search
Back to results

The PREVENTION Trial: Precision Recommendations to Optimize Neurocognition (PREVENTION)

Primary Purpose

Alzheimer Disease, Mild Cognitive Impairment

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Data-Driven Clinical Recommendations
Coached Data-Driven Clinical Recommendations
Sponsored by
Saint John's Cancer Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Alzheimer Disease focused on measuring Alzheimer Disease, Mild Cognitive Impairment, Precision Medicine, Health Coaching, Multi-Modal Intervention, Personal, Dense, Dynamic Data (PD3) Clouds, Cognitive decline

Eligibility Criteria

50 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

  • Subjects must be age 50 to 80 at time of informed consent.
  • Subjects of any gender, race or ethnicity are eligible to enroll in the study.
  • Subjects must have a FAST stage of 2-4.
  • Subjects with FAST Stage 4 must have a caregiver or legally appointed representative willing to accompany participants to the required procedures.
  • As part of the study screening procedure, subjects must be willing to undergo an amyloid PET scan or have previously undergone an amyloid PET scan and agree to make the results available. Subjects must be amyloid positive to be eligible to enroll in the study.
  • Subjects must be proficient in spoken and written English for consenting as well as for study participation since the intervention in this study (e.g., coaching program) is currently only available in English.
  • Subjects with medical conditions must be stable for these conditions. Stable control on medication is acceptable. Subjects should not have started any new medications for chronic conditions within the last three months.
  • A neurological and physical evaluation will be conducted prior to enrollment of the study by a qualified medical doctor and confirmed through medical records that they do not possess any abnormal physical or neurological sign, and/ whether they are considered to be clinically significant. Also an MMSE >19 will be confirmed by a medical doctor prior to study enrollment.
  • Subjects, with or without assistance, must be able to use a computer and web interface. If assistance is needed, it must be readily available to them.
  • Subjects must be able to converse with a coach telephonically. Video-based telephone coaching is part of data-driven health coaching.
  • Subjects must have regular access to a computer and the Internet along with dedicated email address since certain aspects of the program (e.g. cognitive training) are delivered electronically.
  • Subject must have normal visual acuity (or corrected to normal) and normal color vision as indicated by self-report.
  • Subject must have adequate hearing acuity as indicated by self-report.
  • Subject must have adequate motor capacity to use a mobile phone/iPad/computer as indicated by self-report and confirmed by staff before they are enrolled into a treatment arm.
  • Subject must be cleared by a physician to participate in a moderately intensive exercise program.

Exclusion Criteria

  • Subjects with an existing diagnosis of a non-AD neurodegenerative disorder (e.g., Lewy Body Dementia, Frontal-Temporal Dementia).
  • Subjects with a diagnosis of cerebrovascular disease as the primary cause of cognitive impairment.
  • A previously reported AD high-risk mutation (e.g., in the Presenilin Protein (PSEN) or Amyloid Precursor Protein (APP) genes) in the participant or immediate family (children, siblings, or parents). Such patients may accumulate amyloid faster than in late onset AD, and therefore may show less pronounced benefit from intervention.
  • Mini Mental State Exam (MMSE) below 20.
  • Clinical Dementia Rating (CDR) global score of 2 or above.

Sites / Locations

  • Pacific Brain Health CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Group 1 - Data-driven clinical recommendations (CR)

Group 2 - Data-driven coached multi-modal intervention (MMIC)

Arm Description

Data-driven clinical recommendations (CR)

Data-driven coached multi-modal intervention (MMIC)

