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Cognitive ImpairmentNCT04465812

The Impact of a Smartphone-based Personalized Intervention on Cognitive and Cerebrovascular Health in CIRCLE-CHINA

A study testing Self-monitoring and personalized feedback on smartphone app in people with Cognitive Impairment and Stroke, run by Second Affiliated Hospital, Zhejiang University, School of Medicine at 1 site in China.

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 smartphone-based personalized multiple intervention study aims to prevent cognitive impairment and reduce dementia and cerebrovascular events in 45-74 year old persons with high risk of stroke in China. Read more about this study

Who is it for?
Ages 45 to 74 yearsHealthy volunteers can take part
Conditions the study is for
Cognitive Impairment, Stroke, Dementia
What is being tested?
Self-monitoring and personalized feedback on smartphone app
Could I receive a placebo?
No, everyone receives an active treatment
How many people
238 participants
Where
1 siteChina
Study dates
21 Jul 2020to 31 May 2025
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 45 to 74 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • aged 45-74 years
  • high risk of stroke (with ≥ 3 of 8 stroke risk factors, including hypertension, dyslipidemia, diabetes, atrial fibrillation or valvular heart disease, smoking history, obvious overweight or obesity, lack of exercise, family history of stroke, or with transient ischemic attack)

Who cannot join

  • previously diagnosed dementia
  • previously diagnosed stroke (both cerebral infarction and hemorrhage)
  • suspected dementia after clinical assessment by study physician at screening visit
  • disorders affecting safe engagement in the intervention (eg, malignant disease, major depression, symptomatic cardiovascular disease, revascularisation within 1 year previously)
  • severe loss of vision, hearing, or communicative ability;
  • disorders preventing cooperation as judged by the study physician
  • coincident participation in another intervention trial
  • any MRI contraindications

Trial locations and contacts

1 site in 1 country.

China1 site
  • Second Affilated Hospital of Zhejiang University, School of Medicine

    Hangzhou, Zhejiang, 310009

Other trials in China

About this study

Official title: The Impact of a Smartphone-based Self-monitoring and Personalized Feedback Multiple Intervention on Cognitive and Cerebrovascular Health in CIRCLE-CHINA

This smartphone-based personalized multiple intervention study aims to prevent cognitive impairment and reduce dementia and cerebrovascular events in 45-74 year old persons with high risk of stroke in China. The investigators plan to monitor and manage participants' behavioral and health (vascular risk factors control, sleep quality, mental health and cognitive training) based on self-monitoring and personalized feedback via smartphone app. The short-term primary outcome is 1-year change in global cognitive score measured by a modified National Institute of Neurological Disorders and Stroke and Canadian Stroke Network-Canadian Stroke Network protocol. The investigators hypothesize that the intervention based on self-monitoring and personalized feedback will prevent cognitive decline by the initial 1-year intervention. The long-term primary outcome is the development of dementia and cerebrovascular events during a total of 5 years' follow-up. The investigators hypothesize that the smartphone-based personalized multiple intervention may reduce the 5-year risk of dementia and cerebrovascular events, mainly through the improvement in vascular risk factors control, sleep quality, mental health and cognitive training activities.

Read the detailed description

Patients with ≥ 3 stroke risk factors (including hypertension, dyslipidemia, diabetes, atrial fibrillation or valvular heart disease, smoking history, obvious overweight or obesity, lack of exercise, family history of stroke), or with transient ischemic attack, are regarded as patients with high risk of stroke. Studies have indicated that these stroke risk factors might be associated with an increased risk of cerebral small vessel disease (CSVD) progress, glymphatic dysfunction, cognitive decline, dementia, and cerebrovascular events. However, prevention in these patients is largely unknown and the management of these patients is a very troublesome issue. Previous study has demonstrated that interventions in the feedback and monitoring method could improve exercise adherence in older people compared with other methods including comparison of behavior, social support, natural consequences, identity and goals and planning. Therefore, the investigators plan to monitor and manage vascular risk factors control, sleep quality, mental health and cognitive training based on self-monitoring and personalized feedback on a smartphone app in patients with high risk of stroke. The investigators hypothesize that the intervention based on self-monitoring and personalized feedback will reduce cognitive impairment, glymphatic dysfunction, CSVD progress, depressive symptoms, anxious symptoms, improve sleep quality, and reduce dementia and cerebrovascular events incidence in the study group compared to the control group.

