scholarly journals A randomized controlled trial into the cognitive effects of a computer-tailored physical activity intervention in older adults with chronic disease(s)

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Esmee Volders ◽  
Renate H. M. de Groot ◽  
Juul M. J. Coumans ◽  
Catherine A. W. Bolman ◽  
Lilian Lechner
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Chronic Disease ◽  
Cognitive Decline ◽  
Chronic Diseases ◽  
Verbal Memory ◽  
Daily Life ◽  
Intervention Group ◽  
Cognitive Effects ◽  
Intervention Effects

Abstract Background Cognitive functioning (CF) is important for wellbeing and an independent life. However, older adults with chronic diseases are at a higher risk of poorer CF levels. Although, research suggests that physical activity (PA) could play an essential role in maintaining good CF, older adults with chronic diseases have low levels of PA. PA interventions to prevent cognitive decline for this specific group exist. Yet, until now these interventions focused on a single specific chronic disease. Active Plus is a proven effective computer-tailored PA stimulating intervention focused on increasing PA in daily life for the older adult population suffering from a broad range of chronic diseases. This study tests the cognitive effects of Active Plus in older adults with chronic diseases. Methods In this RCT older adults with at least one chronic disease (≥65 years) were allocated to the intervention group (N = 260, mean age = 74.2) or waiting list control group (N = 325, mean age = 74.5). In total, intervention group participants received three times computer-tailored PA stimulating advice within four months (i.e., at baseline, after two months, and after three to four months). The online and print delivered advice were tailored to the specific needs and wishes of the participant and focused on incorporating PA in daily life. Baseline and follow-up measurements of the CF verbal memory (Verbal Learning Test), shifting (Trailmaking Test), inhibition (Stop-signal Task) and processing speed (Letter Digit Substitution Test) were assessed after six and 12 months. Intervention effects were analyzed with multilevel linear mixed-effects models adjusted for the clustered design and confounding variables. Results The dropout rate was 19.1% after 6 months and 25.1% after 12 months. Although both conditions improved on all verbal memory outcomes after 6 months, and all CF outcomes except inhibition after 12 months, no intervention effects were found, not even in subgroups (p > .05). Conclusions To our knowledge this is the first study to test the cognitive effects of a computer-tailored PA stimulating intervention in older adults suffering from a broad range of chronic diseases. The effects of the Active Plus intervention were not strong enough to improve CF or prevent cognitive decline. A blended approach, in which this computer-tailored intervention is combined with a face-to-face PA intervention and / or cognitive training, might be a good suggestion to increase the effects of Active Plus on PA and CF in older adults with chronic diseases. Trial registration Netherlands Trial Register NL6005; Date of Registration 03-21-2017; https://www.trialregister.nl/trial/6005

scholarly journals Associations of Lifestyle Intervention Effect with Blood Pressure and Physical Activity among Community-Dwelling Older Americans with Hypertension in Southern California

2020 ◽  
Vol 17 (16) ◽  
pp. 5673
Author(s):  
Mei-Lan Chen ◽  
Jie Hu ◽  
Thomas P. McCoy ◽  
Susan Letvak ◽  
Luba Ivanov
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Older Adults ◽  
Lifestyle Intervention ◽  
Controlled Trial ◽  
Intervention Group ◽  
Community Dwelling ◽  
Future Research ◽  
Control Group ◽  
Intervention Effects

A healthy lifestyle and regular physical activity are highly recommended for older adults. However, there has been limited research into testing lifestyle intervention effects on physical activity in older adults with hypertension. The purpose of this study was to assess the association of lifestyle intervention effects with physical activity and blood pressure in older adults with hypertension, accounting for social support and perceived stress as control variables. This study performed a secondary analysis of a two-arm randomized controlled trial. A total of 196 participants were randomly assigned to a six-month lifestyle intervention group or a control group. Hierarchical multiple regression analyses demonstrated that lifestyle intervention effects were not significantly associated with improvements in physical activity and blood pressure, but the final regression models were statistically significant (all p < 0.001). The result revealed that only physical activity frequency at baseline was significantly related to improvement in physical activity. Systolic blood pressure (SBP) at baseline and monthly income were significantly associated with change in SBP, while age and diastolic blood pressure (DBP) at baseline were significantly related to change in DBP. The findings provide empirical evidence for developing and optimizing lifestyle interventions for future research and clinical practice in this population.

