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Cognitive performance is negatively related to an impaired glucose metabolism, possibly due to impairments in brain vascular function. Supported by the statement from the American Heart and Stroke Association that a healthy lifestyle is one of the most effective strategies to protect against cognitive decline, the investigators now hypothesise that healthy lifestyle intervention-induced changes in glucose metabolism cause beneficial effects on brain vascular function thereby improving cognitive performance. The primary objective of this intervention study is thus to evaluate in sedentary older men and women the effect of a 16-week aerobic-based exercise program on cerebral blood flow, as quantified by the non-invasive gold standard magnetic resonance imaging (MRI) perfusion method Arterial Spin Labeling (ASL). Cerebral blood flow is a robust and sensitive physiological marker of brain vascular function. Secondary objectives are to examine effects on glucose metabolism using the homeostatic model assessment for insulin resistance (HOMA-ir) and cognitive performance as assessed with a neurophysiological test battery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Healthy lifestyle | Experimental | Healthy lifestyle intervention, which includes physical activity and dietary advice according to the dutch guidelines. |
|
| Control | No Intervention | Maintenance of habitual physical activity and diet |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Healthy Lifestyle | Other | The physical activity guidelines for older consist of 150 minutes per week moderate-to-high intensity exercise, two times per week muscle and bone strengthening exercises, which are combined with balance exercises. Additional health benefits can be achieved with a longer exercise duration, frequency and/or intensity. Furthermore, the amount of time sitting should be minimised. The dietary guidelines are described in detail in the so-called "The Wheel of Five". In brief, the circle is divided into four food groups and one beverage group. More than half of the circle is covered by fruits, vegetables, whole grain (containing) breads, cereals and potatoes. A much smaller part is compromised by animal source foods, spreads and cooking fats. Water, tea and coffee without sugar complete the circle. |
| Measure | Description | Time Frame |
|---|---|---|
| Brain vascular function | Cerebral blood flow as quantified non-invasively by the MRI perfusion method Arterial Spin Labeling (ASL) | Baseline (0 weeks) |
| Brain vascular function | Cerebral blood flow as quantified non-invasively by the MRI perfusion method Arterial Spin Labeling (ASL) | After intervention (16 weeks) |
| Measure | Description | Time Frame |
|---|---|---|
| Cognitive performance | Cambridge Neuropsychological Test Automated Battery (CANTAB) | Baseline (0 weeks) and after intervention (16 weeks) |
| Glucose metabolism | Homeostatic Model Assessment for Insulin Resistance (HOMA-ir) and HbA1c |
| Measure | Description | Time Frame |
|---|---|---|
| Flow-Mediated Vasodilation (FMD) | Peripheral vascular function, endothelial function | Baseline (0 weeks) and after intervention (16 weeks) |
| Carotid Artery Reactivity (CAR) | Peripheral vascular function, endothelial function |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Peter J. Joris, Dr | Maastricht University | Principal Investigator |
| Ronald P. Mensink, Dr | Maastricht University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Maastricht University Medical Center | Maastricht | Limburg | 6229 ER | Netherlands |
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| ID | Term |
|---|---|
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D001519 | Behavior |
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|
| Baseline (0 weeks), at the middle (8 weeks) and after intervention (16 weeks) |
| Baseline (0 weeks) and after intervention (16 weeks) |
| Pulse Wave Analysis (PWA) | Peripheral vascular function, vascular stiffness | Baseline (0 weeks) and after intervention (16 weeks) |
