ClinicalTrials.gg
CompletedNCT03313895Updated Apr 25, 2025

The Combined Aerobic Exercise and Cognitive Training (ACT) Trial: The ACT Trial

An interventional study of Aerobic & Cognitive Training (ACT) and Cycling Only in Mild Cognitive Impairment, sponsored by Arizona State University. Completed at 4 sites in United States. Open to participants aged 65 Years and older. Per ClinicalTrials.gov, last updated 2025-04-25.

Sponsored by Arizona State University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
146
Allocation
Randomized
Ages
65 Years and older
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 1,418 studies in Cognitive Dysfunction with a site in United States — 328 open to participants now, 432 under way, 13 of them phase 3. Cognitive Dysfunction · United States.

Enrollment
258th of 1,143
146 · median 58
Started
2018
with 83 others
No phase
713 of 1,418
181 open now
Registered
514th of 1,418
by date

Among the 1,418 studies in Cognitive Dysfunction with a site in United States, this one is the 258th largest by enrollment of the 1,143 interventional ones that give a count, is one of 84 that started in 2018, is one of 713 with no phase, and was the 514th registered.

Cognitive Dysfunction

3,872 studies on the registry are indexed under Cognitive Dysfunction; 1,119 are open to participants now.

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Open to participants now

328 of the 1,418 studies in Cognitive Dysfunction with a site in United States are open now. Recruiting first, the newest first:

323 more — sign in →

All 328 open studies →

A study can be open while its sites in United States have not opened yet or have stopped. Only those recruiting at a site in United States →

Who these studies take

Of the 750 Cognitive Dysfunction studies recruiting now, 362 (48%) set no upper age limit and 143 (19%) stop at 75 or younger; 46 take children under 18; 259 take healthy volunteers.

This study: 65 Years and older · all sexes · no healthy volunteers.

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02

Study summary

This multi-site clinical trial occurs at the University of Minnesota and University of Rochester. It tests the efficacy and additive/synergistic effects of an ACT intervention on cognition and relevant mechanisms (aerobic fitness, Alzheimer's disease [AD] signature cortical thickness, and default mode network [DMN]) in older adults with amnestic MCI (aMCI).

Read the detailed description

Because almost all drug trials for Alzheimer's disease (AD) have failed, developing non-pharmacological interventions with strong potential to prevent or delay the onset of AD in high-risk populations (e.g., those with mild cognitive impairment [MCI]) is critically important. Aerobic exercise and cognitive training are 2 promising interventions for preventing AD. Aerobic exercise increases aerobic fitness, which in turn improves brain structure and function, while cognitive training improves selective neural function intensively. Hence, combined Aerobic exercise and Cognitive Training (ACT) may very well have an additive or synergistic effect on cognition by complementary strengthening of different neural functions. Few studies have tested ACT's effects, and those studies have reported discrepant findings, largely due to varying ACT programs. The purpose of this single-blinded, 2×2 factorial Phase II randomized controlled trial (RCT) is to test the efficacy and additive/synergistic effects of a 6-month combined cycling and speed of processing (SOP) training intervention on cognition and relevant mechanisms (aerobic fitness, AD signature cortical thickness, and functional connectivity in the default mode network [DMN]) in older adults with amnestic MCI (aMCI).

03

Conditions studied

  • Mild Cognitive Impairment

Keywords

  • Alzheimer's disease
  • exercise
  • cognitive training
  • imaging
04

Who can participate

Ages eligible
65 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • A clinical diagnosis of MCI
  • Community-dwelling
  • Age 65 years and older
  • English-speaking
  • Adequate visual acuity
  • Verified exercise safety by medical provider
  • Stable on drugs affecting cognitive and psychological status
  • Verified MRI safety
  • Capacity to consent

Exclusion criteria

Exclusion Criteria:

  • Geriatric Depression Scale \< 5
  • Resting heart rate (HR) ≤50 due to arrhythmia or ≥100 beats/min
  • Neurological (e.g., dementia, head trauma), psychiatric (e.g., bipolar, schizophrenia, or depression), or substance dependency (alcohol or chemical dependency) in the past 5 years that are the main contributor to MCI
  • to exercise, e.g. unstable angina, recent surgery
  • New symptoms or diseases that have not been evaluated by a health care provider
  • Current enrollment in another intervention study related to cognitive improvement (reduce confounding effects on outcomes)
  • Abnormal MRI findings
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Factorial assignment
Masking
Double (Investigator, Outcomes assessor)
Enrollment
146 participants (actual)

