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The purpose of this pilot study is to demonstrate the safety and feasibility of administering intermittent doses of Dasatinib and Quercetin (D+Q) in older adults at risk of Alzheimer's disease (AD). The study will evaluate whether giving D+Q may improve cerebral blood flow regulation, mobility, and cognition in older adults, and thus may prevent progression to Alzheimer's disease.
The investigators will conduct a 12-week single arm, open label, pre-post pilot study in 12 adults aged 65 or older with slow gait speed (<1.0 m/sec) and Mild Cognitive Impairment (MCI, defined as a Telephone Montreal Cognitive Assessment Score (MoCA) <19). Participants will be asked to take 100mg of Dasatinib and 1,250mg of Quercetin for 2 consecutive days, every two weeks over a period of 12 weeks (12 doses in total, given over 6 cycles).
At baseline, enrolled participants will undergo gait speed and neurocognitive testing, and provide blood and urine to evaluate biomarkers of senescence. At visits 3,4, 6, and 7, participants will have safety labs drawn, and the study team will assess medication adherence and adverse events. At visits 2, 5, and 8, participants will undergo cognitive assessments, gait speed testing, cerebral blood flow and neurovascular coupling testing. At the final study visit, participants will again provide blood and urine to assess biomarkers of senescence.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm 1 | Experimental | Dasatinib and Quercetin |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dasatinib | Drug | Dasatinib 100 mg for 2 consecutive days, every two weeks for 12 weeks |
|
| Measure | Description | Time Frame |
|---|---|---|
| Neurovascular Coupling | Change in cerebral blood flow during an N-back cognitive task using transcranial doppler ultrasound. | Screening, 8, and 14 weeks |
| Executive Function | Assess change in executive cognitive function using TRAILS test, corrected for response time. Higher scores indicate worse executive functioning. | Baseline, 8, and 14 weeks |
| Gait Speed | Assess change in gait speed. Performed without a distracting cognitive task. | Baseline, 8, and 14 weeks |
| Montreal Cognitive Assessment (MoCA) Score | The Montreal Cognitive Assessment evaluates global cognition. Scores range from 0-30 points, with higher scores indicating better cognition | Baseline, 8, and 14 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Physical Performance | Assessment of overall physical function using the short physical performance battery (SPPB) scored from 0-12, based on a composite of balance, strength, and walking speed. Higher scores indicate better mobility. | Baseline, 8, and 14 weeks |
| Mobility |
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Inclusion Criteria:
Exclusion Criteria, or as per clinical judgment:
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| Name | Affiliation | Role |
|---|---|---|
| Lewis Lipsitz, MD | Hebrew Senior Life | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hebrew Senior Life | Boston | Massachusetts | 02131 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40248131 | Derived | Millar CL, Iloputaife I, Baldyga K, Kuo J, Tchkonia T, Kirkland JL, Travison TG, Lipsitz LA. Rationale and Design of STAMINA: Senolytics To Alleviate Mobility Issues and Neurological Impairments in Aging, A Geroscience Feasibility Study. Transl Med Aging. 2023;7:109-117. doi: 10.1016/j.tma.2023.10.004. Epub 2023 Oct 21. |
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Of the 332 individuals that expressed interest in the study, 115 were screened via telephone. Sixty were ineligible due to not meeting the pre-specified inclusion/exclusion criteria. Of the 55 eligible telephone screeners, 24 were not enrolled due to loss of interest (n=12), loss to follow-up (n=10), or closed enrolment (n=2). Of the 31 participants that were screened in-person, 16 were excluded for various reasons, while 15 individuals were eligible and willing to participate.
This study was conducted from 2022-2024 in the greater Boston, MA area. Individuals were recruited through a recruitment firm that utilizes online targeted advertisements based on an individual's browsing history, as well as senior housing presentations, study flyers at clinical practices, and invitations to previous research volunteers who agreed to be in our participant registries.
