Abstract
BackgroundOne in four older adults in Denmark and almost half of the very old above 75 do not meet the World Health Organization’s recommendations for a minimum of physical activity (PA). A cost-efficient and effective way to increase focus on and motivation for daily walking might be to use Physical Activity Monitors (PAMs) in combination with behavioural change intervention. Thus, the objective of this randomized controlled study was to investigate the effect of Motivational Interviewing (MI) as an add-on intervention to a PAM-based intervention measured in community-dwelling older adults.MethodsThis two-arm parallel group randomized controlled effectiveness trial compared a 12-weeks PAM-based intervention with additional MI (PAM+MI group) with a PAM-based intervention alone (PAM group). The primary outcome, average daily step count, was analysed with a linear regression model, adjusted for sex and baseline daily step count. Following the intention-to-treat principle, multiple imputation based on baseline step count, sex and age was performed.ResultsIn total, 38 participants were randomized to the PAM intervention and 32 to the PAM+MI intervention arm. During the intervention period, PAM+MI participants walked on average 909 more steps per day than PAM participants, however insignificant (95%CI: − 71; 1889) and reported 2.3 points less on the UCLA Loneliness Scale (95%CI: − 4.5; − 1.24).ConclusionThe use of MI, in addition to a PAM-based intervention among older adults in PA promoting interventions hold a potential clinically relevant effect on physical activity and should thus be investigated further with adequately powered RCTs.Trial registrationThis study was pre-registered in the clinicaltrials.gov database with identifier: NCT03906162.
Highlights
More than 50% of the European older adults are insufficiently physically active [1]
As walking has been shown to be the most frequent physical activity (PA) modality among older adults [10] and daily step counts to be highly associated with all-cause mortality and cardiovascular disease-morbidity [11], large scale PA programs should include focus on increasing the level of walking in exercising and the amount of walking in ambulant activities
It was chosen to adjust for baseline daily step count to increase the generalizability of the results if any imbalance should have been present after the randomization process
Summary
Background and objectives More than 50% of the European older adults are insufficiently physically active [1]. Higher levels of physical activity (PA) among older adults are associated with positive healthrelated outcomes, including lower levels of frailty [2] and lower levels of all-cause mortality [3]. Inactivity among [1] older adults are associated with higher levels of non-communicable diseases, lower functional health, higher risk of depression and cognitive decline [4,5,6]. As walking has been shown to be the most frequent PA modality among older adults [10] and daily step counts to be highly associated with all-cause mortality and cardiovascular disease-morbidity [11], large scale PA programs should include focus on increasing the level of walking in exercising and the amount of walking in ambulant activities. The objective of this randomized controlled study was to investigate the effect of Motivational Interviewing (MI) as an add-on intervention to a PAM-based intervention measured in community-dwelling older adults
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