Remediating Age Related Cognitive Decline: Mindfulness-Based Stress Reduction and Exercise

 描述(由申请人提供)：绝大多数老年人的认知功能会下降，如记忆和认知控制(或执行功能)，干扰他们参与和从事有意义的活动的能力。重要的是，最近的观察表明，大脑在晚年保持可塑性，这表明及时和个性化的干预可能会补救与年龄相关的认知衰退。两种有希望的干预措施是基于正念的减压和锻炼，每种干预似乎都以多模式的方式作用，使中枢神经系统功能发生可塑性变化，以改善老年人的记忆和认知控制。我们的研究团队已经对这些干预措施进行了几项研究，支持它们的好处和改善认知功能的途径。我们提出了2x2析因设计RCT来明确测试MBSR和运动对年龄相关性认知衰退的补救作用。我们将580名65岁以上居住在社区的健康成年人随机分为四种情况之一：MBSR单独、单独运动、MBSR+运动或健康教育(对照条件)。参与者将接受为期6个月的急性期和12个月的维持期的程序化干预。我们将检查(1)认知改善，使用关注记忆和认知控制的有效和敏感的神经心理学电池；(2)机械性变化，如皮质醇减少和胰岛素敏感性提高；(3)可塑性的神经成像标记物：结构和功能连接性变化，表明认知改善背后的可塑性中枢神经系统的变化；(4)预测干预反应的个体变异性。我们的主要目标是进行高质量的临床试验，使数据和生物样本成为科学界的资源。然后，我们不仅可以通过将个人与最有益于他们的现成干预措施相匹配，在短期内改善老年人的生活，而且我们还可以通过干预措施了解神经可塑性变化的机制，以挽救随着年龄增长而导致的认知衰退，导致一个更活跃、更有活力的老年社区。

 DESCRIPTION (provided by applicant): The vast majority of older adults will suffer declines in cognitive functions such as memory and cognitive control (or executive function), interfering with their ability to participate and engage in meaningful activities. Importantly, the recent observation that the brain retains plasticity late into life suggests that timely and personalized interventions might remediate age-related cognitive decline. Two promising interventions are Mindfulness-Based Stress Reduction and Exercise, each of which appears to act in multi-modal ways to make plastic changes in CNS function to improve memory and cognitive control in older adults. Our research team has conducted several studies of these interventions, supporting their benefits and pathways to improved cognitive functioning. We propose a 2x2 factorial design RCT to definitively test MBSR and exercise for remediation of age-related cognitive decline. We will randomize 580 healthy community-living adults aged 65+ to one of four conditions: MBSR alone, exercise alone, MBSR+exercise, or health education (a control condition). Participants will receive protocolized interventions for a six-month acute period, followed by a 12-month maintenance period. We will examine (1) cognitive improvements using a well-validated and sensitive neuropsychological battery focusing on memory and cognitive control; (2) mechanistic changes such as reduced cortisol and improved insulin sensitivity (3) neuroimaging markers of plasticity: structural and functional connectivity changes indicating plastic CNS changes underlying the cognitive improvements (4) individual variability that predicts response to the interventions. Our main goal is to carry out a high-quality clinical trial, such that data and biosamples will become a resource for the scientific community. Then, we can not only improve the lives of older adults in the near-term by matching individuals to readily available interventions that most benefit them, we can also understand the mechanisms of neuroplastic changes with interventions to rescue cognitive decline with aging, leading to a more active and vital senior community.