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FrailtyMIND&GAITNCT03390478

Promoting Independent Living in Frail Older Adults by Improving Cognition and Gait Ability and Using Assistive Products

A study testing Combined Intervention Group in people with Frailty and Cognition, run by Escola Superior de Enfermagem de Coimbra at 1 site in Portugal.

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

A strategy involving 6 partners was planned, targeting the components of education, innovation, and practice-based research with knowledge transfer into clinical practice.The project MIND\&GAIT aims to promote independent living in frail older people through the development of innovative initiatives and systems to… Read more about this study

Who is it for?
Ages 65 years and older
Conditions the study is for
Frailty, Cognition, Mild Cognitive Impairment
What is being tested?
Combined Intervention Group
Could I receive a placebo?
No, everyone receives an active treatment
How many people
62 participants
Where
1 sitePortugal
Study dates
23 Apr 2018to 22 Oct 2018
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 65 years and older
  • All sexes
  • No healthy volunteers
  • Older adult

Who may be able to join

  • Older adults, age 65 or above;
  • Older adults with the ability to consent in an informed manner their participation in the study;
  • Older adults with clinical conditions that allow them to participate in the combined intervention;
  • Older adults with mild to moderate cognitive frailty criteria as per the 6-CIT scale;
  • Older adults with mild to moderate depressive status as per the Geriatric Depression Scale (15 items version).
  • Older adults that present mild to moderate risk of fall tracked by Tinetti Index;
  • Older adults with physical frailty tracked by the biomechanical gait parameters.

Who cannot join

  • Older adults without a stable clinical condition;
  • Older adults with a cardiac condition that enables them practice of physical activity;
  • Older adults that do not have the desire of participate in the study.

Trial locations and contacts

1 site in 1 country.

Portugal1 site
  • Health Sciences Research Unit: Nursing

    Coimbra, 3000-232

Other trials in Portugal

About this study

Official title: MIND&GAIT - Promoting Independent Living in Frail Older Adults by Improving Cognition and Gait Ability and Using Assistive Products

A strategy involving 6 partners was planned, targeting the components of education, innovation, and practice-based research with knowledge transfer into clinical practice.The project MIND\&GAIT aims to promote independent living in frail older people through the development of innovative initiatives and systems to improve cognition and gait ability. A structured and integrated Combined Intervention (CI) will be developed, composed by: cognitive stimulation program, an animal-assisted therapy program, a physical activity program. Moreover, an auto-blocking mechanism for rolling walkers will be developed and implemented in this study. The results of the study and all the material that was used, will be disseminated in a web platform.

Read the detailed description

In this growing context of aging societies, the number of institutionalized older adults tends to increase. Several reasons lead to the institutionalization of older people, including physical and cognitive decline. In Portugal,in the population aged over 60 years, there was approximately 160,287 people with dementia, which corresponds to 5.91% of the people covered by these age groups. Mild cognitive impairment (MCI) is considered as an intermediate state between normal cognitive ageing and mild dementia, particularly in older people. It is increasingly recognized as a major health problem associated with an increased risk for dementia. Cognitive health maintenance is essential for preventing cognitive impairment and delaying the onset of dementia, dependency, and (in)ability to self-care. In older people with cognitive decline, cognitive stimulation can be a promising intervention for reducing depressive symptoms and depressive vulnerability, improving their quality of life. On the other hand, healthy ageing has traditionally focused on disease prevention, but greater efforts are needed to reduce frailty and dependency, and maintain independent physical and cognitive function among older adults. The aging process associated with a sedentary lifestyle can lead to the decline of some physical capacities. Maintaining functional status and reducing age-related morbidity is an important part of active ageing policies; it promotes independent living, improves the quality of life, and reduces health care costs. In this way exercise programs reduce age-related decline in functional capacity and maintain muscle strength and mass among adults aged 65-85 years.

The research team intend to intervene in the promotion of active ageing, including physical exercise and activities that promote the delay and/or maintenance of the cognitive and physical health of frail older people.

In this way, a randomized controlled trial will be conducted by the research team, composed by two arms: experimental group (CI group) and control group. The aim of this study is to assess the impact of the CI program on frail older people. The evaluation of the effectiveness of the Combined Intervention will have the following methodology:

  • Sample Test: For sample size calculation it was used the software G*Power 3.1.9.2. Power analysis was based on a type I error of 0.05; power of 0.80; effect size f=0.30; and ANOVA: repeated measures between factors determined a total sample size of 62.Participants with more than 65 or more years will be recruited from two homes for the aged. Participants will be randomly distributed in groups of 8, in the control group and in the experimental group. Participants will be classified as having mild to moderate cognitive decline and risk of fall from mild to moderate. The control group will receive usual care.

