Exercise & Health Promotion for MCI: A Controlled Trial

描述(申请人提供)：该项目是一项随机对照试验，旨在评估专门为患有轻度认知障碍(MCI)的老年人设计的集体锻炼和健康促进计划的有效性。它是RO1#AG14777(问题解决/物理干预和老龄化)的竞争性更新，是一种旨在促进身体虚弱、认知正常的老年人独立的干预措施，及其补充，是针对患有MCI的老年人的干预措施(现在称为RALLI--终身独立的资源和活动)的修改版本的可行性试验。这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、耐力和锻炼时间；改善身体功能、自我报告的健康观念、抑郁、生活质量、幸福感、活力和自我控制力。在可行性试验中，对于患有MCI的参与者，在参加9周的RALI后，平均每周锻炼时间增加了172分钟，高密度脂蛋白胆固醇显著改善，MMSE平均得分提高了1.2分。这项调查将比较Ralli和现有的基于社区的老年人运动控制条件(终身健身-LF)。参与者年龄在70岁以上，居住在社区，符合MCI和体力活动不足的标准。他们将在基线、治疗后和36个月内每6个月由对治疗情况视而不见的面试者进行评估。主要和次要结果包括认知功能下降、情感和身体功能、自我评估的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转变为痴呆症的比率、身体残疾程度、独立生活的持续时间和生理健康指标。我们假设，RALLI参与者在治疗后的结果将比LF受试者更好，并且RALLI参与者在36个月内转化为痴呆症的比率更低，身体和功能下降更少。对公众健康的意义：这项提案将调查一项运动和健康促进计划的有效性，该计划旨在保护患有轻度认知障碍的老年人的认知和身体功能。这些老年人在3年内罹患阿尔茨海默病的风险增加，延缓或防止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.