Outcomes

Primary Outcome Measures

NIH ToolBox Cognition Function Battery - Cognitive Function Composite Score
To test the hypothesis that high contact coaching is better than no coaching for people in the early stages and at risk for cognitive decline. We plan to test that after one year of coached data-driven personalized interventions, participants in the coaching (CDDCR) (Group 2) will have less cognitive decline than the non-coaching (DDCR) arm (Group 1) as measured by the NIH ToolBox Cognition Function Battery (NIHTB-CB). The Cognitive Function Composite Score will be our primary outcome measure for cognitive function. The NIHTB-CB contains seven computer-based instruments assessing five cognitive sub-domains: Language, Executive Function, Episodic Memory, Processing Speed, and Working Memory. The Composite Score is calculated using all seven subsets of the NIHTB-CB. Participants will be assessed at baseline and one year.
RAVLT (Rey's Auditory Verbal Learning Test) score
To test the hypothesis that high contact coaching is better than no coaching for people in the early stages and at risk for cognitive decline. We plan to test that after one year of coached data-driven personalized interventions, participants in the coaching (CDDCR) (Group 2) will have less cognitive decline than the non-coaching (DDCR) arm (Group 1) as measured by the he Rey Auditory Verbal Learning Test (RAVLT). The RAVLT is a test derived for assessing verbal learning and memory. The RAVLT will be used to evaluate the changes in memory function of participants in the two different arms. Participants will be assessed at baseline and one year. Changes in RAVLT learn and recall scores will be used to assess changes in cognitive function.
Hippocampal Volume
To test the hypothesis that high contact coaching is better than no coaching for people in the early stages and at risk for cognitive decline. We plan to test that after one year of coached data-driven personalized interventions, participants in the coaching (CDDCR) (Group 2) will have less hippocampal volume decline than the non-coaching (DDCR) arm (Group 1) as measured by the structural magnetic resonance imaging (MRI). Participants will be assessed at baseline and one year.

Secondary Outcome Measures

Blood Urine Nitrogen
To test the hypothesis that high contact coaching is better than no coaching for people in the early stages and at risk for cognitive decline. We plan to test that after one year of coached data-driven personalized interventions, participants in the coaching (CDDCR) (Group 2) will have lower blood urea levels (BUN) than the non-coaching (DDCR) arm (Group 1) as measured by the plasma BUN. Participants will be assessed at baseline and one year.

Full Information

First Posted
July 24, 2019
Last Updated
June 9, 2023
Sponsor
Saint John's Cancer Institute
Collaborators
Institute for Systems Biology, St. Joseph's Healthcare Foundation
search

1. Study Identification

Unique Protocol Identification Number
NCT04082611
Brief Title
The PREVENTION Trial: Precision Recommendations to Optimize Neurocognition
Acronym
PREVENTION
Official Title
The PREVENTION Trial: Precision Recommendations for Environmental Variables, Exercise, Nutrition and Training Interventions to Optimize Neurocognition
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 12, 2019 (Actual)
Primary Completion Date
January 2025 (Anticipated)
Study Completion Date
January 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Saint John's Cancer Institute
Collaborators
Institute for Systems Biology, St. Joseph's Healthcare Foundation