Exercise and Physical Activity for Older Adults

2014 ◽  
Vol 3 (1) ◽  
pp. 101-106 ◽  
Author(s):  
Wojtek J. Chodzko-Zajko
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Risk Factors ◽  
Older Adults ◽  
Chronic Diseases ◽  
Successful Aging ◽  
Healthy Aging ◽  
Improve Quality ◽  
Reduce Risk

For more than half a century fellows of the National Academy of Kinesiology have enthusiastically advocated for the promotion and adoption of physically active lifestyles as an affordable and effective means to prevent chronic diseases and conditions, and enhance independence and high quality of life for older adults. It is possible to discern distinct evolutionary stages when examining scholarship related to the role of physical activity in the promotion of healthy aging. Research into physical activity and aging began with critical early studies that established the underlying scientific evidence for a relationship between physical activity and healthy aging. More recent work has addressed such topics as building consumer demand, developing policies and legislation to support active aging, and understanding the complex interrelationships between physical activity and other lifestyle factors in the prevention and treatment of chronic diseases and conditions. It is increasingly apparent that strategies to promote active and successful aging must be integrated into an effective public policy. Kinesiologists and other health professionals, working in collaboration with colleagues from other disciplines, can help to reduce risk factors for chronic disease and improve quality of life for older adults by building awareness of the importance of physical activity and by assisting with the development and implementation of appropriate and effective interventions that reduce risk factors and improve quality of life.

A Web-based versus a Print-based Physical Activity Intervention for Community-dwelling Older Adults: Randomized Trial With a Cross-over Design (Preprint)

2021 ◽  
Author(s):  
Claudia Pischke ◽  
Claudia Voelcker-Rehage ◽  
Tiara Ratz ◽  
Manuela Peters ◽  
Christoph Buck ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Randomized Trial ◽  
Physical Activity Intervention ◽  
Intervention Group ◽  
Community Dwelling ◽  
Significant Group ◽  
Web Based ◽  
Group Sessions ◽  
Community Dwelling Older Adults

BACKGROUND Despite the crucial role of regular physical activity (PA) for preventing chronic non-communicable diseases, fewer than half of older adults in Germany engage in the recommended levels of endurance training. OBJECTIVE The aim of this study was to compare acceptance and effectiveness of two interventions (web- vs. print-based) for PA promotion among initially inactive community-dwelling older adults aged 60 years and above in a nine-month randomized trial with a cross-over design. METHODS Participants were recruited offline and randomized to one of the following interventions for self-monitoring PA: (a) a print-based intervention (PRINT n=113), (b) a web-based intervention (WEB, n=129). Thirty percent (n=38) of those in group (b) received a PA tracker in addition to WEB (WEB+, (c)). After randomization, participants and researchers were not blinded. Participants’ intervention preferences at baseline were assessed retrospectively. All intervention groups were offered ten weekly face-to-face group sessions led by trained assistants. Afterwards, participants could choose to stay in their group or cross over to one of the other groups and group sessions were continued monthly for another six months. Three-dimensional accelerometers to assess PA and sedentary behavior (SB) at baseline (T0), three-month (T1) and nine-month follow-ups (T2) were employed. Adherence to PA recommendations, attendance of group sessions, and acceptance of the interventions were assessed via self-administered paper-based questionnaires. Linear mixed models were used to calculate differences in moderate-to-vigorous PA (MVPA) and SB between time points and intervention groups. RESULTS One-hundred and ninety-five participants completed T1. Only n=1 changed from WEB to PRINT and n=15 moved from PRINT to WEB (WEB-WEB: n=103, PRINT-PRINT: n=76) when offered to cross over at T1. One-hundred and sixty participants completed T2. MVPA in min per day increased between baseline and T1, but these within-group changes in time disappeared after adjusting for covariates. MVPA decreased by 9 min per day between baseline and T2 (βtime = -9.37, 95% CI: [-18.58; -0.16]), regardless of intervention group (WEB vs. PRINT: βgroup*time = -3.76, 95% CI: [-13.33; 5.82], WEB+ vs. PRINT: βgroup*time = 1.40, 95% CI: [-11.04; 13.83]). Nineteen percent of the participants met PA recommendations at T0, 20% at T1, and 20% at T2. For SB, there were no significant group differences and group-by-time interactions, neither at T1 nor at T2. Intervention acceptance was generally high. Use of intervention material was high to moderate at T1 (e.g., the PA diary was used by over 65% at least once a week) and decreased by T2 (40-50% in PRINT and in WEB used the PA diary at least once a week, and 58% in WEB+). CONCLUSIONS Despite high levels of acceptance of web- and print-based interventions for PA promotion and little movement between groups at T1, when given the choice, participation was not associated with increases in PA or decreases in SB over time. CLINICALTRIAL German Clinical Trials Register DRKS00016073 (Date of registration 10–01-2019).

