A widely-held distinction between """"""""usual aging"""""""" and """"""""successful aging"""""""" implies that a variety of extrinsic factors influence how we age, including how cognitive abilities change with age. There is convincing evidence that physical activity, mental activity, and social engagement have great potential to ameliorate age-related cognitive decline, and that these factors contribute independently and additively to reducing the impact of usual cognitive aging. Using a parallel groups design, we will conduct a pilot randomized controlled trial among healthy older adults aged 70 and above, to assess behavioral interventions predicted to remediate age-related cognitive decline. Prior behavioral interventions in older adults that improved cognitive skills usually failed to show transfer to untrained activities, perhaps reflecting the narrowness of such interventions, a lack of complexity, or both. For these reasons, we have selected experimental interventions that engage multiple pathways linked to cognitive aging. These were also chosen to be easy to implement, appeal to older adults, have intrinsic value, and have the potential for long-term sustainability. The selected interventions are (1) Tai Chi, a moderate-intensity low-impact Eastern exercise program that combines physical activity and intense mental concentration, (2) Guided Autobiography, a complex mental activity performed in a setting that promotes a high level of social engagement, (3) a combined intervention that thus incorporates physical activity, two distinct forms of mental activity, and social engagement, and (4) a general health education control group. We hypothesize that structured programs in Tai Chi, Guided Autobiography, and Tai Chi and Guided Autobiography combined are feasible to implement and maintain in an older population, and - in comparison to a health education control program - will improve neuropsychological measures of executive function and episodic memory. Our research goals are to establish the feasibility of the two experimental interventions alone and combined in healthy older adults, assess which of the experimental interventions is most likely to be successful in a full- scale randomized controlled trial, and to estimate immediate (3 month) and short-term (12 month) parameters needed to guide the design of such a larger trial.

Public Health Relevance

Thirty-seven million Americans are aged 65 and older, and their numbers will nearly double by 2030. Cognitive aging is an important, widespread concern in this age group. We will conduct a pilot randomized controlled trail among healthy older adults to assess whether innovative programs in Tai Chi exercise, guided autobiographical writing, or a combination of both are feasible interventions for remediation of age- related cognitive decline.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Project (R01)
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Special Emphasis Panel (ZAG1-ZIJ-5 (M1))
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King, Jonathan W
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Stanford University
Schools of Medicine
United States
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