Devenney Kate E, Sanders Marit L, Lawlor Brian, Olde Rikkert Marcel G M, Schneider Stefan
Discipline of Physiotherapy, Trinity College Dublin, Dublin, Ireland.
Department of Geriatric Medicine, Radboud Alzheimer Centre, Radboud University Medical Center, Nijmegen, The Netherlands.
BMC Geriatr. 2017 Mar 22;17(1):75. doi: 10.1186/s12877-017-0457-9.
Exercise interventions to prevent dementia and delay cognitive decline have gained considerable attention in recent years. Human and animal studies have demonstrated that regular physical activity targets brain function by increasing cognitive reserve. There is also evidence of structural changes caused by exercise in preventing or delaying the genesis of neurodegeneration. Although initial studies indicate enhanced cognitive performance in patients with mild cognitive impairment (MCI) following an exercise intervention, little is known about the effect of an extensive, controlled and regular exercise regimen on the neuropathology of patients with MCI. This study aims to determine the effects of an extensive exercise programme on the progression of MCI.
METHODS/DESIGN: This randomised controlled clinical intervention study will take place across three European sites. Seventy-five previously sedentary patients with a clinical diagnosis of MCI will be recruited at each site. Participants will be randomised to one of three groups. One group will receive a standardised 1-year extensive aerobic exercise intervention (3 units of 45 min/week). The second group will complete stretching and toning (non-aerobic) exercise (3 units of 45 min/week) and the third group will act as the control group. Change in all outcomes will be measured at baseline (T0), after six months (T1) and after 12 months (T2). The primary outcome, cognitive performance, will be determined by a neuropsychological test battery (CogState battery, Trail Making Test and Verbal fluency). Secondary outcomes include Montreal Cognitive Assessment (MoCA), cardiovascular fitness, physical activity, structural changes of the brain, quality of life measures and measures of frailty. Furthermore, outcome variables will be related to genetic variations on genes related to neurogenesis and epigenetic changes in these genes caused by the exercise intervention programme.
The results will add new insights into the prevailing notion that exercise may slow the rate of cognitive decline in MCI.
ClinicalTrials.gov NCT02913053.
近年来,预防痴呆和延缓认知衰退的运动干预受到了广泛关注。人类和动物研究表明,规律的体育活动通过增加认知储备来改善脑功能。也有证据表明运动引起的结构变化可预防或延缓神经退行性变的发生。尽管初步研究表明,运动干预后轻度认知障碍(MCI)患者的认知能力有所提高,但对于广泛、可控且规律的运动方案对MCI患者神经病理学的影响知之甚少。本研究旨在确定广泛运动方案对MCI进展的影响。
方法/设计:这项随机对照临床干预研究将在欧洲的三个地点进行。每个地点将招募75名临床诊断为MCI且此前久坐不动的患者。参与者将被随机分为三组。一组将接受标准化的为期1年的广泛有氧运动干预(每周3次,每次45分钟)。第二组将完成伸展和塑形(非有氧运动)(每周3次,每次45分钟),第三组作为对照组。所有结局指标的变化将在基线(T0)、6个月后(T1)和12个月后(T2)进行测量。主要结局指标,即认知能力,将通过一套神经心理学测试(CogState测试组电池、连线测验和语言流畅性测试)来确定。次要结局指标包括蒙特利尔认知评估(MoCA)、心血管健康状况、身体活动、脑结构变化、生活质量指标和衰弱指标。此外,结局变量将与神经发生相关基因的遗传变异以及运动干预方案引起的这些基因的表观遗传变化相关。
研究结果将为运动可能减缓MCI认知衰退速度这一普遍观点提供新的见解。
ClinicalTrials.gov NCT02913053。