NCT04171323

Brief Summary

Older adults at risk for dementia show a variety of cognitive deficits, which can be ameliorated by different cognitive training (CT) exercises. The best combination of CT exercises is unknown. The aim is to discover the most efficacious combination of CT exercises as compared to cognitive stimulation (which will serve as a stringent, active control) to modify the functional trajectories of older adults' with MCI, who are at high risk for dementia. The primary objective of the U01 phase was to design and pilot-test an adaptive, randomized clinical trial (RCT) of cognitive training (CT) combinations aimed to enhance performance of instrumental activities of daily living (IADL) among persons with mild cognitive impairment (MCI). In the R01 phase, the objective is to identify the best combination of CT exercises to delay dementia onset among persons with MCI. The longitudinal endpoint goal is reducing incident dementia. The primary aim of the study is to determine which CT combination has the best probability to delay dementia by producing the largest IADL improvements. The study further aims to explore neuroimaging and novel blood-based biomarkers.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,305

participants targeted

Target at P75+ for not_applicable

Timeline
28mo left

Started Mar 2020

Longer than P75 for not_applicable

Geographic Reach
1 country

6 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress73%
Mar 2020Aug 2028

First Submitted

Initial submission to the registry

November 7, 2019

Completed
13 days until next milestone

First Posted

Study publicly available on registry

November 20, 2019

Completed
3 months until next milestone

Study Start

First participant enrolled

March 3, 2020

Completed
8.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 31, 2028

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

August 31, 2028

Last Updated

December 11, 2025

Status Verified

December 1, 2025

Enrollment Period

8.5 years

First QC Date

November 7, 2019

Last Update Submit

December 5, 2025

Conditions

Outcome Measures

Primary Outcomes (1)

  • Dementia incidence

    Clinical diagnosis of dementia

    At follow-up visit between 6 months to 2 years

Secondary Outcomes (5)

  • Useful Field of View Test performance overall score

    change from baseline to immediate post intervention at the end of study completion which is a period of about 6 months

  • Graduated continuous performance test score

    change from baseline to immediate post intervention at the end of study completion which is a period of about 6 months

  • Examiner Executive Function Set shifting, Anti-Saccades, and Flanker performance composite score

    change from baseline to immediate post intervention at the end of study completion which is a period of about 6 months

  • Timed IADL performance score

    change from baseline to immediate post intervention at the end of study completion which is a period of about 6 months

  • ifunction performance efficiency index

    change from baseline to immediate post intervention at the end of study completion which is a period of about 6 months

Other Outcomes (17)

  • blood based biomarker Neurofilament light (Nfl)

    change from baseline to immediate post intervention at the end of study completion which is a period of about 6 months

  • blood based biomarker Total tau

    change from baseline to immediate post intervention at the end of study completion which is a period of about 6 months

  • blood based biomarker hydroxsphingomyelins SM (OH) C22:1, SM (OH) C22:2, SM (OH) C24:1

    change from baseline to immediate post intervention at the end of study completion which is a period of about 6 months

  • +14 more other outcomes

Study Arms (5)

CTa

EXPERIMENTAL

Participants will complete computerized cognitive training. The duration is 60 min/day; the frequency is two to three days/wk, for 16 weeks with the goal of completing 40 sessions.

Behavioral: Cognitive Training

CTab

EXPERIMENTAL

Participants will complete computerized cognitive training. The duration is 60 min/day; the frequency is two to three days/wk, for 16 weeks with the goal of completing 40 sessions.

Behavioral: Cognitive Training

CTac

EXPERIMENTAL

Participants will complete computerized cognitive training. The duration is 60 min/day; the frequency is two to three days/wk, for 16 weeks with the goal of completing 40 sessions.

Behavioral: Cognitive Training

CTabc

EXPERIMENTAL

Participants will complete computerized cognitive training. The duration is 60 min/day; the frequency is two to three days/wk, for 16 weeks with the goal of completing 40 sessions.

Behavioral: Cognitive Training

Computerized Cognitive Stimulation

ACTIVE COMPARATOR

Participants will complete cognitively-stimulating computer activities. The duration is 60 min/day; the frequency is two to three days/wk, for 16 weeks with the goal of completing 40 sessions.

