Please select the eligibility criteria that correspond to the clinical trial below.
Title: Memory Aid - Computer Based Working Memory Training in Elderly With Mild Cognitive Impairment (MCI). A Randomized, Controlled Trial.
Brief Summary: Background:

Mild Cognitive Impairment (MCI) is a condition characterized by memory problems more severe than normal cognitive changes due to old age, and less severe than dementia. Reduced working memory (WM) is regarded as one of the core symptoms of an MCI-condition. Recent studies have indicated that WM can be improved trough computer based training.

Objectives:

The objective of the study is to evaluate if working memory training is effective in improving working memory in elderly MCI-patients. Further, to evaluate if cognitive training relates to structural changes in the white and gray matter of the brain, assessed by structural Magnetic Resonance Imaging. Cognitive phenotypes related to memory impairment and progression to dementia will also be investigated.

Patients and Methods:

The proposed study is a blinded, randomized and controlled trail that will include 90 elderly patients from a Memory Clinic diagnosed with MCI. The groups will be randomized to either training or a placebo version. The intervention is computerized working memory training performed for 45 minutes over 25 sessions. Neuropsychological assessment and structural MRI will be performed before, 6 and 12 months after training.

Relevance:

Currently there is no known treatment available for mild memory impairment/MCI, and few studies on specific cognitive training in MCI-patients have been performed. The proposed study has received funding from a Norwegian Health Region. If computer based training results in positive changes to memory functions in MCI patients this may represent a new, cost-effective treatment. Secondly, evaluation of training induced structural changes to grey or white matter may improve our understanding of the mechanisms behind effective cognitive interventions in MCI patients.


Options:
A: Inclusion Criteria:

1. At least 60 years of age
2. Self-reported levels of proficiency in English (French for Montreal site only) for speaking and understanding spoken language.
3. Able to comply with scheduled visits, treatment plan, and other trial procedures
4. Able to ambulate at least 10 meters independently
5. Having MCI operationalized using Albert et al. criteria as:

   * objective cognitive impairment in one of the following four cognitive domains: memory, executive function, attention, and language evaluated by the Montreal Cognitive Assessment (MoCA) test with scores ranging from 13-24/30.
   * Preserved activities of daily living on the disability scale confirmed by clinician interview
6. Having normal or corrected to normal vision in at least one eye so that they can identify symbols and stimuli presented on a computer screen in front of them.
7. Must be in sufficient health to participate in the study's aerobic-based exercise training program, based on medical history, vital signs, physical examination by study physicians, or written recommendation by family physician indicating one's appropriateness to participate in aerobic-based exercise training program.

Exclusion Criteria:

1. Serious underlying disease (such as active cancer, or recent heart attack) which, in the opinion of the investigator, may preclude engagement in interventions or may interfere with the participant's ability to participate fully in the study.
2. Diagnosis of dementia using criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.
3. Participant with uncontrolled major depression, schizophrenia, severe anxiety and substance abuse.
4. Current parkinsonism or any neurological disorder with residual motor deficits (e.g. stroke with motor deficit), active musculo-skeletal disorders (e.g. severe osteoarthritis of lower limbs) or history of knee/hip replacement affecting gait performance at clinical evaluation.
5. Intention to enroll in other clinical trials during the same time period
6. Pre-existing exercise structured training program involving aerobic or resistance training in previous 6 months.
7. Taking cognitive enhancers, neuroleptics, anticholinergics or Vitamin D3 in doses more than 1000IU/day or equivalent.
B: Inclusion Criteria:

* Patients who meet the Peterson diagnostic criteria of MCI:

  1. memory complaints (preferably confirmed by an informant).
  2. memory impairment according to age and education.
  3. preserved general cognitive function.
  4. intact activities of daily living, absence of dementia.

Exclusion Criteria:

* head trauma with post-traumatic loss of conscience for 30 minutes during lifespan.
* loss of senses (blindness, deafness).
* photo-sensitive epilepsy.
* unsuitability for Magnetic Resonance Imaging-examination due to metal foreign bodies or severe claustrophobia.
* drug and/or alcohol abuse.
C: Inclusion Criteria:

* diagnosis of chronic insomnia
* able to use a home personal computer
* have healthy dominant hand functioning
* Hebrew speakers

Exclusion Criteria:

* have any significant visual or hearing impairment
* have any significant medical, neurological or psychiatric illness that might bring about cognitive change
* have sleep disorders other than insomnia
* have any significant medical disease (including cancer, diabetes, liver, kidney, heart or lung disease)
* alcoholism or other drug abuse
* taking any medication known to affect central nervous system functioning other than sleeping pills
* historical evidence suggesting significant psychiatric conditions such as depression, psychosis or neurologic disease
D: Inclusion Criteria:

* no severe cognitive impairment \[MMSE ≥ 18\]
* fluent language skills
* agreement of a medical doctor
* time commitment to the test and exercise protocol.

Exclusion Criteria:

* concurrent participation in another study
* severe physical or psychological disorders which precluded participation in the intervention (i.e., inability to follow instructions)
* unrecovered neurological disorders such as stroke, traumatic brain injury, unstable medication within the past three months
* severe and uncorrectable vision problems, or hearing aid for less than three months.

Answer: B