Psychomotor Slowing

Researchers are conducting the 100-Year Human Aging Study, an observational trial designed to follow participants over their lifespans to investigate which health measurements can predict mortality, serious diseases, and functional disability. The study aims to validate many longevity measures that currently lack prospective evidence by tracking physiological, cognitive, social, and environmental factors that change with aging. This research will generate important data to improve understanding of aging and longevity medicine. Participants undergo comprehensive multi-system clinical screenings including tests like cardiopulmonary exercise testing, body composition assessment by DEXA, echocardiography, electrocardiography, spirometry, neurocognitive testing, sensory assessments, metabolic testing, and detailed medical and social histories. The study allows for different levels of participation, from single tests to full two-visit screening batteries, and encourages repeat testing to capture health changes over time. During the study, participants receive individualized reports including investigational estimates of biological age and predicted cause of death. Researchers collect data on mortality, serious health events, chronic diseases, functional ability, and lifestyle changes through periodic follow-up over many years, potentially up to 100 years. This extensive data collection helps evaluate how well these measurements predict aging outcomes. All data are stored in raw form for future analysis and participants are supported with ongoing contact and opportunities for repeat assessments.

Researchers are investigating how transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique, affects working memory in older adults with mild cognitive impairment (MCI) compared to cognitively healthy older adults. This mechanistic study aims to understand the brain and cognitive function changes caused by a single session of tDCS. The study uses advanced brain imaging and machine learning to analyze the effects of stimulation on brain structure and working memory performance during specific tasks. Participants will receive either active or sham tDCS using a neuroConn MR-safe device that delivers 2.0 mA current through electrodes placed on the scalp over frontal brain regions. Active stimulation lasts 12 minutes with gradual ramp-up and ramp-down, while sham stimulation mimics the sensation but only delivers current for 30 seconds. Each participant completes three runs of an N-back working memory task before, during, and after stimulation. The study uses a randomized, double-blind, crossover design with at least two weeks between sessions. Throughout the study, participants undergo cognitive testing and brain MRI scans to measure working memory accuracy and brain connectivity changes. The main outcome is working memory performance on the 2-back task comparing active versus sham stimulation. Researchers will also monitor safety and participant ability to perform the tasks and tolerate stimulation. The total participation period includes multiple sessions spaced to allow for washout and evaluation of stimulation effects, with the study concluding by late 2029.

Researchers are studying chronic pain in older adults, focusing on those with knee or hip osteoarthritis. This trial evaluates a mobile, remotely delivered behavioral intervention aimed at increasing physical activity and improving diet to reduce pain and enhance quality of life. The goal is to see if this approach can increase daily steps, reduce pain interference, lower body weight, and improve physical function over 6 months, with a follow-up maintenance phase lasting 12 months. Participants will be randomly assigned to one of two groups. The intervention group will join weekly group sessions with peers and receive individual coaching calls to encourage moving often throughout the day and adopting healthier eating habits to lose weight. They will use an activity monitor and a mobile app for feedback and goal-setting. The comparison group will receive an activity monitor and a wireless weight scale but no behavioral intervention. After 6 months, all participants enter a 12-month no-contact period to maintain their progress independently. During the study, participants will be assessed on daily steps, pain interference, body weight, physical function tests like the 30-second chair stand and gait speed at baseline, 6 months, and 18 months. Researchers will monitor changes in these areas to measure the intervention's effectiveness. Participants will attend virtual testing appointments and complete questionnaires, with the total study duration being 18 months including follow-up.