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| ID | Title | Description |
|---|---|---|
| FG000 | Dasatinib and Quercetin | Participants took 100 mg of Dasatinib and 1,250 mg of Quercetin for 2 consecutive days, every two weeks for 12 weeks |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Dasatinib and Quercetin | Participants took 100 mg of Dasatinib and 1,250 mg of Quercetin for 2 consecutive days, every two weeks for 12 weeks |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Neurovascular Coupling | Change in cerebral blood flow during an N-back cognitive task using transcranial doppler ultrasound. | Posted | Mean | Standard Deviation | cm/s | Screening, 8, and 14 weeks |
|
|
For all participants, adverse events were collected during the entire 14 week study. We were collecting during the period of June 2022 to January 2024, which is approximately 1 year and 8 months.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Dasatinib and Quercetin | Participants took 100 mg of Dasatinib and 1,250 mg of Quercetin for 2 consecutive days, every two weeks for 12 weeks |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Serious Adverse Event | Injury, poisoning and procedural complications | Non-systematic Assessment | Participant was bitten by family dog on both hands. Waited until next day to go to urgent care which told him to go to hospital emergency room. He was admitted one night (discharged November 12) and sent home with antibiotics. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Headache | General disorders | Systematic Assessment |
Although we collected urine samples, the SASP factors (i.e., biomarkers) we were not measured due to insufficient funds and resources. Therefore, we are unable to analyze any data.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Courtney Millar | Marcus Institute | 6179715531 | courtneymillar@hsl.harvard.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_ICF | Yes | No | Yes | Study Protocol and Informed Consent Form | May 9, 2022 | May 27, 2022 | Prot_ICF_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Jan 23, 2024 | Mar 4, 2024 | SAP_001.pdf |
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| ID | Term |
|---|---|
| D000544 | Alzheimer Disease |
| ID | Term |
|---|---|
| D003704 | Dementia |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D000069439 | Dasatinib |
| D011794 | Quercetin |
| ID | Term |
|---|---|
| D013844 | Thiazoles |
| D013457 | Sulfur Compounds |
| D009930 | Organic Chemicals |
| D001393 | Azoles |
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| Quercetin | Drug | Quercetin 1,250 mg for 2 consecutive days, every two weeks for 12 weeks |
|
Test of mobility using timed up and go test, including standing from a chair, walking, and turning. |
| Baseline, 8, and 14 weeks |
| Grip Strength | Measure of grip strength using a hand dynamometer. | Baseline, 8, and 14 weeks |
| Gait Speed During Cognitive Task | Measure of gait speed during a cognitive task. | Baseline, 8, and 14 weeks |
| P16 ink4a Expression in CD3 Positive Cells | Measure of P16 ink4a expression in senescent CD3 lymphocytes in the blood. | Screening and 14 weeks |
| SASP Factors in Blood and Urine | Measure of the senescence-associated biomarkers IL-1alpha picogram/mL and IL-6 picogram/mL. | Screening and 14 weeks |
| SASP Factors in Blood and Urine | Measure of the senescence-associated biomarkers MMP-9 nanograms/mL and MMP-12 nanograms/mL. | Screening and 14 weeks |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Highest Level of Education | Count of Participants | Participants |
|
| 4-meter Gait Speed | Mean | Standard Deviation | meters/second |
|
| Telephone Montreal Cognitive Assessment Score | Range: 0-22 points with higher scores indicating higher cognitive status | Mean | Standard Deviation | points |
|
| Body Mass Index | Mean | Standard Deviation | kg/m^2 |
|
| Osteo- or Degenerative Arthritis | Count of Participants | Participants |
|
| High Blood Pressure | Count of Participants | Participants |
|
| High Cholesterol | Count of Participants | Participants |
|
| Depression | Count of Participants | Participants |
|
| Eye Disease | Count of Participants | Participants |
|
| Stomach Disease (e.g., Acid Reflux) | Count of Participants | Participants |
|
|
| Primary | Executive Function | Assess change in executive cognitive function using TRAILS test, corrected for response time. Higher scores indicate worse executive functioning. | Posted | Mean | Standard Deviation | seconds | Baseline, 8, and 14 weeks |
|
|
|
| Primary | Gait Speed | Assess change in gait speed. Performed without a distracting cognitive task. | Posted | Mean | Standard Deviation | meters/second | Baseline, 8, and 14 weeks |
|
|
|
| Primary | Montreal Cognitive Assessment (MoCA) Score | The Montreal Cognitive Assessment evaluates global cognition. Scores range from 0-30 points, with higher scores indicating better cognition | Posted | Mean | Standard Deviation | points | Baseline, 8, and 14 weeks |
|
|
|
