Clinical Research Directory

High-Velocity Resistance Training for Brain Blood Flow and Cognitive Function in Older Adults

The goal of this clinical trial is to learn whether a 12-week high-velocity resistance training program can improve brain blood flow and thinking skills in adults ages 60 to 79 who are at higher risk for Alzheimer's disease and related dementias. Researchers want to understand whether this type of exercise can improve how well the brain regulates blood flow during mental and physical tasks and whether those changes are linked to improvements in thinking ability. The main questions this study aims to answer are whether high-velocity resistance training improves thinking skills such as executive function and processing speed, and whether it improves how blood flow in the brain responds during cognitive testing, changes in blood pressure, and controlled breathing tasks. Participants will complete two study visits at the University of Illinois Chicago, one before the program begins and one after 12 weeks. During these visits, researchers will measure strength, muscle power, and thinking skills. Participants will also complete non-invasive testing to measure blood flow in the brain using ultrasound. During some tasks, participants will walk on a treadmill at a comfortable pace while completing thinking tests. They will wear small sensors to measure heart rate, blood pressure, and breathing. After the first visit, participants will be randomly assigned, like flipping a coin, to one of two groups. One group will take part in supervised resistance training three times per week for 12 weeks at the University of Illinois Chicago. Each session will last about 60 minutes and will be supervised by trained exercise professionals. The other group will continue their usual daily activities for 12 weeks and then return for follow-up testing. Participants in the comparison group will be offered the exercise program after they complete the final study visit. Researchers hope this study will improve understanding of how structured exercise may support brain health in older adults at risk for dementia and help guide future prevention strategies.

Concurrent Aerobic Exercise and Cognitive Training to Prevent Alzheimer's in At-risk Older Adults (The Exergames Telerehabilitation Study)

Significance of Research Question/Purpose: Subjective cognitive decline (SCD) is regarded as the first clinical manifestation in the AD-dementia continuum and currently has a prevalence of 11.2% in adults over the age of 45, with incidence increasing with greater age. Furthermore, population-based studies suggest that between 50% and 80% of older individuals (aged 70 years and older) who perform normally on cognitive tests, report some form of perceived decline in cognitive functioning when asked. The SCD state is unique as this population is more likely than their healthy peers to present with AD biomarkers such as neurodegeneration and amyloid burden, and therefore represents probable preclinical AD relative to other causes of SCD. Likewise, growing evidence suggests that a significant proportion of those adults are subsequently found to develop MCI, or AD, following the classic SCD-MCI-AD trajectory, with SCD increasing MCI risk 1.5-3 fold. Preventing Alzheimer's disease (AD) is arguably the most important approach to address the dementia epidemic worldwide because 99.6% of drug trials failed and no drugs can yet prevent, cure, or even slow AD. A treatment that delays the onset of AD by five years could save $89 billion in 2030.This highlights an urgent and pressing need to develop behavioral interventions to prevent AD and slow its progression. This study will use a randomized, 2-parallel group, trial design that is guided by the Consolidated Standards of Reporting Trials (CONSORT)and the SPIRIT checklist. We will randomize 104 community-dwelling older adults to one of two arms for 3 months: home-based (asynchronous telerehabilitation) Exergame (HbExergame) or home-based (asynchronous telerehabilitation) aerobic exercise (HbAEx). Randomization will allocate subjects on a 1:1 allocation ratio within each age stratum (65-74 and \>75), and will use permuted blocks of 8 and 4. We do not expect equal numbers of subjects in each age stratum, but want to balance the groups for each age. Investigators will be blinded to group assignment. All participants will be blinded to study aims and reminded as needed not to discuss their experiences with outcome assessors. Outcome assessors (also blinded to group allocations) will measure: 1) feasibility (attendance, adherence to exercise dose, systems usability scale), 2) preliminary cognition: fluid cognition \[primary outcome\], attention, episodic memory, and processing speed \[secondary outcomes\] using the NIH Toolbox cognition battery and aerobic fitness \[VO2peak and 6-minute walk distance\], and 3) blood neurotrophic biomarkers.