Feasibility of a Memory Clinic-Based Physical Activity Prescription Program.

BACKGROUND Effective programs for promoting physical activity are needed for those with cognitive impairment. OBJECTIVE To test the feasibility of mobile Health (mHealth) technology-supported physical activity prescription from a tertiary care memory clinic. METHODS This feasibility study was designed as a 16-week randomized, crossover trial of a physical activity prescription: 8 weeks of intervention, 8 weeks of baseline or maintenance phase data collection. We recruited 2 cohorts: 21 individuals with Alzheimer-related cognitive impairment (mean age 72.3 (5.2), 9 females), and 9 individuals with normal cognition (mean age 69.6 (5.8), 8 females). We gave each cohort an mHealth accelerometer-based physical activity prescription to double number of steps taken. Our primary outcomes were feasibility and safety. Our secondary outcomes were change in weekly steps taken, Dementia Quality of Life Scale, Self-efficacy Scale, 6-minute Walk, and mini-Physical Performance Test. RESULTS Set-up and use of the device was not a barrier to participation. However, only 62% of participants with cognitive impairment completed the intervention. The cohort with cognitive impairment did not change their weekly step count above Week 1. All participants in the cohort with normal cognition were able to set up and use their device and increased their weekly step count above Week 1. There were no differences between Week 1 and Week 8 for any secondary measures in either cohort. CONCLUSIONS Setup and daily use of mHealth technology appears to be feasible for a person with cognitive impairment with the help of a partner, but increasing daily step counts over 8 weeks was not achieved. Future work needs to assess alternative activity prescription goals or additional support for patients and their partners.

[1]  Bambang Parmanto,et al.  Perspectives on the Evolution of Mobile (mHealth) Technologies and Application to Rehabilitation , 2014, Physical Therapy.

[2]  B. Dobkin Wearable motion sensors to continuously measure real-world physical activities. , 2013, Current opinion in neurology.

[3]  E. Vidoni,et al.  Measuring Physical Activity in Older Adults With and Without Early Stage Alzheimer's Disease , 2013, Clinical gerontologist.

[4]  N. Anokye,et al.  Physical activity and health related quality of life , 2012, BMC Public Health.

[5]  G. Schofield,et al.  Healthy Steps Trial: Pedometer-Based Advice and Physical Activity for Low-Active Older Adults , 2012, The Annals of Family Medicine.

[6]  J. Baker,et al.  Successful aging: how does physical activity influence engagement with life? , 2012, European Review of Aging and Physical Activity.

[7]  S. Billinger,et al.  Cardiorespiratory response to exercise testing in individuals with Alzheimer's disease. , 2011, Archives of physical medicine and rehabilitation.

[8]  Nick C Fox,et al.  The diagnosis of mild cognitive impairment due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer's disease , 2011, Alzheimer's & Dementia.

[9]  J. Morris,et al.  The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer's disease , 2011, Alzheimer's & Dementia.

[10]  Robert W Motl,et al.  Physical activity, disability, and quality of life in older adults. , 2010, Physical medicine and rehabilitation clinics of North America.

[11]  W. Brooks,et al.  Reduced lean mass in early Alzheimer disease and its association with brain atrophy. , 2010, Archives of neurology.

[12]  J. Morris,et al.  A brief clinical tool to assess physical function: the mini-physical performance test. , 2010, Archives of gerontology and geriatrics.

[13]  What evidence exists to describe the effect of interventions that use pedometers to reduce risk for and manage chronic disease ? , 2010 .

[14]  Glen E Duncan,et al.  Effects of aerobic exercise on mild cognitive impairment: a controlled trial. , 2010, Archives of neurology.

[15]  W. van Mechelen,et al.  Feasibility and effectiveness of a walking program for community-dwelling older adults with mild cognitive impairment. , 2009, Journal of aging and physical activity.

[16]  S. Marshall,et al.  Effect of Pedometer-Based Physical Activity Interventions , 2009, Research quarterly for exercise and sport.

[17]  Making physical activity accessible to older adults with memory loss: a feasibility study. , 2009, The Gerontologist.

