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Drijver AJ, Reijneveld JC, Wesselman LMP, Klein M. A Web-Based Lifestyle Intervention Aimed at Improving Cognition in Patients With Cancer Returning to Work in an Outpatient Setting: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e22670. [PMID: 33900201 PMCID: PMC8111506 DOI: 10.2196/22670] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/20/2021] [Accepted: 02/16/2021] [Indexed: 01/19/2023] Open
Abstract
Background A high percentage of patients with cancer experience cognitive impairment after cancer treatment, resulting in a decreased health-related quality of life and difficulty returning to work. Consequently, there is a need for effective treatment options to improve cognitive functioning in these patients. In a healthy aging population, multidomain web-based lifestyle interventions have been found to be effective in preventing cognitive decline and improving cognitive functioning. Objective This study aims to investigate the feasibility and effectiveness of the web-based lifestyle intervention Mijn Fitte Brein (My Fit Brain [MFB]) on cognitive functioning in patients with cancer returning to work. Methods The study consists of a feasibility study (N=10), followed by a randomized controlled trial (RCT; N=220). Patients will be recruited by their occupational physicians after their return to work following cancer treatment. Mijn Fitte Brein is organized into 4-week cycles in which patients set a lifestyle goal using the Goal Attainment Scale, receive weekly tips and support, and finally evaluate whether they succeeded in achieving this goal. Lifestyle goals are based on 6 domains: physical exercise, diet, sleep, stress, alcohol use, and smoking. In the feasibility study, data on user experience (structured interview) and usability, assessed with the Post-Study System Usability Scale, will be collected and used to optimize Mijn Fitte Brein. In the RCT, patients will be randomized 1:1 between an intervention group and a control group. Patients will be assessed at baseline, 3 months, and 6 months. The primary outcome measure is subjective cognitive functioning, assessed with the Functional Assessment of Cancer Therapy–Cognitive Function (FACT-Cog). Secondary outcome measures are lifestyle, objective cognitive functioning, and work and psychosocial factors. Results Recruitment for the feasibility study has started in February 2020. As of July 2020, however, no patients have been enrolled (due to COVID-19 restrictions). The findings of the feasibility study will be used to optimize the Mijn Fitte Brein intervention. Enrollment for the RCT will continue when possible. The feasibility study will take 6 months (including making adjustments to the intervention), and the RCT will take 2 years. The final results are expected in 2024. The results of the feasibility study and the RCT will be published in peer-reviewed journals. Conclusions This is the first time the feasibility and efficacy of a multidomain web-based lifestyle intervention will be studied in patients with cancer. If Mijn Fitte Brein is found to be effective in decreasing cognitive complaints in these patients returning to work, it will be a promising treatment option because of being both affordable and accessible. Trial Registration Netherlands Trial Register NL8407; https://www.trialregister.nl/trial/8407 International Registered Report Identifier (IRRID) DERR1-10.2196/22670
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Affiliation(s)
- A Josephine Drijver
- Department of Neurology, Amsterdam UMC, Amsterdam, Netherlands.,Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Jaap C Reijneveld
- Department of Neurology, Amsterdam UMC, Amsterdam, Netherlands.,Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, Netherlands
| | - Linda M P Wesselman
- Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, Amsterdam, Netherlands.,Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Martin Klein
- Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Medical Psychology, Amsterdam UMC, Amsterdam, Netherlands
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2
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Klimova B, Dostalova R. The Impact of Physical Activities on Cognitive Performance among Healthy Older Individuals. Brain Sci 2020; 10:brainsci10060377. [PMID: 32560126 PMCID: PMC7349640 DOI: 10.3390/brainsci10060377] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/10/2020] [Accepted: 06/13/2020] [Indexed: 11/18/2022] Open
Abstract
The population is aging in developed countries. This aging process results in many changes, both physical and mental. Over the years, there has been a gradual decline in the level of cognitive functions closely related to the ageing process, which is most often connected with ageing diseases such as dementia. So far, pharmacological treatment has not yet been able to cure this neurological disorder. Health policies around the world seek to find alternative programs and strategies to help a healthy population prevent cognitive decline and prolong active life. One such strategy appears to be physical activity. The aim of this review is to discuss the impact of physical activity on cognitive performance among healthy older individuals. The methodology of this study is based on a systematic electronic literature search of available studies found in three databases: PubMed, Web of Science and Scopus. The findings suggest that any physical activity in older age seems to have a positive impact on the improvement of cognitive function. Furthermore, it appears that dancing, due to its multiple mechanisms, might have the biggest effect on the enhancement of cognitive performance in healthy older individuals. However, controlled clinical trials of physical activity intervention in older adults are rare. Therefore, further research in this area (particularly on the amount of physical activity, its intensity and type) is needed.
