Investigating Interventions in Alzheimer’s Disease

Researchers have long suspected that certain lifestyle changes might help patients outlive the debilitating effects of Alzheimer’s disease. Now, Hoag is conducting a two-year clinical trial to test that theory and to come up with ways to ensure that Alzheimer’s doesn’t get the better of any of us.

Researchers at the hospital are also conducting a comprehensive biological analysis of patients to better understand the changes in cognitive function over time.

The trial – Coaching for Cognition in Alzheimer’s, or COCOA – was designed by researchers at the Pickup Family Neurosciences Institute at Hoag, Shankle Clinic, Arivale, and Institute for Systems Biology.

“Clinical trials are a critical tool in our ongoing efforts to help those with Alzheimer’s disease,” said William R. Shankle, M.S., M.D., F.A.C.P., program director, and the Judy & Richard Voltmer Endowed Chair in Memory and Cognitive Disorders program at the Pickup Family Neurosciences Institute at Hoag. “We know that individuals benefit from early detection and treatment. Now we are testing multi-domain, lifestyle coaching – including diet, exercise, and cognitive training – which may provide novel insights and approaches into future detection and treatment.”

COCOA participants will be randomly assigned to two groups: The control group will receive only regular medical care. The other group will receive lifestyle coaching from wellness program Arivale in addition to regular medical care. All study participants will be given the opportunity for a genetic assessment, as well as mental and functional ability assessments. In addition, they will receive basic health questionnaires and submit frequent samples for longitudinal, integrated biological data analyses (known as multi-omic analyses). Those not in the control group will also receive coaching sessions by phone.

Thanks to donor support, Hoag was also the first hospital on the West Coast to offer patients access to the Positron emission tomography/magnetic resonance imaging (PET/MR), an innovative imaging technology that helps in early and accurate diagnosis of neurological degeneration, such as Alzheimer’s. PET/MR will also help physicians tailor treatment options to ensure patients receive the care that will most likely work best for them.

“With the COCOA trial, programs like the Orange County Vital Brain Aging Program, and the PET/MR, Hoag is committed to achieving breakthroughs in the detection of cognitive impairment at its earliest possible stage,” said Michael Brant-Zawadzki, M.D., F.A.C.R., senior physician executive and the Ron & Sandi Simon Executive Medical Director Endowed Chair of the Pickup Family Neurosciences Institute at Hoag. “Research continues to prove that this is the best opportunity we have to provide optimal care and management to patients with Alzheimer’s.”

A recent Journal of the American Medical Association article suggested the importance of lifestyle and behavioral modification in slowing the progression of this disease. Hoag’s trial aims to verify that active “coaching” can significantly slow progression of Alzheimer’s symptoms.

The COCOA trial will enroll 200 participants – 100 for each study group – who will be monitored for two years.