COMBINING EXERCISE AND COGNITIVE TRAINING TO IMPROVE EVERYDAY FUNCTION

描述(申请人提供)：生活方式活动可能在晚年有益于认知健康的可能性，对于我们日益老龄化的人口来说是重要的。虽然许多关于老年人身体和认知训练活动的研究都试图证明这种益处，但这些益处的转移和维持一直很少。在这个建议中，我们介绍和评估了两个新的，理论上有动机的进步，以优化培训的效果，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，很少依赖单一的认知过程，一个进步是纳入了训练，将涉及三个认知控制过程(任务协调、前瞻记忆和回顾记忆)的练习交织在一起。第二个进步在于观察到，到目前为止，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的或协同的。因此，一个重要的目标是评估有氧运动和认知训练相结合的好处，以优化认知功能的训练和转移，特别是在日常活动中。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岁之间的男性和女性健康状况稳定，没有运动禁忌，也没有痴呆症或认知障碍的证据。受试者将被随机分配到四组中的一组，为期六个月：运动组、认知训练组、运动与认知联合训练组和控制组。这一设计将使我们能够评估每个干预措施在从基线到培训后在认知控制措施方面改善表现的独特好处，包括培训特定的、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(ADL)和生活质量；以及客观的身体表现。我们还计划比较6个月干预期(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、日常生活能力和主观记忆表现方面的保持。 与公共健康相关：对于我们日益老龄化的人口来说，生活方式活动可能在晚年有益于认知健康的可能性是重要的。虽然许多关于老年人身体和认知训练的研究都试图证明这种好处，但这些好处的转移和维持一直很少。如果认知训练结合有氧运动训练被证明具有转移到日常活动中并持续存在的效果，这项研究的结果最终可能直接应用于各种社区环境，以减少或延缓与年龄相关的认知衰退。

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.