Reaching Movements for Mild Cognitive Impairment

Overseen By Joshua Cashaback

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Delaware

Disqualifiers: Traumatic brain injury, others

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

Compensation: Varies

Number of Visits: Unknown

60 Participants Needed

Trial Summary

What is the purpose of this trial?

The investigators aim to understand the interplay and neural structures involved with decision--making and movement for participants with mild cognitive impairment. Rapidly deciding and acting becomes bottlenecked with mild cognitive impairment and Alzheimer's, leading to detrimental outcomes such as falling and car crashes. The investigators work will have a tangible impact by discovering sensitive biomarkers to detect disease onset and pave the way for informed and effective neurorehabilitation.

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 data supports the effectiveness of the treatment Reaching Movements for Mild Cognitive Impairment?

Research suggests that individuals with mild cognitive impairment (MCI) may experience a general slowing of movement, which could indicate a problem with planning or guiding movements. This implies that treatments focusing on improving reaching movements might help address these issues. ^{1 2 3 4 5}

How does the Reaching Movements treatment differ from other treatments for mild cognitive impairment?

Reaching Movements is unique because it focuses on improving motor control and coordination through specific physical tasks, which may help address the general slowing of movement seen in mild cognitive impairment. Unlike traditional treatments that might focus on medication or cognitive exercises, this approach targets the physical aspect of cognitive decline, potentially offering a novel way to enhance motor skills and quality of life. ^{2 4 6 7 8}

Research Team

Josh Cashaback

Principal Investigator

University of Delaware

Eligibility Criteria

This trial is for people aged 50-85 with good vision (natural or corrected) and the ability to reach. It includes those without any neurological disorders as well as individuals clinically diagnosed with amnestic mild cognitive impairment.

Inclusion Criteria

I can physically reach and handle objects.

I am between 45 and 90 years old.

I have no history of brain disorders or injuries.

Exclusion Criteria

Mild Cognitive Impairment participants with Modified Telephone Interview for Cognitive Status (TICS-m) score greater than 34

Traumatic brain injury, such as concussion, in the last 6 months

Mild Cognitive Impairment participants with Mini-Mental State Examination Second Edition (MMSE-2) score less than 21

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Reaching Task

Participants with mild cognitive impairment and age-matched controls perform decision-making tasks while moving

12 months

Follow-up

Participants are monitored for changes in brain mechanical properties and decision time

4 weeks

Treatment Details

Interventions

• Reaching Movements

Trial Overview The study focuses on how decision-making and movement are connected in people with mild cognitive impairment. Participants will perform reaching movements while their neural responses are observed to identify potential biomarkers for early disease detection.

Participant Groups

Group I: Reaching task Experimental Treatment 1 Intervention

Mild cognitive impairment participants will make decisions while moving

Group II: Reaching Task Active Control 1 Intervention

Age-match control participants will make decision while moving

Who Is Running the Clinical Trial?

University of Delaware

Lead Sponsor

Trials

167

Recruited

25,700+

National Institutes of Health (NIH)

Collaborator

Trials

2,896

Recruited

8,053,000+

National Institute of General Medical Sciences (NIGMS)

Collaborator

Trials

315

Recruited

251,000+

Findings from Research

A 1-year cognitive-motor intervention (CMI) program for patients with early Alzheimer's disease, alongside cholinesterase inhibitor treatment, helped maintain cognitive function at 6 months, while the control group showed significant decline.

The CMI group also had better mood outcomes, with 75% of participants maintaining or improving their affective status at 12 months compared to 47% in the control group, indicating additional psychological benefits from the intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Benefits of cognitive-motor intervention in MCI and mild to moderate Alzheimer disease. Olazarán, J., Muñiz, R., Reisberg, B., et al.[2019]

In a study involving individuals with mild-to-moderate Alzheimer's disease (AD), mild cognitive impairment (MCI), and healthy controls, only a small number of patients (1 out of 10 MCI and 3 out of 17 AD) showed significant deficits in peripheral reaching ability, indicating that such deficits are not common in these conditions.

