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Cognition DisordersCogExNCT03696082

A Precision Rehabilitation Approach to Counteract Age-Related Cognitive Declines

A study testing Aerobic Activity, Resistance Training and Yoga in people with Cognition Disorders and Brain Pathology, run by University of Pittsburgh at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This study examines the behavioral, molecular, and structural biomarkers of brain health that will allow for the stratification of individuals according to their "cognitive signature" and function. Read more about this study

Who is it for?
Ages 65 to 80 yearsHealthy volunteers can take part
What is being tested?
Aerobic Activity, Resistance Training and Yoga
Could I receive a placebo?
No, everyone receives an active treatment
How many people
78 participants
Where
1 siteUnited States
Study dates
1 Sep 2018to 31 Dec 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 65 to 80 years
  • All sexes
  • Healthy volunteers accepted
  • Older adult

Who may be able to join

  • Age 65-80 years.
  • Sedentary, which is defined as regular participation over the past 3 months in <60 minutes per week of moderate-to-vigorous leisure-time or transportation-related physical activity performed in bouts of >10 minutes.
  • Independent ambulation without or with an cane or walking stick.
  • Able to walk (with or without assistive device such as a cane or walking stick) a distance of at least 400 meters based on self-report.
  • The ability to provide clearance from a physician for participation in the assessments and intervention aspects of this study.
  • Ability to provide informed consent.

Who cannot join

  • Reporting engaging in regular aerobic exercise, resistance exercise, or yoga exercise over the prior 3 months.
  • History of stroke, uncontrolled resting hypertension (systolic blood pressure ≥150 mmHg or diastolic blood pressure ≥100 mmHg), congestive heart failure, recent myocardial infarction, or other contraindications to engagement in moderate-intensity physical activity for at least 10 continuous minutes.
  • Incompatibility with the MRI environment (e.g. claustrophobia, metal implants, or body size, etc.)
  • Inability to attend the sessions as prescribed.
  • Consuming >1 alcoholic drink per day on >4 days per week, or current treatment for substance use disorder.
  • Report plans to relocate to a location not accessible to the study site or having employment, personal, or travel commitments that prohibit attendance to at least 80 percent of the scheduled intervention sessions and all of the scheduled assessments.
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  • Use of a walker or rolling walker for ambulation.
  • SPPB score of <6 or unable to perform any of the 3 components of the total score [item score = 0].
  • Inability to complete the 400m walk test; or an unhealthy response to test [e.g., Systolic blood pressure >240 or diastolic blood pressure >115; or a drop in diastolic blood pressure > 10mm].
  • Depressive symptoms not controlled or treated.
  • List the medications that will exclude a participant (e.g., those that may complicate brain imaging, cognitive test, or biomarker testing or interpretation).
  • Degenerative neurological condition [e.g., Parkinson's Disease, multiple sclerosis].
  • Severe respiratory disease [eg COPD with shortness of breath], or use of supplemental oxygen.
  • Lower limb below or above knee amputation / prosthesis.
  • Score of <85 of the 3MS (Modified Mini-Mental State Exam).

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Pittsburgh

    Pittsburgh, Pennsylvania, 15260

Other trials in United States

About this study

Official title: A Precision Rehabilitation Approach to Counteract Age-Related Cognitive

This study examines the behavioral, molecular, and structural biomarkers of brain health that will allow for the stratification of individuals according to their "cognitive signature" and function. This study will randomize older adults into one of four interventions for a period of 12 months: 1) Aerobic Exercise, 2) Resistance Exercise, 3) Yoga Exercise, 4) Health Education (involves stretching and range of motion activities). This aims of this study will examine whether and how these different types of training interventions exert effects cognitive function, brain structure, biomarkers of brain health and cognition, and physical function.

