The SYNERGIC Trial: A Randomized Controlled Trial Assessing Multimodal Interventions to Improve Cognition in Mild Cognitive Impairment in Older Adults
Bibliographic record
Abstract
Abstract Background Older adults with Mild Cognitive Impairment (MCI) have increased risk of dementia. Physical exercise, cognitive training, and vitamin D supplementation are emerging interventions for improving cognition. However, the potential synergism of combining them to improve cognition in MCI has not been yet tested. Methods The SYNERGIC trial (SYNnchronizing Exercises, Remedies in Gait and Cognition)— a multi‐site, double‐blinded, controlled, quasi‐factorial trial—assessed the efficacy and synergistic effect of combining bi‐modal exercises (aerobic + progressive resistance training = E), cognitive training (CT) and, vitamin D supplementation (D = 10000IU 3xweekly) to improve cognition in MCI. Personalized interventions were delivered for 20 weeks in 5 arms: Arm 1 received 3 active interventions (E+CT+D), Arm 2 received E+CT+placebo D, Arm 3 received E+ sham CT+ D, Arm 4 received E+ sham CT and placebo D, and Arm 5 received all control interventions (Control E‐balance and toning‐, sham CT and placebo D). Change in ADAS‐Cog‐13 was the primary outcome assessed with linear mixed effects models adjusting for age, sex, education, and number of comorbidities. Results 170 MCI participants were randomized. As compared to the control group (Arm 5), multimodal intervention (Arm 1) had significant improvements in ADAS‐Cog‐13 scores (difference = ‐2.3 ADAS‐Cog‐13 points; 95% CI: ‐1.06 ‐3.54). Following analyses guidelines for factorial trials, interactions of intervention across arms were analyzed and no significant interactions were found for vitamin D supplementation. Therefore, we collapsed Arms 1 and 2 (combined E + CT), and we collapsed Arms 3 and 4 (E), and compared them to Arm 5 (control). Relative to the control group (Arm 5), the combined exercise and cognitive intervention (Arms 1+2) had significantly improved cognitive function (difference = ‐2.2 ADAS‐Cog‐13 points; 95% CI: ‐0.70, ‐3.72). In contrast, the exercise only intervention (Arms 3+4) did not have significantly improved cognition as compared to the control group (difference = ‐1.24 ADAS‐Cog‐13 points; 95% CI: ‐0.21, 2.69). Conclusion A synergistic effect of combined bi‐modal exercise with sequential computerized cognitive training was found to improve cognition in older adults with MCI with a large effect size = 0.62. Addition of vitamin D supplementation did not improve the effect.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
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".