- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03890861
Reducing African Americans' Alzheimer's Disease Risk Through Exercise (RAATE)" (RAATE)
February 26, 2024 updated by: Robert L. Newton, Jr., Pennington Biomedical Research Center
The RAATE proposal is designed to determine the effects of physical activity on risk factors for Alzheimer's Disease in older African American adults.
The study will compare a physical activity program to an active control group.
There are three main objectives of the protocol: 1) to determine if a physical activity intervention tailored to older African American adults is effective in modifying cognitive function associated with Alzheimer's Disease, 2) to determine if a physical activity intervention tailored to older African American adults is effective in modifying brain function and structure associated with Alzheimer's Disease, and 3) to determine if a physical activity promotion intervention tailored to African American adults is effective at enhancing physiological parameters.
The primary endpoints for the study are episodic memory and executive functioning.
The secondary outcomes include anthropometry, blood pressure, brain activation, cerebral blood flow, volume of whole brain and white matter hyperintensities, cardiorespiratory fitness, objectively measured physical activity, circulating hormones, and telomere length.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Detailed Description
Alzheimer's disease is steadily increasing in prevalence, with a devastating public health impact.
The prevalence of Alzheimer's Disease is higher in African Americans compared to white Americans, thereby constituting a health disparity.
Interventions that prevent Alzheimer's disease or change the course of cognitive decline associated with Alzheimer's disease are needed.
Most older adults do not achieve recommended levels of physical activity, and this includes African Americans.
Regular physical activity has proven to be a safe and effective means to enhance cognitive function in older adults ranging from cognitively healthy to mildly cognitively impaired.
Therefore, our study is focused on physical activity promotion, a potent approach to modifying multiple neurobiological pathways implicated in Alzheimer's Disease.
We evaluate exercise benefits among elderly African Americans, who are understudied and in whom the natural course of neurodegeneration, exercise effects on neuroprotection and neurodegeneration, and resulting clinical phenotypes may differ.
A large body of existing data suggests that exercise improves cardiovascular and cerebrovascular functioning, and thus has the potential to enhance perivascular clearance of amyloid and reduce chronic brain tissue ischemia, among other beneficial effects.
At the same time, chronic exercise has been shown to decrease central levels of inflammatory markers and increase central levels of neurotrophic factors, which in turn promote protection against Alzheimer's Disease neurodegeneration pathways via a variety of mechanisms.
While physical activity interventions have been shown to have positive effects on these factors and on resultant cognitive functioning in older adults, nearly all interventions have had a negligible representation of African Americans.
Prior data suggests that African Americans enter their elderly years against a backdrop of different lifespan exposures to a variety of factors relevant to neuroprotection and neurodegeneration, including cardiovascular risk, exercise, diet, and education.
In addition, prior data suggests that the key genetic risk factor for Alzheimer's Disease (APOE) may have differing consequences for Alzheimer's Disease risk among African Americans, and other genetic differences have the potential to influence the brain benefits of physical activity in this community.
We will utilize a randomized clinical trial to addresses these questions.
Participants will be randomized into a physical activity promotion intervention or a healthy aging information group for 52 weeks.
All participants will be of normal cognitive function.
We will assess cognitive function, brain structure and function, circulating hormones, objectively measured physical activity, cardiorespiratory fitness, and telomere length.
Our study will take the first step toward understanding whether the hypothesized benefits of exercise for the brain carry over to elderly African Americans.
Study Type
Interventional
Enrollment (Estimated)
125
Phase
- Not Applicable
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
- Name: Melissa Harris, PhD
- Phone Number: 225763091
- Email: Melissa.Harris@pbrc.edu
Study Locations
-
-
Louisiana
-
Baton Rouge, Louisiana, United States, 70808
- Recruiting
- Pennington Biomedical Research Center
-
Contact:
- Melissa Harris, MA
- Phone Number: 225-763-3091
- Email: Melissa.Harris@pbrc.edu
-
Contact:
- Jessica St. Romain, MA
- Phone Number: 2257632921
- Email: Jessica.Stromain@pbrc.edu
-
Principal Investigator:
- Robert L Newton, Jr., PhD
-
Principal Investigator:
- Owen Carmichael, PhD
-
-
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
Ages Eligible for Study
60 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
Yes
Description
Inclusion Criteria:
- self- identify as African American
- 60 years and older
- willing to accept randomization
- willing to attend group sessions
- lacking plans to move during the study period
- free of conditions that would make regular exercise unsafe (e.g. uncontrolled asthma, severe sickle cell disease, etc.)
