Aging > Integrated Program Of Cognitive Remediation, Physical Exercise And Socially Stimulating Activity
Cognitive & Physical Activities for Aging-related Mental Health Challenges (I-COACH Trial)
Palo Alto (17 mi)Age: 18+
Sex: Any
Travel: May be covered
Time Reimbursement: Varies
Trial Phase: N/A
Recruiting
Sponsor: Centre for Addiction and Mental Health
No Placebo Group
Trial Summary
What is the purpose of this trial?The I-COACH study will focus on seniors with mental health conditions who are living in senior community housing. This initiative proposes to assess the feasibility and acceptability of a 12-week integrated program of cognitive remediation (CR) in combination with social and physical activity using an open-label design. The program will be provided over three iterative groups of six participants each, with one Personal Support Worker (PSW). The program will be co-designed at a granular level in an iterative process, drawing upon feedback provided by each participant group, PSW, and community housing staff to improve the user experience.
We will build the capacity for community personal support workers (PSWs) to deliver this program independently and with fidelity to the intervention model. Our ultimate goal is to help seniors continue to live as long as possible in their homes within the community.
What safety data exists for the cognitive and physical activity program for aging-related mental health challenges?The home-based exercise program study for older adults with Motoric Cognitive Risk syndrome found that the exercises were safe and feasible, with no adverse effects reported. This suggests that similar integrated programs combining cognitive and physical activities are likely safe for older adults.2491112
Is the I-COACH program a promising treatment for mental health challenges in aging?Yes, the I-COACH program is promising because it combines cognitive exercises, physical activities, and social interactions, which are all shown to help improve mental and physical health in older adults.17101213
Do I need to stop my current medications to join the trial?The trial protocol does not specify if you need to stop your current medications. However, you must be clinically stable, which includes no changes in psychotropic medication dosage within 4 weeks prior to assessment.
What data supports the idea that Cognitive & Physical Activities for Aging-related Mental Health Challenges is an effective treatment?The available research shows that combining cognitive training with physical activities, like Tai Chi and group counseling, can improve brain function and thinking skills in older adults. One study found that after a 6-week program, participants showed better cognitive performance and changes in brain activity that were linked to these improvements. Another study indicated that combining cognitive and physical activities was more effective for overall thinking skills and memory than just cognitive training alone. These findings suggest that this treatment can help maintain a healthy brain and improve thinking abilities in older adults.34568
Eligibility Criteria
This trial is for older adults over 50 living in community housing with mental health conditions, who speak English and are clinically stable. They must be able to see and hear well enough to participate. Those with profound cognitive impairment or recent substance use issues cannot join.Treatment Details
The study tests a 12-week program combining cognitive exercises, physical activity, and social interaction for seniors with mental illness. It's an open-label design where feedback from participants helps refine the program.
1Treatment groups
Experimental Treatment
Group I: Integrated program of cognitive remediation, physical exercise and socially- stimulating activityExperimental Treatment1 Intervention
Cognitive Remediation (CR) is a well-established intervention that aims to improve neurocognitive abilities (such as memory performance, executive functioning, processing speed, and attention) using four techniques: didactic teaching, computerized drills, in-class strategic monitoring and discussions of the generalization of cognitive skills to daily life.
The physical exercise component consists of physical activities designed for the geriatric population that aim to reduce sedentary behaviors while increasing social engagement.
The socially stimulating activity aim to decrease social isolation, improve well-being, community connection and rapport.
The integrated, 12-week, group-based program consists of CR 1h/day, 2 days/week, 30min of physical exercises 1day/week and 1h of socially stimulating activities 1day/week
Find a clinic near you
Research locations nearbySelect from list below to view details:
Center for Addiction and Mental HealthToronto, Canada
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Who is running the clinical trial?
Centre for Addiction and Mental HealthLead Sponsor
LOFT Community ServicesCollaborator
References
The relationship between physical activity and mental factors in the elderly. [2008]There is often a close interplay between physical and mental symptoms in elderly people. Elderly may be fearful of becoming ill and dependent on other people. Physical activity as an integral part of preventive health work is therefore discussed in relation to mental health in the elderly. As regards more direct effects, studies suggest that relatively moderate training can have an effect on mental activity, satisfaction and self-respect. Physical activity is one among a number of modalities to counteract unnecessary passivity in the institutions for the elderly. Information activities could with advantage be directed to attitudes of both old and young towards physical development beyond the age of peak physical performance. Now that the debate in gerontology about the theory of disengagement (38) has calmed down in this country, it appears to be the general view that elderly people--physically and socially--should maintain their level of activity as long as possible. The purpose of this article is to discuss a number of investigations which directly and indirectly can yield some information about the relationship between physical activity and mental conditions. An attempt is made to relate this to practical trim- and training programs for the elderly.
