期刊论文详细信息
Nutrition Journal
A randomised controlled trial investigating the effects of Mediterranean diet and aerobic exercise on cognition in cognitively healthy older people living independently within aged care facilities: the Lifestyle Intervention in Independent Living Aged Care (LIILAC) study protocol [ACTRN12614001133628]
Andrew Pipingas1  Andrew B. Scholey1  Helen Macpherson2  Greg Kennedy1  Roy J. Hardman1 
[1] Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia;Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, Australia
关键词: Aged Care;    Ageing;    Cognition;    Cognitive;    Mediterranean;    Diet;    Exercise;   
Others  :  1222660
DOI  :  10.1186/s12937-015-0042-z
 received in 2014-12-10, accepted in 2015-05-15,  发布年份 2015
PDF
【 摘 要 】

Background

The rapid ageing of the population is becoming an area of great concern, both globally and in Australia. On a societal level, the cost of supporting an ageing demographic, particularly with their associated medical requirements, is becoming an ever increasing burden that is only predicted to rise in the foreseeable future. The progressive decline in individuals’ cognitive ability as they age, particularly with respect to the ever increasing incidence of Alzheimer’s Disease (AD) and other cognitive complications, is in many respects one of the foundation stones of these concerns. There have been numerous observational studies reporting on the positive effects that aerobic exercise and the Mediterranean diet appear to have on improving cognitive ability. However, the ability of such interventions to improve cognitive ability, or even reduce the rate of cognitive ageing, has not been fully examined by substantial interventional studies within an ageing population.

Methods

The LIILAC trial will investigate the potential for cognitive change in a cohort of cognitively healthy individuals, between the ages of 60 and 90 years, living in independent accommodation within Australian aged care facilities. This four-arm trial will investigate the cognitive changes which may occur as a result of the introduction of aerobic exercise and/or Mediterranean diet into individuals’ lifestyles, as well as the mechanisms by which these changes may be occurring. Participants will be tested at baseline and 6 months on a battery of computer based cognitive assessments, together with cardiovascular and blood biomarker assessments. The cardiovascular measures will assess changes in arterial stiffness and central pulse pressures, while the blood measures will examine changes in metabolic profiles, including brain derived neurotrophic factor (BDNF), inflammatory factors and insulin sensitivity.

Conclusion

It is hypothesised that exercise and Mediterranean diet interventions, both individually and in combination, will result in improvements in cognitive performance compared with controls. Positive findings in this research will have potential implications for the management of aged care, particularly in respect to reducing the rate of cognitive decline and the associated impacts both on the individual and the broader community.

Trial registration

Australia New Zealand Clinical Trial Registry-ACTRN12614001133628 webcite

【 授权许可】

   
2015 Hardman et al.; licensee BioMed Central.

【 预 览 】
附件列表
Files Size Format View
20150824115324825.pdf 616KB PDF download
Fig. 1. 67KB Image download
【 图 表 】

Fig. 1.

