Exercise and Activities for Independent Living With Mild Cognitive Impairment (MCI)

This project is a randomized controlled trial to evaluate the efficacy of a group exercise and health promotion program designed specifically for older adults with Mild Cognitive Impairment (MCI). This study builds upon previous studies designed for cognitively intact older adults, with a supplemental study using a modified intervention for MCI participants, and for individuals with Alzheimer's disease.

Taken together, these prior investigations support the efficacy of behaviorally based exercise interventions in improving cognitive, physical, and affective status in cognitively intact and demented older adults. Results from a feasibility study suggest that these positive outcomes can also be obtained in older adults with MCI.

The current study will investigate the efficacy of the modified exercise program called RALLI (Resources and Activities for Life Long Independence) to determine whether it is more effective than the control condition, a social walking program (SW), in delaying cognitive decline, improving self-rated health and health behaviors, improving affect and physical function, and enhancing quality of life. The long-term efficacy of RALLI to delay conversion of MCI to dementia, reduce physical disability, maintain independent living, and improve physiological health indicators will also be investigated.

One hundred seventy participants over the age of 70 who meet American Academy of Neurology criteria for MCI will be recruited from independent living retirement residences. Participants will be randomly assigned to one of the two conditions (RALLI and SW) and assessed at baseline, post treatment (3 months), and follow up visits every 6 months for a total of 3 years (months 6, 12, 18, 24, 30, and 36). The hypothesis is that RALLI participants will experience better post-treatment outcomes than SW participants, and that gains will be maintained over 36 months.

Inclusion criteria

• Mild Cognitive Impairment defined as
• - Memory complaint
• - Objective memory impairment for age and education
• - Largely intact general cognitive function
• - Essentially preserved activities of daily living
• - Not already diagnosed with dementia
• Insufficient physical activity defined as less than 150 minutes per week of moderate intensity physical activity
• Not currently in an exercise program similar to the study program

Exclusion criteria

• Not ambulatory
• Expected to move from the study geographic area during the study period
• Have a known terminal illness
• Actively suicidal, hallucinating, or delusional
• Hospitalized for a psychiatric disorder in the 12 months before baseline
• Uncontrolled chronic conditions, e.g. uncontrolled hypertension, unstable angina, uncontrolled blood glucose
• Blind or deaf