The SYNERGIC RCTs from Can Thumbs Up: Canadian experience in migrating lifestyle interventions to an @Home‐based program to enhance cognition
Bibliographic record
Abstract
Abstract Background The SYNERGIC trial (SYNchronizing Exercises, Remedies in GaIt and Cognition), a large multi‐site randomized controlled trial (RCT), showed promising interim results that individuals with Mild Cognitive Impairment (MCI) who received aerobic exercise combined with progressive resistance training and cognitive training improved their global cognition. When the COVID‐19 pandemic put SYNERGIC on hold, we migrated our interventions and assessments remotely. This experience informed the design of the SYNERGIC@Home trial. Method The SYNERGIC trial was a multi‐site, double‐blinded, five‐arm, randomized controlled trial that assessed the potential synergistic effect of combining bi‐modal exercises (aerobic + progressive resistance training), cognitive training, and, vitamin D supplementation in older adults with MCI. Interventions were delivered for 20 weeks. Results present data in 10 participants who migrated to conducting interventions and assessments at home. Result Ten participants with MCI (mean age 73±6.4, ♀70%) from the SYNERGIC trial migrated to a virtual modality at month 2 of their intervention. Their adherence for the 2‐month in‐person exercise and cognitive training was 90.2%, while for the 4‐month home‐based intervention, it was 95.9%. Participants reported being able to use the digital platform (WebEx© and Zoom Healthcare©) assigned on the first session. Similarly, 95% of the assessments tests were completed, including cognitive (ADAS‐Cog 13), medical, and mobility assessments conducted remotely. One participant was only able to complete half of the assessments due to digital connection issues. Following remote administration of the SYNERGIC trial in this subset of participants, we set up logistics and obtained ethical approval for the SYNERGIC@Home trial, a pilot RCT fully delivered remotely in 64 older adults at risk of dementia. Conclusion Delivering progressive physical exercise and cognitive training at home was feasible in older adults at risk of dementia. Insights gained from this migration informed our SYNERGIC@Home pilot, which is based on the SYNERGIC trial, but will be delivered fully remotely. SYNERGIC@Home will recruit participants with MCI, Subjective Cognitive Impairment, and Normal Cognition and two or more risk factors for dementia. Remote interventions and assessment are becoming particularly important during the COVID‐19 pandemic in which research participation for older adults may only be possible through virtual platforms.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.022 | 0.032 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.005 | 0.002 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".