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Mindfulness-Based Stress Reduction, Health Education and Exercise (MEDEX)

12 de septiembre de 2022 actualizado por: Washington University School of Medicine

Remediating Age Related Cognitive Decline: Mindfulness-Based Stress Reduction and Exercise

The purpose of this research is to examine the effects of four interventions on age-related cognitive decline in healthy older adults. The investigators will examine the effects of Mindfulness Based Stress Reduction (MBSR) psychotherapy, multi-component intensity-based aerobic exercise, and their combination, compared to a discussion group.

Descripción general del estudio

Estado

Terminado

Condiciones

Intervención / Tratamiento

Descripción detallada

MBSR teaches mindfulness, or the focusing of attention and awareness, through various meditation techniques. Mindfulness meditation practices appear to produce neurocircuitry changes that are the reverse of those seen in age-related cognitive decline. It is widely available, acceptable to older people, and carries minimal risk of side effects or adverse events. Exercise - specifically, intense, multi-component exercise - also appears to affect brain structure and function and improve cognitive performance.

The investigators will randomize 580 non-demented healthy adults aged 65 to 84 to one of four conditions: MBSR alone, exercise alone, MBSR + exercise, or a health education discussion group control condition.

The study will consist of a 6-month acute intervention phase with weekly visits followed by a 12-month maintenance phase with weekly or monthly visits and other prompts to maintain intervention behaviors.

Assessments include cognitive tests, biomarkers, neuroimaging assessments, functional assessments to examine real-world benefits of the interventions, and other behavioral assessments to characterize participants and pave the way for further exploratory analyses.

Tipo de estudio

Intervencionista

Inscripción (Actual)

585

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

  • Estados Unidos
    • California
      • San Diego, California, Estados Unidos, 92122
        • University of California San Diego
    • Missouri
      • Saint Louis, Missouri, Estados Unidos, 63110
        • Washington University School of Medicine

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

65 años a 84 años (Adulto Mayor)

Acepta Voluntarios Saludables

Sí

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  • Community-living men and women age 65 to 84.
  • Self-reported cognitive complaints that are a normal part of aging.
  • No current meditation practice nor prior training in it.
  • Sedentary.

Exclusion Criteria:

  • Known diagnosis of dementia, mild cognitive impairment, other clinical neurodegenerative illness (e.g., Parkinson's disease, cerebrovascular disease), psychotic disorder, or any unstable psychiatric condition.
  • Medical conditions that suggest shortened lifespan, such as metastatic cancer; or would prohibit safe participation in the interventions, including cardiovascular disease or musculoskeletal conditions; or would interfere with the assessments, such as taking medications for diabetes or ferromagnetic metal/bridgework that would interfere with MRI signal.
  • IQ <70 as estimated by the Wechsler Test of Adult Reading
  • Sensory impairment (language, hearing, or visual) that would prevent participation.
  • Alcohol abuse within 6 months.
  • Current illicit drug use.
  • Concurrent cognitive training, such as brain-training software, or other interventions expected to affect neuroplasticity.
  • Medications that interfere with measurements, including cancer chemotherapy, glucocorticoids, and interferon.
  • Inability to cooperate with protocol.

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: Tratamiento
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación factorial
  • Enmascaramiento: Único

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: MBSR
Mindfulness-Based Stress Reduction consists of a brief introductory meeting, eight weekly 2.5-hour classes, and a retreat, followed by monthly booster sessions for approximately 15 months. Content includes instruction in mindfulness meditation practices, gentle mindful movement, and exercises to enhance mindfulness in everyday life.
Conductual: MBSR
Otros nombres:
  • Reducción del estrés basada en la atención plena
Experimental: Exercise
The exercise protocol is optimal for improving aerobic fitness and insulin sensitivity in older adults, as well as improving strength and balance and reducing indices of frailty.It consists of classes twice weekly for 6 months, building up to 1.5 hr, under the direct supervision of trained exercise instructors, followed by once weekly classes for 12 months.
Conductual: Ejercicio
Otros nombres:
  • Ejercicio basado en la intensidad de varios componentes
Experimental: MBSR + Exercise

This condition will receive both MBSR and exercise as described above. Participants in this condition will come in once weekly to receive MBSR and twice weekly to receive exercise classes, with at-home exercise the other two days as well as daily, at-home mindfulness practice. After the initial classes participants will also attend additional weekly or monthly sessions until completion of the study.

