Exercise & Health Promotion for MCI: A Controlled Trial

描述（由申请人提供）：本项目是一项随机对照试验，旨在评估专为轻度认知障碍（MCI）老年人设计的团体运动和健康促进计划的有效性。它是RO1#AG14777（问题解决/身体干预和衰老）的竞争性更新，这是一种旨在促进身体虚弱，认知完整的老年人独立性的干预措施，及其补充，是对MCI老年人干预措施（现称为RALLI-终身独立性资源和活动）的修改版本的可行性试验。两项研究的结果都表明了显著的积极治疗结果，包括增加肌肉力量，耐力和运动时间;改善身体功能，自我报告的健康感知，抑郁，生活质量，幸福感，活力和自我控制感。对于可行性试验中的MCI参与者，在参与RALLI 9周后，平均每周运动时间增加了172分钟，HDL胆固醇显著改善，平均MMSE评分提高了1.2分。这项调查将比较RALLI与现有的老年人社区运动控制条件（终身健身-LF）。参与者将超过70岁，居住在社区，并符合MCI和体力活动不足的标准。他们将在基线、治疗后和每6个月一次，持续36个月由对治疗状况不知情的访谈者进行评价。主要和次要结局包括认知下降、情感和身体功能、自测健康和健康行为以及生活质量。探索性结果包括36个月从MCI到痴呆的转换率，身体残疾水平，独立生活的持续性和生理健康指标。我们假设RALLI参与者将比LF受试者经历更好的治疗后结果，并且RALLI参与者在36个月内向痴呆症的转化率较低，身体和功能衰退也较少。对公共卫生的意义：这项提案将调查旨在保护轻度认知障碍老年人认知和身体功能的运动和健康促进计划的有效性。这些老年人在3年内患阿尔茨海默病的风险增加，延迟或预防认知能力下降将保持他们独立生活的能力，并节省公共卫生资金。

DESCRIPTION (provided by applicant): This project is a randomized controlled trial to evaluate the efficacy of a group exercise and health promotion program designed specifically for older adults with Mild Cognitive Impairment (MCI). It is a competitive renewal of RO1#AG14777, (Problem Solving/Physical Intervention & Aging), an intervention aimed at promoting independence in physically frail, cognitively intact older adults, and its supplement, a feasibility trial of a modified version of the intervention (now called RALLI--Resources & Activities for Life Long Independence) for older adults with MCI. Findings from both studies indicated significant positive treatment outcomes, including increased muscle strength, endurance, and exercise time; improved physical functioning, self-reported health perceptions, depression, quality of life, well-being, vitality, and perceived self-control. For participants with MCI in the feasibility trial, after 9-weeks participation in RALLI, mean exercise time increased by 172 minutes per week, HDL cholesterol significantly improved, and mean MMSE scores improved by 1.2 points. This investigation will compare RALLI to an existing community-based exercise control condition for older adults (Lifetime Fitness-LF). Participants will be over age 70, community residing, and meet criteria for MCI and insufficient physical activity. They will be evaluated at baseline, post-treatment, and every 6 months for 36 months by interviewers blind to treatment condition. Primary and secondary outcomes include cognitive decline, affective and physical function, self-rated health and health behaviors, and quality of life. Exploratory outcomes include 36-month rate of conversion from MCI to dementia, level of physical disability, continuation in independent living, and physiological health indicators. We hypothesize that RALLI participants will experience better post-treatment outcomes than LF subjects, and that RALLI participants will have a lower rate of conversion to dementia and less physical and functional decline over 36 months. Significance to Public Health: This proposal will investigate the efficacy of an exercise and health promotion program designed to preserve cognitive and physical function in older adults with mild cognitive impairment. These older adults are at increased risk of developing Alzheimer's disease within 3 years, and delaying or preventing cognitive decline will preserve their ability to live independently and save public health dollars.