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Assessing Causality of the Association Between Exercise and Neurocognitive Gains

Not Applicable
Conditions
Aging Well
Interventions
Other: exercise
Registration Number
NCT05511259
Lead Sponsor
Nanyang Technological University
Brief Summary

Brief Summary: The aim of this project is to examine:

1. The effects of a community based square stepping exercise programme on cognitive and physical functions in older adults.

2. The effects of a community based square stepping exercise programme on neuroplasticity in older adults.

3. The effects of a community based square stepping exercise programme on structural and functional brain changes in older adults.

4. The relationship between exercise-induced changes in neuroplasticity, structural and functional brain activations, and cognitive and physical gains in older adults.

Detailed Description

It is well known regular exercise produces both physical and cognitive benefits. Emerging evidence suggests that physical movements or exercise that have concurrent cognitive demands may have more profound effects on cognitive and brain health outcomes. One training program that incorporates these components is the square stepping exercise (SSE). First demonstrated in Japan, this community-based paradigm has already shown to reduce falls risk and presents as a convenient exercise modality for older adults, that can be conducted in a group setting or even the home. The current project aims to examine the efficacy of this SSE community programme in a Singapore context on cognitive and physical health in older adults. This study also aims to quantify the neural correlates underpinning any observed improvements in cognitive and physical function. Specifically, this project will measure indices of neuroplasticity via structural and functional magnetic resonance imaging, transcranial magnetic stimulation, and electroencephalography.

Sample size estimation: n=80 for behavioural primary outcome measures and n=40 subset of larger sample for neuroimaging and neuroplasticity secondary outcome measures \[anticipated\].

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
80
Inclusion Criteria
  • Older adults aged 55-80
  • Sedentary, defined as exercise less than 3 times per week for 30 minutes
Exclusion Criteria
  • Square stepping exercise:
  • Medical conditions preventing them from movement and/or exercise
  • Psychiatric conditions
  • Cognitive impairment of dementia
  • Upper and/or lower limb injuries in the past 6 months
  • History of falls in the past 6 months
  • Current smokers
  • Neuroimaging (all the above in addition to the following)
  • Patients who have conductive, ferromagnetic, or magnet-sensitive metals implanted in head (e.g., aneurysm clip, stent).
  • Implanted medical device: e.g., cardiac implants, cochlear implant, aneurysm clips, cardiac pacemaker etc.
  • Non-removable metal braces or retainer (dental fillings ok).
  • Permanent tattoos on head.
  • Deep brain stimulators.
  • Previous brain surgery or injury.
  • Patient with epilepsy or any other seizure history, or immediate family history of epilepsy.
  • Clinical EEG that was abnormal or where seizure activity had not been ruled out.
  • Patients with history of head injury with loss of consciousness are to be investigated about the history if/before being recruited.
  • Diagnosis or possibility of neurological disorder (including stroke).
  • Psychiatric condition.
  • Major or unstable medical condition/surgery.
  • Current or suspected pregnancy or lactation.
  • Illicit drug use in the last 7 days.
  • Alcohol use in the last 12 hours or more than 3 standard drinks in last 24 hours.
  • Recent insomnia or severe sleep deprivation.
  • Participation in another study involving brain stimulation (e.g., TMS, TDCS) in the past 7 days.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
InterventionexerciseSquare stepping exercise
Primary Outcome Measures
NameTimeMethod
N-Back task changeBaseline (week 0), mid-intervention (week 7 after session 12), post-intervention (week 13 after session 24)

Number of correct responses (hits)

Static balance (single leg) changeBaseline (week 0), post-intervention (week 13 after session 24)

Duration required to perform single leg stance on left and right legs

Modified Card Sorting task changeBaseline (week 0), mid-intervention (week 7 after session 12), post-intervention (week 13 after session 24)

Total number of perseverative errors

Motor learning changeBaseline (week 0), post-intervention (week 13 after session 24)

Probabilistic Serial Reaction Time Task: learning index, computed using reaction time

Go-No-Go task changeBaseline (week 0), mid-intervention (week 7 after session 12), post-intervention (week 13 after session 24)

Error rate: Number of "Go" responses on "No-Go" trials.

Stroop task colour words and colour blocksBaseline (week 0), mid-intervention (week 7 after session 12), post-intervention (week 13 after session 24)

Average response time (reaction time) for the correct colour word incongruent trials.

Trail Making Test ((TMT) changeBaseline (week 0), mid-intervention (week 7 after session 12), post-intervention (week 13 after session 24)

B:A: Divide the time taken for TMT B by TMT A

Digit Span task changeBaseline (week 0), mid-intervention (week 7 after session 12), post-intervention (week 13 after session 24)

Maximum accurate span length for Digit Span Forward Maximum accurate span length for Digit Span Reverse

Temporal gait parameters changeBaseline (week 0), post-intervention (week 13 after session 24)

11-meter gait test to examine gait speed

Secondary Outcome Measures
NameTimeMethod
Change in grey matter volumeBaseline (week 0), post-intervention (week 13 after session 24)

T1 and T2 weighted images

Change in structural topographyBaseline (week 0), post-intervention (week 13 after session 24)

T1 and T2 weighted images

Change in functional connectivityBaseline (week 0), post-intervention (week 13 after session 24)

Resting state functional magnetic resonance imaging

Change in white matter integrityBaseline (week 0), post-intervention (week 13 after session 24)

Diffusion Tensor Imaging

Change in cortical thicknessBaseline (week 0), post-intervention (week 13 after session 24)

T1 and T2 weighted images

Change in white matter connectivityBaseline (week 0), post-intervention (week 13 after session 24)

Diffusion Tensor Imaging

Brain plasticity changesBaseline (week 0), post-intervention (week 13 after session 24)

Changes in power spectral density and coherence recorded from electroencephalography (EEG)

Trial Locations

Locations (1)

Nanyang Technological University

🇸🇬

Singapore, Singapore

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