COMBINING EXERCISE AND COGNITIVE TRAINING TO IMPROVE EVERYDAY FUNCTION

描述（由申请人提供）：生活方式活动可能有益于晚年的认知健康，这对我们日益老龄化的人口具有重要意义。尽管许多关于老年人身体和认知训练活动的研究试图证明这些益处，但这些益处的转移和维持一直很小。在本提案中，我们介绍并评估了两种新颖的，理论上有动机的进步，以优化训练的效果，包括转移到日常的，现实世界的活动。认识到现实世界的活动，与实验室任务不同，很少依赖于单一的认知过程，一个进步是将涉及三个认知控制过程（任务协调，前瞻性和回顾性记忆）的交叉练习的训练结合起来。第二个进步是基于这样一种观察：迄今为止，很少有研究仔细评估有氧运动和认知训练在产生认知益处方面可能是相加或协同作用的可能性。因此，一个重要的目标是评估有氧运动与认知训练相结合的好处，以优化训练和认知功能的转移，特别是日常活动。我们建议对自然退休社区（NORC）的居民进行一项随机、对照的前瞻性研究。96名年龄在55-75岁、健康状况稳定、无运动禁忌症、无痴呆或认知障碍证据的男性和女性将被纳入研究。个人将被随机分配到四个组中的一个，为期六个月：运动，认知训练，运动和认知训练相结合，和控制。这种设计将使我们能够评估每一种干预措施的独特益处，以提高从基线到训练后的认知控制措施的表现，包括训练特定，实验室和日常转移任务；日常主观记忆表现；自我报告的日常生活活动（ADLs）和生活质量；客观的身体表现。我们还计划比较在6个月的干预期（基线后12个月）后，认知组、运动组和联合组的个体在6个月的转移维持、ADL和主观记忆表现的提高。

DESCRIPTION (provided by applicant): The possibility that lifestyle activities may benefit cognitive health in late life is of major importance for our increasingly aging population. Although many studies of physical and cognitive training activities in older adults have attempted to demonstrate such benefits, transfer and maintenance of these benefits have been minimal. In this proposal, we introduce and evaluate two novel, theoretically motivated advances to optimize the effects of training, including transfer to daily, real world activities. Recognizing that real world activities, unlike laboratory tasks, rarely rely upon a single cognitive process, one advance is the incorporation of training that interleaves practice involving three cognitive control processes (task-coordination, prospective and retrospective memory). A second advance rests on the observation that few studies to date have carefully assessed the possibility that aerobic exercise and cognitive training together may be additive or synergistic in yielding cognitive benefits. Accordingly, an important objective is to evaluate the benefits of combining aerobic exercise with cognitive training for optimizing training and transfer of cognitive function, particularly for daily activities. We propose to conduct a randomized, controlled prospective study with residents of a Naturally Occurring Retirement Community (NORC). Ninety-six men and women, age 55-75 years who are in stable health and without contraindications to exercise or evidence of dementia or cognitive impairment, will be enrolled. Individuals will be randomly assigned to one of four groups for six months: Exercise, Cognitive training, Combined exercise and cognitive training, and Control. This design will allow us to evaluate the unique benefits of each intervention for improving performance from baseline to post-training on measures of cognitive control, including training specific, laboratory and everyday transfer tasks; everyday subjective memory performance; self-reported activities of daily living (ADLs) and quality of life; and objective physical performance. We also plan to compare 6-month maintenance of transfer, ADL, and subjective memory performance gains for individuals in the Cognitive, Exercise, and Combined groups following the 6-month intervention period (12 months after baseline). PUBLIC HEALTH RELEVANCE: The possibility that lifestyle activities may benefit cognitive health in late life is of major importance for our increasingly aging population. Although many studies of physical and cognitive training in older adults have attempted to demonstrate such benefits, transfer and maintenance of these benefits have been minimal. If cognitive training combined with aerobic exercise training is proven to have effects that transfer to everyday activities and are sustained, the results of this study could eventually be directly applied to a variety of community settings to reduce or delay age-related cognitive decline.