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Getting Forgetful With Age? Clinical Trial to Test Ways to Combat Mental Decline

Cognitive effects of exercise, stress reduction and education to be measured in seniors

Some decline in memory and cognitive function is a normal part of aging, but what if it could be prevented? Researchers at University of California, San Diego School of Medicine and Washington University in St. Louis have launched a major clinical trial to investigate whether mental decline in seniors can be slowed or halted through exercise and other health-related interventions.  

Funded by the McKnight Brain Research Foundation and a $15 million grant from the National Institutes of Health, the trial will explore how Mindfulness Based Stress Reduction (MBSR), physical exercise and health education influence cognitive processes, such as attention and memory in older adults.  Approximately 580 seniors in San Diego and St. Louis will be recruited for the trial.

“This will be one of the largest and most comprehensive studies of its kind,” said Julie Wetherell, PhD, co-principal investigator and professor in UC San Diego School of Medicine’s Department of Psychiatry. “Our overall goal is to find out how to improve memory and concentration in older people.”

The researchers note that the trial is timely given the rising numbers of elderly. Currently, 10,000 Baby Boomers turn 65 every day and in the next few decades the country’s population aged 65 and older will almost double, from 43 million in 2012 to nearly 84 million by 2050.

“As our society ages, we want to preserve cognitive function and enhance it if possible,” said Wetherell. “We know the brain is capable of growing new connections into old age. If we demonstrate that one, two or all three of these interventions work, it will be good news for older people who want to maintain and improve their cognitive abilities.”

Earlier research conducted by Wetherell and Washington University researchers suggests there is room for optimism. In two smaller studies looking at the effects of Mindfulness Based Stress Reduction and health education on cognitive function in the elderly, they found improvements in the participants’ memory and thinking, with the stress reduction group showing greater gains.

The current clinical trial will add exercise to the mix and will place participants into one of four groups. Three of the groups will test the interventions individually and a fourth group will test a combination of exercise plus Mindfulness Based Stress Reduction.

“We’ll be doing a huge battery of tests looking at memory and executive functions, such as planning and sequential switching between tasks,” said Wetherell. Participants will undergo baseline MRI brain scans and will be retested at intervals. The scans will assess brain size, neural activity and other standard measures of cognitive function.

“We’re also looking at certain physiological indicators, such as glucose tolerance,” said Wetherell. Impaired glucose tolerance, which plays havoc with blood sugar levels, can damage parts of the brain. In addition, diabetes is a known risk factor for vascular dementia.  

Wetherell said levels of cortisol, a stress hormone, will also be tracked. “Elevated levels of cortisol have been shown to have a malign influence on the hippocampus and frontal lobes, which are areas associated with memory and executive function,” she said.

The researchers hope that the trial’s stress reduction, exercise and education measures will improve both physiological indicators and the brain. “We hope we’ll be able to tell a causal story showing that the trial’s interventions will lead to improvements in these risk factors and changes in actual brain function,” she said.

The trial is in its early stages and participants are sought. Qualifying individuals must be 65 to 84 years old and not currently engaged in regular physical activity, but healthy enough to start an exercise program. Excluded health conditions include diabetes, cardiac issues or dementia. Each participant’s involvement will last 18 months; the study will run over the next five years.

To learn more about the trial, call 858-534-8118, email medexstudy@ucsd.edu or view the study website at medexstudy.com


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