Mindful Walking Neural Correlates of Executive Function in SC Older Adults at Risk of Dementias

June 5, 2026 updated by: Chih-Hsiang Yang, University of South Carolina

The Impact of Mindful Walking on Neural Correlates of Executive Function in SC Older Adults at Risk of Alzheimer's and Dementias

Mindful walking is a promising and practical strategy because it combines two activities known to support healthy aging: walking and mindfulness. Unlike many structured exercise programs, mindful walking is low intensity, accessible, and easier to sustain in daily life. It may be especially useful for older adults at elevated risk for ADRD. However, most existing mindful walking studies have focused on mental health outcomes, such as stress reduction, rather than cognitive health. Little is known about whether mindful walking can support cognition or how it may influence brain function. To address this gap and strengthen a future R01 resubmission, the investigators propose a two-arm randomized controlled pilot trial using functional near-infrared spectroscopy (fNIRS), a safe, non-invasive brain imaging method. fNIRS measures brain activity through sensors placed on the scalp and is well-suited for repeated assessments in older adults because it is quiet, portable, painless, and cost-effective. The investigators will recruit racially and ethnically diverse middle-aged and older adults from the Midlands of South Carolina who are at elevated risk for ADRD. Participants will be randomly assigned to one of two groups: mindful walking or walking-only control. Both groups will complete 8 staff-supervised individual sessions over 4 weeks. The mindful walking group will learn and practice simple mindfulness skills while walking in multiple settings, including lab-based, indoor, and outdoor environments, to support real-world use. Findings from this pilot study will provide important evidence on whether mindful walking can support brain and cognitive health in adults at elevated risk for ADRD. The results will also help establish a practical, scalable, and sustainable prevention strategy for underserved aging populations in South Carolina.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

The number of older adults living with Alzheimer's disease and related dementias (ADRD) is escalating around the world, yet no effective treatment is currently available. Non-pharmacological early preventive strategies are urgently needed to mitigate the social and economic burden of ADRD and to sustain quality of life in the aging population, including the seniors living in South Carolina (SC). Mindful walking represents a promising prevention approach to sustain cognition, as it simultaneously practices mindfulness skills during physical activity (walking). However, existing mindful walking programs primarily focused on mental health outcomes (e.g., stress reduction) and overlooked the potential efficacy on cognition. This lower-intensity lifestyle physical activity may be a more viable and inclusive prevention strategy with greater scalability and long-term sustainability to serve ADRD at-risk aging populations. Our preliminary work in African American older adults around the Midlands of SC has established preliminary signals that mindful walking is feasible, acceptable, and it may sustain proximal cognitive function. However, the literature to date has not tested the neural-level correlates underlying mindful walking to infer the potential mechanism related to executive function enhancement. This is also a gap raised by a reviewer from our scored R01 in 2023 (not funded, 40th percentile). To address this knowledge gap and strengthen our R01 resubmission, our team proposes to conduct a two-arm randomized controlled pilot trial to determine the neural-level underpinning of mindful walking using the Functional near-infrared spectroscopy (fNIRS). fNIRS offers a non-invasive neuroimaging tool that uses source-detector channels placed on the scalp to measure event-evoked neural activities across the lifespan (e.g., engaged executive function while practicing mindfulness skills). fNIRS is a device that is well-suited for within-subjects repeated data collection in older adults because it is noiseless and compact, painless, and cost-effective, making it suitable to apply in a behavioral trial that requires multiple assessments. This randomized controlled trial will recruit race and ethnically diverse middle-aged and older adults who have elevated risk(s) for ADRD from the Midlands of SC. Participants will be randomly assigned to participate in 8 sessions of individual mindful walking or a walking-only control group supervised by the staff across 4 weeks. The mindful walking group will be instructed to practice simple but fundamental mindfulness skills in multiple settings to facilitate real-world skill translation (in lab, indoor, outdoor). This study will administer lab-based measures of cognitive assessments, including the fNIRS, MoCA, and NIH Toolbox Cognition Battery, to examine group differences in neural activations measured using fNIRS (Aim 1) and the concordance between executive function measured using fNIRS, MoCA, and NIH Toolbox (Aim 2). Findings from this study have the potential to provide a viable and achievable behavioral strategy that can be engaged in daily life to address cognitive health and reduce ADRD risk among underserved older populations in the Midlands of SC. It will also well-position our team to submit R01s in the following years to support this timely and critical research.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
54

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • United States
    • South Carolina
      • Columbia, South Carolina, United States, 29201
        • Recruiting
        • University of South Carolina
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  1. Age 60 or older
  2. Sedentary (sit ≥9hrs per day) and not meeting the US physical activity guidelines

  3. Have at least one of the following ADRD risk factors:

    i. family history of ADRD (>= first-degree relative) ii. subjective experience of cognitive complaints iii. currently overweight or obese (BMI≥25)

  4. Adequate hearing, visual and cognitive ability to complete study tasks and assessments
  5. Able to walk without others' assistance
  6. Medically stable with or without medication (do not expect to have major health status changes or a surgery in the next 4 months)