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The PREVENTION Trial is a 12-month, two-arm randomized clinical trial (RCT) in adults 50-80 years old experiencing cognitive decline. Our study clinicians will refer patients for enrollment based on three categories: 1) a diagnosis of mild AD according to criteria established by the National Institute of Neurological and Communicative Disorders and Stroke (AD and Related Disorders Association [NINCDS-ADRDA]), 2) those with mild cognitive impairment will be diagnosed according to the Petersen method, and 3) subjective memory impairment as assessed by neuropsychological assessments and self-report. Enrollment will require evidence of AD pathophysiological processes (as defined by a positive amyloid positron emission tomography (PET) scan). The first objective is to evaluate the efficacy of a coached, data-driven, multi-modal lifestyle intervention to treat cognitive decline. Subjects will be randomized into one of two groups: Group 1 (Active Control) or Group 2 (Intervention). Group 1 (Data-driven clinical recommendations (CR)) will serve as the active control group and will receive data-driven clinical recommendations by a study physician based on study assessments and clinical lab values. Group 2 (Data-driven multi-modal intervention with coaching (MMIC)) will receive the same clinical recommendations and also an intensive multi-modal intervention with health coaching, support and resources to carry out these recommendations. This includes health coaching sessions (with an RDN), dietary counseling sessions (with an RDN), and group cognitive and physical exercise classes (CogFit) with a certified personal trainer and a computer-based neurocognitive program at home. Both groups will be measured for treatment related changes in cognitive and functional abilities, quality of life, biological, and biochemical measures. The second objective is to analyze longitudinal multi-omic data, including metabolomics, proteomics, genetics, microbiome, behavior and cognition into personalized, dense, dynamic data (i.e. PD3) from individuals with cognitive decline and underlying Alzheimer's neuropathology. The goal analysis is to identify models of causation that can further advance knowledge and research in neurodegenerative disorders and healthy living.
Detailed Description
Subject identification and recruitment - All participants will be recruited from the Pacific Brain Health Center in Santa Monica, which is a high-volume memory-care and dementia outpatient clinic within a large physician medical group affiliated with Providence Saint John's Health Center. 60 participants will be randomized into the RCT, with 30 in each treatment arm. Procedures for Obtaining Informed Consent - All participants will receive the Experimental Research Subject's Bill of Rights prior to signing the informed consent form (ICF), authorization of use and disclosure of protected health information (PHI), and authorization of medical record release for the subject's treating physician, will be obtained from each participants prior to enrolling in the study. A copy of all signed ICF's will be given to the participants, and the investigator will retain the original. A Functional Assessment Staging Test (FAST) will be done before participants are consented to determine whether they or a legally appointed representative (LAR) can consent to participate in the study. In this study, participants with FAST stages 2-4 will be recruited (see Inclusion Criteria). Considerations for consenting: FAST Stages 2-3 Participants - FAST stages 2-3 participants are usually capable of making medical and legal decisions, and will be consented directly, unless there is a caregiver, legally appointed representative, or other reason to think that an informed consent cannot be given by the participants without approval by a reliable informant acting on their behalf. Considerations for consenting: FAST Stage 4 (mild dementia) Participants - FAST stage 4 participants will be consented by having them give oral or written assent, indicating their preference with regard to study participation. In addition, the caregiver or legally appointed representative of a demented participants will be consented to assure full understanding of study procedures and willingness on behalf of the participants to participate in the study. The consenting approach for patients with cognitive impairment has been evaluated by the Department of Psychiatry and Behavioral Sciences at Johns Hopkins, and found to adequately ensure informed consent. They concluded that ADRD participants should not be excluded from study participation if they cannot directly consent themselves, so long as their caregivers can consent, and the participants can assent, either verbally or in writing, their preference to participate in the study. The caregiver or legally appointed representative will be required to accompany participants to participate in the required procedures. A copy of the appropriate document (e.g., the power of attorney for healthcare) will be obtained and filed with the original ICF.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer Disease, Mild Cognitive Impairment
Keywords
Alzheimer Disease, Mild Cognitive Impairment, Precision Medicine, Health Coaching, Multi-Modal Intervention, Personal, Dense, Dynamic Data (PD3) Clouds, Cognitive decline

