Home-Based Assessment for Alzheimer Disease Prevention

NCT ID: NCT00546767

Last Updated: 2014-09-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

640 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-09-30

Study Completion Date

2013-06-30

Brief Summary

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The purpose of this study is to evaluate three methods of performing home-based assessments in Alzheimer's Disease (AD) prevention trials. The initial in-person assessment will be done in the clinic or at home.

Detailed Description

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There is an unmet need for effective, efficient, and economical methods for conducting AD prevention trials. Traditional in-person visits to clinical assessment sites are time consuming and costly and may exclude some people from participation, such as those who are older, or are less mobile or with significant medical illnesses. These may be the people who are at greatest risk for cognitive decline, and also may be without financial resources for services such as transportation to a study site. Prevention trials require long observation periods and these same issues of health, resources, and transportation may cause significant drop out. These obstacles increase expense of clinical trials which require large sample sizes, costly clinical staff and long observation periods. Thus, home-based assessments may lead to more representative recruitment of those most at risk for decline, as well as better retention and reduced study costs.

This is a randomized study of 600 participants, comparing three methods of test administration and data collection. Each enrolled participant will have an In-person (Standard) assessment (in the clinic or at home) prior to baseline.

Participants will be classified as either normal or MCI (Mild Cognitive Impairment) and randomly assigned to an assessment method and to a frequency of assessment. Cognitive performance, self-rated cognitive complaint, functioning in daily life, affective symptoms, global change, quality of life and resource use will all be assessed in each method at each visit. The total time for the at-home assessments will be approximately 45 minutes. In addition, all participants will be provided a multi-vitamin to be taken twice a day, and a measure of medication adherence will be collected for each assessment method.

Changes in certain cognitive measures may "trigger" an in-person assessment, in which participants may change from a categorization of normal or amnestic MCI, to non-amnestic MCI, impaired not MCI, or dementia (i.e., specifically Alzheimer's Disease or another dementia). We estimate that 12% of the study population will trigger over the 4 years of the study and will progress to a more impaired diagnostic category. In addition, a random sample of non-triggered cases (25%) will be selected for an in-person re-assessment during the 4 years of the protocol as a comparison for the trigger group. At the end of the 4-year study period all participants will undergo an in-person evaluation.

Conditions

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Mild Cognitive Impairment Alzheimer's Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SCREENING

Blinding Strategy

NONE

Study Groups

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Mail and Live Phone

Group Type EXPERIMENTAL

Mail and Live Phone

Intervention Type BEHAVIORAL

This group will receive assessments of all domains by mail, except for the cognitive performance assessment which will be administered via phone by a live, trained evaluator. Medication compliance will be monitored by a written medication log which will be returned by mail with the other mail-in assessments.

IVR

Group Type EXPERIMENTAL

Interactive Voice Response (IVR)

Intervention Type BEHAVIORAL

In this group, participants will be asked to answer questions via an automated phone system using interactive voice recognition (IVR) and key-pad response entry. Medication compliance will be monitored by the same method. A standard large-key telephone and training in the use of the interactive phone system will be provided to all participants.

Computer Kiosk

Group Type EXPERIMENTAL

Home-based Computer Kiosk

Intervention Type BEHAVIORAL

Participants at entry will receive a special Kiosk-like device for collecting assessment information and will be taught to use this device. The user interface will consist of a monitor with a touch screen and a telephone handset, similar to what is often used in museum displays. Pre-recorded instructions will be delivered through the handset as well as displayed visually on the screen. Data will be collected using the handset's high-quality microphone. Daily activity assessments of timed medication use will be obtained via an automated medication tracking device.

Traditional

Group Type ACTIVE_COMPARATOR

Traditional Evaluation Instruments

Intervention Type BEHAVIORAL

Evaluation methods typically used in clinical trials

Interventions

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Mail and Live Phone

This group will receive assessments of all domains by mail, except for the cognitive performance assessment which will be administered via phone by a live, trained evaluator. Medication compliance will be monitored by a written medication log which will be returned by mail with the other mail-in assessments.

Intervention Type BEHAVIORAL

Interactive Voice Response (IVR)

In this group, participants will be asked to answer questions via an automated phone system using interactive voice recognition (IVR) and key-pad response entry. Medication compliance will be monitored by the same method. A standard large-key telephone and training in the use of the interactive phone system will be provided to all participants.

Intervention Type BEHAVIORAL

Home-based Computer Kiosk

Participants at entry will receive a special Kiosk-like device for collecting assessment information and will be taught to use this device. The user interface will consist of a monitor with a touch screen and a telephone handset, similar to what is often used in museum displays. Pre-recorded instructions will be delivered through the handset as well as displayed visually on the screen. Data will be collected using the handset's high-quality microphone. Daily activity assessments of timed medication use will be obtained via an automated medication tracking device.