Student-led exercise sessions yield significant fitness gains for Alzheimer's patients. [2022]At a time when they are losing skills in virtually all arenas of life, persons with Alzheimer's disease can experience significant, esteem-building achievements in physical fitness and mood through supervised participation in an exercise program. The effects of physical exercise plus cognitive and social stimulation on persons with early stage Alzheimer's disease were assessed in a longitudinal study. Twenty-four such individuals, aged 54 to 88 at program entry, participated in 16 to 20 exercise sessions and 10 community activity sessions per semester for two to eight semesters. Half of the weekly exercise sessions included memory and language stimulation activities. Students, supplemented by family caregivers, supervised the sessions. Exercise sessions consisted of flexibility, balance, aerobic, and weight resistance activities. Preparticipation and semiannual post-testing of aerobic fitness and duration and upper and lower body strength was done. Highly significant fitness gains (p
Study of Mental Activity and Regular Training (SMART) in at risk individuals: a randomised double blind, sham controlled, longitudinal trial. [2022]The extent to which mental and physical exercise may slow cognitive decline in adults with early signs of cognitive impairment is unknown. This article provides the rationale and methodology of the first trial to investigate the isolated and combined effects of cognitive training (CT) and progressive resistance training (PRT) on general cognitive function and functional independence in older adults with early cognitive impairment: Study of Mental and Regular Training (SMART). Our secondary aim is to quantify the differential adaptations to these interventions in terms of brain morphology and function, cardiovascular and metabolic function, exercise capacity, psychological state and body composition, to identify the potential mechanisms of benefit and broader health status effects.
A rehabilitation program for Alzheimer's disease. [2015]We present the design and implementation of a rehabilitation program (RP) adapted for people diagnosed with various phases of Alzheimer's disease (AD). The RP is a cognitive stimulation program that integrates the recommendations of the American College of Sports Medicine for aerobic, resistance, and balance exercises.
Combined cognitive-psychological-physical intervention induces reorganization of intrinsic functional brain architecture in older adults. [2022]Mounting evidence suggests that enriched mental, physical, and socially stimulating activities are beneficial for counteracting age-related decreases in brain function and cognition in older adults. Here, we used functional magnetic resonance imaging (fMRI) to demonstrate the functional plasticity of brain activity in response to a combined cognitive-psychological-physical intervention and investigated the contribution of the intervention-related brain changes to individual performance in healthy older adults. The intervention was composed of a 6-week program of combined activities including cognitive training, Tai Chi exercise, and group counseling. The results showed improved cognitive performance and reorganized regional homogeneity of spontaneous fluctuations in the blood oxygen level-dependent (BOLD) signals in the superior and middle temporal gyri, and the posterior lobe of the cerebellum, in the participants who attended the intervention. Intriguingly, the intervention-induced changes in the coherence of local spontaneous activity correlated with the improvements in individual cognitive performance. Taken together with our previous findings of enhanced resting-state functional connectivity between the medial prefrontal cortex and medial temporal lobe regions following a combined intervention program in older adults, we conclude that the functional plasticity of the aging brain is a rather complex process, and an effective cognitive-psychological-physical intervention is helpful for maintaining a healthy brain and comprehensive cognition during old age.
Physical Exercise with Multicomponent Cognitive Intervention for Older Adults with Alzheimer's Disease: A 6-Month Randomized Controlled Trial. [2020]This study aimed to investigate the effect of 6-month physical exercise with a multicomponent cognitive program (MCP) on the cognitive function of older adults with moderate to severe Alzheimer's disease (AD).
The Mental Activity and eXercise (MAX) trial: Effects on physical function and quality of life among older adults with cognitive complaints. [2021]Older adults with cognitive complaints are vulnerable to dementia, physical impairments, and poor quality of life. Exercise and mental activity may improve physical function and health-related quality of life (HRQOL) but combinations have not been investigated systematically. The Mental Activity and eXercise (MAX) trial found that mental activity plus exercise over 12weeks improved cognitive function (primary outcome) in sedentary older adults with cognitive complaints.
