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Cognitive TrainingNCT04615169

Multi-component Cognitive Intervention for Older Adults With Mixed Cognitive Abilities

A study testing Multi-component cognitive intervention with simulated everyday tasks (MCI-SET) in people with Cognitive Training and Dementia, run by National Cheng Kung University at 1 site 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

Objective: To assess the feasibility and preliminary effectiveness of an evidence-driven, pragmatic multi-component cognitive intervention with simulated everyday tasks (MCI-SET) with an inclusive group design in community centers Methods: One group, pre-test, post-test, and 3-month follow up research design. Read more about this study

Who is it for?
Ages 65 years and older
Conditions the study is for
Cognitive Training, Dementia, Occupational Therapy
What is being tested?
Multi-component cognitive intervention with simulated everyday tasks (MCI-SET)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
140 participants
Where
1 siteTaiwan
Study dates
1 Aug 2017to 31 Dec 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

  • equal to or more than 65 years old, and frailty status according to the Study of Osteoporotic Fractures (SOF) criteria of frailty, or dependence with at least one daily activities.

Who cannot join

  • People with non-cognitive issues, such as severe visual, hearing, or physical impairments, that interfered with completion of evaluations.

Trial locations and contacts

1 site in 1 country.

Taiwan1 site
  • National Cheng-Kung University

    Tainan, 701

Other trials in Taiwan

About this study

Objective: To assess the feasibility and preliminary effectiveness of an evidence-driven, pragmatic multi-component cognitive intervention with simulated everyday tasks (MCI-SET) with an inclusive group design in community centers Methods: One group, pre-test, post-test, and 3-month follow up research design. The participants who were >=65 and frail, dependence in >= one activity of daily living, or with a confirmed dementia from eight community centers. MCI-SET consisted 12 two-hour weekly group sessions. Feasibility was described with intervention development, fidelity, and acceptability. Outcomes included general daily functioning, general cognition, memory, attention, executive functioning, and processing speed.

Read the detailed description

According to the World Alzheimer Report 2018, 50 million people are living with dementia and the number is expected to triple to 152 million by 2050. Most people at high risk of dementia or with dementia reside in the community. Effective community-based programs can help to maintain functional levels and mitigate or prevent excessive functional decline. There are increasing empirical evidence to support structured and regular cognitive activities as part of brain health lifestyle .

Cognitive intervention is an increasing popular approach that aim to maintain or improve the cognitive functioning of the older adults with or without cognitive impairments. Appropriate cognitive intervention has the potential to change their brain neuro-mechanism. Recent evidence suggests that repeated practices of a carefully designed cognitive exercises with a high degree of similarity with real-life activities of daily living (ADL) (e.g., remembering the instructions for taking prescription medicine, identifying the medicine precautions, etc.) can improve both cognitive skills and cognitive functional performance.

Because of the complexity of cognitive issues people with cognitive impairments encounter, scholars have advocated for a multi-component cognitive intervention that includes more than one approach to make the best use of the individual approaches. The investigators conducted a quasi-experimental study that combined motor-cognitive dual-task exercises with high cognitive demands, cognitive training, and cognitive rehabilitation. The results showed that the intervention can improve cognitive skills and cognitive functional performance for people with mild cognitive impairments.

However, the need to strengthen the research design and to standardize treatment protocols led most cognitive intervention research to target a group of participants with similar cognitive skills, such as those with normal cognition, those with mild cognitive impairments, or those with dementia, etc. This homogeneity in participants is in sharp contrast to what is observed in communities, where most likely the group is inclusive of persons with different levels of cognitive skills. The efficacy of cognitive intervention with an inclusive group design was rarely examined.

Scholars have called for more effort to speed up the process of bridging evidence-based intervention to the everyday settings people live in. Cognitive intervention is in a situation of "leaky pipeline," that is, no systematic examination of how the evidence can be translated, tested in real-world settings (practice), and/or implemented across communities in the continuum of research evidence to widespread implementation. The increasing use of feasibility research design is mostly used as a precursor of randomized clinical trial, examining whether a study protocol requires adjustment, what the barriers and potential strategies are. With the abundance of research that supports the efficacy of cognitive intervention, to the best of the investigators' knowledge, there are no study that investigated the transportability of evidence-based cognitive intervention into the community.

This study discusses the feasibility, implementation, and preliminary effectiveness of an evidence-driven, multi-component cognitive intervention using simulated everyday tasks (MCI-SET) for cognitively-vulnerable older adults in community organizations in two cities in southern Taiwan.

