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“安龄”试验:一项行为改变干预的试点随机对照试验,旨在促进健康老龄化并降低晚年患痴呆症的风险。

The Agewell trial: a pilot randomised controlled trial of a behaviour change intervention to promote healthy ageing and reduce risk of dementia in later life.

作者信息

Clare Linda, Nelis Sharon M, Jones Ian R, Hindle John V, Thom Jeanette M, Nixon Julie A, Cooney Jennifer, Jones Carys L, Tudor Edwards Rhiannon, Whitaker Christopher J

机构信息

Research in Ageing and Cognitive Health, School of Psychology, Bangor University, Bangor, Gwynedd, LL57 2AS, UK.

Wales Institute of Social & Economic Research, Data & Methods, Cardiff University, Cardiff, UK.

出版信息

BMC Psychiatry. 2015 Feb 19;15:25. doi: 10.1186/s12888-015-0402-4.

Abstract

BACKGROUND

Lifestyle factors represent prime targets for behaviour change interventions to promote healthy ageing and reduce dementia risk. We evaluated a goal-setting intervention aimed at promoting increased cognitive and physical activity and improving mental and physical fitness, diet and health.

METHODS

This was a pilot randomised controlled trial designed to guide planning for a larger-scale investigation, provide preliminary evidence regarding efficacy, and explore feasibility and acceptability. Primary outcomes were engagement in physical and cognitive activity. Participants aged over 50 living independently in the community were recruited through a community Agewell Centre. Following baseline assessment participants were randomly allocated to one of three conditions: control (IC) had an interview in which information about activities and health was discussed; goal-setting (GS n = 24) had an interview in which they set behaviour change goals relating to physical, cognitive and social activity, health and nutrition; and goal-setting with mentoring (GM, n = 24) had the goal-setting interview followed by bi-monthly telephone mentoring. Participants and researchers were blinded to group assignment. Participants were reassessed after 12 months.

RESULTS

Seventy-five participants were randomised (IC n = 27, GS n = 24, GM n = 24). At 12-month follow-up, the two goal-setting groups, taken together (GS n = 21, GM n = 22), increased their level of physical (effect size 0.37) and cognitive (effect size 0.15) activity relative to controls (IC n = 27). In secondary outcomes, the two goal-setting groups taken together achieved additional benefits compared to control (effect sizes ≥ 0.2) in memory, executive function, cholesterol level, aerobic capacity, flexibility, balance, grip strength, and agility. Adding follow-up mentoring produced further benefits compared to goal-setting alone (effect sizes ≥ 0.2) in physical activity, body composition, global cognition and memory, but not in other domains. Implementation of the recruitment procedure, assessment and intervention was found to be feasible and the approach taken was acceptable to participants, with no adverse effects.

CONCLUSIONS

A brief, low-cost goal-setting intervention is feasible and acceptable, and has the potential to achieve increased activity engagement.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN30080637.

摘要

背景

生活方式因素是行为改变干预措施的主要目标,以促进健康老龄化并降低痴呆风险。我们评估了一项目标设定干预措施,旨在促进认知和身体活动增加,并改善心理和身体健康、饮食及健康状况。

方法

这是一项试点随机对照试验,旨在为大规模调查的规划提供指导,提供有关疗效的初步证据,并探索可行性和可接受性。主要结局是参与身体和认知活动。通过社区老年健康中心招募了50岁以上独立生活在社区中的参与者。在基线评估后,参与者被随机分配到三种情况之一:对照组(IC)进行了一次访谈,讨论了有关活动和健康的信息;目标设定组(GS,n = 24)进行了一次访谈,他们设定了与身体、认知和社交活动、健康及营养相关的行为改变目标;目标设定与指导组(GM,n = 24)进行目标设定访谈后,每两个月进行一次电话指导。参与者和研究人员对分组情况不知情。12个月后对参与者进行重新评估。

结果

75名参与者被随机分组(IC组n = 27,GS组n = 24,GM组n = 24)。在12个月的随访中,两个目标设定组(GS组n = 21,GM组n = 22)与对照组(IC组n = 27)相比,身体活动水平(效应量0.37)和认知活动水平(效应量0.15)有所提高。在次要结局方面,两个目标设定组与对照组相比(效应量≥0.2),在记忆、执行功能、胆固醇水平、有氧能力、柔韧性、平衡能力、握力和敏捷性方面取得了额外的益处。与仅进行目标设定相比,增加随访指导在身体活动、身体成分、整体认知和记忆方面产生了进一步的益处(效应量≥0.2),但在其他领域则没有。发现招募程序、评估和干预的实施是可行的,并且所采用的方法为参与者所接受,没有不良影响。

结论

一项简短、低成本的目标设定干预措施是可行且可接受的,并且有可能实现活动参与度的提高。

试验注册

当前对照试验ISRCTN30080637。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8773/4337106/542955e91ccd/12888_2015_402_Fig1_HTML.jpg

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