Internet-Based Conversational Engagement Randomized Controlled Clinical Trial (I-CONECT) Among Socially Isolated Adults 75+ Years Old With Normal Cognition or Mild Cognitive Impairment: Topline Results.
Alzheimer’s disease and related dementias
Behavioral intervention
Cognitive reserve
Semistructured conversations
Social interactions
Journal
The Gerontologist
ISSN: 1758-5341
Titre abrégé: Gerontologist
Pays: United States
ID NLM: 0375327
Informations de publication
Date de publication:
01 Apr 2024
01 Apr 2024
Historique:
received:
28
04
2023
pubmed:
8
11
2023
medline:
8
11
2023
entrez:
7
11
2023
Statut:
ppublish
Résumé
Social isolation is a risk factor for cognitive decline and dementia. We conducted a randomized controlled clinical trial (RCT) of enhanced social interactions, hypothesizing that conversational interactions can stimulate brain functions among socially isolated older adults without dementia. We report topline results of this multisite RCT (Internet-based conversational engagement clinical trial [I-CONECT]; NCT02871921). The experimental group received cognitively stimulating semistructured conversations with trained interviewers via internet/webcam 4 times per week for 6 months (induction) and twice per week for an additional 6 months (maintenance). The experimental and control groups both received weekly 10 minutes telephone check-ins. Protocol modifications were required due to the coronavirus disease 2019 pandemic. A total of 186 participants were randomized. After the induction period, the experimental group had higher global cognitive test scores (Montreal Cognitive Assessment [primary outcome]; 1.75 points [p = .03]) compared with the control group. After induction, experimental group participants with normal cognition had higher language-based executive function (semantic fluency test [secondary outcome]; 2.56 points [p = .03]). At the end of the maintenance period, the experimental group of mild cognitive impairment subjects had higher encoding function (Craft Story immediate recall test [secondary outcome]; 2.19 points [p = .04]). Measure of emotional well-being improved in both control and experimental groups. Resting-state functional magnetic resonance imaging showed that the experimental group had increased connectivity within the dorsal attention network relative to the control group (p = .02), but the sample size was limited. Providing frequent stimulating conversational interactions via the internet could be an effective home-based dementia risk-reduction strategy against social isolation and cognitive decline. NCT02871921.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
Social isolation is a risk factor for cognitive decline and dementia. We conducted a randomized controlled clinical trial (RCT) of enhanced social interactions, hypothesizing that conversational interactions can stimulate brain functions among socially isolated older adults without dementia. We report topline results of this multisite RCT (Internet-based conversational engagement clinical trial [I-CONECT]; NCT02871921).
RESEARCH DESIGN AND METHODS
METHODS
The experimental group received cognitively stimulating semistructured conversations with trained interviewers via internet/webcam 4 times per week for 6 months (induction) and twice per week for an additional 6 months (maintenance). The experimental and control groups both received weekly 10 minutes telephone check-ins. Protocol modifications were required due to the coronavirus disease 2019 pandemic.
RESULTS
RESULTS
A total of 186 participants were randomized. After the induction period, the experimental group had higher global cognitive test scores (Montreal Cognitive Assessment [primary outcome]; 1.75 points [p = .03]) compared with the control group. After induction, experimental group participants with normal cognition had higher language-based executive function (semantic fluency test [secondary outcome]; 2.56 points [p = .03]). At the end of the maintenance period, the experimental group of mild cognitive impairment subjects had higher encoding function (Craft Story immediate recall test [secondary outcome]; 2.19 points [p = .04]). Measure of emotional well-being improved in both control and experimental groups. Resting-state functional magnetic resonance imaging showed that the experimental group had increased connectivity within the dorsal attention network relative to the control group (p = .02), but the sample size was limited.
DISCUSSION AND IMPLICATIONS
CONCLUSIONS
Providing frequent stimulating conversational interactions via the internet could be an effective home-based dementia risk-reduction strategy against social isolation and cognitive decline.
CLINICAL TRIALS REGISTRATION NUMBER
BACKGROUND
NCT02871921.
Identifiants
pubmed: 37935416
pii: 7342399
doi: 10.1093/geront/gnad147
pmc: PMC10943511
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT02871921']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NIA NIH HHS
ID : K00 AG068492
Pays : United States
Organisme : NIA NIH HHS
ID : R01AG051628
Pays : United States
Investigateurs
Elena Alfaro
(E)
Mattie McDonald
(M)
Jacob Lindsey
(J)
Colton Scavone
(C)
Nita Sheridan
(N)
Khoa Nguyen
(K)
Alexis Ellis
(A)
Louis Weisberg
(L)
Deborah Moore
(D)
Brandy Peacock
(B)
Brennan Heller
(B)
Carissa Thornall
(C)
Sandy Ruhf
(S)
Mary Ziemer-McGinn
(M)
Farah Custodio
(F)
Diane Farrell
(D)
Aimee Lynch
(A)
Dillon Banker
(D)
Gracia Reyes
(G)
Kathryn Rabe
(K)
Laura Seeton
(L)
Jessica Pedroza
(J)
David Forystek
(D)
Nicolas May
(N)
Jonathan Reader
(J)
Arijit K Bhaumik
(AK)
Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America.