Researchers are evaluating a combined sleep promotion and cognitive training intervention to help improve cognitive function in older survivors of intensive care units (ICU). This study focuses on adults aged 60 and older who are at high risk for delirium and cognitive decline similar to mild Alzheimer's disease after ICU discharge. The study aims to assess whether these interventions can reduce the risk of developing Alzheimer's disease and related dementias by addressing sleep deficiency, inactivity, and circadian rhythm disturbances common in ICU survivors. Participants will be randomly assigned to one of four groups: a combination of nighttime sleep promotion using earplugs and eye masks plus daily 30-minute computerized cognitive training sessions; cognitive training alone; sleep promotion alone; or an active control group receiving educational modules on brain health. The interventions last up to seven days following ICU discharge, with cognitive training sessions scheduled based on individual circadian rhythms measured by a wearable sensor. During the study, participants will be monitored using body temperature sensors to optimize the timing of cognitive training. Researchers will assess cognitive function, including executive function and working memory, at several time points: within seven days after hospital discharge, and at one, six, and twelve months follow-up. The study also examines how sleep and activity may influence cognitive outcomes, with safety and ongoing care monitored throughout the study period, which concludes in May 2027.

Researchers are evaluating a new 360-degree dual-task training to improve cognitive function in elderly people with subjective memory complaints or mild cognitive impairment. The study aims to develop an interactive and realistic rehabilitation program and test its effectiveness in these two groups. This research explores non-drug approaches to support brain health in early stages of cognitive decline. Participants will be randomly assigned to one of two groups: receiving the 360-degree media training or treatment as usual (TAU). The training includes two phases: first, supervised sessions in hospital using a head-mounted display; then, unsupervised sessions at home using a tablet with a non-immersive version of the program. Both memory complaint and mild cognitive impairment groups will be evenly divided between these treatments. During the study, participants will undergo cognitive and motor function tests immediately after completing the training. The hospital sessions are supervised by therapists, while home sessions are done independently. Researchers will measure changes in brain function and physical abilities using a full neuropsychological battery. The total study period includes in-hospital and at-home rehabilitation phases to assess the training's impact on cognitive health.

Researchers are evaluating a patient-centered, low-burden intervention designed to improve the measurement of functional status in older Veterans receiving care in VA primary care settings. Functional status refers to the ability to perform daily activities such as bathing, dressing, and preparing meals, which is vital for quality of life and independence. The study aims to increase identification and management of functional impairment and frailty to inform better care and strategic planning for long-term services and supports. The intervention includes routine, standardized functional status measurement combined with nursing screening, follow-up assessments by primary care providers, electronic tools for screening and documentation, educational sessions for care teams, and tailored reports. The study begins with a 3-month run-in period using standard implementation strategies like champions and system-level audit and feedback. Sites with lower screening uptake will be randomly assigned to receive either continued standard strategies or enhanced strategies including technical assistance and clinician-level audit and feedback, followed by crossover and further standard implementation periods. Participants will be Veterans aged over 60 who receive care in VA primary care after the study starts. Researchers will monitor changes in screening reach, clinical effectiveness, adoption, fidelity, patient experience, and sustainability over 24 months. Data from electronic health records and functional status assessments will be collected regularly. The study measures outcomes at multiple time points up to two years to evaluate the impact of the intervention on managing functional impairment and frailty among older Veterans.

Researchers are evaluating whether a cognitive training program can improve processing speed in individuals who have recently experienced an acute traumatic spinal cord injury (SCI). This pilot randomized controlled trial aims to address cognitive difficulties such as attention, memory, and information processing speed, which can significantly impact rehabilitation outcomes and quality of life. The study focuses on early intervention to potentially enhance overall health and well-being for people with acute SCI. Participants are randomly assigned to one of two groups: an experimental group or a placebo control group. Both groups complete pre-specified game-like computerized tasks using an internet-based cognitive training portal. These sessions occur three times per week, lasting 60 minutes each, over a total of 12 weeks. The study uses a quadruple masking design to reduce bias. During the study, participants undergo assessments at baseline, immediately after treatment (week 13), and at long-term follow-up (week 25). Researchers measure processing speed using tests such as the Useful Field of View (UFOV), Letter & Pattern Comparison (LPC), and Symbol Digit Modalities Test (SDMT). Quality of life related to spinal cord injury is also evaluated. The total participation period spans approximately six months, including treatment and follow-up evaluations.

