P de Souto Barreto, K Pothier, G Soriano, M Lussier, L Bherer, S Guyonnet, A Piau, P-J Ousset, B Vellas
Journal: The journal of prevention of Alzheimer's disease 2021;8(2):142-150
PMID: 33569560
In recent years, the multidomain strategy, an approach characterised by the combination of several lifestyle interventions, have received increasing attention. The main aim of this study was to describe the feasibility and acceptability of a 6-month randomised controlled trial (RCT) of a web-based multidomain lifestyle training intervention for community-dwelling older people with spontaneous memory complaint. A secondary objective was to test the effects of the intervention on both function and lifestyle-related outcomes. This study (eMIND) is a 6-month pilot, parallel-arm, RCT of a multidomain lifestyle intervention composed of cognitive training, exercise training, and nutritional advice, among community-dwelling older adults. Participants were randomly assigned to one of the two arms: multidomain intervention group (MIG) or control group (CG). Results show that study procedures were well-accepted, but expectations regarding participant’s adherence to the intervention were not met, particularly for exercise. Moreover, compared to the CG, participants of the MIG have improved their health-related quality of life at the end of the 6-month intervention. Authors conclude that implementing a web-based multidomain lifestyle-training platform accessible to a large number of older people could have a major positive impact in a public health perspective.
UNLABELLED
Importance/Objective: To describe the feasibility and acceptability of a 6-month web-based multidomain lifestyle training intervention for community-dwelling older people and to test the effects of the intervention on both function- and lifestyle-related outcomes.
DESIGN
6-month, parallel-group, randomized controlled trial (RCT).
SETTING
Toulouse area, South-West, France.
PARTICIPANTS
Community-dwelling men and women, ≥ 65 years-old, presenting subjective memory complaint, without dementia.
INTERVENTION
The web-based multidomain intervention group (MIG) received a tablet to access the multidomain platform and a wrist-worn accelerometer measuring step counts; the control group (CG) received only the wrist-worn accelerometer. The multidomain platform was composed of nutritional advices, personalized exercise training, and cognitive training. Main outcomes and measures: Feasibility, defined as the proportion of people connecting to ≥75% of the prescribed sessions, and acceptability, investigated through content analysis from recorded semi-structured interviews. Secondary outcomes included clinical (eg, cognitive function, mobility, health-related quality of life (HRQOL)) and lifestyle (eg, step count, food intake) measurements.
RESULTS
Among the 120 subjects (74.2 ±5.6 years-old; 57.5% women), 109 completed the study (n=54, MIG; n=55, CG). 58 MIG subjects connected to the multidomain platform at least once; among them, adherers of ≥75% of sessions varied across multidomain components: 37 people (63.8% of 58 participants) for cognitive training, 35 (60.3%) for nutrition, and three (5.2%) for exercise; these three persons adhered to all multidomain components. Participants considered study procedures and multidomain content in a positive way; the most cited weaknesses were related to exercise: too easy, repetitive, and slow progression. Compared to controls, the intervention had a positive effect on HRQOL; no significant effects were observed across the other clinical and lifestyle outcomes.
CONCLUSIONS AND RELEVANCE
Providing multidomain lifestyle training through a web-platform is feasible and well-accepted, but the training should be challenging enough and adequately progress according to participants' capabilities to increase adherence. Recommendations for a larger on-line multidomain lifestyle training RCT are provided.
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