| Secondary | Physical Performance | Assessment of overall physical function using the short physical performance battery (SPPB) scored from 0-12, based on a composite of balance, strength, and walking speed. Higher scores indicate better mobility. | Posted | Mean | Standard Deviation | points | Baseline, 8, and 14 weeks |
|
|
|
| Secondary | Mobility | Test of mobility using timed up and go test, including standing from a chair, walking, and turning. | Posted | Mean | Standard Deviation | seconds | Baseline, 8, and 14 weeks |
|
|
|
| Secondary | Grip Strength | Measure of grip strength using a hand dynamometer. | Posted | Mean | Standard Deviation | kilograms | Baseline, 8, and 14 weeks |
|
|
|
| Secondary | Gait Speed During Cognitive Task | Measure of gait speed during a cognitive task. | Posted | Mean | Standard Deviation | meters/second | Baseline, 8, and 14 weeks |
|
|
|
| Secondary | P16 ink4a Expression in CD3 Positive Cells | Measure of P16 ink4a expression in senescent CD3 lymphocytes in the blood. | Posted | Mean | Standard Deviation | relative expression to housekeeping gene | Screening and 14 weeks |
|
|
|
| Secondary | SASP Factors in Blood and Urine | Measure of the senescence-associated biomarkers IL-1alpha picogram/mL and IL-6 picogram/mL. | Posted | Mean | Standard Deviation | picograms/mL | Screening and 14 weeks |
|
|
|
| Secondary | SASP Factors in Blood and Urine | Measure of the senescence-associated biomarkers MMP-9 nanograms/mL and MMP-12 nanograms/mL. | Posted | Mean | Standard Deviation | nanograms/mL | Screening and 14 weeks |
|
|
|
| 0 |
| 15 |
| 1 |
| 15 |
| 12 |
| 15 |
|
| Producing more urine than usual | Renal and urinary disorders | Systematic Assessment |
|
| Bruising | Injury, poisoning and procedural complications | Systematic Assessment |
|
| High Glucose | Metabolism and nutrition disorders | Systematic Assessment |
|
| Low White Blood Cell Count | Blood and lymphatic system disorders | Systematic Assessment |
|
| High Cystatin C Value | Renal and urinary disorders | Systematic Assessment |
|
| Irregular Glomerular Filtration Rate | Renal and urinary disorders | Systematic Assessment |
|
| Ankle Edema | General disorders | Systematic Assessment |
|
| Basilar Rales | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| Irregular Heart Beat | Cardiac disorders | Systematic Assessment |
|
| Muscle or Hip Pain | Injury, poisoning and procedural complications | Systematic Assessment |
|
| Difficulty with Balance | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Depressed Mood or Anxiety | Psychiatric disorders | Systematic Assessment |
|
| Sore Throat | General disorders | Systematic Assessment |
|
| Difficulty Breathing | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| Low Hemoglobin | Blood and lymphatic system disorders | Systematic Assessment |
|
| Chest Pressure | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| High Potassium | Blood and lymphatic system disorders | Systematic Assessment |
|
| High Creatinine | Blood and lymphatic system disorders | Systematic Assessment |
|
| Diarrhea or Loose Stool | Gastrointestinal disorders | Systematic Assessment |
|
| Fluttering in Chest | Cardiac disorders | Systematic Assessment |
|
| Loss of Appetite or Nausea | Gastrointestinal disorders | Systematic Assessment |
|
| Fatigue or Tiredness | General disorders | Systematic Assessment |
|
| Dizziness | General disorders | Systematic Assessment |
|
| Bloating | Gastrointestinal disorders | Systematic Assessment |
|
| Low Hematocrit Level | Blood and lymphatic system disorders | Systematic Assessment |
|
| Tingling in Extremeties | Nervous system disorders | Systematic Assessment |
|
| Sprained wrist | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Low blood pressure | Cardiac disorders | Systematic Assessment |
|
| Coughing | Respiratory, thoracic and mediastinal disorders | Systematic Assessment |
|
| Restless Sleep | General disorders | Systematic Assessment |
|
| Memory Concerns | Psychiatric disorders | Systematic Assessment |
|
| High Blood Urea Nitrogen | Renal and urinary disorders | Systematic Assessment |
|
| High ALT Level | Hepatobiliary disorders | Systematic Assessment |
|
| High Heart Rate | Cardiac disorders | Systematic Assessment |
|
| Chronic Kidney Disease | Renal and urinary disorders | Systematic Assessment |
|
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| D024801 |
| Tauopathies |
| D019636 | Neurodegenerative Diseases |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D006573 |
| Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D011743 | Pyrimidines |
| D044948 | Flavonols |
| D005419 | Flavonoids |
| D002867 | Chromones |
| D001578 | Benzopyrans |
| D011714 | Pyrans |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
|
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| Title |
|---|
| Measurements |
|---|
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| Title |
|---|
| Measurements |
|---|
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| Serum IL-6 Week 14 |
|