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Affiliation(s)
- Blanka Klimova
- Department of Applied Linguistics, Faculty of Informatics and Management, University of Hradec Kralove, Rokitanskeho 62, 50003 Hradec Kralove, Czech Republic
- Correspondence:
| | - Radka Dostalova
- Department of Physical Education and Sports, Faculty of Education, University of Hradec Kralove, Rokitanskeho 62, 50003 Hradec Kralove, Czech Republic;
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3
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Karsten MDA, van Oers AM, Groen H, Mutsaerts MAQ, van Poppel MNM, Geelen A, van de Beek C, Painter RC, Mol BWJ, Roseboom TJ, Hoek A. Determinants of successful lifestyle change during a 6-month preconception lifestyle intervention in women with obesity and infertility. Eur J Nutr 2019; 58:2463-2475. [PMID: 30076459 PMCID: PMC6689274 DOI: 10.1007/s00394-018-1798-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 07/26/2018] [Indexed: 01/01/2023]
Abstract
PURPOSE To identify demographic, (bio)physical, behavioral, and psychological determinants of successful lifestyle change and program completion by performing a secondary analysis of the intervention arm of a randomized-controlled trial, investigating a preconception lifestyle intervention. METHODS The 6-month lifestyle intervention consisted of dietary counseling, physical activity, and behavioral modification, and was aimed at 5-10% weight loss. We operationalized successful lifestyle change as successful weight loss (≥ 5% weight/BMI ≤ 29 kg/m2), weight loss in kilograms, a reduction in energy intake, and an increase in physical activity during the intervention program. We performed logistic and mixed-effect regression analyses to identify baseline factors that were associated with successful change or program completion. RESULTS Women with higher external eating behavior scores had higher odds of successful weight loss (OR 1.10, 95% CI 1.05-1.16). Women with the previous dietetic support lost 0.94 kg less during the intervention period (95% CI 0.01-1.87 kg). Women with higher self-efficacy reduced energy intake more than women with lower self-efficacy (p < 0.01). Women with an older partner had an increased energy intake (6 kcal/year older, 95% CI 3-13). A high stage of change towards physical activity was associated with a higher number of daily steps (p = 0.03). A high stage of change towards weight loss was associated with completion of the intervention (p = 0.04). CONCLUSIONS Determinants of lifestyle change and program completion were: higher external eating behavior, not having received previous dietetic support, high stage of change. This knowledge can be used to identify women likely to benefit from lifestyle interventions and develop new interventions for women requiring alternative support. TRIAL REGISTRATION The LIFEstyle study was registered at the Dutch trial registry (NTR 1530; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1530 ).