-Intervention: The combined intervention will be implemented over 21 weeks, 4 times a week. Cognitive Stimulation Program (CSP) will be applied once a week and Physical Activity Program (PAP) 3 times a week for 30-60 min. Participants using rolling walkers will benefit from the autoblocking kit mechanism for rolling walkers mechanism (ABMRW) during the execution of the PAP.

-Data analysis: Statistical analysis will be performed through repeated meaures and ANOVA. Age, gender, and initial scores of depression and Activities of Daily Living (ADLs) will be introduced as covariates. Intention-to-treat analysis will be done to analyze the data of the people who left the study.

Being tested
Combined Intervention Group
Keywords
Frailty, Aged, Cognitive Stimulation, Technology
Medical subject headings
Frailty, Cognitive Dysfunction

What participants receive

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

  • Combined Intervention GroupOther

    Experimental: Combined Intervention Program is composed by a Cognitive Stimulation Program (CSP), a Physical Activity Program (PAP) and Animal Assisted Therapy (AAT). During the PAP participants that use rolling-walkers, will do PAP using the Auto-Blocking kit mechanism for rolling walkers (ABMRW).

Study groups in NCT03390478
Study groupRoleWhat they receive
Control GroupNo interventionThe participants that will be assign to the control group will receive institutional usual care.
Combined Intervention GroupExperimentalThe participants that will be assigned to the experimental group will receive the Combined Intervention Program
Receives: Other: Combined Intervention Group

What is being measured

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

  1. Change from Baseline in the participant's Cognition

    Outcome measure: "Montreal Cognitive Assessment (MoCA)" - Portuguese version of Freitas, S., Simões, M. R., Santana, I., Martins, C. \& Nasreddine, Z. (2013).

    Measured: Intermediate assessment (week 12)

  2. Change from Baseline in the participant's Cognition

    Outcome measure: "Montreal Cognitive Assessment (MoCA)" - Portuguese version of Freitas, S., Simões, M. R., Santana, I., Martins, C. \& Nasreddine, Z. (2013).

    Measured: Post-intervention assessment (week 21)

  3. Change from Baseline in the participant's Physical Frailty

    Outcome measure: "Gait B" with a stopwatch that will be adapted to the specific context. It will also be measure biomechanical parameters of gait using the Novel EMED-X pressure platform. The fall risk it will be measure with "Tinetti Index", original version of Tinetti, Wiliams and Mayewski (1986), translated and adapted to portuguese by Elisa Petiz (2001).

    Measured: Intermediate assessment (week 12)

  4. Change from Baseline in the participant's Physical Frailty

    Outcome measure: "Gait B" with a stopwatch that will be adapted to the specific context. It will also be measure biomechanical parameters of gait using the Novel EMED-X pressure platform. The fall risk it will be measure with "Tinetti Index", original version of Tinetti, Wiliams and Mayewski (1986), translated and adapted to portuguese by Elisa Petiz (2001).

    Measured: Post-intervention assessment (week 21)

Secondary outcomes (2)
  1. Change from Baseline in the participant's Activities of Daily Living

    Outcome measure: "Barthel ADL Index - Portuguese version"

    Measured: Intermediate assessment (week 12)

  2. Change from Baseline in the participant's Activities of Daily Living

    Outcome measure: "Barthel ADL Index - Portuguese version"

    Measured: Post-intervention assessment (week 21)

Timeline

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

  1. First posted4 Jan 2018
  2. Study start23 Apr 2018
  3. Primary completion23 May 2018
  4. Study completion22 Oct 2018

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
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants will be assigned in two groups, a control group who will receive institutional usual care and an experimental group who will receive the combined intervention.
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
62 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03390478
Sponsor's protocol ID
CT_MIND&GAIT
Acronym
MIND&GAIT
Status last verified
Jan 2020
First submitted
29 Dec 2017
Last updated
30 Jan 2020
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Bradley SM, Hernandez CR. Geriatric assistive devices. Am Fam Physician. 2011 Aug 15;84(4):405-11.

