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Active, not recruitingNCT04792528REACT MCIUpdated Apr 30, 2026

REACT MCI - Repeated Advanced Cognitive Training in Mild Cognitive Impairment

An interventional study of Computerized cognitive training. and Generalized brain training / Active control in Mild Cognitive Impairment, sponsored by Sorlandet Hospital HF. Active, not recruiting at 5 sites in Norway. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2026-04-30.

Sponsored by Sorlandet Hospital HF · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
205
Allocation
Randomized
Ages
18 Years to 80 Years
Sex
All
01

Study summary

Background:

Dementia is a debilitating and devastating disease impacting the individuals, their families, and the health care system. According to the World Health Organization the dementia epidemic could overwhelm the global health care system and undermine social and economic development. Currently, no curative treatment for dementia exists despite immense research activity.

The cognitive and functional impairment in dementia, especially Alzheimer's disease (AD), develop slowly decades before clinical signs emerge. This knowledge has led to the recognition of a prodromal period of mild cognitive impairment (MCI), between normal cognition and dementia. This is at present the earliest stage for intervention in dementia; even a short delay in dementia progression will have a large impact on global economy and health care.

Objectives:

In this clinical multicenter study, we aim to investigate the efficiency and cost-effectiveness of working memory training in MCI. To identify high responders to training analysis of genetic markers, relative's stress and craniospinal clearance will be performed.

Participants and methods:

This study is a blinded, randomized and controlled trail that will include 213 participants, diagnosed with MCI, included from five Norwegian Memory clinics in four health care regions. The groups will be randomized to either two training periods, one training period or active control. The intervention is computerized working memory training. Neuropsychological status, activities of daily living (ADL), and relative stress and quality of life will be assessed at baseline and 3, 6, 12 ,24 and 48 months after training. Structural MRI will be performed at baseline, and 3 and 6 months after training.

For participants in the REACT MCI glymphatics substudy craniospinal clearance will be measured at baseline.

A cost-utility analysis will be performed to evaluate if the working memory training is more cost-effective compared to the active control group in the MCI phase, taking a societal perspective.

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Conditions studied

  • Mild Cognitive Impairment

Keywords

  • computer-based cognitive training
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In context

Cognitive Dysfunction

3,843 studies on the registry are indexed under Cognitive Dysfunction; 1,100 are open to participants now.

This study's enrollment of 205 is above the median of 65 across 2,808 interventional studies indexed under Cognitive Dysfunction.

Browse Cognitive Dysfunction studies →

Lead sponsor

Sorlandet Hospital HF is the lead sponsor of 73 studies on the registry; 12 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Diagnosis of MCI, based on the Mayo/winblad criteria or confirmation of current MCI status within the last 6 months before study enrollment.
  • The ability to use and accessibility to an iPad or computer.
  • Fluent in Norwegian.
  • Spinal tap performed and results available

Exclusion criteria

Exclusion Criteria for the REACT MCI study:

  • Patients unable to undergo a MRI investigation based on claustrophobia or metal foreign bodies are excluded from the study.
  • Major psychiatric illness and current substance abuse
  • Recent stroke

Inclusion Criteria for the REACT MCI Glymphatics substudy:

  • Enrollment in the REACT MCI study
  • Participant allocated to Sorlandet Hospital or Oslo University Hospital

Exclusion Criteria for the REACT MCI Glymphatics substudy:

  • Individuals with known allergy against contrast solutions
  • Individuals with other serious allergies
  • Individuals with kidney failure or glomerular filtration rate \< 30
  • Individuals younger than 18 or older than 80
  • Pregnant or lactating women
  • For individuals >70 years or with medications affecting kidney function the glomerular filtration rate needs to be less than week old.
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Investigator)
Enrollment
205 participants (actual)

Study arms

  • Experimental
    One training period

    One training period of 30 minutes of daily adaptive training for 4-5 days a week up for 20- 25 trainings using computerized cognitive training.

    Other: Computerized cognitive training.

  • Experimental
    Two training periods

    Two training periods of 30 minutes of daily adaptive training for 4-5 days a week up for 20- 25 trainings using computerized cognitive training.

    Other: Computerized cognitive training.

  • Active comparator
    Active control

    The generalized brain training group (Active control) will play solitaire 30 minutes daily for 25 sessions

    Other: Generalized brain training / Active control

Interventions

  • OtherComputerized cognitive training.

