Clinical Research Oriented Workshop (CROW) Meeting: Apr 9, 2020

1.                   Warm Up: Campus spirit in the 70s meant something different than today

2.                   Mariana and Nancy: Adult Changes in Thought (ACT)

a.       What does “ACT” really mean here?

                                                   i.      Long term study, including post mortem study of brain tissue

                                                 ii.      Here: short term, survey based review

b.       Overview

                                                   i.      Comparison of physical activity and cognition

1.       What is our population’s exercise related activities (mode, frequency, intensity, duration)

a.       Many types; dichotomized into “physical” and “motor”

                                                                                                                           i.      Physical: repetitive

                                                                                                                         ii.      Motor: high neuromuscular demand

2.       How PA relates to CASI (cognitive abilities screening instrument)

                                                 ii.      Exploratory design based on a lot of descriptive data

1.       E.g. Do those with >1 exercise have higher CASI scores

2.       Overall: what characteristics of exercise are related to higher CASI

                                               iii.      Approach: model development through correlation analysis

1.       Possible questions can range in complexity, e.g. determining the simultaneous effect of many factors on the outcome is very complicated

2.       A simpler and still FINER question tests the dichotomy between physical and motor categories of exercise

c.       Seeking an approach that provides a recommendation for what kind of exercise to do

                                                   i.      Each subject has an array of characteristics (mode, etc.)

1.       Each characteristic is a variable with CI’s and P values

2.       Analysis controls for some characteristics (frequency, intensity) in order to evaluate the others

                                                 ii.      Subjects: 1100 – 1300

1.       Allows for a variety of characteristics

2.       Split on motor/physical and test this theory (this dichotomy) – this keeps the analysis cleaner

                                               iii.      Categorization of exercise

1.       Physical: repetition vs. Motor: ACM “skill related elements”, power and reaction time

2.       This is different from “aerobic” vs “nonaerobic” later in the document; be consistent

                                               iv.      What is the research question:

1.       Test a hypothesis

a.       Does the distinction between physician vs motor have meaning?  Cofounders don’t matter.

b.       If asking why, then confounders matter a lot.

2.       Describe many variables

3.       Case control: which were the best outcomes – but this is for studies where collecting the data is difficult or few for the cases and the controls are plentiful

d.       Review of the survey

                                                   i.      To what degree does the survey identify the dichotomy of physical vs motor

                                                 ii.      The CASI provides many outcomes and the data on exercise provides many variables: need a science theory to help specify a valuable relationship

1.       Initial plan: classify degree of cognitive impairment, but there are no cutoff scores that matter

2.       Consider splitting at median CASI score, resulting in a dichotomous outcome

3.       Consider splitting exercise into “one kind” vs “variety of exercises” – is this FINER?

4.       Consider creating an index of variability of exercise use

e.       Table 5

                                                   i.      Stay away from many categories

3.                   4/30: Open for suggestions

a.       Future topics TBD