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Published in: Trials 1/2009

Open Access 01-12-2009 | Study protocol

The PACE Study: A randomised clinical trial of cognitive activity (CA) for older adults with mild cognitive impairment (MCI)

Authors: Mandy R Vidovich, Nicola T Lautenschlager, Leon Flicker, Linda Clare, Osvaldo P Almeida

Published in: Trials | Issue 1/2009

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Abstract

Background

Research evidence from observational studies suggests that cognitive activity reduces the risk of cognitive impairment in later life as well as the rate of cognitive decline of people with dementia. The Promoting Healthy Ageing with Cognitive Exercise (PACE) study has been designed to determine whether a cognitive activity intervention decreases the rate of cognitive decline amongst older adults with mild cognitive impairment (MCI).

Methods/Design

The study will recruit 160 community-dwelling men and women aged 65 years of age or over with mild cognitive impairment (MCI). Participants will be randomly allocated to two treatment groups: non-specific education and cognitive activity. The intervention will consist of ten 90-minute sessions delivered twice per week over a period of five weeks. The primary outcome measure of the study is the change from baseline in the total score on the Cambridge Cognitive Score (CAMCOG). Secondary outcomes of interest include changes in memory, attention, executive functions, mood and quality of life. Primary endpoints will be collected 12, 52 and 104 weeks after the baseline assessment.

Discussion

The proposed project will produce the best available evidence on the merits of increased cognitive activity as a strategy to prevent cognitive decline among older adults with MCI. We anticipate that the results of this study will have implications for the development of evidence-based preventive strategies to reduce the rate of cognitive decline amongst older people at risk of dementia.

