Integrative Therapy for Holistic, Natural Cognition and Lifestyle Rehabilitation

Study Overview
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Brief Summary
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An observational study to determine outcomes of older adults who are under naturopathic medical care for cognitive complaints at a specific clinic in Southern California.

Detailed Description
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This prospective observational study will examine patient outcomes associated with individualized, whole-system integrative medical care, provided by a naturopathic physician at a specific clinic in the state of California. Participants will be older adult patients of the clinic who present with objectively measurable cognitive dysfunction, and who elect to voluntarily participate in the study. Participants' cognitive function will be assessed using validated objective (NIH Toolbox) and subjective (NIH Neuro-Quality of Life questionnaires) instruments. The primary outcomes are change from baseline to six months post-baseline in these two instruments. Additionally, physical activity and sleep data will be tracked using wearable telemetry, and neurophysiological parameters will be measured with electroencephalography. Detailed treatment descriptions and adverse events will be tracked.

Official Title
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Integrative Therapy for Holistic, Natural Cognition and Lifestyle Rehabilitation

Conditions
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Cognitive Dysfunction

Intervention / Treatment
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* Other: Whole-practice cognitive optimization


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Community-dwelling adults ≥60 years of age. Montreal Cognitive Assessment (MoCA) score of 12-23. Able to independently make decisions. Able to safely travel to North County Natural Medicine for 4 study visits and approximately 4 clinical visits, for a duration of 6 months. Able to wear an Oura Ring, download data every 6 days, and keep the ring regularly charged for the duration of participants' involvement in the study. A high school diploma or equivalent. Ability to communicate via email. Ability to independently fill out a computer-administered questionnaire. Ability to withhold from seeing another integrative or alternative medicine provider for the 6 months of participation in the study. Exclusion Criteria: Inability to read and write in English. MoCA score >23. A visual impairment that would prevent reading a computer screen. Partial or full deafness. A previous diagnosis of dementia (e.g. Alzheimer's Disease or any other kind of dementia). Congenital cognitive impairment or disability. Alcohol or substance abuse. Serious somatic disease, neurodegenerative disease, acute onset of cognitive decline, or rapid neurological impairment. Inability to bring an affiliate to the Informed Consent Consultation.

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Enrolled Participants<br>This is a whole-practice precision medicine model in which a participant-specific Naturopathic treatment program is developed and implemented for older adults with cognitive complaints. | Other: Whole-practice cognitive optimization<br>* This intervention is a whole-practice intervention that may include nutritional assessment & supplementation, determination of food sensitivities and dietary changes, natural products such as herbal anti-inflammatories, assessment of whole body-burden of toxicants (such as heavy metals and fungal toxins) and steps to reduce exposures, and behavioral changes such as exercise, meditation, and sleep hygiene optimization.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| NIH Toolbox-Cognitive Battery | Change from baseline to 6 months in scores on a computer-administered cognitive function test | Baseline, 6 months | 
| Quality of Life in Neurological Disorders questionnaire (Neuro-QoL) | Change from baseline to 6 months in scores on a brief, validated questionnaire that monitors the physical, mental, and social effects experienced by individuals living with neurological conditions | Baseline, 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Event-related potential (P300) | Change from baseline to 6 months of an auditory event provoked change in electrical potential of the brain, measured noninvasively by electroencephalography (EEG) | 6 months post-baseline visit | 
| Peak alpha frequency | Change from baseline to 6 months of the peak (highest intensity) frequency in electrical activity of the brain between 8 Hz and 12 Hz, measured noninvasively by electroencephalography (EEG) | 6 months post-baseline visit | 
| Physical activity | Change from baseline to 6 months in participants' overall physical activity as measured with telemetry from a wrist-worn activity tracker | 6 months | 
| Sleep quantity | Change from baseline to 6 months in participants' total sleep as measured with telemetry from a wrist-worn activity tracker | 6 months | 
| Number and type of Adverse Events | Total number of adverse events and serious adverse events (using NIH's Common Terminology Criteria for Adverse Events version 4.0) | From enrollment through study completion, a period of 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Mild Cognitive Impairment (MCI), Cognitive Decline, Alzheimer's Disease (AD), Dementia