Exercise training to improve cognitive function_523_Sparrow

项目背景/基本原理。阿尔茨海默病(AD)困扰着近600万美国人，这是一个数字 预计在未来几十年内将会增长。众所周知，AD有一个很长的临床前阶段，在这个阶段，病理生理学 在临床症状出现之前，这些过程会发展很多年，甚至几十年。在这个临床前阶段 有证据表明，认知功能持续下降，尤其是情景记忆。到目前为止， 药物干预延缓这种认知功能下降的有效性的证据一直是 有限，导致人们对包括运动在内的非药物干预的效用越来越感兴趣。 项目目标。我们建议评估一种新的以家庭为基础的运动干预的可行性 使用阻力训练与远程提供的实时指导相结合的方式改善情节记忆 60名50岁或以上有轻度认知障碍的个人。关于成果衡量的初步数据 (Rey-Osterrieth复杂图形测试、韦氏逻辑记忆测试)，一个潜在的中介(胰岛素样生长 因子-1)，并获得潜在的调节剂(载脂蛋白EƐ4)。 项目方法。我们将估计干预组(n=30)和对照组(n=30)之间的差异。 情景记忆的6个月变化(Rey-Osterrieth复杂图形测验、韦氏逻辑记忆测验) 以及效应大小，这将被用作拟议的更大研究的样本量计算的基础。 此外，我们还将探讨6个月内血清胰岛素样生长因子-1浓度的变化。 阻力运动程序作为运动相关事件记忆变化的潜在中介。此外， 我们将探讨载脂蛋白EƐ4的携带者状态(携带者/非携带者)作为潜在的调节因子。

Project Background/Rationale. Alzheimer's disease (AD) afflicts nearly 6 million Americans, a number projected to grow in coming decades. AD is known to have a long preclinical phase in which pathophysiologic processes develop many years, even decades, before the onset of clinical symptoms. During this preclinical phase there is evidence of unremitting decline in cognitive function, particularly in episodic memory. Thus far, evidence of the efficacy of pharmacological interventions to slow this decline in cognitive function has been limited, leading to increasing interest in the utility of nonpharmacological interventions including exercise. Project Objectives. We propose to assess the feasibility of a novel home-based exercise intervention to improve episodic memory that uses resistance training coupled with real-time guidance delivered remotely in 60 individuals 50 years of age or older with mild cognitive impairment. Preliminary data on outcome measures (Rey-Osterrieth Complex Figure Test, Wechsler Logical Memory Test), a potential mediator (insulin-like growth factor-1), and a potential moderator (apolipoprotein EƐ4) will be obtained. Project Methods. We will estimate the difference between the intervention (n=30) and the control group (n=30) on 6-month change in episodic memory (Rey-Osterrieth Complex Figure Test, Wechsler Logical Memory Test) as well as the effect size, which will be used as a basis for sample size calculation for a proposed larger study. In addition, we will explore 6-month change in serum insulin-like growth factor-1 concentration during the resistance exercise program as a potential mediator of exercise-related changes in episodic memory. Further, we will explore apolipoprotein EƐ4 carrier status (carrier/noncarrier) as a potential moderator.