Researchers are investigating how hearing aids might affect cognitive function in older adults with age-related hearing loss, also known as presbycusis. This study focuses on individuals aged 60 to 85 and aims to understand whether improving hearing ability can slow down the decline in memory and cognition associated with hearing loss. The research is being conducted at a single center and plans to follow participants for several years to assess changes over time. Participants are divided into two groups: one group receives hearing aids and the other does not receive any intervention. Those in the hearing aid group will use the device continuously for five years. Follow-up visits occur every six months, during which various tests are performed, including hearing assessments, cognitive tests, and brain imaging. The study uses a double-blind, randomized design to compare outcomes between the groups. Throughout the study, participants will have their cognitive functions measured using tools like the Montreal Cognitive Assessment (MoCA) and the Mini-Mental Status Exam (MMSE) every six months. Hearing ability will also be evaluated regularly through audiometry tests. Researchers will monitor the effects of hearing aids on cognitive decline and hearing improvement over the five-year period. Safety and adherence to the hearing aid intervention will be tracked as well.

Researchers are evaluating the effects of six months of aerobic exercise on older adults aged 65 years or older who have mild cognitive impairment (MCI) or probable/possible mild Alzheimer's disease (AD). This Phase II mechanistic Sequential, Multiple Assignment, Randomized Trial (SMART) aims to assess how aerobic exercise influences aerobic fitness, brain white matter changes, and patient-centered outcomes. The study also seeks to identify the best exercise approaches to improve aerobic fitness and understand how exercise impacts memory mechanisms in early AD. Participants are assigned to one of several exercise programs: moderate intensity continuous training (MICT) cycling for 30-50 minutes three times a week, chair-based stretching for 30-50 minutes three times a week, a combination of MICT followed by high-intensity interval training (HIIT) cycling for 40 minutes three times a week, or MICT followed by strength-building exercises three times a week for three months. The study includes an initial 3-month exercise phase with possible adaptation based on fitness response, lasting up to six months. During the study, participants will undergo cognitive testing and exercise assessments five times over one year, brain MRI scans three times in the same period, and monthly follow-ups discussing health and wellness. Researchers will measure peak oxygen consumption and white matter hyperintensity volume at baseline and six months, along with memory, physical function, behavioral symptoms, caregiver burden, quality of life, and blood biomarkers over one year. The trial includes safety monitoring and aims to improve understanding of exercise effects on early Alzheimer's disease.

Apathy, characterized by loss of motivation and withdrawal, commonly affects many people after a stroke and significantly lowers quality of life for both patients and their caregivers. This research aims to evaluate if a fast-delivered form of repetitive transcranial magnetic stimulation (rTMS) targeting the medial prefrontal cortex (mPFC) can be safe, tolerable, and helpful for treating apathy following stroke. The study is a randomized, double-blind trial designed to explore efficacy, safety, and other impacts beyond apathy in stroke survivors. The trial compares two groups: one receiving active accelerated intermittent theta burst stimulation (iTBS) rTMS to the left dorsal medial prefrontal cortex (dmPFC), and the other receiving a sham version that mimics the procedure without active stimulation. Participants receive 12 sessions daily over six treatment days within two weeks, totaling 72 sessions and 43,200 pulses. Brain imaging and neuronavigation guide precise treatment delivery, and the study uses advanced devices to ensure blinding and standardized targeting. Participants will be assessed at baseline, immediately after treatment, and one month later through clinical tests, brain MRIs, and questionnaires evaluating apathy and cognition. Safety is monitored throughout each treatment day, and participant retention and treatment acceptability are tracked. Outcomes include changes in apathy symptoms, cognition, and depression, as well as any adverse events, with the total involvement spanning the treatment period plus follow-up assessments.