Being tested
Self-monitoring and personalized feedback on smartphone app
Medical subject headings
Cognitive Dysfunction, Stroke, Dementia

What participants receive

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

  • Self-monitoring and personalized feedback on smartphone appBehavioural

    1. Patients will record their blood pressure (once 1-week for patients with hypertension, every 3-month for those without), blood glucose (once 1-month for patients with diabetes), serum lipid metabolism (every 3-month for patients with dyslipidemia) on app, and medical staff will suggest continuing monitoring and recording or recommend outpatient visit;
    2. Patients will complete Pittsburgh sleep quality index test on app every 3-month, and medical staff will contact with patients with index > 15 to assess detail clinical status and recommend outpatient visit if necessary;
    3. Patients will complete Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) on app every 3-month, and medical staff will contact with patients with SAS>49 or SDS>52 to assess detail clinical status and recommend outpatient visit if necessary;
    4. Patients will complete cognitive training games every week on app;
    5. Medical staff will send health information on app
Study groups in NCT04465812
Study groupRoleWhat they receive
Standard health counseling at baselineNo interventionStandard health counseling at baseline
Self-monitoring and personalized feedback on smartphone appExperimental1. Patients will record their blood pressure (once 1-week for patients with hypertension, every 3-month for those without), blood glucose (once 1-month for patients with diabetes), serum lipid metabolism (every 3-month for patients with dyslipidemia) on app, and medical staff will suggest continuing monitoring and recording or recommend outpatient visit; 2. Patients will complete Pittsburgh sleep quality index test on app every 3-month, and medical staff will contact with patients with index > 15 to assess detail clinical status and recommend outpatient visit if necessary; 3. Patients will complete Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) on app every 3-month, and medical staff will contact with patients with SAS>49 or SDS>52 to assess detail clinical status and recommend outpatient visit if necessary; 4. Patients will complete cognitive training games every week on app; 5. Medical staff will send health information on app
Receives: Behavioral: Self-monitoring and personalized feedback on smartphone app

What is being measured

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

  1. Global cognitive function change assessed with Z-score of a modified National Institute of Neurological Disorders and Stroke and Canadian Stroke Network-Canadian Stroke Network protocol

    Primary Outcome

    Measured: 1 year

Secondary outcomes (27)
  1. The change of cognitive score for each domain of NINDS-CSN battery from baseline to 12-month(attention, executive, Language, visuomotor speed, visuospatial function, memory)

    Short-term Secondary Outcome

    Measured: 1year

  2. Cognitive function change assessed by scores of Mini-Mental State Examination (MMSE) (minimum value = 0, maximum value = 30, and higher scores mean a better outcome)

    Short-term Secondary Outcome

    Measured: 1 year

  3. Cognitive function change assessed by scores of Montreal Cognitive Assessment (MoCA) (minimum value = 0, maximum value = 30, and higher scores mean a better outcome)

    Short-term Secondary Outcome

    Measured: 1 year

  4. Dementia and cerebrovascular events incidence

    Short-term Secondary Outcome

    Measured: 1 year

  5. Changes in glymphatic function assessed by dispersion coefficient of periarterial and perivenous spaces on DTI

    Short-term Secondary Outcome

    Measured: 1 year

  6. Changes in image markers (WMHs, lacunes, microbleeds, perivascular spaces, brain atrophy, micro-infarcts) of CSVD assessed on MRI

    Short-term Secondary Outcome

    Measured: 1 year

  7. Dementia and cerebrovascular events incidence

    Long-term Secondary Outcome

    Measured: 5 years

  8. Depressive symptoms assessed by scores of Hamilton depression scale (HAMD) (minimum value = 0, maximum value = 77, and higher scores mean a worse outcome)

    Short-term Secondary Outcome

    Measured: 1 year

  9. Depressive symptoms assessed by scores of Hamilton anxiety scale (HAMA) (minimum value = 0, maximum value = 56, and higher scores mean a worse outcome)

    Short-term Secondary Outcome

    Measured: 1 year

  10. Sleep quality assessed by Pittsburgh sleep quality index (minimum value = 0, maximum value = 21, and higher scores mean a worse outcome)

    Short-term Secondary Outcome

    Measured: 1 year

  11. Global cognitive function change assessed with Z-score of a modified National Institute of Neurological Disorders and Stroke and Canadian Stroke Network-Canadian Stroke Network protocol

