Department of Psychiatry, Indiana University School of Medicine, United States of America.
Department of Neurology, Indiana University School of Medicine, United States of America.
Contemp Clin Trials. 2023 Aug;131:107249. doi: 10.1016/j.cct.2023.107249. Epub 2023 Jun 1.
Treatments that delay progression of cognitive impairment in older adults are of great public health significance. This manuscript outlines the protocol, recruitment, baseline characteristics, and retention for a randomized controlled trial of cognitive and aerobic physical training to improve cognition in individuals with subjective cognitive dysfunction, the "Cognitive and Aerobic Resilience for the Brain" (CARB) study.
Community-dwelling, older adults with self-reported memory loss were randomly assigned to receive either computer-based cognitive training, aerobic physical training, combined cognitive and physical training, or education control. Treatment was delivered 2- to 3-times per week in 45- to 90-min sessions for 12 weeks by trained facilitators videoconferencing into subject's home. Outcome assessments of were taken at the baseline, immediately following training, and 3-months after training.
191 subjects were randomized into the trial (mean age, 75.5 years; 68% female; 20% non-white; mean education, 15.1 years; 30% with 1+ APOE e4 allele). The sample was generally obese, hypertensive, and many were diabetic, while cognition, self-reported mood, and activities of daily living were in the normal range. There was excellent retention throughout the trial. Interventions were completed at high rates, participants found the treatments acceptable and enjoyable, and outcome assessments were completed at high rates.
This study was designed to determine the feasibility of recruiting, intervening, and documenting response to treatment in a population at risk for progressive cognitive decline. Older adults with self-reported memory loss were enrolled in high numbers and were well engaged with the intervention and outcome assessments.
治疗能够延缓老年人认知障碍进展具有重要的公共卫生意义。本文概述了一项随机对照试验的方案、招募情况、基线特征和保留率，该试验旨在通过认知和有氧身体训练来改善有主观认知功能障碍的个体的认知，即“认知和有氧大脑弹性”（CARB）研究。
社区居住的、有自我报告记忆丧失的老年人被随机分配接受基于计算机的认知训练、有氧身体训练、认知和身体训练相结合或教育对照。治疗由经过培训的协调员通过视频会议到受试者家中进行，每周 2-3 次，每次 45-90 分钟，持续 12 周。在基线、训练结束后立即和训练结束后 3 个月进行结局评估。
191 名受试者被随机分配到试验中（平均年龄 75.5 岁；68%为女性；20%为非白人；平均受教育年限 15.1 年；30%有 1 个以上 APOE e4 等位基因）。该样本普遍肥胖、高血压，许多人患有糖尿病，而认知、自我报告的情绪和日常生活活动都在正常范围内。整个试验的保留率非常高。干预措施的完成率很高，参与者认为治疗方法可接受且愉快，并且结局评估的完成率也很高。
本研究旨在确定在有进行性认知衰退风险的人群中招募、干预和记录治疗反应的可行性。有自我报告记忆丧失的老年人被大量招募，并且很好地参与了干预和结局评估。