    COGMED RM program (Pearson Inc., UK)

  • OtherGeneralized brain training / Active control

    Solitaire

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What researchers measure

Primary outcomes

  1. Working memory training is superior to active control measured by spatial span backwards at 6 months

    Time frame: From enrollment until 6 months

  2. Reduced function in the glymphatic system is associated with reduced working memory training effect measured by CT evaluated craniospinal clearance

    Craniospinal clearance will be evaluated with a single CT image scan at level with the foramen magnum.

    Time frame: Enrollment to 12 months

  3. Working memory training impact quality of life measure in the participants as compared to active control measured by EuroQOL5D-5L after 12 months.

    Time frame: Enrollment to12 months

  4. Working memory training prolongs the MCI phase as compared to active controls

    We consider the participants as having dementia when they no longer rapport intact activities of daily living and in addition display reduction of 1.5 standard deviation on test score on two tests on three or more cognitive domains.

    Time frame: Enrollment to 48 months

Secondary outcomes

  1. The effect of working memory training is dose related measured by spatial span backwards after 6 months

    Time frame: Enrollment to 6 months

  2. Allelic variations in predefined genetic markes influence training effects after 3 months measured by spatial span backwards.

    Allelic variations of LMX1a, APOE, AQP4 and/or COMT have in previous publications shown variable impact on working memory training. A statistical model combining these genes will be fitted for this investigation

    Time frame: Enrollment to 3 months

  3. Workin memory training reduces relatives stress scores as compared to relatives stress scores in the active control group after 12 months

    Relatives stress score (RSS) is a validated scale measuring the stress for relatives

    Time frame: Enrollment to 12 months

  4. Working memory training reduces QALY associated cost as compared to active controls at 24 months.

    The generic outcome in the analysis is QALYs (Quality adjusted life years) derived from the instrument EQ-5D 5L. The second outcome is production loss of the relatives and patients associated with MCI through the progression of dementia The health economic analysis will include following costs: 1) intervention related costs 2) direct costs/health care costs, mainly related to use of health care services, including primary, secondary and tertiary care and health services 3) indirect costs, including work absence for the patients and the relatives of the patients (i.e., productivity loss). Data will be collected through a self-report measures (EQ-5D 5L), and from the Norwegian patient registry.

    Time frame: Enrollment to 24 months

  5. Working memory training reduces QALY associated cost as compared to active controls at 48 months.

    The generic outcome in the analysis is QALYs (Quality adjusted life years) derived from the instrument EQ-5D 5L. The second outcome is production loss of the relatives and patients associated with MCI through the progression of dementia The health economic analysis will include following costs: 1) intervention related costs 2) direct costs/health care costs, mainly related to use of health care services, including primary, secondary and tertiary care and health services 3) indirect costs, including work absence for the patients and the relatives of the patients (i.e., productivity loss). Data will be collected through a self-report measures (EQ-5D 5L), and from the Norwegian patient registry.

    Time frame: enrollment to 48 months

07

Study locations

5 sites
  • Sørlandet Sykehus Arendal
    Arendal, Norway
  • NKS Olaviken Alderspsykiatriske sykehus - Hukommelsesklinikk
    Bergen, 5009, Norway
  • N.K.S. Kløveråsen
    Bodø, 8076, Norway
  • Oslo Universitetssykehus Ullevål
    Oslo, Norway
  • St. Olavs Hospital
    Trondheim, 7006, Norway
08

References and documents

Publications

  • Hernes SS, Nordnes PR, Hol HR, Ringstad G, Knapskog AB, Emhjellen P, Lohaugen G, Emini M, Edwin TH. The REACT MCI study: a randomized controlled clinical trial on the effect of repeated advanced cognitive training in mild cognitive impairment. Trials. 2026 May 7;27(1):363. doi: 10.1186/s13063-026-09711-6. PubMed 42098801 ↗

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 30, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT04792528
Lead sponsor
Sorlandet Hospital HF
Collaborators
Oslo University Hospital, NKS Olaviken, St. Olavs Hospital, NKS Kloverasen, Barrow Neurological Institute, University of Maryland
Responsible party
Sponsor
First posted
Mar 11, 2021
Start date
May 15, 2021
Primary completion
Apr 15, 2028 (estimated)
Completion
Oct 25, 2028 (estimated)
Last update
Apr 30, 2026

Study contacts

Susanne S Hernes, M.D. Phd.
principal investigator · Sørlandet Sykehus HF, Universitetet i Bergen

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

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