scholarly journals Planning and optimising a digital intervention to protect older adults’ cognitive health

2021 ◽  
Author(s):  
Rosie Essery ◽  
Sebastien Pollet ◽  
Kirsten A. Smith ◽  
Fiona Mowbray ◽  
Joanna Slodkowska-Barabasz ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Performance ◽  
Development Process ◽  
Qualitative Interviews ◽  
Intervention Development ◽  
Dementia Prevalence ◽  
Scoping Reviews ◽  
Intervention Content ◽  
Intervention Planning ◽  
Protective Behaviours

Abstract Background By 2050 worldwide dementia prevalence is expected to triple, rising to 152 million. Affordable, scalable interventions are required to support protective behaviours such as physical activity, cognitive training and healthy eating. This paper outlines the development of ‘Active Brains’: a multi-domain digital behaviour change intervention to reduce cognitive decline amongst older adults, and key findings arising from this process. Methods A theory-, evidence- and person-based approach to intervention development was undertaken. Scoping reviews and behavioural analysis contributed to intervention planning. Optimisation involved qualitative interviews with 52 older adults with higher and lower cognitive performance scores. Data were analysed thematically and informed changes.Results The development process synthesised findings from planning and optimisation activities. Scoping reviews and qualitative interviews suggested that the same intervention content should be suitable for individuals with higher and lower cognitive performance. Qualitative findings revealed that maintaining independence and enjoyment motivated engagement in intervention-targeted behaviours, whereas managing ill health was a potential barrier. Social support for engaging in such activities could provide motivation, but was not desirable for all. These findings informed development of highly acceptable intervention content and functionality for target users.Conclusions A digitally-delivered intervention with minimal support appears acceptable and potentially engaging to older adults with higher and lower levels of cognitive performance. As well as informing our own intervention, the insights obtained through our development process may be useful for others working with, and developing interventions for, older adults and/or those with cognitive impairment.

scholarly journals Planning and optimising a digital intervention to reduce older adults’ cognitive decline

2020 ◽  
Author(s):  
Rosie Essery ◽  
Sebastien Pollet ◽  
Kirsten A. Smith ◽  
Fiona Mowbray ◽  
Joanna Slodkowska-Barabasz ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Cognitive Performance ◽  
Development Process ◽  
Qualitative Interviews ◽  
Intervention Development ◽  
Dementia Prevalence ◽  
Scoping Reviews ◽  
Intervention Content ◽  
Intervention Planning

Abstract Background By 2050 worldwide dementia prevalence is expected to triple, rising to 152 million. Affordable, scalable interventions are required to support protective behaviours such as physical activity, cognitive training and healthy eating. This paper outlines the development of ‘Active Brains’: a multi-domain digital behaviour change intervention to reduce cognitive decline amongst older adults, and key findings arising from this process. Methods A theory-, evidence- and person-based approach to intervention development was undertaken. Scoping reviews and behavioural analysis contributed to intervention planning. Optimisation involved qualitative interviews with 52 older adults with higher and lower cognitive performance scores. Data were analysed thematically and informed changes. Results The development process synthesised findings from planning and optimisation activities. Scoping reviews and qualitative interviews suggested that the same intervention content should be suitable for individuals with higher and lower cognitive performance. Qualitative findings revealed that maintaining independence and enjoyment motivated engagement in intervention-targeted behaviours, whereas managing ill health was a potential barrier. Social support for engaging in such activities could provide motivation, but was not desirable for all. These findings informed development of highly acceptable intervention content and functionality for target users. Conclusions A digitally-delivered intervention with minimal support appears acceptable and potentially engaging to older adults with higher and lower levels of cognitive performance. As well as informing our own intervention, the insights obtained through our development process may be useful for others working with, and developing interventions for, older adults and/or those with cognitive impairment.

scholarly journals Planning and optimising a digital intervention to reduce older adults' cognitive decline

2020 ◽  
Author(s):  
Rosie Essery ◽  
Sebastien Pollet ◽  
Kirsten A Smith ◽  
Fiona Mowbray ◽  
Joanna Slodkowska-Barabasz ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Cognitive Performance ◽  
Development Process ◽  
Qualitative Interviews ◽  
Intervention Development ◽  
Dementia Prevalence ◽  
Scoping Reviews ◽  
Intervention Content ◽  
Intervention Planning

