scholarly journals COVEPIC (Cognitive and spOrt Virtual EPIC training) investigating the effects of home-based physical exercise and cognitive training on cognitive and physical functions in community-dwelling older adults: study protocol of a randomized single-blinded clinical trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Emma Gabrielle Dupuy ◽  
Florent Besnier ◽  
Christine Gagnon ◽  
Thomas Vincent ◽  
Catherine-Alexandra Grégoire ◽  
...  
Keyword(s):  
Older Adults ◽  
Clinical Trial ◽  
Physical Exercise ◽  
Physical Health ◽  
Social Isolation ◽  
Cognitive Training ◽  
Community Dwelling ◽  
Physical Exercises ◽  
Home Based ◽  
Physical Functions

Abstract Background In the context of the COVID-19 pandemic, lockdown and social distancing measures are applied to prevent the spread of the virus. It is well known that confinement and social isolation can have a negative impact on physical and mental health, including cognition. Physical activity and cognitive training can help enhance older adults’ cognitive and physical health and prevent the negative collateral impacts of social isolation and physical inactivity. The COVEPIC study aims to document the effects of 6 months of home-based physical exercise alone versus home-based physical exercise combined with cognitive training on cognitive and physical functions in adults 50 years and older. Methods One hundred twenty-two healthy older adults (> 50 years old) will be recruited from the community and randomized to one of the two arms for 6 months: (1) home-based physical exercises monitoring alone and (2) combined physical exercises monitoring with home-based cognitive training. The primary outcome is cognition, including general functioning (Montreal Cognitive Assessment (MoCA) score), as well as executive functions, processing speed, and episodic memory (composite Z-scores based on validated neuropsychological tests and computerized tasks). The secondary outcome is physical functions, including balance (one-leg stance test), gait and mobility performance (Timed Up and Go, 4-meter walk test), leg muscle strength (5-time sit-to-stand), and estimated cardiorespiratory fitness (Matthews’ questionnaire). Exploratory outcomes include mood, anxiety, and health-related quality of life as assessed by self-reported questionnaires (i.e., Geriatric depression scale-30 items, Perceived stress scale, State-trait anxiety inventory-36 items, Perseverative thinking questionnaire, Connor-Davidson Resilience Scale 10, and 12-item Short Form Survey). Discussion This trial will document the remote monitoring of home-based physical exercise alone and home-based physical combined with cognitive training to enhance cognitive and physical health of older adults during the COVID-19 pandemic period. Remote interventions represent a promising strategy to help maintain or enhance health and cognition in seniors, and potentially an opportunity to reach older adults in remote areas, where access to such interventions is limited. Trial registration Clinical trial Identifier NCT04635462. COVEPIC was retrospectively registered on November 19, 2020.

EFFECTS OF COMPUTERIZED COGNITIVE TRAINING ON GAIT SPEED IN COMMUNITY DWELLING OLDER ADULTS, A PILOT STUDY

2016 ◽  
pp. 1-6
Author(s):  
J. Blackwood ◽  
T. Houston
Keyword(s):  
Older Adults ◽  
Cognitive Training ◽  
Gait Speed ◽  
Independent Living ◽  
Functional Decline ◽  
Community Dwelling ◽  
Computerized Cognitive Training ◽  
Home Based ◽  
Improved Function ◽  
Community Dwelling Older Adults

Background: In older adults declines in gait speed have been identified as predictors of functional decline and have been found in those with cognitive dysfunction. Cognitive training interventions that emphasize addressing executive function (EF) have resulted in a transfer effect from training cognitive processes into improved function. However research examining the effects of an EF specific computerized cognitive training (CCT) program on gait speed (GS) is limited. Objectives: To compare the effects of a six week EF specific CCT program on GS in community dwelling older adults using a pretest/posttest experimental design with subgroup comparisons based on a cutoff GS of 1.0m/s. Setting: Home based Participants: Forty independent living older adults (>65 years) without diagnosed cognitive impairment participated in either the intervention or control groups. Intervention: A six week long progressively challenging EF focused CCT program was performed at home. Measurements: Demographic variables, cognitive function (Trail-Making Test Part B) and GS were measured at baseline at week 7. Between group comparisons were completed for the whole sample initially with subgroup comparisons performed based on participants’ initial GS (Slow walkers: GS<1.0m/s; Fast Walkers: GS>1.0m/s). Results: No differences in GS were found for the whole population, but subgroup analyses restricted to slow walkers demonstrated a statistically significant improvement in GS after 6 weeks of CCT (µ =0.33 m/s, p = 0.03). Other outcomes measures were not statistically different at posttest. Conclusions: Older adults who walk at speeds <1.0m/s may benefit from a progressively challenging CCT program when self-administered in the home.

