Prevention of Cognitive Decline and Falls With Dalcroze Eurhythmics and a Simple Home Exercise Strength Program for Seniors With Subjective Cognitive Decline (SCD) - MOVE for Your MIND
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University of Zurich
- Enrollment
- 195
- Locations
- 1
- Primary Endpoint
- Change in cognitive function
Study Overview
Brief Summary
Among the most promising interventions targeting both cognitive and functional decline, is Exercise. However, evidence regarding exercise interventions among seniors with cognitive impairment are inconclusive, likely due to challenges of recruitment and adherence. Alternatively, seniors with subjective cognitive decline (SCD), who are not yet meeting objective criteria of cognitive impairment, but have been shown to have twice the conversion rate to dementia compared with healthy seniors, are more likely to be motivated to participate and adhere to exercise interventions. Thus, exercise interventions in seniors with SCD may provide a window of opportunity for early prevention of dementia and falls.
The investigators aim to test the effect of a group exercise (multi-task Jaques-Dalcroze Eurhythmics) and a simple home strength exercise program on change of cognitive function and the rate of falling among seniors with SCD.
Detailed Description
In Europe and in Switzerland, the number of seniors age 70 and older is predicted to increase from 25% to 40% by 2030, as is the number of seniors with cognitive impairments, physical frailty and resulting consequences, such as falls and loss of autonomy. One out of three seniors age 65 and one out of two seniors age 80 experience at least one fall per year. Prevalence of dementia increases with age and more than doubles a seniors' risk of falling.
Among the most promising interventions targeting both cognitive and functional decline, is Exercise. However, evidence regarding exercise interventions among seniors with cognitive impairment are inconclusive, likely due to challenges of recruitment and adherence. Alternatively, seniors with subjective cognitive decline (SCD), who are not yet meeting objective criteria of cognitive impairment, but have been shown to have twice the conversion rate to dementia compared with healthy seniors, are more likely to be motivated to participate and adhere to exercise interventions. Thus, exercise interventions in seniors with SCD may provide a window of opportunity for early prevention of dementia and falls.
The investigators aim to test the effect of a group exercise (multi-task Jaques-Dalcroze Eurhythmics) and a simple home strength exercise program on change of cognitive function and the rate of falling among seniors with SCD.
The MOVE for your MIND trial will be a single center, single-blinded randomized controlled clinical trial among 195 senior men and women and a 12 month follow-up. Participants will be community-dwelling seniors, age 70+ who meet the criteria for SCD without evidence for objective cognitive impairment. The 3 treatment arms are: (1) Jaques-Dalcroze Eurhythmics group exercise (1x60min/week), (2) simple home exercise strength program (3x30min/week), (3) control group without exercise intervention. All participants will receive a monthly "Healthy Nutrition" lecture. The hypothesis is that both exercise groups are superior to control. Under these assumptions, and a sample size of 195 seniors, the investigators will have >90% power for change in cognitive function and >80% power for the difference in the rate of falls. Clinical visits will be at baseline, 6 months, and 12 months. Therapeutic interventions for seniors with early subjective signs of cognitive decline that are effective, affordable, and well-tolerated in the prevention of both, cognitive and physical function decline, are urgently needed and will have an outstanding impact on public health as a whole. To the investigator's knowledge, this is the first exercise trial to target seniors with SCD and with the change in cognitive function and the rate of falls as the primary endpoints. Providing an evidence-base for a group- and a home-based exercise will give a choice to patients. Further, the mechanistic biomarker study for brain and muscle health among seniors with SCD will support the findings at the cellular level and whole-brain MRI imaging will support them at a structural level.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Prevention
- Masking
- Double (Investigator, Outcomes Assessor)
Eligibility Criteria
- Ages
- 70 Years to — (Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Age 70+, living in the community
- •Meet the criterion for SCD defined by a score of ≥25 points on the MAC-Q questionnaire
Exclusion Criteria
- •Signs of mild cognitive impairment (MCI), MoCA score ≤24
- •Score of ≥5 on the short form of the Geriatric Depression Scale (15items)
- •Inability to walk or to come to the study entre
- •Severe gait impairment or diseases with a risk of recurrent falling (e.g. Parkinson's disease/syndrome, Hemiplegia after stroke, symptomatic stenosis of the spinal canal, polyneuropathy, epilepsy, recurring vertigo, recurring syncope, heavy alcohol consumption)
- •Currently engaged in regular (once a week or more) strength training instructed by a professional teacher and including the explicit aim to improve muscle strength, or regular (once a week or more) Dalcroze eurhythmics classes
- •Active cancer or current cancer treatment
- •Inability to read and/or speak German necessary to understand the instructions
Arms & Interventions
Dalcroze Eurhythmics program
music-based multi-task exercise intervention
Intervention: Dalcroze Eurhythmics Program (Other)
home exercise strength program
simple strength training program to perform individually at home
Intervention: home exercise strength program (Other)
Control group
no change in the daily activities, no exercise intervention
Outcomes
Primary Outcomes
Change in cognitive function
Time Frame: 12 months
assessed with the CERAD-plus test
Rate of falls
Time Frame: 12 months
The circumstances and injuries associated with the fall will be ascertained with a questionnaire.
Secondary Outcomes
- Cognitive function: Trial Making Test A(12 months)
- Functional decline: timed up and go test(12 months)
- Cognitive function: Constructional Praxis(12 months)
- Proportion of seniors with any falls and injurious falls(12 months)
- Cognitive function: Mini Mental State Exam(12 months)
- Cognitive function: verbal fluency test(12 months)
- Cognitive function: Word List Recognition(12 months)
- Rate of injurious falls(12 months)
- Cognitive function: Boston Naming test(12 months)
- Cognitive function: Phonematic Fluency Test(12 months)
- Incident MCI(12 months)
- Cognitive function: Constructional Praxis Recall(12 months)
- Functional decline: repeated sit-to-stand test(12 months)
- Change in gait variability under single task condition(12 months)
- Quality of life: RAND 36-Item Short Form Survey(12 months)
- Changes in biomarkers of inflammation: hr-CRP(12 months)
- Functional decline: gait speed(12 months)
- Cognitive function: Trial Making Test B(12 months)
- Cognitive function: Word List Learning(12 months)
- Cognitive function: Word List Recall(12 months)
- Quality of life: EuroQuol(12 months)
- Changes in biomarkers of inflammation: IL-6(12 months)
- Functional decline: short physical performance battery(12 months)
- Change in gait variability under dual task condition(12 months)
- Changes in IGF-1(12 months)
- Functional decline: grip strength(12 months)
- Mental Health: Geriatric Depression Scale(12 months)