Exclusion Criteria:

  1. Diagnosis of ADRD or other brain abnormalities (i.e., strokes, epilepsy, Parkinson's disease)
  2. Diagnosis of mental disorders (i.e., depression)
  3. Inability to complete surveys on mobile device or wear the activity monitor (i.e., due to arthritis, physical limitations, or other reasons)
  4. Plan to move or have surgery in next 4 months
  5. Currently participate in other study involving physical activity or cognitive training that may interfere with the study outcomes
  6. Unable to provide consent due to disabilities

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Mindful walking arm
Older adults will participate in 8 sessions of mindful walking over one month
Behavioral: Mindfulness-based walking
Implementing mindfulness skills during the walking movement
Active Comparator: Walking-only arm
Older adults will participate in 8 sessions of walking over one month
Behavioral: Mindfulness-based walking
Implementing mindfulness skills during the walking movement

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Hemodynamic activation signal
Time Frame: Assessed at baseline, 4 weeks, 8 weeks
Hemodynamic activation in the prefrontal and parietal regions as an indication of EF. Neural activation will be measured using functional nearinfrared spectroscopy (fNIRS).
Assessed at baseline, 4 weeks, 8 weeks

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Neuropsychological function
Time Frame: Assessed at baseline, 4 weeks, 8 weeks
Montreal Cognitive Assessment (MoCA) is sensitive to measure normal cognitive aging from those with mild cognitive decline. MoCA scores range from 1-30 to detect cognitive impairment. Higher scores indicate better cognitive function.
Assessed at baseline, 4 weeks, 8 weeks
Executive function
Time Frame: Assessed at Baseline, 4 weeks, 8 weeks
NIH Toolbox Cognitive Battery will be used to measure fluid cognitive abilities
Assessed at Baseline, 4 weeks, 8 weeks
Trait Mindfulness Levels
Time Frame: Assessed at Baseline, 4 weeks, 8 weeks
Using the validated five-facet mindfulness scale (FFMQ) to measure trait mindfulness. FFMQ scores range from 39-195. Higher scores indicate higher trait mindfulness levels.
Assessed at Baseline, 4 weeks, 8 weeks
State Mindfulness Levels
Time Frame: Assessed at baseline, 4 weeks, 8 weeks
Using the validated state mindfulness scale (SMS) to measure state mindfulness. SMS scores range from 21-105. Higher scores indicate higher state mindfulness levels.
Assessed at baseline, 4 weeks, 8 weeks

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Overall (in)activity levels
Time Frame: Assessed at Baseline, 8 weeks
Using the physical activity and sedentary behavior questionnaire (PASB-Q) to assess older adults' overall (in)activity levels. The questionnaire asks participants about their typical weekly physical activity minutes and daily sitting hours.
Assessed at Baseline, 8 weeks
Overall everyday cognition
Time Frame: Assessed at Baseline, 8 weeks
Using everyday cognition scale (ECog) to assess memory, planning, organization, and divided attention in daily contexts. Each item ranges from 1-4 points. The overall score is calculated as an average of all completed items, resulting in a score range of 1 to 4. The higher scores represent worse everyday cognition.
Assessed at Baseline, 8 weeks
Overall health status
Time Frame: Assessed at Baseline, 8 weeks
Using SF-36 questionnaire to assess overall health status. For all domain scales and component scores, the scoring range is 0 to 100, with higher scores representing a more favorable or higher level of health.
Assessed at Baseline, 8 weeks
Height
Time Frame: Assessed at Baseline, 8 weeks
Applying the NIH PhenX Toolkit protocol. Participants' standing height is measured from the top of the participant's head to their heels. The measure will be conducted in duplicates and will be recorded to the nearest 0.1 cm. This measure will be combined with the weight measure to measure participants' BMI in kg/ m^2.
Assessed at Baseline, 8 weeks
Weight
Time Frame: Baseline, 8 weeks
Applying the NIH PhenX Toolkit protocol. Participants' weight will be measured using a digital floor scale. Their weight will be measured in duplicates and will be recorded to the nearest 0.1 kg. This measure will be combined with the height measure to calculate participants' BMI in kg/ m^2.
Baseline, 8 weeks
Mobility
Time Frame: Assessed at baseline, 8 weeks
Applying the NIH PhenX Toolkit 10-meter walk protocol to assess mobility. The test outcome is typically expressed as gait speed in meters per second (m/s). The lower values indicate a higher risk of adverse health events.
Assessed at baseline, 8 weeks
Demographics
Time Frame: Assessed at baseline
Collected basic demographics via an online survey. All items are assessed using multiple-choice or multiple-selection questions of different types of participants' demographic status. The response options are thus categorical but not a scale.
Assessed at baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
University of South Carolina

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
USC The Center for Clinical & Translational Research

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
May 22, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
July 1, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
September 1, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
May 16, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 5, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
June 10, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 10, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 5, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
June 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • MODCR00000007

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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