【 参考文献 】
  • [1]Daffner KR. Promoting successful cognitive aging: a comprehensive review. J Alzheimers Dis. 2010; 19:1101-22.
  • [2]Deary IJ, Corley J, Gow AJ, Harris SE, Houlihan M, Marioni RE et al.. Age-associated cognitive decline. Br Med Bull. 2009; 92:135-52.
  • [3]Levy R. Aging-associated cognitive decline. Int Psychogeriatrics. 1994; 6:63-8.
  • [4]Nation DA, Wierenga CE, Delano-Wood L, Jack AJ, Delis DC, Salmon DP et al.. Elevated pulse pressure is associated with age-related decline in language ability. J Int Neuropsychol Soc. 2010; 16:933-8.
  • [5]Sachdev P. The aging brain. Kripps, Lisse; 2003.
  • [6]World Population Ageing 2007. United Nations Publications, New York; 2007.
  • [7]Lutz W, Sanderson W, Scherbov S. The coming acceleration of global population ageing. Nature. 2008; 451:716-9.
  • [8]Scherbov S, Lutz WL, Sanderson WC. The uncertain timing of reaching 8 billion, peak world population, and other demographic milestones. Popul Dev Rev. 2011; 37:571-8.
  • [9]Vickland V, Werner J, Morris T, McDonnell G, Draper B, Low L-F et al.. Who pays and who benefits? How different models of shared responsibilities between formal and informal carers influence projections of costs of dementia management. BMC Public Health. 2011; 11:793. BioMed Central Full Text
  • [10]Christensen H. What cognitive changes can be expected with normal ageing? Aust N Z J Psychiatry. 2001; 35:768-75.
  • [11]Horn JL, Cattell RB. Refinement and test of the theory of fluid and crystallized general intelligences. J Educ Psychol. 1966; 57:253-70.
  • [12]Christensen H, Kumar R. Cognitive changes and tha aging brain. In: The aging brain. Sachdev P, editor. Swets & Zeitlinger, Lisse; 2003: p.75-95.
  • [13]Cattell R. Fluid and crystallized intelligence. In: Stud invidual Differ search Intell. Jenkins J, Patterson D, editors. Appleton-Centruy-Crofts, East Norwalk; 1961: p.738-46.
  • [14]Gunstad J, Paul RH, Brickman AM, Cohen R, Arns M, Roe D et al.. Patterns of cognitive performance in middle-aged and older adults: A cluster analytic examination. J Geriatr Psychiatry Neurol. 2006; 19:59-64.
  • [15]Pipingas A, Harris E, Tournier E, King R, Kras M, Stough CK. Assessing the efficacy of nutraceutical interventions on cognitive functioning in the elderly. Curr Top Nutraceutical Res. 2010; 8:79-88.
  • [16]Morse CK. Does variability increase with age? An archival study of cognitive measures. Psychol Aging. 1993; 8:156-64.
  • [17]Singer T, Verhaeghen P, Ghisletta P, Lindenberger U, Baltes PB. The fate of cognition in very old age: six-year longitudinal findings in the Berlin Aging Study (BASE). Psychol Aging. 2003; 18:318-31.
  • [18]Denney NW. A model of cognitive development across the life Span. Dev Rev. 1984; 4:171-91.
  • [19]Mariani E, Polidori MC, Cherubini A, Mecocci P. Oxidative stress in brain aging, neurodegenerative and vascular diseases: an overview. J Chromoatogr. 2005; 827:65-75.
  • [20]Small G, Silverman D, Siddarth P, Ercoli LM, Miller K, Lavretsky H et al.. Effects of a 14-day healthy longevity lifestyle program on cognition and brain function. Am J Geriatr Psychiatr. 2006; 14:538-45.
  • [21]Vaynman S, Ying Z, Wu A, Gomez-Pinilla F. Coupling energy metabolism with a mechanism to support brain-derived neurotropic factor-mediated synaptic plasticity. Neuroscience. 2006; 139:1221-34.
  • [22]Greenwood PM. Functional plasticity in cognitive aging : review and hypothesis. Neuropsychology. 2007; 21:657-73.
  • [23]Hertzog C, Kramer AF, Wilson RS, Lindenberger U. Enrichment effects on adult cognitive development: can the functional capacity of older adults be preserved and enhanced? Psychol Sci Public Interes. 2009; 9:1-66.