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Affiliation(s)
- Matty D A Karsten
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
- Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Anne M van Oers
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
- Department of Obstetrics and Gynecology, Medisch Spectrum Twente, Koningsplein 1, 7512 KZ, Enschede, The Netherlands
| | - Henk Groen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Meike A Q Mutsaerts
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Mireille N M van Poppel
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
- Institute of Sport Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria
| | - Anouk Geelen
- Division of Human Nutrition, Wageningen University and Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands
| | - Cornelieke van de Beek
- Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Rebecca C Painter
- Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Ben W J Mol
- Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Department of Obstetrics and Gynecology, School of Medicine, Monash University, Clayton Road, Melbourne, Australia
| | - Tessa J Roseboom
- Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Annemieke Hoek
- Department of Obstetrics and Gynecology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
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Wesselman LM, Hooghiemstra AM, Schoonmade LJ, de Wit MC, van der Flier WM, Sikkes SA. Web-Based Multidomain Lifestyle Programs for Brain Health: Comprehensive Overview and Meta-Analysis. JMIR Ment Health 2019; 6:e12104. [PMID: 30964438 PMCID: PMC6477576 DOI: 10.2196/12104] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 01/28/2019] [Accepted: 02/14/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The number of people living with dementia is increasing worldwide, mainly because of aging of the population. To date, there is no pharmaceutical intervention to delay or treat cognitive decline or dementia. As an estimated one-third of dementia cases might be attributable to modifiable lifestyle factors (such as cognitive and physical activity), multidomain lifestyle interventions are a promising way to maintain or improve brain health. Offering programs online would enable large-scale implementation. An overview of multidomain Web-based lifestyle programs for brain health would facilitate comparison and improvement of such programs to develop effective and sustainable interventions. OBJECTIVE This study aimed to (1) provide a comprehensive overview of Web-based multidomain lifestyle programs aimed at optimizing brain health in healthy adult populations and (2) describe the programs and targeted lifestyle factors, availability, and evaluation of adherence and user experience. In addition, a meta-analysis was performed to evaluate the effectiveness of these programs. METHODS Electronic databases (PubMed, EMBASE, and PsycINFO) were searched for Web-based lifestyle programs that were included when the program (1) aimed to optimize brain health, (2) focused on multiple lifestyle factors, (3) was completely Web-based (website, Web application or mobile app), (4) consisted of multiple sessions, and (5) focused on a healthy adult population. Program characteristics (target population, duration, frequency, tailoring, platform, and availability) and results of program evaluations (effectiveness, user evaluations, and adherence) were extracted and compared. Studies using a controlled design were included in a random-effects meta-analysis on the effectiveness on brain health outcomes. Study quality was assessed using the physiotherapy evidence database (PEDro) scale. RESULTS The electronic searches yielded 44 documents describing 14 Web-based lifestyle programs; physical and cognitive activities were targeted in all programs. Four programs (4/14, 29%) were publicly available and free of charge, whereas others were restricted to research settings (5/14, 36%), available after payment (1/14, 7%), or not available at all (2/14, 14%). User evaluations were reported for 8 (57%) of the 14 programs. Reported dropout of the intervention groups ranged from 2% to 52%. Overall, 3 studies evaluated the effectiveness of a program using a controlled design and were included in the meta-analysis (moderate-to-high quality). Pooled results showed a significant small-to-medium effect of the Web-based multidomain lifestyle interventions on outcome measures for brain health (global cognition score, subjective cognitive score, and lifestyle risk score; standard mean difference=0.45; 95% CI 0.12-0.78), with a high degree heterogeneity across studies (I2=75%; P=.02). CONCLUSIONS In total, 14 Web-based multidomain lifestyle programs aimed at optimizing brain health were found. The programs showed heterogeneity in both characteristics and effectiveness evaluation. Despite this heterogeneity, this meta-analysis suggests that Web-based lifestyle programs can positively influence brain health outcomes and have the potential to contribute to the prevention of dementia.
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Affiliation(s)
- Linda Mp Wesselman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Astrid M Hooghiemstra
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands.,Department of Medical Humanities, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Linda J Schoonmade
- University Library, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Marjolein Cj de Wit
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Sietske Am Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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Gentry MT, Lapid MI, Rummans TA. Geriatric Telepsychiatry: Systematic Review and Policy Considerations. Am J Geriatr Psychiatry 2019; 27:109-127. [PMID: 30416025 DOI: 10.1016/j.jagp.2018.10.009] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/12/2018] [Accepted: 10/12/2018] [Indexed: 01/02/2023]
Abstract
Telemental health (TMH) for older patients has the potential to increase access to geriatric specialists, reduce travel times for patients and providers, and reduce ever growing healthcare costs. This systematic review article examines the literature regarding psychiatric assessment and treatment via telemedicine for geriatric patients. English language literature was searched using Ovid Medline, PubMed, and PsycINFO with search terms including telemedicine, telemental health, aging, and dementia. Abstracts were reviewed for relevance based on inclusion criteria. Multiple study types were reviewed, including open label, qualitative and randomized controlled trial study designs. Data was compiled regarding participants, study intervention, and outcomes. 76 articles were included. TMH was shown to be feasible and well accepted in the areas of inpatient and nursing home consultation, cognitive testing, dementia diagnosis and treatment, depression in integrated and collaborative care models, and psychotherapy. There is limited data on cost-effectiveness of TMH in the elderly. This article will discuss the current barriers to broader implementation of telemedicine for geriatric patients including reimbursement from the Medicare program. Medicare reimbursement for telemedicine is limited to rural areas, which does not allow for the widespread development of telemedicine programs. All Medicare beneficiaries would benefit from increased access to telemedicine services, not only those living in rural areas. As many elderly and disabled individuals have mobility problems, home-based telemedicine services should also be made available. There are efforts in Congress to expand the coverage of these services under Medicare, but strong advocacy will be needed to ensure these efforts are successful.