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Participant
Masking Description
Participants will be assigned with a participant identification number (ID), so that data will not be identified by any names or personally identifiable information. This ID will be used throughout this study.
Allocation
Randomized
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Group 1 - Data-driven clinical recommendations (CR)
Arm Type
Active Comparator
Arm Description
Data-driven clinical recommendations (CR)
Arm Title
Group 2 - Data-driven coached multi-modal intervention (MMIC)
Arm Type
Experimental
Arm Description
Data-driven coached multi-modal intervention (MMIC)
Intervention Type
Behavioral
Intervention Name(s)
Data-Driven Clinical Recommendations
Intervention Description
Data-driven clinical recommendations. Participants will receive routine care with data-driven, personalized, multi-modal clinical recommendations by a study physician based on study assessments and clinical lab values and be monitored and re-assessed for a period of 12 months.
Intervention Type
Behavioral
Intervention Name(s)
Coached Data-Driven Clinical Recommendations
Intervention Description
Data-driven multi-modal lifestyle intervention with coaching. Participants will receive coached routine care with data-driven, personalized, multimodal recommendations. MMIC participants will receive an intensive multi-modal intervention with health coaching, support and resources to carry out these recommendations. This additional intervention services include: 13 personal, data-driven brain health coaching sessions (with an RDN), 7 personal dietary counseling sessions (with an RDN), 33 group-based cognitive and physical exercise classes (CogFit) with a certified personal trainer and a computer-based neurocognitive program at home and be monitored and re-assessed for a period of 12 months.
Primary Outcome Measure Information:
Title
NIH ToolBox Cognition Function Battery - Cognitive Function Composite Score
Description
To test the hypothesis that high contact coaching is better than no coaching for people in the early stages and at risk for cognitive decline. We plan to test that after one year of coached data-driven personalized interventions, participants in the coaching (CDDCR) (Group 2) will have less cognitive decline than the non-coaching (DDCR) arm (Group 1) as measured by the NIH ToolBox Cognition Function Battery (NIHTB-CB). The Cognitive Function Composite Score will be our primary outcome measure for cognitive function. The NIHTB-CB contains seven computer-based instruments assessing five cognitive sub-domains: Language, Executive Function, Episodic Memory, Processing Speed, and Working Memory. The Composite Score is calculated using all seven subsets of the NIHTB-CB. Participants will be assessed at baseline and one year.
Time Frame
1 year
Title
RAVLT (Rey's Auditory Verbal Learning Test) score
Description
To test the hypothesis that high contact coaching is better than no coaching for people in the early stages and at risk for cognitive decline. We plan to test that after one year of coached data-driven personalized interventions, participants in the coaching (CDDCR) (Group 2) will have less cognitive decline than the non-coaching (DDCR) arm (Group 1) as measured by the he Rey Auditory Verbal Learning Test (RAVLT). The RAVLT is a test derived for assessing verbal learning and memory. The RAVLT will be used to evaluate the changes in memory function of participants in the two different arms. Participants will be assessed at baseline and one year. Changes in RAVLT learn and recall scores will be used to assess changes in cognitive function.
Time Frame
1 year
Title
Hippocampal Volume
Description
To test the hypothesis that high contact coaching is better than no coaching for people in the early stages and at risk for cognitive decline. We plan to test that after one year of coached data-driven personalized interventions, participants in the coaching (CDDCR) (Group 2) will have less hippocampal volume decline than the non-coaching (DDCR) arm (Group 1) as measured by the structural magnetic resonance imaging (MRI). Participants will be assessed at baseline and one year.
