Vestibular Therapy in Alzheimer's Disease

Launched by JOHNS HOPKINS UNIVERSITY · Jan 8, 2019

Keywords

ClinConnect Summary

This clinical trial is studying whether vestibular therapy, which focuses on improving balance and stability, can help reduce falls in people with Alzheimer's disease (AD). Many individuals with AD struggle with balance, which increases their risk of falling. The researchers want to understand if this type of therapy can make a difference for these patients since it has never been tested in this group before.

To participate, individuals must be at least 60 years old, have a diagnosis of mild to moderate Alzheimer's disease, and experience some issues with balance. They should also have a caregiver who can help with the study activities and attend weekly therapy sessions for eight weeks. Participants will engage in balance exercises and complete assessments to track their progress. It's important to note that those with more severe Alzheimer's or other types of dementia won't be eligible for this trial. This study represents a unique opportunity to see if improving balance can enhance the safety and quality of life for those living with Alzheimer's.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Diagnosis of AD based on the National Institute on Aging-Alzheimer Association 2011 criteria that is mild-moderate (CDR=0.5-2).
• • Age ≥ 60 years.
• • Vestibular loss defined as bilaterally impaired vestibular responses (semicircular canal or otolith responses).
• • Able to participate in study procedures including vestibular physiologic testing, balance and gait assessment, neurocognitive testing, and VT or active control.
• • Able to give informed consent, as further detailed in the Human Subjects section. The investigators anticipate that individuals who are too impaired to provide informed consent would also not be able to effectively participate in VT or active control.
• • Presence of a caregiver, defined as an individual who spends at least 10 hours per week with the patient. The caregiver must be able to participate in study procedures, specifically the text-messaging system. Both the VT and active control involve 8 weeks of once weekly visits and daily home exercises, and the investigators believe a caregiver would increase the likelihood of successful completion of either therapy.
• Exclusion Criteria:
• • Diagnosis of severe AD (CDR≥3).
• • Diagnosis of mild cognitive impairment or diagnosis of non-AD dementia, for example Parkinson's disease dementia, Dementia with Lewy Bodies, vascular dementia, fronto-temporal dementia, and primary progressive aphasia.
• • Deemed unable to participate in study procedures and VT or active control, (e.g. patients with significant medical comorbidities, excessive agitation, or use of mobility aids such as a cane or walker.)
• • Use of daily vestibular suppressant medications, specifically anti-histamines and benzodiazepines, as this can alter the response to VT.
• • Lack of availability to participate in 8 weeks of VT or active control.