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.

项目摘要/摘要 患有阿尔茨海默氏病（AD）及其护理人员的成年人代表着大量且服务不足的部分 中等体育锻炼（MPA）的人群。可用证据表明定期 MPA可以提高移动性，日常生活活动的表现，一般认知和成人平衡 与广告。额外的MPA可能会降低AD发展的风险，并改善健康和福祉 照顾者。但是，在社区住宅成年人及其护理人员中增加MPA的选择是 有限的。没有专门设计的试验来检查每天增加长期（≥12个月）的策略。 该组的MPA。与当前选择相关的重大障碍（医疗诊所，社区现场， 家庭探访，交付的护理人员），包括与前往诊所或社区网站旅行相关的时间和费用， 与单个家庭访问相关的费用以及护理人员的额外燃烧定向运动减少 这些方法的潜力导致MPA持续改善。提供干预措施 通过实时视频会议与成年人的广告及其护理人员的成年人群 （RGV）代表了增加该组MPA的潜在有效方法。这种方法消除了 需要运输到医疗诊所或其他社区设施，并为同伴提供潜力 支持和社会化，这对于MPA的主动性和维护可能很重要。我们建议 将RVG方法与常规护理的有效性进行比较，并通过护理人员支持（EUC）增强 在100个社区住宅成年人中增加了MPA，具有轻度至中度的AD及其护理人员（Dyads）。 双臂的参与者将提供iPad®用于干预交付的iPad®，Fitbit用于自我监控MPA， 并将要求完成总MPA/周的150分钟。两臂中的二元组都将以书面形式提供 美国国家衰老研究所的锻炼和体育锻炼的材料，并将被要求 完成简介（15-20分钟）FaceTime®会议（0-6 mos。= 2/mo。; 7-12 mos。= 1/mo。;，13-18 mos。= 0/mo。） 热火教练讨论进度，提供支持并获得有关 增加/维护MPA。 RGV臂中的二元组将被要求完成组（5-8个二元组）练习 （有氧，抵抗，平衡/协调）由训练有素的健康教练通过Zoom®软件交付 iPad®。小组会议（45分钟）将举行3 d/wk。在MOS期间。 0-6，1 d/wk。在MOS期间。 7-12，将会 在无合同期（MOS.13-18）中停产。 EUC手臂中的二元组将有一个 建议自己完成自己的锻炼计划。我们的主要目的是比较总MPA（最小/周）。 在6个MOS的AD成人和他们的护理人员的成人中，RGV和EUC臂之间。次要我们会的 比较总MPA和其他结果，例如认知功能，日常生活活动，照顾者Burnen等。 在RGV和EUC臂之间穿越18个月。