NCT07721467

Brief Summary

Background: Normal aging, as well as dementias such as Alzheimer s disease, can cause changes in the brain that affect memory, attention, and thinking. Researchers want to know if regular mental tasks (cognitive training) can improve brain function in older adults. They also want to know if psilocybin, a compound found in certain mushrooms, can further support improved brain function. Objective: To learn how regular cognitive training, with or without psilocybin, can improve brain health in older adults. Eligibility: People aged 65 years and older with mild cognitive impairment or early-stage Alzheimer s disease. Healthy older adults with normal cognition are also needed. Design: Participants will be screened. They will have a test of their heart function and an imaging scan. They will have mental health screening and tests of their thinking and memory. They will practice brain-training tasks on a tablet. Participants will be divided into 2 groups: 1 will have cognitive training plus psilocybin; 1 will have cognitive training only. Those having cognitive training only will have 5 or 6 clinic visits. They will take the tablet home to practice brain training daily. They will wear a device to measure brain waves as they sleep; they may have 1 overnight stay in the clinic, or they may wear the device at home. Imaging scans and other tests will be repeated at each visit. Those taking psilocybin will have up to 9 clinic visits. In addition to the visits for cognitive training, they will take 1 psilocybin capsule by mouth 2 weeks apart (the second dose is optional). They will remain in the clinic for 24 hours after each dose.

Trial Health

63
Monitor

Trial Health Score

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

Enrollment
200

participants targeted

Target at P75+ for phase_2

Timeline
52mo left

Started Oct 2026

Typical duration for phase_2

Geographic Reach
1 country

1 active site

Status
not yet 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

First Submitted

Initial submission to the registry

July 22, 2026

Completed
1 day until next milestone

First Posted

Study publicly available on registry

July 23, 2026

Completed
2 months until next milestone

Study Start

First participant enrolled

October 1, 2026

Expected
4.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2030

Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2030

Last Updated

July 24, 2026

Status Verified

July 7, 2026

Enrollment Period

4.3 years

First QC Date

July 22, 2026

Last Update Submit

July 23, 2026

Conditions

Keywords

AgingPsilocybinCognitive Training

Outcome Measures

Primary Outcomes (1)

  • Determine whether psilocybin enhances neuroplasticity (Neuroplasticity Composite Score (NPCS))

    two doses, 25 mg each, of psilocybin given two weeks apart plus 4 weeks of cognitive training vs. cognitive training alone.

    4 weeks

Secondary Outcomes (1)

  • Assess the safety and tolerability of psilocybin in cognitively healthy older adults and individuals with early-stage AD.

    6 weeks

Study Arms (4)

early-stage Alzheimer's Disease (AD) population - cognitive training only

ACTIVE COMPARATOR

older adults with early-stage AD, 4 weeks of cognitive training alone

Other: Cognitive Training

early-stage Alzheimer's Disease (AD) population - cognitive training plus psilocybin

EXPERIMENTAL

older adults with early-stage AD, two oral doses of 25mg of psilocybin, administered two weeks apart, plus cognitive training for four weeks

Drug: PsilocybinOther: Cognitive Training

Normal Cognition population - cognitive training only

ACTIVE COMPARATOR

Older adults with normal cognition, 4 weeks of cognitive training alone

Other: Cognitive Training

Normal Cognition population - cognitive training plus psilocybin

EXPERIMENTAL

Older adults with normal cognition, two oral doses of 25mg of psilocybin, administered two weeks apart, plus cognitive training for four weeks

Drug: PsilocybinOther: Cognitive Training

Interventions

25 mg orally x 2 (2 weeks apart)

Normal Cognition population - cognitive training plus psilocybinearly-stage Alzheimer's Disease (AD) population - cognitive training plus psilocybin

daily for 4 weeks

Normal Cognition population - cognitive training onlyNormal Cognition population - cognitive training plus psilocybinearly-stage Alzheimer's Disease (AD) population - cognitive training onlyearly-stage Alzheimer's Disease (AD) population - cognitive training plus psilocybin

Eligibility Criteria

Age65 Years - 120 Years
Sexall
Healthy VolunteersYes
Age GroupsOlder Adult (65+)

You may qualify if:

