Impact of Exercise and Engagement on Cognition in Older Adults

描述（由申请人提供）：本申请是对RFA OD-09-003的回应，“恢复法案有限竞争：NIH健康与科学研究挑战拨款（RC1）”。该申请涉及广泛的挑战领域（05），比较有效性研究和特定的挑战主题，05- ag -105“包括神经退行性疾病在内的疾病和衰老综合征的比较干预试验”。这项竞争性修订的资金将使其能够雇用总共3.25名全职人员：一名兼职运动生理学家，1.5名博士后研究员和1.25名研究助理。也许21世纪最紧迫的科学挑战是开发干预措施来减缓认知老化的过程，以便在生命的最后阶段，大多数老年人都能控制自己的智力，他们和他们的家人可以在人类发展的最后阶段享受高质量的生活。本应用程序的重点是仔细检查生活方式变量的作用，这些变量通常被认为在促进健康的认知衰老中“对大脑有益”。有明确的证据表明，体育锻炼可以改善成年后期的认知健康。尚未研究的是，通过锻炼增强神经血管系统是否是获得认知干预益处的重要条件。造成这种知识差距的主要原因之一是实施和研究这种复杂的生活方式干预措施的成本。这个拟议中的项目是研究运动和认知干预项目联合效应的首批尝试之一，该项目在达拉斯大脑健康中心（Center for Brain Health）的丹尼斯·帕克（Denise Park）实验室已经资助的一项关于认知参与的干预研究中加入了运动条件。Synapse研究了将成年人浸入为期12周、每周15- 20小时的新学习挑战中对认知功能的影响。科目学习被子，执行数码摄影，或两者兼而有之。在这个新的应用程序中，我们将在未来三年为Synapse项目增加两个组：一个仅运动组，通过步行计划改善心血管健康，这将使我们能够评估运动与认知参与的影响。我们还将增加一个由锻炼和参与突触的受试者组成的“锻炼+参与”小组，使我们能够评估锻炼是否会增强认知参与效果。因为Synapse项目的基础设施成本已经得到了资助，我们可以解决关于运动和认知干预的关键科学问题，这些问题在以前的工作中被证明过于昂贵而无法轻易解决。该项目的两个主要目标是：(a)直接比较运动干预和认知干预，以确定每个领域的相对有效性；(b)检查联合运动/认知干预计划的互动效果。我们假设一个健康的心血管系统将大大提高认知干预的效果。此外，我们将利用经颅多普勒成像的新颖和异常敏感的脑血管健康测量方法，这种方法尚未用于运动/认知领域。除了测量VO2-Max外，我们还将测量脑灌注不足、血管反应性和动脉僵硬度，以便我们仔细测量血管健康状况。

DESCRIPTION (provided by applicant): This application is a response to RFA OD-09-003, "Recovery Act Limited Competition: NIH Challenge Grants in Health and Science Research (RC1)." This application addresses broad Challenge Area (05), Comparative Effectiveness Research, and specific Challenge Topic, 05-AG-105 "Comparative Intervention Trials for Diseases and Syndromes of Aging including Neurodegenerative Diseases." Funding of this competing revision will enable the hiring of a total of 3.25 full time people: a half-time exercise physiologist, 1.5 postdoctoral fellows and a 1.25 research assistants. Perhaps the most urgent scientific challenge for the 21st century is to develop interventions to slow the process of cognitive aging so that at the end of life, most older adults are in control of their mental faculties and they and their families can enjoy a high quality of life in this final phase of human development. The focus of the present application is to examine carefully the role of lifestyle variables that are commonly believed to be "good for the mind" in facilitating healthy cognitive aging. There is clear evidence that physical exercise improves cognitive health in late adulthood. What has not been studied is whether enhancing neural vasculature through exercise is an important condition for reaping the benefits of cognitive interventions. One of the main reasons for this gap in knowledge is the cost of implementing and studying such complex lifestyle interventions. The proposed project is one of the first attempts to study the joint effects of exercise and a cognitive intervention program by adding exercise conditions to an already-funded intervention study on cognitive engagement in the laboratory of Denise Park at the Center for Brain Health in Dallas. Synapse involves investigating the impact on cognitive function of immersing adults in a 12 week new learning challenge for 15- 20 hours each week. Subjects learn to quilt, perform digital photography, or do both. In this new application, we will add two groups to the Synapse project for the next three years: an Exercise Only group that improves cardiovascular health through a walking program that will allow us to assess the impact of exercise versus cognitive engagement. We will also add an Exercise Plus Engagement group comprised of subjects that both exercise and participate in Synapse, allowing us to assess whether exercise potentiates cognitive engagement effects. Because the infrastructure costs of the Synapse project are already funded, we can address critical scientific questions about exercise and cognitive interventions which have proven to be too expensive to easily address in previous work. The two primary goals of the project are to (a) directly compare exercise interventions and cognitive interventions to determine relative effectiveness of each domain and (b) examine the interactive effects of a joint exercise/cognitive intervention program. We hypothesize that a healthy cardiovascular system will greatly enhance cognitive intervention effects. In addition, we will utilize novel and exceptionally sensitive measures of cerebrovascular fitness by employing transcranial Doppler imaging, a method that has not yet been used in the exercise/cognition domain. Besides measuring VO2-Max, we will measure cerebral hypoperfusion, blood vessel reactivity, and arterial stiffness so that we will have careful measures of vascular health. PUBLIC HEALTH RELEVANCE: The focus of the present application is to examine carefully the role of lifestyle variables that are commonly believed to be "good for the mind" in facilitating healthy cognitive aging. There is clear evidence that physical exercise improves cognitive health in late adulthood. What has not been studied is whether enhancing neural vasculature through exercise is an important condition for reaping the benefits of cognitive interventions. The proposed project is one of the first attempts to study the joint effects of exercise and a cognitive intervention program on cognition.