# Water-based Activity to Enhance Recall in Veterans: A Randomized Clinical Trial

> **NIH VA I01** · VETERANS ADMIN PALO ALTO HEALTH CARE SYS · 2020 · —

## Abstract

The primary research question of the proposed study is this: Is a water-based exercise plus cognitive
training intervention efficacious in improving cognitive outcomes for Veterans with Mild Cognitive
Impairment (MCI)? We address the need to improve cognitive function in this vulnerable population through
a novel combined training program that will combine two interventions: water-based exercise and cognitive
training. The proposed four-year randomized controlled trial will compare water-based exercise + cognitive
training (WATER+CT) to a Usual Care Control Condition (UC). The primary aim of the proposed research
is to evaluate the efficacy of WATER+CT to improve cognitive function in Veterans with MCI. Secondary
aims of the proposed research are: 1) to evaluate the efficacy of WATER+CT to improve peak oxygen
consumption and 2) to evaluate the durability of the cognitive benefits derived from WATER+CT.
Exploratory aims of the proposed research are to evaluate moderators and mediators of treatment
response.
These aims will be tested in a single-blind randomized controlled trial that will compare the efficacy of
WATER+CT to UC. This trial will include 190 Veterans meeting criteria for MCI age 50-90 with half
randomized to WATER+CT and half randomized to UC. For the WATER+CT condition, the exercise
training (i.e., WATER) consists of a six-month long individualized exercise program of water-based
exercises. During this phase, Veterans will come to thrice-weekly group sessions at Aquatic Therapy
Center at the VA Palo Alto Health Care System (VAPAHCS). After completion of the exercise program,
Veterans will begin classroom-based cognitive training at the VAPAHCS for up to two months. The CT is
based on an efficacious training program that is structured around two components, pre-training and
mnemonic training, both of which have been used successfully in persons with MCI. Veterans randomized
to the UC control condition will receive educational materials about brain health in addition to their usual
care, which is the care they would typically receive in the VA. After completion of the active treatment
phase, Veterans will transition to the six-month long follow-up phase. At the end of the six-month long
follow-up phase, participants will return to the VA for a final follow-up visit.
Participants will complete a variety of neuropsychological measures taping into areas of cognition such as
attention, executive functioning, and memory. Participants will also undergo physical fitness assessments
including a 6-minute walk test and an exercise treadmill test. To study possible predictors of response to
treatment, we will also collect biological (cardiovascular functioning and BDNF plasma levels) and genetic
data (APOE and BDNF genotypes) from these participants. We hope to provide evidence of the efficacy of
an exercise training augmentation for cognitive training thus laying the groundwork for future VA health care
system wide deployment of a lifestyle inte...

## Key facts

- **NIH application ID:** 9952843
- **Project number:** 1I01RX003143-01A2
- **Recipient organization:** VETERANS ADMIN PALO ALTO HEALTH CARE SYS
- **Principal Investigator:** Jennifer Kaci Fairchild
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2020-07-01 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9952843

## Citation

> US National Institutes of Health, RePORTER application 9952843, Water-based Activity to Enhance Recall in Veterans: A Randomized Clinical Trial (1I01RX003143-01A2). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9952843. Licensed CC0.

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