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Mild Cognitive ImpairmentNCT02512627

Evolving Methods to Combine Cognitive and Physical Training for Individuals With Mild Cognitive Impairment

A study testing Cognitive training and Physical exercise in people with Mild Cognitive Impairment, run by Chang Gung Memorial Hospital at 9 sites in Taiwan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study aims to investigate and compare the intervention effects of combining exercise and cognitive training (either sequentially or simultaneously in a dual-task paradigm) in elderly with mild cognitive impairment. Read more about this study

Who is it for?
Ages 20 years and olderHealthy volunteers can take part
Conditions the study is for
Mild Cognitive Impairment
What is being tested?
Cognitive training and Physical exercise
Could I receive a placebo?
No, everyone receives an active treatment
How many people
55 participants
Where
9 sitesTaiwan
Study dates
30 Jan 2015to 13 Mar 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 20 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • able to follow instruction,
  • clinical dementia rating (CDR) = 0.5 or 1,
  • self- or informant-reported memory or cognitive complaint, and
  • able to perform activities of daily living (Barthel Index ≥ 70).

Who cannot join

  • recent myocardial infarction,
  • heart failure,
  • recent heart surgery,
  • severe asthma,
  • concomitant with other neurological disorders, or
  • joint deformity that might prevents them performing exercise or cognitive training.

Trial locations and contacts

9 sites in 1 country.

9 sites in 1 country

Taiwan9 sites
  • Baliexcelsior Nursing Home

    New Taipei City, 249

  • Pine nursing home

    Taichung, 412

  • Zhishan community home

    Taipei, 11150

  • Bailing clinics and nursing homes

    Taipei, 11165

  • Shihlin cum day care center

    Taipei, 111

  • Xihu day care center

    Taipei, 11443

  • TaoSheng Nursing home

    Taipei

  • Chang Gung Memorial Hospital

    Taoyuan, 333

  • Chang Gung Memorial Hospital Taoyuan Branch

    Taoyuan

Other trials in Taiwan

About this study

Official title: Evolving Methods to Combine Cognitive and Physical Training for Individuals With Mild Cognitive Impairment: An Efficacy Study

This study aims to investigate and compare the intervention effects of combining exercise and cognitive training (either sequentially or simultaneously in a dual-task paradigm) in elderly with mild cognitive impairment. The investigators hypothesize that (1) both sequential and dual-task training can induce greater improvements in the outcome measures than single mode of training; (2) the improvement in cognitive functions and other outcomes may differ between the groups.

Read the detailed description

Background and study aims:

Mild cognitive impairment (MCI) or minor neurocognitive disorder is a syndrome defined as an intermediate stage between cognitively intact and clinically diagnosed dementia. The age-adjusted prevalence of MCI in Taiwan is approximately 18%, while women have higher prevalence for MCI than men. The progression rate from MCI to dementia ranges from 10 to 15% each year, and over 50% of the MCI population will develop into severe cognitive impairment or dementia in 5 years. Therefore, early detection of the individuals who manifest MCI and provide appropriate interventions may help reduce the burden of their caregivers and the medical expenses of the health-care system. Previous studies found that cognitive training or exercise has emerged as an important therapeutic approach for individuals with MCI. However, the intervention effects of combining exercise and cognitive training remain to be determined. Furthermore, whether exercise and cognitive training should be administered in sequential order or simultaneously is an important question to pursue. The overall goal of this study is to determine and compare the intervention effects cognitive training, exercise, and combining cognitive and exercise training in individuals with MCI.

Who can participate? Individuals with MCI.

What does the study involve? The participants will receive a total of 36 training sessions, and each session will contain 90 minutes of training. Training frequency will be 2-3 times per week for 12-18 weeks. All participants will received pretreatment test, post treatment test, and a 6-month follow-up test.

What are the possible benefits and risks of participating? The possible benefits include improvement in cognitive, physical, and daily functions. There are no risks for participating.

Where to conduct the study? The investigators anticipate recruiting a total of 80 participants from geriatric day care centers and nursing homes from multiple cities in Taiwan.