scholarly journals COMPUTERIZED COGNITIVE TRAINING, WITH OR WITHOUT EXERCISE, TO PROMOTE COGNITIVE FUNCTION: A RANDOMIZED TRIAL

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S55-S56
Author(s):  
Lisanne F ten Brinke ◽  
John R Best ◽  
Joey L Chan ◽  
Cheyenne Ghag ◽  
Kirk I Erickson ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Exercise ◽  
Executive Functions ◽  
Cognitive Training ◽  
Verbal Learning ◽  
Stroop Test ◽  
Community Dwelling ◽  
Computerized Cognitive Training ◽  
Improved Performance ◽  
At Home

Abstract Given the world’s aging population, it is important to identify strategies that promote healthy cognitive aging. Computerized cognitive training (CCT) may be a promising method to combat cognitive decline in older adults. Moreover, physical exercise immediately prior to CCT might provide additional cognitive benefits. We conducted a randomized controlled trial to examine the effect of a CCT intervention, alone or preceded by physical exercise, on memory and executive functions in older adults. 124 community-dwelling older adults aged 65-85 years were randomly assigned to either 8-weeks of: 1) 3x/week group-based CCT plus 3x/week CCT sessions at home; 2) 3x/week group-based CCT combined with a 15-minute brisk walk (Ex-CCT) plus 3x/week Ex-CCT sessions at home; or 3)3x/week group-based sham exercise and education sessions (CON). At baseline and 8-weeks standard neuropsychological tests of verbal memory and learning and executive functions were administered, including the Rey Auditory Verbal Learning Test (RAVLT), Stroop test, Flanker test, Trail Making Tests (TMT B-A), and Dimensional Change Card Sort (DCCS) Test. At trial completion, there were no differences in RAVLT performance. Compared with CON, FBT and Ex-FBT participants significantly improved performance on the Stroop test (p = .001 and p = .023, respectively). Additionally, those randomized to Ex-CCT improved performance on the Flanker test (p = .002), TMT B-A (p = .047), and the DCCS Test (p = .023) compared with BAT. These findings suggest that an 8-week CCT program could benefit executive functions, and that implementing exercise immediately prior to CCT could provide broader benefits.

scholarly journals Investigation of the Effects of Home-Based Exercise and Cognitive Training on Cognitive and Physical Functions in Cardiac Patients: The COVEPICARDIO Study Protocol of a Randomized Clinical Trial

2021 ◽  
Vol 8 ◽  
Author(s):  
Florent Besnier ◽  
Emma Gabrielle Dupuy ◽  
Christine Gagnon ◽  
Thomas Vincent ◽  
Catherine-Alexandra Grégoire ◽  
...  
Keyword(s):  
Physical Exercise ◽  
Cognitive Training ◽  
Cognitive Stimulation ◽  
Cardiac Patients ◽  
Secondary Outcome ◽  
Home Based ◽  
Related Quality ◽  
Present Context ◽  
General Functioning ◽  
Physical Functions

Introduction: During the COVID-19 pandemic, confinement measures are likely to produce collateral damage to health (stress, confusion, anxiety), especially in frail individuals and those living with cardiovascular disease (CVD). In cardiac patients in particular, these measures dramatically increase the level of physical inactivity and sedentary lifestyle, which can decrease cardiorespiratory capacity and increase the risk of acute events, rehospitalization, and depressive syndromes. Maintaining a minimum level of physical activity and cognitive stimulation during the COVID-19 crisis is essential for cardiac patients. This study is designed to document the effects of 6 months of home-based physical exercise alone or combined with cognitive training on cognitive and physical functions in patients with CVD over 50 years old.Methods and Analysis: 122 patients (&gt;50 years old) with stable CVD and no contraindication to perform physical exercise training will be recruited and randomly assigned to one of the 2 following arms: (1) Home-based physical exercise alone, (2) Home-based physical exercise combined with cognitive training. The intervention lasts 6 months, with remote assessments performed prior to, mid and post-training. A follow-up 6 months after the end of the intervention (12 month) is also proposed. The primary outcome is cognition, including general functioning (Montreal Cognitive Assessment (MoCA) score), as well as performances on measures of executive functions, processing speed, and episodic memory. The secondary outcome is physical performance, including balance, gait and mobility, leg muscle strength and estimated cardiorespiratory fitness. Tertiary outcomes include mood, anxiety, and health-related quality of life as assessed by self-reported online questionnaires.Discussion: With the COVID-19 crisis, there is a critical need for remote exercise and cognitive training, and to further investigate this topic, in particular for cardiac patients. The present context can be viewed as an opportunity to perform a major shift from center-based programs to home-based physical exercise. This is especially important to reach out to older adults living in remote areas, where access to such interventions is limited.ClinicalTrials.gov: [https://clinicaltrials.gov/ct2/show/NCT04661189], NCT04661189.

