ABOUT THE ASSESSMENTS

WHAT IS THE WALKING TREADMILL TEST?
We will assess your heart function using a walking treadmill test and electrocardiogram (EKG).  For the EKG, you will lie on a table and we will put small sticky metal discs on you. Your heart activity will be monitored by EKG throughout the stress test. You will begin walking on the treadmill at a moderate pace. The incline will slowly increase and become more difficult. Your heart will beat faster and your breathing will become heavier; this is normal. You should continue on the treadmill for as long as you are able. At that point, the test will be complete. During the test, we will record your heart rate and blood pressure. If you feel dizzy or breathless, or if you want to stop the test for any reason, you may do so immediately. All parts of this procedure will take about 30 minutes to complete.


WHAT IS THE ORAL GLUCOSE TOLERANCE TEST (fsOGTT)?
 For the oral glucose tolerance test, you will be given a sweet drink to see how your body handles extra sugar. On the night before this test, you will be asked not to eat or drink anything except water for 10-12 hours before your test is scheduled to begin. In the morning, you will come to UCSD where we will measure your height and weight and then have you sit in a hospital bed or reclining chair. A small catheter (a plastic tube, also called an IV) will be inserted into a vein of your hand, wrist or bend of your arm. This feels like getting a shot.

Once the IV catheter is in your vein, it does not hurt. We will use the catheter to get blood samples during the study. We will draw approximately 104cc (7-8 tablespoons) of blood during the baseline visit and 91cc (6-7 tablespoons) at your 6 month and 18 month visits. You will then drink a very sweet drink. Blood samples will be taken from the catheter in your hand or wrist or arm at different times during the study. This will be done to check sugar levels in your blood along with some other routine blood tests. You will complete other study related assessments during this test, including interview questions about your ability to solve problems related to everyday tasks. After the fsOGTT, you will be given a meal.


WHY ARE YOU COLLECTING DNA BLOOD SAMPLES?
As part of the process of taking blood samples using the IV catheter, we will collect a blood sample from you to be used for genetic analysis. “Genetic analysis” means that we will test whether your genes (your biology that you inherited from your parents) are associated with emotions and cognition. These genetic samples will be kept after the end of this study. You may request to have it destroyed at any time. The results of the genetic analysis will not be provided to you or placed in your medical record. Your samples will have a code number on them instead of your name. This way, the results of this genetic analysis remain private.


WHY ARE YOU COLLECTING SALIVA SAMPLES?
We will ask you to provide saliva samples to look at levels of cortisol, a stress hormone. We will show you how to collect samples of your saliva at home. We will send you home with kits to use and return on your next visit. The kit will include pieces of cotton to put in your mouth and plastic containers that are labeled with the time that you are to collect your sample. You will be asked to collect your saliva 3 times a day (waking, 30 minutes later, and at bedtime) for 3 days at home. We will ask you to do this at the beginning, after you have participated in the study for 6 months, and again at the end of the study.


WHAT IS MAGNETIC RESONANCE IMAGING (MRI)?
The Magnetic Resonance Imaging (MRI) scanner is a powerful magnet that uses simple radio waves to take pictures of your brain. There is no pain associated with this procedure. You will be asked to lie on your back on the scanner bed and made to feel as comfortable as possible. The scanner bed will be moved inside a large tube so that your head and your chest are inside, but you will be able to see out into the room by your feet. During the scan, you will hear loud, rhythmic knocking sounds. Your ears will be covered to keep the noise at a minimum. There is a speaker and a microphone in the scanner so that you can talk to the MRI technician if there is something you need. Once the scan starts, you will need to lie still since moving around will interfere with taking pictures of your brain. You will be able to end the scan at any time if you feel uncomfortable. You may be asked to do a task while in the scanner. The MRI will take about 1 hour to complete.


WHAT IS DEXA?

You will have a dual-energy x-ray absorptiometry (DEXA) scan. This will be done to measure your body fat, body muscle content, and bone mineral density of the bones in your hip. You will lie still on a table in your regular clothes or a hospital gown. Your body will be scanned by a machine for about 7-10 minutes. You will not be able to feel the DEXA machine scanning.


WHAT ARE THE MEMORY AND ATTENTION ASSESSMENTS?
We will assess memory and problem solving abilities with paper and pencil, and computerized measures. We will ask you to sit at a computer where different images will be presented on the screen. These could be numbers, letters, words, sentences, or pictures (faces, parts of the body, locations, and tools). You will be asked to respond by pressing a button, reading aloud what you see on the screen, or picking from among a group of answers. You will do these tests at the baseline visit, after 3 months, 6 months, and at the end of the study.


WHAT ARE THE BEHAVIORAL SURVEYS?

You will be asked to complete self-report surveys regarding your emotions, cognition, and sleep on a computer and using paper and pencil tests at baseline, and after 3 months, 6 months, and at the end of the study.


WHERE WILL I HAVE TO GO?
You will be asked to come to the UC San Diego campus in La Jolla for testing and assessments. The MBSR group as well as the Health Education group will be held at the UC San Diego Center for Mindfulness in University City. The Exercise group will be held at either the Mission Valley YMCA or the Toby Wells YMCA in Kearny Mesa.