A Randomized Controlled Trial on the Effects of a 6-Month Home-Based Physical Activity Program with Individual Goal-Setting and Volunteer Mentors on Physical Activity, Adherence, and Physical Fitness in Inactive Older Adults at Risk of Cognitive Decline: The INDIGO Study.

Kay L Cox, Linda Clare, Elizabeth V Cyarto, Kathryn A Ellis, Christopher Etherton-Beer, Jenny Southam, David Ames, Leon Flicker, Osvaldo P Almeida, Dina LoGiudice, Danny Liew, Philip Vlaskovsky, Nicola T Lautenschlager

Journal: Journal of Alzheimer's disease : JAD 2022;84(1):207-226

PMID: 34511499

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Abstract

BACKGROUND

Increasing physical activity (PA) in those who have memory concerns requires innovative approaches.

OBJECTIVE

To compare in this randomized controlled trial (RCT) the effects on PA, adherence, and fitness of two approaches to deliver a 6-month home-based PA program in older, inactive individuals at risk of cognitive decline.

METHODS

Individuals (n = 52) aged 60-85 years, inactive with mild cognitive impairment or subjective cognitive decline were recruited from the community and memory clinics. Randomization was to 6 months of 150 min/week moderate intensity PA with either: goal-setting with mentor support; or education and peer contact. A subset of participants (n = 36) continued for a further 6 months. PA, moderate and vigorous PA, and secondary outcomes, fitness, goal performance/satisfaction and self-efficacy were assessed at baseline, 6 and 12 months. Modelling of primary and secondary outcomes was conducted with linear mixed models.

RESULTS

Participants were mean age (±sd) 70.1 (6.4) years. Six-month retention was 88.5%(n = 46). No significant between-group differences were observed for PA or fitness. Post-hoc combined group data showed a significant, moderate-large effect size increase in PA with time. PA increased by a mean 1,662 (943, 2383) steps/day (95%CI) and 1,320 (603, 2037) steps/day at 6 and 12 months (p < 0.001). Median (quartiles Q1-Q3) 6 and 6-12 month combined group adherence was 88.9 (74.4-95.7)%and 84.6 (73.9-95.4)%respectively.

CONCLUSION

In this target group, no differences were detected between groups both intervention strategies were highly effective in increasing PA and fitness.

Address: Medical School, University of Western Australia, Perth, Australia.; Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Australia.; Centre for Research in Ageing and Cognitive Health, College of Medicine and Health, University ofExeter, UK.; Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.; Bolton Clarke Research Institute, Brisbane, Australia.; Faculty of Health and Behavioural Sciences, The University of Queensland, Qld, Australia.; Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.; Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia.; Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.; Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.; St George's Hospital, Kew, Victoria, Australia.; Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia.; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.; Royal Perth Hospital Research Foundation Biostatistical Unit, Perth, Australia.; Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Australia.; Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.; North Western Mental Health, Royal Melbourne Hospital, Melbourne, Australia.

DOI: 10.3233/JAD-210479

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MeSH Terms: Aged, Cognitive Dysfunction, Exercise, Female, Goals, Humans, Male, Mentors, Sedentary Behavior, Self Efficacy