Trial registration

ACTRN12608000556347
Literature
1.
go back to reference Mathers CD, Stein C, Ma Fat D, Rao C, Inoue M, Tomijima N, Bernard C, Lopez AD, Murray CJL: Global Burden of Disease 2000: Version 2, Methods and Results. Global Program on Evidence for Health Policy Discussion Paper 50. 2002, WHO, Geneva Mathers CD, Stein C, Ma Fat D, Rao C, Inoue M, Tomijima N, Bernard C, Lopez AD, Murray CJL: Global Burden of Disease 2000: Version 2, Methods and Results. Global Program on Evidence for Health Policy Discussion Paper 50. 2002, WHO, Geneva
2.
go back to reference Portet F, Ousset PJ, Visser PJ, Frisoni GB, Nobili F, Scheltens P, Vellas B, Touchon J, the MCI Working Group of the European Consortium on Alzheimer's Disease (EADC): Mild cognitive impairment (MCI) in medical practice: a critical review of the concept and new diagnostic procedure. Report of the MCI Working Group of the European Consortium on Alzheimer's Disease. J Neurol Neurosurg Psychiatry. 2006, 77: 714-718. 10.1136/jnnp.2005.085332.CrossRefPubMedPubMedCentral Portet F, Ousset PJ, Visser PJ, Frisoni GB, Nobili F, Scheltens P, Vellas B, Touchon J, the MCI Working Group of the European Consortium on Alzheimer's Disease (EADC): Mild cognitive impairment (MCI) in medical practice: a critical review of the concept and new diagnostic procedure. Report of the MCI Working Group of the European Consortium on Alzheimer's Disease. J Neurol Neurosurg Psychiatry. 2006, 77: 714-718. 10.1136/jnnp.2005.085332.CrossRefPubMedPubMedCentral
3.
go back to reference Gauthier S, Reisberg B, Zaudig M, Petersen RC, Ritchie K, Broich K, Belleville S, Broadty H, Bennett D, Chertkow H, Cummings JL, de Leon M, Feldman H, Ganguli M, Hampel H, Scheltens P, Tierney MC, Whitehouse P, Winblad B: Mild cognitive impairment. Lancet. 2006, 367: 1262-1270. 10.1016/S0140-6736(06)68542-5.CrossRefPubMed Gauthier S, Reisberg B, Zaudig M, Petersen RC, Ritchie K, Broich K, Belleville S, Broadty H, Bennett D, Chertkow H, Cummings JL, de Leon M, Feldman H, Ganguli M, Hampel H, Scheltens P, Tierney MC, Whitehouse P, Winblad B: Mild cognitive impairment. Lancet. 2006, 367: 1262-1270. 10.1016/S0140-6736(06)68542-5.CrossRefPubMed
4.
go back to reference Verghese J, Lipton RB, Katz MJ, Hall CB, Derby CA, Kuslansky G, Ambrose AF, Sliwinskil M, Buschke H: Leisure activities and the risk of dementia in the elderly. N Engl J Med. 2003, 348: 2508-2516. 10.1056/NEJMoa022252.CrossRefPubMed Verghese J, Lipton RB, Katz MJ, Hall CB, Derby CA, Kuslansky G, Ambrose AF, Sliwinskil M, Buschke H: Leisure activities and the risk of dementia in the elderly. N Engl J Med. 2003, 348: 2508-2516. 10.1056/NEJMoa022252.CrossRefPubMed
5.
go back to reference Wang JYJ, Zhou DH, Li J, Zhang M, Deng J, Tang M, Gao C, Lian Y, Chen M: Leisure activity and risk of cognitive impairment: The Chongqing aging study. Neurology. 2006, 66: 911-913. 10.1212/01.wnl.0000192165.99963.2a.CrossRefPubMed Wang JYJ, Zhou DH, Li J, Zhang M, Deng J, Tang M, Gao C, Lian Y, Chen M: Leisure activity and risk of cognitive impairment: The Chongqing aging study. Neurology. 2006, 66: 911-913. 10.1212/01.wnl.0000192165.99963.2a.CrossRefPubMed
6.
go back to reference Salthouse TA: Mental exercise and mental aging: evaluating the validity of the 'Use It or Lose It' hypothesis. Perspect Psychol Sci. 2006, 1: 68-87. 10.1111/j.1745-6916.2006.00005.x.CrossRefPubMed Salthouse TA: Mental exercise and mental aging: evaluating the validity of the 'Use It or Lose It' hypothesis. Perspect Psychol Sci. 2006, 1: 68-87. 10.1111/j.1745-6916.2006.00005.x.CrossRefPubMed
7.
go back to reference Clare L, Woods RT, Moniz Cook ED, Orrell M, Spector A: Cognitive rehabilitation and cognitive training for early-stage Alzheimer's disease and vascular dementia. The Cochrane Database of Systematic Reviews. 2003, CD003260-4 Clare L, Woods RT, Moniz Cook ED, Orrell M, Spector A: Cognitive rehabilitation and cognitive training for early-stage Alzheimer's disease and vascular dementia. The Cochrane Database of Systematic Reviews. 2003, CD003260-4
8.
go back to reference Thompson G, Foth D: Cognitive-training programs for older adults: What are they and can they enhance mental fitness?. Educ Gerontol. 2005, 31: 603-626. 10.1080/03601270591003364.CrossRef Thompson G, Foth D: Cognitive-training programs for older adults: What are they and can they enhance mental fitness?. Educ Gerontol. 2005, 31: 603-626. 10.1080/03601270591003364.CrossRef
9.
go back to reference World Health Organisation: International Statistical Classification of Diseases and Related Health Problems - 10th Revision. Geneva. 2007 World Health Organisation: International Statistical Classification of Diseases and Related Health Problems - 10th Revision. Geneva. 2007
10.
go back to reference Folstein MF, Folstein SE, McHugh PR: Mini-mental State: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975, 12: 189-198. 10.1016/0022-3956(75)90026-6.CrossRefPubMed Folstein MF, Folstein SE, McHugh PR: Mini-mental State: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975, 12: 189-198. 10.1016/0022-3956(75)90026-6.CrossRefPubMed
