SHARP-P

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目及 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 与年龄相关的认知障碍的发病率正在迅速增加，并成为一个主要的临床和公共卫生问题。已经开发了治疗痴呆症的药物，并且已经测试了作为预防剂的化合物，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具有相当大的前景，在某种程度上，它们经常被推荐，但它们的疗效尚未通过充分的随机临床试验（RCT）确定。我们的目标是开发和进行这样一个精心设计的试验，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显著认知能力下降的风险。在本申请中，我们建议通过开展一项试点研究来为此做好准备，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单独改善6个月内的执行功能和情景记忆，以确定联合干预是否具有超越单独干预的前景而不影响依从性，并设计一项组织良好且有效的全规模多中心RCT。基于执行功能和情景记忆的复合测量被选为主要结果：这些组成部分是认知老化的重要标志物，可能对我们的干预措施最敏感。

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.