Independent Walking for Brain Health

Not Applicable

Terminated

Interventions: Behavioral: Mobile Health Walking Condition
Behavioral: Healthy Aging Education Condition

Brief Summary: Physical activity interventions with older adults can improve brain health; however most interventions have been performed in gym-like settings that reach a small sector of the senior population. Since not everyone can access a gym, it is important to study whether brisk walking in real world environments can also help brain health. This study will use mobile health devices to help older adults independently walk for brain health, thus representing a critical step towards the dissemination of physical activity intervention programs aimed at preserving cognitive function in aging.

Detailed Description: Physical activity interventions conducted in supervised settings (laboratories and group settings) with older adults have consistently shown improved cardiovascular and cerebrovascular health and improved cognitive function. What is lacking is the development of interventions that take place in real world environments and that take advantage of new technologies to help objectively track real time physical activity behaviors. Real world physical activity interventions have the potential to reach a larger segment of the population and to enhance maintenance after the intervention period ends. This study will develop a novel physical activity intervention using mobile health technologies to promote physical activity levels likely to affect cerebral blood flow and cognition in real world environments in cognitively normal older adults. A randomized controlled trial will be conducted with 30 participants being assigned to the mobile health physical activity condition (walking in free-living environments tracked via mobile health technologies) and another 30 to an education control condition (at home reading about healthy aging materials) for 3 months.

Recruitment & Eligibility

Inclusion Criteria

Men and women between the ages of 65-80
Ability to obtain a signed physician's clearance for participation in this study
English-speaking as needed to complete cognitive testing and follow study procedures
Cognitively normal (based on comprehensive neuropsychological assessment)
No contraindications for Magnetic Resonance Imaging (MRI)
Must be ambulatory and able to walk independently

Exclusion Criteria

History of head injury involving loss of consciousness within the past 6 months and/or history of severe traumatic brain injury
Major neurological disorders (dementia, multiple sclerosis, epilepsy, etc)
Chronic major psychiatric disorders (schizophrenia, major recurrent affective disorder)
History of major vascular events (myocardial infarction, stroke, etc),
History of diabetes
History of falls in the last year resulting in hospitalization
Unstable or poorly controlled medical problems e.g. heart failure, diabetes (poorly controlled or on insulin), uncontrolled hypertension, pulmonary disease with hypoxia or hypercapnia, significant liver problems or renal failure, treatment of cancer in the past 2 years (other than non-melanoma skin cancer), HIV positive
Objective evidence of cognitive impairment based on neuropsychological assessment

Arm && Interventions

Group	Intervention	Description
Mobile Health Walking Condition	Mobile Health Walking Condition	Physically inactive older adults in this condition will perform 3 months of prescribed brisk walking (to increase cardio respiratory fitness) in their real world environments, using mobile health (mHealth) devices during each exercise session to achieve and maintain a minimum of 150 minutes of moderate to vigorous physical activity (MVPA) per week.
Healthy Aging Education Condition	Healthy Aging Education Condition	The education control condition will provide participants with printed materials and homework assignments on issues related to successful aging, such as nutrition, social activity, cognitive and social engagement.

Primary Outcome Measures

Name	Time	Method
Moderate to Vigorous Physical Activity (MVPA) Average Per Day	Pre (baseline) and post (3 months)	Average minutes per day spent in moderate to vigorous levels of physical activity (MVPA) (defined as =\>1952 accelerometer counts per minute). MVPA minutes were determined based on one-week of accelerometer wear on the hip at baseline and post intervention.

Secondary Outcome Measures

Name	Time	Method
Cerebral Blood Flow (Hippocampal and Frontal)	Pre (baseline) and post (3 months)	Average cerebral blood flow measured with arterial spin labeling magnetic resonance imaging in ml/100g/min. Cerebral blood flow was obtained via arterial spin labeling MRI and Freesurfer software was utilized to delineate regions of interest for each participant (right and left regions were averaged). For the frontal lobe cerebral blood flow we averaged the mean of superior frontal, rostral and caudal middle frontal, pars opercularis, pars triangularis, pars orbitalis, lateral and medial orbitofrontal, precentral, paracentral, and frontal pole.