Abstract 22: Visit-to-Visit Variability in Blood Pressure is Related to Late-Life Cognitive Decline

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Bo Qin ◽  
Anthony J Viera ◽  
Linda S Adair ◽  
Brenda L Plassman ◽  
Lloyd J Edwards ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Verbal Memory ◽  
Repeated Measures ◽  
Community Dwelling ◽  
Cognitive Testing ◽  
Cognitive Test ◽  
Nutrition Survey

Introduction: Recent studies suggest higher visit-to-visit variability of blood pressure (BP) is associated with worse cognitive function, but evidence based on longitudinal cognitive testing has not been reported. Hypothesis: We assessed the hypothesis that higher visit-to-visit variability in BP, but not mean BP, would be associated with faster decline in cognitive function among community-dwelling older adults. Methods: This prospective cohort study comprised 1213 adults who had two or more waves of BP measurements as part of the China Health and Nutrition Survey from 1991, up to their first cognitive tests, and completed a cognitive screening test at two or more waves in 1997, 2000 or 2004. Mean (SD) age at first cognitive test was 64 (6) y. Outcomes were repeated measures of global cognitive scores (baseline mean ± SD: 19 ± 6 points), standardized composite cognitive and verbal memory scores (standardized units [SU]). Visit-to visit BP variability was expressed as the standard deviation [SD] or as the variation independent of mean (SD/mean^x, with x derived from curve fitting) in BP measures obtained at a mean interval of 3.6 years. Multivariable-adjusted linear mixed-effects models were used to determine the association of changes in cognitive scores with visit-to visit BP variability. Results: Higher visit-to-visit variability in systolic BP, but not mean systolic BP, was associated with a faster decline of cognitive function (adjusted mean difference [95% CI] for high vs. low tertile of SD in variability (Figure): global score -0.23 points/y [-0.41 to -0.04], composite scores -0.029 SU/y [-0.056 to -0.002] and verbal memory -0.044 SU/y [-0.075 to -0.012]). Higher visit-to-visit variability in diastolic BP was associated with a faster decline of global cognitive function only among adults 55-64 years, independent of mean diastolic BP. Conclusion: Higher long-term BP visit-to-visit variability predicted a faster rate of cognitive decline among older adults.

scholarly journals Health Trajectories in Swedish Centenarians

2020 ◽  
Vol 76 (1) ◽  
pp. 157-163
Author(s):  
Davide L Vetrano ◽  
Giulia Grande ◽  
Alessandra Marengoni ◽  
Amaia Calderón-Larrañaga ◽  
Debora Rizzuto
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Chronic Diseases ◽  
Care Delivery ◽  
Cognitive Status ◽  
National Study ◽  
Health Trajectories ◽  
Kungsholmen Project ◽  
Cognitively Intact

