NCT04997681

Brief Summary

Background: Prevention of Alzheimer's Disease and Related Dementias (ADRDs) may be possible for persons with subjective (SCI) or mild cognitive impairment (MCI), or normal cognition and risk factors. Physical exercise and cognitive training have been shown to enhance cognitive function and mobility in MCI when delivered in a research facility. The feasibility of delivering interventions in the home of older adults at risk for developing ADRDs is not known. What preferences the participants have for these interventions are also unknown. The primary goals are: 1) assess feasibility of a home-based delivery of exercise and cognitive interventions 2) evaluate the relationship between participants' intervention preferences and adherence. Secondary objectives focus on cognition, frailty, mobility, sleep, diet and mental health. Methods and analysis: SYNERGIC@Home is a randomized control trial (using a 2 x 2 factorial design) with a 16-week home-based intervention program of physical exercises with cognitive training. Sixty-four participants will be randomized in blocks of four: 1) combined exercise (aerobic and resistance) + cognitive training (NEUROPEAK™); 2) combined exercise + control cognitive training (web searching); 3) control exercise (balance and toning) + cognitive training; and 4) control exercise + control cognitive training. It will be implemented virtually through video conferencing. Baseline, 4- and 10-month post-intervention will include measures of cognition, frailty, mobility, sleep, diet, and psychological health. Feasibility outcomes include recruitment and retention. Preference will be used to determine the relationship between preference adherence. Secondary outcomes will evaluate the effect of the interventions on cognitive, mobility, and general well-being.

Trial Health

87
On Track

Trial Health Score

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

Enrollment
60

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Jul 2021

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

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

First Submitted

Initial submission to the registry

June 1, 2021

Completed
2 months until next milestone

Study Start

First participant enrolled

July 28, 2021

Completed
13 days until next milestone

First Posted

Study publicly available on registry

August 10, 2021

Completed
1.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 8, 2023

Completed
5 months until next milestone

Study Completion

Last participant's last visit for all outcomes

July 27, 2023

Completed
Last Updated

October 2, 2023

Status Verified

September 1, 2023

Enrollment Period

1.6 years

First QC Date

June 1, 2021

Last Update Submit

September 29, 2023

Conditions

Keywords

ExerciseCognitive trainingIntervention preferenceElderlyGaitDementiaHome-based interventionCognitive impairment

Outcome Measures

Primary Outcomes (2)

  • Intervention Adherence

    Defined as the mean percent of all Intervention sessions attended of the 48 planned sessions per participant.

    Post-intervention at 4 months

  • Intervention Preference

    The primary analytic goal of SYNERGIC@Home is to assess the relationship between participants' adherence to the interventions and their affinity for each intervention going into the trial. All participants will be given the Intervention Preference Questionnaire (IPQ) prior to implementation of the intervention

    Baseline

Secondary Outcomes (64)

  • Recruitment Rate

    Through study completion, an average of 10 months

  • Retention Rate

    Through study completion, an average of 10 months

  • Assessment Tolerability

    Baseline

  • Trial Experience

    10 months follow-up

  • Adverse Events

    Monitored from start of study until end of study

  • +59 more secondary outcomes

Study Arms (4)

Exercise Intervention Training and Cognitive Intervention Training

EXPERIMENTAL

Combined Aerobic Exercise and Resistance Training (AE + RT) + Cognitive Training (NeuropeakTM)

Behavioral: Combined Aerobic Exercise and Resistance Training (AE + RT)Behavioral: Cognitive Training (NeuropeakTM)

Exercise Intervention Training and Control Cognitive Training

ACTIVE COMPARATOR

Combined Aerobic Exercise and Resistance Training (AE + RT) + Control Cognitive Training of Website Searching and Video Watching (WS+V)

Behavioral: Combined Aerobic Exercise and Resistance Training (AE + RT)Behavioral: Control Cognitive Training of Website Searching and Video Watching (WS+V)

Control Exercise Training and Cognitive Intervention Training

ACTIVE COMPARATOR

Control Balance and Toning Exercise Training (BAT) + Cognitive Training (NeuropeakTM)

Behavioral: Cognitive Training (NeuropeakTM)Behavioral: Control Balance and Toning Exercise Training (BAT)

Control Exercise Training and Control Cognitive Training

PLACEBO COMPARATOR

Control Balance and Toning Exercise Training (BAT) + Control Cognitive Training of Website Searching and Video Watching (WS+V)

Behavioral: Control Cognitive Training of Website Searching and Video Watching (WS+V)Behavioral: Control Balance and Toning Exercise Training (BAT)

Interventions

AE + RT will be conducted via a video-conferencing platform under the direct supervision and coaching of a certified exercise physiologist with certification from the Canadian Society for Exercise Physiology (CSEP; or equivalent certification). These certified trainers will administer the exercise interventions in a one trainer to one participant ratio. AE + RT includes a set of warm up exercises, which will be completed in approximately 5 minutes, followed by a break. Next, 6 strength training exercises (that progressively increase in resistance intensity over time) will be completed followed by a break. Aerobic exercises that safely increase the participant's heart rate will follow for 30 minutes followed by a break and a set of cool down exercises for 5 minutes. In total the AE + RT exercise session is approximately 65 minutes.