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Blood Urine Nitrogen
Description
To test the hypothesis that high contact coaching is better than no coaching for people in the early stages and at risk for cognitive decline. We plan to test that after one year of coached data-driven personalized interventions, participants in the coaching (CDDCR) (Group 2) will have lower blood urea levels (BUN) than the non-coaching (DDCR) arm (Group 1) as measured by the plasma BUN. Participants will be assessed at baseline and one year.
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Subjects must be age 50 to 80 at time of informed consent. Subjects of any gender, race or ethnicity are eligible to enroll in the study. Subjects must have a FAST stage of 2-4. Subjects with FAST Stage 4 must have a caregiver or legally appointed representative willing to accompany participants to the required procedures. As part of the study screening procedure, subjects must be willing to undergo an amyloid PET scan or have previously undergone an amyloid PET scan and agree to make the results available. Subjects must be amyloid positive to be eligible to enroll in the study. Subjects must be proficient in spoken and written English for consenting as well as for study participation since the intervention in this study (e.g., coaching program) is currently only available in English. Subjects with medical conditions must be stable for these conditions. Stable control on medication is acceptable. Subjects should not have started any new medications for chronic conditions within the last three months. A neurological and physical evaluation will be conducted prior to enrollment of the study by a qualified medical doctor and confirmed through medical records that they do not possess any abnormal physical or neurological sign, and/ whether they are considered to be clinically significant. Also an MMSE >19 will be confirmed by a medical doctor prior to study enrollment. Subjects, with or without assistance, must be able to use a computer and web interface. If assistance is needed, it must be readily available to them. Subjects must be able to converse with a coach telephonically. Video-based telephone coaching is part of data-driven health coaching. Subjects must have regular access to a computer and the Internet along with dedicated email address since certain aspects of the program (e.g. cognitive training) are delivered electronically. Subject must have normal visual acuity (or corrected to normal) and normal color vision as indicated by self-report. Subject must have adequate hearing acuity as indicated by self-report. Subject must have adequate motor capacity to use a mobile phone/iPad/computer as indicated by self-report and confirmed by staff before they are enrolled into a treatment arm. Subject must be cleared by a physician to participate in a moderately intensive exercise program. Exclusion Criteria Subjects with an existing diagnosis of a non-AD neurodegenerative disorder (e.g., Lewy Body Dementia, Frontal-Temporal Dementia). Subjects with a diagnosis of cerebrovascular disease as the primary cause of cognitive impairment. A previously reported AD high-risk mutation (e.g., in the Presenilin Protein (PSEN) or Amyloid Precursor Protein (APP) genes) in the participant or immediate family (children, siblings, or parents). Such patients may accumulate amyloid faster than in late onset AD, and therefore may show less pronounced benefit from intervention. Mini Mental State Exam (MMSE) below 20. Clinical Dementia Rating (CDR) global score of 2 or above.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jennifer Bramen, PhD
Phone
310-829-8043
Email
jbramen@pacificneuro.org
First Name & Middle Initial & Last Name or Official Title & Degree
Jared Roach, MD
Phone
2067322108
Email
jroach@systemsbiology.org
Facility Information:
Facility Name
Pacific Brain Health Center
City
Santa Monica
State/Province
California
ZIP/Postal Code
90404
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jennifer Bramen, PhD
Phone
310-829-8043
Email
jbramen@pacificneuro.org
First Name & Middle Initial & Last Name & Degree
David H Merrill, MD, PhD
Phone
(310) 582-7641
Email
david.merrill@providence.org