Note that at each site a pilot group is undergoing MBSR + Exercise (not randomized, separate from the RCT).
Conductual: MBSR
Otros nombres:
  • Reducción del estrés basada en la atención plena
Conductual: Ejercicio
Otros nombres:
  • Ejercicio basado en la intensidad de varios componentes
Comparador activo: Health Education
Health Education is a group-based intervention that increases health-related knowledge and action. Health Education improves chronic disease management.Health Education consists of ten weekly 2.5-hour classes, followed by monthly classes for approximately 15 months.
Conductual: Educación para la salud

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Memory Composite Score
Periodo de tiempo: Month 0, Month 3, Month 6, and Month 18
The memory composite variable consists of the list recall, paragraph recall, and picture sequence memory tasks. For each memory variable, a z score is computed for each participant [(participant score - mean)/standard deviation]. Then the composite memory variable is created by averaging the z scores. The higher the z-score, the better the outcome. A Z-score of 0 represents the population mean.
Month 0, Month 3, Month 6, and Month 18
Cognitive Control Composite Score
Periodo de tiempo: Month 0, Month 3, Month 6, Month 18
The cognitive control composite variable uses the CVOE, SART, Color Word Interference, flanker, dimensional change card sort, and list-sorting tasks. For each cognitive variable, a z score is computed for each participant [(participant score - mean)/standard deviation]. Then the composite cognitive control variable is created by averaging the z scores. The higher the z-score, the better the outcome. A Z-score of 0 represents the population mean.
Month 0, Month 3, Month 6, Month 18

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Hippocampal Volume
Periodo de tiempo: Month 0, Month 6, Month 18
The hippocampal volume is derived from structural MRI high-resolution T1-weighted images.
Month 0, Month 6, Month 18
DLPFC Surface Area
Periodo de tiempo: Month 0, Month 6, Month 18
The Dorsal Lateral Pre-Frontal Cortex (DLPFC) surface area is derived from structural MRI high-resolution T1-weighted images.
Month 0, Month 6, Month 18
DLPFC Cortical Thickness
Periodo de tiempo: Month 0, Month 6, and Month 18
The Dorsal Lateral Pre-Frontal Cortex Cortical Thickness is derived from structural MRI high-resolution T1-weighted images.
Month 0, Month 6, and Month 18
OTDL (Observed Tasks of Daily Living).
Periodo de tiempo: Month 0, Month 6, Month 18
The Revised Observed Tasks of Daily Living (OTDL-R) is a performance-based test of everyday problem-solving. Subjects completed tasks testing medication use (following medicine label directions, and completing a patient record form); telephone use (finding and dialing a number from the yellow pages); and financial management (making change with coins and bills, and balancing a checkbook). The scores were summed with the total score having a range from 0 to 28. The higher the score, the more likely the participant is able to complete everyday activities.
Month 0, Month 6, Month 18
Quality of Life in Neurological Disorders Cognitive Function Scale (NQoL).
Periodo de tiempo: Month 0, Month 3, Month 6, Month 18
The Quality of Life in Neurological Disorders (NQoL) Cognitive Function Scale is an 18-item self-report measure that assesses the health-related quality of life of adults. The total score ranges from 18 to 90 where a higher score represents a better outcome.
Month 0, Month 3, Month 6, Month 18

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Washington University School of Medicine

Colaboradores

University of California, San Diego
National Institutes of Health (NIH)
National Institute on Aging (NIA)
National Center for Complementary and Integrative Health (NCCIH)
The Brain Research Foundation

Investigadores

  • Investigador principal: Eric J Lenze, MD, Washington University School of Medicine

Publicaciones y enlaces útiles

La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.

Enlaces Útiles

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 (Actual)

1 de abril de 2015

Finalización primaria (Actual)

1 de junio de 2020

Finalización del estudio (Actual)

1 de mayo de 2021

Fechas de registro del estudio

Enviado por primera vez

12 de enero de 2016

Primero enviado que cumplió con los criterios de control de calidad

22 de enero de 2016

Publicado por primera vez (Estimar)

27 de enero de 2016

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

28 de septiembre de 2022

Última actualización enviada que cumplió con los criterios de control de calidad

12 de septiembre de 2022

Última verificación

1 de septiembre de 2022

Más información

Términos relacionados con este estudio

Palabras clave

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • 201410093
  • 1R01AG049369-01 (Subvención/contrato del NIH de EE. UU.)

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

SÍ

Descripción del plan IPD

A cleaned, complete, and de-identified copy of the final data set including administrative and technical metadata records will be made available for release upon request to qualified investigators.

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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