The Coaching for Cognition in Alzheimer's (COCOA) trial: Study design

Area of Science:

• Neuroscience
• Gerontology
• Public Health

Background:

• Alzheimer's disease (AD) and related dementias (ADRD) stem from complex biological system interactions, limiting monotherapy success.
• Multimodal, multi-domain therapies are needed for dementia prevention and treatment, offering personalized approaches.
• Lifestyle modifications, including diet, cognitive training, and exercise, are crucial for comprehensive AD management.

Purpose of the Study:

• To test the hypothesis that coached multimodal interventions beneficially alter the trajectory of cognitive decline in individuals with ADRD.
• To evaluate the effectiveness of personalized, data-driven remote coaching in managing cognitive decline.
• To explore the impact of multimodal interventions on cognitive and functional outcomes in early-stage AD spectrum patients.

Main Methods:

• A two-arm prospective randomized controlled trial (RCT) design for the Coaching for Cognition in Alzheimer's (COCOA) trial.
• Collection of psychometric, clinical, lifestyle, genomic, proteomic, metabolomic, and microbiome data over 2 years for systems biology analyses.
• Intervention arms: standard care plus generic recommendations versus standard care plus personalized data-driven remote coaching.

Main Results:

• The primary outcome measure is the Memory Performance Index (MPI), assessing cognition.
• Secondary outcome measures include the Functional Assessment Staging Test (FAST), evaluating function.
• Enrollment began in January 2018, with data collection ongoing for 2 years.

Conclusions:

• Multimodal interventions are hypothesized to ameliorate cognitive decline in ADRD.
• Data-driven health coaching may enhance compliance, personalize interventions, and improve patient outcomes.
• Inexpensive lifestyle interventions hold potential for reducing global socioeconomic disparities in dementia care.