A Web-Based Multidomain Lifestyle Intervention for Older Adults: The eMIND Randomized Controlled Trial

Abstract

Importance/Objective: To describe the feasibility and acceptability of a 6-month web-based multidomain lifestyle training intervention for community-dwelling older people and to test the effects of the intervention on both function- and lifestyle-related outcomes. Design: 6-month, parallel-group, randomized controlled trial (RCT). Setting: Toulouse area, South-West, France. Participants: Community-dwelling men and women, ≥ 65 years-old, presenting subjective memory complaint, without dementia. Intervention: The web-based multidomain intervention group (MIG) received a tablet to access the multidomain platform and a wrist-worn accelerometer measuring step counts; the control group (CG) received only the wrist-worn accelerometer. The multidomain platform was composed of nutritional advices, personalized exercise training, and cognitive training. Main outcomes and measures: Feasibility, defined as the proportion of people connecting to ≥75% of the prescribed sessions, and acceptability, investigated through content analysis from recorded semi-structured interviews. Secondary outcomes included clinical (eg, cognitive function, mobility, health-related quality of life (HRQOL)) and lifestyle (eg, step count, food intake) measurements. Results: Among the 120 subjects (74.2 ±5.6 years-old; 57.5% women), 109 completed the study (n=54, MIG; n=55, CG). 58 MIG subjects connected to the multidomain platform at least once; among them, adherers of ≥75% of sessions varied across multidomain components: 37 people (63.8% of 58 participants) for cognitive training, 35 (60.3%) for nutrition, and three (5.2%) for exercise; these three persons adhered to all multidomain components. Participants considered study procedures and multidomain content in a positive way; the most cited weaknesses were related to exercise: too easy, repetitive, and slow progression. Compared to controls, the intervention had a positive effect on HRQOL; no significant effects were observed across the other clinical and lifestyle outcomes. Conclusions and Relevance: Providing multidomain lifestyle training through a web-platform is feasible and well-accepted, but the training should be challenging enough and adequately progress according to participants’ capabilities to increase adherence. Recommendations for a larger on-line multidomain lifestyle training RCT are provided.

The Effect of Multidomain Interventions on Global Cognition, Symptoms of Depression and Apathy – A Pooled Analysis of Two Randomized Controlled Trials

“…Furthermore, results were still statistically significant after multiple-comparison correction (p < 0.01 after Bonferroni correction). These findings should be confirmed in the multidomain intervention trials that are currently underway (35)(36)(37).…”

Cognitive Intervention Using Information and Communication Technology for Older Adults with Mild Cognitive Impairment: A Systematic Review and Meta-Analysis

“…In papers in which four or more items were found to be ‘high risk’, through author agreement, we decided to exclude them as papers for systematic review and data ex-traction. Accordingly, a total of 11 papers [ 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ] were included except Styliadis (2015) for systematic review and data extraction ( Figure 2 ).…”

“…We identified studies with high heterogeneity by performing cumulative sensitive analysis. The study of de Souto Barreto [ 37 ] was identified with high heterogeneity. Therefore, in Figure 6 , a forest plot without de Souto Barreto’s study [ 37 ] is presented.…”

“…The study of de Souto Barreto [ 37 ] was identified with high heterogeneity. Therefore, in Figure 6 , a forest plot without de Souto Barreto’s study [ 37 ] is presented. As a result, the SMD of multidomain intervention was 0.75 (CI: 0.47–1.03, p < 0.001), and the SMD of single cognitive intervention was 0.35 (CI: 0.02–0.67, p = 0.04).…”

Possible Sarcopenia and Impact of Dual-Task Exercise on Gait Speed, Handgrip Strength, Falls, and Perceived Health

“…While previous studies have emphasized on the need of resistance exercise and protein supplement, our study is the first to document improvement in gait speed, with reduction in the prevalence of SG and poor HGS after 3 months of dualtask exercise. While there are many studies evaluating web-based multi-domain interventions in the home setting, the inclusion of web-based dual-task exercises combined with resistance exercise, and protein enriched diet needs to studied to guide Public Health authorities on measures to prevent sarcopenia during future pandemics and lockdown (52).…”