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This study will begin to evaluate personalized preventative dementia treatments for Veterans at risk for developing dementia. The investigators will target Veterans with Motoric Cognitive Risk syndrome (MCR), which is characterized by slow gait speed and cognitive concerns (e.g., problems with memory or concentrations).
This study will involve therapeutic exercise treatments for Veterans with pre-clinical dementia syndrome. Participants will either participate in functional power training, music-based walking training, or a combination of both. The study will use a sequential multiple assignment, randomized trial (SMART) design. Successful completion of this study will lay the foundation for subsequent research trials, contributing to valuable evidence for personalized rehabilitation medicine for older Veterans.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Stage 1 Exercise Treatment | Experimental | Participants will first be randomized to 6-week exercise treatment (FPT or MBDT) |
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| Stage 2: Exercise Treatment | Experimental | At 6-week, responsiveness (change in gait speed = 0.05 m/s) will be evaluated. Responders will continue with their assigned treatment and non-responders will be randomized to either continue assigned treatment or combined treatment for an additional 6 weeks. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Functional Power Training (FPT) | Behavioral | Participants will receive twice weekly FPT, a progressive functional-based exercises that target optimizing leg force production and leg velocity. |
| Measure | Description | Time Frame |
|---|---|---|
| Enrollment/Baseline | Enrollment will be defined as the number of participants who were recruited and consented to the study. | Enrollment |
| Retention | Retention will be defined as the number of participants who completed the 12-week exercise treatment. | Baseline to end of 12-week treatment |
| Compliance | Compliance will be defined by the proportion of completed treatment sessions. | Baseline to end of 12-week treatment |
| Acceptability | Acceptability will be recorded by conducting interviews with participants who completed the 12-week exercise treatment. | End of 12-week treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Gait Speed | Change in gait speed will be assessed after 12-week exercise treatment. | Baseline to end of 12-week treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Cognition - Executive Function | Change in executive function will be assessed after 12-week exercise treatment using Delis-Kaplan Executive Function System. | Baseline to end of 12-week treatment |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Elisa Ogawa, PhD MS BS | Contact | (857) 364-4011 | elisa.ogawa@va.gov |
| Name | Affiliation | Role |
|---|---|---|
| Elisa Ogawa, PhD MS BS | VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA | Recruiting | Boston | Massachusetts | 02130-4817 | United States |
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Sequential Multiple Assignment Randomized Trial (SMART)
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| Music-Based Digital Therapy (MBDT) | Behavioral | Participants will receive twice weekly MBDT, a technology-driven gait training that is grounded in evidence-based rehabilitation treatment, rhythmic auditory stimulation. |
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| FPT + MBDT | Behavioral | For non-responders who were randomized to augment treatment, they will receive combined FPT and MBDT treatment. |
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