Concurrent Aerobic Exercise and Cognitive Training to Prevent Alzheimer's in at-risk Older Adults

Abstract The proposed project will implement and test a unique Virtual Reality Cognitive TrainingVRCTcombined with concurrent cycling on a recumbent stationary cyclealso known as exergame that seamlessly integrates specific cognitive tasks into a virtual environment and is synchronized with cycling to promote cognitionCycling through an interesting virtual environment will motivate and engage the older adult to participate in the exerciseand VRCT could augment cyclingandapos s effects on cognitionA further innovation is that the exergame will be developed as an Apple TV applicationmaking it widely accessible and availableIt will provide a low cost VRCT exergame option that currently does not existone that is affordable and compatible with almost any stationary cycleThis project is significant because treatment that delays the onset of Alzheimerandapos s DiseaseADby five years could save the U Seconomy an estimated $billion byand no drugs can yet preventcureor even slow ADAerobic exercise and cognitive training are two such promising interventionsEmerging mechanistic studies further suggest that the two interventions together may have a synergisticsuperior cognitive effect than either intervention aloneThe purpose of this project is to demonstrate the feasibility and efficacy of the exergame intervention on cognition through two phasesIn Phase Ia prototype of the VRCT exergame will be developedfollowed by a feasibility testing using a single group mixed methods designIn Phase II a more fully featured version of the VRCT exergame will be developed followed by a an RCT which will randomize subjects on aallocation ratio toparallel groupsexergame cycling only attention controlMixed methods will be used to assess outcomes in both phasesThis project is innovative because the older adult user will be able to cycle through a virtual world displayed on a flat screen TV with specific assigned cognitive tasks to accomplish during cyclingthe exergame will be widely accessible and availableand the exergame provides a low cost VR exergame option that currently does not exist Narrative A treatment that delays the onset of Alzheimerandapos s DiseaseADby five years could save an estimated $billion in healthcare costs bybecause no drugs can yet preventcureor even slow ADThis highlights an urgent and pressuring need to develop behavioral interventions to prevent AD and slow its progressionAerobic exercise and cognitive training are two such promising interventionsEmerging mechanistic studies further suggest that the two interventions together may have a synergisticsuperior cognitive effect than either intervention aloneThe proposed project will implement and test a unique Virtual Reality Cognitive TrainingVRCTcombined with concurrent cycling on a recumbent stationary cyclealso known as exergame that seamlessly integrates specific cognitive tasks into a virtual environment and is synchronized with cycling to promote cognition