SHARP-P

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 与年龄相关的认知障碍的发生率正在迅速增加，并成为一个主要的临床和公共卫生问题。治疗痴呆症的药物已经开发出来，化合物已经作为预防药物进行了测试，虽然已经取得了一些进展，但非药物干预也需要研究。来自小型或非对照研究的证据表明，体育锻炼和认知训练作为预防策略有相当大的前景，尽管它们经常被推荐，但它们的有效性尚未被足够有力的随机临床试验(RCT)确定。我们的目标是开发和进行这样一项精心设计的试验，以评估涉及体力活动和认知训练的多因素干预是否可以降低老年人认知能力显著下降的风险。在这项应用中，我们建议通过进行一项试点研究为自己做好准备，该研究将提供经验和数据，以评估体力活动和认知训练是否在6个月内分别改善执行功能和情景记忆，确定联合干预是否在不影响坚持的情况下超越单独干预的前景，并设计组织良好和有效的全面、多中心随机对照试验。基于执行功能和情景记忆的综合测量被选为主要结果：这些成分是认知老化的重要标志，可能对我们的干预最敏感。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The incidence of age-associated cognitive impairment is increasing rapidly and looms as a major clinical and public health issue. Drugs have been developed to treat dementia and compounds have been tested as preventive agents, and while some progress has been made, non-pharmacologic interventions also require study. Evidence from small or uncontrolled studies indicates that physical exercise and cognitive training have considerable promise as prevention strategies, to the extent that they are often recommended, however their efficacy has not been established by an adequately powered randomized clinical trial (RCT). Our goal is to develop and conduct such a well-designed trial to assess whether a multi-factorial intervention involving physical activity and cognitive training reduces the risk of significant cognitive decline in older individuals. We propose in this application to prepare ourselves for this by conducting a pilot study, which will provide the experience and data to assess whether physical activity and cognitive training separately improve executive function and episodic memory over 6 months, to determine whether a combination intervention holds promise beyond individual interventions without compromising adherence, and to design a well-organized and efficient full scale, multi-center RCT. A composite measure based on executive function and episodic memory is chosen as the primary outcome: these components are important markers of cognitive aging and may be most responsive to our interventions.