scholarly journals Promoting Adherence to Exercise Prescription Using Mobile Health Technology: Lessons Learned from Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 843-843
Author(s):  
Zvinka Zlatar ◽  
Camille Nebeker
Keyword(s):  
Older Adults ◽  
Heart Rate ◽  
Mobile Health ◽  
Healthy Aging ◽  
Exercise Intervention ◽  
Haptic Feedback ◽  
Exercise Prescription ◽  
Controlled Trial ◽  
Lessons Learned ◽  
Exercise Session

Abstract We will present the implementation approach used to evaluate a novel mobile health (mHealth) exercise intervention designed to improve older adult’s fitness and brain health. A randomized controlled trial design evaluated if the use of mHealth strategies improved walking speed in real world environments to help participants achieve current physical activity guidelines. Cognitively healthy older adults were randomized to a 12-week, unsupervised, exercise prescription condition or to a healthy aging education condition. Participants used a heart rate tracker programmed to provide haptic feedback when they fell outside of their prescribed heart rate target during an exercise session. Participant’s perceptions regarding the mHealth technology device, as well as their feedback regarding the privacy of their data when using mHealth devices will be presented. Recommendations to improve the design of future mHealth exercise trials will be discussed.

scholarly journals Design and Development of a Mobile Health (mHealth) Platform for Dementia Prevention in the Prevention of Dementia by Mobile Phone Applications (PRODEMOS) Project

2021 ◽  
Vol 12 ◽  
Author(s):  
Melanie Hafdi ◽  
Esmé Eggink ◽  
Marieke P. Hoevenaar-Blom ◽  
M. Patrick Witvliet ◽  
Sandrine Andrieu ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Mobile Health ◽  
Healthy Aging ◽  
Progress Monitoring ◽  
Controlled Trial ◽  
End Users ◽  
Lessons Learned ◽  
Healthy Lifestyles ◽  
Pilot Studies ◽  
Mobile Phone Applications

Background: Mobile health (mHealth) has the potential to bring preventive healthcare within reach of populations with limited access to preventive services, by delivering personalized support at low cost. Although numerous mHealth interventions are available, very few have been developed following an evidence-based rationale or have been tested for efficacy. This article describes the systematic development of a coach-supported mHealth application to improve healthy lifestyles for the prevention of dementia and cardiovascular disease in the United Kingdom (UK) and China.Methods: Development of the Prevention of Dementia by Mobile Phone applications (PRODEMOS) platform built upon the experiences with the Healthy Aging Through Internet Counseling in the Elderly (HATICE) eHealth platform. In the conceptualization phase, experiences from the HATICE trial and needs and wishes of the PRODEMOS target population were assessed through semi-structured interviews and focus group sessions. Initial technical development of the platform was based on these findings and took place in consecutive sprint sessions. Finally, during the evaluation and adaptation phase, functionality and usability of the platform were evaluated during pilot studies in UK and China.Results: The PRODEMOS mHealth platform facilitates self-management of a healthy lifestyle by goal setting, progress monitoring, and educational materials on healthy lifestyles. Participants receive remote coaching through a chat functionality. Based on lessons learned from the HATICE study and end-users, we made the intervention easy-to-use and included features to personalize the intervention. Following the pilot studies, in which in total 77 people used the mobile application for 6 weeks, the application was made more intuitive, and we improved its functionalities.Conclusion: Early involvement of end-users in the development process and during evaluation phases improved acceptability of the mHealth intervention. The actual use and usability of the PRODEMOS intervention will be assessed during the ongoing PRODEMOS randomized controlled trial, taking a dual focus on effectiveness and implementation outcomes.

scholarly journals The ACHIEVE Trial: Lessons Learned From Nesting a Randomized Controlled Trial Within an Observational Cohort Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 811-811
Author(s):  
Jennifer Deal ◽  
Nicholas Reed ◽  
David Couper ◽  
Kathleen Hayden ◽  
Thomas Mosley ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Observational Study ◽  
Cognitive Decline ◽  
Controlled Trial ◽  
Lessons Learned ◽  
Community Dwelling ◽  
Randomized Controlled ◽  
Study Staff ◽  
Increased Risk

Abstract Hearing impairment in older adults is linked to accelerated cognitive decline and a 94% increased risk of incident dementia in population-based observational studies. Whether hearing treatment can delay cognitive decline is unknown but could have substantial clinical and public health impact. The NIH-funded ACHIEVE randomized controlled trial of 977 older adults aged 70-84 years with untreated mild-to-moderate hearing loss, is testing the efficacy of hearing treatment versus health education on cognitive decline over 3 years in community-dwelling older adults (Clinicaltrials.gov Identifier: NCT03243422.) This presentation will describe lessons learned from ACHIEVE’s unique study design. ACHIEVE is nested within a large, well-characterized multicenter observational study, the Atherosclerosis Risk in Communities Study. Such nesting within an observational study maximizes both operational and scientific efficiency. With trial results expected in 2022, this presentation will focus on the benefits gained in design and recruitment/retention, including dedicated study staff, well-established protocols, and established study staff-participant relationships. Part of a symposium sponsored by Sensory Health Interest Group.