  • [24]Scuteri A, Volpe M, Asmar R. Arterial stiffness and cognitive impairment in the elderly. High Blood Press Cardiovasc Prev. 2007; 14:33-7.
  • [25]Ram N, Gerstorf D, Lindenberger U, Smith J. Developmental change and intraindividual variability: relating cognitive aging to cognitive plasticity, cardiovascular lability, and emotional diversity. Psychol Aging. 2011; 26:363-71.
  • [26]Sierpina VS, Sierpina M, Loera JA, Grumbles L. Complementary and integrative approaches to dementia. South Med J. 2005; 98:636-45.
  • [27]Colcombe S, Kramer AF. Fittness effects on the cognitive function of older adults: a meta-analytic study. Psychol Sci. 2003; 14:125-31.
  • [28]Smith PJ, Blumenthal JA, Hoffman BM, Strauman TA, Welsh-bohmer K, Jeffrey N et al.. Aerobic exercise and neurocognitive performance: a meta-analytic review of randomized controlled trials. Psychosom Med. 2011; 72:239-52.
  • [29]Lautenschlager NT, Cox KL, Flicker L, Foster JK, van Bockxmeer FM, Xiao J et al.. Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease: a randomized trial. JAMA. 2008; 300:1027-37.
  • [30]Masley S, Roetzheim R, Gualtieri T. Aerobic exercise enhances cognitive flexibility. J Clin Psychol Med Settings. 2009; 16:186-93.
  • [31]Rolland Y, van Kan GA, Vellas B. Healthy brain aging : role of exercise and physical activity. Clin Geriatr Med. 2010; 26:75-87.
  • [32]Maki Y, Ura C, Yamaguchi T, Murai T, Isahai M, Kaiho A et al.. Effects of intervention using a community-based walking program for prevention of mental decline: a randomized controlled trial. J Am Geriatr Soc. 2012; 60:505-10.
  • [33]Cotman CW, Berchtold NC. Physical activity and the maintenance of cognition: learning from animal models. Alzheimers Dement. 2007; 3 Suppl 2:30-7.
  • [34]Ahlskog JE, Geda YE, Graff-Radford NR, Petersen RC. Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. Mayo Clin Proc. 2011; 86:876-84.
  • [35]Gómez-Pinilla F. Brain foods : the effects of nutrients on brain function. Nat Rev Neurosci. 2010; 9:568-78.
  • [36]Middleton LE, Yaffe K. Targets for the prevention of dementia. J Alzheimers Dis. 2010; 20:915-24.
  • [37]Scarmeas N, Stern Y, Tang M, Mayeux R, Luchsinger JA. Mediterranean diet and risk for alzheimer’s disease. Ann Neurol. 2006; 59:912-21.
  • [38]Scarmeas N, Stern Y, Mayeux R, Manly JJ, Schupf N, Luchsinger JA. Mediterranean diet and mild cognitive impairment. Arch Neurol. 2009; 66:216-25.
  • [39]Singh B, Parsaik A, Mielke M, Erwin P, Knopman D, Petersen R et al.. Association of mediterranena diet with mild cognitive impairment and Alzheimer’s disease: a systematic review and meta-analysis. J Alzheimers Dis. 2014; 39:271-82.
  • [40]Féart C, Samieri C, Rondeau V, Amieva H, Portet F, Dartigues J-F et al.. Adherence to a Mediterranean diet, cognitive decline, and risk of dementia. JAMA. 2009; 302:638-48.
  • [41]Psaltopoulou T, Kyrozis A, Stathopoulos P, Trichopoulos D, Vassilopoulos D, Trichopoulou A. Diet, physical activity and cognitive impairment among elders : the EPIC-Greece cohort (European Prospective Investigation into Cancer and Nutrition). Public Health Nutr. 2008; 11:1054-62.
  • [42]Tangney CC, Kwasny MJ, Li H, Wilson RS, Evans DA, Morris MC. Adherence to a Mediterranean-type dietary pattern and cognitive decline in a community population. Am J Clin Nutr. 2011; 93:601-7.
  • [43]Gardener S, Gu Y, Rainey-Smith SR, Keogh JB, Clifton PM, Mathieson SL et al.. Adherence to a Mediterranean diet and Alzheimer’s disease risk in an Australian population. Transl Psychiatr. 2012; 164:1-7.