    PubMed 21842786
  • Peretz C, Korczyn AD, Shatil E, Aharonson V, Birnboim S, Giladi N. Computer-based, personalized cognitive training versus classical computer games: a randomized double-blind prospective trial of cognitive stimulation. Neuroepidemiology. 2011;36(2):91-9. doi: 10.1159/000323950. Epub 2011 Feb 10.

    PubMed 21311196
  • Tinetti ME, Williams TF, Mayewski R. Fall risk index for elderly patients based on number of chronic disabilities. Am J Med. 1986 Mar;80(3):429-34. doi: 10.1016/0002-9343(86)90717-5.

    PubMed 3953620
  • Reeves ND, Narici MV, Maganaris CN. Musculoskeletal adaptations to resistance training in old age. Man Ther. 2006 Aug;11(3):192-6. doi: 10.1016/j.math.2006.04.004. Epub 2006 Jun 19.

    PubMed 16782393
  • Skelton DA, Beyer N. Exercise and injury prevention in older people. Scand J Med Sci Sports. 2003 Feb;13(1):77-85. doi: 10.1034/j.1600-0838.2003.00300.x.

    PubMed 12535321
  • Narici MV, Maganaris CN, Reeves ND, Capodaglio P. Effect of aging on human muscle architecture. J Appl Physiol (1985). 2003 Dec;95(6):2229-34. doi: 10.1152/japplphysiol.00433.2003. Epub 2003 Jul 3.

    PubMed 12844499
  • Narici MV, Maffulli N. Sarcopenia: characteristics, mechanisms and functional significance. Br Med Bull. 2010;95:139-59. doi: 10.1093/bmb/ldq008. Epub 2010 Mar 2.

    PubMed 20200012
  • Macaluso A, De Vito G. Muscle strength, power and adaptations to resistance training in older people. Eur J Appl Physiol. 2004 Apr;91(4):450-72. doi: 10.1007/s00421-003-0991-3. Epub 2003 Nov 25.

    PubMed 14639481
  • Puthoff ML, Nielsen DH. Relationships among impairments in lower-extremity strength and power, functional limitations, and disability in older adults. Phys Ther. 2007 Oct;87(10):1334-47. doi: 10.2522/ptj.20060176. Epub 2007 Aug 7.

    PubMed 17684086
  • Skelton DA. Effects of physical activity on postural stability. Age Ageing. 2001 Nov;30 Suppl 4:33-9. doi: 10.1093/ageing/30.suppl_4.33. No abstract available.

    PubMed 11769787
  • Paiva, Diana S; Apóstolo, João L. A. 2015. Estudo de adaptação transcultural e validação do Six Item Cognitive Impairment Test . In J. Apóstolo & M. Almeida (Eds). Elderly Health Care Nursing. Monographic Series - Health Sciences Education and Research, 3 - 18. ISBN: 978-989-99426-1-5. Coimbra: Unidade de Investigação em Ciências da Saúde: Enfermagem (UICISA: E) ESEnfC.

  • Guideline for the prevention of falls in older persons. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. J Am Geriatr Soc. 2001 May;49(5):664-72. No abstract available.

    PubMed 11380764
  • Carter ND, Kannus P, Khan KM. Exercise in the prevention of falls in older people: a systematic literature review examining the rationale and the evidence. Sports Med. 2001;31(6):427-38. doi: 10.2165/00007256-200131060-00003.

    PubMed 11394562
  • Bandeira, M. L., Azevedo, A. B., Gomes, C. S., Tomé, L. P., Mendes, M. F., Baptista, M. I., & Moreira, M. J. (2014). Dinâmicas demográficas e envelhecimento da população portuguesa( 1950-2011): evolução e perspetivas. Lisboa: Francisco Manuel dos Santos.

  • Santana I, Farinha F, Freitas S, Rodrigues V, Carvalho A. [The Epidemiology of Dementia and Alzheimer Disease in Portugal: Estimations of Prevalence and Treatment-Costs]. Acta Med Port. 2015 Mar-Apr;28(2):182-8. Epub 2015 May 29. Portuguese.

    PubMed 26061508

Questions about this trial

What is this clinical trial studying?

A study testing Combined Intervention Group in people with Frailty and Cognition, run by Escola Superior de Enfermagem de Coimbra at 1 site in Portugal.

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 7 inclusion and 3 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 30 Jan 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Portugal. 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 from Baseline in the participant's Cognition (time frame: Intermediate assessment (week 12)). 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 NCT03390478, which also lists 48 linked publications.

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 30 Jan 2020.

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