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OPTI-EX: Optimising exercise interventions for people at risk of dementia


   Institute of Cancer and Genomic Sciences

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  Prof Sarah Aldred  No more applications being accepted  Competition Funded PhD Project (Students Worldwide)

About the Project

The prevalence of dementia continues to rise, and effective strategies are needed to prevent, delay, or slow its progression. Increased physical activity is thought to facilitate healthy brain ageing and reduce the risk of dementia (Calverley et al., 2020). However, little is known about what constitutes optimal exercise in relation to mode, frequency, duration, or intensity. This lack of understanding leads to poorly designed randomised control trials (RCTs) that fail to deliver on their potential impact for people with dementia. Examples of poor study design include the use of inappropriate control groups, sub-optimal exercise protocols and not maximising the potential impact of an exercise intervention for disease progression (Izquierdo et al., 2021). For example, strategies to prevent or delay dementia should arguably begin early in the life course to target ‘at-risk’ individuals, where interventions are likely to have the greatest impact (O'Brien et al., 2020). Further, a critical component of delivering successful exercise interventions is to maximise participant adherence and reduce drop-out in follow-up periods. This is often reflected in a ‘trade-off’ between delivering the most effective exercise protocols with delivering an intervention that is sustainable and maintains participant engagement which is better in the longer term.

Therefore, this project aims to design a framework to optimise the design and implementation of exercise protocols for RCTs. Using an ‘outcome-focused’ design we will utilise existing data sets to identify the effects of exercise modes/intensities/durations on dementia risk factors applying a weighting for their impact on brain health markers. Discussion with focus groups will be used to gather data on what is favourable for improving adherence to a longitudinal exercise intervention. This will be followed by an acute phase exercise testing trial where physiological markers of brain health will be measured. This will then be implemented into an evidence-based exercise trial to convey benefits to people at risk of dementia whilst focusing on maximising participant adherence.

What the Studentship will encompass: This studentship will encompass the design of evidence-based theoretical framework to develop and deliver optimised exercise interventions for people with dementia, or people at risk of developing dementia. This will then be tested in ‘real-life’ research whereby acute bouts of exercise will be assessed for their ability to impact biomarkers of brain health in people at risk of dementia. This project will primarily focus on how exercise orientated RCTs can be implemented to deliver benficial functional and physiological outcomes whilst improving participant adherence. Finally, this project will involve conducting a longitudinal exercise intervention to test the application of the designed framework in a dementia cohort. This will test both the feasibility and clinical application of the proposed framework for delivering optimised exercise interventions in dementia. The findings of this project will inform RCTs that use exercise as the main intervention to maximise the efficacy of exercise in dementia prevention and treatment.

Prof. Sarah Aldred (PI) has a track record of delivering exercise and lifestyle intervention for people at risk of dementia (see MEDEX-UK) and psychosis (see FEPEX) in addition to successful supervision of over 20 PhD students all completed under 4 years. Therefore, SA is uniquely positioned to facilitate the candidate’s progression and development through this PhD project, SA will be the prospective student’s primary supervisor. Dr Richard Elsworthy (CO-I) is a research fellow who will assist in the running of the project on a day-to-day basis. RE has expertise in dementia and has current research funding by ARUK. RE will act as the first point of contact and mentor for the prospective student. Dr Leigh Breen, FHEA, FECSS (CO-supervisor) has been awarded over £2.5million in research funding (BBSRC, Dunhill Medical Trust) to develop exercise and nutritional approached to improve physical performance in health and disease. LB will primarily provide support and advice on delivering exercise sessions.

During the project there will be a significant interaction with people at risk of dementia and ‘healthy’ participants. This interaction will be from recruitment, running focus group discussions to guiding exercise sessions and testing. This project will also involve significant laboratory experience and running of biochemical assays to test the effectiveness of exercise in brain health.

Participant retention during an intervention is key to its success, therefore, it is imperative to minimise possible barriers to exercise. This involves managing the trade-off between prescribing a high volume of exercise for maximal physiological benefits, against poor long-term adherence to the intervention. In the initial phases of the project meetings with focus groups will be used to guide this discussion to identify particular modes and volumes of exercise that are most suitable for the target population. During this time additional data will be collected on the participants perceptions of exercise and a way to reduce risk of dementia in later-life. Prior to this application, the research team have been involved in focus group discussions with people at risk of dementia relating to lifestyle interventions. The aim of these sessions was to identify barriers, perceptions and expectations of exercise trials for the target population.

Essential qualification: A degree in biosciences or related subject.

Desirable qualification: A Masters level qualification or equivalent with some experience working with clinical groups or lifestyle/exercise interventions.

HOW TO APPLY

You are applying for a PhD studentship from the MRC TMRP DTP. A list of potential projects and the application form is available online at:

http://www.methodologyhubs.mrc.ac.uk/about/tmrp-doctoral-training-partnership/

Please complete the form fully. Incomplete forms will not be considered. CVs will not be accepted for this scheme.

Please apply giving details for your first choice project. You can provide details of up to two other TMRP DTP projects you may be interested in at section B of the application form.

Before making an application, applicants should contact the project primary supervisor to find out more about the project and to discuss their interests in the research.

The deadline for applications is 4pm (GMT) 18 February 2022. Late applications will not be considered.

Completed application forms must be returned to: [Email Address Removed]

Informal enquiries may be made to [Email Address Removed]


Funding Notes

Studentships are funded by the Medical Research Council (MRC) for 3 years. Funding will cover tuition fees at the UK rate only, a Research Training and Support Grant (RTSG) and stipend (stipend to include London Weighting where appropriate). We aim to support the most outstanding applicants from outside the UK and are able to offer a limited number of bursaries that will enable full studentships to be awarded to international applicants. These full studentships will only be awarded to exceptional quality candidates, due to the competitive nature of this scheme.
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