R01AG070349

Cognitive Training to Reduce Incidence of Cognitive Impairment in Older Adults - Project Summary

Dementia is the most expensive medical condition in the US. There is an urgent need to intervene to curb the increasing prevalence of dementia in our population. Strong preliminary data from more than 18 randomized clinical trials demonstrate that computerized, cognitive speed of processing training (SPT) improves cognition and transfers to improved instrumental activities of daily living. Recent evidence further indicates that SPT may reduce dementia risk. Analyses of 10-year data from the ACTIVE trial revealed that older adults randomized to SPT were 29% less likely to develop dementia. Moreover, those who completed additional training had a 48% reduced risk of dementia across 10 years. Two limitations of this study were a lack of clinical diagnosis of dementia and use of a no-contact control condition. Thus, an important question is, "Can SPT be successfully implemented to reduce incidence of mild cognitive impairment (MCI) or dementia?".

Our primary goal is to test the effectiveness of SPT to reduce incidence of MCI or dementia. The Preventing Alzheimer's with Cognitive Training-PACT field trial advances prior research by rigorously implementing SPT in a large population of cognitively normal older adults and examining the primary endpoint of MCI or dementia clinical diagnoses. Older adults are randomized to SPT or an active control arm of cognitive stimulation (i.e., computer games) and progression to MCI or dementia will be clinically assessed after 3 years. We further will explore if SPT effects are moderated by the degree of amyloid pathology or apolipoprotein E4 status.

To demonstrate feasibility, our investigative team is implementing the study protocol in an R56 phase and successfully enrolled 744 older adults at the time of proposal submission. Three years after enrollment, we will re-assess study participants to identify those exhibiting cognitive decline. Such participants will be provided a thorough medical evaluation to clinically ascertain MCI or dementia diagnosis. Those classified as MCI or dementia will further complete an amyloid PET scan and genetic testing.

This non-pharmacological prevention trial is innovative with a highly efficient experimental design and optimized SPT training protocols including an active control group. The proposed research will determine if SPT successfully reduces incidence of MCI or dementia. This outcome will be significant in that if an intervention can delay the onset of dementia by only one year, there will be ~9.2 million fewer cases of the disease by 2050, substantially reducing cost. Positive results would support use of a relatively inexpensive and easy to apply intervention that could delay or prevent the onset of Alzheimer's disease and/or related dementias. Such an outcome would justify further research to identify mechanisms of action. Results will inform clinical practice of effective interventions to attenuate age-related cognitive and functional decline and thereby improve public health.

University Of South Florida

TO ENCOURAGE BIOMEDICAL, SOCIAL, AND BEHAVIORAL RESEARCH AND RESEARCH TRAINING DIRECTED TOWARD GREATER UNDERSTANDING OF THE AGING PROCESS AND THE DISEASES, SPECIAL PROBLEMS, AND NEEDS OF PEOPLE AS THEY AGE. THE NATIONAL INSTITUTE ON AGING HAS ESTABLISHED PROGRAMS TO PURSUE THESE GOALS. THE DIVISION OF AGING BIOLOGY EMPHASIZES UNDERSTANDING THE BASIC BIOLOGICAL PROCESSES OF AGING. THE DIVISION OF GERIATRICS AND CLINICAL GERONTOLOGY SUPPORTS RESEARCH TO IMPROVE THE ABILITIES OF HEALTH CARE PRACTITIONERS TO RESPOND TO THE DISEASES AND OTHER CLINICAL PROBLEMS OF OLDER PEOPLE. THE DIVISION OF BEHAVIORAL AND SOCIAL RESEARCH SUPPORTS RESEARCH THAT WILL LEAD TO GREATER UNDERSTANDING OF THE SOCIAL, CULTURAL, ECONOMIC AND PSYCHOLOGICAL FACTORS THAT AFFECT BOTH THE PROCESS OF GROWING OLD AND THE PLACE OF OLDER PEOPLE IN SOCIETY. THE DIVISION OF NEUROSCIENCE FOSTERS RESEARCH CONCERNED WITH THE AGE-RELATED CHANGES IN THE NERVOUS SYSTEM AS WELL AS THE RELATED SENSORY, PERCEPTUAL, AND COGNITIVE PROCESSES ASSOCIATED WITH AGING AND HAS A SPECIAL EMPHASIS ON ALZHEIMER'S DISEASE. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION.

93.866 - Aging Research

National Institute on Aging (NIA) [HHS - NIH]

Florida United States

State-Wide

Late Stage Clinical Trials for the Spectrum of Alzheimers Disease and Age-related Cognitive Decline (R01 Clinical Trial Required) (PAR-18-878)

Amendment Since initial award the End Date has been extended from 01/31/26 to 01/31/27 and the total obligations have increased 408% from $7,349,774 to $37,326,564.