Study arms

  • Active comparator
    Cycling Only

    Moderate-intensity cycling, 3 times a week for 6 months, supervised by an exercise specialist

    Behavioral: Cycling Only

  • Active comparator
    Cognitive Training Only

    Computerized cognitive training, 3 times a week for 6 months, supervised by a specialist

    Behavioral: Cognitive Training Only

  • Experimental
    ACT

    Moderate-intensity cycling followed by computerized cognitive training, 3 times a week for 6 months, supervised by a specialist

    Behavioral: Aerobic & Cognitive Training (ACT)

  • Sham comparator
    Stretching and Mental Stimulation Activities

    Stretching and mental stimulation activities, 3 times a week for 6 months, supervised by a specialist

    Behavioral: Stretching and Mental Stimulating Activities

Interventions

  • BehavioralAerobic & Cognitive Training (ACT)

    ACT stands for combined aerobic exercise and cognitive training.

  • BehavioralCycling Only

    Cycling on a recumbent stationary cycle

  • BehavioralCognitive Training Only

    Engage in cognitive training on a computer

  • BehavioralStretching and Mental Stimulating Activities

    Stretching exercises and mental stimulating activities on a computer

06

What researchers measure

Primary outcomes

  1. Executive function

    EXAMINER

    Time frame: Change from baseline to 3, 6, 12, and 18 months

  2. Episodic memory

    RAVLT and BVMTR

    Time frame: Change from baseline to 3, 6, 12, and 18 months

  3. AD-signature cortical thickness

    Magnetic Resonance Imaging (MRI)

    Time frame: Change from baseline to 6, 12, and 18 months

  4. Functional connectivity in DMN

    Functional MRI for Default Mode Network

    Time frame: Change from baseline to 6, 12, and 18 months

  5. Aerobic fitness

    VO2peak from symptom-limited peak cycle-ergometer test, and 10-m Incremental Shuttle Walk Test

    Time frame: Change from baseline to 3, 6, 12, and 18 months

  6. Conversion to Alzheimer's disease

    Clinical adjudication of Alzheimer's disease dementia

    Time frame: Change from baseline to 6, 12, and 18 months

07

Study locations

4 sites
  • Arizona State University
    Phoenix, Arizona 85004, United States
  • Stanford University
    Stanford, California 94305, United States
  • University of Minnesota
    Minneapolis, Minnesota 55455, United States
  • University of Rochester
    Rochester, New York 14642, United States
08

References and documents

Publications

  • Li D, Mielke MM, Bell WR, Reilly C, Zhang L, Lin FV, Yu F. Blood biomarkers as surrogate endpoints of treatment responses to aerobic exercise and cognitive training (ACT) in amnestic mild cognitive impairment: the blood biomarkers study protocol of a randomized controlled trial (the ACT Trial). Trials. 2020 Jan 6;21(1):19. doi: 10.1186/s13063-019-3798-1. PubMed 31907024 ↗
  • Yu F, Lin FV, Salisbury DL, Shah KN, Chow L, Vock D, Nelson NW, Porsteinsson AP, Jack C Jr. Efficacy and mechanisms of combined aerobic exercise and cognitive training in mild cognitive impairment: study protocol of the ACT trial. Trials. 2018 Dec 22;19(1):700. doi: 10.1186/s13063-018-3054-0. PubMed 30577848 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Jul 2018 to primary completion in Jul 2024, 72 months.

Of 1,442 non-industry interventional studies with no phase under Cognitive Dysfunction, half reached primary completion within 27 months of starting (the median), counting those still running; a quarter within 13 and three quarters within 51. This study's 72 months is above that.

Counting every sponsor, half of 1,511 studies reached it within 27 months; a quarter within 12 and three quarters within 50.

How these figures are worked out, and which studies are left out of them.

Registered
Oct 6, 2017
First posted
Oct 18, 2017
StartActual
Jul 5, 2018
Primary completionActual
Jul 17, 2024
CompletionActual
Jul 17, 2024
Last update
Apr 25, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Apr 25, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03313895
Collaborators
University of Rochester, Mayo Clinic, University of St Thomas, University of Minnesota
Responsible party
Sponsor
First posted
Oct 18, 2017
Start date
Jul 5, 2018
Primary completion
Jul 17, 2024
Completion
Jul 17, 2024
Last update
Apr 25, 2025

Study contacts

Fang Yu, PhD
principal investigator · Arizona State University

Oversight

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

Not currently enrolling

This study is completed, as verified in Aug 2024. You cannot join it, but the record below documents what was studied.

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