Home-Based Physical Activity Program Improves Depression and Anxiety in Older Adults

2018 ◽  
Vol 15 (9) ◽  
pp. 692-696 ◽  
Author(s):  
Susan Aguiñaga ◽  
Diane K. Ehlers ◽  
Elizabeth A. Salerno ◽  
Jason Fanning ◽  
Robert W. Motl ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Healthy Aging ◽  
Exercise Intervention ◽  
Leisure Time Physical Activity ◽  
Total Sample ◽  
Health Concern ◽  
Depression And Anxiety ◽  
Home Based ◽  
Self Worth

Background: Late-life depression and anxiety among older adults is an important public health concern. This study examined the effect of a DVD-delivered exercise intervention on the secondary outcomes of depression and anxiety in older adults and the extent to which physical self-worth mediated the relationship between leisure-time physical activity and depression and anxiety. Methods: Older adults (N = 307) were randomized to a 6-month flexibility, toning, and balance DVD (FlexToBa™, FTB) or healthy aging DVD control. Self-reported physical activity and questionnaires were administered at baseline and postintervention. Statistical analyses were conducted in the total sample and in a subsample of participants with elevated levels of depression or anxiety. Results: FTB participants with elevated depression and anxiety symptoms at baseline had significantly greater reductions in depression and anxiety (d = 1.66 and 2.90) than the control condition (d = 0.77 and 0.73). The effect of physical activity on depression and anxiety was partially mediated by increases in physical self-worth in the total sample but not in those with elevated depression or anxiety. Conclusion: A home-based physical activity intervention may be a viable treatment for reducing depression and anxiety in older adults with elevated baseline scores.

scholarly journals The Effect of a Multicomponent Dual-Task Exercise on Cortical Thickness in Older Adults with Cognitive Decline: A Randomized Controlled Trial

2020 ◽  
Vol 9 (5) ◽  
pp. 1312
Author(s):  
Seongryu Bae ◽  
Kenji Harada ◽  
Sangyoon Lee ◽  
Kazuhiro Harada ◽  
Keitaro Makino ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Cognitive Decline ◽  
Cognitive Training ◽  
Cortical Thickness ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Exercise Group ◽  
Control Group ◽  
Randomized Controlled

The aim of this study was to examine cortical thickness changes associated with a multicomponent exercise intervention combining physical exercise and cognitive training in older adults with cognitive decline. This study involved a secondary analysis of neuroimaging data from a randomized controlled trial with 280 older adults having cognitive decline who were randomly assigned to either a multicomponent exercise group (n = 140) that attended weekly 90-minute exercise and cognitive training sessions or a health education control group (n = 140). The cortical thickness and cognitive performance were assessed at the baseline and at trial completion (10 months). The cortical thickness in the frontal and temporal regions was determined using FreeSurfer software. Cognitive performance was evaluated using the Gerontology-Functional Assessment Tool (NCGG-FAT). The cortical thickness significantly increased in the middle temporal (p < 0.001) and temporal pole (p < 0.001) in the multicomponent exercise group compared with the control group. Cortical thickness changes were significantly associated with change in trail making test (TMT)-A, TMT-B, and story memory after a 10-month multicomponent exercise intervention. This study suggests that multicomponent exercise programs combining physical exercise and cognitive training have important implications for brain health, especially in providing protection from age-related cortical thinning.

scholarly journals Assessing the feasibility of heart rate variability as an objective indicator of anxiety in older adults with dementia living in care homes

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Milena A. Quinci ◽  
Arlene J. Astell
Keyword(s):  
Older Adults ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Autonomic Function ◽  
Exercise Intervention ◽  
Care Home ◽  
Care Homes ◽  
Mean Square ◽  
Objective Indicator ◽  
Physiological Indicator

Abstract Objective Anxiety is reportedly prevalent in older adults with dementia living in care homes and, within this population, is most often assessed through caregiver reports. Heart rate variability (HRV) is a physiological indicator of autonomic function, whereby reduced vagally-mediated HRV is associated with a variety of anxiety symptoms and disorders. This study evaluates the feasibility of collecting HRV data within this population, presents HRV data for older adults with dementia living in a care home, and examines HRV in the context of self-reported anxiety. These data were collected during a larger study examining an exercise intervention. Results HRV data, in the form of log-transformed root mean square of the successive differences (lnRMSSD), were in line with transformed data from previous research. These data provide a promising direction for the use of wrist-worn devices in future HRV research with people living with dementia in care homes.

scholarly journals Oxygen consumption and heart rate obtained in a ramp protocol are equivalent during exercise session of rectangular loading at ventilatory thresholds for athletes

2019 ◽  
Vol 21 ◽  
Author(s):  
Victor Hugo Gasparini Neto ◽  
Paulo Azevedo ◽  
Luciana Carletti ◽  
Anselmo José Perez
Keyword(s):  
Heart Rate ◽  
Exercise Prescription ◽  
Ventilatory Threshold ◽  
Cardiopulmonary Exercise Testing ◽  
Exercise Session ◽  
Cardiopulmonary Exercise ◽  
Adequate Stimulus ◽  
Continuous Running ◽  
Sedentary Subjects ◽  
Good Agreement

