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Home-Based Assessment for Alzheimer Disease Prevention (HBA)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00546767
Recruitment Status : Completed
First Posted : October 19, 2007
Last Update Posted : September 16, 2014
National Institute on Aging (NIA)
Information provided by (Responsible Party):
Alzheimer's Disease Cooperative Study (ADCS)

Brief Summary:
The purpose of this study is to evaluate three methods of performing home-based assessments in Alzheimer's Disease (AD) prevention trials. The initial in-person assessment will be done in the clinic or at home.

Condition or disease Intervention/treatment Phase
Mild Cognitive Impairment Alzheimer's Disease Behavioral: Mail and Live Phone Behavioral: Interactive Voice Response (IVR) Behavioral: Home-based Computer Kiosk Behavioral: Traditional Evaluation Instruments Not Applicable

Detailed Description:

There is an unmet need for effective, efficient, and economical methods for conducting AD prevention trials. Traditional in-person visits to clinical assessment sites are time consuming and costly and may exclude some people from participation, such as those who are older, or are less mobile or with significant medical illnesses. These may be the people who are at greatest risk for cognitive decline, and also may be without financial resources for services such as transportation to a study site. Prevention trials require long observation periods and these same issues of health, resources, and transportation may cause significant drop out. These obstacles increase expense of clinical trials which require large sample sizes, costly clinical staff and long observation periods. Thus, home-based assessments may lead to more representative recruitment of those most at risk for decline, as well as better retention and reduced study costs.

This is a randomized study of 600 participants, comparing three methods of test administration and data collection. Each enrolled participant will have an In-person (Standard) assessment (in the clinic or at home) prior to baseline.

Participants will be classified as either normal or MCI (Mild Cognitive Impairment) and randomly assigned to an assessment method and to a frequency of assessment. Cognitive performance, self-rated cognitive complaint, functioning in daily life, affective symptoms, global change, quality of life and resource use will all be assessed in each method at each visit. The total time for the at-home assessments will be approximately 45 minutes. In addition, all participants will be provided a multi-vitamin to be taken twice a day, and a measure of medication adherence will be collected for each assessment method.

Changes in certain cognitive measures may "trigger" an in-person assessment, in which participants may change from a categorization of normal or amnestic MCI, to non-amnestic MCI, impaired not MCI, or dementia (i.e., specifically Alzheimer's Disease or another dementia). We estimate that 12% of the study population will trigger over the 4 years of the study and will progress to a more impaired diagnostic category. In addition, a random sample of non-triggered cases (25%) will be selected for an in-person re-assessment during the 4 years of the protocol as a comparison for the trigger group. At the end of the 4-year study period all participants will undergo an in-person evaluation.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 640 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Screening
Official Title: Multi-Center Trial to Evaluate Home-Based Assessment Methods for Alzheimer Disease Prevention Research in People Over 75 Years Old
Study Start Date : September 2007
Actual Primary Completion Date : June 2013
Actual Study Completion Date : June 2013

Arm Intervention/treatment
Experimental: Mail and Live Phone Behavioral: Mail and Live Phone
This group will receive assessments of all domains by mail, except for the cognitive performance assessment which will be administered via phone by a live, trained evaluator. Medication compliance will be monitored by a written medication log which will be returned by mail with the other mail-in assessments.

Experimental: IVR Behavioral: Interactive Voice Response (IVR)
In this group, participants will be asked to answer questions via an automated phone system using interactive voice recognition (IVR) and key-pad response entry. Medication compliance will be monitored by the same method. A standard large-key telephone and training in the use of the interactive phone system will be provided to all participants.

Experimental: Computer Kiosk Behavioral: Home-based Computer Kiosk
Participants at entry will receive a special Kiosk-like device for collecting assessment information and will be taught to use this device. The user interface will consist of a monitor with a touch screen and a telephone handset, similar to what is often used in museum displays. Pre-recorded instructions will be delivered through the handset as well as displayed visually on the screen. Data will be collected using the handset's high-quality microphone. Daily activity assessments of timed medication use will be obtained via an automated medication tracking device.

Active Comparator: Traditional Behavioral: Traditional Evaluation Instruments
Evaluation methods typically used in clinical trials

Primary Outcome Measures :
  1. Feasibility Data -- the number of subjects recruited, screened, enrolled, and retained [ Time Frame: 4 years ]
  2. Efficiency Data -- staff time required to successfully complete data collection [ Time Frame: Each experimental visit ]
  3. Transition from cognitive health to impairment [ Time Frame: 4 years ]
  4. Method-Specific Adherence, including medication adherence [ Time Frame: 4 years ]
  5. Rate of change in domains of assessment [ Time Frame: 4 years ]

Secondary Outcome Measures :
  1. Research blood samples [ Time Frame: 4 years ]
  2. Safety Assessments: symptom checklist and adverse event checklist [ Time Frame: 4 years ]

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   75 Years and older   (Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Age 75 and older
  • Willing to sign consent
  • Willing to take multi-vitamins provided by the study
  • Minimal computer skills or willingness to learn (as demonstrated by completion during screening of a demonstration module for each arm)
  • English fluency
  • MMSE greater than 26
  • Able to answer and dial a telephone
  • Able to complete the in-person assessment
  • Able to complete the computerized assessment including adequate speech, hearing and vision
  • Independently living adults, defined as living in a setting in which the participant can ensure access to the resources for study procedures
  • Participation of a study partner is desirable and encouraged, but not required

Exclusion Criteria:

  • Dementia
  • Use of prescription cognitive-enhancing drugs at entry (e.g. Aricept, Razadyne, Exelon, Namenda)
  • Intent to continue use of own multi-vitamins (for the duration of the study participants must agree to take only study-distributed multi-vitamins)
  • History or presence of major psychiatric, neurological or neurodegenerative conditions associated with significant cognitive impairment such as major stroke, Parkinson's disease, Multiple Sclerosis or Huntington's disease. Transient Ischemic Attack (TIA) is acceptable if over 6 months ago
  • Medical conditions associated with life expectancy of less than 5 years
  • Transient domicile interfering with ability to collect study-related data
  • Current participation in a clinical trial involving Central Nervous System (CNS) medications or cognitive testing that would interfere with the current protocol (participation in Uniform Data Set (UDS) assessments by an ADC is permitted)
  • Cohabitation with another participant in this particular study

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00546767

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Sponsors and Collaborators
Alzheimer's Disease Cooperative Study (ADCS)
National Institute on Aging (NIA)
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Principal Investigator: Mary Sano, PhD Mount Sinai Medical School
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Responsible Party: Alzheimer's Disease Cooperative Study (ADCS) Identifier: NCT00546767    
Other Study ID Numbers: IA0123
1RC2AG036535 ( U.S. NIH Grant/Contract )
First Posted: October 19, 2007    Key Record Dates
Last Update Posted: September 16, 2014
Last Verified: September 2014
Additional relevant MeSH terms:
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Alzheimer Disease
Cognitive Dysfunction
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Neurodegenerative Diseases
Neurocognitive Disorders
Mental Disorders
Cognition Disorders