http://archinte.jamanetwork.com/ en-us Mon, 13 May 2013 00:00:00 GMT Tue, 14 May 2013 18:46:43 GMT Silverchair editor@archinte.jamanetwork.com webmaster@archinte.jamanetwork.com http://archinte.jamanetwork.com/article.aspx?articleID=1673747 Mon, 13 May 2013 00:00:00 GMT Barnes DE, Santos-Modesitt W, Poelke G, et al. <span class="paragraphSection"><div class="boxTitle">Importance</div>The prevalence of cognitive impairment and dementia are projected to rise dramatically during the next 40 years, and strategies for maintaining cognitive function with age are critically needed. Physical or mental activity alone result in relatively small, domain-specific improvements in cognitive function in older adults; combined interventions may have more global effects.<div class="boxTitle">Objective</div>To examine the combined effects of physical plus mental activity on cognitive function in older adults.<div class="boxTitle">Design</div>Randomized controlled trial with a factorial design.<div class="boxTitle">Setting</div>San Francisco, California.<div class="boxTitle">Participants</div>A total of 126 inactive, community-residing older adults with cognitive complaints.<div class="boxTitle">Interventions</div>All participants engaged in home-based mental activity (1 h/d, 3 d/wk) plus class-based physical activity (1 h/d, 3 d/wk) for 12 weeks and were randomized to either mental activity intervention (MA-I; intensive computer) or mental activity control (MA-C; educational DVDs) plus exercise intervention (EX-I; aerobic) or exercise control (EX-C; stretching and toning); a 2 × 2 factorial design was used so that there were 4 groups: MA-I/EX-I, MA-I/EX-C, MA-C/EX-1, and MA-C/EX-C.<div class="boxTitle">Main Outcome Measures</div>Global cognitive change based on a comprehensive neuropsychological test battery.<div class="boxTitle">Results</div>Participants had a mean age of 73.4 years; 62.7% were women, and 34.9% were Hispanic or nonwhite. There were no significant differences between the groups at baseline. Global cognitive scores improved significantly over time (mean, 0.16 SD; P < .001) but did not differ between groups in the comparison between MA-I and MA-C (ignoring exercise, P = .17), the comparison between EX-I and EX-C (ignoring mental activity, P = .74), or across all 4 randomization groups (P = .26).<div class="boxTitle">Conclusions and Relevance</div>In inactive older adults with cognitive complaints, 12 weeks of physical plus mental activity was associated with significant improvements in global cognitive function with no evidence of difference between intervention and active control groups. These findings may reflect practice effects or may suggest that the amount of activity is more important than the type in this subject population.<div class="boxTitle">Trial Registration</div>clinicaltrials.gov Identifier: NCT00522899</span> 173 9 797 804 10.1001/jamainternmed.2013.189 http://archinte.jamanetwork.com/article.aspx?articleID=1673747 http://archinte.jamanetwork.com/article.aspx?articleID=1673749 Mon, 13 May 2013 00:00:00 GMT Lautenschlager NT, Cox KL. <span class="paragraphSection">With many societies around the globe experiencing increasing longevity, one challenging research question of our times is how to reduce the risk of cognitive decline in old age. Modifiable risk or protective factors for Alzheimer disease (AD) are of specific interest, because probably up to half of AD cases worldwide are potentially attributable to modifiable factors. It has been estimated, for example, that up to 1 million AD cases could be prevented globally if a 25% reduction in physical inactivity could be achieved in the world population. Although the body of literature on this topic is substantial, randomized controlled trials (RCTs) involving older adults at increased risk of cognitive decline are still quite sparse, and RCTs that combine more than a single protective lifestyle factor in their intervention are even less common.</span> 173 9 805 806 10.1001/jamainternmed.2013.206 http://archinte.jamanetwork.com/article.aspx?articleID=1673749