Being tested
Cognitive training, Physical exercise
Keywords
mild cognitive impairment, exercise, cognitive training
Medical subject headings
Cognitive Dysfunction, Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Cognitive trainingBehavioural

    visuospatial, attention, memory, and executive abilities

  • Physical exerciseBehavioural

    endurance, balance, and mobility

Study groups in NCT02512627
Study groupRoleWhat they receive
Cognitive training group (Cog)Active comparatorThe BrainHQ program will be used to train different cognitive functions of the participants. The participants will practice tasks that involve the abilities of visuospatial processing, attention, memory, language, and/or executive functions. The tasks will become more difficult as the participants progress in their abilities.
Receives: Behavioral: Cognitive training
Physical exercise group (PE)Active comparatorThe participants in this group participate in multimodal exercise programs including aerobic exercise, balance, and strength training. The entire exercise program for the PE group will contain 10 minutes of warm-up, 70 minutes of physical exercise, and 10 minutes of cool-down. The 70 minutes of exercise session will be break up into 2 to 3 parts, and the participants can rest as needed during the exercise period.
Receives: Behavioral: Physical exercise
Sequential training group (Seq)ExperimentalThe participants in this group will first perform 45 minutes of physical exercise followed by 45 minutes of cognitive training. The physical exercise training will be similar to the programs used in the PE group. The entire exercise program for the PE group will contain 5 minutes of warm-up, 35 minutes of physical exercise, and 5 minutes of cool-down. The cognitive training will be implemented with BrainHQ similar to what has been described in the COG group.
Receives: Behavioral: Cognitive training; Behavioral: Physical exercise
Dual-task training group (Dual)ExperimentalIn this group, the participants will be instructed to perform physical exercise and cognitive tasks simultaneously (e.g., math calculation while stepping). The difficulty of the cognitive tasks will increase as the participants improve in their performance.
Receives: Behavioral: Cognitive training; Behavioral: Physical exercise

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change scores of Montreal Cognitive Assessment (MoCA)

    The MoCA will be used to assess general cognitive functions. It examines several cognitive domains with a total score of 30.

    Measured: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)

  2. Change scores of Stroop test

    The Stroop test will be used to assess the processing speed, inhibition, set-shifting, and selective attention abilities. The participants will be tested under 2 conditions: congruent and incongruent conditions. In the congruent condition, the color ink of a word is consistent with the written color name; while the color ink differs from the written color name under the incongruent condition.

    Measured: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)

  3. Change scores of Dual-task test

    The dual-task tests will be assessed to determine the ability for an individual to perform 2 tasks simultaneously. The investigators will assess the dual-task performance during walking and performing box and block test. The results of the dual-task tests will provide information regarding to whether the 2 tasks compete for the same class of neural resources or one of the tasks can be carried out automatically.

    Measured: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)

  4. Change scores of Timed up and go (TUG) test

    The TUG test will be used to assess the mobility and dynamic balance ability. The participants will be required to stand up from a chair, walk 3 meters, turn around, then walk back to the chair, and sit down. The time to complete the TUG test has been shown to be a good indicator to detect potential fallers and frail elderly (Podsiadlo \& Richardson, 1991). The test-retest reliability of TUG on individuals with cognitive impairment was excellent (Blankevoort, van Heuvelen, \& Scherder, 2013).

    Measured: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)

Secondary outcomes (17)
  1. Change scores of the Verbal Fluency Test

    Verbal fluency tests will be used to evaluate the semantic memory of the participants. The participants will be instructed to say as many words as possible from a given category (i.e., fruit or animal) in 1 minute. The validity, reliability, and normative performance of verbal fluency tests have been well-established (Harrison, Buxton, Husain, \& Wise, 2000).

    Measured: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)

  2. Change scores of the Useful Field of View (UFOV)

    Useful field of view (UFOV) is the visual area over which useful information could be obtained at a quick glance without eye or head movements. This UFOV will be assessed with the BrainHQ program. The UFOV will assess the abilities of visuomotor processing speed, divided attention, and selective attention (Ball, Edwards, \& Ross, 2007).

    Measured: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)

  3. Change scores of the 30 second chair stand test (CST)

    The 30 second chair stand test (CST) will be assessed to indicate the strength and endurance level of the lower extremities. The participants will be asked to stand up from a standardized chair and then sit down as many times as possible within 30 seconds. The feasibility and reliability of using CST in people with cognitive impairment have been established to be good (Blankevoort et al., 2013).

