Water-based Activity to Enhance Recall in Veterans (WATER-Vet)
Mild Cognitive Impairment
About this trial
This is an interventional treatment trial for Mild Cognitive Impairment focused on measuring Mild Cognitive Impairment, Cognition, Alzheimer's Disease, Physical Exercise, Cognitive Training
Eligibility Criteria
Inclusion Criteria:
- Veterans, aged 50 to 90, of any racial or ethnic group
- Diagnosis of single or multi-domain amnestic MCI using criteria per National Institute on Aging/Alzheimer's Association Guidelines
- Available informant for completion of the Clinical Dementia Rating Scale
- Visual and auditory acuity to allow neuropsychological testing
- Willingness to participate in clinical trial for 14 months (8-month treatment phase, 6-month no-contact follow-up phase)
- Musculoskeletal illness or injury (i.e., osteoporosis, degenerative disc or joint disease, arthritis, obesity)
- Approval by Primary Care Provider to participate in water-based physical exercise
Exclusion Criteria:
Psychiatric Exclusions
- Current, uncontrolled severe psychiatric disorder, such as Bipolar I, Schizophrenia, or Major Depressive Disorder as determined by the Mini International Neuropsychiatric Interview (MINI)
- Diagnosis of dementia, Clinical Dementia Rating Scale (CDR) > 0.5; modified Hachinksi score 4; or delirium. Those Veterans with scores indicative of dementia (CDR > 0.5, modified Hachinksi 4) will be referred to the Memory Disorders Clinic at VAPAHCS for a full diagnostic work-up
Medical Exclusions
- History of neurological (e.g., multiple sclerosis, seizure disorder, stroke,) or system illness affecting CNS function (e.g., liver failure, kidney failure, congestive heart failure, systemic cancer)
- Acute illness or unstable chronic illness, e.g., history of severe liver disease (cirrhosis, esophageal varices, ascites, portal hypertension, hepatic encephalopathy)
- Current severe cardiac disease (e.g., uncontrolled atrial fibrillation, defined as mean 24 hour heart rate >85 beats/min, or 24 hour maximal ventricular rate >150 beats/min; uncontrolled ventricular arrhythmias, defined as recurrent ventricular tachycardia >3 beats in succession, or 24 hour PVC count >20%; active pericarditis or myocarditis; Class III/IV heart failure and / or ejection fraction < 20%; thrombophlebitis; pulmonary disease with a drop in O2 Sat with exercise to 90% without oxygen; embolism within past 6 months)
- Inability to participate in an exercise stress test
- Inability to read, verbalize understanding and voluntarily sign the Informed Consent
Sites / Locations
- VA Palo Alto Health Care System, Palo Alto, CARecruiting
Arms of the Study
Arm 1
Arm 2
Other
Experimental
Usual Care
WATER+CT
Usual Care condition involves receipt of educational materials about brain health and healthy lifestyles as well as regular contact with study staff.
This is an 8 month long two phase intervention. The first phase consists of 6 months of thrice weekly pool based physical activity occurring at the Palo Alto VA Health Care System. After completion of the 6 month long water based physical activity, participants transition to a ten session cognitive training program at the Palo Alto VA. The cognitive training classes are approximately two hours in length and will be spread over ten sessions across 4 weeks.