Impact of Exercise and Engagement on Cognition in Older Adults

描述（由申请人提供）：本申请是对RFA OD-09-003“恢复法案有限竞争：NIH健康和科学研究挑战赠款（RC 1）”的回应。本申请涉及广泛的挑战领域（05），比较有效性研究，和特定的挑战主题，05-AG-105“疾病和衰老综合征（包括神经退行性疾病）的比较干预试验。“这项竞争性修订的资金将使我们能够雇用总共3.25名全职人员：一名兼职运动生理学家、1.5名博士后研究员和1.25名研究助理。也许21世纪最紧迫的科学挑战是制定干预措施来减缓认知老化的过程，以便在生命的最后阶段，大多数老年人能够控制他们的智力，他们和他们的家人可以在人类发展的最后阶段享受高质量的生活。本申请的重点是仔细检查通常被认为是“对心智有益”的生活方式变量在促进健康认知老化中的作用。有明确的证据表明，体育锻炼可以改善成年后期的认知健康。尚未研究的是，通过运动增强神经血管是否是获得认知干预益处的重要条件。造成这种知识差距的主要原因之一是实施和研究这种复杂的生活方式干预措施的成本。拟议中的项目是研究运动和认知干预计划的联合效应的首批尝试之一，通过将运动条件添加到达拉斯脑健康中心Denise Park实验室已经资助的认知参与干预研究中。Synapse涉及研究将成年人沉浸在为期12周的新学习挑战中，每周15- 20小时对认知功能的影响。受试者学习被子，进行数码摄影，或两者兼而有之。在这个新的应用程序中，我们将在未来三年内为Synapse项目增加两个小组：一个只锻炼的小组，通过步行计划改善心血管健康，这将使我们能够评估锻炼与认知参与的影响。我们还将增加一个锻炼加参与组，由既锻炼又参与Synapse的受试者组成，使我们能够评估锻炼是否会增强认知参与效应。由于Synapse项目的基础设施成本已经得到资助，我们可以解决有关运动和认知干预的关键科学问题，这些问题已被证明过于昂贵，无法在以前的工作中轻松解决。该项目的两个主要目标是（a）直接比较运动干预和认知干预，以确定每个领域的相对有效性和（B）检查联合运动/认知干预计划的交互作用。我们假设，健康的心血管系统将大大提高认知干预的效果。此外，我们将利用新的和非常敏感的措施，脑血管健康，采用经颅多普勒成像，一种方法，尚未被用于运动/认知领域。除了测量VO 2-Max，我们还将测量脑灌注不足，血管反应性和动脉僵硬度，以便我们能够仔细测量血管健康。 公共卫生相关性：本申请的重点是仔细检查通常被认为是“对心智有益”的生活方式变量在促进健康认知老化中的作用。有明确的证据表明，体育锻炼可以改善成年后期的认知健康。尚未研究的是，通过运动增强神经血管是否是获得认知干预益处的重要条件。该项目是研究运动和认知干预计划对认知的联合影响的首次尝试之一。

DESCRIPTION (provided by applicant): This application is a response to RFA OD-09-003, "Recovery Act Limited Competition: NIH Challenge Grants in Health and Science Research (RC1)." This application addresses broad Challenge Area (05), Comparative Effectiveness Research, and specific Challenge Topic, 05-AG-105 "Comparative Intervention Trials for Diseases and Syndromes of Aging including Neurodegenerative Diseases." Funding of this competing revision will enable the hiring of a total of 3.25 full time people: a half-time exercise physiologist, 1.5 postdoctoral fellows and a 1.25 research assistants. Perhaps the most urgent scientific challenge for the 21st century is to develop interventions to slow the process of cognitive aging so that at the end of life, most older adults are in control of their mental faculties and they and their families can enjoy a high quality of life in this final phase of human development. The focus of the present application is to examine carefully the role of lifestyle variables that are commonly believed to be "good for the mind" in facilitating healthy cognitive aging. There is clear evidence that physical exercise improves cognitive health in late adulthood. What has not been studied is whether enhancing neural vasculature through exercise is an important condition for reaping the benefits of cognitive interventions. One of the main reasons for this gap in knowledge is the cost of implementing and studying such complex lifestyle interventions. The proposed project is one of the first attempts to study the joint effects of exercise and a cognitive intervention program by adding exercise conditions to an already-funded intervention study on cognitive engagement in the laboratory of Denise Park at the Center for Brain Health in Dallas. Synapse involves investigating the impact on cognitive function of immersing adults in a 12 week new learning challenge for 15- 20 hours each week. Subjects learn to quilt, perform digital photography, or do both. In this new application, we will add two groups to the Synapse project for the next three years: an Exercise Only group that improves cardiovascular health through a walking program that will allow us to assess the impact of exercise versus cognitive engagement. We will also add an Exercise Plus Engagement group comprised of subjects that both exercise and participate in Synapse, allowing us to assess whether exercise potentiates cognitive engagement effects. Because the infrastructure costs of the Synapse project are already funded, we can address critical scientific questions about exercise and cognitive interventions which have proven to be too expensive to easily address in previous work. The two primary goals of the project are to (a) directly compare exercise interventions and cognitive interventions to determine relative effectiveness of each domain and (b) examine the interactive effects of a joint exercise/cognitive intervention program. We hypothesize that a healthy cardiovascular system will greatly enhance cognitive intervention effects. In addition, we will utilize novel and exceptionally sensitive measures of cerebrovascular fitness by employing transcranial Doppler imaging, a method that has not yet been used in the exercise/cognition domain. Besides measuring VO2-Max, we will measure cerebral hypoperfusion, blood vessel reactivity, and arterial stiffness so that we will have careful measures of vascular health. PUBLIC HEALTH RELEVANCE: The focus of the present application is to examine carefully the role of lifestyle variables that are commonly believed to be "good for the mind" in facilitating healthy cognitive aging. There is clear evidence that physical exercise improves cognitive health in late adulthood. What has not been studied is whether enhancing neural vasculature through exercise is an important condition for reaping the benefits of cognitive interventions. The proposed project is one of the first attempts to study the joint effects of exercise and a cognitive intervention program on cognition.