Mindfulness-Based Stress Reduction, Health Education and Exercise (MEDEX)
Remediating Age Related Cognitive Decline: Mindfulness-Based Stress Reduction and Exercise
研究概览
详细说明
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.
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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California
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San Diego、California、美国、92122
- University of California San Diego
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Missouri
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Saint Louis、Missouri、美国、63110
- Washington University School of Medicine
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
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.
学习计划
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：阶乘赋值
- 屏蔽：单身的
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的：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.
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其他名称：
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实验性的：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.
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其他名称：
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实验性的：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). |
其他名称：
其他名称：
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有源比较器：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.
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
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Memory Composite Score
大体时间：Month 0, Month 3, Month 6, and Month 18
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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.
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Month 0, Month 3, Month 6, and Month 18
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Cognitive Control Composite Score
大体时间：Month 0, Month 3, Month 6, Month 18
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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.
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Month 0, Month 3, Month 6, Month 18
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
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Hippocampal Volume
大体时间：Month 0, Month 6, Month 18
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The hippocampal volume is derived from structural MRI high-resolution T1-weighted images.
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Month 0, Month 6, Month 18
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DLPFC Surface Area
大体时间：Month 0, Month 6, Month 18
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The Dorsal Lateral Pre-Frontal Cortex (DLPFC) surface area is derived from structural MRI high-resolution T1-weighted images.
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Month 0, Month 6, Month 18
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DLPFC Cortical Thickness
大体时间：Month 0, Month 6, and Month 18
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The Dorsal Lateral Pre-Frontal Cortex Cortical Thickness is derived from structural MRI high-resolution T1-weighted images.
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Month 0, Month 6, and Month 18
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OTDL (Observed Tasks of Daily Living).
大体时间：Month 0, Month 6, Month 18
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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.
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Month 0, Month 6, Month 18
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Quality of Life in Neurological Disorders Cognitive Function Scale (NQoL).
大体时间：Month 0, Month 3, Month 6, Month 18
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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.
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Month 0, Month 3, Month 6, Month 18
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合作者和调查者
合作者
调查人员
- 首席研究员：Eric J Lenze, MD、Washington University School of Medicine
出版物和有用的链接
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他研究编号
- 201410093
- 1R01AG049369-01 (美国 NIH 拨款/合同)
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)？
IPD 计划说明
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