older adults, and also physical activity in the form of light stretching activities and movements. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision. |
|
|
| Resistance Training | Behavioral | Resistance exercise that involves participating in activities similar to lifting weights that cause the participant to work specific muscles of your body, with activity progressing to 150 minutes per week. This can involve using weight training machines, elastic tubes that create resistance, or weights such a dumbbells. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision. |
|
| Yoga | Behavioral | Yoga involves a series of movements and poses that are performed in a specific sequence that are adapted to your ability, with activity progressing to 150 minutes per week. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision. |
|
| Health Education | Behavioral | This involves the participant receiving information regarding aspects of health that are important for older adults, and also physical activity in the form of light stretching activities and movements. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision. |
|
Assessed with a 400 meter corridor walk.
| Baseline, 3 months, 6 months, 12 months |
| Change from Baseline Repeatable Battery for the Assessment of Neuropsychological Status at 3, 6, and 12 months | This is a brief standardized paper-and-pencil neurocognitive battery measuring immediate and delayed memory, attention, language, and visuospatial skills. The test comprises of 12 subtests that is administered by a trained examiner. | Baseline, 3 months, 6 months, 12 months |
| Change from Baseline Modified Mini-Mental Status Exam at 3, 6, and 12 months | This is an expanded 100-point version of the original Mini-Mental Status Exam, administered in ~7 minutes, which assesses global cognitive function. This measure has very good reliability, validity, and sensitivity to moderate cognitive changes and has a proven record in clinical trials. | Baseline, 3 months, 6 months, 12 months |
| Change from Baseline Auditory Verbal Learning Test at 3, 6, and 12 months | The participant is read a list of 15 words, 5 times. After each time, the participant is asked to immediately recall as many words as possible. Following the 5th recall, an interference list is presented, after which the participant is asked to spontaneously recall words from the original list. After a 10-minute interval has passed, the participant is asked again to recall as many words as possible from the original list. | Baseline, 3 months, 6 months, 12 months |
| Change from Baseline Physical Activity (minutes per week) at 3, 6, and 12 months | Measured by Actigraphy | Baseline, 3 months, 6 months, 12 months |
| Change from Baseline Physical Activity (minutes per week) at 3, 6, and 12 months | Measured by CHAMPS questionnaire. | Baseline, 3 months, 6 months, 12 months |
| Change from Baseline Physical Activity (minutes per week) at 3, 6, and 12 months | Measured by Paffenbarger questionnaire. | Baseline, 3 months, 6 months, 12 months |
| Change from Baseline Sedentary Behavior (minutes per day) at 3, 6, and 12 months | Measured by modified CARDIA questionnaire | Baseline, 3 months, 6 months, 12 months |
| Change from Baseline Sedentary Behavior (minutes per day) at 3, 6, and 12 months | Measured by Actigraphy | Baseline, 3 months, 6 months, 12 months |
| Change from Baseline Peripheral biomarkers at 3, 6, and 12 months | Assessed from venous blood collection and includes measures of neuroinflammation, neurogenesis, and cerebral vascularity | Baseline, 3 months, 6 months, 12 months |
Measured by the Positive and Negative Affect Schedule (PANAS) questionnaire
| Baseline, 3 months, 6 months, 12 months |
| Change from Baseline Self-Efficacy for Physical Activity at 3, 6, and 12 months | Measured by questionnaire with higher scores indicating greater self-efficacy | Baseline, 3 months, 6 months, 12 months |
| Change from Baseline Physical Activity Outcome Expectations at 3, 6, and 12 months | Measured by questionnaire with higher scores indicating great outcome expectations. | Baseline, 3 months, 6 months, 12 months |
| Change from Baseline Physical Activity Barriers at 3, 6, and 12 months | Measured by questionnaire with higher scores indicating greater barriers. | Baseline, 3 months, 6 months, 12 months |
| Change from Baseline Social Support for Physical Activity at 3, 6, and 12 months | Measured by questionnaire with higher scores indicating greater social support | Baseline, 3 months, 6 months, 12 months |
| Change from Baseline Weight in kilograms at 3, 6, and 12 months | Measured using a digital scale | Baseline, 3 months, 6 months, 12 months |
| Change from Baseline Height in centimeters at 3, 6, and 12 months | Measured using a wall-mounted stadiometer | Baseline, 3 months, 6 months, 12 months |
| Change from Baseline resting systolic and diastolic blood pressure in mmHg at 3, 6, and 12 months | Measured using an automated blood pressure system | Baseline, 3 months, 6 months, 12 months |
| Change from Baseline resting heart rate in beats per minute at 3, 6, and 12 months | Measured using an automated system | Baseline, 3 months, 6 months, 12 months |
| D005081 | Exercise Therapy |
| D012046 | Rehabilitation |
| D000359 | Aftercare |
| D003266 | Continuity of Patient Care |
| D005791 | Patient Care |
| D013812 | Therapeutics |
| D026741 | Physical Therapy Modalities |
| D064797 | Physical Conditioning, Human |
| D026441 | Mind-Body Therapies |
| D000529 | Complementary Therapies |
| D026443 | Spiritual Therapies |
| D026241 | Exercise Movement Techniques |