    Long-term Secondary Outcome

    Measured: 5 years

  12. Cognitive function change assessed by scores of Mini-Mental State Examination (MMSE) (minimum value = 0, maximum value = 30, and higher scores mean a better outcome)

    Long-term Secondary Outcome

    Measured: 5 years

  13. Cognitive function change assessed by scores of Montreal Cognitive Assessment (MoCA) (minimum value = 0, maximum value = 30, and higher scores mean a better outcome)

    Long-term Secondary Outcome

    Measured: 5 years

  14. Changes in image markers (WMHs, lacunes, microbleeds, perivascular spaces, brain atrophy, micro-infarcts) of CSVD assessed on MRI

    Long-term Secondary Outcome

    Measured: 5 years

  15. Changes in glymphatic function assessed by dispersion coefficient of periarterial and perivenous spaces on DTI

    Long-term Secondary Outcome

    Measured: 5 years

  16. Depressive symptoms assessed by scores of Hamilton depression scale (HAMD) (minimum value = 0, maximum value = 77, and higher scores mean a worse outcome)

    Long-term Secondary Outcome

    Measured: 5 years

  17. Depressive symptoms assessed by scores of Hamilton anxiety scale (HAMA) (minimum value = 0, maximum value = 56, and higher scores mean a worse outcome)

    Long-term Secondary Outcome

    Measured: 5 years

  18. Sleep quality assessed by Pittsburgh sleep quality index (minimum value = 0, maximum value = 21, and higher scores mean a worse outcome)

    Long-term Secondary Outcome

    Measured: 5 years

  19. Global cognitive function change assessed with Z-score of a modified National Institute of Neurological Disorders and Stroke and Canadian Stroke Network-Canadian Stroke Network protocol

    Long-term Secondary Outcome

    Measured: 2 years

  20. Dementia and cerebrovascular events incidence

    Long-term Secondary Outcome

    Measured: 2 years

  21. Cognitive function change assessed by scores of Mini-Mental State Examination (MMSE) (minimum value = 0, maximum value = 30, and higher scores mean a better outcome)

    Long-term Secondary Outcome

    Measured: 2 years

  22. Cognitive function change assessed by scores of Montreal Cognitive Assessment (MoCA) (minimum value = 0, maximum value = 30, and higher scores mean a better outcome)

    Long-term Secondary Outcome

    Measured: 2 years

  23. Changes in image markers (WMHs, lacunes, microbleeds, perivascular spaces, brain atrophy, micro-infarcts) of CSVD assessed on MRI

    Long-term Secondary Outcome

    Measured: 2 years

  24. Changes in glymphatic function assessed by dispersion coefficient of periarterial and perivenous spaces on DTI

    Long-term Secondary Outcome

    Measured: 2 years

  25. Depressive symptoms assessed by scores of Hamilton depression scale (HAMD) (minimum value = 0, maximum value = 77, and higher scores mean a worse outcome)

    Long-term Secondary Outcome

    Measured: 2 years

  26. Depressive symptoms assessed by scores of Hamilton anxiety scale (HAMA) (minimum value = 0, maximum value = 56, and higher scores mean a worse outcome)

    Long-term Secondary Outcome

    Measured: 2 years

  27. Sleep quality assessed by Pittsburgh sleep quality index (minimum value = 0, maximum value = 21, and higher scores mean a worse outcome)

    Long-term Secondary Outcome

    Measured: 2 years

Timeline

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

  1. First posted10 Jul 2020
  2. Study start21 Jul 2020
  3. Primary completion5 Aug 2021
  4. Study completion31 May 2025

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
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
238 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04465812
Sponsor's protocol ID
CIRCLE-CHINA II
Status last verified
Jan 2024
First submitted
28 Jun 2020
Last updated
15 Jun 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A study testing Self-monitoring and personalized feedback on smartphone app in people with Cognitive Impairment and Stroke, run by Second Affiliated Hospital, Zhejiang University, School of Medicine at 1 site in China.

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 2 inclusion and 8 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 15 Jun 2025. 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 China. 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?

Global cognitive function change assessed with Z-score of a modified National Institute of Neurological Disorders and Stroke and Canadian Stroke Network-Canadian Stroke Network protocol (time frame: 1 year). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 15 Jun 2025.

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