Piedmont Aging, Cognition & Exercise Study-2 (PACE-2)
13 de agosto de 2018 actualizado por: Wake Forest University
A Randomized Controlled Trial to Examine the Effects of Aerobic Exercise on Cognition and Aging-related Biomarkers for Adults With Prediabetes and Mild Cognitive Impairment
The purpose of this research study is to examine the effects of high and low intensity exercise for those with mild memory loss and pre-diabetes.
The investigators will also examine the effects of this exercise on certain proteins and hormones in body fluids, and on brain structure and function using magnetic resonance imaging (MRI).
Recent studies indicate that exercise improves memory and thinking abilities for adults with mild memory loss OR pre-diabetes.
This study examines the effects of exercise on people with mild memory loss AND pre-diabetes.
Descripción general del estudio
Estado
Terminado
Condiciones
Intervención / Tratamiento
Tipo de estudio
Intervencionista
Inscripción (Actual)
33
Fase
- No aplica
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Ubicaciones de estudio
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North Carolina
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Winston-Salem, North Carolina, Estados Unidos, 27157
- Wake Forest Baptist Health
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Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
50 años a 89 años (Adulto, Adulto Mayor)
Acepta Voluntarios Saludables
Sí
Géneros elegibles para el estudio
Todos
Descripción
Inclusion Criteria:
- 50 years or older
- Mild memory concerns
- In good health
- Not taking diabetes medications
- Not currently exercising
Exclusion Criteria:
- Significant neurologic disease that might affect cognition, such as AD, stroke, Parkinson's disease, multiple sclerosis, or severe head injury with loss of consciousness > 30 min or with permanent neurologic sequelae;
- Significant medical illness or organ failure, such as:
- Liver disease: history of hepatitis or hepatic failure
- Significant elevations in liver function tests: lab values more than 2.5 times the upper limit of normal
- Kidney disease known history of kidney failure.
- Uncontrolled hypertension
- Cardiovascular disease, defined as: any acute cardiovascular abnormality, such as new or unstable angina, uncontrolled irregular heart beat (treated a-fib and occasional PVC's are OK) or symptomatic heart failure, acute shortness of breath for any reason, or clinically significant edema, is an exclusion. History in the last year of myocardial infarction, angina, coronary artery angioplasty, bypass grafting, pacemaker insertion, STENT placement, postural hypotension, transient ischemic attack, or carotid artery surgery.
- Chronic lung disease, such as: COPD/emphysema
- Hemoglobin A1c levels that fall outside the range of 5.7-6.4%; If 2-h OGTT glucose values 220 mg/dL and hemoglobin A1c levels meet inclusion criteria (5.7-6.4%), then PCP written indication that no pharmacologic intervention for type 2 diabetes is needed at present will be required for continued study participation.
- Current use of anti-psychotic, anti-convulsant, anxiolytic, or sedative medication;
- Current use of any cognition-enhancing medication, including experimental medications within the past 60 days;
- Current or previous use of hypoglycemic agents or insulin (except during pregnacy); diabetics previously on oral agents but have been off of them for > 1 year are ok pending PI and study physician approval.
- Musculoskeletal impairment sufficient to interfere with study participation
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Prevención
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Único
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
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Comparador activo: High-Intensity Program-aerobic exercises
This exercise program will consist of walking or running on a treadmill or elliptical trainer, or spinning on a stationary bicycle.
The goal of the program will be for participants to exercise at a moderate to high level of intensity, defined as 70-80% (American College of Sports Medicine guidelines) of heart rate reserve (HRR), for 45-60 minutes 4 days per week.
At the start of each training session and following a 5-minute warm-up, subjects will exercise at 50% HRR (0.5[HRmax-HRrest] +HRrest) and intensity will gradually be increased to the individualized target heart rate training zone.
Exercise facilitators will use a pre-specified computerized program.
This program provides guidelines for the individualized progression of exercise based on age and resting heart rate.
Subjects will wear a digital heart rate monitoring device for the duration of the training session to ensure they are exercising safely at the specified level of intensity.
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Comparador de placebos: Low-intensity Program-Stretching
The low-intensity activity program will consist of an individualized and organized series of stretching and balance activities for the whole body, specifically designed for older adults.
Consistent with the high-intensity protocol, subjects will complete the prescribed 45-60 minute stretching routine 4 days per week at the exercise facility.
All stretching routines will include warm-up and cool-down activities, and will be within each subject's range of motion.
Each stretch will be held for 20-30 s and repeated 5-10 times.
Subjects will wear a digital heart rate monitoring device to ensure they are stretching safely and at an intensity below 35% HRR.
The activity log completed during each stretching session will include HR, stretching duration, and mean HR during stretching.
Subjects will also have the option to participate in structured pre-approved (by the exercise facilitator) stretching classes at the exercise facility when available.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Change in cognitive performance from baseline following 6 month of high or low intensity exercise regimen
Periodo de tiempo: 2 assessments, one before and one after 6 months of exercise
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The cognitive variables identified above, by domain, will be subjected to separate treatment group X treatment month (3, 6) multivariate analyses of covariance (MANCOVA), with baseline scores and age serving as covariates. When the MANCOVA proves significant, separate post-hoc analysis of covariance (ANCOVA) will be conducted on the relevant dependent variables. Cognitive tests include measures of executive function and working memory. |
2 assessments, one before and one after 6 months of exercise
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Change from baseline in blood sugar concentration and cerebrospinal fluid glucose measures during an oral glucose tolerance test following 6 months of high or low intensity exercise
Periodo de tiempo: 3 Oral glucose tolerance tests over a 6 month period; 2 lumbar punctures, one before and one after the 6 month exercise regimen
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Multiple regression and correlational (MRC) analyses will be conducted to evaluate whether treatment-induced change in insulin sensitivity and in other blood and cerebrospinal fluid biomarkers predict cognitive performance among subjects in the aerobic group.
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3 Oral glucose tolerance tests over a 6 month period; 2 lumbar punctures, one before and one after the 6 month exercise regimen
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Otras medidas de resultado
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Change from baseline in brain network connectivity using brain imaging
Periodo de tiempo: 2 brain scans over a 6 month period, one before and one after the 6 month exercise regimen
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Whole-brain averages will be computed, reflecting characteristics of the entire system.
Whole-brain averages will be compared with random networks generated with the same node number and degree,48 and will be compared between intervention groups using general linear regression models.
Regions of interest (hippocampus, posterior cingulate/precuneus, prefrontal cortex) will be extracted using WFU Pickatlas and regional degree, Eglob, or Eloc will be compared between groups using the general linear model.
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2 brain scans over a 6 month period, one before and one after the 6 month exercise regimen
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Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Laura D. Baker, Ph.D, Wake Forest University Health Sciences
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio
1 de marzo de 2013
Finalización primaria (Actual)
1 de abril de 2017
Finalización del estudio (Actual)
1 de abril de 2017
Fechas de registro del estudio
Enviado por primera vez
3 de octubre de 2014
Primero enviado que cumplió con los criterios de control de calidad
5 de diciembre de 2014
Publicado por primera vez (Estimar)
9 de diciembre de 2014
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
15 de agosto de 2018
Última actualización enviada que cumplió con los criterios de control de calidad
13 de agosto de 2018
Última verificación
1 de agosto de 2018
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- IRB00022598
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
No
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
No
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