Qualitative Evaluation Informs Understanding of Motor Cognition and Therapies in Older Adults with Mild Cognitive Impairment

Article type: Research Article

Authors: Lazris, David^a | Perkins, Molly M.^{a; b; c; d} | Bay, Allison A.^a | Hackney, Madeleine E.^{a; b; c; e; *}

Affiliations: [a] Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA | [b] Birmingham/Atlanta VA Geriatric Research, Education and Clinical Center (GRECC), Atlanta, GA, USA | [c] Emory University School of Nursing, Atlanta, GA, USA | [d] Emory University, Department of Sociology, Atlanta, GA, USA | [e] Atlanta VA Center for Visual and Neurocognitive Rehabilitation, Atlanta, GA, USA

Correspondence: [*] Correspondence to: Madeleine E. Hackney, PhD, Associate Professor, Department of Medicine, Division of Geriatrics and Gerontology; Research Health Scientist, Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, 1841 Clifton Rd. NE #553, Atlanta, GA 30324, USA. E-mails: mehackn@emory.edu; madeleine.hackney@gmail.com.

Abstract: Background:10%to 20%of Americans aged 65 and older have mild cognitive impairment (MCI) with 10%progressing to Alzheimer’s disease (AD) each year. Underserved groups, including African Americans (AAs), are among the most vulnerable to MCI and AD. Although evidence continues to amass, the benefits of exercise and movement for AD is still understudied in AD. Objective:Understanding the attitudes, perceptions, and beliefs about motor-cognitive integration and examining the physical activity of a sample of predominantly Black women community members with self-reported memory problems will allow improved recruitment and refinement of multimodal interventions designed to improve motor-cognitive and cognitive function. Methods:We conducted focus groups with older adults who reported subjective memory complaints (n = 15; Black: n = 12, White: n = 3, mean age 71.7±5.8). Results:Findings from thematic analysis showed most participants knew of benefits of exercise. However, most participants reported not getting adequate exercise due to factors such as pain, increased responsibilities, and fear of injury. Despite barriers, participants expressed enthusiasm for multimodal interventions designed to target body and brain health and provided several suggestions to improve or enhance the proposed interventions. Conclusion:Results provide useful insights regarding improving participation among historically under-represented groups in clinical movement-based research. Participants’ discussion focused primarily on the way motor-cognitive integration prevents falls, maintains memory, and provides a social benefit. The reported perceived benefits and limitations of exercise, as this population understands it, can help researchers and physicians better engage the community for lifestyle changes that will support greater motor-cognitive health.

Keywords: Alzheimer’s disease, cognitive impairment, exercise, motor cognition, older adults, patient engagement, patient’s perspective

DOI: 10.3233/JAD-210617

Journal: Journal of Alzheimer's Disease, vol. 84, no. 2, pp. 691-703, 2021