Real World Recruiting of Older Subjects with Mild Cognitive Impairment for Exercise Trials: Community Readiness is Pivotal

Sanders, Mark; Stuckenschneider, Tim; Devenney, Kate; Lawlor, Brian A.; Schneider, Stefan; Rikkert, Marcel G M Olde

doi:10.3233/jad-171083

Cited by 10 publications

(12 citation statements)

References 8 publications

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“…The challenges of recruiting older adults into clinical trials are well documented. [81][82][83][84] Because of the large sample size and relatively tight inclusion/exclusion criteria of the randomized controlled trial, we generated a robust recruitment plan in order to meet overall and minority-specific recruitment goals. In the later years of the study, we were able to receive a supplement from the funding institute so that we could hire recruitment specialists to help meet these goals.…”

Section: Recruitment Into the Randomized Controlled Trialmentioning

confidence: 99%

Mindfulness, Education, and Exercise for age-related cognitive decline: Study protocol, pilot study results, and description of the baseline sample

et al. 2020

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Background/Aims Age-related cognitive decline is a pervasive problem in our aging population. To date, no pharmacological treatments to halt or reverse cognitive decline are available. Behavioral interventions, such as physical exercise and Mindfulness-Based Stress Reduction, may reduce or reverse cognitive decline, but rigorously designed randomized controlled trials are needed to test the efficacy of such interventions. Methods Here, we describe the design of the Mindfulness, Education, and Exercise study, an 18-month randomized controlled trial that will assess the effect of two interventions—mindfulness training plus moderate-to-vigorous intensity exercise or moderate-to-vigorous intensity exercise alone—compared with a health education control group on cognitive function in older adults. An extensive battery of biobehavioral assessments will be used to understand the mechanisms of cognitive remediation, by using structural and resting state functional magnetic resonance imaging, insulin sensitivity, inflammation, and metabolic and behavioral assessments. Results We provide the results from a preliminary study (n = 29) of non-randomized pilot participants who received both the exercise and Mindfulness-Based Stress Reduction interventions. We also provide details on the recruitment and baseline characteristics of the randomized controlled trial sample (n = 585). Conclusion When complete, the Mindfulness, Education, and Exercise study will inform the research community on the efficacy of these widely available interventions improve cognitive functioning in older adults.

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Section: Recruitment Into the Randomized Controlled Trialmentioning

confidence: 99%

Mindfulness, Education, and Exercise for age-related cognitive decline: Study protocol, pilot study results, and description of the baseline sample

et al. 2020

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“…Participants were screened and recruited from a network of memory clinics (n=38) and through community recruitment (n=26) 15 16. Details of the study inclusion and exclusion criteria have been published in the NeuroExercise study protocol 16.…”

Section: Methodsmentioning

confidence: 99%

Acute high-intensity aerobic exercise affects brain-derived neurotrophic factor in mild cognitive impairment: a randomised controlled study

Devenney

Guinan

Kelly

et al. 2019

BMJ Open Sport Exerc Med

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ObjectiveTo investigate the brain-derived neurotrophic factor (BDNF) and cognitive response to a short bout of high-intensity aerobic exercise in older adults with mild cognitive impairment (MCI).MethodsParticipants were randomised to one of two testing schedules, completing either a standardised exercise test (group A) or a resting control condition (group B). Blood sampling and cognitive measures (visuospatial learning and memory, sustained attention and executive function) were collected at baseline (T1) and postintervention (T2). An additional measurement of study outcomes was collected after exercise (T3) in group B only.Results64 participants (female 53.2%, mean age 70.5±6.3 years) with MCI were recruited. From T1 to T2, serum BDNF (sBDNF) concentration increased in group A (n=35) (median (Md) 4564.61±IQR 5737.23 pg/mL to Md 5173.27±5997.54 pg/mL) and decreased in group B (Md 4593.74±9558.29 pg/mL to Md 3974.66±3668.22 pg/mL) (between-group difference p=0.024, effect size r=0.3). The control group made fewer errors on the sustained attention task compared with the exercise group (p=0.025). Measures of visuospatial learning and memory or executive function did not change significantly between groups.ConclusionThis study is the first to show that a short bout of high-intensity aerobic exercise increases peripheral sBDNF in a population with MCI. However, acute exercise did not improve cognitive performance.

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“…[31] Neurobehavioral Considerations Over the past two decades, an explosion of empirical evidence has been published linking lifestyle behaviors to brain function [19,[32][33][34][35][36]. Indeed, great strides have been made at multiple levels of inference, including randomized trials of clinical populations, [37][38][39][40][41]. mechanistic studies within preclinical older adults using neuroimaging modalities, [42][43][44] and animal studies linking neurobehavioral changes to alterations in mitochondrial structure, [45][46][47] neurotrophic, [48,49] and metabolic function [50,51] to underlying changes of neuropathological pathways [52][53][54].…”

Section: Behavior and The Brain: Conceptual Framework Linking Lifestmentioning

confidence: 99%

Pathways of Prevention: A Scoping Review of Dietary and Exercise Interventions for Neurocognition

Smith

2019

BPL

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Alzheimer's disease and related dementias (ADRD) represent an increasingly urgent public health concern, with an increasing number of baby boomers now at risk. Due to a lack of efficacious therapies among symptomatic older adults, an increasing emphasis has been placed on preventive measures that can curb or even prevent ADRD development among middle-aged adults. Lifestyle modification using aerobic exercise and dietary modification represents one of the primary treatment modalities used to mitigate ADRD risk, with an increasing number of trials demonstrating that exercise and dietary change, individually and together, improve neurocognitive performance among middle-aged and older adults. Despite several optimistic findings, examination of treatment changes across lifestyle interventions reveals a variable pattern of improvements, with large individual differences across trials. The present review attempts to synthesize available literature linking lifestyle modification to neurocognitive changes, outline putative mechanisms of treatment improvement, and discuss discrepant trial findings. In addition, previous mechanistic assumptions linking lifestyle to neurocognition are discussed, with a focus on potential solutions to improve our understanding of individual neurocognitive differences in response to lifestyle modification. Specific recommendations include integration of contemporary causal inference approaches for analyzing parallel mechanistic pathways and treatment-exposure interactions. Methodological recommendations include trial multiphase optimization strategy (MOST) design approaches that leverage individual differences for improved treatment outcomes.

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Real World Recruiting of Older Subjects with Mild Cognitive Impairment for Exercise Trials: Community Readiness is Pivotal

Cited by 10 publications

References 8 publications

Mindfulness, Education, and Exercise for age-related cognitive decline: Study protocol, pilot study results, and description of the baseline sample

Mindfulness, Education, and Exercise for age-related cognitive decline: Study protocol, pilot study results, and description of the baseline sample

Acute high-intensity aerobic exercise affects brain-derived neurotrophic factor in mild cognitive impairment: a randomised controlled study

Pathways of Prevention: A Scoping Review of Dietary and Exercise Interventions for Neurocognition

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