The SYNERGIC RCTs from Can Thumbs Up: Canadian experience in migrating lifestyle interventions to an @Home‐based program to enhance cognition. (31st December 2021)

• Record Type: Journal Article
• Authors: Montero‐Odasso, Manuel; Jarrett, Pamela; Handrigan, Grant; Chamard‐Witkowski, Ludivine; Bouchard, Danielle R; Tranchant, Carole C; Yetman, Linda; Belleville, Sylvie; Chertkow, Howard; Feldman, Howard; Nygaard, Haakon B; Almeida, Quincy J; Bherer, Louis; Liu‐Ambrose, Teresa; Middleton, Laura E; Speechley, Mark R; Kamkar, Nellie; McGibbon, Chris A
• Is Part Of: Alzheimer's & dementia. Volume 17(2021)Supplement 10
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-12-31
• Subjects: Alzheimer's disease -- Periodicals; Alzheimer Disease -- Periodicals; Dementia -- Periodicals; Démence; Maladie d'Alzheimer; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.83
• DOI: 10.1002/alz.055806
• Languages: English
• ISSNs: 1552-5260

Abstract

Abstract: Background: The SYNERGIC trial (SYNchronizing Exercises, Remedies in GaIt and Cognition), a large multi‐site randomized controlled trial (RCT), showed promising interim results that individuals with Mild Cognitive Impairment (MCI) who received aerobic exercise combined with progressive resistance training and cognitive training improved their global cognition. When the COVID‐19 pandemic put SYNERGIC on hold, we migrated our interventions and assessments remotely. This experience informed the design of the SYNERGIC@Home trial. Method: The SYNERGIC trial was a multi‐site, double‐blinded, five‐arm, randomized controlled trial that assessed the potential synergistic effect of combining bi‐modal exercises (aerobic + progressive resistance training), cognitive training, and, vitamin D supplementation in older adults with MCI. Interventions were delivered for 20 weeks. Results present data in 10 participants who migrated to conducting interventions and assessments at home. Result: Ten participants with MCI (mean age 73±6.4, ♀70%) from the SYNERGIC trial migrated to a virtual modality at month 2 of their intervention. Their adherence for the 2‐month in‐person exercise and cognitive training was 90.2%, while for the 4‐month home‐based intervention, it was 95.9%. Participants reported being able to use the digital platform (WebEx© and Zoom Healthcare©) assigned on the first session. Similarly, 95% of the assessments tests were completed, including cognitive (ADAS‐Cog 13), medical, and mobility assessments conducted remotely. One participant was only able to complete half of the assessments due to digital connection issues. Following remote administration of the SYNERGIC trial in this subset of participants, we set up logistics and obtained ethical approval for the SYNERGIC@Home trial, a pilot RCT fully delivered remotely in 64 older adults at risk of dementia. Conclusion: Delivering progressive physical exercise and cognitive training at home was feasible in older adults at risk of dementia. Insights gained from this migration informed our SYNERGIC@Home pilot, which is based on the SYNERGIC trial, but will be delivered fully remotely. SYNERGIC@Home will recruit participants with MCI, Subjective Cognitive Impairment, and Normal Cognition and two or more risk factors for dementia. Remote interventions and assessment are becoming particularly important during the COVID‐19 pandemic in which research participation for older adults may only be possible through virtual platforms.