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Cognitive ImpairmentHERITAGENCT05886114

A Multi-domain Lifestyle Intervention Among Aged Community-residents in Zhejiang, China

A study testing Structured Multi-domain Intervention and Self-Guided Intervention in people with Cognitive Impairment and Alzheimer Disease, run by Zhejiang University at 1 site in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

A study conducted in Finland discovered that a multidomain intervention, consisting of physical activity, nutritional guidance, cognitive training, social activities, and management of vascular risk factors, effectively decelerated cognitive decline in healthy older adults who were at an increased risk of cognitive… Read more about this study

Who is it for?
Ages 60 to 80 yearsHealthy volunteers can take part
What is being tested?
Structured Multi-domain Intervention and Self-Guided Intervention
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,200 participants
Where
1 siteChina
Study dates
28 May 2023to 28 Apr 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 60 to 80 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • At risk of cognitive decline: cognitive performance at the mean level or slightly lower than expected for age with no dementia (AD8>=3 and/or 5-min MoCA >, < 11)
  • Free of physical disabilities that preclude participation in the study
  • Willing to complete all study-related activities for 24 months
  • Willing to be randomized to either lifestyle intervention group

Who cannot join

  • Diagnosed dementia patients
  • Diagnosed major depression or other neuropsychological diseases
  • Malignant diseases
  • Symptomatic cardiovascular disease
  • Revascularization within one year
  • Severe loss of vision, hearing or communicative ability

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Changzheng Yuan, PhD contact

chy478@zju.edu.cn

China1 site, 1 recruiting
  • School of Public Health and The Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, China

    Hangzhou, Zhejiang, 310000

    Xuhao Zhao, MPH, zhaoxuhao@zju.edu.cn

    Recruiting

Other trials in China

About this study

A study conducted in Finland discovered that a multidomain intervention, consisting of physical activity, nutritional guidance, cognitive training, social activities, and management of vascular risk factors, effectively decelerated cognitive decline in healthy older adults who were at an increased risk of cognitive decline. The HERITAGE study is a 2-year clustered randomized controlled trial (clustered-RCT) that explores the efficacy of a multidomain intervention among 1200 elderly residents with a higher risk of cognitive decline and dementia in Zhejiang Province, China

Read the detailed description

The effectiveness of a multidomain lifestyle intervention on the prevention of cognitive decline and dementia have not been studied in Asian elderly at high risk of dementia conversion. Dementia is caused by both nonmodifiable genetic variables, and modifiable lifestyle risk factors. While neuroimaging biomarkers have been well documented in the neurophysiology of ageing and age-associated cognitive decline, their role as surrogate endpoints and intermediate variables between multi-domain lifestyle intervention and cognitive benefits has not been studied. The current study aims to understand brain functional and structural changes that may result from a multi-domain lifestyle intervention and whether the changes correlate with improvement in cognitive function. At risk elderly aged 60-80 years will be randomly allocated to either the control arm (self-guided management) or the intervention (multi-domain lifestyle) arm, which consists of nutritional guidance, physical exercise, cognitive training and the monitoring and management of vascular and metabolic risk factors. We hypothesize that the multi-domain lifestyle intervention will promote favorable changes in cognitive function. Moreover, such intervention will slow down the progression of cerebrovascular disease and neurodegeneration in participants in the intervention arm. Findings from the present study will shed light on the biological mechanisms of age-related cognitive decline and neurodegenerative disease. Insight obtained from the study could be translated into new targets of nonpharmacological interventions which aim at the potential causal molecular pathways implicated in ageing and age-related cognitive decline. Adaption and implementation of our findings into clinical and public health practice will further promote healthy and confident ageing among Chinese elderly, to eventually expand their health span.

Being tested
Structured Multi-domain Intervention, Self-Guided Intervention
Medical subject headings
Cognitive Dysfunction, Alzheimer Disease, Brain Diseases, Central Nervous System Diseases, Nervous System Diseases, Neurocognitive Disorders, Mental Disorders, Cognition Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Structured Multi-domain InterventionBehavioural

    Also called SMI

    Structured Multi-domain Intervention (SMI) involves providing participants with intensive structure and support by a team of trainers to increase physical exercise, adhere to a healthy diet, cognitive training, increase intellectual/social stimulation, and better manage vascular risk factors.

  • Self-Guided InterventionBehavioural

    Also called SGI

    In the Self-Guided Intervention (SGI), education about the importance of a healthy lifestyle as a preventive strategy and support to encourage change will be provided.

