A randomized controlled trial into the cognitive effects of a computer-tailored physical activity intervention in older adults with chronic disease(s)

Esmee Volders,Renate H M De Groot,Lilian Lechner,Catherine A W Bolman,Juul M J Coumans

doi:10.1186/s11556-021-00259-9

Esmee Volders, Renate H M De Groot + Show 3 more

Open Access

https://doi.org/10.1186/s11556-021-00259-9

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Abstract

BackgroundCognitive functioning (CF) is important for wellbeing and an independent life. However, older adults with chronic diseases are at a higher risk of poorer CF levels. Although, research suggests that physical activity (PA) could play an essential role in maintaining good CF, older adults with chronic diseases have low levels of PA. PA interventions to prevent cognitive decline for this specific group exist. Yet, until now these interventions focused on a single specific chronic disease. Active Plus is a proven effective computer-tailored PA stimulating intervention focused on increasing PA in daily life for the older adult population suffering from a broad range of chronic diseases. This study tests the cognitive effects of Active Plus in older adults with chronic diseases.MethodsIn this RCT older adults with at least one chronic disease (≥65 years) were allocated to the intervention group (N = 260, mean age = 74.2) or waiting list control group (N = 325, mean age = 74.5). In total, intervention group participants received three times computer-tailored PA stimulating advice within four months (i.e., at baseline, after two months, and after three to four months). The online and print delivered advice were tailored to the specific needs and wishes of the participant and focused on incorporating PA in daily life. Baseline and follow-up measurements of the CF verbal memory (Verbal Learning Test), shifting (Trailmaking Test), inhibition (Stop-signal Task) and processing speed (Letter Digit Substitution Test) were assessed after six and 12 months. Intervention effects were analyzed with multilevel linear mixed-effects models adjusted for the clustered design and confounding variables.ResultsThe dropout rate was 19.1% after 6 months and 25.1% after 12 months. Although both conditions improved on all verbal memory outcomes after 6 months, and all CF outcomes except inhibition after 12 months, no intervention effects were found, not even in subgroups (p > .05).ConclusionsTo our knowledge this is the first study to test the cognitive effects of a computer-tailored PA stimulating intervention in older adults suffering from a broad range of chronic diseases. The effects of the Active Plus intervention were not strong enough to improve CF or prevent cognitive decline. A blended approach, in which this computer-tailored intervention is combined with a face-to-face PA intervention and / or cognitive training, might be a good suggestion to increase the effects of Active Plus on PA and CF in older adults with chronic diseases.Trial registrationNetherlands Trial Register NL6005; Date of Registration 03-21-2017; https://www.trialregister.nl/trial/6005

Highlights

Cognitive functioning (CF) is important for wellbeing and an independent life
(2021) 18:3 (Continued from previous page) training, might be a good suggestion to increase the effects of Active Plus on physical activity (PA) and CF in older adults with chronic diseases
150 min of moderate-to-vigorous physical activity (MVPA) per week their CF test scores over time, there were no effects of the Active Plus intervention on the assessed domains of CF, nor did we find any cognitive effects of the intervention in subgroups of older adults with chronic diseases

Summary

Introduction

Cognitive functioning (CF) is important for wellbeing and an independent life. older adults with chronic diseases are at a higher risk of poorer CF levels. Largest declines in CF are seen in the executive functions (working memory, inhibition, shifting) and processing speed [1, 4] These functions are necessary to learn, understand and perform complex daily actions [2], and important for wellbeing and an independent life [1]. To a socially integrated network and cognitive challenging leisure activities, regular physical activity (PA) is the factor with highest potential to slow down the rate of cognitive decline and to prevent dementia [5,6,7] These claims are supported by reviews combining different types of research (e.g., cross-sectional studies, animal studies, intervention studies, etc.) on the protective effect of PA on cognitive decline [8,9,10]. Improvements in processing speed and long-term memory have been demonstrated as well in older adults [14]

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