The social burden regarding dementia patients is increasing due to the aging society, but the development of drugs for treatment and prevention of dementia has been worse than expected. In particular, there are drugs for cure of mild cognitive impairment which is an intermediate stage between dementia and the normal cognition. In this situation, non-pharmaceutical methods of lifestyle improvement through exercise, nutrition, cognitive intervention, and vascular risk factor management have emerged as preventive measures for dementia, and large-scale interventional studies in Finland have proven effective. Among them, regular exercise has provided the strongest evidence in the prevention of dementia, and the mild cognitive impairment guidelines published recently in the American Academy of Neurology suggest that exercise if based on a higher level than other treatments, including medication. 

The effects of exercise to prevent cognitive decline have been known, but the standards for the type, frequency, and intensity of exercise to see the effect have not been proposed. This research team developed a multi-domain, structured dementia prevention exercise program, and performed a 12-week prior study in patients with pre-dementia to confirm high compliance and safety.

The purpose of this study is to evaluate the effectiveness of the developed exercise program in patients with mild cognitive impairment and to show that multi-domain, structured dementia prevention exercise program is effective in preventing cognitive decline.

Prevention

The non-intervention group will perform the regular walking exercise and will implement the structured multi-domain exercise intervention program in the intervention group. Both groups are 20 weeks long, with 50 minutes of an exercise session, 3 times a week, and the intervention program consists of aerobic, strength, balance and flexibility exercises.

Arm Label

Target Number of Participant

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The exercise intervention group is divided into 2 groups of 13 participants with a trainer respectively. The exercise intervention program consists of aerobic, strength, balance and flexibility exercises for 50 minutes, 3 times a week for 20 weeks using the number mats, elastic bands and chairs.

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Target Number of Participant

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The walking exercise group is also divided into 2 groups of 13 participants and performs the walking exercise at the usual walking speed.

Gender

Age

Description

1. One or more of the following dementia risk factors:
  1) Hypertension on medication
  2) Diabetes mellitus on oral hypoglycemic agent or insulin
  3) Dyslipidemia on medication
  4) Obesity: BMI 25kg/m2 and above
  5) Smoking: patients who have smoked at least 100 cigarettes in their lifetime and smoked more than 1 cigarette in the last month
  6) Excessive drinking: more than 170 grams of alcohol per week
  7) An educational background of less than 9 years
  8) Aerobic exercise with moderate strength (3~6 METS) less than 150 minutes per week (more than 30 minutes, more than 5 days a weak) or high-intensity aerobic exercise (>6METS) less than 60 minutes per week (20 minutes or more, 3 days or more per week)
  9) Insufficient strength exercise; do not perform 8 to 10 muscle group exercises for 10 to 15 repetitions per every exercise session for 2 days or more per week

2. No significant daily life dysfunction: KIADL 0.42 or below
3. The participant should not be dementia in the judgement of clinicians.
4. Literacy
5. Written consent to participate in the research

1. Mental illness such as major depression disorder
2. Dementia
3. Other neurodegenerative diseases such as Parkinson's disease
4. MMSE z-score -1.5 or less
5. Malignant tumors within 5 years of not being cured
6. Revascularization or stent insertion within 1 year
7. Severe or unstable symptomatic cardiovascular disease
8. Any other evidence of serious or unstable physical condition (acute or severe asthma, active gastrointestinal ulcer, severe liver disease or kidney disease enough to receive dialysis), patients with other medical conditions that may interfere with the completion of the clinical trial
9. Severe vision loss, severe hearing loss, or communication impairment beyond which intervention and validation cannot be performed
10. Illiteracy
11. In case it is deemed difficult to participate in the research in cooperation with the researchers' judgment to the end
12. In case of difficulty in safely participating in arbitration programs in the judgment of the researchers
13. Participation in other intervention studies

physical activity (muscle strength, balance, flexibility, cardiopulmonary endurance, cooperation)

Before and after the 20-week exercise program, 10th week of the exercise program

Neuropsychological test for cognitive evaluation

Before and after the 20-week exercise program

brain imaging (brain MRI for evaluating cortical thickness and activated brain area)

Before and after the 20-week exercise program

Electroencephalogram

Before and after the 20-week exercise program

Blood biomarker (BDNF, anandamide, 2-arachidonoylglycerol)

Exercise program start date, a 10-week workout day, a 20-week workout day

Emotional state (depression, anger proneness)

Before and after the 20-week exercise program, 10th week of the exercise program