The Combined Aerobic Exercise and Cognitive Training (ACT) Trial: The ACT Trial
- Conditions
- Mild Cognitive Impairment
- Interventions
- Behavioral: Cognitive Training OnlyBehavioral: Stretching and Mental Stimulating ActivitiesBehavioral: Aerobic & Cognitive Training (ACT)Behavioral: Cycling Only
- Registration Number
- NCT03313895
- Lead Sponsor
- Arizona State University
- Brief Summary
This multi-site clinical trial occurs at the University of Minnesota and University of Rochester. It tests the efficacy and additive/synergistic effects of an ACT intervention on cognition and relevant mechanisms (aerobic fitness, Alzheimer's disease \[AD\] signature cortical thickness, and default mode network \[DMN\]) in older adults with amnestic MCI (aMCI).
- Detailed Description
Because almost all drug trials for Alzheimer's disease (AD) have failed, developing non-pharmacological interventions with strong potential to prevent or delay the onset of AD in high-risk populations (e.g., those with mild cognitive impairment \[MCI\]) is critically important. Aerobic exercise and cognitive training are 2 promising interventions for preventing AD. Aerobic exercise increases aerobic fitness, which in turn improves brain structure and function, while cognitive training improves selective neural function intensively. Hence, combined Aerobic exercise and Cognitive Training (ACT) may very well have an additive or synergistic effect on cognition by complementary strengthening of different neural functions. Few studies have tested ACT's effects, and those studies have reported discrepant findings, largely due to varying ACT programs. The purpose of this single-blinded, 2×2 factorial Phase II randomized controlled trial (RCT) is to test the efficacy and additive/synergistic effects of a 6-month combined cycling and speed of processing (SOP) training intervention on cognition and relevant mechanisms (aerobic fitness, AD signature cortical thickness, and functional connectivity in the default mode network \[DMN\]) in older adults with amnestic MCI (aMCI).
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 146
- A clinical diagnosis of MCI
- Community-dwelling
- Age 65 years and older
- English-speaking
- Adequate visual acuity
- Verified exercise safety by medical provider
- Stable on drugs affecting cognitive and psychological status
- Verified MRI safety
- Capacity to consent
- Geriatric Depression Scale < 5
- Resting heart rate (HR) ≤50 due to arrhythmia or ≥100 beats/min
- Neurological (e.g., dementia, head trauma), psychiatric (e.g., bipolar, schizophrenia, or depression), or substance dependency (alcohol or chemical dependency) in the past 5 years that are the main contributor to MCI
- Contraindications to exercise, e.g. unstable angina, recent surgery
- New symptoms or diseases that have not been evaluated by a health care provider
- Current enrollment in another intervention study related to cognitive improvement (reduce confounding effects on outcomes)
- Abnormal MRI findings
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- FACTORIAL
- Arm && Interventions
Group Intervention Description Cognitive Training Only Cognitive Training Only Computerized cognitive training, 3 times a week for 6 months, supervised by a specialist Stretching and Mental Stimulation Activities Stretching and Mental Stimulating Activities Stretching and mental stimulation activities, 3 times a week for 6 months, supervised by a specialist ACT Aerobic & Cognitive Training (ACT) Moderate-intensity cycling followed by computerized cognitive training, 3 times a week for 6 months, supervised by a specialist Cycling Only Cycling Only Moderate-intensity cycling, 3 times a week for 6 months, supervised by an exercise specialist
- Primary Outcome Measures
Name Time Method Executive function Change from baseline to 3, 6, 12, and 18 months EXAMINER
Episodic memory Change from baseline to 3, 6, 12, and 18 months RAVLT and BVMTR
AD-signature cortical thickness Change from baseline to 6, 12, and 18 months Magnetic Resonance Imaging (MRI)
Functional connectivity in DMN Change from baseline to 6, 12, and 18 months Functional MRI for Default Mode Network
Aerobic fitness Change from baseline to 3, 6, 12, and 18 months VO2peak from symptom-limited peak cycle-ergometer test, and 10-m Incremental Shuttle Walk Test
Conversion to Alzheimer's disease Change from baseline to 6, 12, and 18 months Clinical adjudication of Alzheimer's disease dementia
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (4)
Stanford University
🇺🇸Stanford, California, United States
University of Rochester
🇺🇸Rochester, New York, United States
Arizona State University
🇺🇸Phoenix, Arizona, United States
University of Minnesota
🇺🇸Minneapolis, Minnesota, United States