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

 描述(由申请人提供)： 这项拟议研究的主要研究问题是：针对患有遗忘性轻度认知障碍(MCI)的老年退伍军人，结合水基体育锻炼+认知训练计划是否可行？拟议研究的主要目的是：1)证明足够的招募和留存率；2)完善纳入/排除标准；3)进一步完善水基体育锻炼+认知训练(水+CT)的组合干预。这些目标将在两个阶段的临床试验中进行测试，采用单组设计：1运动训练阶段和2)认知训练阶段。运动训练阶段包括一项水基体育运动计划，强调通过结合非负重运动(包括陆上伸展和水上活动)进行心血管健康和力量训练。这项为期两年的试点项目将包括50名被诊断患有遗忘型MCI的退伍军人，年龄在50-90岁之间。锻炼部分包括为期六个月的水基锻炼计划，然后是为期四周的认知训练计划。在水基锻炼计划的前两个月，退伍军人将每周三次来到弗吉尼亚州帕洛阿尔托医疗保健系统的水上治疗中心参加小组会议。在接下来的四个月里，这将过渡到自定节奏的锻炼计划。完成锻炼计划后，退伍军人将在VAPAHCS开始基于课堂的认知训练。认知训练基于一个有效的认知计划，该计划围绕两个部分构建，即预训练和助记训练，这两个部分都已成功地用于急性MCI患者。将在整个治疗过程中进行依从性评估，并在治疗后完成可行性措施。参与者将完成各种神经心理学测量，包括注意力、执行功能和记忆等认知领域。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数据(心血管功能和BDNF血浆水平)和遗传数据(APOE和BDNF基因型别)。我们希望为水基运动训练增强认知训练的可行性提供初步证据，从而为 旨在通过非药物手段减轻遗忘性MCI患者认知障碍的全面临床试验的基础工作。

 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.