Teresa Liu-Ambrose1,2,3, Elizabeth Dao4,5, Rachel A Crockett6,7,8, Cindy K Barha6,7,8, Ryan S Falck6,7,8, John R Best6,9,10,11, Ging-Yeuk R Hsiung7,12, Thalia S Field7,12,13, Kenneth M Madden8,14, Walid A Alkeridy12,15, Narlon C Boa Sorte Silva6,7,8, Jennifer C Davis8,16, Lisanne F Ten Brinke6,7,8, Stephanie Doherty6,7,8, Roger C Tam7,4,17. 1. Department of Physical Therapy, University of British Columbia (UBC), Vancouver, British Columbia, Canada. teresa.ambrose@ubc.ca. 2. Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, Canada. teresa.ambrose@ubc.ca. 3. Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada. teresa.ambrose@ubc.ca. 4. Department of Radiology, UBC, Vancouver, British Columbia, Canada. 5. International Collaboration on Repair Discoveries, Vancouver, British Columbia, Canada. 6. Department of Physical Therapy, University of British Columbia (UBC), Vancouver, British Columbia, Canada. 7. Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, Canada. 8. Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada. 9. Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada. 10. Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada. 11. Department of Psychiatry, UBC, Vancouver, British Columbia, Canada. 12. Division of Neurology, UBC, Vancouver, British Columbia, Canada. 13. Vancouver Stroke Program, Vancouver, British Columbia, Canada. 14. Division of Geriatric Medicine, Department of Medicine, UBC, Vancouver, British Columbia, Canada. 15. Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia. 16. Social and Economic Change Laboratory, Faculty of Management, UBC-Okanagan, Kelowna, British Columbia, Canada. 17. School of Biomedical Engineering, UBC, Vancouver, British Columbia, Canada.
Abstract
BACKGROUND:Subcortical ischemic vascular cognitive impairment (SIVCI) is the most common form of vascular cognitive impairment. Importantly, SIVCI is considered the most treatable form of cognitive impairment in older adults, due to its modifiable risk factors such as hypertension, diabetes mellitus, and hypercholesterolemia. Exercise training is a promising intervention to delay the progression of SIVCI, as it actively targets these cardiometabolic risk factors. Despite the demonstrated benefits of resistance training on cognitive function and emerging evidence suggesting resistance training may reduce the progression of white matter hyperintensities (WMHs), research on SIVCI has predominantly focused on the use of aerobic exercise. Thus, the primary aim of this proof-of-concept randomized controlled trial is to investigate the efficacy of a 12-month, twice-weekly progressive resistance training program on cognitive function and WMH progression in adults with SIVCI. We will also assess the efficiency of the intervention. METHODS:Eighty-eight community-dwelling adults, aged > 55 years, with SIVCI from metropolitan Vancouver will be recruited to participate in this study. SIVCI will be determined by the presence of cognitive impairment (Montreal Cognitive Assessment < 26) and cerebral small vessel disease using computed tomography or magnetic resonance imaging. Participants will be randomly allocated to a twice-weekly exercise program of (1) progressive resistance training or (2) balance and tone training (i.e., active control). The primary outcomes are cognitive function measured by the Alzheimer's Disease Assessment Scale-Cognitive-Plus (ADAS-Cog-13 with additional cognitive tests) and WMH progression. DISCUSSION: The burden of SIVCI is immense, and to our knowledge, this will be the first study to quantify the effect of progressive resistance training on cognitive function and WMH progression among adults with SIVCI. Slowing the rate of cognitive decline and WMH progression could preserve functional independence and quality of life. This could lead to reduced health care costs and avoidance of early institutional care. TRIAL REGISTRATION: ClinicalTrials.gov NCT02669394 . Registered on February 1, 2016.
RCT Entities:
BACKGROUND: Subcortical ischemic vascular cognitive impairment (SIVCI) is the most common form of vascular cognitive impairment. Importantly, SIVCI is considered the most treatable form of cognitive impairment in older adults, due to its modifiable risk factors such as hypertension, diabetes mellitus, and hypercholesterolemia. Exercise training is a promising intervention to delay the progression of SIVCI, as it actively targets these cardiometabolic risk factors. Despite the demonstrated benefits of resistance training on cognitive function and emerging evidence suggesting resistance training may reduce the progression of white matter hyperintensities (WMHs), research on SIVCI has predominantly focused on the use of aerobic exercise. Thus, the primary aim of this proof-of-concept randomized controlled trial is to investigate the efficacy of a 12-month, twice-weekly progressive resistance training program on cognitive function and WMH progression in adults with SIVCI. We will also assess the efficiency of the intervention. METHODS: Eighty-eight community-dwelling adults, aged > 55 years, with SIVCI from metropolitan Vancouver will be recruited to participate in this study. SIVCI will be determined by the presence of cognitive impairment (Montreal Cognitive Assessment < 26) and cerebral small vessel disease using computed tomography or magnetic resonance imaging. Participants will be randomly allocated to a twice-weekly exercise program of (1) progressive resistance training or (2) balance and tone training (i.e., active control). The primary outcomes are cognitive function measured by the Alzheimer's Disease Assessment Scale-Cognitive-Plus (ADAS-Cog-13 with additional cognitive tests) and WMH progression. DISCUSSION: The burden of SIVCI is immense, and to our knowledge, this will be the first study to quantify the effect of progressive resistance training on cognitive function and WMH progression among adults with SIVCI. Slowing the rate of cognitive decline and WMH progression could preserve functional independence and quality of life. This could lead to reduced health care costs and avoidance of early institutional care. TRIAL REGISTRATION: ClinicalTrials.gov NCT02669394 . Registered on February 1, 2016.
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