Efficacy of Adapted Tai Ji Quan to Slow Cognitive Decline in Older Adults

项目摘要/摘要 背景资料。运动通常被认为是一种非药理学策略，它对 保护老年人认知功能或减缓认知障碍进展的作用 成人轻度认知障碍(MCI)。然而，大多数运动干预只专注于 身体发育。相对较少的干预措施将身体训练和认知训练结合在一起 同时或明确地整合认知-物理成分，用于认知刺激。此外， 运动改善患有MCI的老年人认知功能的证据是有限的，也是不确定的。 这使得推荐最佳实践变得困难。 目标。这项应用的主要目标是确定认知增强的疗效 运动干预-太极拳：运动保持大脑健康(TJQMMBH)。TJQMMBH构建在 全面研究的循证计划，已被证明具有多种健康结果 但现在明确集成了一个认知组件，旨在增加多任务处理成本和认知 对执行刻意的日常运动任务的要求。因此，基于我们充满希望的试点数据，我们的 这项拟议研究的主要目的是确定新开发的TJQMMBH干预是否会 对老年遗忘型MCI患者的认知功能有积极影响。我们还有四个中学 目的是研究(1)TJQMMBH是否可以减缓认知障碍的进展；(2) 整体认知功能的改善是通过获得运动自信心来实现的；(3) TJQMMBH对认知结果的干预在干预后的随访期内持续；以及(4) 执行功能的变化与身体表现之间存在关联。 接近。我们实现研究目标的核心方法是进行前瞻性、单盲、三臂、 对认知增强型TJQMMBH干预进行评估的随机(主动对照)试验 反对标准的太极拳干预和伸展运动控制。我们的设计将允许我们测试 关于为期6个月的TJQMMBH干预相对于标准太极拳疗效的假设 和伸展控制，在改善全球认知功能和运动-认知双重功能的主要结果方面- 任务步态表现与社区特定领域认知功能的次要结果-- 居住已根据既定临床标准诊断为遗忘性MCI的老年人。 意义和影响。这项工作意义重大，因为它解决了 社区和临床实践，提供解决老年人认知能力下降的最有效策略 患有MCI的成年人。因此，如果拟议的干预措施被证明是有效的，其科学影响可能会 在提供替代的、非基于药物的认知训练干预方面是很高的 改善患有MCI的老年美国人的认知能力下降，延迟或预防痴呆症的发生。

Project Summary/Abstract Background. Exercise is generally considered a non-pharmacological strategy that plays an important protective role in preserving cognitive function or mitigating the progression of cognitive impairment for older adults with mild cognitive impairment (MCI). Most exercise interventions, however, focus exclusively on physical development. Relatively few interventions have either combined physical and cognitive training concomitantly or explicitly integrated cognitive-physical components for cognitive stimulation. Moreover, the evidence that exercise improves cognitive function in older adults with MCI is both limited and inconclusive, making it difficult to recommend best practices. Objective. The primary objective of this application is to determine the efficacy of a cognitively enhanced exercise intervention - Tai Ji Quan: Moving to Maintain Brain Health (TJQMMBH). TJQMMBH is built on a comprehensively researched, evidence-based program that has been shown to have multiple health outcomes but now explicitly integrates a cognitive component aimed at increasing multitasking costs and cognitive demands on performing deliberate daily motor tasks. Accordingly, grounded on our promising pilot data, our primary aim in this proposed study is to determine whether the newly developed TJQMMBH intervention will have a positive effect on cognitive function in older adults with amnestic MCI. We also have four secondary aims that will examine whether (1) TJQMMBH can slow the progression of cognitive impairment; (2) improvement in global cognitive function is mediated through gains in movement confidence; (3) the benefits of the TJQMMBH intervention on cognitive outcomes persist over a post-intervention follow-up period; and (4) there is an association between change in executive function and physical performance. Approach. Our core approach to achieving our research aims is to perform a prospective, single-blind, 3-arm, randomized (active control) trial in which the cognitively enhanced TJQMMBH intervention will be evaluated against a standard Tai Ji Quan intervention and a stretching exercise control. Our design will allow us to test the hypothesis regarding the efficacy of a 6-month TJQMMBH intervention, relative to standard Tai Ji Quan and stretching control, in improving the primary outcomes of global cognitive function and motor-cognitive dual- task gait performance and the secondary outcomes of domain-specific cognitive functions in community- dwelling older adults who have been diagnosed with amnestic MCI per established clinical criteria. Significance and impact. This work is significant because it addresses the currently limited options in community and clinical practice for offering the most effective strategies that address cognitive decline in older adults with MCI. Therefore, if the proposed intervention proves to be effective, the scientific impact is likely to be high in terms of providing an alternative, non-pharmacological-based cognitive training intervention to ameliorate cognitive decline in older Americans with MCI and delay or prevent the onset of dementia.