Efficacy of a Multimodal Brain Health Intervention for Older African Americans

Oregon Health and Science University13 enrolled

Overview

This study tests the feasibility, acceptability, and efficacy of a multimodal intervention (walking, social engagement, and reminiscence), including the use of wearable digital biomarkers, for cognitively healthy and mildly cognitively impaired African Americans aged 65 and older.

Cognitively healthy and mildly cognitively impaired participants engage in up to 8 weeks of baseline data collection and 4-16 weeks of triadic neighborhood walking using a group tablet device to access pre-programmed 1-mile routes. GPS (Global Positioning System)-triggered historical images of local Black culture and history along the route prompt conversational reminiscence about Portland, Oregon's historically Black neighborhoods. Digital biomarker technology (a continuously worn actigraph watch and an unobtrusive under-the-mattress sleep sensor) and weekly online surveys via a study Chromebook assess feasibility, acceptability, efficacy, and health outcomes. Intermittent discussions and check-ins with participants, and observational sessions will be used to elicit participant feedback.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

Conditions

Cognitive Impairment, Mild Cognitive Decline

Interventions

Walking conversational reminiscenceBEHAVIORAL

Triadic walking with prompted conversational reminiscence

Eligibility

Sex: ALLMin age: 65 YearsMax age: 110 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria for walkers: 1. Self-identified African American, 2. Age \> 65 years old 3. Reside or resided for \>10 years in Portland's historically Black neighborhoods (to be familiar with Memory Markers about this area), 4. Able to ambulate independently. 5. Meeting Cognition Criteria 1. Participants with MCI (Mild Cognitive Impairment) will meet criteria consistent with the criteria outlined by the NIA-Alzheimer's Association workgroup 2. Participants without cognitive impairment will have a Montreal Cognitive Assessment (MoCA) score \> 24 (and not meet MCI criteria). Participants' cognitive function should allow them to get to and from walk locations independently or with minimal assistance. 6. Cognitive function allows independent (or minimally assisted) travel to and from walk locations 7. In-home reliable broadband internet (for weekly online surveys). 8. Ability to read, speak, and understand English Exclusion Criteria: 1. Self-reported or clinically diagnosed dementia 2. Significant disease of the central nervous system 3. Severely depressed (CES-D score \> 16), significantly symptomatic psychiatric disorder 4. Advanced cardiovascular disease that would make walking difficult, including history of congestive heart failure 5. Unstable insulin-dependent diabetes mellitus, received diagnosis Type 1 Diabetes, started insulin within past 3 months, hospitalized for hypoglycemia within past 6 months.

Locations (1)

Oregon Health & Science University

Portland, Oregon, United States

Outcomes

Primary Outcomes

Daily Average Steps Recorded by Actigraphy Watch

Daily steps are recorded on a continuously worn actigraphy watch (Withings), which measures 24-hour activity (gross motor activity).

Time frame: 24 weeks

Daily Average Sleep Time Recorded by an Emfit QS Sleep Sensor

Emfit QS under-the-mattress sleep sensor measured sleep-wake cycles per 24-hour period.

Time frame: 24 weeks

Weekly Health Update Survey Response Time

Participants completed a brief health update survey every week via their home computer or phone. Response time (the time it took each participant to complete the survey) was recorded in seconds.

Time frame: 24 weeks

Pittsburgh Sleep Quality Index

The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire assessing sleep quality and sleep disturbances over a 1-month time period. The PQSI is composed of 19 query items, a combination of open-ended questions and Likert-type scales which are scored from 0 (no difficulty) to 3 (severe difficulty), and includes 7 sleep components: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. A global score is calculated from the sum of scores for each of the seven components. Total scores range from 0 to 21, a higher score indicates more acute sleep disturbances.

Time frame: 24 weeks

Weekly Survey Completion Rate

Healthy and mildly cognitively impaired participants completed a weekly online health update survey, receiving weekly reminders to complete it. Survey completion rates and completion times over the study's duration is another measure of cognitive change.

Time frame: 24 Weeks

Data from ClinicalTrials.gov

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