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

Article type: Research Article

Authors: Cox, Kay L.^{a; b; *} | Clare, Linda^c | Cyarto, Elizabeth V.^{d; e; f} | Ellis, Kathryn A.^{d; g} | Etherton-Beer, Christopher^{a; b} | Southam, Jenny^d | Ames, David^{d; h} | Flicker, Leon^{a; b} | Almeida, Osvaldo P.^{a; b} | LoGiudice, Dinaⁱ | Liew, Danny^j | Vlaskovsky, Philip^k | Lautenschlager, Nicola T.^{b; d; l}

Affiliations: [a] Medical School, University of Western Australia, Perth, Australia | [b] Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Australia | [c] Centre for Research in Ageing and Cognitive Health, College of Medicine and Health, University ofExeter, UK | [d] Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia | [e] Bolton Clarke Research Institute, Brisbane, Australia | [f] Faculty of Health and Behavioural Sciences, The University of Queensland, Qld, Australia | [g] Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia | [h] St George’s Hospital, Kew, Victoria, Australia | [i] Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia | [j] School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia | [k] Royal Perth Hospital Research Foundation Biostatistical Unit, Perth, Australia | [l] North Western Mental Health, Royal Melbourne Hospital, Melbourne, Australia

Correspondence: [*] Correspondence to: Kay L. Cox, Medical School (Royal Perth Hospital Unit), University of Western Australia, Rear 50 Murray Street, Perth, 6000, Western Australia. Tel.: +61 8 92240237; E-mail: kay.cox@uwa.edu.au.

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.

Keywords: Aged, cognitive dysfunction, exercise, goals, mentors, physical fitness, sedentary behavior, volunteers

DOI: 10.3233/JAD-210479

Journal: Journal of Alzheimer's Disease, vol. 84, no. 1, pp. 207-226, 2021