Memory and Exercise Training Study in Older Adults With Subjective Memory Complaints

A total of 90 non-demented healthy older adult volunteers (age 60-75) with subjective memory
complaints (controls or MCI) will be screened and enrolled into the study. The CTRC/IPCN site
will enroll 30 subjects (10 in each group); the MPTF site will enroll 60 subjects (20 in each
group). Baseline assessments will include neuropsychological testing of all study subjects.
At UCLA CTRC/IPCN, baseline assessments will also include cardiorespiratory fitness, body
composition, YMCA fitness tests, and blood-based markers of metabolism and plasticity. To
control for total activity levels, all study subjects will wear continuous physical activity
monitors (FitBit accelerometers) and keep exercise and cognitive activity logs during the
entire study. All subjects (n = 90) will first complete a 1-week observational period to
capture baseline activity levels. Subjects will then be randomized to one of three groups:
SIM-AR-E&MT, SEQ-AR-E&MT, or SEQ-ST-MET (n = 30 per group). SIM-AR-MET and SEQ-AR-MET
subjects will complete a 3-week exercise only 'ramp-up' period consisting of twice weekly
1-hour sessions practicing stationary bicycling, improving cardiovascular fitness enough to
complete the upcoming 4-weeks of MET sessions (described below), and practicing stretching
and toning; SEQ-ST-MET subjects 3-week exercise only 'ramp-up' period will consist of an
equal number of six stretching and toning sessions (no aerobic components). All 3 programs
will then have two 2-hour sessions per week for 4 weeks. The SIM-AR-MET and SEQ-ST-MET
subjects will do stretching/toning during the first hour; SEQ-AR-MET subjects will do aerobic
cycling during the first hour. During the second half of the sessions, all 3 groups will
first learn new memory training strategies while sedentary. SIM-AR-MET subjects will then
practice the memory techniques while cycling while SEQ-AR-MET and SEQ-ST-MET subjects will
practice the memory techniques while still sedentary. The three groups will have group
specific exercise and memory training homework assignments, along with monitoring of activity
and logging of cognitively enriching activities. The NP testing will be done again at the end
of the 4 weeks of memory training classes for all study subjects. UCLA CTRC/IPCN subjects
will have the additional testing done at baseline (e.g., blood-based markers, etc.).

Consideration was given to having a purely observational 'wait-list' group, but in our
experience with this population such groups have typically initiated greater levels of
self-guided exercise and memory training in reaction to being put on a wait list.
Alternatively, if no increase in activity or memory training is undertaken by wait list
subjects, the investigators would not expect any differences in cognitive performance to be
measurable within the brief 3 month total time frame of this initial study. The investigators
also considered have a group do aerobic exercise immediately after memory training, but based
on current literature, this combination seemed the least likely to impact memory
synergistically. Thus, these two groups will be deferred for the pilot until later, larger
studies can be done to confirm or refute these hypotheses. Similarly, while our primary aim
assessing change in NP performance will be tested in all subjects, the pilot nature of the
study prohibits testing of secondary aims in both sites. The academic medical center site
will leverage the assistance of the UCLA CTRC/IPCN to accomplish preliminary testing of the
secondary aims in 30 subjects, while the UCLA MPTF community site will test only the primary
study aim of change in NP performance.

Inclusion Criteria:

- In good health

- Have memory problems or complaints

- Living independently

Exclusion Criteria:

- History of neurodegenerative disease or dementia

- Major psychiatric conditions

- Neurological disorders

- Active alcohol or substance abuse

- Head trauma or systemic diseases affecting brain function

- Uncontrolled hypertension or cardiovascular disease