| Pulse Wave Velocity (PWV) | Peripheral vascular function, vascular stiffness | Baseline (0 weeks) and after intervention (16 weeks) |
| Retinal microvascular calibers | Peripheral vascular function, microcirculation | Baseline (0 weeks) and after intervention (16 weeks) |
| Blood pressure (systolic, diastolic and mean pressure) | Office and 24-hour ambulatory blood pressure | Baseline (0 weeks) and after intervention (16 weeks) |
| Serum lipid profile concentration | Concentration of serum lipids | Baseline (0 weeks), at the middle (8 weeks) and after intervention (16 weeks) |
| Serum insulin concentration | Concentration of insulin in serum | Baseline (0 weeks), at the middle (8 weeks) and after intervention (16 weeks) |
| Plasma glucose concentration | Concentration of glucose in plasma | Baseline (0 weeks), at the middle (8 weeks) and after intervention (16 weeks) |
| Homeostatic Model Assessment for Insulin Resistance (HOMA-ir) | HOMA-ir is a method used to quantify insulin resistance and beta-cell function | Baseline (0 weeks), at the middle (8 weeks) and after intervention (16 weeks) |
| Circulating markers for low-grade systemic inflammation | Markers for low-grade systemic inflammation (IL-6, TNF-alpha) | Baseline (0 weeks), at the middle (8 weeks) and after intervention (16 weeks) |
| Circulating markers for microvascular function | Markers for microvascular function (sCAM-1, vWf, cGMP) | Baseline (0 weeks), at the middle (8 weeks) and after intervention (16 weeks) |
| Circulating marker of neurogenesis | Brain-derived neurotrophic factor (BDNF) | Baseline (0 weeks), at the middle (8 weeks) and after intervention (16 weeks) |
| Glycated haemoglobin (HbA1C) | HbA1C is a form of hemoglobin (abbreviated Hb) that is chemically linked to a sugar. | Baseline (0 weeks) and after intervention (16 weeks) |
| Aerobic fitness | Incremental exhaustive exercise test (Maximal oxygen consumption and power output) | Baseline (0 weeks), at the middle (8 weeks) and after intervention (16 weeks) |
| Physical fitness (1) | Incremental exhaustive exercise test (Maximal Power output) | Baseline (0 weeks), at the middle (8 weeks) and after intervention (16 weeks) |
| Physical fitness (2) | The 6-minute walk test (6 MWT) | Baseline (0 weeks) and after intervention (16 weeks) |
| Activity monitoring | activPAL activity monitor | Baseline (0 weeks) and after intervention (16 weeks) for four consecutive days |
| Self reported physical activity | The International Physical Activity Questionnaire | Baseline (0 weeks), at the middle (8 weeks) and after intervention (16 weeks) |
| Food frequency questionnaire | Self reported food consumption | Baseline (0 weeks), at the middle (8 weeks) and after intervention (16 weeks) |
| Dutch Healthy Diet index 2015 | Compliance to the Dutch dietary guidelines based on the FFQ | Baseline (0 weeks), at the middle (8 weeks) and after intervention (16 weeks) |
| Quality of Life score | The Quality of life will be assessed using a 32-item questionnaire | Baseline (0 weeks) and after intervention (16 weeks) |
| Sleep characteristics | Sleep characteristics will be assessed using the 10-item Pittsburgh Sleep Quality Index | Baseline (0 weeks) and after intervention (16 weeks) |
| Fat mass | Body composition measured with whole body air-displacement by the BodPod | Baseline (0 weeks) and after intervention (16 weeks) |
| Fat free mass | Body composition measured with whole body air-displacement by the BodPod | Baseline (0 weeks) and after intervention (16 weeks) |
| Anthropometrics (1) | Weight | Baseline (0 weeks) and after intervention (16 weeks) |
| Anthropometrics (2) | BMI | Baseline (0 weeks), at the middle (8 weeks) and after intervention (16 weeks) |
| Anthropometrics (3) | Waist and hip circumference (ratio) | Baseline (0 weeks), at the middle (8 weeks) and after intervention (16 weeks) |
| Structural brain status (1) | MRI MPRAGE | Baseline (0 weeks) and after intervention (16 weeks) |
| Structural brain status (2) | T2FLAIR | Baseline (0 weeks) and after intervention (16 weeks) |
| Structural brain status (3) | R2* | Baseline (0 weeks) and after intervention (16 weeks) |