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Affiliation(s)
- Melanie T Gentry
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.
| | - Maria I Lapid
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Teresa A Rummans
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
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Dam AEH, van Boxtel MPJ, Rozendaal N, Verhey FRJ, de Vugt ME. Development and feasibility of Inlife: A pilot study of an online social support intervention for informal caregivers of people with dementia. PLoS One 2017; 12:e0183386. [PMID: 28886056 PMCID: PMC5590823 DOI: 10.1371/journal.pone.0183386] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 08/03/2017] [Indexed: 11/23/2022] Open
Abstract
Background Informal caregivers of individuals with dementia have an increased risk to face social isolation due to progression of the disease. Online social media interventions might offer a new opportunity to increase access to social support and enhance positive interactions and openness in dementia care networks. Objective This explorative pilot study describes (1) the development of an online social support intervention Inlife, and (2) the evaluation of the feasibility of this intervention and the measurements to assess its effectiveness. Methods The Medical Research Council (MRC) framework guided the development of the online social support intervention. This is a stepwise approach that integrates potential users’ views with the development and validation of the program content. The program was developed by combining (1) individual caregiver interviews (n = 10), (2) focus group sessions with experts and web designers (n = 6), and (3) individual think-aloud tests (n = 2). Subsequently, a pilot study with informal caregivers was conducted (n = 25) to examine the program’s feasibility and preliminary effectiveness. Online self-report measures were completed at baseline and at four follow-up time points. Results In total, 23 participants completed the newly developed Inlife intervention. Despite the high number of low-active users (17/23, 73%), Inlife had a good feasibility score of 7.1 (range: 1–10). The Calendar and Timeline were used most frequently and contributed to better care coordination and positive interactions. Conclusions Although the Inlife platform received a sufficient feasibility rating, the uptake was not optimal. Therefore, the Inlife platform was adapted to limit the number of low-active users and improve user friendliness. Recommendations for additional treatment adherence were provided. The development according to the MRC framework and the sufficient feasibility rating of Inlife formed the basis for a future effectiveness study.
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Affiliation(s)
- Alieske E. H. Dam
- Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Martin P. J. van Boxtel
- Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Nico Rozendaal
- Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Frans R. J. Verhey
- Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Marjolein E. de Vugt
- Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- * E-mail:
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Wouters H, Aalbers T, Maessen MFH, Verbeek ALM, Rikkert MGMO, Kessels RPC, Hopman MTE, Eijsvogels TMH. Physical Activity and Cognitive Function of Long-Distance Walkers: Studying Four Days Marches Participants. Rejuvenation Res 2017; 20:367-374. [PMID: 28602152 DOI: 10.1089/rej.2016.1876] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Studies show physical activity to be beneficial for cognitive function. However, studies usually included individuals who were not particularly inclined to exercise. Following research among master athletes, we examined associations between physical activity and cognitive function in participants of the International Nijmegen Four Days Marches. These individuals are also inclined to exercise. On 4 consecutive days >40,000 participants walk a daily distance of 30-50 km (120-200 km or 75-125 miles in total). Four Days Marches participants and less active or inactive control participants from the Nijmegen Exercise Study were examined. Self-reported current and lifelong physical activities were quantified in Metabolic Equivalent of Task minutes/day, and training walking speed was estimated in km/h. Cognitive functioning in the domains of working memory, executive function, and visuospatial short-term memory was assessed using the validated Brain Aging Monitor. Data from 521 participants (mean age 54.7, standard deviation 12.9) showed neither positive associations between lifelong physical activity and working memory, executive function, and visuospatial short-term memory nor positive associations between current physical activity and cognitive functioning in these domains (p-values >0.05). However, a positive association between training walking speed and working memory was revealed (age adjusted β = 0.18, p-value <0.01). Walking speed as a surrogate marker of fitness, but not lifelong and current physical activity levels was associated with cognitive function. Therefore, walking speed deserves more attention in research aimed at unraveling associations between physical activity and cognitive function.