Read the detailed description

Physical activity is increasingly recognized to play a role in maintenance of brain health and attenuation of physical decline associated with aging. While physical activity has been shown to gradually decline with increasing age, initiation of an exercise protocol attenuates declines in cognition associated with advancing age, including impaired neurogenesis as well as decreased attention and learning. These benefits may be attributed, at least in part, to physical activity's role in maintaining an anti-inflammatory phenotype, and several clinical observational studies performed in older adults have shown an inverse relationship between self-reported physical activity and inflammatory biomarkers. Pre-clinical studies have also revealed that exposing aged animals to circulating factors derived from young animal counterparts significantly improves cognitive function and promotes neurogenesis.

A major limitation of clinical studies investigating the effect of physical activity on cognitive function is that subjects display considerable variability in their responses to the intervention. There are likely to be multiple biological pathways by which physical activity influences brain structure and function, and the type of physical activity that may be effective for influencing these pathways is likely to vary greatly. A better mechanistic understanding of how different modes of physical activity may target varying regions of the brain and other aspects of aging is therefore warranted.

This study examines the behavioral, molecular, and structural biomarkers of brain health that will allow for the stratification of individuals according to their "cognitive signature" and function. This study will randomize older adults into one of four interventions for a period of 12 months: 1) Aerobic Exercise, 2) Resistance Exercise, 3) Yoga Exercise, 4) Health Education (involves stretching and range of motion activities).

This aims of this study will examine whether and how these different types of training interventions exert differential effects on potential pathways of cognition and function in aged individuals, and the role of baseline subject characteristics in mediating these responses. The specific aims are:

  1. To compare changes in cognitive function in response to three different types of physical activity (aerobic activity, resistance training activity, yoga) versus health education control.
  2. To compare changes in brain structure in response to three different types of physical activity (aerobic activity, resistance training activity, yoga) versus health education control.
  3. To compare biomarkers of brain health and cognition in response to three different types of physical activity (aerobic activity, resistance training activity, yoga) versus health education control.
  4. To examine changes in physical function in response to three different types of physical activity (aerobic activity, resistance training activity, yoga) versus health education control.
  5. To conduct post-hoc analyses to examine whether baseline measures of cognitive function, brain structure, biomarkers, or physical function influence responsiveness to any of the three different types of physical activity (aerobic activity, resistance training activity, yoga) versus health education control.
Being tested
Aerobic Activity, Resistance Training, Yoga, Health Education
Medical subject headings
Cognition Disorders, Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Aerobic ActivityBehavioural

    Moderate-intensity exercise aerobic exercise that involves participating in activities similar to brisk walking that increase heart rate and breathing rate, with activity progressing to 150 minutes per week. Activities other than brisk walking, such as dance, aerobics, swimming, cycling or other activities that increase heart rate and breathing rate to a moderate intensity that can be sustained for at least 10 minutes will also be encouraged. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision.

  • Resistance TrainingBehavioural

    Resistance exercise that involves participating in activities similar to lifting weights that cause the participant to work specific muscles of your body, with activity progressing to 150 minutes per week. This can involve using weight training machines, elastic tubes that create resistance, or weights such a dumbbells. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision.

  • YogaBehavioural

    Yoga involves a series of movements and poses that are performed in a specific sequence that are adapted to your ability, with activity progressing to 150 minutes per week. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision.

  • Health EducationBehavioural

    This involves the participant receiving information regarding aspects of health that are important for older adults, and also physical activity in the form of light stretching activities and movements. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision.

Study groups in NCT03696082
Study groupRoleWhat they receive
Aerobic ActivityExperimentalModerate-intensity exercise aerobic exercise that involves participating in activities similar to brisk walking that increase heart rate and breathing rate, with activity progressing to 150 minutes per week. Activities other than brisk walking, such as dance, aerobics, swimming, cycling or other activities that increase heart rate and breathing rate to a moderate intensity that can be sustained for at least 10 minutes will also be encouraged. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision.
Receives: Behavioral: Aerobic Activity
Resistance TrainingExperimentalResistance exercise that involves participating in activities similar to lifting weights that cause the participant to work specific muscles of your body, with activity progressing to 150 minutes per week. This can involve using weight training machines, elastic tubes that create resistance, or weights such a dumbbells. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision.
Receives: Behavioral: Resistance Training
YogaExperimentalYoga involves a series of movements and poses that are performed in a specific sequence that are adapted to your ability, with activity progressing to 150 minutes per week. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision.
Receives: Behavioral: Yoga
Health EducationExperimentalThis involves the participant receiving information regarding aspects of health that are important for older adults, and also physical activity in the form of light stretching activities and movements. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision.
Receives: Behavioral: Health Education

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change from Baseline Brain Structure at 6 and 12 months

    Measured used MRI and fMRI tasks.