Exercise Intervention Training and Cognitive Intervention TrainingExercise Intervention Training and Control Cognitive Training

NeuropeakTM is a program which will be completed by participants remotely using a tablet or computer. It consists of cognitive training including dual-task training that requires participants to maintain and prepare for many response alternatives (working memory) and to share attention between two concurrent tasks (divided attention). Difficulty of cognitive training is tailored to their individual functioning level. During each session, participants perform one of two different visuo-motor tasks, which include sets of visual stimuli (e.g., letters, numbers, animals, vehicles, fruits, celestial bodies) and respective hand-button correspondences (i.e., keys that are to be tapped on either the right or the left side of the screen). Participants are instructed to perform these tasks as fast as possible, while maintaining accuracy. Training also includes online feedback and a histogram of daily performance to encourage improvement. NeuropeakTM takes approximately 30 minutes to complete.

Control Exercise Training and Cognitive Intervention TrainingExercise Intervention Training and Cognitive Intervention Training

During the WS + V task, participants alternate between 2 different tasks (touristic searching using internet and video watching). For the touristic searching using internet, participants are required to find 3 hotels, 3 touristic places, and 3 restaurants of their own preference in a city assigned by the instructor (a new city will be selected each session). They will also need to include the respective addresses of those places on their log sheet. For the video watching task, participants watch a National Geographic video on YouTube selected by the instructor with a different video selected for each session. They will watch the video for 20 minutes and during the remaining 5 minutes they will answer the following questions on their log sheet: 1) What is the video about? 2) What is the most important information in your opinion? 3) Create a question based on the video and answer your own question. WS + V sessions take approximately 30 minutes to complete.

Control Exercise Training and Control Cognitive TrainingExercise Intervention Training and Control Cognitive Training

BAT exercises will be conducted via a video-conferencing platform under the direct supervision and coaching of a certified exercise physiologist with certification from the Canadian Society for Exercise Physiology (CSEP; or equivalent certification). These certified trainers will administer the exercise interventions in a one trainer to one participant ratio. BAT includes a set of warm up exercises, which will be completed in approximately 5 minutes, followed by a break. Next, 6 balance and toning exercises will be completed followed by a break. Stretching exercises will follow for 30 minutes followed by a break and a set of cool down exercises for 5 minutes. In total the BAT exercise session is approximately 65 minutes.

Control Exercise Training and Cognitive Intervention TrainingControl Exercise Training and Control Cognitive Training

Eligibility Criteria

Age60 Years - 90 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age 60 to 90 years old.
  • Has a Family Physician
  • Has internet access (and have regular access to email), and the technology ability (able to send and receive emails).
  • Resides in their own home/apartment in the community.
  • Has access to a home computer and/or a tablet computer device.
  • Self-reported levels of proficiency in English and/or French for speaking and understanding spoken and written language.
  • Able to comply with scheduled home-based assessments, interventions, and other trial procedures.
  • Able to ambulate at least 10 m independently with or without a walking aid.
  • Being at risk of developing dementia:
  • Mild Cognitive Impairment (MCI) Group. Diagnosis of Mild Cognitive Impairment, in accordance with the criteria used in the Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) study2 (Table 1).
  • Subjective Cognitive Impairment (SCI) Group. Diagnosis of Subjective Cognitive Impairment, in accordance with the COMPASS-ND study2 definition (Table 1).
  • Cognitively Intact with Risk Factors Group. Cognitively Intact based on COMPASS ND study2 definition (Table 1)) AND have a history of two or more risk factors for dementia, defined as the following (Table 1):
  • Obesity: Defined as a Body Mass Index (BMI) \> 30 kg/m2 (as derived from the National Institute of Health BMI calculator52)
  • Hypertension: Defined as a documented Systolic Blood Pressure \> 140 mm Hg, OR a physician's diagnosis of hypertension, OR presence of physician prescribed medical treatment for hypertension, OR other approaches to treatment for hypertension (i.e., diet or exercise).
  • Diabetes: Defined as a physician's diagnosis of diabetes, OR presence of physician prescribed medical treatment for diabetes, OR other approaches to treatment for diabetes (i.e., diet or exercise).
  • +8 more criteria