scholarly journals Changes in health behaviors, mental and physical health among older adults under severe lockdown restrictions during the COVID-19 pandemic in Spain

2021 ◽  
Author(s):  
Esther García-Esquinas ◽  
Rosario Ortolá ◽  
Iago Gine-Vázquez ◽  
José A Carnicero ◽  
Asier Mañas ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Older Adults ◽  
Health Behaviors ◽  
Physical Health ◽  
Social Isolation ◽  
Community Dwelling ◽  
Viewing Time ◽  
Housing Conditions ◽  
Mental And Physical Health

AbstractBackgroundWe aimed to examine main changes in health behaviors, mental and physical health among older adults under severe lockdown restrictions during the COVID-19.MethodsWe used prospective data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain. Data were obtained using validated questionnaires through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning the COVID-19 lockdown. Lineal or multinomial, as appropriate, regression models with adjustment for the main confounders were used to assess changes in the outcome variables from the pre-pandemic to the confinement period, and to identify their associated factors.ResultsOn average, the confinement was not associated with a deterioration in lifestyle risk factors (smoking, alcohol intake, diet or weight), except for a decreased physical activity and increased sedentary time, which reversed with the end of confinement. However, chronic pain worsened, and moderate declines in mental health, that did not seem to reverse after restrictions were lifted, were observed. Several subgroups of individuals were at increased risk of developing unhealthier lifestyles or mental health decline with confinement: (i)-males (for physical activity and sedentariness), (ii)-those with greater social isolation (for diet, physical activity, mental health), (iii)-feelings of loneliness (for diet, sleep quality, mental health), (iv)-poor housing conditions (for diet, physical activity, TV viewing time), (v)-unhealthy sleep duration (for physical activity and sedentariness), and (vi-worse overall health or chronic morbidities (for physical activity, screen time, mental health). On the other hand, previously having a greater adherence to the Mediterranean diet and doing more physical activity protected older adults from developing unhealthier lifestyles with confinement.ConclusionsThe lockdown during the first wave of the COVID-19 in Spain, which was one of the most restrictive in Europe, only led to minor average changes in health behaviors among older adults. However, mental health was moderately affected. If another lockdown were imposed on this or future pandemics, public health programs should specially address the needs of older individuals with male sex, greater social isolation, poor housing conditions and chronic morbidities, because of their greater vulnerability to the enacted movement restrictions

scholarly journals Health impacts of the “Stay at Home” order on community dwelling older adults and how technologies may help: A focus group study (Preprint)

2020 ◽  
Author(s):  
Jessica Daly ◽  
Colin Depp ◽  
Sarah Graham ◽  
Dilip V. Jeste ◽  
Ho-Cheol Kim ◽  
...  
Keyword(s):  
Older Adults ◽  
Focus Group ◽  
Physical Health ◽  
Social Isolation ◽  
Community Dwelling ◽  
Potential Game ◽  
Viral Spread ◽  
The Impact ◽  
Mental And Physical Health ◽  
At Home

BACKGROUND The COVID-19 pandemic has resulted in nearly 250,000 deaths as of mid-November 2020 with 80% of those being people over 65 years of age. Since March 2020, preventive measures including lockdowns, social isolation, quarantine and social distancing have been implemented to reduce viral spread. These measures, while effective for risk prevention, may contribute to increased social isolation and loneliness among older adults and negatively impact mental and physical health. OBJECTIVE A qualitative study was conducted to identify the impact of the “Stay-at-Home” order on older adults living in a Continued Care Senior Housing Community (CCSHC) in southern California. METHODS Four 90-minute focus groups were convened using the Zoom communications platform during May 2020 with 21 CCSHC residents participating. Participants were asked to describe how they were managing during the “stay-at-home” mandate that was implemented in March 2020, including impact on their physical and mental health. Transcripts of each focus group were analyzed using qualitative methods. RESULTS Four themes emerged from the qualitative data including: Impact of Quarantine on Health and Well-Being; 2 - Communication Innovation; 3 - Effective Ways of Coping with Quarantine; and 4 – Improving Access to Technology and Training. Participants reported a threat to their mental and physical health directly tied to quarantine and exacerbated by social isolation and decreased physical activity. Technology was identified as a lifeline for many who are socially isolated from friends and family. CONCLUSIONS Technology access, connectivity, and literacy are potential game-changers to supporting the mental and physical health of older adults and must be prioritized. CLINICALTRIAL N/A

scholarly journals Health Impacts of the Stay-at-Home Order on Community-Dwelling Older Adults and How Technologies May Help: Focus Group Study

