Cognitive decline in older adults is a significant public health issue and a major health concern for older adults. Approximately 40% of U.S. adults age 65 years and older have some cognitive impairment which increases their risk for developing dementia. Age-related cognitive deficits may occur in complex skills associated with executive functions (e.g., attention, planning, sequencing, problem solving, working memory, cognitive flexibility, inhibition, and decision-making) and are most susceptible to age-related decline. Physical activity has been identified as one strategy to maintain and improve executive function. Despite the well-known benefits of regular exercise on cognitive health, older adults tend to be less physically active than other age groups. Outcomes from short interventions using the mind-body exercise Feldenkrais have shown promising improvements of cognitive executive function in independent living older adults. Furthermore, results of these mind-body interventions suggest that adherence to Feldenkrais is better than adherence to conventional exercise programs. However, because the ability of Feldenkrais to improve executive functions has not been rigorously compared to that of other exercise modes using a randomized trial design, we do not know whether Feldenkrais is in fact beneficial and if so, whether the positive effects are sustained. In addition, because most previous Feldenkrais interventions have been relatively short, we do not know if the favorable adherence rates shown in previous work are long lasting. The proposed study will address these knowledge gaps using a 3-arm randomized controlled trial. Independent living older adults (N=90) age 65 to 85 will be randomized to a (1) Feldenkrais group (FG), (2) strength training (SG) and (3) no-intervention control group (CG). Intervention groups will meet twice a week for 12 weeks. Assessments will be taken at baseline, post-intervention and at a 3-month follow-up. We will examine changes in cognitive executive functions within and across groups (Aim 1). We will also examine attendance (adherence) and explore selected barriers and facilitators to exercise participation (Aim 2). Cognition and motor performance measures of the NIH Toolbox will be used to allow cross-measure comparisons on nationally representative samples. Results of the study will contribute to the body of research on aging by adding to our knowledge about cognitive function and the understanding of adherence to physical activity programs. If significant improvements in executive function are obtained through Feldenkrais, as compared to strength training and/or waitlist controls, such interventions would be a viable low-cost option for older adults to maintain cognitive vitality. Such findings could have an impact on exercise guidelines for older adults, and would point to the need for studies to determine whether similar effects could be observed in clinical populations. This study proposed for the Academic Research Enhancement Award program will also strengthen the research capability in health related disciplines of the institution and provide ample opportunities to expose students to research in the field of aging.
Decline in cognitive function associated with aging is one of the greatest concerns of older adults and often leads to significant burden for individuals, families, and the health care system. This study responds to the urgent need to identify strategies which can enhance and/or maintain cognitive vitality in older adults and will examine the effects of both the mind-body exercise Feldenkrais and strength training on cognitive executive function. Outcomes of the study could provide a novel strategy for reducing age-related cognitive decline and thereby impact the development of programs and guidelines for combatting such declines.