  • [44]Zainuddin MSA, Thuret S. Nutrition, adult hippocampal neurogenesis and mental health. Br Med Bull. 2012; 103:89-114.
  • [45]McMillan L, Owen L, Kras M, Scholey A. Behavioural effects of a 10-day Mediterranean diet. Results from a pilot study evaluating mood and cognitive performance. Appetite. 2011; 56:143-7.
  • [46]Valls-Pedret C, Lamuela-Ravent RM, Quintana M, Corella D, Pint X, Angel M. Polyphenol-rich foods in the Mediterranean diet are associated with better cognitive function in elderly subjects at high cardiovascular risk. J Alzheimers Dis. 2012; 29:773-82.
  • [47]Frisardi V, Panza F, Seripa D, Imbimbo BP, Vendemiale G, Pilotto A et al.. Nutraceutical properties of Mediterranean diet and cognitive decline: possible underlying mechanisms. J Alzheimers Dis. 2010; 22:715-40.
  • [48]Hermsdorff HHM, Zulet MA, Abete I, Martinez JA. Discriminated benefits of a Mediterranean dietary pattern within a hypocaloric diet program on plasma RBP4 concentrations and other inflammatory markers in obese subjects. Endoer. 2009; 36:445-51.
  • [49]Polidori MC, Praticó D, Mangialasche F, Mariani E, Aust O, Anlasik T et al.. High fruit and vegetable intake is positively correlated with antioxidant status and cognitive performance in healthy subjects. J Alzheimers Dis. 2009; 17:921-7.
  • [50]Ajani UA, Ford ES, Mokdad AH. Dietary fiber and C-reactive protein: findings from national health and nutrition examination survey data. J Nutr. 2004; 134:1181-5.
  • [51]Ruxton CHS, Reed SC, Simpson MJA, Millington KJ. The health benefits of omega-3 polyunsaturated fatty acids: a review of the evidence. J Hum Nutr Diet. 2004; 17:449-59.
  • [52]Young JM, Shand BI, McGregor PM, Scott RS, Frampton CM. Comparative effects of enzogenol and vitamin C supplementation versus vitamin C alone on endothelial function and biochemical markers of oxidative stress and inflammation in chronic smokers. Free Radic Res. 2006; 40:85-94.
  • [53]Martinez-Gonzalez MA, Bes-Rastrollo M, Serra-Majem L, Lairon D, Estruch R, Trichopoulou A. Mediterranean food pattern and the primary prevention of chronic disease : recent developments. Nutr Rev. 2009; 67:S111-6.
  • [54]Psaltopoulou T, Naska A, Orfanos P, Trichopoulos D, Mountokalakis T, Trichopoulou A. Olive oil, the Mediterranean diet, and arterial blood pressure : The Greek European Prospective Investigation into Cancer and Nutrition (EPIC) study. Am J Clin Nutr. 2004; 80:1012-8.
  • [55]Serra-Majem L, Roman B, Estruch R. Scientific evidence of interventions using the mediterranean diet : a systematic review. Nutr Rev. 2006; 64:S27-47.
  • [56]Trichopoulou A, Corella D, Martı MA, Soriguer F, Ordovas JM. The Mediterranean diet and cardiovascular epidemiology. Nutr Rev. 2006; 64:13-9.
  • [57]Dilis V, Katsoulis M, Lagiou P, Trichopoulos D, Naska A, Trichopoulou A. Mediterranean diet and CHD : the Greek European Prospective Investigation into Cancer and Nutrition cohort. Br J Nutr. 2012; 108:699-709.
  • [58]Martínez-Lapiscina EH, Galbete C, Corella D, Toledo E, Buil-Cosiales P, Salas-Salvado J et al.. Genotype patterns at CLU, CR1, PICALM and APOE, cognition and Mediterranean diet: the PREDIMED-NAVARRA trial. Genes Nutr. 2014; 393:1-13.
  • [59]Gomez-Pinilla F. The impact of diet and exercise on brain plasticity and disease. Nutr Health. 2006; 18:277-84.
  • [60]Noble EE, Mavanji V, Little MR, Billington CJ, Kotz CM, Wang C. Exercise reduces diet-induced cognitive decline and increases hippocampal brain-derived neurotrophic factor in CA3 neurons. Neurobiol Learn Mem. 2014; 114:40-50.
