title: SMART: physical activity and cerebral metabolism in older people: study protocol for a randomised controlled trial.
abstract: BACKGROUND
  Physical activity exerts a variety of long-term health benefits in older adults. In particular, it is assumed to be a protective factor against cognitive decline and dementia.
  
  
  METHODS
  Randomised controlled assessor blinded 2-armed trial (n = 60) to explore the exercise- induced neuroprotective and metabolic effects on the brain in cognitively healthy older adults. Participants (age ≥ 65), recruited within the setting of assisted living facilities and newspaper advertisements are allocated to a 12-week individualised aerobic exercise programme intervention or a 12-week waiting control group. Total follow-up is 24 weeks. The main outcome is the change in cerebral metabolism as assessed with Magnetic Resonance Spectroscopic Imaging reflecting changes of cerebral N-acetyl-aspartate and of markers of neuronal energy reserve. Imaging also measures changes in cortical grey matter volume. Secondary outcomes include a broad range of psychometric (cognition) and movement-related parameters such as nutrition, history of physical activity, history of pain and functional diagnostics. Participants are allocated to either the intervention or control group using a computer-generated randomisation sequence. The exercise physiologist in charge of training opens sealed and opaque envelopes and informs participants about group allocation. For organisational reasons, he schedules the participants for upcoming assessments and exercise in groups of five. All assessors and study personal other than exercise physiologists are blinded.
  
  
  CONCLUSIONS
  Magnetic Resonance Spectroscopic Imaging gives a deeper insight into mechanisms of exercise-induced changes in brain metabolism. As follow-up lasts for 6 months, this study is able to explore the mid-term cerebral metabolic effects of physical activity assuming that an individually tailored aerobic ergometer training has the potential to counteract brain ageing.
  
  
  BACKGROUND
  NCT02343029 (clinicaltrials.gov; 12 January 2015).
authors: Department of Sports Medicine, Institute of Sports Sciences, Goethe University, Ginnheimer Landstrasse 39, Frankfurt am Main, 60487, Germany. Johannes.fleckenstein@sport.uni-frankfurt.de.
authors: Johannes
authors: J
authors: Fleckenstein
authors: Institute of General Practice, Goethe University, Frankfurt/Main, Germany. Matura@allgemeinmedizin.uni-frankfurt.de.
authors: Silke
authors: S
authors: Matura
authors: Department of Sports Medicine, Institute of Sports Sciences, Goethe University, Ginnheimer Landstrasse 39, Frankfurt am Main, 60487, Germany. engeroff@sport.uni-frankfurt.de.
authors: Tobias
authors: T
authors: Engeroff
authors: Department of Sports Medicine, Institute of Sports Sciences, Goethe University, Ginnheimer Landstrasse 39, Frankfurt am Main, 60487, Germany. fuezeki@sport.uni-frankfurt.de.
authors: Eszter
authors: E
authors: Füzéki
authors: Institute of General Practice, Goethe University, Frankfurt/Main, Germany. Tesky@allgemeinmedizin.uni-frankfurt.de.
authors: Valentina A
authors: VA
authors: Tesky
authors: Institute of Neuroradiology, Goethe University Hospital Frankfurt, Frankfurt, Germany. u.pilatus@em.uni-frankfurt.de.
authors: Ulrich
authors: U
authors: Pilatus
authors: Institute of Neuroradiology, Goethe University Hospital Frankfurt, Frankfurt, Germany. Elke.Hattingen@kgu.de.
authors: Elke
authors: E
authors: Hattingen
authors: Brain Imaging Centre, Frankfurt/Main, Germany. deichmann@med.uni-frankfurt.de.
authors: Ralf
authors: R
authors: Deichmann
authors: Department of Sports Medicine, Institute of Sports Sciences, Goethe University, Ginnheimer Landstrasse 39, Frankfurt am Main, 60487, Germany. l.vogt@sport.uni-frankfurt.de.
authors: Lutz
authors: L
authors: Vogt
authors: Department of Sports Medicine, Institute of Sports Sciences, Goethe University, Ginnheimer Landstrasse 39, Frankfurt am Main, 60487, Germany. banzer@sport.uni-frankfurt.de.
authors: Winfried
authors: W
authors: Banzer
authors: Institute of General Practice, Goethe University, Frankfurt/Main, Germany. Pantel@allgemeinmedizin.uni-frankfurt.de.
authors: Johannes
authors: J
authors: Pantel
mesh_terms: D000328:Adult; D001921:Brain / Q000378:metabolism*; D002985:Clinical Protocols; D015444:Exercise; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy