Walking adaptation problems in older adults with mild cognitive impairment or Alzheimer's disease

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

The researchers will compare locomotor adaptation and gait performance in older adults diagnosed with amnestic MCI or Alzheimer's disease using repeated split-belt treadmill sessions. Participants will complete five sessions of split-belt treadmill-based locomotor adaptation while investigators measure gait variables, adaptation magnitude, and cognitive-motor performance. The protocol includes standardized cognitive and mobility testing to link changes in walking adaptation with cognitive status and fall-risk-related gait features. All testing and training occur in person at a rehabilitation clinic with participants selected based on neurologist-confirmed diagnoses.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* AD and MCI will be defined through formal diagnosis provided by a board-certified Neurologist. Amnestic MCI will be defined using the AD Neuroimaging Initiative (ADNI) criteria. All MCI participants in ADNI are required to have an amnestic subtype defined as:

  * Subjective memory concern or a memory problem noted by their partner
  * Abnormal memory function documented by a specified education adjusted cutoff score on the delayed paragraph recall of the Anna Thompson story of the Logical Memory subtest from the Wechsler Memory Scale-Revised
  * Mini-Mental State Exam (MMSE) score between 20 and 26 (inclusive). Exceptions may be made for subjects with less than 8 years of education at the discretion of the PI. (iv) Single or multi-domain amnestic MCI (both subtypes are at high risk for progression to AD)
  * Clinical Dementia Rating (CDR) = 0.5 (Memory Box score must be at least 0.5)
  * General functional performance sufficiently preserved
* Evidence of impaired executive function based on Montreal Cognitive Assessment (MoCA) score 13-17
* Able to walk 10 or more feet without an assistive device
* Completed six grades of education or has a good work history (sufficient to exclude intellectual disabilities)
* Not hospitalized within the last 60 days

Exclusion Criteria:

* Acute medical illness requiring hospitalization
* Uncontrolled congestive heart failure
* History of stroke
* Inability to perform study procedures
* Medical or physical conditions that would preclude participation or walking (e.g., severe arthritis or mobility problems, uncontrolled hypertension or diabetes, renal failure, history of angina with activity)
* On medications that could adversely affect cognition, eg: antipsychotics, opioids, stimulants, chemotherapy, anti-parkinsonian drugs (eg Levodopa), neurologic prescriptions to treat Multiple sclerosis and/or Parkinson's
* Psychotic disorders
* Confounding neurologic conditions (e.g., active central nervous system (CNS) opportunistic infections, seizure disorders, head injury with loss of consciousness \>30 minutes, intracranial neoplasms, stroke with neurological or neuropsychiatric sequelae)
* Substance Use Disorder, Major Depressive and Generalized Anxiety Disorders within six months of evaluation

Where it's running

• Emory Rehabilitation Hospital
  Atlanta, Georgia, United States Recruiting

Study contacts

• Principal investigator: Trisha Kesar, PT, PhD — Emory University
• Study coordinator: Trisha Kesar, PT, PhD
• Email: tkesar@emory.edu
• Phone: (404) 712-5803

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.