This randomized controlled trial will enroll individuals aged ≥ 40 years without dementia who are at high risk for stroke, collecting multi-modal MRI imaging, serum, and fecal samples to investigate the effects of a smartphone-based multimodal health intervention on cognitive function measured using digital-evaluated cognitive scores.
The Smartphone-based multimodal Health Intervention for Neurological Enhancement (SHINE) trial is designed to test the impact of a 6-month artificial intelligence(AI)-assisted intervention utilizing smartphone-based multimodal lifestyle and stroke risk factor management on 1036 participants aged 40 years and above who are without dementia and are at high risk for stroke. The multimodal digital program integrated adaptive cognitive training, personalized cardiovascular risk management, smart wristband-based physical activity and sleep monitoring, and dietary guidance, all delivered through a smartphone application incorporating behavioral change and AI techniques. Participants in the intervention group will receive the lifestyle and stroke risk factors management, while participants in the control group will receive standard educational materials and care. The investigation will explore potential mediators and modifiers of the intervention's effects by collecting various cardiovascular risk factors, serum samples, fecal samples, neuropsychological assessment results, and multi-modal magnetic resonance imaging at baseline, 6 months, 1 year, and 2 years.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
1,036
Participants will undergo a 6-month multimodal intervention via a digital platform, which includes: (1) Personalized cognitive training; (2) Self-monitoring and management of stroke risk factors including hypertension, dyslipidemia, diabetes, smoking and obesity; (3) Smart wristband-based exercise monitoring and management; (4) Smart wristband-based sleep monitoring and management; (5) Health dietary recording and guidance
Second Affilated Hospital of Zhejiang University, School of Medicine
Hangzhou, Zhejiang, China
Global cognitive function change assessed with Z-score of a digital cognitive assessment protocol
Primary Outcome
Time frame: 6 months
Cognitive function change assessed by Montreal Cognitive Assessment (minimum value = 0, maximum value = 30, and higher scores mean a better outcome)
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
Cognitive function change assessed with Mini-Mental State Examination (minimum value = 0, maximum value = 30, and higher scores mean a better outcome)
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
Metabolite composition to measure the metabolite profiles in participants' faecal samples and serum samples
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
The Oriental Intervention for Enhanced Neurocognitive health (ORIENT) diet score (minimum value = 0, maximum value = 14, and higher scores mean a better outcome)
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
Sleep quality assessed by Pittsburgh sleep quality index (minimum value = 0, maximum value = 21, and higher scores mean a worse outcome)
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
Dementia and cerebrovascular events incidence
Secondary Outcome
Time frame: 2 years, 5 years
Gut microbiota determined by measuring specific bacterial levels in the fecal samples
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
Frequency of digital platform usage for lifestyle and risk factor management (number of weekly platform feature accesses, tracked through platform analytics)
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
Completeness of data uploads on digital platform
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
Change in waist circumference if overweight/obese
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
Change in body mass index (BMI) if overweight/obese
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
working memory domain cognitive score change assessed with a digital cognitive assessment protocol (higher scores mean a better outcome)
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
executive function domain cognitive score change assessed with a digital cognitive assessment protocol (higher scores mean a better outcome)
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
language domain cognitive score change assessed with a digital cognitive assessment protocol (higher scores mean a better outcome)
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
visual motor speed domain cognitive score change assessed with a digital cognitive assessment protocol (higher scores mean a better outcome)
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
visual spatial function domain cognitive score change assessed with a digital cognitive assessment protocol (higher scores mean a better outcome)
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
memory and recognition domain cognitive score change assessed with a digital cognitive assessment protocol (higher scores mean a better outcome)
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
Visual Analogue Scale (VAS) score of EuroQol Five Dimension Five Level (EQ-5D-5L) Questionnaire (higher VAS score indicates better health status)
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
Utility index of EuroQol Five Dimension Five Level (EQ-5D-5L) Questionnaire (higher utility index indicates better health-related quality of life)
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
Change in level of physical activity assessed with daily step count
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
Change in level of physical activity assessed with Metabolic Equivalent of Task [MET] per week, higher MET per week means higher physical activity levels
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
Change in systolic blood pressure (SBP) in participants with self-report history of hypertension
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
Change in diastolic blood pressure (DBP) in participants with self-report history of hypertension
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
Change in fasting blood glucose levels in participants with self-report history of hypertension in participants with self-report history of diabetes
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
Change in insulin resistance assessed by Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) in participants with self-report history of diabetes (higher HOMA-IR indicatehigher insulin resistance)
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
Change in glycated hemoglobin (HbA1c) levels (%) in participants with self-report history of diabetes
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
Change in low-density lipoprotein cholesterol (LDL-C) levels in participants with self-report history of dyslipidemia
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
Change in high-density lipoprotein cholesterol (HDL-C) levels in participants with self-report history of dyslipidemia
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
Change in total cholesterol (TC) levels in participants with self-report history of dyslipidemia
Secondary Outcome
Time frame: 6 months, 1 year, 2 years
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