Vascular Cognitive Impairment No Dementia
Conditions
Brief summary
The global population is aging rapidly, with the number of elderly people with dementia projected to rise sharply, posing significant challenges to quality of life and societal burden.Frequent language switching, such as in interpreting, enhances cognitive abilities by improving attention, flexibility, and memory.Dialect-switching training, similar to interpreting, is a non-invasive method that shows potential for promoting cognitive health in the elderly but remains under-researched.This study aims to investigate the cognitive-enhancing effects of a dialect-switching training program on older adults with vascular risk factors through a six-month intervention.
Detailed description
The global population is aging rapidly, with those aged 65+ expected to reach 16% of the total population by 2050. Aging is linked to increased cognitive impairment risks, including dementia prevalence rates of 5%-10% among the elderly in developed countries. In China, the number of elderly with dementia is projected to soar from 7.4 million to 18 million by 2030 without intervention. This trend poses significant challenges to quality of life and societal burden. Language experiences, particularly frequent switching between languages, enhance cognitive abilities. Interpreting, which demands high-intensity language switching, significantly improves cognitive control and memory. Interpreters' need for rapid language conversion and reliance on attention, flexibility, and inhibition contribute to their cognitive advantages. Similar to interpreting, switching between dialects and standard language requires high-frequency, high-intensity language conversion. This non-invasive training method is suitable for promoting cognitive health in the elderly. However, its potential benefits for cognitive enhancement in this population remain underexplored. This study aims to design a dialect-switching training program simulating interpreting and investigate its potential cognitive-enhancing effects through a six-month intervention in older adults with vascular risk factors.
Interventions
BEHAVIORALDialect Interpreting Training
The intervention group will receive a combination of offline and online language-switching training. The offline intervention will last for 2 months, with three training sessions per week, each lasting 1 hour. The training content will simulate the interpreting process, requiring participants to switch and convert rapidly and accurately between two dialects, covering multiple aspects including listening comprehension, oral expression, and information processing. The online intervention will last for 4 months, during which participants will regularly complete exercises through a language training app or website and upload their assignments.
Sponsors
Second Affiliated Hospital, School of Medicine, Zhejiang University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients aged ≥ 60 years * High risk of stroke (with ≥ 3 of 8 stroke risk factors, including hypertension, dyslipidemia, diabetes, atrial fibrillation or valvular heart disease, smoking history, obvious overweight or obesity, lack of exercise, family history of stroke, or with transient ischemic attack) * command of Hangzhou dialect * Written informed consent available * Willingness to complete all assessments and participate in follow-up * Adequate Visual and auditory acuity to undergo neuropsychological testing
Exclusion criteria
* previously diagnosed dementia * Suspected dementia after clinical assessment by study physician at screening visit * Previous history of major head trauma and any intracranial surgery * Intracranial abnormalities, such as intracerebral hemorrhage, subarachnoid hemorrhage and other space occupying lesions * Extrapyramidal symptoms or mental illness which may affect neuropsychological measurement * Severe loss of vision, hearing, or communicative ability * Patients presenting a malignant disease with life expectancy \< 3 years * Participation in an ongoing investigational drug study * Any MRI contraindications
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in brain functional network connectivity assessed by resting state functional magnetic resonance imaging (fMRI) | 6 months | Primary Outcome |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in brain functional network activity intensity assessed by resting state fMRI | 2 years | long-term secondary outcome |
| Changes in brain functional network connectivity assessed by resting state fMRI | 2 years | long-term secondary outcome |
| Global cognitive function change assessed with Z-score of a modified National Institute of Neurological Disorders and Stroke and Canadian Stroke Network-Canadian Stroke Network (NINDS-CSN) protocol (higher scores mean a better outcome) | 6 months | short-term secondary outcome |
| Cognitive domain change assessed with Z-score of a modified National Institute of Neurological Disorders and Stroke and Canadian Stroke Network-Canadian Stroke Network (NINDS-CSN) protocol (higher scores mean a better outcome) | 6 months | short-term secondary outcome |
| Cognitive function change assessed with Mini-Mental State Examination (minimum value = 0, maximum value = 30, and higher scores mean a better outcome) | 6 months | short-term secondary outcome |
| Cognitive function change assessed by Montreal Cognitive Assessment (minimum value = 0, maximum value = 30, and higher scores mean a better outcome) | 6 months | short-term secondary outcome |
| Changes in white matter hyperintensity (WMH) assessed on MRI with T2-Fluid-Attenuated-Inversion-Recovery (FLAIR) sequence | 6 months | short-term secondary outcome |
| Changes in lacunes assessed on MRI with T2 FLAIR sequence | 6 months | short-term secondary outcome |
| Changes in brain functional network efficiency assessed by resting state fMRI | 2 years | long-term secondary outcome |
| Changes in microbleeds assessed on MRI with Susceptibility Weighted Imaging (SWI) sequence sequence | 6 months | short-term secondary outcome |
| Changes in brain atrophy (width of the sulci greater than 5mm) assessed on MRI | 6 months | short-term secondary outcome |
| Changes in white matter hyperintensity (WMH) assessed on MRI with T2 FLAIR sequence | 2 years | long-term secondary outcome |
| Changes in microbleeds assessed on MRI with SWI sequence sequence | 2 years | long-term secondary outcome |
| Changes in cerebral glymphatic function assessed by non-invasive diffusion tensor image analysis along the perivascular space (ALPS-index) | 6 months | short-term secondary outcome |
| Changes in cerebral blood flow (CBF) in the territory of the culprit artery assessed by arterial spin labeling (ASL) perfusion image | 6 months | short-term secondary outcome |
| Metabolite profiles in participants' faecal samples and serum samples | 6 months | short-term secondary outcome: metabolite composition was analyzed via liquid chromatography tandem mass spectrometry (LC-MS/MS) |
| Incidence of stroke event including ischemic and hemorrhagic stroke | 6 months | short-term secondary outcome |
| Changes in perivascular spaces assessed on MRI with T2 FLAIR sequence | 6 months | short-term secondary outcome |
Contacts
Primary ContactMin Lou, PhD, MD
Outcome results
None listed