Reducing African American's Alzheimer's Risk Through Exercise-Mild Cognitive Impairment (RAATE-MCI)

Inclusion criteria

• are African American (self-identify)
• are 60 and older
• are physically capable of exercise
• are willing to accept randomization
• are willing to attend group sessions
• plan to live in the study area over the next 13 months and capable of traveling to designated study facility for clinic visits and intervention sessions for the next year
• are free of conditions (e.g. uncontrolled asthma, severe sickle cell disease, etc.) that would make regular exercise unsafe as deemed by the medical investigator
• have not engaged in regular physical activity
• have a Short Physical Performance Battery ≥4
• physically capable of exercise
• are unable to utilize devices and/or applications as required for study participation
• willing to attend group sessions
• willing to allow researchers to use data for research purposes after study participation is completed
• meet criteria for MCI as defined by the NIA-AA research framework a. cognitive performance below normal range (score \< 1.5 SDs below the mean on NIH Toolbox scores for their age and sex on at least one of the subtests)

Exclusion criteria

• have cognitive impairment that would interfere with participating in a group discussion
• a. cognitive performance in the demented range (score \< 3 SDs below the mean on NIH Toolbox scores for their age and sex on at least one of the subtests)
• meet criteria for dementia
• are unwilling to give written informed consent or accept randomization in either study group
• are too active (as defined by ≥10 min bouts of MVPA as measured by Actigraph) if:
• Sum of MVPA bouts for the 7 day wear period ≥40 mins
• Or ≤40 mins of MVPA 10min bouts AND ≥3 days of bouts
• have uncontrolled hypertension (systolic blood pressure \> 150 mmHg and/or diastolic blood pressure \> 90 mmHg).
• have had a myocardial infarction, major heart surgery (i.e., valve replacement or bypass surgery), stroke, deep vein thrombosis, pulmonary embolus, hip fracture, hip or knee replacement, or spinal surgery in the past 6 months
• are undergoing cardiopulmonary rehabilitation
• have uncontrolled diabetes that in the judgment of the MI may interfere with study participation
• have clinically diagnosed osteoporosis that in the judgment of the MI may interfere with study participation
• are currently enrolled in another randomized trial involving lifestyle or pharmaceutical interventions
• have another member of the household that is a participant in RAATE or RAATE MCI
• refuse to participate in the study without disclosure of their amyloid PET scan results
• refuse to allow anonymized versions of their study data for research after this study is completed.
• have other medical, psychiatric, or behavioral factors that in the judgment of the Principal or Medical Investigator may interfere with study participation or the ability to follow the intervention protocol