    Measured: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)

  4. Change scores of the Chinese version of the International Physical Activity Questionnaires (IPAQ)

    The Chinese version of the International Physical Activity Questionnaires (IPAQ) is an international measure for health-related physical activity. A short form of IPAQ will be used to assess changes in physical activity before and after intervention in this study. The reliability and validity of IPAQ has been established across 12 countries (Craig et al., 2003).

    Measured: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)

  5. Change scores of the Barthel Index (BI)

    Assess activities of daily living

    Measured: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)

  6. Change scores of the Lawton Instrumental Activities of Daily Living Scale

    Assess activities of daily living.

    Measured: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)

  7. Change scores of the Disability Assessment for Dementia (DAD)

    Assess activities of daily living.

    Measured: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)

  8. Change scores of the Quality of Life in Alzheimer's Disease Instrument (QoLAD)

    The Chinese version of QoLAD will be used.

    Measured: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)

  9. Change scores of the Caregiver Burden Inventory (CBI)

    The Chinese version of CBI will be used.

    Measured: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)

  10. Change scores of the Geriatric Depression Scale (GDS)

    The Chinese version of short form GDS will be used.

    Measured: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)

  11. Change scores of the Community Integration Questionnaire (CIQ)

    The CIQ measures items relevant to home integration, social integration, and productive activities.

    Measured: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)

  12. Change scores of the ActiGraph GX3 accelerometers Change scores of the ActiGraph

    The actigraphy will be placed on the waist for a 3-day period immediately before and after the intervention. The participants will wear the actigraphy during all daily activities except for those that involve water (i.e., showering or swimming).

    Measured: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)

  13. Change scores of evaluating isometric knee flexors and extensors muscle strength

    The participant will be seated upright in a chair with back support, the knee will be placed in 90-degree flexion and the evaluator will stabilize the thing to eliminate synergistic movements. Participants will be asked to perform a maximal isometric contraction of knee flexion and extension with both lower extremities. The investigators will record the mean value of 3 attempts.

    Measured: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)

  14. Change scores of using hand dynamometer to measure grip strength of both hand

    The participant is seated, with the elbow at 90-degree flexion. The investigators will record the mean value of 3 attempts.

    Measured: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)

  15. Change scores of Wechsler Memory Scale - Third Edition (WMS-III)

    The investigators will use the WMS-III subtests, including Faces Recognition (score range 0-48), Verbal Paired Associates (score range 0-32), Word Lists (0-48), and Spatial Span (0-32) to assess the immediate, delayed, and working memory tests. Higher scores indicated better performance for each subtest. The raw score of each subtest will also be transferred to standardized Z scores and summed to represent an index of general memory function.

    Measured: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)

  16. Change scores of Wechsler Adult Intelligence Scale - Third Edition (WAIS-III)

    The WAIS-III includes tests that evaluate cognitive functions in verbal comprehension, working memory, perceptual organization, and processing speed. The subtests that the investigators will use are the Digit Symbol-Coding (scores range 0-133) and Matrix Reasoning tests (0-26). The raw score of each subtest will also be transferred to standardized Z scores and summed to represent an index of general cognitive function.

    Measured: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)

  17. BDNF val66met genotype

    Saliva samples will be collected at baseline to determine the Brain-Derived Neurotrophic Factor (BDNF) val66met genotype.

    Measured: baseline

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted31 Jul 2015 (estimated)
  2. Study start30 Jan 2015
  3. Primary completion29 Jan 2018
  4. Study completion13 Mar 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
55 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02512627
Sponsor's protocol ID
103-6651A3
Status last verified
May 2019
First submitted
20 Jul 2015
Last updated
12 Jul 2019
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Lee YY, Wu CY, Teng CH, Hsu WC, Chang KC, Chen P. Evolving methods to combine cognitive and physical training for individuals with mild cognitive impairment: study protocol for a randomized controlled study. Trials. 2016 Oct 28;17(1):526. doi: 10.1186/s13063-016-1650-4.

    PubMed 27793183

Questions about this trial

What is this clinical trial studying?

A study testing Cognitive training and Physical exercise in people with Mild Cognitive Impairment, run by Chang Gung Memorial Hospital at 9 sites in Taiwan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Jul 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in Taiwan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change scores of Montreal Cognitive Assessment (MoCA) (time frame: baseline, posttest (an expected average of 3 months), follow-up (up to 9 months)). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02512627, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Jul 2019.

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