Study groups in NCT05886114
Study groupRoleWhat they receive
Structured Multi-domain InterventionExperimentalMulti-domain structured intervention will be tailored by Chinese traditional and social norms and then conducted among the intervention group. That includes: Nutritional and dietary instruction, Cognitive training, Physical exercises, and Vascular risks monitoring and control.
Receives: Behavioral: Structured Multi-domain Intervention
Self-Guided InterventionExperimentalEvery 6-12 months, control group will receive a regular health education campaign to encourage a healthy lifestyle and a regular health monitoring and examination of blood pressure, weight, fasting blood glucose and liposome group
Receives: Behavioral: Self-Guided Intervention

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Global Cognition

    Globe cognitive performance (composite z-score) measured by comprehensive Neuropsychological Test Battery (NTB)

    Measured: Up to 2 years

  2. Domain-specific Cognition

    NTB domain-specific cognitive performance (composite z-score) for memory, executive function, attention, language, visuomotor speed and visuoconstruction.

    Measured: Up to 2 years

Secondary outcomes (27)
  1. Neuroimaging: MRA

    Changes in brain blood flow assessed by magnetic resonance angiography(MRA)

    Measured: Up to 2 years

  2. Neuroimaging: MRI

    Changes in brain structural integrity (gray matter volume loss, white matter microstructure degradation and increase of cerebrovascular markers) assessed by T1-weighted Magnetization Prepared Rapid Gradient Recalled Echo, Fluid Attenuated Inversion Recovery (FLAIR), T2-weighted, and Susceptibility Weighted Imaging sequences

    Measured: Up to 2 years

  3. Neuroimaging: fMRI

    Changes in brain functional networks assessed by fMRI

    Measured: Up to 2 years

  4. Number of participants with Laboratory Values /Blood markers

    Blood samples will be collected from all patients in tubes with ethylenediaminetetraacetic acid 0.1%. Changes in Novel and accessible blood markers to monitor AD- and CeVD- associated pathologies. Plasma concentrations of cardiac markers (High-sensitive cardiac troponin T (hs Troponin T), N-terminal pro b-type natriuretic peptide (NT-proBNP) and Growth/differentiation factor 15 (GDF 15)), and peripheral biomarkers of Aβ, tau and synaptic pathology, oxidative stress, endothelial/cardiovascular injury and degenerative protein modifications (DPMs) damaged proteins will be measured by laboratory testings.

    Measured: Up to 2 years

  5. Incident dementia

    Incidence of dementia. Dementia diagnoses will be made by CDR and DSM-IV criteria.

    Measured: Up to 2 years

  6. Clinical Dementia Rating-Sum of Boxes (CDR-SB)

    The Clinical Dementia Rating-Sum of Boxes (CDR-SB) is scored from 0 to 18. Higher scores reflect worse performance.

    Measured: Up to 2 years

  7. Alzheimer's Disease Cooperative Study Activities of Daily Living Mild Cognitive Impairment-Activities of Daily Living Inventory (ADCS MCI-ADL)

    The Alzheimer's Disease Cooperative Study Activities of Daily Living-Mild Cognitive Impairment-Activities of Daily Living Inventory (ADCS MCI-ADL) is scored from 0 to 53. Higher scores reflect better performance.

    Measured: Up to 2 years

  8. Cardiovascular morbidity

    Physician-diagnosed cardiometabolic health disorders will be identified based on ICD-9 or ICD-10 codes (in any position). Any incident cardiometabolic morbidity, for example, ardiac dysrhythmias, heart failure, peripheral and visceral atherosclerosis, non-alcoholic fatty liver disease, chronic kidney disease, type 2 diabetes, hypercholesterolemia, and hypertension, will be recorded.

    Measured: Up to 2 years

  9. Physical Performance: Grip strength

    Grip strength will be assessed by a hydraulic hand dynamometer and expressed in absolute units(kilograms) andrelative units(kilograms divided by bodyweight).

    Measured: Up to 2 years

  10. Physical Performance: Gaid speed

    Walking pace will be assessed by the speed (m/second) of completing a 1.5 meters walk.

    Measured: Up to 2 years

  11. Physical Performance: Balance

    Balance will be measured by standing on one foot and expressed in absolute units(seconds).

    Measured: Up to 2 years

  12. Physical Performance: Endurance

    Endurance will be assessed by the 2MW. Participants will be asked to "walk as fast as you can without running" for 2 minutes around a 50-foot course. A greater distance(m) indicates better endurance.

    Measured: Up to 2 years

  13. Physical Performance: Lower limb strength

    Lower limb strength will be assessed by 30 second sit to stand test and expressed by completion times.

    Measured: Up to 2 years

  14. Quality of Life Questionnaire (15D)

    The Quality of Life Questionnaire (15D) has a single index (15D score) on a 0-1 scale, which represents overall HRQoL (0 = being dead, 0.0162 = being unconscious or comatose, 1 = no problems on any dimension = 'full' HRQOL). This is calculated from the health state descriptive system by using a set of population-based preference or utility weights.

    Measured: Up to 2 years

  15. The Geriatric Depression Scale (GDS)

    The Geriatric Depression Scale (GDS) is scored from 0 to 15. Scores of 0-4 are considered normal, 5-8 indicate mild depression; 9-11 indicate moderate depression; and 12-15 indicate severe depression.