  • [61]Nash DT. Nutritional and exercise aspects of cognitive impairment. J Clin Lipidol. 2007; 1:242-7.
  • [62]Waldstein SR, Rice SC, Thayer JF, Najjar SS, Scuteri A, Zonderman AB. Pulse pressure and pulse wave velocity are related to cognitive decline in the Baltimore Longitudinal Study of Aging. Hypertension. 2008; 51:99-104.
  • [63]Klonizakis M, Alkhatib A, Middleton G. Long-term effects of an exercise and Mediterranean diet intervention in the vascular function of an older, healthy population. Microvasc Res. 2014; 95:103-7.
  • [64]Meeusen R. Exercise, nutrition and the brain. Sport Med. 2014; 44 Suppl 1:S47-56.
  • [65]Cohen J. Quantitative methods in psychology. Psychol Bull. 1992; 112:155-9.
  • [66]Harris E, Macpherson H, Vitetta L, Kirk J, Sali A, Pipingas A. Effects of a multivitamin, mineral and herbal supplement on cognition and blood biomarkers in older men: a randomised, placebo-controlled trial. Hum Psychopharmacol. 2012; 27:370-7.
  • [67]Macpherson H, Ellis KA, Sali A, Pipingas A. Memory improvements in elderly women following 16 weeks treatment with a combined multivitamin, mineral and herbal supplement: a randomized controlled trial. Psychopharmacology (Berl). 2012; 220:351-65.
  • [68]Pipingas A, Silberstein RB, Vitetta L, Rooy C, Van VE, Young JM et al.. Improved cognitive performance after dietary supplementation with a Pinus radiata bark extract formulation. Phyther Res. 2008; 22:1168-74.
  • [69]Parmelee PA, Katz IR. Geriatric depression scale. J Am Geriatr Soc. 1990; 38:1379.
  • [70]Stough CK, Pase MP, Cropley V, Myers S, Nolidin K, King R et al.. A randomized controlled trial investigating the effect of Pycnogenol and Bacopa CDRI08 herbal medicines on cognitive, cardiovascular, and biochemical functioning in cognitively healthy elderly people: the Australian Research Council Longevity Intervention. Nutr J. 2012; 11:1-9. BioMed Central Full Text
  • [71]Simpson T, Camfield D, Pipingas A, Macpherson H, Stough C. Improved processing speed: online computer-based cognitive training in older adults. Educ Gerontol. 2012; 38:445-58.
  • [72]Brown TA, Chorpita BF, Korotitsch W, Barlow DH. Psychometric properties of the depression anxiety stress scale (DASS) in clinical samples. Behav Res Ther. 1997; 35:79-89.
  • [73]McNair DM, Lorr M, Droppleman LF. Profile of Mood States (POMS)-revised Manual. Education and Industrial Testing Service, San Diego, CA; 1992.
  • [74]Goldberg DP, Williams PA. User’s Guide to the General Health Questionnaire: GHQ. GL Assessment, London, England; 2006.
  • [75]Adams T, Bezner J, Steinhardt M. The conceptualization and measurement of perceived wellness: integrating balance across and within dimensions. Am J Heal Promot. 1997; 11:208-18.
  • [76]Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989; 28:193-213.
  • [77]Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. Adherence to a mediterranean diet and survival in a greek population. N Engl J Med. 2003; 348:2599-608.
  • [78]Giles G, Ireland P. Dietary Questionnaire for Epidemiological Studies (Version 2). The Cancer Council Victoria, Melbourne; 1996.
  • [79]Troosters T, Gosselink R, Decramer M. Six minute walking distance in healthy elderly subjects. Eur Respir J. 1999; 14:270-4.
  • [80]Borg GAV. Borg’s perceived exertion and pain scales. Human Kinetics, Champaign, IL; 1998.
  • [81]Stewart AL, Mills KM, King AC, Haskell WL, Gillis D, Ritter PL. CHAMPS physical activity questionnaire for older adults: outcomes for interventions. Med Sci Sports Exerc. 2001; 33:1126-41.
  文献评价指标  
  下载次数:11次 浏览次数:17次