Szabo-Reed Amanda N, Watts Amber, Vidoni Eric D, Mahnken Jonathan, Van Sciver Angela, Finley Katrina, Clutton Jonathan, Holden Rachel, Key Mickeal N, Burns Jeffery M
University of Kansas Medical Center.
University of Kansas.
medRxiv. 2024 Aug 1:2024.07.29.24311181. doi: 10.1101/2024.07.29.24311181.
The health care system is insufficiently capitalizing on the benefits of physical exercise in America's aging population. Few tools exist to help clinicians incorporate physical activity into their clinical care, while barriers limit older adults from initiating and maintaining exercise programs. The Lifestyle Empowerment for Alzheimer's Prevention (LEAP! Rx) Program has been designed to support providers and participants in lifestyle change. LEAP! Rx uses two forms of participant enrollment: physician referrals through electronic health records and self-referrals to test the efficacy of delivering a community-based exercise and healthy lifestyle program to older adults. After referral into the program, participants are randomized to receive the LEAP! Rx Program or are placed in a standard-of-care group to receive the program later. The LEAP! Rx program consists of a personalized and structured exercise program, lifestyle education, and mobile health monitoring. This includes a 12-week Empowerment phase with coaching and supervised exercise training, followed by a 40-week Lifestyle phase with intermittent supervised exercise and coaching. Lifestyle education includes monthly, evidence-based classes on optimal aging. The evaluation of LEAP! Rx focuses on 1) the assessment of implementation and scalability of the LEAP!Rx Program for clinicians and patients 2) the effect of the LEAP! Rx Program on cardiorespiratory fitness, 3) the impact of the LEAP! Rx Program on secondary intervention outcome measures of chronic disease risk factors, including insulin resistance, body composition, and lipids. If successful, this study's findings could advance future healthcare practices, providing a new and practical approach to aging and chronic disease prevention.
美国的医疗保健系统未能充分利用体育锻炼给老年人口带来的益处。几乎没有什么工具能帮助临床医生将体育活动纳入其临床护理工作中，同时，各种障碍也限制了老年人启动和维持锻炼计划。阿尔茨海默病预防生活方式赋能（LEAP! Rx）项目旨在支持医疗服务提供者和参与者进行生活方式改变。LEAP! Rx采用两种参与者招募形式：通过电子健康记录由医生转诊以及自我转诊，以测试向老年人提供基于社区的锻炼和健康生活方式项目的效果。在被转诊到该项目后，参与者被随机分组，一组接受LEAP! Rx项目，另一组被纳入常规护理组以便稍后接受该项目。LEAP! Rx项目包括个性化且结构化的锻炼计划、生活方式教育以及移动健康监测。这包括一个为期12周的赋能阶段，有指导和监督下的锻炼训练，随后是一个为期40周的生活方式阶段，有间歇性的监督锻炼和指导。生活方式教育包括每月一次基于证据的关于最佳衰老的课程。对LEAP! Rx的评估重点在于：1）评估LEAP! Rx项目对临床医生和患者的实施情况及可扩展性；2）LEAP! Rx项目对心肺适能的影响；3）LEAP! Rx项目对慢性病风险因素的二级干预结果指标的影响，包括胰岛素抵抗、身体成分和血脂。如果研究成功，本研究的结果可能会推动未来的医疗实践，为衰老和慢性病预防提供一种新的实用方法。
