A Precision Rehabilitation Approach to Counteract Age-Related Cognitive Declines

• Change from Baseline Functional Fitness at 3, 6, and 12 months[ Time Frame: Baseline, 3 months, 6 months, 12 months ]
  Assessed with the Short Physical Performance Battery
• Change from Baseline Fitness at 3, 6, and 12 months[ Time Frame: Baseline, 3 months, 6 months, 12 months ]
  Assessed with a 400 meter corridor walk.
• Change from Baseline Repeatable Battery for the Assessment of Neuropsychological Status at 3, 6, and 12 months[ Time Frame: Baseline, 3 months, 6 months, 12 months ]
  This is a brief standardized paper-and-pencil neurocognitive battery measuring immediate and delayed memory, attention, language, and visuospatial skills. The test comprises of 12 subtests that is administered by a trained examiner.
• Change from Baseline Modified Mini-Mental Status Exam at 3, 6, and 12 months[ Time Frame: Baseline, 3 months, 6 months, 12 months ]
  This is an expanded 100-point version of the original Mini-Mental Status Exam, administered in ~7 minutes, which assesses global cognitive function. This measure has very good reliability, validity, and sensitivity to moderate cognitive changes and has a proven record in clinical trials.
• Change from Baseline Auditory Verbal Learning Test at 3, 6, and 12 months[ Time Frame: Baseline, 3 months, 6 months, 12 months ]
  The participant is read a list of 15 words, 5 times. After each time, the participant is asked to immediately recall as many words as possible. Following the 5th recall, an interference list is presented, after which the participant is asked to spontaneously recall words from the original list. After a 10-minute interval has passed, the participant is asked again to recall as many words as possible from the original list.
• Change from Baseline Physical Activity (minutes per week) at 3, 6, and 12 months[ Time Frame: Baseline, 3 months, 6 months, 12 months ]
  Measured by Actigraphy
• Change from Baseline Physical Activity (minutes per week) at 3, 6, and 12 months[ Time Frame: Baseline, 3 months, 6 months, 12 months ]
  Measured by CHAMPS questionnaire.
• Change from Baseline Physical Activity (minutes per week) at 3, 6, and 12 months[ Time Frame: Baseline, 3 months, 6 months, 12 months ]
  Measured by Paffenbarger questionnaire.
• Change from Baseline Sedentary Behavior (minutes per day) at 3, 6, and 12 months[ Time Frame: Baseline, 3 months, 6 months, 12 months ]
  Measured by modified CARDIA questionnaire
• Change from Baseline Sedentary Behavior (minutes per day) at 3, 6, and 12 months[ Time Frame: Baseline, 3 months, 6 months, 12 months ]
  Measured by Actigraphy
• Change from Baseline Peripheral biomarkers at 3, 6, and 12 months[ Time Frame: Baseline, 3 months, 6 months, 12 months ]
  Assessed from venous blood collection and includes measures of neuroinflammation, neurogenesis, and cerebral vascularity

This study examines the behavioral, molecular, and structural biomarkers of brain health that will allow for the stratification of individuals according to their "cognitive signature" and function. This study will randomize older adults into one of four interventions for a period of 12 months: 1) Aerobic Exercise, 2) Resistance Exercise, 3) Yoga Exercise, 4) Health Education (involves stretching and range of motion activities). This aims of this study will examine whether and how these different types of training interventions exert effects cognitive function, brain structure, biomarkers of brain health and cognition, and physical function.

• Behavioral: Aerobic Activity
  Moderate-intensity exercise aerobic exercise that involves participating in activities similar to brisk walking that increase heart rate and breathing rate, with activity progressing to 150 minutes per week. Activities other than brisk walking, such as dance, aerobics, swimming, cycling or other activities that increase heart rate and breathing rate to a moderate intensity that can be sustained for at least 10 minutes will also be encouraged. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision.
• Behavioral: Resistance Training
  Resistance exercise that involves participating in activities similar to lifting weights that cause the participant to work specific muscles of your body, with activity progressing to 150 minutes per week. This can involve using weight training machines, elastic tubes that create resistance, or weights such a dumbbells. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision.
• Behavioral: Yoga
  Yoga involves a series of movements and poses that are performed in a specific sequence that are adapted to your ability, with activity progressing to 150 minutes per week. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision.
• Behavioral: Health Education
  This involves the participant receiving information regarding aspects of health that are important for older adults, and also physical activity in the form of light stretching activities and movements. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision.

• Experimental: Aerobic Activity
  Moderate-intensity exercise aerobic exercise that involves participating in activities similar to brisk walking that increase heart rate and breathing rate, with activity progressing to 150 minutes per week. Activities other than brisk walking, such as dance, aerobics, swimming, cycling or other activities that increase heart rate and breathing rate to a moderate intensity that can be sustained for at least 10 minutes will also be encouraged. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision.
• Experimental: Resistance Training
  Resistance exercise that involves participating in activities similar to lifting weights that cause the participant to work specific muscles of your body, with activity progressing to 150 minutes per week. This can involve using weight training machines, elastic tubes that create resistance, or weights such a dumbbells. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision.
• Experimental: Yoga
  Yoga involves a series of movements and poses that are performed in a specific sequence that are adapted to your ability, with activity progressing to 150 minutes per week. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision.
• Experimental: Health Education
  This involves the participant receiving information regarding aspects of health that are important for older adults, and also physical activity in the form of light stretching activities and movements. This will require the participant to attend one supervised session each week for a period of 12 months with the remaining sessions being performed on their own without supervision.