Abstract BackgroundBy 2050 worldwide dementia prevalence is expected to triple, rising to 152 million. Affordable, scalable interventions are required to support protective behaviours such as physical activity, cognitive training and healthy eating. This paper outlines the development of ‘Active Brains’: a multi-domain digital behaviour change intervention to reduce cognitive decline amongst older adults, and key findings arising from this process.MethodsA theory-, evidence- and person-based approach to intervention development was undertaken. Scoping reviews and behavioural analysis contributed to intervention planning. Optimisation involved qualitative interviews with 52 older adults with higher and lower cognitive performance scores. Data were analysed thematically and informed changes.ResultsThe development process synthesised findings from planning and optimisation activities. Scoping reviews and qualitative interviews suggested that the same intervention content should be suitable for individuals with higher and lower cognitive performance. Qualitative findings revealed that maintaining independence and enjoyment motivated engagement in intervention-targeted behaviours, whereas managing ill health was a potential barrier. Social support for engaging in such activities could provide motivation, but was not desirable for all. These findings informed development of highly acceptable intervention content and functionality for target users.ConclusionsA digitally-delivered intervention with minimal support appears acceptable and potentially engaging to older adults with higher and lower levels of cognitive performance. As well as informing our own intervention, the insights obtained through our development process may be useful for others working with, and developing interventions for, older adults and/or those with cognitive impairment.

scholarly journals Planning and optimising a digital intervention to protect older adults’ cognitive health

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Rosie Essery ◽  
Sebastien Pollet ◽  
Kirsten A. Smith ◽  
Fiona Mowbray ◽  
Joanna Slodkowska-Barabasz ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Performance ◽  
Qualitative Interviews ◽  
Intervention Development ◽  
Logic Model ◽  
Structured Interviews ◽  
Behavioural Analysis ◽  
Scoping Reviews ◽  
Intervention Content ◽  
Guiding Principles

Abstract Background By 2050, worldwide dementia prevalence is expected to triple. Affordable, scalable interventions are required to support protective behaviours such as physical activity, cognitive training and healthy eating. This paper outlines the theory-, evidence- and person-based development of ‘Active Brains’: a multi-domain digital behaviour change intervention to reduce cognitive decline amongst older adults. Methods During the initial planning phase, scoping reviews, consultation with PPI contributors and expert co-investigators and behavioural analysis collated and recorded evidence that was triangulated to inform provisional ‘guiding principles’ and an intervention logic model. The following optimisation phase involved qualitative think aloud and semi-structured interviews with 52 older adults with higher and lower cognitive performance scores. Data were analysed thematically and informed changes and additions to guiding principles, the behavioural analysis and the logic model which, in turn, informed changes to intervention content. Results Scoping reviews and qualitative interviews suggested that the same intervention content may be suitable for individuals with higher and lower cognitive performance. Qualitative findings revealed that maintaining independence and enjoyment motivated engagement in intervention-targeted behaviours, whereas managing ill health was a potential barrier. Social support for engaging in such activities could provide motivation, but was not desirable for all. These findings informed development of intervention content and functionality that appeared highly acceptable amongst a sample of target users. Conclusions A digitally delivered intervention with minimal support appears acceptable and potentially engaging to older adults with higher and lower levels of cognitive performance. As well as informing our own intervention development, insights obtained through this process may be useful for others working with, and developing interventions for, older adults and/or those with cognitive impairment.

Interventions to optimise medication prescribing and adherence in older people with cancer: A systematic scoping review

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i23-i24
Author(s):  
M Murphy ◽  
K Bennett ◽  
S Ryan ◽  
C Hughes ◽  
A Lavan ◽  
...  
Keyword(s):  
Older Adults ◽  
Scoping Review ◽  
Grey Literature ◽  
Intervention Development ◽  
Control Group ◽  
Sample Population ◽  
Inclusion Criteria ◽  
Scoping Reviews ◽  
Medication Prescribing ◽  
Broad Overview

