A Dyadic Approach for a Remote Physical Activity Intervention in Adults with Alzheimer's Disease and their Caregivers

对患有阿尔茨海默病的成人及其护理人员进行远程身体活动干预的二元方法

• 批准号: 10663826
• 负责人: Joseph E. Donnelly
• 金额: $ 68.09万
• 依托单位: UNIVERSITY OF KANSAS LAWRENCE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-15 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10663826
• 关键词: Accelerometer; Activities of Daily Living; Adult; Aerobic; Aerobic Exercise; Age; Alzheimer' s Disease; Alzheimer' s disease caregiver; Alzheimer' s disease risk; Body mass index; Caregiver Burden; Caregiver support; Caregiver well-being; Caregivers; Characteristics; Clinic; Cognition; Communities; Computer software; Contracts; Dementia; Development; Effectiveness; Elderly; Equilibrium; Exercise; Fatigue; Goals; Health; Home; Home visitation; Individual; Intervention; Maintenance; Medical; Mental Depression; Moderate Exercise; Monitor; Motivation; National Institute on Aging; Outcome; Participant; Performance; Personal Satisfaction; Physical activity; Population; Process; Quality of life; Randomized; Recommendation; Resistance; Risk Reduction; Site; Sleep; Social support; Socialization; Structure; Tablet Computer; Time; Transportation; Travel; Videoconferencing; Writing; arm; cognitive function; compare effectiveness; cost; design; enhanced care; exercise intervention; fitbit; fitness; health training; improved; improved mobility; innovation; intervention delivery; meetings; neuropsychiatric symptom; pedometer; peer; peer support; pilot trial; primary outcome; remote delivery; resistance exercise; secondary outcome; sedentary; sex; treatment as usual

Project Summary/Abstract Adults with Alzheimer’s disease (AD) and their caregivers represent a sizeable and underserved segment of the population with low levels of moderate physical activity (MPA). Available evidence suggests that regular MPA can improve mobility, performance of activities of daily living, general cognition, and balance in adults with AD. Additionally, MPA may reduce the risk of development of AD and improve health and well-being in caregivers. However, options for increased MPA in community dwelling adults with AD and their caregivers are limited. No trials have been designed specifically to examine strategies to increase long-term (≥12 mos.) daily MPA in this group. The significant barriers associated with current options (medical clinic, community site, home visits, caregiver delivered), including the time and cost associated with travel to clinic or community site, expense associated with individual home visits and the additional burden of caregiver directed exercise reduce the potential of these approaches to result in sustained improvements in MPA. An intervention delivered remotely via real-time video conferencing to groups of adults with AD and their caregivers in their homes (RGV), represents a potentially effective approach for increasing MPA in this group. This approach eliminates the need for transportation to a medical clinic or other community facility, and offers the potential for peer support and socialization, which may be important for initiation and maintenance of MPA. We propose to compare the effectiveness of the RVG approach with usual care, enhanced with caregiver support (EUC), for increasing MPA in 100 community dwelling adults with mild to moderate AD and their caregiver (dyads). Participants in both arms will be provided with an iPad® for intervention delivery, Fitbit for self-monitoring MPA, and will be asked to complete a 150 min of total MPA/wk. Dyads in both arms will be provided with written materials regarding exercise and physical activity from the National Institute on Aging, and will be asked to complete brief (15-20 min) FaceTime® meetings (0-6 mos.= 2/mo.; 7-12 mos.= 1/mo.;, 13-18 mos. =0/mo.) with the heath coach to discuss progress, provide support and receive additional guidance on increasing/maintaining MPA. Dyads in the RGV arm will be asked to complete group (5-8 dyads) exercise (aerobic, resistance, balance/coordination) delivered by a trained health coach via Zoom® software on an iPad®. Group sessions (45-min) will be held 3 d/wk. during mos. 0-6, 1 d/wk. during mos. 7-12, and will be discontinued during the no-contract period (mos.13-18). Dyads in the EUC arm, will be provided with a recommended exercise plan to complete own their own. Our primary aim is to compare total MPA (min/wk.) between the RGV and EUC arms in adults with AD and their caregiver across 6 mos. Secondarily we will compare total MPA and other outcomes, e.g., cognitive function, activities of daily living, caregiver burden etc. between the RGV and EUC arms across 18 mos.

项目概要/摘要 患有阿尔茨海默病 (AD) 的成年人及其照顾者代表了相当大的且服务不足的群体 现有证据表明，适度体力活动 (MPA) 水平较低的人群。 MPA 可以改善成人的活动能力、日常生活活动表现、一般认知和平衡能力 此外，MPA 还可以降低患 AD 的风险并改善患者的健康和福祉。 然而，对于社区居住的患有 AD 的成年人及其护理人员来说，增加 MPA 的选择是 目前还没有专门设计的试验来检验长期（≥12 个月）每日增加的策略。 该组中的 MPA 与当前选择（医疗诊所、社区站点、 家访、护理人员提供的服务），包括前往诊所或社区场所所需的时间和费用， 与个人家访相关的费用以及护理人员指导锻炼的额外负担减少 这些方法带来 MPA 持续改进的潜力 实施的干预措施。 通过实时视频会议远程与 AD 成人群体及其家中的护理人员进行交流 (RGV)，代表了增加该组 MPA 的潜在有效方法。 需要前往医疗诊所或其他社区设施，并为同伴提供了潜力 支持和社会化，这对于 MPA 的启动和维护可能很重要。 比较 RVG 方法与常规护理的有效性，并通过护理人员支持 (EUC) 进行增强，以 增加 100 名患有轻度至中度 AD 的社区居民及其照顾者（二人组）的 MPA。 双臂参与者将获得用于干预实施的 iPad®、用于自我监控 MPA 的 Fitbit、 并要求双臂每周完成 150 分钟的 MPA 总成绩，并提供书面证明。 来自国家老龄化研究所的有关锻炼和身体活动的材料，并将被要求 完整的简短（15-20 分钟）FaceTime® 会议（0-6 个月= 2/月；7-12 个月= 1/月；13-18 个月=0/月） 健康教练讨论进展情况，提供支持并接受额外指导 RGV 臂中的二人组将被要求完成小组（5-8 人）练习。 （有氧、阻力、平衡/协调）由训练有素的健康教练通过 Zoom® 软件在 iPad® 小组课程（45 分钟）每周 0 点至 6 点举行，每周 7 点至 12 点举行 1 天。 在无合同期间（第 13-18 章）停产的 EUC 部门中的二元组将获得一个 我们的主要目的是比较总 MPA（分钟/周）。 其次，我们将在患有 AD 的成人及其护理人员的 RGV 和 EUC 臂之间进行 6 个月的研究。 比较总 MPA 和其他结果，例如认知功能、日常生活活动、护理人员负担等。 RGV 和 EUC 臂之间的时间跨度为 18 个月。