Study protocol for the BRAIN Training Trial: a randomised controlled trial of Balance, Resistance, And INterval training on cognitive function in older adults with mild cognitive impairment.

Trinidad Valenzuela, Jeff S Coombes, Teresa Liu-Ambrose, Yorgi Mavros, Nicole Kochan, Perminder S Sachdev, Jeffrey Hausdorff, Emily C Smith, Matthew Hollings, Tess C Hawkins, Nicholas J Ashley, Natan Feter, Guy C Wilson, Isabel Hui En Shih, Yareni Guerrero, Jiyang Jiang, Wei Wen, Tom Bailey, Dorthe Stensvold, Ulrik Wisløff, Ryan S Falck, Maria Fiatarone Singh

Journal: BMJ open 2023;12(12):e062059

PMID: 36600421

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Abstract

INTRODUCTION

Epidemiological evidence suggests that both poor cardiovascular fitness and low muscle mass or strength markedly increase the rate of cognitive decline and incident dementia in older adults. Results from exercise trials for the improvement of cognition in older adults with mild cognitive impairment (MCI) have reported mixed results. This is possibly due to insufficient exercise intensities. The aim of the Balance, Resistance, And INterval (BRAIN) Training Trial is to determine the effects of two forms of exercise, high-intensity aerobic interval training (HIIT) and high-intensity power training (POWER) each compared with a sham exercise control group on cognition in older adults with MCI.

METHODS AND ANALYSIS

One hundred and sixty community-dwelling older (≥ 60 years) people with MCI have been randomised into the trial. Interventions are delivered supervised 2-3 days per week for 12 months. The primary outcome measured at baseline, 6 and 12 months is performance on a cognitive composite score measuring the executive domain calculated from a combination of computerised (NeuroTrax) and paper-and-pencil tests. Analyses will be performed via repeated measures linear mixed models and generalised linear mixed models of baseline, 6-month and 12-month time points, adjusted for baseline values and covariates selected a priori. Mixed models will be constructed to determine the interaction of GROUP × TIME.

ETHICS AND DISSEMINATION

Ethical approval was obtained from the University of Sydney (HREC Ref.2017/368), University of Queensland (HREC Ref. 2017/HE000853), University of British Columbia (H16-03309), and Vancouver Coastal Health Research Institute (V16-03309) Human Research Ethics. Dissemination will be via publications, conference presentations, newsletter articles, social media, talks to clinicians and consumers and meetings with health departments/managers.It is expected that communication of results will allow for the development of more effective evidence-based exercise prescription guidelines in this population while investigating the benefits of HIIT and POWER on subclinical markers of disease.

TRIAL REGISTRATION NUMBER

ACTRN12617001440314 Australian New Zealand Clinical Trials Registry.

Address: Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia [email protected].; Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile.; Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Herston, Queensland, Australia.; Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.; Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.; Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.; Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.; Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.; Sagol School of Neuroscience and Department of Physical Therapy, Faculty of Medicine, Tel Aviv University Sackler, Tel Aviv, Israel.; Postgraduate Program of Physical Education, Universidade Federal de Pelotas, Pelotas, Brazil.; Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Herston, Queensland, Australia.; School of Nursing Midwifery and Social Work, Faculty of Health and Behavioural Sciences, The University of Queensland, Herston, Queensland, Australia.; Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.; Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Herston, Queensland, Australia.; Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.; School of Biomedical Engineering, Faculty of Applied Science, The University of British Columbia, Vancouver, British Columbia, Canada.; Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.; Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.

DOI: 10.1136/bmjopen-2022-062059

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MeSH Terms: Humans, Aged, Cognitive Training, Australia, Cognitive Dysfunction, Cognition, Exercise Therapy, Resistance Training, Randomized Controlled Trials as Topic