iPACES v3 MCI NIA Protocol Copied for iPACES v4 PD NINDS

A specific aim is to evaluate the effects of iPACES for persons with Parkinson's Disease, while also examining the potentially unique contribution of combining mental and physical exercise in an interactive way: "pedal-to-play" (iPACES), as compared with non-interactive, but simultaneous: "pedal-while-play" (PACE).

Inclusion criteria

• 50 years of age or older
• meets criteria for MCI (per site staff/MD/neuropsychologist and confirmed by study-administered Montreal Cognitive Assessment; MoCA; score = between 16-26, non-inclusive; Milani, 2018)

• available for participation for one year (tablet surveys, videoconference evaluations) 5. willing and able to exercise 3-5 times per week for at least 6 months 6. can pedal an under-table elliptical 7. can read off of a small tablet screen 8. proficient in English (speaking and reading for completion of interview, surveys, game); Spanish language option anticipated soon 9. can participate in testing and read and operate tablet touch screen (adequate hearing, vision, speech) 10. written approval from primary care physician and cardiologist (if applicable) to participate in exercise for this study 11. can provide informed consent

Exclusion criteria

• already exercising at recommended levels (45 min of moderate intensity aerobic exercise 5-7x/wk)
• significant history of cardiovascular problems
• significant history of stroke
• significant history of memory problems (e.g., dementia/Alzheimer's)
• significant history of other neurological condition (e.g., seizures, etc.)
• significant uncontrolled tremor such that would interfere with touch-screen use required throughout the study (surveys, game-play, etc.)
• not prone to cybersickness (e.g., "car sickness" or problems with "screen time")
• cannot provide informed consent (i.e., when phone screened with the Impaired Decision Making Capacity screen)