Abstract
BackgroundPhysical activity not only is beneficial to a person’s health, but can also have a positive influence on cognitive functioning. However, elderly people with chronic illness(es) often do not meet the physical activity guidelines. Physical activity programs for the elderly exist, but these are often expensive and not easily accessible to the elderly with chronic illness(es). In addition, the beneficial effects of these physical activity programs on cognitive functioning have never been specifically tested in this target group. Hence, this randomized controlled trial aims to test whether Active Plus, a proven effective physical activity intervention, is able to improve the cognitive functioning of elderly people with chronic illness(es) or to slow down cognitive decline. In addition, it studies what kind of activity, intensity, duration and frequency of physical activity most strongly influence cognitive functioning.MethodsA randomized controlled trial is performed, comparing the Active Plus intervention group to a waiting list control group. In total 540 older adults (≥65 years) with at least one chronic illness that limits mobility are recruited from 7 municipalities. Comparable neighborhoods within a municipality are randomly allocated to the intervention or control group. Baseline and follow-up measurements after 6 and 12 months assess cognitive functioning and physical activity behavior, measured both objectively with an accelerometer and subjectively with a self-report questionnaire. Multilevel analyses are conducted to assess effects on cognitive functioning, including analyses on moderation effects for physical activity type, frequency, duration and intensity.DiscussionTo our knowledge this is the first study to investigate effectiveness of a physical activity program on cognitive functioning in elderly people suffering from a broad range of chronic illnesses. If proven effective Active Plus would be a very cost effective intervention not only to increase physical activity, but also to improve cognitive functioning or slow down cognitive decline. Up till now clear evidence is lacking on the kind of physical activity, intensity, duration and frequency needed to achieve cognitive benefits. By measuring both with accelerometers and self-report questionnaires we hope to gain insight in these processes.Trial registrationNederlands Trial Register NL6005; Date of Registration 21-03-2017.
Highlights
Physical activity is beneficial to a person’s health, but can have a positive influence on cognitive functioning
This paper describes the protocol for this objective and the other objectives below
Program on cognitive functioning (CF) in people aged 65 years or older who suffer from a broad range of chronic illness(es)
Summary
Study design The study is a parallel, two-group cluster-RCT with a waiting list control group and assessments at baseline, six and 12 months. After 6 months and 12 months participants are contacted again to make an appointment for the second and third measurement They wear the accelerometer device again, are visited at home to take the cognitive tests and complete a questionnaire. Waiting list control condition Participants allocated to the waiting list control condition do not have access to the personalized PA advises, the additional information, user forum or examples of PA exercises until the end of the 12 month study period As such, they have no access to any of the intervention features, and are encouraged to continue with their usual activities. Secondary outcomes Self-reliance is measured with the WHODAS II [68] This questionnaire is based on an international classification system and is used when assessing the level of functioning of a person with an emphasis on activities and participation level. The most appropriate procedure for handling missing data will be selected after inspecting the amount and pattern of missing data
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