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EMuNI Project: Multiple Nonpharmacological Interventions

Not Applicable
Completed
Conditions
Lifestyle Risk Reduction
Interventions
Dietary Supplement: Nutritional supplementation
Behavioral: Educational training
Behavioral: Counselling on a brain-healthy diet
Behavioral: Physical exercise training
Behavioral: Computerized cognitive training
Registration Number
NCT03382353
Lead Sponsor
IRCCS Centro San Giovanni di Dio Fatebenefratelli
Brief Summary

By 2030, the global prevalence of Alzheimer's Disease (AD) is predicted to reach 65.7 million worldwide. Despite extensive research efforts, a cure for AD has not been identified. Recent studies on non-demented individuals have demonstrated the importance of a healthy lifestyle (physical exercise, healthy diet) and non pharmacological interventions (diet supplements) to delay the onset of the cognitive decline (Vemuri P et al., 2012). Given that AD is a multi-factorial disorder, some multi- component interventions at early stages could be the best strategy currently available to delay the AD onset. The aim of this study is to investigate the effects of combined non-pharmacological interventions, at different levels of intensity, on cognitive performance, on basic (hippocampal, brain ventricle volumes and white matter lesions) and advanced magnetic resonance imaging (MRI) markers (Resting-state Functional MRI, Probabilistic Diffusion Tensor Tractography

Detailed Description

BACKGROUND Recent evidence showed that aerobic exercise, dietary habits and nutritional supplements consumption seem essential for maintaining good cognitive performances increasing hippocampal volume (HV) in healthy elderly people (Erickson et al., 2011; Bowman et al., 2012). Computerized cognitive trainings are effective in improving cognitive functions of healthy older adults (Lampit et al., 2014). Subjective memory complaint (SMC) individuals showed HV, white matter lesions (WML) and brain ventricle volumes (BVV) at limits of normative population (Cavedo et al., 2012) supporting the hypothesis that they are persons at risk of AD (Sperling et al., 2011). The above non-pharmacological treatments, when separately applied, do not impact on cognition and neuropathological processes of AD. On the contrary, combined treatments, in persons at risk to develop AD, could represent the first line of intervention to delay the onset of cognitive impairment.

SPECIFIC AIMS

1. To investigate the combined effect of aerobic exercise, dietary habits, nutritional supplements, and cognitive training administered at three different levels of intensity on cognitive performance in subjective memory complaints individuals. The three different intensity levels of nonpharmacological treatments will be organized as follows: (i) No Treatment (NT) will include educational training (sham condition); (ii) Partial Treatment (PT) will include exclusively the consumption of a nutritional supplement and a training for a balanced diet; (iii) Full treatment (FT) will include all above condition plus computerized cognitive training (no sham condition) and aerobic fitness training.

2. To investigate the effect of the above treatments (NT, PT, FT) on basic markers of magnetic resonance imaging (MRI) such as HV, WML and Brain Ventricle Volume (BVV) in subjective memory complaints individuals.

3. To investigate the effect of NT, PT and FT on advanced MRI markers such as structural brain connectivity and brain resting networks in subjective memory complaints individuals.

HYPHOTESIS AND SIGNIFICANCE An improvement in cognitive performances, basic (HV, WML, BVV) and advanced (structural brain connectivity and brain resting networks) MRI markers will be expected in FT group compared to NT group. Moreover, the investigators hypothesize an effect dependent of the number of combined treatments, thus the PT group is expected to show intermediate results (among NT and FT groups) in the cognitive performances, basic and advanced MRI markers previously described.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
120
Inclusion Criteria
  • age between 60 and 80 years;
  • presence of memory complaints
Exclusion Criteria
  • objective cognitive impairment on standard neuropsychological testing;
  • history of psychiatric disorders or current clinically relevant depressive or anxious symptoms;
  • pacemakers, cochlear implant, metal inserts in the head or shoulders

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Full Treatment (FT)Counselling on a brain-healthy dietNutritional supplementation \& Counselling on a brain-healthy diet \& Physical exercise training \& Computerized cognitive training
Partial Treatment (PT)Nutritional supplementationNutritional supplementation \& Counselling on a brain-healthy diet
No Treatment (NT)Educational trainingEducational training
Partial Treatment (PT)Counselling on a brain-healthy dietNutritional supplementation \& Counselling on a brain-healthy diet
Full Treatment (FT)Physical exercise trainingNutritional supplementation \& Counselling on a brain-healthy diet \& Physical exercise training \& Computerized cognitive training
Full Treatment (FT)Computerized cognitive trainingNutritional supplementation \& Counselling on a brain-healthy diet \& Physical exercise training \& Computerized cognitive training
Full Treatment (FT)Nutritional supplementationNutritional supplementation \& Counselling on a brain-healthy diet \& Physical exercise training \& Computerized cognitive training
Primary Outcome Measures
NameTimeMethod
Cognitive functions12 months

Neuropsychological test performances

Secondary Outcome Measures
NameTimeMethod
Basic imaging marker 212 months

White matter hyperintensities volumes

Basic imaging marker 312 months

Brain ventricle volumes

Basic imaging marker 112 months

Hippocampal volumes

Trial Locations

Locations (2)

IRCCS Centro San Giovanni di Dio Fatebenefratelli

🇮🇹

Brescia, Italy

Ospedale San Raffaele

🇮🇹

Milan, Italy

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