Study Results
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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COMPLETED
NA
122 participants
INTERVENTIONAL
2009-06-30
2017-03-30
Brief Summary
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Detailed Description
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Hypothesis: Cataract removal produces measurable benefits in vision, perception, independent function, and quality of life in patients with co-morbid Alzheimer's disease.
Primary Specific Aim: To determine the effects of cataract removal on visual acuity, spatial contrast sensitivity, vision dependent functions, visual information processing, and quality of life in patients with Alzheimer's disease.
Secondary Specific Aims.
1. To delineate the baseline characteristics of those patients who benefit most from the surgical intervention.
2. To assess the thickness of the retinal nerve fiber layer (RNFL) with optical coherence tomography (OCT) in large samples of AD patients classified with mild or moderate dementia to determine if the thickness of the RNFL is associated with dementia severity, visual performance measures, and other patient characteristics.
The study is designed as a Randomized Controlled Trial (RCT) with two cohorts of AD patients in a longitudinal investigation. Each person will be evaluated periodically over a 6 month period. All participants will be diagnosed with visually significant bilateral cataractous lens. The cohorts will be established by randomly assigning patients to either the immediate or the (optional) delayed surgery group. Patients will be stratified by AD severity (CDR mild or moderate) and cataract severity prior to being randomized. Comparisons between and within groups will test the change over time in vision, visual information processing, and quality of life associated with or without the removal of cataracts. The RNFL thickness of each person will be evaluated with optical coherence tomography (OCT). The thickness of the RNFL will be compared across dementia severity levels. Each consented participant will have a consenting study partner who may be referred to as a Research Partner, and who will often be the participant's caregiver. The latter will help to assure protocol adherence by the AD participants and will provide information about behavioral symptoms, activities of daily living, and amount of resources used. The study will demonstrate the clinical efficacy of cataract removal as a direct intervention to potentially improve the visual and cognitive functions, and the quality of life in persons diagnosed with AD.
Conditions
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Keywords
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Study Design
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RANDOMIZED
PARALLEL
OTHER
NONE
Study Groups
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Immediate Cataract Surgery
Subjects randomly selected into the Immediate Surgery group will have their cataract surgery scheduled one month from the time their initial study visits are completed. The subjects will be followed monthly for a period of 6 months for surgical and non-surgical adverse events. At the 6-month point, subjects will receive a final comprehensive eye exam and neuropsychological testing. The research partners will complete final activities of daily living and resource utilization questionnaires.
Immediate Cataract Surgery
Cataract surgery, as part of standard of care, will be performed on 1/2 of the group under investigation.
Delayed Cataract Surgery
Subjects selected into the Delayed Surgery group will be asked to delay their surgery for 6 months after their initial study visits. At 6 months, this group will also undergo the same testing as the Surgery Group.
No interventions assigned to this group
Interventions
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Immediate Cataract Surgery
Cataract surgery, as part of standard of care, will be performed on 1/2 of the group under investigation.
Eligibility Criteria
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Inclusion Criteria
* clinical diagnosis of possible/probable Alzheimer's disease, or other type of dementia, mild (CDR-1), moderate (CDR-2), or severe (CDR-3)
* at least 1 visually significant cataract
* no ocular pathology
* psychotropic drug must be with stable dosage for 30 days
Exclusion Criteria
* history of visually significant retinal, or optic nerve abnormalities
* informed consent cannot be obtained from either subject or their research partner
* subject shows evidence (in preoperative testing) of unstable cardiac or pulmonary function
* history of uncontrolled diabetes or hypertension
* history of stroke in areas known to affect cognition
* life expectancy of less than 1 year
* Down's Syndrome
50 Years
90 Years
ALL
No
Sponsors
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Case Western Reserve University
OTHER
MetroHealth Medical Center
OTHER
National Institute on Aging (NIA)
NIH
University Hospitals Cleveland Medical Center
OTHER
Responsible Party
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Grover C. Gilmore, PhD.
Principal Investigator
Principal Investigators
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Grover C. Gilmore, PhD.
Role: PRINCIPAL_INVESTIGATOR
Case Western Reserve University
Sara Debanne, PhD.
Role: STUDY_DIRECTOR
Case Western Reserve University
Julie Belkin, M.D.
Role: STUDY_DIRECTOR
University Hospitals Cleveland Medical Center
Jonathan Lass, M.D.
Role: STUDY_DIRECTOR
University Hospitals Cleveland Medical Center
Alan Lerner, M.D.
Role: STUDY_DIRECTOR
University Hospitals Cleveland Medical Center
Thomas Steinemann, M.D.
Role: STUDY_DIRECTOR
MetroHealth Medical Center
Locations
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University Hospitals Case Medical Center
Cleveland, Ohio, United States
MetroHealth Medical Center
Cleveland, Ohio, United States
Countries
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Other Identifiers
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04-09-21
Identifier Type: -
Identifier Source: org_study_id