JMIR Aging ◽  
10.2196/25779 ◽  
2021 ◽  
Vol 4 (1) ◽  
pp. e25779
Author(s):  
Jessica R Daly ◽  
Colin Depp ◽  
Sarah A Graham ◽  
Dilip V Jeste ◽  
Ho-Cheol Kim ◽  
...  
Keyword(s):  
Older Adults ◽  
Focus Group ◽  
Physical Health ◽  
Social Isolation ◽  
Technology Use ◽  
Community Dwelling ◽  
Potential Game ◽  
The Impact ◽  
Mental And Physical Health ◽  
At Home

Background As of March 2021, in the USA, the COVID-19 pandemic has resulted in over 500,000 deaths, with a majority being people over 65 years of age. Since the start of the pandemic in March 2020, preventive measures, including lockdowns, social isolation, quarantine, and social distancing, have been implemented to reduce viral spread. These measures, while effective for risk prevention, may contribute to increased social isolation and loneliness among older adults and negatively impact their mental and physical health. Objective This study aimed to assess the impact of the COVID-19 pandemic and the resulting “Stay-at-Home” order on the mental and physical health of older adults and to explore ways to safely increase social connectedness among them. Methods This qualitative study involved older adults living in a Continued Care Senior Housing Community (CCSHC) in southern California, USA. Four 90-minute focus groups were convened using the Zoom Video Communications platform during May 2020, involving 21 CCSHC residents. Participants were asked to describe how they were managing during the “stay-at-home” mandate that was implemented in March 2020, including its impact on their physical and mental health. Transcripts of each focus group were analyzed using qualitative methods. Results Four themes emerged from the qualitative data: (1) impact of the quarantine on health and well-being, (2) communication innovation and technology use, (3) effective ways of coping with the quarantine, and (4) improving access to technology and training. Participants reported a threat to their mental and physical health directly tied to the quarantine and exacerbated by social isolation and decreased physical activity. Technology was identified as a lifeline for many who are socially isolated from their friends and family. Conclusions Our study findings suggest that technology access, connectivity, and literacy are potential game-changers to supporting the mental and physical health of older adults and must be prioritized for future research.

Addressing COVID-19 Worry and Social Isolation in Home-Based Primary Care

2020 ◽  
Author(s):  
Rachel Elizabeth Weiskittle ◽  
Michelle Mlinac ◽  
LICSW Nicole Downing
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Primary Care ◽  
Social Workers ◽  
Social Isolation ◽  
Mental Health Providers ◽  
Health Providers ◽  
Home Based Primary Care ◽  
Home Based ◽  
Socially Isolated

Social distancing measures following the outbreak of COVID-19 have led to a rapid shift to virtual and telephone care. Social workers and mental health providers in VA home-based primary care (HBPC) teams face challenges providing psychosocial support to their homebound, medically complex, socially isolated patient population who are high risk for poor health outcomes related to COVID-19. We developed and disseminated an 8-week telephone or virtual group intervention for front-line HBPC social workers and mental health providers to use with socially isolated, medically complex older adults. The intervention draws on skills from evidence-based psychotherapies for older adults including Acceptance and Commitment Therapy, Cognitive-Behavioral Therapy, and Problem-Solving Therapy. The manual was disseminated to VA HBPC clinicians and geriatrics providers across the United States in March 2020 for expeditious implementation. Eighteen HBPC teams and three VA Primary Care teams reported immediate delivery of a local virtual or telephone group using the manual. In this paper we describe the manual’s development and clinical recommendations for its application across geriatric care settings. Future evaluation will identify ways to meet longer-term social isolation and evolving mental health needs for this patient population as the pandemic continues.

scholarly journals COVID-19 lockdown has altered the dynamics between affective symptoms and social isolation among older adults: results from a longitudinal network analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Junhong Yu ◽  
Rathi Mahendran
Keyword(s):  
Older Adults ◽  
Social Isolation ◽  
Anxiety Symptoms ◽  
Community Dwelling ◽  
Depression Symptoms ◽  
Network Analyses ◽  
Correlation Networks ◽  
Affective Symptoms ◽  
Tightly Coupled ◽  
Community Dwelling Older Adults

