Clinical Research Directory

Agility Training and Its Relations in Elderly Adults With and Without MCI

The following three-part proposal will focus on the effects of agility training as well as the relationship between agility ability and motor and cognitive function, and risk of falls in elderly adults with or without mild cognitive impairment (MCI). Part I is a cross-sectional study design that will assess the level of agility in healthy young adults, healthy elderly adults, and elderly adults with MCI to determine the effect of aging and cognition decline on agility and the relations between agility, cognitive, and motor functions. Thirty participants will be screened for eligibility and recruited for each group (90 participants total). After collecting basic data, all participants will undergo cognitive and motor function tests, as well as an agility test. Cognitive function tests include tests of global cognition, working memory, mental set shifting, and selective attention. Motor function tests include tests of single and dual task walking, strength, power, balance, flexibility, and endurance. The agility test contains stop-and-go, change of direction, and spatial orientation components. Functional near-infrared spectroscopy (fNIRS) will be used to evaluate the brain activation during the agility test, cognitive tests, and single and dual task walking. Results from all tests will be used to determine the motor, cognitive, and other predictive factors associated with agility performance, and will be used in the design of the training program in Part II and III. Part II and III are single-blinded randomized controlled trials that will explore the short and long-term effects of a multicomponent training and an agility training protocol on agility, motor, and cognitive function in elderly adults with and without MCI. Seventy-five elderly adults with MCI (Part II) and seventy-five healthy elderly (Part III) will be recruited. After screening for eligibility and collection of demographic data, participants will undergo a pretest assessment. In addition to the motor, cognitive, and agility tests used in Part I, information on history of falls, falls efficacy, and quality of life will be assessed for each participant. Brain activation will be assessed during the agility test, cognitive tests, and single and dual task walking assessments using fNIRS. Participants will be randomly allocated into one of three groups: the control group, the multicomponent training group, or the agility training group (n=25 in each group). Intervention will be executed at a frequency of 45 minutes per session, 2 times a week for 8 weeks. The control group will receive home-based health education guidelines. The multicomponent training group will engage in 3 to 4 exercises each training session comprising the influencing factors of agility, and the agility training group will engage in integrated task-specific training. A post-test will be conducted after the 8-week intervention, and 1-month, 6-month, and 12-month follow-ups will be conducted for elderly adults with MCI. The healthy elderly adults will be assessed after the intervention and at the 1-month follow-up after training.

Sleep Apnea in Elderly

Sleep-disordered breathing (SDB or sleep apnea) is very common among elderly Veterans and leads to increased morbidity and mortality in this population. The proposal aims to identity whether oxygen, finasteride and acetazolamide can be effective in reducing unstable breathing and eliminating sleep apnea in the elderly via different mechanisms. This proposal will enhance the investigators' understanding of the pathways that contribute to the development of sleep apnea in the elderly. The investigators expect that the results obtained from this study will positively impact the health of Veterans by identifying new treatment modalities for sleep apnea. A cumulative effect of the investigators' research will fulfill the long-term goal of improving the quality of life of elderly Veterans suffering from sleep apnea and its potential life-threatening complications.

Cognitive Intervention for Cognitive Impairment

Mild cognitive impairment is characterized by cognitive dysfunction without impairment in instrumental activities of daily living, with aging being the primary risk factor. Cognitive interventions employ stimulation and training techniques to address this impairment. Objective: To determine the effect of a cognitive intervention on mild cognitive impairment in older adults with type 2 diabetes mellitus. Methods: A double-blind, randomized clinical trial involving 102 patients, who will be assigned to either a control group or an intervention group. Data collection will utilize a sociodemographic profile questionnaire and the Montreal Cognitive Assessment (MoCA). The cognitive intervention will be implemented over an average period of two months per subgroup, consisting of eight weekly, 60-minute sessions. Analysis will be conducted using descriptive statistics, and a linear mixed-effects model for repeated measures will be applied to evaluate the intervention's effect.

Effects of Eccentric Training at Long Muscle Length on Functional Capacities of Elderly Adults

As aging leads to a decline in muscle function and overall physical performance, interventions targeting muscle strength and neuromechanical properties are critical for maintaining functional independence in older adults. Long-length eccentric training has shown promise in enhancing muscle performance, but its effects in older adults, particularly in a home-based setting, remain underexplored. The aim of this trial is to assess whether a targeted home-based training intervention incorporating long-length eccentric contractions can enhance functional capacity and neuromechanical properties in healthy older adults. Participants will be semi-randomly allocated to one of two groups: an experimental group incorporating long-length eccentric contractions (Group 1) or a conventional resistance training group (Group 2), with group assignment stratified to ensure an equal number of men and women in each group. Each participant will complete three laboratory-based experimental sessions (i.e., two Pre-training sessions and one Post-training session) , during which five key evaluations will be conducted: (i) the 5-Time Sit to Stand test, serving as the primary outcome measure; (ii) the Timed Up and Go test; (iii) assessments of isometric and dynamic muscle strength in the knee extensors and plantar flexors; (iv) measurements of the cross-sectional areas of the vastus lateralis, rectus femoris, gastrocnemius medialis, and soleus muscles; and (v) evaluation of tendon stiffness. Following the pre-evaluation, each participant will engage in a 24-session, semi-supervised, home-based training protocol over a period of 8 to 11 weeks. The training program will include eight exercises, with four targeting the upper limbs and four focused on the lower limbs. Group 1 will perform the lower limb exercises at long muscle lengths, while Group 2 will perform the same exercises in a conventional manner (i.e., at neutral or shorter muscle lengths). The total training volume (calculated as repetitions × sets, in arbitrary units) will be matched across both groups, ensuring that any observed differences in outcomes are attributable to the specific training modality rather than differences in workload.