Abstract Introduction Older adults with cancer often require multiple medications (polypharmacy) comprising cancer-specific treatments, supportive care medications (e.g. analgesics) and medications for pre-existing conditions. The reported prevalence of polypharmacy in older adults with cancer ranges from 13–92% (1). Increasing numbers of medications pose risks of potentially inappropriate prescribing and medication non-adherence. Aim The aim of this scoping review was to provide an overview of evaluations of interventions to optimise medication prescribing and/or adherence in older adults with cancer, with a particular focus on the interventions, study populations and outcome measures that have been assessed in previous evaluations. Methods Four databases (PubMed, EMBASE, CINAHL, PsycINFO) were searched from inception to 29th November 2019 using relevant search terms (e.g. cancer, older adults, prescribing, adherence). Eligible studies evaluated interventions seeking to improve medication prescribing and/or adherence in older adults (≥65 years) with an active cancer diagnosis using a comparative evaluation (e.g. inclusion of a control group). All outcomes for studies that met inclusion criteria were included in the review. Two reviewers independently screened relevant abstracts for inclusion and performed data extraction. As a scoping review aims to provide a broad overview of existing literature, formal assessments of methodological quality of included studies were not undertaken. Extracted data were collated using tables and accompanying narrative descriptive summaries. The review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines (2). Results The electronic searches yielded 21,136 citations (Figure 1). Nine studies met inclusion criteria. Included studies consisted of five randomised controlled trials (RCTs), including one cluster RCT, and four before-and-after study designs. Studies were primarily conducted in oncology clinics, ranging from single study sites to 109 oncology clinics. Sample sizes ranged from 33 to 4844 patients. All studies had a sample population with a mean/median age of ≥65 years, however, only two studies focused specifically on older populations. Interventions most commonly involved patient education (n=6), and were delivered by pharmacists or nurses. Five studies referred to the intervention development process and no studies reported any theoretical underpinning. Three studies reported on prescribing-related outcomes and seven studies reported on adherence-related outcomes, using different terminology and a range of assessments. Prescribing-related outcomes comprised assessments of medication appropriateness (using Beers criteria), drug-related problems and drug interactions. Adherence-related outcomes included assessments of self-reported medication adherence and calculation of patients’ medication possession ratio. Conclusion The main strength of this scoping review is that it provides a broad overview of the existing literature on interventions aimed at optimising medication prescribing and adherence in older adults with cancer. The review highlights a lack of robust studies specifically targeting this patient population and limited scope to pool outcome data across included studies. Limitations of the review were that searches were restricted to English language publications and no grey literature was searched. Future research should focus specifically on older patients with cancer, and exercise rigour during intervention development, evaluation and reporting in order to generate findings that could inform future practice. References 1. Maggiore RJ, Gross CP, Hurria A. Polypharmacy in older adults with cancer. The oncologist. 2010;15(5):507–22. 2. Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467–73.

scholarly journals A Qualitative Exploration of Perceptions of a Digital Intervention to Promote Physical Activity in Older Adults

2020 ◽  
pp. 1-13
Author(s):  
Sebastien Pollet ◽  
James Denison-Day ◽  
Katherine Bradbury ◽  
Rosie Essery ◽  
Elisabeth Grey ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Qualitative Analysis ◽  
Intrinsic Motivation ◽  
Cognitive Load ◽  
Physical Activity Intervention ◽  
Qualitative Interviews ◽  
Intervention Development ◽  
Web Based ◽  
Qualitative Exploration

Purpose: This study explored participant views of a web-based physical activity intervention for older adults and examined how they resonate with the key principles that guided intervention development. Methods: Qualitative interviews were carried out with 52 older adults. A deductive qualitative analysis approach was taken, based around the intervention’s key principles. Results: Participants expressed mostly positive views of the intervention features, broadly confirming the appropriateness of the key principles, which were to: (a) encourage intrinsic motivation for physical activity, (b) minimize the risk of users receiving activity suggestions that are inappropriate or unsafe, (c) offer users choice regarding the activities they engage with and build confidence to undertake more activity, and (d) minimize the cognitive load and need to engage with the intervention website. The findings also identified ways in which content could be improved to further increase acceptability. Conclusion: This study illustrates how using the person-based approach has enabled the identification and implementation of features that older adults appreciate.

Pedometer-assessed steps per day as a predictor of cognitive performance in older adults.

2018 ◽  
Vol 32 (8) ◽  
pp. 941-949 ◽  
Author(s):  
Matthew Calamia ◽  
Alyssa De Vito ◽  
John P. K. Bernstein ◽  
Daniel S. Weitzner ◽  
Owen T. Carmichael ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Performance ◽  
Steps Per Day

scholarly journals Older workers imagining retirement: the collapse of agency, or freedom at last?

2021 ◽  
pp. 1-19
Author(s):  
Anne Skevik Grødem ◽  
Ragni Hege Kitterød
Keyword(s):  
Older Adults ◽  
Old Age ◽  
Older Workers ◽  
Qualitative Interviews ◽  
Social Meaning ◽  
Active Engagement ◽  
Work Patterns ◽  
Ideal Types ◽  
Retirement Decisions ◽  
The Ideal

Abstract Images of what retirement is and ought to be are changing. Older workers are being encouraged to work for longer, at the same time, older adults increasingly voice expectations of a ‘third age’ of active engagement and new life prospects. In this article, we draw on the literature on older workers’ work patterns and retirement transitions (noting push/pull/stay/stuck/jump factors), and on scholarship on the changing social meaning of old age, most importantly the notions of a ‘third’ and ‘fourth’ age. The analysis is based on qualitative interviews with 28 employees in the private sector in Norway, aged between 55 and 66 years. Based on the interviews, we propose three ideal-typical approaches to the work–retirement transition: ‘the logic of deadline’, ‘the logic of negotiation’ and ‘the logic of averting retirement’. The ideal-types are defined by the degree to which informants assume agency in the workplace, their orientation towards work versus retirement and the degree to which they expect to exercise agency in retirement. We emphasise how retirement decisions are informed by notions of the meaning of ageing, while also embedded in relationships with employers and partners.