Both AD and MCI groups exhibited significantly longer reach durations compared to healthy controls, suggesting that cognitive decline may lead to a generalized slowing of movement, potentially reflecting issues in planning or guiding reaching movements.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Peripheral reaching in Alzheimer's disease and mild cognitive impairment. Mitchell, AG., Rossit, S., Pal, S., et al.[2022]

In a study of 816 older Catholic clergy members, those with mild cognitive impairment (MCI) exhibited impaired motor function compared to individuals without cognitive impairment, but better motor function than those with dementia.

Impaired lower extremity motor performance and parkinsonian gait in individuals with MCI were found to significantly increase the risk of developing Alzheimer's disease, with those in the lowest performance percentile being 2 to 3 times more likely to develop AD than those in the highest percentile.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motor dysfunction in mild cognitive impairment and the risk of incident Alzheimer disease. Aggarwal, NT., Wilson, RS., Beck, TL., et al.[2022]

In early-stage Alzheimer's disease (AD), patients showed significant impairments in reach-to-grasp movements, including slower reaching speeds, reduced grasping accuracy, and increased variability, compared to cognitively normal adults.

The study suggests that these kinematic and kinetic changes in grasping are linked to the neuropsychological status of early-stage AD, indicating that analyzing these movements could serve as a non-invasive method for screening or evaluating the disease.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reach-to-grasp kinematics and kinetics with and without visual feedback in early-stage Alzheimer's disease. Zhang, J., Xiao, Y., Li, ZM., et al.[2022]

In a study of 2,640 older adults over 2 years, the outcomes of 16 different classifications of mild cognitive impairment (MCI) showed that most individuals either reverted to normal cognitive function or had impairments that could not be classified, indicating variable outcomes for MCI.

Progression to dementia was relatively rare and depended on the specific classification used and the age of the individuals, suggesting that current MCI definitions may exclude many who could benefit from interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Two-year progression from mild cognitive impairment to dementia: to what extent do different definitions agree? Matthews, FE., Stephan, BC., McKeith, IG., et al.[2022]

Mild cognitive impairment (MCI) is a significant transitional phase that leads to dementia, characterized by cognitive and motor decline, which negatively impacts the health and quality of life of affected individuals.

The article suggests that multicomponent interventions focusing on both cognitive and motor skills may enhance motor functions in MCI patients, highlighting the need for future research in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mild cognitive impairment affects motor control and skill learning. Wu, Q., Chan, JS., Yan, JH.[2017]

In a study of 136 elderly individuals, those with Alzheimer's disease (AD) showed the highest levels of apraxia, with average scores significantly lower than those of healthy elderly controls and patients with Mild Cognitive Impairment (MCI).

The presence of apraxia was found to effectively differentiate between healthy elderly individuals, those with MCI, and AD patients, indicating its potential as a valuable assessment tool for cognitive impairments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessment for apraxia in mild cognitive impairment and Alzheimer's dise. Ward, M., Cecato, JF., Aprahamian, I., et al.[2022]

The study analyzed handwriting processes in 31 individuals with mild cognitive impairment (MCI), 22 with mild Alzheimer's disease, and 41 healthy controls, revealing significant differences in handwriting characteristics across the groups.

Individuals with more cognitive decline (Alzheimer's) exhibited slower temporal measures and lower pressure in their handwriting, suggesting that kinematic analysis can help differentiate between cognitive impairment levels, although it was less effective for accurately classifying those with MCI.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Handwriting process variables discriminating mild Alzheimer's disease and mild cognitive impairment. Werner, P., Rosenblum, S., Bar-On, G., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Benefits of cognitive-motor intervention in MCI and mild to moderate Alzheimer disease. [2019]

2. Italy pubmed.ncbi.nlm.nih.gov

Peripheral reaching in Alzheimer's disease and mild cognitive impairment. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Motor dysfunction in mild cognitive impairment and the risk of incident Alzheimer disease. [2022]

4. England pubmed.ncbi.nlm.nih.gov

Reach-to-grasp kinematics and kinetics with and without visual feedback in early-stage Alzheimer's disease. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Two-year progression from mild cognitive impairment to dementia: to what extent do different definitions agree? [2022]

6. Germany pubmed.ncbi.nlm.nih.gov

Mild cognitive impairment affects motor control and skill learning. [2017]

7. Brazil pubmed.ncbi.nlm.nih.gov

Assessment for apraxia in mild cognitive impairment and Alzheimer's dise. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Handwriting process variables discriminating mild Alzheimer's disease and mild cognitive impairment. [2022]