- not engaged in regular physical activity
- Short Physical Performance Battery score >/= 4
- physically capable of exercise,
Exclusion Criteria:
- cognitive impairment that would interfere with participating in group interactions
- unwilling to give written informed consent
- inability to attend group sessions
- conditions that prevent regular exercise
- conditions that the medical or principal investigator determine to warrant exclusion
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: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Physical activity intervention
The intervention group will target 150 minutes of moderate to vigorous aerobic physical activity and two days of strength training, consistent with the current physical activity recommendations.
Participants will engage in 2 days per week of supervised activity at community facilities.
These participants will be requested to engage in an additional 30 minutes of moderate to vigorous aerobic physical activity two days per week at home.
|
Promotion of physical activity to the current federal physical activity guidelines.
|
Active Comparator: Active control
The active control group will be based on a low-intensity activity program and a healthy aging educational component.
The physical activities will include stretching, balance training, flexibility, relaxation, and practicing activities of daily living.
The successful aging education component will cover topics including avoiding scams, fall prevention, living wills, and dementia awareness.
|
Seminars of health topics related to aging in African Americans with light stretching and low intensity activites
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in episodic memory
Time Frame: Baseline, 24 weeks, 52 weeks
|
The Rey Auditory Verbal Learning Test (RAVLT) is a common neuropsychological tool used to evaluate episodic memory.
The RAVLT involves providing participants with 15 unrelated words and asking them to recall the word list.
There are 5 trials designed to determine short-term memory and then a 30 minute delay to assess long-term memory.
The total words correct in both the short- and long-term trials are used as outcome measures.
|
Baseline, 24 weeks, 52 weeks
|
Change in executive function
Time Frame: Baseline, 24 weeks, 52 weeks
|
The NIH Toolbox Executive Function subdomain consists of the Flanker Inhibitory Control and Attention Test and the Dimensional Change Card Sort Test.
The Flanker test is a measure of one's ability to inhibit attention to irrelevant conditions.
Participants must identify the direction of a central visual stimuli amongst flanking stimuli either congruent or incongruent with the central stimuli.
There are 40 trials and scores range from 0 - 10.
The Card Sort is a measure of the ability to shift attention based on rules.
Participants must match a target visual stimuli to either a color or word stimuli and this matching shifts during the assessment.
|
Baseline, 24 weeks, 52 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in cognitive status
Time Frame: Baseline, 24 weeks, 52 weeks
|
The Mini-Mental Status Examination is 30-point questionnaire to assess cognitive impairment.
|
Baseline, 24 weeks, 52 weeks
|
Change in glucose
Time Frame: Baseline, 24 weeks, 52 weeks
|
Fasting levels of glucose will be assessed using standard assays.
|
Baseline, 24 weeks, 52 weeks
|
Change in time spent in physical activity
Time Frame: Baseline, 24 weeks, 52 weeks
|
The Actigraph WGT3X+ accelerometer (ActiGraph LLC, Pensacola, FL) will be worn by the participant for a 7-day period.
The device provides both the number of steps per day as well as time in sedentary, light, moderate, and vigorous activity in 1-minute epochs (for adults) using the default filter.
|
Baseline, 24 weeks, 52 weeks
|
Change in cardiorespiratory fitness
Time Frame: Baseline, 24 weeks, 52 weeks
|
All participants will perform a standardized graded exercise testing protocol administered on a treadmill.
Fitness will be measured in terms of mL oxygen/kg/min.
|
Baseline, 24 weeks, 52 weeks
|
Change in physical function-NIH Toolbox
Time Frame: Baseline, 24 weeks, 52 weeks
|
Physical function will be assessed using the NIH-TB Motor assessment, which assesses dexterity, balance, locomotion, grip strength, and strength.
|
Baseline, 24 weeks, 52 weeks
|
Change in telomere length
Time Frame: Baseline, 24 weeks, 52 weeks
|
DNA will be extracted from the blood draw and amplified using real-time quantitative polymerase chain reaction (qPCR) to determine average relative telomere length represented by the telomere repeat copy number to single gene copy number (T/S) ratio in triplicate as previously described
|
Baseline, 24 weeks, 52 weeks
|
Change in weight
Time Frame: Baseline, 24 weeks, 52 weeks
|
Weight will be measured using a standard stadiometer.
