Enriching Vitality and Compressing Risk for Alzheimers Disease Among Aging Veterans with TBI
Abstract
Scientific Objective and Rationale: Traumatic brain injury (TBI), while seemingly uncommon, accounts for 153 deaths per day among Americans. Currently, in adults over the age of 45 years, TBI is in one of the top causes of emergency room admissions. As we seek treatment options for our aging loved ones who have suffered from a past TBI earlier in life, we quickly realize that there are few programs available to address the primary complaints and challenges experienced by these individuals, including planning difficulties, depression, and social isolation. Additionally, the majority of these programs focus on younger patients. However, even a single TBI to the brain leaves one vulnerable to impairments in attention, memory, and daily function, making this group a high-priority target for the development of programs that help them compensate with TBI and ensure they meet future challenges. We will use a unique approach that will try to improve planning, memory, and brain health in TBI patients by training complex abilities related to day-to-day activity in the real world (e.g., driving, cooking, social interaction). As stated earlier, the challenges in aging adults with TBI can extend to worsening memory, not venturing outside the home for fear of falling, and being less active than usual. Scientific studies have shown that when we train cognition (and related brain processes) along with physical activity simultaneously, the positive effects on health are synergistic and complementary. We have developed from this model a video game that “trains” those who play the game on improving cognition and being physically active during the game. Called simply “Bandit the Dolphin,” the video game involves playing as a dolphin in the ocean while trying to eat fish and avoid sharks. There are minimal controllers in the game. You would simply use your hands to direct Bandit to move in a particular direction and the infra-red sensor would detect your movement. Players throughout the game find challenging puzzles on catching fish, as well as using the arms and upper body to move Bandit throughout the ocean. Bandit is a highly innovative and enjoyable experience that we have adapted to reach aging adults with TBI. The interactive video gaming intervention proposed here has been successfully used and adapted from older adults with stroke and healthy older adults. Based on this research, we now want to evaluate the efficacy of Bandit video gaming on executive functions (e.g., planning, organizing, prioritizing), mobility (e.g., walking, reaching, reaction speed) and in brain markers linked to risk for Alzheimer’s disease. At the same time, we want to see if playing a game that trains to the real world will increase daily activities that in turn promote the brain and body. To examine how the Bandit video gaming activity impacts the brain and the body, we propose the following specific aims for the study: • To determine, in a group of individuals with prior TBI, the impact of our innovative video gaming activity on cognition, lifestyle, and independent activities of daily living by comparing this group to a group of similar individuals receiving a control intervention (an arm aerobic exercise intervention). • To examine the influence of this intervention on biological markers that predict Alzheimer’s disease and related dementia by collecting before- and after-intervention brain imaging (e.g., volume of particular brain regions, resting brain function). • To assess the durability of any observed change in cognition, lifestyle, and independent activities of daily living 9 months after the intervention has been stopped. In order to complete our scientific objective and specific aims, we propose a 12-week randomized controlled trial in a population of individuals with history of TBI that compares our innovative video gaming activity to a control intervention (an arm aerobic exercise intervention). In the proposed study, w
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Nov 19, 2019
- Source ID
- W81XWH1910730
Entities
People
- Michelle Carlson
Organizations
- Johns Hopkins University
- United States Army