SMART: physical activity and cerebral metabolism in older people: study protocol for a randomised controlled trial

  • BACKGROUND: hysical 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/DESIGN: 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. DISCUSSION: 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. NCT02343029 (; 12 January 2015).

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Author:Johannes FleckensteinORCiDGND, Silke MaturaORCiDGND, Tobias EngeroffORCiDGND, Eszter FüzékiORCiDGND, Valentina TeskyGND, Ulrich PilatusORCiD, Elke HattingenORCiDGND, Ralf DeichmannORCiD, Lutz VogtGND, Winfried BanzerGND, Johannes PantelORCiDGND
Pubmed Id:
Parent Title (English):Trials
Publisher:BioMed Central
Place of publication:London
Document Type:Article
Date of Publication (online):2015/04/11
Date of first Publication:2015/04/11
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2016/06/14
Tag:Aerobic exercise training; Cognition; Cognitive impairment; Dementia; Magnetic resonance spectroscopic imaging; Older adults; Prevention; Psychometric tests
Page Number:10
© Fleckenstein et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
Institutes:Psychologie und Sportwissenschaften / Sportwissenschaften
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0