PlanYourLifespan.org for Cognitive Impairment

Overseen By Lee A Lindquist, MD, MBA, MPH

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Northwestern University

Disqualifiers: Previous study participation

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how older adults decide between aging in place and long-term care. It examines the influence of cognition (thinking skills), health knowledge, chronic conditions, social support, and the environment on these decisions. Participants will have access to a web-based tool called PlanYourLifespan.org to aid in planning for future care needs. Individuals who are part of the LitCog Trial, speak English, live in the community, and use the internet on a computer or tablet may be well-suited for this trial. As an unphased study, this trial offers a unique opportunity to enhance understanding of decision-making in aging, potentially benefiting future care strategies.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this web-based intervention is safe for older adults?

Research has shown that PlanYourLifespan.org is an online tool designed to help seniors plan for future health needs, such as hospital visits, falls, and memory issues. This tool is widely accessible and helps people understand and discuss their options for future support.

No safety concerns have been reported with using PlanYourLifespan.org. As an informational website, it doesn't involve taking medications or undergoing physical treatments, which means there is very little risk in using it. This resource empowers older adults and their caregivers to make informed decisions.

Prospective participants in a study using PlanYourLifespan.org can feel confident that using this tool is safe based on current information. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about PlanYourLifespan.org for cognitive impairment because it offers a unique, web-based approach to planning for future health needs. Unlike traditional treatments that focus on managing symptoms, this intervention empowers individuals with cognitive challenges to actively plan their care and lifestyle, potentially reducing stress and improving quality of life. This proactive method could complement existing therapies by addressing the broader needs of individuals and their families, fostering a sense of control and preparedness.

What evidence suggests that PlanYourLifespan.org is effective for cognitive impairment?

Research has shown that PlanYourLifespan.org (PYL) aids seniors in planning for future health events. Studies have found that PYL encourages better planning and raises awareness about the importance of preparing for hospital stays and memory loss. Users of PYL often make more informed decisions about aging in place and planning for long-term care. The program also positively influences how individuals view and prepare for age-related changes. This trial will provide all participants with access to the web-based intervention, PlanYourLifespan.org, suggesting that PYL could be a valuable tool for older adults, especially those experiencing changes in memory or thinking. ^{1 2 6 7 8}

Are You a Good Fit for This Trial?

This trial is for older adults who are part of the LitCog Trial, speak English, live in their own home, and use a computer or tablet with internet. It's not open to those who were in the Advanced Planning for Home Services study.

Inclusion Criteria

Currently use a computer or tablet with internet

You live in a community, not in a hospital or care facility.

English-speaking

Exclusion Criteria

Previous participation in the Advanced Planning for Home Services study [IH-12-11-4259]

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants are given access to PlanYourLifespan.org, a web-based decision-making and planning tool

36 months

Online access with periodic assessments

Follow-up

Participants are monitored for decision-making changes and implementation of long-term care plans

6 months

Assessments every six months

Extended Follow-up

Continued monitoring of decision-making and plan implementation up to 42 months

6 months

What Are the Treatments Tested in This Trial?

Interventions

• PlanYourLifespan.org

Trial Overview The study examines how an online tool called PlanYourLifespan.org affects decision-making regarding living arrangements and long-term care plans among seniors with cognitive challenges like Alzheimer's.

How Is the Trial Designed?

Group I: Access to Web-Based Intervention Experimental Treatment 1 Intervention

All study participants will be given access to the web-based study intervention, PlanYourLifespan.org.

Who Is Running the Clinical Trial?

Northwestern University

Lead Sponsor

Trials

1,674

Recruited

989,000+

National Institute on Aging (NIA)

Collaborator

Trials

1,841

Recruited

28,150,000+

Published Research Related to This Trial

The development of the ACPVoice tool involved cognitive interviews with 20 participants, including individuals with mild cognitive impairment and their care partners, to ensure the tool was understandable and user-friendly for older adults with cognitive challenges.

Revisions to the wording and format of the tool significantly enhanced comprehension and response accuracy, suggesting that such tailored approaches can effectively engage community-dwelling individuals with cognitive impairment in advance care planning discussions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development of an Advance Care Planning Portal-Based Tool for Community-Dwelling Persons Living With Cognitive Impairment: The ACPVoice Tool. Gabbard, J., Strahley, AE., Pajewski, NM., et al.[2023]

A study involving 16 participants aged 65 and older showed that older adults with mild cognitive impairment (MCI) found physical activity apps like Sworkit® and 7-Minute Workout® easy to use and enjoyable, with 100% of participants smiling while playing these games.

In contrast, cognitive training apps were less engaging, with only 35% of participants smiling, indicating that physical activity apps may be more appealing and effective for this population, highlighting the importance of user feedback in app development.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Usability of Physical Activity and Cognitive Training Applications in People With Mild Cognitive Impairment. Smith, L., Argentina, V.[2021]

In a 12-week intervention trial involving 127 elderly patients with Mild Cognitive Impairment (MCI), 84% showed significant improvements in cognitive function after participating in a personalized Brain Fitness Program.