Abstract Training near or at ventilatory threshold (VT) is an adequate stimulus to improve the thresholds for sedentary subjects, but a higher intensity is necessary for conditioned subjects. The choice of cardiopulmonary exercise testing (CPx) protocol has an influence on VTs identification and can reduce their reliability for exercise prescription. This study tested if VO2 and heart rate (HR) corresponding to first (VT1) and second ventilatory threshold (VT2) determined during a ramp protocol were equivalent to those observed in rectangular load exercises at the same intensity in runners elite athletes (EA) and non-athletes (NA). Eighteen health subjects were divided into two groups: EA (n = 9, VO2max 68.6 mL·kg-1·min-1) and NA (n = 9, VO2max 47.2 mL·kg-1·min-1). They performed CPx and 48h and 96h later, a continuous running lasting 1 h for VT1 and until exhaustion for VT2. The results showed that EA at VT1 session, presented delta differences for VO2 (+9.1%, p = 0.125) vs. NA (+20.5%, p = 0.012). The Bland-Altman plots for VT1 presented biases of (4.4 ± 6.9) and (5.5 ± 5.6 mLO2·kg-1·min-1) for AE and NA, respectively. In VT2, the VO2 and HR of the NA showed biases of (0.4 ± 2.9 mLO2·kg-1·min-1) and (4.9 ± 4.2 bpm). The ramp protocol used in this study was inappropriate for NA because it underestimates the values of VO2 and HR at VT1 found in the rectangular load exercise. The HR showed good agreement at VT2 with CPx and may be a good parameter for controlling exercise intensity.

scholarly journals The First Intervention Study for LGBTQ+ Older Adults With Dementia and Caregivers: COVID-19 Lessons Learned

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 112-112
Author(s):  
Karen Fredriksen Goldsen ◽  
Linda Teri ◽  
Hyun-Jun Kim ◽  
Charles Emlet ◽  
Ryan Petros ◽  
...  
Keyword(s):  
Older Adults ◽  
Culturally Responsive ◽  
Intervention Study ◽  
Retention Rate ◽  
Controlled Trial ◽  
Lessons Learned ◽  
Technology Support ◽  
Disadvantaged Communities ◽  
Aging Services ◽  
Home Technology

Abstract LGBTQ+ older adults face significant health disparities with higher rates of cognitive impairment and social isolation. Yet, the cognitive health needs of LGBTQ+ adults and caregivers have not been adequately addressed in clinical trials and services. In this presentation, we will share findings from Aging with Pride: IDEA (Innovations in Dementia Empowerment and Action), the first randomly controlled trial (RCT) intervention study designed to improve quality of life of LGBTQ+ adults living with dementia and caregivers, and to reduce institutionalization. In this presentation, we will share preliminary efficacy findings, the effectiveness of culturally responsive approaches, and Covid-19 adaptations, including delivery by virtual chat rather than in-home, technology training, ensuring safety of virtual intervention components, and providing on-going technology support. Preliminary findings suggest a higher intervention retention rate in the virtual delivery as compared to in-home. This study illustrates innovative ways to serve disadvantaged communities in dementia care and aging services.

scholarly journals Multimodal Intervention to Improve Functional Status in Hypertensive Older Adults: A Pilot Randomized Controlled Trial

2019 ◽  
Vol 8 (2) ◽  
pp. 196 ◽  
Author(s):  
Liliana C. Baptista ◽  
Byron C. Jaeger ◽  
Stephen D. Anton ◽  
Anthony A. Bavry ◽  
Eileen M. Handberg ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Functional Status ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Functional Limitations ◽  
Antihypertensive Medications ◽  
Randomized Controlled ◽  
Pilot Rct ◽  
Pilot Randomized Controlled Trial

This pilot randomized controlled trial (RCT) was designed to provide the preliminary data necessary to conduct a full-scale trial to compare the efficacy of differing first-line antihypertensive medications in improving functional status in older adults, when combined with exercise. The primary objectives were to assess study feasibility, safety, and protocol integrity. Dependent outcomes included gait speed, exercise capacity, body composition, and systemic cardiometabolic biomarkers. Thirty-one physically inactive older adults (70.6 ± 6.1 years) with hypertension and functional limitations were randomly assigned to 1) Perindopril (8 mg/day n = 10), 2) Losartan (100 mg/day; n = 13), or 3) Hydrochlorothiazide (HCTZ: 25 mg/day; n = 8). Participants were also assigned to a 24-week multimodal exercise intervention, separated into an aerobic and concurrent (aerobic + resistance) phase to evaluate potential mode effects. Retention was 84% (26/31), and compliance was >90% and >79% with medication and exercise, respectively. A total of 29 adverse events (Perindopril = 5; Losartan = 12; HCTZ = 11) and one unrelated serious adverse event were observed throughout the trial. Overall, this pilot RCT provided critical data and identified several challenges to ultimately designing and implementing a fully powered trial.

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