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CompletedNCT03254381Updated Dec 6, 2023

The Effect of Exercise on Cognition in Older Adults At-risk for Diabetes: A Feasibility Pilot Study

An interventional study of Resistance Training and Balance and Tone Training in Cognitive Impairment, sponsored by Western University, Canada. Completed at 1 site in Canada. Open to participants aged 60 Years to 80 Years. Per ClinicalTrials.gov, last updated 2023-12-06.

Sponsored by Western University, Canada · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
24
Allocation
Randomized
Ages
60 Years to 80 Years
Sex
All
01

Study summary

Older adults with type 2 diabetes experience cognitive decline and are at higher risk for developing dementia. Consequently, older adults at-risk for developing type 2 diabetes (based on body mass, glucose levels) are at higher risk for cognitive decline, and intervening at this point may prevent or delay the onset of such decline. One promising lifestyle intervention that has been shown to improve cognitive function in other populations is exercise. However, before investigators can examine whether exercise will improve cognitive function and brain health (structure and function) in this at-risk population, a feasibility pilot study is needed to determine whether a larger-scale trial would be viable.

Read the detailed description

Investigators will conduct a six-month randomized control trial (RCT) exercise intervention. Thirty older adults (aged 60-80) at-risk for diabetes will be randomly assigned into one of two groups: 1) Resistance training, or 2) Balance and Tone training (control). All participants will engage in three one-hour exercise classes per week. Once a month, a neutral assessor will visit the classes to evaluate the quality of the classes for participants. Assessments will be made at baseline, midpoint (three months) and trial completion (six months), and will include cognitive testing, health questionnaires, physical testing, and magnetic resonance imaging (MRI; to assess structural and functional brain changes). Throughout the study, investigators will examine data for trends in successful recruitment strategies and rates of recruitment and adherence to inform future clinical trials in this population. Research assistants (n = 30) in the study will complete an anonymous feedback survey upon completion of their volunteer term, to assist in improving the study for future participants and volunteers.

02

Conditions studied

  • Cognitive Impairment

Keywords

  • cognitive assessment
  • cognitive function
  • community dwelling older people
  • pre-diabetes
  • randomized control trial
  • exercise
  • pilot study
  • feasibility study
03

Who can participate

Ages eligible
60 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. be community-dwelling 2) be aged 60-80 years 3) be "at-risk" for diabetes, where they have one of the following: i) blood glucose level of 6.1-7 mmol/L, ii) BMI > 25, or iii) score > 21 on the CANRISK diabetes questionnaire 4) score > 24/30 on MMSE 5) score > 6/8 on Lawton and Brody's Independent Activities of Daily Living (IADL) scale 6) have visual acuity of at least 20/40, with or without corrective lenses 7) speak and understand English fluently 8) complete the Physical Activity Readiness Questionnaire (PAR-Q) 9) obtain physician's clearance to start a supervised exercise program

Exclusion criteria

Exclusion Criteria:

  1. have a current medical condition for which exercise is contraindicated 2) have participated regularly in resistance or aerobic training in the last 6 months 3) have been diagnosed with neurodegenerative disease (including dementia, Alzheimer's disease, or Parkinson's disease) 4) have experienced a vascular incident (e.g., stroke, myocardial infarction) 5) have been diagnosed with a psychiatric condition 6) have untreated depression 7) are currently on hormone replacement therapy 8) have clinically significant peripheral neuropathy or severe musculoskeletal or joint disease 9) are currently taking psychotropic medications 10) are unable to participate in MRI (have metal or electronic implants, or are claustrophobic)
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
24 participants (actual)

Study arms

  • Experimental
    Resistance Training

    Participants will use programmable weight machines along with free weights to target primary muscle groups. In addition, they will complete mini-squats, mini-lunges, and lunge walks. Participants will complete two sets of 6-8 reps. Training stimulus will be increased using the 7RM method - when 2 sets of 6-8 reps are completed with proper form and without discomfort. Investigators will record the number of sets completed and the load lifted for each exercise for each participant at every class.

    Behavioral: Resistance Training

  • Experimental
    Balance and Tone Training (Control)

    Exercises will include stretching exercises, range of motion exercises, basic core-strength exercises, balance exercises, and relaxation techniques. Only bodyweight will be applied (i.e., no additional loading). This group controls for confounding variables such as physical training received by traveling to the training centres, social interaction, and changes in lifestyle secondary to study participation.

    Behavioral: Balance and Tone Training

Interventions

  • BehavioralResistance Training

    Six months of thrice-weekly resistance training that will gradually progress in intensity. Each training session will be 60 minutes (10 minutes of warm-up, 40 minutes of training, and 10 minutes of cool-down). Classes will be group classes, with up to five participants in each.

  • BehavioralBalance and Tone Training

    Six months of thrice-weekly stretching and relaxation exercises. Each session will be 60 minutes. Classes will be group classes, with up to five participants in each.

05

What researchers measure

Primary outcomes

  1. Number of participants recruited after 12 months

    Time frame: 12 months

  2. Number of exercise classes attended at trial completion (6 months)

    Time frame: 6 months

Secondary outcomes

  1. Change in cognitive function as measured by Alzheimer's Disease Assessment Scale - Cog - Plus (ADAS-Cog-Plus)

    Time frame: Baseline, 3 months, and 6 months

  2. Change in hippocampal volume as measured via high resolution T1 images collected during MRI scanning in both 3T and 7T machines.

    Time frame: Baseline and 6 months

  3. Change in hippocampal functional activation as measured during performance on associative memory task during fMRI scanning

    For this task, participants will be asked to encode and then recall items (face or places) and items in conjunction (faces matched with places)

    Time frame: Baseline and 6 months

  4. Change in memory as measured by performance on associative memory task

    Time frame: Baseline, 3 months, and 6 months

  5. Change in executive functions as measured by Stroop Test

    Time frame: Baseline, 3 months, and 6 months

  6. Change in aerobic fitness as measured by six minute walk test

    Time frame: Baseline, 3 months, and 6 months

  7. Change in mobility and balance as measured by Short Physical Performance Battery

    Time frame: Baseline, 3 months, and 6 months

  8. Change in muscle strength as measured by one-repetition maximum test

    Time frame: Baseline, 3 months, and 6 months

  9. Change in blood glucose levels as measured by finger prick glucose test

    Time frame: Baseline, 3 months, and 6 months

06

Study locations

1 site
  • Community
    London, Ontario, Canada
07

References and documents

Publications

  • Furlano JA, Nagamatsu LS. Feasibility of a 6-month pilot randomised controlled trial of resistance training on cognition and brain health in Canadian older adults at-risk for diabetes: study protocol. BMJ Open. 2019 Oct 3;9(10):e032047. doi: 10.1136/bmjopen-2019-032047. PubMed 31585978 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03254381
Lead sponsor
Western University, Canada
Responsible party
Lindsay Nagamatsu (Assistant Professor, Western University, Canada) — Principal investigator
First posted
Aug 18, 2017
Start date
Nov 2, 2017
Primary completion
Oct 3, 2019
Completion
Oct 3, 2019
Last update
Dec 6, 2023

Study contacts

Lindsay S Nagamatsu
principal investigator · Western University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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