Aging Clinical Trial
— OPTIMIZEOfficial title:
Optimal Timing of Computerized Cognitive Training for Older Intensive Care Unit Survivors
More than 60% of intensive care unit (ICU) patients are adults ages 60 and older, who are at high risk for ICU-acquired cognitive impairment. After ICU discharge, ICU survivors often experience sleep disturbances and inactivity, and almost 80% of ICU patients experience disturbances in circadian rhythm, which may affect cognitive function. Understanding the optimal, chronotherapeutic timing of cognitive interventions is crucial to promote circadian realignment and cognitive function, and may improve intervention feasibility, acceptability, and efficacy. Specific Aim 1 will determine feasibility, acceptability, and preliminary effect sizes for: 1) a morning session of a computerized cognitive training intervention [COG]; and 2) a late afternoon/early evening session of the COG intervention; compared to 3) standard inpatient care/usual care [UC]. Specific Aim 2 will examine circadian rhythm parameters to determine the optimal timing of the daily COG intervention. Exploratory Aim 3 will explore if the effects of the COG intervention on cognitive function are mediated by daytime activity, and explore if selected biological and clinical factors moderate intervention effects on cognitive function.
Status | Recruiting |
Enrollment | 40 |
Est. completion date | December 31, 2024 |
Est. primary completion date | December 31, 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 60 Years and older |
Eligibility | Inclusion Criteria: - Age = 60 years - ICU length of stay = 24 hours - Active transfer order or expected discharge from ICU to a post-ICU unit - Fluent in English - Functional independence prior to hospital admission (Katz Index = 6) - No suspicion of Alzheimer's disease/dementia - Current hospitalization at University of Washington Medical Center Exclusion Criteria: - Documented history or suspicion of Alzheimer's disease/dementia, or current prescription of anti-dementia medication - Documented history of bipolar disorder or schizophrenia - Documented acute stroke or acute traumatic brain injury - Severe visual impairment - Severe hearing impairment - Severe dominant arm paresis/paralysis - Transfer from inpatient rehabilitation or skilled nursing care facility |
Country | Name | City | State |
---|---|---|---|
United States | University of Washington Medical Center | Seattle | Washington |
Lead Sponsor | Collaborator |
---|---|
University of Washington | American Association of Critical Care Nurses |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Feasibility of morning-only sessions of computerized cognitive training | A retention rate of 80% will determine feasibility: the percentage of participants who complete all COG-AM sessions and cognitive outcome assessments. Adherence to the COG-AM intervention will be defined as the proportion of minutes spent training by the total minutes required per protocol (total minutes trained / [30 minutes x number of intervention days]). | 7 days | |
Primary | Feasibility of afternoon/evening-only sessions of computerized cognitive training | A retention rate of 80% will determine feasibility: the percentage of participants who complete all COG-PM sessions and cognitive outcome assessments. Adherence to the COG-PM intervention will be defined as the proportion of minutes spent training by the total minutes required per protocol (total minutes trained / [30 minutes x number of intervention days]). | 7 days | |
Primary | Acceptability of morning-only sessions of computerized cognitive training | Likert-type surveys including open-ended questions will be collected regarding acceptability of the COG-AM intervention. To evaluate tolerability, reasons why participants were unable to complete COG-AM sessions in their entirety will be recorded. | 7 days | |
Primary | Acceptability of afternoon/evening-only sessions of computerized cognitive training | Likert-type surveys including open-ended questions will be collected regarding acceptability of the COG-PM intervention. To evaluate tolerability, reasons why participants were unable to complete COG-PM sessions in their entirety will be recorded. | 7 days | |
Secondary | Cognitive function: attention | NIH Toolbox Cognition Battery: Flanker Inhibitory Control and Attention Test (age- and education-adjusted T-score); range: 0-100; higher scores indicate better performance | 7 days | |
Secondary | Cognitive function: cognitive flexibility | NIH Toolbox Cognition Battery: Dimensional Change Card Sort Test (age- and education-adjusted T-score); range: 0-100; higher scores indicate better performance | 7 days | |
Secondary | Cognitive function: processing speed | NIH Toolbox Cognition Battery: Pattern Comparison Processing Speed Test (age- and education-adjusted T-score); range: 0-100; higher scores indicate better performance | 7 days | |
Secondary | Cognitive function: global cognition | National Alzheimer's Coordinating Center Uniform Data Set: Montreal Cognitive Assessment; range: 0-30; higher scores indicate better performance | 7 days | |
Secondary | Cognitive function: verbal working memory | National Alzheimer's Coordinating Center Uniform Data Set: Number Span Test Forward; number of correct trials, range: 0-14; higher scores indicate better performance | 7 days | |
Secondary | Cognitive function: executive function | National Alzheimer's Coordinating Center Uniform Data Set: Number Span Test Backward; number of correct trials, range: 0-14; higher scores indicate better performance | 7 days | |
Secondary | Cognitive function: set-shifting | National Alzheimer's Coordinating Center Uniform Data Set: Oral Trail Making Test; time in seconds, range: 0-300; higher scores indicate worse performance | 7 days | |
Secondary | Circadian rhythm of continuous body temperature | Circadian rhythm: amplitude, acrophase, mesor via continuous body temperature obtained from wearable sensors | 7 days | |
Secondary | Activity counts per minute | Daytime activity: activity counts per minute during daytime hours via wrist actigraphy | 7 days | |
Secondary | Total sleep time in minutes | Nighttime sleep: total sleep time in minutes during nighttime hours via wrist actigraphy | 7 days |
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