    Measured: Up tp 2 years

  16. Pittsburgh Sleep Quality Index (PSQI)

    The Pittsburgh Sleep Quality Index (PSQI) is scored from 0 to 21. Higher scores indicate worse sleep quality.

    Measured: Up to 2 years

  17. Leisure-Time Activities Questionnaire

    The Leisure-Time Activities Questionnaire measures the frequency of engagement in the following activities: Health activities, Social activities, Productive activities, Fitness activities, Recreational activities, Any cognitively-stimulating activities. Scores are measured on a 3-point scale. Higher scores represent higher frequency of engagement in leisure-time activities.

    Measured: Up to 2 years

  18. Resource Use Inventory (RUI)

    The Resource Use Inventory (RUI) measures 4 domains: direct medical care, direct nonmedical care, informal care, and subjects' time use. The RUI is filled in based on the frequency and amount of resources used. If none were used, '00' is entered.

    Measured: Up to 2 years

  19. Hight

    Height will be measured in metres

    Measured: Up to 2 years

  20. Weight

    Weight will be measured in kilograms.

    Measured: Up to 2 years

  21. Hip circumference

    Hip circumference will be measured in centimetres.

    Measured: Up to 2 years

  22. Waist circumference

    Waist circumference will be measured in centimetres.

    Measured: Up to 2 years

  23. Changes in Blood Pressure

    Vascular and metabolic risk factors measured by changes in blood pressure in mmHg. Incident events using serious adverse event reports will also be assessed.

    Measured: Up to 2 years

  24. Changes in lipid Profile

    Blood samples will be collected from all patients in tubes with ethylenediaminetetraacetic acid 0.1%. Lipid Profile will be expressed by total cholesterol, LDL-cholesterol, HDL-cholesterol or triglycerides in mmol/L.

    Measured: Up to 2 years

  25. Changes in Glucose Regulation

    Vascular and metabolic risk factors measured by changes in glucose regulation in mmol/L.

    Measured: Up to 2 years

  26. Retinal Imaging Markers

    Retinal fundus photographs will be taken of each eye with a nonmydriatic digital camera after dilation of pupils with 1% tropicamide eye drops. A semi-automated computer-assisted program will be used to assess retinal vascular fractal dimensions (among other parameters such as vessel caliber and vessel tortuosity) from optic disc-centered images of a randomly selected eye per participant.

    Measured: Up to 2 years

  27. Falls

    Prospective rate of falls, causes and consequences via monthly calendar will be recorded.

    Measured: Up to 2 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Jun 2023
  2. Study start28 May 2023 (estimated)
  3. Primary completion28 Apr 2025 (estimated)
  4. Study completion28 Apr 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Outcomes assessor
Enrolment
1,200 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05886114
Sponsor's protocol ID
31005808A111272274170
Acronym
HERITAGE
Status last verified
Jun 2023
First submitted
8 May 2023
Last updated
6 Jun 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Interested collaborators may put in a request.

Publications

  • Xu X, Chew KA, Wong ZX, Phua AKS, Chong EJY, Teo CKL, Sathe N, Chooi YC, Chia WPF, Henry CJ, Chew E, Wang M, Maier AB, Kandiah N, Chen CL. The SINgapore GERiatric Intervention Study to Reduce Cognitive Decline and Physical Frailty (SINGER): Study Design and Protocol. J Prev Alzheimers Dis. 2022;9(1):40-48. doi: 10.14283/jpad.2022.5.

    PubMed 35098972
  • Zhao X, Hu R, Wen H, Xu G, Pang T, He X, Zhang Y, Zhang J, Chen C, Wu X, Xu X. A voice recognition-based digital cognitive screener for dementia detection in the community: Development and validation study. Front Psychiatry. 2022 Jul 22;13:899729. doi: 10.3389/fpsyt.2022.899729. eCollection 2022.

    PubMed 35935417
  • Xu X, Pang T, Zhou Y, Zhang H, Ma A, Yuan C, Chen H, Wen X, Yang Q, Xu X. The Multi-domain Lifestyle Intervention for Cognitive Impairment in Community-Dwelling Older Adults in Hangzhou (The Heritage Study): Study Design and Protocol. J Prev Alzheimers Dis. 2024;11(3):601-611. doi: 10.14283/jpad.2024.59.

    PubMed 38706276

Questions about this trial

What is this clinical trial studying?

A study testing Structured Multi-domain Intervention and Self-Guided Intervention in people with Cognitive Impairment and Alzheimer Disease, run by Zhejiang University at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 6 Jun 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Xin Xu, PhD (+8613575760802, xuxinsummer@zju.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Global Cognition (time frame: Up to 2 years). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05886114, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Jun 2023.

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