Water-based Activities to Enhance Recall in Veterans (WATER-VET)

 描述（由申请人提供）： 本研究的主要研究问题是：对患有遗忘型轻度认知障碍（MCI）的老年退伍军人进行水基体育锻炼+认知训练的组合方案是否可行？拟议研究的主要目的是：1）证明足够的招募和保留率; 2）完善入选/排除标准; 3）进一步完善水基体育锻炼+认知训练（WATER+CT）组合干预。这些目标将在一项具有单组设计的两阶段临床试验中进行测试：1）运动训练阶段和2）认知训练阶段。运动训练阶段包括一个以水为基础的体育锻炼计划，强调心血管健康和力量训练，通过结合非负重运动，包括陆基伸展和水上活动。这个为期2年的试点项目将包括50名年龄在50-90岁之间被诊断患有遗忘型MCI的退伍军人。运动部分包括为期六个月的水上运动计划，然后是为期四周的认知训练计划。在水上运动计划的前两个月，退伍军人将在VA帕洛阿尔托医疗保健系统的水上治疗中心参加每周三次的小组会议。这将过渡到剩下的四个月的自定进度的锻炼计划。完成训练计划后，退伍军人将开始在VAPAHCS进行基于课堂的认知训练。认知训练是基于一个有效的认知程序，该程序围绕两个组成部分，即预训练和记忆训练，这两个部分都已成功地用于aMCI患者。将在整个治疗期间进行依从性评估，并在治疗后完成可行性测量。参与者将完成各种神经心理学测量，涉及认知领域，如注意力，执行功能和记忆。为了研究治疗反应的可能预测因素，我们还将收集这些参与者的生物学（心血管功能和BDNF血浆水平）和遗传学数据（APOE和BDNF基因型）。我们希望为认知训练的水基运动训练增强的可行性提供初步证据，从而奠定基础。 为通过非药物手段减轻遗忘型MCI患者认知功能障碍的全面临床试验奠定了基础。

 DESCRIPTION (provided by applicant): The primary research question of the proposed study is this: Is a combination water-based physical exercise + cognitive training program for older veterans with amnestic Mild Cognitive Impairment (MCI) feasible? The primary aims of the proposed research are: 1) demonstrate adequate recruitment and retention rates; 2) refinement of inclusion/exclusion criteria; and 3) further refine the combination water- based physical exercise + cognitive training (WATER+CT) intervention. These aims will be tested in a two-phase clinical trial with a single group design: 1 exercise training phase and 2) a cognitive training phase. The exercise training phase consists of a water-based physical exercise program that emphasizes cardiovascular fitness and strength training through a combination of non-weight bearing exercises that include land-based stretching and water-based activities. This 2-year pilot project will include 50 veterans diagnosed with amnestic MCI age 50-90. The exercise component consists of a six-month water-based exercise program followed by a four-week cognitive training program. For the first two months of the water-based exercise program, veterans will come to thrice-weekly group sessions at Aquatic Therapy Center at the VA Palo Alto Health Care System. This will transition to a self-paced exercise program for the remaining four months. After completion of the exercise program, veterans will begin classroom-based cognitive training at the VAPAHCS. The cognitive training is based on an efficacious cognitive program that is structured around two components, pre-training and mnemonic training, both of which have been used successfully in persons with aMCI. Assessments of adherence will be administered throughout treatment and measures of feasibility will be completed post-treatment. Participants will complete a variety of neuropsychological measures taping into areas of cognition such as attention, executive functioning, and memory. To study possible predictors of treatment response, we will also collect biological (cardiovascular functioning and BDNF plasma levels) and genetic data (APOE and BDNF genotypes) from these participants. We hope to provide initial evidence of the feasibility of a water- based exercise training augmentation for cognitive training thus laying the groundwork for full-scale clinical trials targeting the lessening of cognitive impairment in person with amnestic MCI by non-pharmacological means.