LatAm-FINGERS Initiative for Cognitive Change

Prior treatment

• Use of psychoactive medications within the past 3 months, including tricyclic antidepressants, antipsychotics, psychotropic mood-stabilizing agents (e.g., lithium salts), psychostimulants, opioid analgesics, antiparkinsonian medications, anticonvulsant medications (except gabapentin and pregabalin for non-convulsant indications), systemic corticosteroids, or medications with significant central anticholinergic activity; in the absence of major depression, stable doses of selective serotonin reuptake inhibitors or serotonin and norepinephrine reuptake inhibitors are permitted.

Other illness

• Dementia
• Any medical condition that affects the participant's safety.
• Significant neurological disease, including dementia, cognitive impairment, Parkinson's disease, Huntington's disease, normal pressure hydrocephalus, brain tumor, progressive supranuclear palsy, seizure disorder, subdural hematoma, multiple sclerosis or history of significant head injury with persistent neurological sequelae or structural brain abnormalities, major depressive disorder within the last 2 months, history of bipolar disorder or schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders V (DSM V) criteria.
• Cerebral vascular disease in the last 2 years.
• Insulin-dependent diabetes mellitus.
• Pulmonary disease requiring oxygen and/or steroids.
• History within the last 2 years of treatment for primary or recurrent malignant disease.
• History of hip fracture, knee replacement, or spinal surgery within the last 6 months.
• History of bariatric surgery.
• Cardiac surgery in the last year.
• History of alcoholism or substance abuse in the last 2 years, according to DSM V criteria.

Lab values

• Severe cardiovascular disease, including heart failure, clinically significant aortic stenosis, history of uncontrolled acute myocardial infarction (AMI) or angina and Cardiac rhythm disorders: g3 conduction block, uncontrolled arrhythmia, alterations in Q wave, S waver and T wave segment or QT segment and auricular fibrillation (AF) of less than one year of evolution, venous thrombosis or pulmonary thromboembolism (PTE) of less than 6 months of evolution and any pathology that in clinical judgment compromises the intervention of physical activity.
• Renal disease defined as increased renal glomerular filtration rate \<60ml/min/1.73mt2 or albumin excretion rate (AER) \> 30mg/24 hrs.
• Clinically significant laboratory abnormalities as judged by the investigator.

Other

• MMSE \< 20
• Severe osteoarticular problems that preclude the implementation of the physical activity intervention outlined in the protocol, such as, for example: osteoarthrosis of the knee(s), coxofemoral, or other.
• Body Mass Index \>40
• Being in cardiopulmonary rehabilitation.
• Severe sensory loss or loss of communication skills.
• No schooling.
• Active participation in another intervention study.

• Age: 60-77 years.
• Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) Risk Score \> 6.
• Mini-Mental State Examination (MMSE) z score between 0 and -1.5 OR
• CERAD Word List Learning Task (10 word x 3 repetitions) \< 0 z score OR
• CERAD (delayed word list recall) \< z score \< 0