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Affiliation(s)
- Hans Wouters
- 1 Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen , Groningen, The Netherlands
| | - Teun Aalbers
- 2 Department of Geriatric Medicine, Radboud University Medical Centre , Nijmegen, The Netherlands .,3 Radboudumc Alzheimer Centre, Radboud University Medical Centre , Nijmegen, The Netherlands
| | - Martijn F H Maessen
- 4 Department of Physiology, Radboud University Medical Centre , Nijmegen, The Netherlands
| | - André L M Verbeek
- 5 Department of Health Evidence, Radboud University Medical Centre , Nijmegen, The Netherlands
| | - Marcel G M Olde Rikkert
- 2 Department of Geriatric Medicine, Radboud University Medical Centre , Nijmegen, The Netherlands .,3 Radboudumc Alzheimer Centre, Radboud University Medical Centre , Nijmegen, The Netherlands
| | - Roy P C Kessels
- 6 Donders Institute for Brain, Cognition and Behaviour, Radboud University , Nijmegen, The Netherlands .,7 Department of Medical Psychology, Radboud University Medical Centre , Nijmegen, The Netherlands
| | - Maria T E Hopman
- 4 Department of Physiology, Radboud University Medical Centre , Nijmegen, The Netherlands
| | - Thijs M H Eijsvogels
- 4 Department of Physiology, Radboud University Medical Centre , Nijmegen, The Netherlands .,8 Research Institute for Sports and Exercise Sciences, Liverpool John Moores University , Liverpool, United Kingdom
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Aalbers T, Qin L, Baars MA, de Lange A, Kessels RP, Olde Rikkert MG. Changing Behavioral Lifestyle Risk Factors Related to Cognitive Decline in Later Life Using a Self-Motivated eHealth Intervention in Dutch Adults. J Med Internet Res 2016; 18:e171. [PMID: 27317506 PMCID: PMC4930530 DOI: 10.2196/jmir.5269] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 02/23/2016] [Accepted: 05/04/2016] [Indexed: 11/13/2022] Open
Abstract
Background Our labor force is aging, but aged workers are not yet coached on how to stay cognitively fit for the job. Objective In this study, we tested whether a self-motivated, complex eHealth intervention could improve multiple health-related behaviors that are associated with cognitive aging among working Dutch adults. Methods This quasi-experimental prospective study with a pre-post design was conducted with employees of Dutch medium to large companies. All employees with Internet access, a good understanding of the Dutch language, and who provided digital informed consent were eligible to participate. In total, 2972 participants (2110/2972, 71.11% females) with a mean (standard deviation, SD) age of 51.8 (SD 12.9) years were recruited; 2305 became active users of the intervention, and 173 completed the 1-year follow-up. This self-motivated eHealth lifestyle intervention stimulates participants to set personally relevant, monthly health behavior change goals using Goal Attainment Scaling and to realize these goals by implementing behavior change techniques grounded in behavior change theory. The primary outcomes were the goal-setting success rate and the change in overall lifestyle score from baseline to the 1-year follow-up; the score was based on physical activity, diet, smoking, alcohol, sleep, and stress scores. The secondary outcomes were the changes in body weight, body mass index, specific lifestyle characteristics, and website usage. Results A total of 1212 participants set 2620 behavior change goals; 392 participants assessed 1089 (1089/2288, 47.59%) goals and successfully achieved 422 (422/1089, 38.75%) of these goals. Among the goal-setting participants in follow-up, this led to a +0.81-point improvement (95% CI 0.49-1.13, P<.001) in overall lifestyle (d=0.32) and weight loss of 0.62 kg (95% CI −1.16 to −0.07, P=.03). These participants also showed significant improvement in 8 out of 11 specific lifestyle components. Conclusions Among an adult Dutch population, this eHealth intervention resulted in lifestyle changes in behavioral risk factors associated with cognitive decline, and these improvements lasted over the period of 1 year. Given the general aging of our workforce, this eHealth intervention opens new avenues for the widespread use of cost-effective self-motivated prevention programs aimed at prevention of early-stage cognitive decline and more self-management of their risk factors. Trial Registration Nederlands Trial Register: NTR4144; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4144 (Archived by WebCite at http://www.webcitation.org/6cZzwZSg3).
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Affiliation(s)
- Teun Aalbers
- Radboud University Medical Center, Department of Geriatric Medicine, Nijmegen, Netherlands.
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