11.
go back to reference Kroenke K, Spitzer RL, Williams JBW: The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001, 16: 606-613. 10.1046/j.1525-1497.2001.016009606.x.CrossRefPubMedPubMedCentral Kroenke K, Spitzer RL, Williams JBW: The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001, 16: 606-613. 10.1046/j.1525-1497.2001.016009606.x.CrossRefPubMedPubMedCentral
12.
go back to reference Spitzer RL, Williams JBW, Kroenke K, Linzer M, deGruy FV, Hahn SR, Brody D, Johnson JG: Utility of a new procedure for diagnosing mental disorders in primary care: the PRIME-MD 1000 study. JAMA. 1994, 272: 1749-1756. 10.1001/jama.272.22.1749.CrossRefPubMed Spitzer RL, Williams JBW, Kroenke K, Linzer M, deGruy FV, Hahn SR, Brody D, Johnson JG: Utility of a new procedure for diagnosing mental disorders in primary care: the PRIME-MD 1000 study. JAMA. 1994, 272: 1749-1756. 10.1001/jama.272.22.1749.CrossRefPubMed
13.
go back to reference Breitner J, Welsh K, Magruder-Habib K, Churchill CM, Robinette CD, Folstein MF: Alzheimer's disease in the National Academy of Sciences Registry of Aging Twin Veterans, Pilot investigation. Dementia. 1990, 1: 287-303. Breitner J, Welsh K, Magruder-Habib K, Churchill CM, Robinette CD, Folstein MF: Alzheimer's disease in the National Academy of Sciences Registry of Aging Twin Veterans, Pilot investigation. Dementia. 1990, 1: 287-303.
14.
go back to reference Morris JC, Heyman A, Mohs RC, Hughes JP, van Belle G, Fillenbaum G, Mellits ED, Clark C: The consortium to establish a registry for Alzheimer's disease (CERAD): I Clinical and neuropsychological assessment of Alzheimer's disease. Neurology. 1989, 39: 1159-1165.CrossRefPubMed Morris JC, Heyman A, Mohs RC, Hughes JP, van Belle G, Fillenbaum G, Mellits ED, Clark C: The consortium to establish a registry for Alzheimer's disease (CERAD): I Clinical and neuropsychological assessment of Alzheimer's disease. Neurology. 1989, 39: 1159-1165.CrossRefPubMed
15.
go back to reference Chandler MJ, Lacritz LH, Hynan LS, Barnard BA, Allen G, Deschner M, Weiner MF, Cullum CM: A total score for the CERAD neuropsychological battery. Neurology. 2005, 65: 102-106. 10.1212/01.wnl.0000167607.63000.38.CrossRefPubMed Chandler MJ, Lacritz LH, Hynan LS, Barnard BA, Allen G, Deschner M, Weiner MF, Cullum CM: A total score for the CERAD neuropsychological battery. Neurology. 2005, 65: 102-106. 10.1212/01.wnl.0000167607.63000.38.CrossRefPubMed
16.
go back to reference Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M: Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption. Addiction. 1993, 88: 791-804. 10.1111/j.1360-0443.1993.tb02093.x.CrossRefPubMed Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M: Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption. Addiction. 1993, 88: 791-804. 10.1111/j.1360-0443.1993.tb02093.x.CrossRefPubMed
17.
go back to reference Mahurin RK, DeBettignieis , Pirozzolo FJ: Structured assessment of independent living skills: preliminary report of a performance measure of functional abilities in dementia. J Gerontol. 1991, 46: 58-66.CrossRef Mahurin RK, DeBettignieis , Pirozzolo FJ: Structured assessment of independent living skills: preliminary report of a performance measure of functional abilities in dementia. J Gerontol. 1991, 46: 58-66.CrossRef
18.
go back to reference Roth M, Huppert FA, Mountjoy CQ, Tym E: The Cambridge exam for mental disorders of the elderly - revised. 1998, Cambridge University Press, UK Roth M, Huppert FA, Mountjoy CQ, Tym E: The Cambridge exam for mental disorders of the elderly - revised. 1998, Cambridge University Press, UK
19.
go back to reference Huppert FA, Jorm AF, Brayne C, Girling DM, Barkley C, Beardsall L, Paykel E: Psychometric properties of the CAMCOG and its efficacy in the diagnosis of dementia. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 1996, 3: 201-214.CrossRef Huppert FA, Jorm AF, Brayne C, Girling DM, Barkley C, Beardsall L, Paykel E: Psychometric properties of the CAMCOG and its efficacy in the diagnosis of dementia. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 1996, 3: 201-214.CrossRef
20.
go back to reference Cullum S, Huppert FA, McGee M, Dening T, Ahmed A, Paykel ES, Brayne C: Decline across different domains of cognitive function in normal ageing: results of a longitudinal population-based study using CAMCOG. Int J Geriatr Psychiatry. 2000, 15: 853-62. 10.1002/1099-1166(200009)15:9<853::AID-GPS211>3.0.CO;2-T.CrossRefPubMed Cullum S, Huppert FA, McGee M, Dening T, Ahmed A, Paykel ES, Brayne C: Decline across different domains of cognitive function in normal ageing: results of a longitudinal population-based study using CAMCOG. Int J Geriatr Psychiatry. 2000, 15: 853-62. 10.1002/1099-1166(200009)15:9<853::AID-GPS211>3.0.CO;2-T.CrossRefPubMed
21.