Measurements will be taken to the nearest cm.
|
Baseline, 24 weeks, 52 weeks
|
Change in brain structure
Time Frame: Baseline, 24 weeks, 52 weeks
|
Volumes of the cranial vault, brain tissue, gray matter, white matter, and cerebrospinal fluid, which will be provided as the primary brain structural outcome measures of interest from MRI.
|
Baseline, 24 weeks, 52 weeks
|
Changes in brain function
Time Frame: Baseline, 24 weeks, 52 weeks
|
Pre-selected inhibitory control ROIs (ACC for the Stroop; DLPFC, thalamus, superior frontal, inferior frontal, fusiform, and middle frontal gyri; and ACC and middle frontal gyri for the ANT) are of primary interest.
|
Baseline, 24 weeks, 52 weeks
|
Change in lipoproteins
Time Frame: Baseline, 24 weeks, 52 weeks
|
Fasting levels of lipids will be assessed using standard assays.
|
Baseline, 24 weeks, 52 weeks
|
APOE genotype
Time Frame: Baseline
|
APOE genotype will be assessed using standard assays.
|
Baseline
|
Change in physical activity
Time Frame: Continuously for 52 weeks
|
The Fitbit Charge 2 will be worn by participants in both groups.
|
Continuously for 52 weeks
|
Change in mood
Time Frame: Baseline, 24 weeks, 52 weeks
|
The Geriatric Depression Scale will be used to measure depressive symptoms.
|
Baseline, 24 weeks, 52 weeks
|
Change in height
Time Frame: Baseline, 24 weeks, 52 weeks
|
Height will be assessed using a standard stadiometer.
|
Baseline, 24 weeks, 52 weeks
|
Change in physical function-SPPB
Time Frame: Baseline, 24 weeks, 52 weeks
|
Physical function will be assessed using the the Short Physical Performance Battery (SPPB), which is a brief performance battery based on timed short distance walk, repeated chair stands and balance test.
|
Baseline, 24 weeks, 52 weeks
|
Change in blood pressure
Time Frame: Blood pressure will be measured using the Omron, Model BP710 automatic blood pressure cuff.
|
Blood pressure will be measured using the Omron, Model BP710 automatic blood pressure cuff.
|
Blood pressure will be measured using the Omron, Model BP710 automatic blood pressure cuff.
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Investigators
- Principal Investigator: Robert L Newton, Jr., PhD, Pennington Biomedical Research Center
- Principal Investigator: Owen L Carmichael, PhD, Pennington Biomedical Research Center
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 (Actual)
August 9, 2019
Primary Completion (Estimated)
June 1, 2025
Study Completion (Estimated)
November 30, 2026
Study Registration Dates
First Submitted
March 18, 2019
First Submitted That Met QC Criteria
March 25, 2019
First Posted (Actual)
March 26, 2019
Study Record Updates
Last Update Posted (Actual)
February 28, 2024
Last Update Submitted That Met QC Criteria
February 26, 2024
Last Verified
February 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- PBRC 2019-002
- R01AG062200-01 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
YES
IPD Plan Description
For all study data, Pennington Biomedical has a well-structured internal process for data sharing and transfer.
The Office of Legal and Regulatory Compliance is responsible for all data agreements which includes data subject to the protection under HIPAA.
As part of the Louisiana State University System, Pennington Biomedical ensures that data agreements are in place in the following circumstances: business associate agreements when the transfer of data contains all identifiers, data use agreements when the transfer of data contains those identifiers that constitute a limited data set and a data transfer agreement in instances where data is de-identified, but still may be subject of protection in order to protect intellectual property rights.
Transmission of data to ensure proper safeguards are in place on the data in motion and data at reset are carried out with assistance of the Research Computing Group or the Office of Computing Services.
IPD Sharing Time Frame
Data will be available after data analysis has occurred.
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
- CSR
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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