Effects of a Cognitive Training With and Without Additional Physical Activity in Healthy Older Adults: A Follow-Up 1 Year After a Randomized Controlled Trial. [2020]Background: Combining cognitive training (CT) with physical activity (CPT) has been suggested to be most effective in maintaining cognition in healthy older adults, but data are scarce and inconsistent regarding long-term effects (follow-up; FU) and predictors of success. Objective: To investigate the 1-year FU effects of CPT versus CT and CPT plus counseling (CPT+C), and to identify predictors for CPT success at FU. Setting and Participants: We included 55 healthy older participants in the data analyses; 18 participants (CPT group) were used for the predictor analysis. Interventions: In a randomized controlled trial, participants conducted a CT, CPT, or CPT+C for 7 weeks. Outcome Measures: Overall cognition, verbal, figural, and working memory, verbal fluency, attention, planning, and visuo-construction. Results: While within-group comparisons showed cognitive improvements for all types of training, only one significant interaction Group × Time favoring CPT in comparison to CPT+C was found for overall cognition and verbal long-term memory. The most consistent predictor for CPT success (in verbal short-term memory, verbal fluency, attention) was an initial low baseline performance. Lower education predicted working memory gains. Higher levels of insulin-like growth factor 1 (IGF-1) and lower levels of brain-derived neurotrophic factor at baseline (BDNF) predicted alternating letter verbal fluency gains. Discussion: Within-group comparisons indicate that all used training types are helpful to maintain cognition. The fact that cognitive and sociodemographic data as well as nerve growth factors predict long-term benefits of CPT contributes to the understanding of the mechanisms underlying training success and may ultimately help to adapt training to individual profiles. Clinical Trial Registration: WHO ICTRP (http://apps.who.int/trialsearch/), identifier DRKS00005194.
Interactive Effects of Physical Activity and Cognitive Activity on Cognition in Older Adults Without Mild Cognitive Impairment or Dementia. [2021]Objective: The purpose of this secondary analysis was to test effects of interactions between accelerometer-measured physical activity and self-reported cognitive activity on cognition in older adults without cognitive impairment. Method: Participants were 742 older adults from the Rush Memory and Aging Project who completed annual clinical evaluations. A series of parallel growth models tested effects of interactions between physical activity and cognitive activity on cognition (global index, five domains) at Year 5, controlling for demographics, health factors, and corresponding cognition measures at Year 1. Results: Results were mixed, with significant physical and cognitive activity interactive effects for working and semantic memory. In models without interactions, higher physical and cognitive activities at Year 1 and less decline in cognitive activity over time were independently associated with better cognition at Year 5. Discussion: These findings may inform interventions that enhance physical and cognitive activities to prevent cognitive impairment in older adults.
Effects of Aerobic Exercise, Cognitive and Combined Training on Cognition in Physically Inactive Healthy Late-Middle-Aged Adults: The Projecte Moviment Randomized Controlled Trial. [2022]Lifestyle interventions are promising strategies to promote cognitive health in aging. Projecte Moviment examines if aerobic exercise (AE), computerized cognitive training (CCT), and their combination (COMB) improves cognition, psychological health, and physical status compared to a control group. We assessed the moderating role of age and sex and the mediating effects of cardiorespiratory fitness (CRF), physical activity (PA), and psychological health on intervention-related cognitive benefits.
Home-based exercise program for older adults with Motoric Cognitive Risk syndrome: feasibility study. [2021]Aim: We developed a home-based goal-directed exercise program with telephonic coaching to overcome barriers to exercise participation in cognitively impaired older adults. Methods: Six patients with Motoric Cognitive Risk syndrome at high risk for dementia were enrolled, three assigned to goal-directed exercises and three to stretching exercises. All participants underwent an in-person training session followed by a session at home with a telephonic coach. Sessions were supervised by a physiatrist, and exercise programs were personalized. Results: In-person training and remote telephonic coaching support promoted adherence. There were no adverse effects and interventions were rated highly. Participant and logistical barriers were identified that can inform design of home-based clinical trials. Conclusion: Home-based exercises are safe and feasible in older adults with Motoric Cognitive Risk.
A cross-sectional survey of a public, evidence-based multimodal program for cognitive health in older adults. [2021]In recent decades, the proportion of older adults in the population has continued to rise, and with it, the need for intervention programs to maintain cognitive functions into old age. Multiple lifestyle factors, including physical, cognitive, and social activities, are crucial to forestalling a decline in cognitive functions. However, Covid-19 curtailed most activities, and therefore, strategies are needed to support older adults in remaining cognitively healthy. This study describes a newly developed and publicly available multimodal program, called "brain coach", to support and stimulate cognitive activity in older adults. The autonomy supportive program integrates into daily life recommendations for evidence-based physical, cognitive, social, mindful, and creative activation exercises.
Study protocol for 'the effects of multimodal training of cognitive and/or physical functions on cognition and physical fitness of older adults: a cluster randomized controlled trial'. [2022]The elderly population worldwide is increasing exponentially which will be associated with more people suffering from cognition and fitness declines. The well-established benefits of exercise training for the elderly's cognitive and physical functioning have been observed. However, the amalgamated effect of combining cognitive and physical exercises on the older adults' cognitive functions, physical fitness, or psycho-related health remains unclear. Thus, this study protocol was planned to conduct different combinations of cognitive and/or physical training interventions to community-dwelling older adults and expected to see the multifaceted effects of the varied combination of training on their health.