Temporal Relations and Exercise Interventions of Various Gait and Cognitive Domains in Older Adults
Trial Snapshot
- Phase
- Not Applicable
- Sponsor
- Taipei Medical University
- Enrollment
- 189
- Locations
- 1
- Primary Endpoint
- Gait characteristics
Study Overview
Brief Summary
The effectiveness of conventional exercise, tai chi chuan and health education/usual physical activity over a 6-month intervention period in improving primary outcomes and secondary outcomes in older mild cognitive impairment adults will be compared. Third, whether changes in serum levels of the brain-derived neurotrophic factor (BDNF), insulin-like growth factor (IGF)-1, and vascular endothelial growth factor (VEGF) and expression of the apolipoprotein E (APOE) ε4 allele parallel changes in gait characteristics and cognitive functions after the intervention will be examined.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Prevention
- Masking
- Single (Participant)
Eligibility Criteria
- Ages
- 65 Years to 100 Years (Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •At least 65 years old
- •Had an emergency department visit due to a fall at least 3 months prior to the baseline assessment (assuming a full recovery time from a fall to be 3 months)
- •Can ambulate independently
- •Has mild cognitive impairment
Exclusion Criteria
- •Do not live in a community setting
- •Cannot ambulate independently and communicate with researchers
- •Have a major unstable cardiopulmonary disease (e.g., ischemic chest pain, shortness of breath, recurrent syncopal episodes, orthopnea, paroxysmal nocturnal dyspnea, palpitations, or tachycardia)
- •Have a contraindication to physical exercise (e.g., severe osteoarthritis or severe pulmonary hypertension)
Arms & Interventions
Conventional exercise
This exercise will comprise stretching, muscle strengthening, and balance training at increasing difficulty levels, tailored and supervised by a physical therapist, and will take place at a subject's residence or in the neighborhood once a week for 6 months. Each session will last 60 min.
Intervention: Exercise (Behavioral)
Tai chi chuan
The 8-form Yang-style tai chi chuan intervention will take place at a subject's residence or in the neighborhood once a week for 6 months, and each session will last 60 min.
Intervention: Exercise (Behavioral)
Health education/usual physical activity
After the baseline, the case manager will visit subjects in this group once for comparability with the other two intervention groups and instruct them to maintain their usual physical activity.
Outcomes
Primary Outcomes
Gait characteristics
Time Frame: 12 months
Performance on six gait characteristics (velocity, cadence, stride length, swing time, stride length variability, and swing time variability) will be measured with a 6-m electronic walkway of GAITRite.
Global cognition
Time Frame: 12 months
Global cognition will be assessed using the Mini-Mental State Examination (MMSE). The MMSE comprises 11 questions, and the score ranges 0\~30, with lower scores indicating poorer global cognition.
Serum levels of IGF-1
Time Frame: 12 months
Serum IGF-1 concentrations will be assessed.
Serum levels of BDNF
Time Frame: 12 months
Serum BDNF concentrations will be assessed.
Serum levels of VEGF
Time Frame: 12 months
Serum VEGF concentrations will be assessed.
Secondary Outcomes
- Fear of falling(12 months)
- Falls(12 months)
- Mobility(12 months)
- Muscle strength(12 months)
- Tinetti balance(12 months)
- Depressive symptoms(12 months)