scholarly journals Service providers’ use of harm reduction approaches in working with older adults experiencing abuse: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Donna Goodridge ◽  
Kerstin Stieber Roger ◽  
Christine A. Walsh ◽  
Elliot PausJenssen ◽  
Marina Cewick ◽  
...  
Keyword(s):  
Older Adults ◽  
Harm Reduction ◽  
Professional Practice ◽  
Service Provision ◽  
Service Providers ◽  
Qualitative Interviews ◽  
Risk Environment ◽  
Intervention Process ◽  
Process Enactment ◽  
Humanistic Approach

Abstract Background Although abuse experienced by older adults is common and expected to increase, disclosure, reporting and interventions to prevent or mitigate abuse remain sub-optimal. Incorporating principles of harm reduction into service provision has been advocated as a strategy that may improve outcomes for this population. This paper explores whether and how these principles of harm reduction were employed by professionals who provide services to older adults experiencing abuse. Methods Thematic analysis of qualitative interviews with 23 professionals providing services to older adults experiencing abuse across three Western provinces of Canada was conducted. Key principles of harm reduction (humanism, incrementalism, individualism, pragmatism, autonomy, and accountability without termination) were used as a framework for organizing the themes. Results Our analysis illustrated a clear congruence between each of the six harm reduction principles and the approaches reflected in the narratives of professionals who provided services to this population, although these were not explicitly articulated as harm reduction by participants. Each of the harm reduction principles was evident in service providers’ description of their professional practice with abused older adults, although some principles were emphasized differentially at different phases of the disclosure and intervention process. Enactment of a humanistic approach formed the basis of the therapeutic client-provider relationships with abused older adults, with incremental, individual, and pragmatic principles also apparent in the discourse of participants. While respect for the older adult’s autonomy figured prominently in the data, concerns about the welfare of the older adults with questionable capacity were expressed when they did not engage with services or chose to return to a high-risk environment. Accountability without termination of the client-provider relationship was reflected in continuation of support regardless of the decisions made by the older adult experiencing abuse. Conclusions Harm reduction approaches are evident in service providers’ accounts of working with older adults experiencing abuse. While further refinement of the operational definitions of harm reduction principles specific to their application with older adults is still required, this harm reduction framework aligns well with both the ethical imperatives and the practical realities of supporting older adults experiencing abuse.

scholarly journals The Benefits of Physical Activity in Individuals with Cardiovascular Risk Factors: A Longitudinal Investigation Using fNIRS and Dual-Task Walking

2021 ◽  
Vol 10 (4) ◽  
pp. 579
Author(s):  
Deborah Talamonti ◽  
Thomas Vincent ◽  
Sarah Fraser ◽  
Anil Nigam ◽  
Frédéric Lesage ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Older Adults ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cognitive Performance ◽  
Dual Task ◽  
Gait Speed ◽  
Regular Physical Activity ◽  
Cortical Response

Cardiovascular fitness is linked to better executive functions, preserved gait speed, and efficient cortical activity. Older adults with cardiovascular risk factors (CVRFs) typically show poor cognitive performance, low physical fitness, and altered brain functioning compared with healthy individuals. In the current study, the impact of regular physical activity on cognition, locomotion, and brain functions was explored in a cohort of older adults with low or high CVRFs. Cortical activation of the frontal areas was investigated using functional Near-Infrared Spectroscopy (fNIRS) at baseline, at 6 months and at 12 months. Evoked cortical response and behavioral performance were assessed using the dual-task walking paradigm, consisting of three conditions: single cognitive task (2-back task), single walking task (walking), and dual-task (2-back whilst walking). Results show greater task-related cortical response at baseline in individuals with high CVRFs compared to those with low CVRFs. Moreover, participants with high CVRFs benefitted the most from participating in regular physical activity, as their cortical response decreased at the 12-month follow-up and became comparable to that of participants with low CVRFs. These changes were observed in conjunction with improved cognitive performance and stable gait speed throughout the 12-month period in both groups. Our findings provide evidence that participation in regular physical activity may be especially beneficial in individuals with CVRFs by promoting brain and cognitive health, thus potentially contributing to prevention of cognitive decline. Future research may explore whether such effects are maintained in the long-term in order to design ad-hoc interventions in this specific population.

Sign in / Sign up

Export Citation Format

Share Document