Intervention Type BEHAVIORAL

Traditional Evaluation Instruments

Evaluation methods typically used in clinical trials

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Age 75 and older
* Willing to sign consent
* Willing to take multi-vitamins provided by the study
* Minimal computer skills or willingness to learn (as demonstrated by completion during screening of a demonstration module for each arm)
* English fluency
* MMSE greater than 26
* Able to answer and dial a telephone
* Able to complete the in-person assessment
* Able to complete the computerized assessment including adequate speech, hearing and vision
* Independently living adults, defined as living in a setting in which the participant can ensure access to the resources for study procedures
* Participation of a study partner is desirable and encouraged, but not required

Exclusion Criteria

* Dementia
* Use of prescription cognitive-enhancing drugs at entry (e.g. Aricept, Razadyne, Exelon, Namenda)
* Intent to continue use of own multi-vitamins (for the duration of the study participants must agree to take only study-distributed multi-vitamins)
* History or presence of major psychiatric, neurological or neurodegenerative conditions associated with significant cognitive impairment such as major stroke, Parkinson's disease, Multiple Sclerosis or Huntington's disease. Transient Ischemic Attack (TIA) is acceptable if over 6 months ago
* Medical conditions associated with life expectancy of less than 5 years
* Transient domicile interfering with ability to collect study-related data
* Current participation in a clinical trial involving Central Nervous System (CNS) medications or cognitive testing that would interfere with the current protocol (participation in Uniform Data Set (UDS) assessments by an ADC is permitted)
* Cohabitation with another participant in this particular study
Minimum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Institute on Aging (NIA)

NIH

Sponsor Role collaborator

Alzheimer's Disease Cooperative Study (ADCS)

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Mary Sano, PhD

Role: PRINCIPAL_INVESTIGATOR

Mount Sinai Medical School

Locations

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University of Alabama at Birmingham

Birmingham, Alabama, United States

Site Status

Sun Health Reseach Institute

Sun City, Arizona, United States

Site Status

University of California, Irvine Institute for Brain Aging and Dementia

Irvine, California, United States

Site Status

University of California-San Diego ADRC/Neurosciences

La Jolla, California, United States

Site Status

University of California, Davis

Martinez, California, United States

Site Status

Stanford University / PAIRE

Palo Alto, California, United States

Site Status

Yale University Alzheimer's Disease Research Unit

New Haven, Connecticut, United States

Site Status

Georgetown University

Washington D.C., District of Columbia, United States

Site Status

Mayo Clinic Jacksonville Neurology

Jacksonville, Florida, United States

Site Status

Wien Center

Miami Beach, Florida, United States

Site Status

University of South Florida, Suncoast Alzheimer's & Gerontology Center

Tampa, Florida, United States

Site Status

Northwestern University Cognitive Neurology & Alzheimer's Disease

Chicago, Illinois, United States

Site Status

Rush Alzheimer's Disease Center

Chicago, Illinois, United States

Site Status

Indiana University

Indianapolis, Indiana, United States

Site Status

University of Kentucky Sanders-Brown Center on Aging

Lexington, Kentucky, United States

Site Status

Johns Hopkins University

Baltimore, Maryland, United States

Site Status

Boston University Alzheimer's Disease Clinical and Research Program

Boston, Massachusetts, United States

Site Status

University of Michigan Psychiatry - Neuropsychology

Ann Arbor, Michigan, United States

Site Status

University of Nevada School of Medicine

Las Vegas, Nevada, United States

Site Status

New York University Aging and Dementia Research Center

New York, New York, United States

Site Status

Mount Sinai School of Medicine

New York, New York, United States

Site Status

Neurological Care of CNY

Syracuse, New York, United States

Site Status

Wake Forest University Gerontology and Geriatric Medicine

Winston-Salem, North Carolina, United States

Site Status

Case Western Reserve University

Cleveland, Ohio, United States

Site Status

The Ohio State University

Columbus, Ohio, United States

Site Status

Oregon Health & Science University

Portland, Oregon, United States

Site Status

University of Pennsylvania Geriatrics

Philadelphia, Pennsylvania, United States

Site Status

University of Utah Center for Alzheimer's Care

Salt Lake City, Utah, United States

Site Status

Countries

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United States

References

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Galasko D, Bennett DA, Sano M, Marson D, Kaye J, Edland SD; Alzheimer's Disease Cooperative Study. ADCS Prevention Instrument Project: assessment of instrumental activities of daily living for community-dwelling elderly individuals in dementia prevention clinical trials. Alzheimer Dis Assoc Disord. 2006 Oct-Dec;20(4 Suppl 3):S152-69. doi: 10.1097/01.wad.0000213873.25053.2b.

Reference Type BACKGROUND
PMID: 17135809 (View on PubMed)

Mundt JC, Ferber KL, Rizzo M, Greist JH. Computer-automated dementia screening using a touch-tone telephone. Arch Intern Med. 2001 Nov 12;161(20):2481-7. doi: 10.1001/archinte.161.20.2481.

Reference Type BACKGROUND
PMID: 11700161 (View on PubMed)

Piette JD. Interactive voice response systems in the diagnosis and management of chronic disease. Am J Manag Care. 2000 Jul;6(7):817-27.

Reference Type BACKGROUND
PMID: 11067378 (View on PubMed)

Tornatore JB, Hill E, Laboff JA, McGann ME. Self-administered screening for mild cognitive impairment: initial validation of a computerized test battery. J Neuropsychiatry Clin Neurosci. 2005 Winter;17(1):98-105. doi: 10.1176/jnp.17.1.98.

Reference Type BACKGROUND
PMID: 15746489 (View on PubMed)

Walsh SP, Raman R, Jones KB, Aisen PS; Alzheimer's Disease Cooperative Study Group. ADCS Prevention Instrument Project: the Mail-In Cognitive Function Screening Instrument (MCFSI). Alzheimer Dis Assoc Disord. 2006 Oct-Dec;20(4 Suppl 3):S170-8. doi: 10.1097/01.wad.0000213879.55547.57.

Reference Type BACKGROUND
PMID: 17135810 (View on PubMed)

Other Identifiers

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1RC2AG036535

Identifier Type: NIH

Identifier Source: secondary_id

View Link

ADC-030-HBA

Identifier Type: -

Identifier Source: secondary_id

IA0123

Identifier Type: -

Identifier Source: org_study_id

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