Managing Pain and Cognitions in Older Adults With Early Cognitive Decline and Chronic Pain
Chronic Pain, Mild Cognitive Impairment, Older Adults
About this trial
This is an interventional treatment trial for Chronic Pain focused on measuring Chronic Pain, Mild Cognitive Impairment, Older Adults, Physical Activity, Memory Related Problems, Early Cognitive Decline
Eligibility Criteria
Inclusion Criteria:
- Male and female outpatients, age 60 years or older
- Have nonmalignant chronic pain for more than 3 months
- Reports early cognitive decline (subjective or objective)
- Telephone Interview for Cognitive Status-30 score greater than or equal to 17
- Functional Activities Questionnaire score less than 9
- Able to perform a 6-minute walk test at an accelerated pace
- English fluency/literacy
- Willingness and ability to participate and use an ActiGraph watch and smartphone app to view and sync the step count and sleep data
- Free of concurrent psychotropic or pain medication for at least 2 weeks prior to initiation of treatment, OR stable on current psychotropic or pain medication for a minimum of 6 weeks and willing to maintain a stable dose
- Cleared by a medical doctor for study participation and no self-reported concerns about physical functioning on the revised Physical Activity Readiness Questionnaire (PAR-Q; score 0)
Exclusion Criteria:
- Diagnosed with dementia or neurodegenerative disease
- Diagnosed with medical illness expected to worsen in the next 6 months
- Diagnosed with serious untreated mental illness (i.e., schizophrenia) or untreated substance use disorder
- Current suicidal ideation reported on self-report
- Engaging in regular mindfulness practice > 45 min/week or has completed a course of cognitive behavioral therapy in the past 3 months
- Regular use of a digital-monitoring device
- Engagement in regular intensive physical exercise for >30 minute daily
Sites / Locations
- Massachusetts General HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Active Brains 1
Active Brains 2
Active Brains 1 uses a multimodal approach to introduce and reinforce new skills, including didactics, in-session activities, discussions and weekly practice assignments (homework). The Active Brains sessions teach skills and strategies to manage early cognitive concerns and chronic pain. The format is an 8-week program with weekly meetings and a focus on relaxation response strategies, cognitive behavioral training, positive psychology and mind-body interactions. Active Brains 1 uses a wrist-worn digital monitoring device (ActiGraph) for recording of physical activity.
This active comparison condition controls for the effect of time spent, group member support/feedback and interventionist support/feedback. Active Brains 2 addresses population-specific challenges of chronic pain and early cognitive decline symptoms. Participants also receive lifestyle education consistent from public health recommendations and standards for health promotion (e.g., "Sleep", "Nutrition", "Healthy Weight" and "Medical appointments". The Active Brains 2 program consists on 8 group sessions (each session is 90 minutes) that occur concurrently with the active intervention condition. The Active Brains 2 is conducted in the same format as Active Brains 1, but participants are not taught the mind-body, walking or cognitive-behavioral skills. Active Brains 2 uses a wrist-worn digital monitoring device (ActiGraph) for recording of physical activity.