go back to reference Delis DC, Kramer JH, Kaplan E, Ober BA: California Verbal Learning Test: Adult version manual. 1999, San Antonio, The Psychological Corporation Delis DC, Kramer JH, Kaplan E, Ober BA: California Verbal Learning Test: Adult version manual. 1999, San Antonio, The Psychological Corporation
22.
go back to reference Tuokko H, Frerichs RJ: Cognitive Impairment with No Dementia (CIND): Longitudinal studies, the findings and the issues. Clin Neuropsychol. 2000, 14: 504-525.CrossRefPubMed Tuokko H, Frerichs RJ: Cognitive Impairment with No Dementia (CIND): Longitudinal studies, the findings and the issues. Clin Neuropsychol. 2000, 14: 504-525.CrossRefPubMed
23.
go back to reference Wechsler D: Wechsler Adult Intelligence Scale. 1997, The Psychological Corporation. San Antonio: Harcourt Brace and Company, Third Wechsler D: Wechsler Adult Intelligence Scale. 1997, The Psychological Corporation. San Antonio: Harcourt Brace and Company, Third
24.
go back to reference Wilson RS, Mendes de Leon CF, Barnes LL, Schneider JA, Bienias JL, Evans DA, Bennett DA: Participation in Cognitively Stimulating Activities and Risk of Incident Alzheimer Disease. JAMA. 2002, 287: 742-748. 10.1001/jama.287.6.742.CrossRefPubMed Wilson RS, Mendes de Leon CF, Barnes LL, Schneider JA, Bienias JL, Evans DA, Bennett DA: Participation in Cognitively Stimulating Activities and Risk of Incident Alzheimer Disease. JAMA. 2002, 287: 742-748. 10.1001/jama.287.6.742.CrossRefPubMed
25.
go back to reference Spreen O, Strauss E: A Compendium of Neuropsychological Tests. 1991, New York: Oxford University Press Spreen O, Strauss E: A Compendium of Neuropsychological Tests. 1991, New York: Oxford University Press
26.
go back to reference Koenig HG, Westlund R, George LK, Hughes DC, Hybels C: Abbreviating the Duke Social Support Index for use in chronically ill older adults. Psychosomatics. 1993, 34: 61-69.CrossRefPubMed Koenig HG, Westlund R, George LK, Hughes DC, Hybels C: Abbreviating the Duke Social Support Index for use in chronically ill older adults. Psychosomatics. 1993, 34: 61-69.CrossRefPubMed
27.
go back to reference Jamrozik K, Norman PE, Spencer CA, Parsons RW, Tuohy R, Lawrence-Brown MM, Dickinson JA: Screening for abdominal aortic aneurysm: lessons from a population-based study. Med J Aust. 2000, 173: 345-350.PubMed Jamrozik K, Norman PE, Spencer CA, Parsons RW, Tuohy R, Lawrence-Brown MM, Dickinson JA: Screening for abdominal aortic aneurysm: lessons from a population-based study. Med J Aust. 2000, 173: 345-350.PubMed
28.
go back to reference Gilewski MJ, Zelinski EM, Schaie KW: The Memory Functioning Questionnaire for assessment of memory complaints in adulthood and old age. Psychol Aging. 1990, 5: 482-490. 10.1037/0882-7974.5.4.482.CrossRefPubMed Gilewski MJ, Zelinski EM, Schaie KW: The Memory Functioning Questionnaire for assessment of memory complaints in adulthood and old age. Psychol Aging. 1990, 5: 482-490. 10.1037/0882-7974.5.4.482.CrossRefPubMed
29.
go back to reference Logsdon RG, Gibbons LE, McCurry SM, Teri L: Assessing quality of life in older adults with cognitive impairment. Psychosom Med. 2002, 64: 510-519.CrossRefPubMed Logsdon RG, Gibbons LE, McCurry SM, Teri L: Assessing quality of life in older adults with cognitive impairment. Psychosom Med. 2002, 64: 510-519.CrossRefPubMed
30.
go back to reference Cullum S, Huppert FA, McGee M, Dening T, Ahmed A, Paykel ES, Brayne C: Decline across different domains of cognitive function in normal aging: results of a longitudinal population-based study using CAMCOG. Int J Geriatr Psychiatry. 2000, 15: 853-62. 10.1002/1099-1166(200009)15:9<853::AID-GPS211>3.0.CO;2-T.CrossRefPubMed Cullum S, Huppert FA, McGee M, Dening T, Ahmed A, Paykel ES, Brayne C: Decline across different domains of cognitive function in normal aging: results of a longitudinal population-based study using CAMCOG. Int J Geriatr Psychiatry. 2000, 15: 853-62. 10.1002/1099-1166(200009)15:9<853::AID-GPS211>3.0.CO;2-T.CrossRefPubMed
31.
go back to reference Lautenschlager NT, Cox K, Flicker L, Foster JK, van Bockxmeer F, Xiao J, Greenop KR, Almeida OP: Effects of Physical Activity on Cognitive Function in Older Adults at Risk for Alzheimer's Disease. JAMA. 2008, 300: 1027-1037. 10.1001/jama.300.9.1027.CrossRefPubMed Lautenschlager NT, Cox K, Flicker L, Foster JK, van Bockxmeer F, Xiao J, Greenop KR, Almeida OP: Effects of Physical Activity on Cognitive Function in Older Adults at Risk for Alzheimer's Disease. JAMA. 2008, 300: 1027-1037. 10.1001/jama.300.9.1027.CrossRefPubMed
Metadata
Title
The PACE Study: A randomised clinical trial of cognitive activity (CA) for older adults with mild cognitive impairment (MCI)
Authors
Mandy R Vidovich
Nicola T Lautenschlager
Leon Flicker
Linda Clare
Osvaldo P Almeida
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Trials / Issue 1/2009
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/1745-6215-10-114

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