Behavioral: Computerized Cognitive Stimulation

Interventions

Participants will be completing a total of 40 computerized cognitive stimulation sessions.

Computerized Cognitive Stimulation

Participants will be completing a total of 40 computerized sessions.

CTaCTabCTabcCTac

Eligibility Criteria

Age55 Years - 89 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • to 89 years of age
  • Montreal Cognitive Assessment Score of 18-27 inclusive
  • History of some change in cognitive function relative to established baseline and either 1) a CDR of 0.5; or 2) CDR of 0 and a clinical diagnosis of mild cognitive impairment (MCI) based on a multidisciplinary evaluation that included standardized neuropsychological testing
  • If reports use of medications typically prescribed for dementia such as Namenda, Memantine, Namzaric, Donepezil, Aricept, Rivastigmine, Exelon, Razadyne, Galantamine, or Reminyl, dose has been stable for at least 30 days
  • Adequate auditory capacity to understand normal speech. No greater than moderate hearing loss evident by thresholds less than or equal to 50 dB at 1000 and 2000 Hz in at least one ear determined by an audioscope.
  • Adequate visual capacity to read from a computer screen at a normal viewing distance as measured by binocular visual acuity of 20/50 or better tested with a standard near visual acuity chart
  • Reports and shows adequate motor capacity to touch a computer screen or control a computer mouse.
  • Wiling to complete all study activities
  • Willing and capable of providing informed consent
  • Ability to understand study procedures and comply with them for the length of the study

You may not qualify if:

  • Currently enrolled in another randomized clinical trial, treatment trial, or another research study that assesses cognition
  • Dementia diagnosis
  • Clinical Dementia Rating Scale of 1 or greater
  • History of large vessel stroke with significant residual motor or cognitive impairment
  • History of moderate to severe traumatic brain injury with residual cognitive symptoms
  • History of brain tumor
  • Undergoing or plans to undergo surgery requiring anesthesia, chemotherapy, or radiation treatment in the six months following screening
  • Congestive heart failure diagnosis
  • Primary diagnosis of idiopathic Parkinson's disease
  • Multiple sclerosis or Amyotrophic lateral sclerosis (ALS) diagnosis
  • Evidence of a non-neurodegenerative neurological disorder that would interfere with the ability to carry out study activities.
  • Evidence of any other unstable medical conditions that would interfere with the ability to carry out study activities or cause fluctuations in cognition (e.g., unstable diabetes, chronic obstructive pulmonary disorder dependent on oxygen)
  • Geriatric Depression short scale score \>5/15. Participants with mood disorders that are treated and stable and have a GDS score \< 6/15 are not excluded.
  • Any other clinically significant or unstable medical condition (e.g., ongoing alcohol dependency or drug abuse, schizophrenia, psychosis) that in the assessor's opinion would interfere with the ability to carry out study activities.
  • Previous participation in 10 or more hours of a computerized cognitive intervention program in the past two years
  • +3 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (6)

University of California San Francisco

San Francisco, California, 94158, United States

RECRUITING

University of Florida

Gainesville, Florida, 32611, United States

RECRUITING

Active Mind Study

Tampa, Florida, 33617, United States

RECRUITING

University of Minnesota

Minneapolis, Minnesota, 55455, United States

ACTIVE NOT RECRUITING

Clemson University

Greenville, South Carolina, 29607, United States

RECRUITING

Clemson University

Seneca, South Carolina, 29672, United States

RECRUITING

MeSH Terms

Conditions

Cognitive DysfunctionDementia

Interventions

Cognitive Training

Condition Hierarchy (Ancestors)

Cognition DisordersNeurocognitive DisordersMental DisordersBrain DiseasesCentral Nervous System DiseasesNervous System Diseases

Intervention Hierarchy (Ancestors)

Neurological RehabilitationRehabilitationAftercareContinuity of Patient CarePatient CareTherapeuticsHealth ServicesHealth Care Facilities Workforce and Services

Study Officials

  • Jerri Edwards, PhD

    University of Alabama at Birmingham

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

November 7, 2019

First Posted

November 20, 2019

Study Start

March 3, 2020

Primary Completion (Estimated)

August 31, 2028

Study Completion (Estimated)

August 31, 2028

Last Updated

December 11, 2025

Record last verified: 2025-12

Locations