Being tested
Multi-component cognitive intervention with simulated everyday tasks (MCI-SET)
Keywords
cognitive training, dementia prevention, Dementia, occupational therapy, community based practice, older people, long term care
Medical subject headings
Dementia

What participants receive

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

  • Multi-component cognitive intervention with simulated everyday tasks (MCI-SET)Behavioural

    2 hours per session: consisted primarily of modified everyday cognitive tasks, which were adjusted for individuals and for the group by the group leader to provide an error-reduction learning environment. Each session consisted of: (1) Warm-up: a 15-30 minute dual task of motor-cognitive exercises that increase arousal level and provide cognitive stimulation. For example, at the beginning of the group, the members would sing a song, mimic dance movement of the group leader, and clap hands when specific words occur in the song.

    (2) 30-minutes guided and repetitive practices of contextually-relevant simulated everyday cognitive tasks with one 15 to 20- minute break in between; Cognitive tasks addressed complex attention, visual scanning, auditory attention, visual and motor memory, auditory memory, prospective memory, executive functioning, problem solving, etc.

Study groups in NCT04615169
Study groupRoleWhat they receive
multi-component cognitive intervention using simulated everyday tasks (MCI-SET)Experimentalthe 12-week intervention, 2 hours weekly session of MCI-SET.
Receives: Behavioral: Multi-component cognitive intervention with simulated everyday tasks (MCI-SET)

What is being measured

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

  1. Kihon Checklist-Taiwan (KCL)

    KCL is a self-reported questionnaire, consisted of 25 items (yes/no) divided into 7 sub-categories: general independence, physical strength, nutrition, oral function, level of social activities outside of home, cognitive function, and risk of depression. It takes about 15 minutes to complete. Each item is rated as pass (0) or fail (1). A higher total score indicates worse functioning. KCL has been used as a reliable indicator of daily functioning and progression of disability in Japan National Long-term Care. Taiwan Ministry of Health and Welfare adopted KCL-Taiwan version as an indicator of daily functioning for the use of national-wide disability prevention and delay community-based programs.

    Measured: up to one month before the start of intervention

  2. Kihon Checklist-Taiwan (KCL)

    KCL is a self-reported questionnaire, consisted of 25 items (yes/no) divided into 7 sub-categories: general independence, physical strength, nutrition, oral function, level of social activities outside of home, cognitive function, and risk of depression. It takes about 15 minutes to complete. Each item is rated as pass (0) or fail (1). A higher total score indicates worse functioning. KCL has been used as a reliable indicator of daily functioning and progression of disability in Japan National Long-term Care. Taiwan Ministry of Health and Welfare adopted KCL-Taiwan version as an indicator of daily functioning for the use of national-wide disability prevention and delay community-based programs.

    Measured: up to one month after the end of intervention

  3. Kihon Checklist-Taiwan (KCL)

    KCL is a self-reported questionnaire, consisted of 25 items (yes/no) divided into 7 sub-categories: general independence, physical strength, nutrition, oral function, level of social activities outside of home, cognitive function, and risk of depression. It takes about 15 minutes to complete. Each item is rated as pass (0) or fail (1). A higher total score indicates worse functioning. KCL has been used as a reliable indicator of daily functioning and progression of disability in Japan National Long-term Care. Taiwan Ministry of Health and Welfare adopted KCL-Taiwan version as an indicator of daily functioning for the use of national-wide disability prevention and delay community-based programs.

    Measured: up to 4 months after the end of intervention

  4. General Cognition

    Montreal Cognitive Assessment-Taiwan version (MoCA-T). MoCA-T is in paper-and-pencil format and the maximal score is 30, with higher scores indicating better cognition. MoCA-T total score is adjusted for education effects.

    Measured: up to one month before the start of intervention

  5. General Cognition

    Montreal Cognitive Assessment-Taiwan version (MoCA-T). MoCA-T is in paper-and-pencil format and the maximal score is 30, with higher scores indicating better cognition. MoCA-T total score is adjusted for education effects.

    Measured: up to one month after the end of intervention

  6. General Cognition

    Montreal Cognitive Assessment-Taiwan version (MoCA-T). MoCA-T is in paper-and-pencil format and the maximal score is 30, with higher scores indicating better cognition. MoCA-T total score is adjusted for education effects.

    Measured: up to 4 months after the end of intervention

Secondary outcomes (9)
  1. Functional episodic memory

    Functional episodic memory was assessed by using the event-based task in Miami Prospective Memory Test (MPMT). The participants were asked to pick up an envelope on the desk, get a fixed amount of paper bills from the envelope, give one bill to the examiner and put another one in another envelope when an alarm sounds in 30 minutes later. A total score ranges from 0-9 from three sub-scores of "intention to perform, accuracy, and need for reminders."