    Measured: Baseline, 6 months, 12 months

Secondary outcomes (11)
  1. Change from Baseline Functional Fitness at 3, 6, and 12 months

    Assessed with the Short Physical Performance Battery

    Measured: Baseline, 3 months, 6 months, 12 months

  2. Change from Baseline Fitness at 3, 6, and 12 months

    Assessed with a 400 meter corridor walk.

    Measured: Baseline, 3 months, 6 months, 12 months

  3. Change from Baseline Repeatable Battery for the Assessment of Neuropsychological Status at 3, 6, and 12 months

    This is a brief standardized paper-and-pencil neurocognitive battery measuring immediate and delayed memory, attention, language, and visuospatial skills. The test comprises of 12 subtests that is administered by a trained examiner.

    Measured: Baseline, 3 months, 6 months, 12 months

  4. Change from Baseline Modified Mini-Mental Status Exam at 3, 6, and 12 months

    This is an expanded 100-point version of the original Mini-Mental Status Exam, administered in ~7 minutes, which assesses global cognitive function. This measure has very good reliability, validity, and sensitivity to moderate cognitive changes and has a proven record in clinical trials.

    Measured: Baseline, 3 months, 6 months, 12 months

  5. Change from Baseline Auditory Verbal Learning Test at 3, 6, and 12 months

    The participant is read a list of 15 words, 5 times. After each time, the participant is asked to immediately recall as many words as possible. Following the 5th recall, an interference list is presented, after which the participant is asked to spontaneously recall words from the original list. After a 10-minute interval has passed, the participant is asked again to recall as many words as possible from the original list.

    Measured: Baseline, 3 months, 6 months, 12 months

  6. Change from Baseline Physical Activity (minutes per week) at 3, 6, and 12 months

    Measured by Actigraphy

    Measured: Baseline, 3 months, 6 months, 12 months

  7. Change from Baseline Physical Activity (minutes per week) at 3, 6, and 12 months

    Measured by CHAMPS questionnaire.

    Measured: Baseline, 3 months, 6 months, 12 months

  8. Change from Baseline Physical Activity (minutes per week) at 3, 6, and 12 months

    Measured by Paffenbarger questionnaire.

    Measured: Baseline, 3 months, 6 months, 12 months

  9. Change from Baseline Sedentary Behavior (minutes per day) at 3, 6, and 12 months

    Measured by modified CARDIA questionnaire

    Measured: Baseline, 3 months, 6 months, 12 months

  10. Change from Baseline Sedentary Behavior (minutes per day) at 3, 6, and 12 months

    Measured by Actigraphy

    Measured: Baseline, 3 months, 6 months, 12 months

  11. Change from Baseline Peripheral biomarkers at 3, 6, and 12 months

    Assessed from venous blood collection and includes measures of neuroinflammation, neurogenesis, and cerebral vascularity

    Measured: Baseline, 3 months, 6 months, 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Oct 2018
  2. Study start1 Sep 2018
  3. Primary completion31 Jan 2022
  4. Study completion31 Dec 2022

Why it stopped: Funding ended

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Sequential
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
78 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03696082
Sponsor's protocol ID
PRO17100528
Acronym
CogEx
Status last verified
Mar 2023
First submitted
13 Sep 2018
Last updated
22 Mar 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Aerobic Activity, Resistance Training and Yoga in people with Cognition Disorders and Brain Pathology, run by University of Pittsburgh at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 22 Mar 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: Funding ended). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change from Baseline Brain Structure at 6 and 12 months (time frame: Baseline, 6 months, 12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Mar 2023.

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