Exercise & Health Promotion for MCI: A Controlled Trial

描述（由申请人提供）：本项目是一项随机对照试验，旨在评估专门为轻度认知障碍（MCI）老年人设计的团体运动和健康促进计划的疗效。这是RO1#AG14777的竞争性更新，（问题解决/物理干预和衰老），旨在促进身体虚弱，认知完整的老年人的独立性的干预措施，以及它的补充，对MCI老年人干预的修改版本（现在称为RALLI-资源和活动终身独立）的可行性试验。两项研究的结果都显示了显著的积极治疗结果，包括肌肉力量、耐力和运动时间的增加；改善身体机能、自我报告的健康观念、抑郁、生活质量、幸福感、活力和自我控制能力。可行性试验中MCI患者，参加RALLI 9周后，平均每周运动时间增加172分钟，HDL胆固醇显著改善，MMSE平均得分提高1.2分。本研究将RALLI与现有的老年人社区运动控制条件（终生健身- lf）进行比较。参与者年龄在70岁以上，居住在社区，符合轻度认知障碍和身体活动不足的标准。他们将在基线、治疗后和每6个月进行一次评估，为期36个月，由面试官对治疗情况进行盲测。主要和次要结局包括认知能力下降、情感和身体功能、自评健康和健康行为以及生活质量。探索性结果包括从轻度认知损伤到痴呆的36个月转换率、身体残疾水平、独立生活的持续时间和生理健康指标。我们假设RALLI参与者比LF受试者有更好的治疗后结果，并且在36个月内，RALLI参与者的痴呆转归率更低，身体和功能下降更少。对公共卫生的意义：本提案将调查旨在保持轻度认知障碍老年人认知和身体功能的运动和健康促进计划的功效。这些老年人在3年内患阿尔茨海默病的风险增加，延缓或预防认知能力下降将保持他们独立生活的能力，并节省公共卫生资金。

DESCRIPTION (provided by applicant): This project is a randomized controlled trial to evaluate the efficacy of a group exercise and health promotion program designed specifically for older adults with Mild Cognitive Impairment (MCI). It is a competitive renewal of RO1#AG14777, (Problem Solving/Physical Intervention & Aging), an intervention aimed at promoting independence in physically frail, cognitively intact older adults, and its supplement, a feasibility trial of a modified version of the intervention (now called RALLI--Resources & Activities for Life Long Independence) for older adults with MCI. Findings from both studies indicated significant positive treatment outcomes, including increased muscle strength, endurance, and exercise time; improved physical functioning, self-reported health perceptions, depression, quality of life, well-being, vitality, and perceived self-control. For participants with MCI in the feasibility trial, after 9-weeks participation in RALLI, mean exercise time increased by 172 minutes per week, HDL cholesterol significantly improved, and mean MMSE scores improved by 1.2 points. This investigation will compare RALLI to an existing community-based exercise control condition for older adults (Lifetime Fitness-LF). Participants will be over age 70, community residing, and meet criteria for MCI and insufficient physical activity. They will be evaluated at baseline, post-treatment, and every 6 months for 36 months by interviewers blind to treatment condition. Primary and secondary outcomes include cognitive decline, affective and physical function, self-rated health and health behaviors, and quality of life. Exploratory outcomes include 36-month rate of conversion from MCI to dementia, level of physical disability, continuation in independent living, and physiological health indicators. We hypothesize that RALLI participants will experience better post-treatment outcomes than LF subjects, and that RALLI participants will have a lower rate of conversion to dementia and less physical and functional decline over 36 months. Significance to Public Health: This proposal will investigate the efficacy of an exercise and health promotion program designed to preserve cognitive and physical function in older adults with mild cognitive impairment. These older adults are at increased risk of developing Alzheimer's disease within 3 years, and delaying or preventing cognitive decline will preserve their ability to live independently and save public health dollars.