Feasibility of a Synchronous, Remoted‐Delivered, Aerobic Exercise Training Program in Rural‐Dwelling Adults with Subjective Cognitive Decline ‐ The MN RIDE Pilot

Abstract

AbstractBackgroundSubjective cognitive decline (SCD), the subjective experience of worsening memory or cognition, is one of the earliest noticeable symptoms of Alzheimer’s disease and related dementias (ADRD), and offers a therapeutic window where interventions have strong potential to prevent or delay the progression to the ADRD. Out of all the modifiable risk factors for ADRD, physical inactivity is the strongest; therefore, it is no surprise that exercise is linked to a 30‐40% risk reduction for ADRD, with moderate intensity being the most beneficial. Rural communities have greater barriers in participating in exercise due to lack of social support, travel/weather problems, and lack of facilities/equipment. The purpose of this pilot study was to implement and evaluate the feasibility of a synchronous, remoted‐delivered, aerobic exercise (AEx) training program in persons with SCD living in rural areas.MethodThe MN RIDE Pilot Study employed a single group, pre‐posttest design. Participants were shipped all needed equipment to complete the intervention (cycle, heart rate monitors, etc.). All AEx sessions were supervised remotely via smart devices and Zoom® by an exercise physiologist. AEx was prescribed as progressive, moderate‐intensity cycling for 20‐50 minutes, 3 times/week for 3 months (36 sessions). Intensity was evaluated using the Borg Rating of Perceived Exertion (RPE) 6‐20 scale and heart rate max (HRmax) methods. Moderate intensity was defined as RPE 13 and HRmax 64‐76%. Feasibility was assessed by session attendance, intensity adherence, and presence of adverse events.ResultThe average age of the study sample (n = 9) was 57.44±7.16 years old (average age of SCD onset 53.44 [7.47] years old) with 14.00±5.57 years of education and 77.8% female. Out of the possible 324 sessions scheduled, 276 were attended (86% session adherence). Average intensity metrics achieved over the AEx sessions were 13.2 (0.5) and 72.0 (7.9) for RPE and HRmax respectively. No adverse events were reported.ConclusionOur study provides preliminary evidence of the feasibility of AEx telerehabilitation program designed to reduced ADRD risk in persons with SCD living in underserved rural communities. AEx telerehabilitation in rural communities should be further explored given AEx’s potential to reduce ADRD risk.