12. IPD Sharing Statement

Citations:
PubMed Identifier
21775213
Citation
Barnes DE, Yaffe K. The projected effect of risk factor reduction on Alzheimer's disease prevalence. Lancet Neurol. 2011 Sep;10(9):819-28. doi: 10.1016/S1474-4422(11)70072-2. Epub 2011 Jul 19.
Results Reference
background
PubMed Identifier
20094021
Citation
Black BS, Rabins PV, Sugarman J, Karlawish JH. Seeking assent and respecting dissent in dementia research. Am J Geriatr Psychiatry. 2010 Jan;18(1):77-85. doi: 10.1097/JGP.0b013e3181bd1de2.
Results Reference
background
PubMed Identifier
9502356
Citation
Friedenreich CM, Courneya KS, Bryant HE. The lifetime total physical activity questionnaire: development and reliability. Med Sci Sports Exerc. 1998 Feb;30(2):266-74. doi: 10.1097/00005768-199802000-00015.
Results Reference
background
PubMed Identifier
16925881
Citation
Hagstromer M, Oja P, Sjostrom M. The International Physical Activity Questionnaire (IPAQ): a study of concurrent and construct validity. Public Health Nutr. 2006 Sep;9(6):755-62. doi: 10.1079/phn2005898.
Results Reference
background
PubMed Identifier
28744111
Citation
Park YH, Moon SH, Ha JY, Lee MH. The long-term effects of the health coaching self-management program for nursing-home residents. Clin Interv Aging. 2017 Jul 11;12:1079-1088. doi: 10.2147/CIA.S137821. eCollection 2017.
Results Reference
background
PubMed Identifier
18302232
Citation
Jack CR Jr, Bernstein MA, Fox NC, Thompson P, Alexander G, Harvey D, Borowski B, Britson PJ, L Whitwell J, Ward C, Dale AM, Felmlee JP, Gunter JL, Hill DL, Killiany R, Schuff N, Fox-Bosetti S, Lin C, Studholme C, DeCarli CS, Krueger G, Ward HA, Metzger GJ, Scott KT, Mallozzi R, Blezek D, Levy J, Debbins JP, Fleisher AS, Albert M, Green R, Bartzokis G, Glover G, Mugler J, Weiner MW. The Alzheimer's Disease Neuroimaging Initiative (ADNI): MRI methods. J Magn Reson Imaging. 2008 Apr;27(4):685-91. doi: 10.1002/jmri.21049.
Results Reference
background
PubMed Identifier
7069156
Citation
Pfeffer RI, Kurosaki TT, Harrah CH Jr, Chance JM, Filos S. Measurement of functional activities in older adults in the community. J Gerontol. 1982 May;37(3):323-9. doi: 10.1093/geronj/37.3.323.
Results Reference
background
PubMed Identifier
28714965
Citation
Price ND, Magis AT, Earls JC, Glusman G, Levy R, Lausted C, McDonald DT, Kusebauch U, Moss CL, Zhou Y, Qin S, Moritz RL, Brogaard K, Omenn GS, Lovejoy JC, Hood L. A wellness study of 108 individuals using personal, dense, dynamic data clouds. Nat Biotechnol. 2017 Aug;35(8):747-756. doi: 10.1038/nbt.3870. Epub 2017 Jul 17.
Results Reference
background
PubMed Identifier
26633093
Citation
Thom DH, Hessler D, Willard-Grace R, DeVore D, Prado C, Bodenheimer T, Chen EH. Health coaching by medical assistants improves patients' chronic care experience. Am J Manag Care. 2015 Oct;21(10):685-91.
Results Reference
background
PubMed Identifier
25755034
Citation
Willard-Grace R, Chen EH, Hessler D, DeVore D, Prado C, Bodenheimer T, Thom DH. Health coaching by medical assistants to improve control of diabetes, hypertension, and hyperlipidemia in low-income patients: a randomized controlled trial. Ann Fam Med. 2015 Mar;13(2):130-8. doi: 10.1370/afm.1768.
Results Reference
background
PubMed Identifier
25030513
Citation
Norton S, Matthews FE, Barnes DE, Yaffe K, Brayne C. Potential for primary prevention of Alzheimer's disease: an analysis of population-based data. Lancet Neurol. 2014 Aug;13(8):788-94. doi: 10.1016/S1474-4422(14)70136-X. Erratum In: Lancet Neurol. 2014 Nov;13(11):1070.
Results Reference
background
PubMed Identifier
29016550
Citation
Slavich GM, Shields GS. Assessing Lifetime Stress Exposure Using the Stress and Adversity Inventory for Adults (Adult STRAIN): An Overview and Initial Validation. Psychosom Med. 2018 Jan;80(1):17-27. doi: 10.1097/PSY.0000000000000534.
Results Reference
background
PubMed Identifier
10391658
Citation
Washburn RA, McAuley E, Katula J, Mihalko SL, Boileau RA. The physical activity scale for the elderly (PASE): evidence for validity. J Clin Epidemiol. 1999 Jul;52(7):643-51. doi: 10.1016/s0895-4356(99)00049-9.
Results Reference
background
PubMed Identifier
20693631
Citation
Hansmannel F, Sillaire A, Kamboh MI, Lendon C, Pasquier F, Hannequin D, Laumet G, Mounier A, Ayral AM, DeKosky ST, Hauw JJ, Berr C, Mann D, Amouyel P, Campion D, Lambert JC. Is the urea cycle involved in Alzheimer's disease? J Alzheimers Dis. 2010;21(3):1013-21. doi: 10.3233/JAD-2010-100630.
Results Reference
background
PubMed Identifier
6610841
Citation
McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984 Jul;34(7):939-44. doi: 10.1212/wnl.34.7.939.
Results Reference
background
PubMed Identifier
10190820
Citation
Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol. 1999 Mar;56(3):303-8. doi: 10.1001/archneur.56.3.303. Erratum In: Arch Neurol 1999 Jun;56(6):760.
Results Reference
background
Links:
URL
https://books.google.com/books?id=8DAtDwAAQBAJ&pg=PA459&lpg=PA459&dq=Jacobs,+P.+(Ed.).+(2017).+NSCA%27s+Essentials+of+Training+Special+Populations.+Human+Kinetics.&source=bl&ots=xfOeLBhO-N&sig=ACfU3U3rj-6QOloF2EuMVf0X3Wm7QZp8Fw&hl=en&sa=X&ved=2ahUKEwiE_8r07bnjAhWD_J4KHTP7BR0Q6AEwBnoECAkQAQ#v=onepage&q=Jacobs%2C%20P.%20(Ed.).%20(2017).%20NSCA's%20Essentials%20of%20Training%20Special%20Populations.%20Human%20Kinetics.&f=false
Description
Jacobs, P. (Ed.). (2017). NSCA's Essentials of Training Special Populations. Human Kinetics.

Learn more about this trial

The PREVENTION Trial: Precision Recommendations to Optimize Neurocognition

We'll reach out to this number within 24 hrs