Mild Cognitive Impairment Clinical Trial
Official title:
Measuring the Impact of Cognitive and Psychosocial Interventions in Persons With Mild Cognitive Impairment
Memory interventions are training programs that provide a variety of cognitive and
psychological strategies meant to improve memory. These interventions have been shown to
yield significant benefits to normal aged persons and small-size studies have shown that
they are suitable and beneficial for persons with mild cognitive impairment. The goal of
this proposal is to assess with a well-controlled design the efficiency and specificity of
cognitive training in persons with mild cognitive impairment.
The hypothesis is that cognitive training can improve the cognition of persons with mild
cognitive impairment and that this improvement can be enduring.
Elderly persons with mild cognitive impairment experience a cognitive decline that is
confirmed by a neuropsychological examination but do not meet the clinical criteria for
dementia. However, longitudinal studies have shown that up to 75% of these persons develop
dementia of the Alzheimer type after 5 years of follow-up. A significant proportion of these
persons are thus in a prodromal phase of the disease. This phase is likely to represent a
key moment in which to apply appropriate interventions. Indeed, these persons have the
cognitive capabilities to benefit from such interventions. Cognitive training has been shown
to be effective in improving the memory function of older persons without cognitive decline
and increasing evidence indicates that persons with MCI might also benefit from such
interventions. However, there is few researches have focused on the Mild Cognitive
Impairment population in spite of the fact that they are at-risk of experiencing significant
cognitive problems in the next few years while still having the potential to benefit from
non-pharmacological interventions. In a number of pilot studies, the investigators compared
cognitive and psychosocial intervention to a control intervention in persons with MCI. The
participants' performance improved on proximal outcomes and on distal outcomes (activities
of daily living). The purpose of this project is to study the efficacy of the cognitive
intervention in a larger group of participants, compare it with a non-cognitive
intervention, assess the long term maintenance of the improvement and measure the potential
implication of cognitive and psychosocial factors.
Persons with Mild Cognitive Impairment will first receive a comprehensive clinical
assessment to determine whether they meet the research criteria for Mild Cognitive
Impairment. They will then be randomly allocated to one of three groups. One group will
receive cognitive training, one group will receive psychosocial intervention and one group
will receive no intervention. The two interventions will be offered on a one-session per
week basis during an 8-week period. The cognitive intervention will include training of
attention and episodic memory. This intervention is based on recently acquired knowledge
regarding the nature of the deficits in mild cognitive impairment as well as factors that
are known to optimize memory. The psychosocial intervention will focus on goal management.
Booster sessions will be offered to the intervention groups after 3 and 6 months. Each
intervention will act as social contact control group for the other intervention. The third
group will receive no intervention and will be used as a no-contact control group.
All groups will undergo one pre-intervention assessment (1-2 week before beginning of
intervention), one post-intervention assessment (1-2 week after end of intervention) and
additional assessments one week after before the booster sessions and nine month following
end of training. This last assessment will measure long-term retention of training and will
assess the degree of change in the clinical profile of patients.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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