Abstract Background Longitudinal studies describing centenarians’ health trajectories are currently lacking. We compared health trajectories of older adults becoming centenarians and their shorter-living counterparts in terms of chronic diseases, disability, and cognitive decline. Methods We identified 3,573 individuals participating in the Kungsholmen Project and the Swedish National Study on Aging and Care in Kungsholmen who lived &lt;100 years and 222 who survived to their 100th birthday. Trajectories of chronic diseases, disability (impaired activities of daily living), and cognitive status were obtained via linear mixed models over 13 years. Results Centenarians had fewer chronic diseases than noncentenarians. Before age 85, centenarians showed slower health changes. In centenarians, multimorbidity, disability, and cognitive impairment occurred 4 to 9 years later than in noncentenarians. After age 85, the speed of accumulation of chronic diseases, disabilities, and cognitive decline accelerated in centenarians. At age 100, 39% of the centenarians were cognitively intact and 55% had escaped disability. Only 5% were free of multimorbidity at age 100. When compared with their shorter lived counterparts, in terms of years spent in poor health, centenarians experienced more years with multimorbidity (9.4 vs 6.8 years; p &lt; .001), disability (4.3 vs 3.1 years; p = .005), and cognitive impairment (6.3 vs 4.3 years; p &lt; .001). Conclusions Older people who become centenarians present a delay in the onset of morbidity, but spend more years in this condition compared to their shorter lived peers. The observation of older adults’ health trajectories might help to forecast healthier aging, and plan future medical and social care delivery.

Physical activity can attenuate, but not eliminate, the negative relationships of high TV viewing with some chronic diseases: findings from a cohort of 60 202 Brazilian adults

2019 ◽  
Author(s):  
André O Werneck ◽  
Adewale L Oyeyemi ◽  
Paul J Collings ◽  
Edilson S Cyrino ◽  
Enio R V Ronque ◽  
...  
Keyword(s):  
Physical Activity ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Leisure Time Physical Activity ◽  
Sodium Intake ◽  
Viewing Time ◽  
Negative Effects ◽  
Tv Viewing ◽  
Logistic Regression Models ◽  
Nationally Representative

Abstract Background This study examined the joint associations of leisure time physical activity and television (TV) viewing time with the prevalence of chronic diseases among Brazilian adults. Methods Data from the Brazilian Health Survey, a nationally representative survey conducted in 2013 (n = 60 202; ≥18 years), were used. Time spent in TV viewing and leisure physical activity, physician diagnoses of diabetes, hypertension and heart disease and information on co-variables (chronological age, education, ethnicity, candies/sweets consumption, sodium intake and tobacco smoking) were collected via interview. Descriptive statistics (mean and 95% confidence interval) and logistic regression models were used for etiological analyses. Results Physical activity attenuated but did not eliminate the risk associated with high TV viewing for at least one chronic disease in the general population [odds ratio [OR]: 1.29 (1.11–1.50)] and among women [OR: 1.31 (1.09–1.60)], adults [OR: 1.24 (1.05–1.46)] and older adults [OR: 1.63 (1.05–2.53)]. On the other hand, physical activity eliminated the risk associated with high TV viewing for at least one chronic disease among men [OR: 1.24 (0.98–1.58)]. Conclusions We conclude that physical activity can attenuate but not eliminate the negative effects of high TV viewing on chronic disease among subgroups of Brazilian adults.

Chronic Disease Self-Management Among Iranian Older Adults: A Scoping Review

2019 ◽  
Vol 39 (8) ◽  
pp. 922-930 ◽  
Author(s):  
Aein Zarrin ◽  
Nima Tourchian ◽  
George A. Heckman
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Chronic Disease ◽  
Scoping Review ◽  
Self Management ◽  
Cochrane Library ◽  
Self Monitoring ◽  
Care Models ◽  
Language Objectives ◽  
Main Components

Background: Implementing care models that emphasize chronic disease self-management (CDSM) strategies may be an effective approach to the growing prevalence of chronic conditions in Iran. We, therefore, conducted a scoping review on CDSM among older Iranians to identify existing gaps and opportunities to improve chronic disease care. Method: We conducted a search in CINAHL, EMBASE, MEDLINE/PubMed, and Cochrane library. Selected articles were charted based on year of publication, language, objectives, methods, target chronic disease(s), sample demographics, self-management type, and key findings. Results: We selected 73 articles. The main components of CDSM addressed were social support, education, physical activity, nutrition, self-monitoring, spirituality, and financial support. Older Iranians reported low levels of physical activity. Conclusion: Enhancing the quality of CDSM research and provision of coaching to enhance older adults’ social and mental health are among the main strategies to enhance CDSM among the Iranian older population.

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