    Measured: up to one month before the start of intervention

  2. Functional episodic memory

    Functional episodic memory was assessed by using the event-based task in Miami Prospective Memory Test (MPMT). The participants were asked to pick up an envelope on the desk, get a fixed amount of paper bills from the envelope, give one bill to the examiner and put another one in another envelope when an alarm sounds in 30 minutes later. A total score ranges from 0-9 from three sub-scores of "intention to perform, accuracy, and need for reminders."

    Measured: up to one month after the end of intervention

  3. Functional episodic memory

    Functional episodic memory was assessed by using the event-based task in Miami Prospective Memory Test (MPMT). The participants were asked to pick up an envelope on the desk, get a fixed amount of paper bills from the envelope, give one bill to the examiner and put another one in another envelope when an alarm sounds in 30 minutes later. A total score ranges from 0-9 from three sub-scores of "intention to perform, accuracy, and need for reminders."

    Measured: up to 4 months after the end of intervention

  4. short-term memory and working memory

    Wechsler Adult Intelligence Scale-IV Digit Span subtest (Digits Forward, DF, and Digits Backwards, DB) measure short-term memory (DF) and working memory (DB). Participants listened to a sequence of digits and were asked to recall the sequence correctly (DF) or in reverse-order (DB). Total scores ranged from 2-9 for DF and 2-8 for DB

    Measured: up to one month before the start of intervention

  5. short-term memory and working memory

    Wechsler Adult Intelligence Scale-IV Digit Span subtest (Digits Forward, DF, and Digits Backwards, DB) measure short-term memory (DF) and working memory (DB). Participants listened to a sequence of digits and were asked to recall the sequence correctly (DF) or in reverse-order (DB). Total scores ranged from 2-9 for DF and 2-8 for DB

    Measured: up to one month after the end of intervention

  6. short-term memory and working memory

    Wechsler Adult Intelligence Scale-IV Digit Span subtest (Digits Forward, DF, and Digits Backwards, DB) measure short-term memory (DF) and working memory (DB). Participants listened to a sequence of digits and were asked to recall the sequence correctly (DF) or in reverse-order (DB). Total scores ranged from 2-9 for DF and 2-8 for DB

    Measured: up to 4 months after the end of intervention

  7. Attention and executive Functioning

    Attention and executive Functioning was measured by Color Trail Test Part 1 (CTT-1)(attention) and Part 2 (CTT-2) (executive function) (D'Elia, Satz, Uchiyama, \& White, 1996). Participants were asked to connect 25 numbered circles as quickly as possible. Their tests are timed in seconds. The shorter time indicates better performance.

    Measured: up to one month before the start of intervention

  8. Attention and executive Functioning

    Attention and executive Functioning was measured by Color Trail Test Part 1 (CTT-1)(attention) and Part 2 (CTT-2) (executive function) (D'Elia, Satz, Uchiyama, \& White, 1996). Participants were asked to connect 25 numbered circles as quickly as possible. Their tests are timed in seconds. The shorter time indicates better performance.

    Measured: up to one month after the end of intervention

  9. Attention and executive Functioning

    Attention and executive Functioning was measured by Color Trail Test Part 1 (CTT-1)(attention) and Part 2 (CTT-2) (executive function) (D'Elia, Satz, Uchiyama, \& White, 1996). Participants were asked to connect 25 numbered circles as quickly as possible. Their tests are timed in seconds. The shorter time indicates better performance.

    Measured: up to 4 months after the end of intervention

Timeline

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

  1. First posted4 Nov 2020
  2. Study start1 Aug 2017
  3. Primary completion31 Dec 2018
  4. Study completion31 Dec 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
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
A multi-center one-group pretest, post-test, and 3-month follow up design
Masking
None (open label)
Enrolment
140 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04615169
Sponsor's protocol ID
National Cheng Kung University
Status last verified
Oct 2020
First submitted
23 Oct 2020
Last updated
4 Nov 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Mao HF, Tsai AY, Chang LH, Tsai IL. Multi-component cognitive intervention for older adults with mixed cognitive levels: implementation and preliminary effectiveness in real-world settings. BMC Geriatr. 2021 Oct 12;21(1):543. doi: 10.1186/s12877-021-02489-z.

    PubMed 34641803

Questions about this trial

What is this clinical trial studying?

A study testing Multi-component cognitive intervention with simulated everyday tasks (MCI-SET) in people with Cognitive Training and Dementia, run by National Cheng Kung University at 1 site 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 1 inclusion and 1 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 4 Nov 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 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?

Kihon Checklist-Taiwan (KCL) (time frame: up to one month before the start of intervention). The study lists 6 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 NCT04615169, 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 4 Nov 2020.

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