You may not qualify if:

  • A diagnosis of dementia
  • Participants living in Nursing Homes or Adult Residential Facilities (Special Care Homes) will be excluded.
  • Serious underlying disease, which, in the opinion of the study physician excludes engagement in interventions or may interfere with the participant's ability to participate fully in the study.
  • Has had surgery within the last two months or has planned surgery in the coming 12 months that, deemed by the study physician, could interfere with the participant's vision, hearing, mobility or any other ability to participate in the study.
  • Has a history of intracranial surgery.
  • Regular Benzodiazepine use by a participant that the study physician determines to be significant enough to interfere with the participants ability to participate in the assessments and interventions in the study will be excluded.
  • Presence of major depression, schizophrenia, severe anxiety or drug/alcohol abuse, or other medical illness that would prohibit them from safely participating in the study or may cause harm to the participant.
  • Current Parkinsonism or any neurological disorder with residual motor deficits (e.g. stroke with motor deficit), active musculoskeletal disorders (e.g. severe osteoarthritis of lower limbs), or history of knee/hip replacement affecting gait performance during the baseline assessment.
  • Severe visual and/or auditory impairment, which, according to the vision and hearing assessment, precludes the participant from engaging in the trial.
  • Intention to enroll in other clinical trials during the same time period.
  • Active participation in an organized and planned exercise program involving aerobic exercise and/or resistance training regimen in the previous 6 months.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

The University of New Brunswick

Fredericton, New Brunswick, E3B 5A2, Canada

Location

Related Publications (3)

  • Omar H, Yetman L, Tranchant CC, Gallibois M, Hache JC, Faig K, Handrigan G, McGibbon C, Jarrett P. "It's About Connections": A Grounded Theory of Older Adults' Engagement in Remotely Delivered Home-Based Physical and Cognitive Exercise Interventions Aiming to Reduce the Risk of Dementia. J Patient Exp. 2025 Oct 30;12:23743735251392324. doi: 10.1177/23743735251392324. eCollection 2025.

  • Drahota A, Udell JE, Mackenzie H, Pugh MT. Psychological and educational interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2024 Oct 3;10(10):CD013480. doi: 10.1002/14651858.CD013480.pub2.

  • McGibbon C, Jarrett P, Handrigan G, Bouchard D, Tranchant CC, Sexton AM, Yetman L, Robinson B, Crapoulet S, Chamard-Witkowski L, Liu-Ambrose T, Middleton LE, Almeida QJ, Bherer L, Lim A, Speechley M, Kamkar N, Montero Odasso M; Canadian Consortium on Neurodegeneration in Aging (CCNA), CAN-THUMBS UP Group. Protocol for SYNchronising Exercises, Remedies in GaIt and Cognition at Home (SYNERGIC@Home): feasibility of a home-based double-blind randomised controlled trial to improve gait and cognition in individuals at risk for dementia. BMJ Open. 2022 Mar 31;12(3):e059988. doi: 10.1136/bmjopen-2021-059988.

MeSH Terms

Conditions

Cognitive DysfunctionMotor ActivityDementia

Interventions

Resistance TrainingCognitive Training

Condition Hierarchy (Ancestors)

Cognition DisordersNeurocognitive DisordersMental DisordersBehaviorBrain DiseasesCentral Nervous System DiseasesNervous System Diseases

Intervention Hierarchy (Ancestors)

Exercise TherapyRehabilitationAftercareContinuity of Patient CarePatient CareTherapeuticsPhysical Therapy ModalitiesPhysical Conditioning, HumanExerciseMotor ActivityMovementMusculoskeletal Physiological PhenomenaMusculoskeletal and Neural Physiological PhenomenaNeurological RehabilitationHealth ServicesHealth Care Facilities Workforce and Services

Study Officials

  • Chris McGibbon, PhD

    University of New Brunswick

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, OUTCOMES ASSESSOR
Purpose
PREVENTION
Intervention Model
FACTORIAL
Model Details: 2x2 factorial design
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

June 1, 2021

First Posted

August 10, 2021

Study Start

July 28, 2021

Primary Completion

March 8, 2023

Study Completion

July 27, 2023

Last Updated

October 2, 2023

Record last verified: 2023-09

Data Sharing

IPD Sharing
Will share

Deidentified IPD will be stored on a secure server called LORIS (Longitudinal Online Research and Imaging System) at the McGill Centre for Integrative Neuroscience, McGill University, Montreal, Quebec.

Shared Documents
STUDY PROTOCOL
Time Frame
12 months after the principal paper answering primary research questions are published.
Access Criteria
Qualified persons may request access via email to the Canadian Consortium for Neurodegeneration and Aging \[ccna.admin@ladydavis.ca\].

Locations