  • In order to be eligible to participate in this study, an individual must meet all of the following criteria:
  • Capacity to provide informed consent.
  • Stated willingness to comply with all study procedures and availability for the duration of the study.
  • Male or female, age \>= 65 years old.
  • Cognitive Status:
  • Early-stage AD population: Meets the 2024 Alzheimer s Association Workgroup revised criteria for diagnosis and staging of AD (symptomatic cognitive impairment consistent with amnestic MCI or mild AD dementia) with a CDR score of 0.5-1(including 0.5 for the memory box) and a Montreal Cognitive Assessment (MoCA) score of 20-25.5
  • Cognitively normal population: No cognitive impairment based on clinical history and examination, with a CDR score of 0 and MoCA score \>= 26.
  • For participants with early-stage AD, evidence of underlying AD pathology by the currently only FDA-approved blood-based test, Lumipulse G p217-Tau/Abeta42 ratio \>= 0.00738.123 Alternatively, participants who had previously underwent amyloid PET or CSF testing for diagnosis of AD (to qualify for treatment with anti-amyloid monoclonal antibodies or for any other reason) may provide report of the amyloid PET scan or result of CSF analysis compatible with underlying AD pathophysiology; Lumipulse G p217- Tau/Abeta42 will still be measured to maintain consistency in study assessments, but values \< 0.00738 will not disqualify them.
  • Absence of serious neuropsychiatric symptoms, defined as a score of 0 on Delusions and Hallucinations items and a score \<= 2 on Anxiety, Aggression, Irritability, and Disinhibition items of the Neuropsychiatric Inventory Questionnaire (NPI-Q).
  • Acetylcholinesterase inhibitors and/or memantine are permitted (alone or in combination) provided the dose(s) have been stable for (Bullet) 6 weeks prior to screening and are expected to remain stable through the psilocybin dosing period and primary outcome assessments, unless a change is medically necessary as determined by the prescribing clinician.
  • Concurrent pharmacotherapy with a single selective serotonin reuptake inhibitor (SSRI) other than fluoxetine, serotonin and norepinephrine reuptake inhibitor (SNRI), tricyclic anti-depressant (TCA) or monoamine oxidase inhibitor (MAOI) is allowed only if the participant is willing and able to taper off this medication after Visit 1 (Screening) and have stayed off it for a washout period of at least 7 +/- 2 days prior to Visit 2 (Baseline) and at least 14 +/- 2 days prior to Visit 3 (for the Psilocybin + Cognitive Training group) or Visit 4 (for the Cognitive Training alone group). Bupropion (\<= 300 mg/day) is permitted without taper or washout if the dose has been stable for \>= 6 weeks before screening.
  • Absence of active suicidal ideation with plan/intent and no suicidal behavior within the past 6 months, as defined by Columbia-Suicide Severity Rating Scale (C-SSRS) of 0 or 1. Participants with passive ideation (severity 1) may be included only if risk is judged low, a safety plan is documented, and there is no suicidal behavior in the prior 6 months.
  • For the early-stage AD population, participation of a study partner who is willing and able to serve as a medical history informant, accompany participants during visits, and provide psychological support following psilocybin sessions. For the cognitively normal population, participation of a study partner will be encouraged, but will not be mandated as eligibility criterion.
  • Ability to take oral medication.
  • Pregnancy prevention:
  • +3 more criteria

You may not qualify if:

  • An individual who meets any of the following criteria will be excluded from participation in this study:
  • Medical history
  • Neurological disorders (besides AD): Clinically significant brain disorders, either previously diagnosed or revealed through the screening exams or baseline neuroimaging, including:
  • Stroke (except single asymptomatic old lacune)
  • Transient Ischemic Attack (TIA) within the past year, unless full work-up reveals no ongoing risk
  • Extensive microvascular pathology or microbleeds
  • Multiple sclerosis or related demyelinating disorders
  • Parkinson s disease or related movement disorders (e.g., Multiple Systems Atrophy, Progressive Supranuclear Palsy)
  • Brain tumors
  • History of meningitis or encephalitis
  • History of moderate/severe traumatic brain injury (Glasgow Coma Scale \<= 12)
  • Other dementias (e.g., vascular dementia, mixed neurodegenerative-vascular dementia, Lewy body disease, frontotemporal dementia, primary progressive aphasia, Huntington s disease, corticobasal degeneration)
  • Epilepsy
  • Stable, mild neurological conditions (e.g., migraine, essential tremor, peripheral neuropathy) may be allowed at the discretion of the medically responsible investigator.
  • Psychiatric disorders:
  • +31 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

National Institute of Aging, Clinical Research Unit

Baltimore, Maryland, 21224, United States

Location

MeSH Terms

Conditions

Alzheimer Disease

Interventions

PsilocybinCognitive Training

Condition Hierarchy (Ancestors)

DementiaBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesTauopathiesNeurodegenerative DiseasesNeurocognitive DisordersMental Disorders

Intervention Hierarchy (Ancestors)

Indole AlkaloidsAlkaloidsHeterocyclic CompoundsIndolesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingTryptaminesIndolizidinesIndolizinesNeurological RehabilitationRehabilitationAftercareContinuity of Patient CarePatient CareTherapeuticsHealth ServicesHealth Care Facilities Workforce and Services

Study Officials

  • Dimitrios I Kapogiannis, M.D.

    National Institute on Aging (NIA)

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Dimitrios I Kapogiannis, M.D.

CONTACT

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
NONE
Purpose
OTHER
Intervention Model
PARALLEL
Sponsor Type
NIH
Responsible Party
SPONSOR

Study Record Dates

First Submitted

July 22, 2026

First Posted

July 23, 2026

Study Start (Estimated)

October 1, 2026

Primary Completion (Estimated)

December 31, 2030

Study Completion (Estimated)

December 31, 2030

Last Updated

July 24, 2026

Record last verified: 2026-07-07

Data Sharing

IPD Sharing
Will not share

Locations