Among a subset of 17 patients who underwent MRI scans, 12 exhibited either no hippocampal atrophy or an increase in hippocampal volume, suggesting potential for reversing cognitive decline associated with MCI.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Personalized 12-week "Brain Fitness Program" for Improving Cognitive Function and Increasing the Volume of Hippocampus in Elderly with Mild Cognitive Impairment. Fotuhi, M., Lubinski, B., Trullinger, M., et al.[2022]

In a 48-week trial followed by a 28-week extension study involving 821 patients with amnestic mild cognitive impairment (aMCI), donepezil (10 mg) was found to be generally safe and well-tolerated, with most adverse events being mild to moderate in severity.

The most common side effects included diarrhea, muscle spasms, insomnia, and nausea, with a higher discontinuation rate due to adverse events in the placebo group (22.1%) compared to the donepezil group (10.3%), indicating that donepezil is better tolerated than placebo in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Safety and tolerability of donepezil in mild cognitive impairment: open-label extension study. Doody, RS., Ferris, S., Salloway, S., et al.[2018]

The Digital Memory Notebook (DMN) app was developed to assist older individuals with memory loss, and a manual-based intervention showed promising results in improving everyday memory and functioning among participants.

In a series of three case studies, two participants reported significant reductions in memory lapses and improved daily functioning, while all participants demonstrated enhanced coping skills and satisfaction with life after using the DMN app.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The development of a manual-based digital memory notebook intervention with case study illustrations. Chudoba, LA., Church, AS., Dahmen, JB., et al.[2023]

The PREPAREforYourCare.org advance care planning program was found to be feasible and user-friendly for 20 older adults with mild-to-moderate cognitive impairment and their caregivers, with high satisfaction ratings (mean of 8.6 for patients and 9.4 for caregivers on a 10-point scale).

After using the program for one week, 80% of participants showed increased engagement in advance care planning, with caregivers reporting significant improvements in knowledge and self-efficacy, indicating the program's potential to enhance decision-making support for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Engaging Diverse Older Adults With Cognitive Impairment and Caregivers in Advance Care Planning: A Pilot Study of the Interactive PREPARE Website. Kotwal, AA., Barnes, DE., Volow, AM., et al.[2023]

Home-based virtual reality (VR) exercise is safe and feasible for individuals with mild cognitive impairment, with participants completing 99% of the prescribed sessions over 6 weeks without major adverse events.

While most participants enjoyed the VR program and reported physical benefits, no significant changes were observed in physical or cognitive outcomes after the 6-week intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Use of Home-Based Nonimmersive Virtual Reality to Encourage Physical and Cognitive Exercise in People With Mild Cognitive Impairment: A Feasibility Study. Sheehy, L., Sveistrup, H., Knoefel, F., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6065258/

PlanYourLifeSpan.org – an intervention to help seniors make ... We sought to assess the efficacy of PlanYourLifeSpan.org (PYL), in influencing seniors' planning behaviors, perception of the importance of ...

2. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0738399117303762

PlanYourLifeSpan.org − an intervention to help seniors ... We sought to assess the efficacy of PlanYourLifespan.org (PYL), in influencing seniors' planning behaviors, perception of the importance of planning, and ...

3. planyourlifespan.org planyourlifespan.org/

Home Plan Your Lifespan This website will help you plan for health events such as hospitalizations, falls, and memory loss that may happen as people get older.

4. breakthroughsforphysicians.nm.org breakthroughsforphysicians.nm.org/aspects-of-cognition-that-impact-aging-in-place-and-long-term-care-planning.html

Aspects of Cognition That Impact Aging-In-Place and Long- ... As part of the PlanYourLifespan (PYL)-LitCog study, we longitudinally examined AIP-LTC decision-making among a cohort (LitCog) of community- ...

5. agsjournals.onlinelibrary.wiley.com agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.19475

What Changed Your Mind? Influencers of Older Adults ... At BL, 22.2% (n = 30) had cognitive impairment (< 26) on the Montreal Cognitive Assessment (Table 1). ... cognitive decline or memory loss as they ...

6. agsjournals.onlinelibrary.wiley.com agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.17927

Aspects of cognition that impact aging‐in‐place and long‐term ... PlanYourLifespan.org (PYL) ... Cognitive decline is associated with risk aversion and temporal discounting in older adults without dementia.

7. clinicaltrials.gov clinicaltrials.gov/study/NCT02256072?cond=(SILVER-RUSSELL%20SYNDROME)%20OR%20(place)&rank=7&checkSpell=

Advance Planning for Home Services for Seniors (APHS) Plan Your Lifespan is a Web-based planning tool that provides information for seniors related to advanced health planning for home services in specific content ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12353053/

What Changed Your Mind? Influencers of Older Adults ... In the event of worsening cognitive or physical function, older adults need additional support to age‐in‐place or choose to live in long‐term ...