[18]  Maria E Fernandez,et al.  How we design feasibility studies. , 2009, American journal of preventive medicine.

[19]  P. Harris,et al.  Research electronic data capture (REDCap) - A metadata-driven methodology and workflow process for providing translational research informatics support , 2009, J. Biomed. Informatics.

[20]  Nathaniel Mercaldo,et al.  The Alzheimer's Disease Centers' Uniform Data Set (UDS): The Neuropsychologic Test Battery , 2009, Alzheimer disease and associated disorders.

[21]  W. Brooks,et al.  Bone density and brain atrophy in early Alzheimer's disease. , 2009, Journal of Alzheimer's disease : JAD.

[22]  B. Harrison,et al.  Caregiver burden among dementia patient caregivers: A review of the literature , 2008, Journal of the American Academy of Nurse Practitioners.

[23]  Y. Rolland,et al.  Physical activity and Alzheimer's disease: from prevention to therapeutic perspectives. , 2008, Journal of the American Medical Directors Association.

[24]  A. Lucia,et al.  Exercise training is beneficial for Alzheimer's patients. , 2008, International journal of sports medicine.

[25]  Abby C King,et al.  A Lifestyle Physical Activity Intervention for Caregivers of Persons With Alzheimer's Disease , 2008, American journal of Alzheimer's disease and other dementias.

[26]  W. Mechelen,et al.  Walking or vitamin B for cognition in older adults with mild cognitive impairment? A randomised controlled trial , 2008, British Journal of Sports Medicine.

[27]  I. Olkin,et al.  Using pedometers to increase physical activity and improve health: a systematic review. , 2007, JAMA.

[28]  R. Tappen,et al.  Effect of Exercise on Mood in Nursing Home Residents With Alzheimer's Disease , 2007, American journal of Alzheimer's disease and other dementias.

[29]  A. King,et al.  Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. , 2007, Medicine and science in sports and exercise.

[30]  W. van Mechelen,et al.  The effect of walking and vitamin B supplementation on quality of life in community-dwelling adults with mild cognitive impairment: a randomized, controlled trial , 2007, Quality of Life Research.

[31]  Barbara Williams,et al.  The Rapid Assessment of Physical Activity (RAPA) Among Older Adults , 2006, Preventing chronic disease.

[32]  B E Ainsworth,et al.  How many days of pedometer monitoring predict weekly physical activity in adults? , 2005, Preventive medicine.

[33]  R. West,et al.  Neural correlates of cognitive control and conflict detection in the Stroop and digit-location tasks , 2003, Neuropsychologia.

[34]  A. LaCroix,et al.  Exercise plus behavioral management in patients with Alzheimer disease: a randomized controlled trial. , 2003, JAMA.

[35]  J. Koval,et al.  Can primary care doctors prescribe exercise to improve fitness? The Step Test Exercise Prescription (STEP) project. , 2003, American journal of preventive medicine.

[36]  Laura E. Gibbons,et al.  Assessing Quality of Life in Older Adults With Cognitive Impairment , 2002, Psychosomatic medicine.

[37]  ATS statement: guidelines for the six-minute walk test. , 2002, American journal of respiratory and critical care medicine.

[38]  William Rakowski,et al.  Physician-based physical activity counseling for middle-aged and older adults: A randomized trial , 1999, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[39]  A. Stewart,et al.  Conceptualization and measurement of quality of life in dementia: the dementia quality of life instrument (DQoL). , 1999, The Gerontologist.

[40]  B. Swinburn,et al.  The green prescription study: a randomized controlled trial of written exercise advice provided by general practitioners. , 1998, American journal of public health.

[41]  A. Stewart,et al.  Evaluation of champs, a physical activity promotion program for older adults , 1997, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[42]  R. Schulz,et al.  Preventive health behaviors among spousal caregivers. , 1997, Preventive medicine.

[43]  Rejeski Wj,et al.  Physical Activity and Health‐related Quality of Life , 1996, Exercise and sport sciences reviews.

[44]  M. Johnston,et al.  Measures in Health Psychology: A User's Portfolio , 1995 .