AbstractThe COVID-19 lockdown has drastically limited social interactions and brought about a climate of fear and uncertainty. These circumstances not only increased affective symptoms and social isolation among community dwelling older adults but also alter the dynamics between them. Using network analyses, we study the changes in these dynamics before and during the lockdown. Community-dwelling older adults (N = 419) completed questionnaires assessing depression, anxiety, and social isolation, before the COVID-19 pandemic, as part of a cohort study, and during the lockdown period. The total scores of these questionnaires were compared across time. For the network analyses, partial correlation networks were constructed using items in the questionnaires as nodes, separately at both timepoints. Changes in edges, as well as nodal and bridge centrality were examined across time. Depression and anxiety symptoms, and social isolation had significantly increased during the lockdown. Significant changes were observed across time on several edges. Greater connectivity between the affective and social isolation nodes at lockdown was observed. Depression symptoms have become more tightly coupled across individuals, and so were the anxiety symptoms. Depression symptoms have also become slightly decoupled from those of anxiety. These changing network dynamics reflect the greater influence of social isolation on affective symptoms across individuals and an increased vulnerability to affective disorders. These findings provide novel perspectives and translational implications on the changing mental health context amidst a COVID-19 pandemic situation.

scholarly journals Long-term participation in community group exercise improves lower extremity muscle strength and delays age-related declines in walking speed and physical function in older adults

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Chisato Hayashi ◽  
Soshiro Ogata ◽  
Tadashi Okano ◽  
Hiromitsu Toyoda ◽  
Sonoe Mashino
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Physical Exercise ◽  
Lower Extremity ◽  
Physical Function ◽  
Community Dwelling ◽  
Group Exercise ◽  
Community Based ◽  
Lower Extremity Muscle

Abstract Background The effects of group exercise on the physical function of community-dwelling older adults remain unclear. The changes in lower extremity muscle strength, timed up and go (TUG) time, and the motor fitness scale (MFS), over time, among older adults who expressed a willingness to participate in community-based physical exercise groups, were determined using multilevel modelling. Methods We analyzed data of 2407 older adults between April 2010 and December 2019 from the registry of physical tests of community-based physical exercise groups. We conducted a retrospective cohort study to assess the effect of physical exercise on lower extremity muscle strength, TUG time, and MFS scores. The durations of the exercises were evaluated by frequency of physical test’s participate. Results A deterioration in lower extremity muscle strength was found in the short-term participant group only. However, in the mid-term and long-term participation groups, lower extremity muscle strength showed a trend of improvement. The TUG time and the MFS score were negatively correlated with increasing age in both groups divided by the duration of participation. However, there was a slower rate of deterioration in the long-term participation group. Discussion Lower extremity muscle strength, TUG time, and MFS scores decline with increasing age and there were differences in the slope of deterioration that depended on the duration of participation in community-based group exercise. Conclusion Participation in group exercise improved lower extremity muscle strength, TUG time, and MFS scores of older adults living in a community. The positive effects of group exercise were dependent on long-term participation.

scholarly journals Changes in Health Behaviors, Mental and Physical Health among Older Adults under Severe Lockdown Restrictions during the COVID-19 Pandemic in Spain

2021 ◽  
Vol 18 (13) ◽  
pp. 7067
Author(s):  
Esther García-Esquinas ◽  
Rosario Ortolá ◽  
Iago Gine-Vázquez ◽  
José A. Carnicero ◽  
Asier Mañas ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Older Adults ◽  
Social Isolation ◽  
Community Dwelling ◽  
Housing Conditions ◽  
Older Individuals ◽  
Lifestyle Risk Factors ◽  
Increased Risk ◽  
Lifestyle Risk

We used data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain collected through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning of the COVID-19 lockdown. On average, the confinement was not associated with a deterioration in lifestyle risk factors (smoking, alcohol intake, diet, or weight), except for a decreased physical activity and increased sedentary time, which reversed with the end of confinement. However, chronic pain worsened, and moderate declines in mental health, that did not seem to reverse after restrictions were lifted, were observed. Males, older adults with greater social isolation or greater feelings of loneliness, those with poorer housing conditions, as well as those with a higher prevalence of chronic morbidities were at increased risk of developing unhealthier lifestyles or mental health declines with confinement. On the other hand, previously having a greater adherence to the Mediterranean diet and doing more physical activity protected older adults from developing unhealthier lifestyles with confinement. If another lockdown were imposed during this or future pandemics, public health programs should specially address the needs of older individuals with male sex, greater social isolation, sub-optimal housing conditions, and chronic morbidities because of their greater vulnerability to the enacted movement restrictions.

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