Reshaping the path of mild cognitive impairment by refining exercise prescription: a study protocol of a randomized controlled trial to understand the "what," "for whom," and "how" of exercise to promote cognitive function

Authors

Cindy K. Barha, The University of British Columbia
Ryan S. Falck, The University of British Columbia
John R. Best, Simon Fraser University
Lindsay S. Nagamatsu, Western University
Ging Yuek Robin Hsiung, Djavad Mowafaghian Centre for Brain Health
A. William Sheel, The University of British Columbia
Chun Liang Hsu, Harvard Medical School
Arthur F. Kramer, Northeastern University
Michelle W. Voss, University of Iowa
Kirk I. Erickson, University of Pittsburgh
Jennifer C. Davis, Vancouver Coastal Health Research Institute
J. Kevin Shoemaker, Western UniversityFollow
Lara Boyd, The University of British Columbia
Rachel A. Crockett, The University of British Columbia
Lisanne ten Brinke, The University of British Columbia
Louis Bherer, University of Montreal
Joel Singer, University of British Columbia, Faculty of Medicine
Liisa A.M. Galea, Djavad Mowafaghian Centre for Brain Health
Claudia Jacova, Pacific University
Alexis Bullock, The University of British Columbia
Sofia Grant, The University of British Columbia
Teresa Liu-Ambrose, The University of British Columbia

Document Type

Article

Publication Date

9-9-2022

Journal

Trials

Volume

23

Issue

1

First Page

766

URL with Digital Object Identifier

10.1186/s13063-022-06699-7

Abstract

BACKGROUND: Targeted exercise training is a promising strategy for promoting cognitive function and preventing dementia in older age. Despite the utility of exercise as an intervention, variation still exists in exercise-induced cognitive gains and questions remain regarding the type of training (i.e., what), as well as moderators (i.e., for whom) and mechanisms (i.e., how) of benefit. Both aerobic training (AT) and resistance training (RT) enhance cognitive function in older adults without cognitive impairment; however, the vast majority of trials have focused exclusively on AT. Thus, more research is needed on RT, as well as on the combination of AT and RT, in older adults with mild cognitive impairment (MCI), a prodromal stage of dementia. Therefore, we aim to conduct a 6-month, 2 × 2 factorial randomized controlled trial in older adults with MCI to assess the individual effects of AT and RT, and the combined effect of AT and RT on cognitive function and to determine the possible underlying biological mechanisms. METHODS: Two hundred and sixteen community-dwelling adults, aged 65 to 85 years, with MCI from metropolitan Vancouver will be recruited to participate in this study. Randomization will be stratified by biological sex and participants will be randomly allocated to one of the four experimental groups: (1) 4×/week balance and tone (BAT; i.e., active control); (2) combined 2×/week AT + 2×/week RT; (3) 2×/week AT + 2×/week BAT; or (4) 2×/week RT + 2×/week BAT. The primary outcome is cognitive function as measured by the Alzheimer's Disease Assessment Scale-Cognitive-Plus. Secondary outcomes include cognitive function, health-related quality of life, physical function, actigraphy measures, questionnaires, and falls. Outcomes will be measured at baseline, 6 months (i.e., trial completion), and 18 months (i.e., 12-month follow-up). DISCUSSION: Establishing the efficacy of different types and combinations of exercise training to minimize cognitive decline will advance our ability to prescribe exercise as "medicine" to treat MCI and delay the onset and progression of dementia. This trial is extremely timely as cognitive impairment and dementia pose a growing threat to global public health. TRIAL REGISTRATION: ClinicalTrials.gov NCT02737878 . Registered on April 14, 2016.