The Support Person's Preferences and Perspectives of Physical Activity Programs for Older Adults With Cognitive Impairment

Pounding the Pavement: Is the Path to Brain Health Steeper for People Experiencing Greater Socioeconomic Deprivation?

Dementia is a global public health priority. Physical activity has myriad health benefits, including for reducing dementia risk. To increase physical activity, detailed understanding of influencing factors is needed. Socioeconomic deprivation affects many aspects of health and wellbeing. Qualitative research with older people experiencing socioeconomic deprivation is needed to explore barriers and enablers to engaging in physical activity, with the view to co-designing interventions for implementation trials. A whole of society approach is pivotal to improving effectiveness of physical activity interventions for older adults with cognitive impairment, and target support for people experiencing socioeconomic deprivation, to improve their health outcomes.

Exploring the Feasibility of a Self-Managed Lifestyle Intervention, Based on Exercise and Behaviour Support, as an Adjunct Therapy to Compression: A Sub-Study Focusing on People with Venous Leg Ulcers and Early Neuro-Degenerative Diseases (FISCU-NDD)

BACKGROUND

The aim of this study was to adapt the "FISCU Home" intervention (a co-produced, self-managed and expert-supported lifestyle intervention comprising exercise and behaviour support aimed at people with Venous Leg Ulcers (VLUs), in a way that is suitable for the needs of people with combined VLUs and early-stage, Neuro-degenerative diseases (NDDs), and to explore its feasibility (e.g., estimate rates of recruitment and completion of sessions, calculate study adherence rates, assess participant satisfaction via participant interviews, and assess ease of data collection) within this clinical sub-group.

METHODS

We recruited seven people belonging to this VLUs sub-group (e.g., people with early-stage dementia or Parkinson's), who were ≥18 years' old, had VLU(s) of diameter ≥1 cm, ABPI ≥ 0.8, had the ability to tolerate lower-leg compression and were receiving VLU treatment at home. In Phase 1, participants helped us adapt the intervention. In Phase 2 we carried out a 4-week "training crash-course". This consisted of three, 1 h, self-managed, exercise sessions per week (12 sessions in total), among the participants that completed the interviews. For Phase 3, we carried out post-interviews with all participants to investigate their study experiences, which were analysed using content analysis.

RESULTS

All assessments were completed successfully (100% retention and assessment completion), with no exercise-related adverse events. All participants completed the 4-week intervention (100%; all sessions completed by all participants).

CONCLUSION

Our findings suggest that the adapted intervention is feasible, enjoyable and well-received, and has the potential to provide clinical benefits to the participants.

Self-management preferences in patients with mild cognitive impairment: A qualitative study

Purpose

Patients with mild cognitive impairment (MCI) require self-management, yet current self-management compliance is low. Taking patients’ preferences into account can improve the self-management situation. The purpose of this study is to look into MCI patients’ preferences for self-management in China.

Methods

A qualitative research was conducted using semi-structured in-depth interviews with 21 patients recently diagnosed with MCI who were chosen by purposive sampling. These interviews were analyzed through thematic analysis and identified emerging themes.

Results

Five themes of self-management preference were identified: (1) Preference for acquiring disease knowledge; (2) Preference for participating in drug therapy; (3) Preference for participating in exercise; (4) Preference for applying memory compensation strategy; (5) Preferences for emotional expression and response.

Conclusion

Our study identified the specific preferences of MCI patients in China for the main self-management items. The findings are valuable insights for knowing MCI patients’ self-management content and preferences and provide better guidance for health practitioners to improve self-management compliance.

Factors Influencing Long-Term Physical Activity Maintenance: A Qualitative Evaluation of a Physical Activity Program for Inactive Older Adults at Risk of Cognitive Decline: The INDIGO Follow-Up Study

BACKGROUND

Physical inactivity is a modifiable risk factor for dementia, but there remains a research translation gap in effective physical activity (PA) implementation, particularly in the longer-term. The INDIGO trial investigated the effectiveness of a six-month PA intervention for inactive older adults at risk of cognitive decline with subjective cognitive decline or mild cognitive impairment.

OBJECTIVE

This follow-up study aimed to collect feedback from INDIGO participants about their experience of involvement in the trial, including barriers and enablers to longer-term maintenance of PA.

METHODS

A qualitative study using semi-structured individual interviews was conducted and transcripts analyzed thematically. All INDIGO trial completers were invited, with 29 participating (follow-up period 27-66 months post-baseline).

RESULTS

At long-term follow-up, participants described INDIGO trial participation as beneficial. The theme of "Motivation" (subthemes: structure and accountability, knowledge and expected benefits, preferences and motivation, tools) followed by "Situation" (subthemes: environment and time, social aspects, aging and physical health) appeared to be critical to PA "Action". Most participants had a positive view of goal-setting and peer mentoring/support, but there was some polarization of opinion. Key factors to longer-term "Maintenance" of PA were self-efficacy and perceived benefits, habit formation, and for some participants, enjoyment.

CONCLUSION

PA interventions for older adults at risk of cognitive decline should include behavior change techniques tailored to the individual. Effective techniques should focus on "Motivation" (particularly structure and accountability) and "Situation" factors relevant to individuals with the aim of developing self-efficacy, habit formation, and enjoyment to increase the likelihood of longer-term PA maintenance.