Accelerated Age-related Cognitive Decline: Impact of Exercise on Executive Function and Neuroplasticity
Columbia University
144 participants
Jun 18, 2024
INTERVENTIONAL
Conditions
Summary
The purpose of this study is to see if 6 months of home-based walking will improve memory, and brain structure and function, compared to health education in older adults that have chronic kidney disease and mild cognitive impairment.
Eligibility
Inclusion Criteria6
- • Diagnosed stage 3-4 chronic kidney disease (CKD, estimated glomerular filtration rate (eGFR) \<60 to 20 ml/min);
- \>55 yrs of age
- Mild cognitive impairment (18-26 on the MOCA)
- ability to undergo an MR
- no history of major head trauma (No head trauma/concussion with loss of consciousness)
- Speaks, reads, writes English
Exclusion Criteria11
- • Diagnosed Dementia or a Clinical Dementia Rating Scale score of \<2, or a MOCA of \<18
- Participating in a supervised exercise program with intent to increase fitness levels 3 days/week,
- Requires assistive ambulation
- Limited exercise capacity due to claudication; unstable angina, severe arthritis, extreme dyspnea on exertion, unstable coronary artery disease
- Class III-IV heart failure
- History of uncontrolled sustained arrhythmias, severe/symptomatic aortic or mitral stenosis, hypertrophic obstructive cardiomyopathy, severe pulmonary hypertension, active myocarditis/pericarditis, thrombophlebitis, and recent systemic/pulmonary embolus
- Resting systolic BP \>200 mmHg or resting diastolic BP \>110 mmHg
- Any unforeseen illness or disability that would preclude cognitive testing or exercise training
- One or more contraindication for MRI; cardiac pacemaker, aneurysm clip, cochlear implants, shrapnel, history of metal fragments in eyes, neurostimulators, diagnosed claustrophobia (MRI only)
- Any self-reported major psychiatric disorders requiring medical therapy (e.g. schizophrenia, bipolar disorder).
- Self-reported new diagnosis of clinical depression within 3 months of enrollment or unstable clinical depression requiring medication adjustment within 3 months of enrollment
Interventions
A 6-month partially supervised walking exercise program using a tapered approach.Participants will begin exercise (walking) at a relatively low intensity and progress to moderate intensity. Intensity will start at 40% and progress as tolerated up to 60-70%. Rating of perceived exertion of 12-14 (fairly light to moderate) will be used to aid intensity (Rating of perceived exertion 6-20 scale). This is an accepted method for achieving desired exercise intensity. Participants will progress over time to exercise 3-4/week for 30-45 minutes. The exercise program may need to be adjusted for (e.g. 10 minutes of exercise 3 times), to achieve the minimum exercise dose of 30 minutes. This will be determined for each individual participants as needed.
Health education and stretching
Locations(1)
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NCT05655325