Feasibility of a Lifestyle Physical Activity Intervention to Prevent Memory Loss in Older Women With Cardiovascular Disease: A Mixed-Methods Approach

Abstract

Background Memory loss in older age affects women more than men and cardiovascular disease is a leading risk factor. Physical activity can improve memory in healthy older adults; however, few physical activity interventions have targeted women with cardiovascular disease, and none utilized lifestyle approaches. Purpose The purpose of this study was to examine feasibility, acceptability, and preliminary effects of a 24-week lifestyle physical activity intervention (physical activity prescription, five group meetings, and nine motivational interviewing calls). Methods A sequential mixed-methods approach was used. Participants were 18 sedentary women ≥65 years with cardiovascular disease and without cognitive impairment recruited in August 2017. Feasibility, acceptability, self-reported health, accelerometer-assessed physical activity, and neurocognitive memory tests were measured using a pre-post test design. Two post-intervention focus groups ( n = 8) were conducted in June 2018. Concept analysis was used to identify barriers/motivators of intervention participation. Results Meeting attendance was >72% and retention was 94%. Participants rated the program with high satisfaction. There were significant improvements at 24 weeks in self-rated physical health, objective daily steps, and estimated cardiorespiratory fitness ( d = .30–.64). Focus group themes generated recommendations for modifying the intervention. Conclusion Findings support adapting the intervention further for women with cardiovascular disease and testing it in an efficacy trial.

General population perspectives of dementia risk reduction and the implications for intervention: A systematic review and thematic synthesis of qualitative evidence

“…Forty-one papers, describing the results of 37 individual studies, were included and synthesised [43-83] (Fig 3). From updated searches, a further 27 full-text papers were assessed and an additional nine papers met inclusion criteria [84][85][86][87][88][89][90][91][92] (Fig 3).…”

“…Participants across diverse studies also sought similar general characteristics in social interactions. They tended to evaluate interactions with peers [48,50,52,74,76,78,87], or with healthcare professionals and other research or public health professionals [52,53,55,63,70,71,75,88] as helpful when they were positive and collaborative, respectful, considerate of individual circumstances and reciprocal. For example, one participant described appreciating behaviour change sessions during an intervention trial because they were "not advice but more like a conversation" [63].…”

“…51,52,55,59,60,66,68,71,74,80], but described a variety of other, more subtle knowledge gaps, including for: conceptual knowledge[51,52,60,66,71,74,81,86,88,92]; specific theories of dementia risk reduction[45, 49, 51-53, 57, 59, 60, 64-67, 71, 74, 80, 81, 84, 85, 89, 91]; and procedural knowledge for when and how to effectively operationalise general dementia risk reduction understanding in specific behaviour patterns[50-52, 57, 59, 62, 63, 66, 68, 69, 71, 74, 78, 84, 86, 88]. Individual theories of how to reduce dementia risk were limited and largely restricted to combinations of staying cognitively active [43-45, 52, 53, 55, 57, 60, 64, 66, 67, 73, 76, 81, 82, 85, 89]; staying socially active [45, 49, 53, 59, 66, 73, 77, 85, 89]; staying physically active [43, 52, 53, 66, 67, 74, 76, 77, 80, 81, 82, 85, 89, 91]; eating well [43, 45, 49, 52, 53, 57, 67, 71, 73, 80-82, 89, 91]; or generic healthy lifestyles [43, 45, 46, 49, 52, 53, 57, 61, 64, 67, 73, 74, 80-82, 85], such as one study reporting "references to 'keeping busy' or 'staying active'"…”

Football Coaching Relevance to Nursing Leadership: #Notahailmary!

“…I worked with national experts in neuropsychology and neurophysiology at the Rush Alzheimer’s Disease Center to further my understanding of biomarkers of cognitive function and brain health, and I sought out mentorship from nurse scientists both at Rush University and the University of Indiana to gain an understanding of the interrelationship of cardiovascular disease and cognition. As a postdoctoral fellow, I (a) published a secondary data analysis of physical activity and MRI brain measures from a large epidemiological study (Halloway, Arfanakis, Wilbur, Schoeny, & Pressler, 2018); (b) published two reviews on cognition and aging (Halloway & Buchholz, 2017; Halloway, Wilbur, Schoeny, & Arfanakis, 2019); and (c) received recognition from the American Heart Association (Best Nursing Abstract Award) and the Alzheimer’s Association International Conference (Best Postdoc Poster Award). In addition, I garnered a Sigma Theta Tau International research award, along with internal funding, to develop and pilot test a multimodal, lifestyle intervention ( MindMoves).…”

“…In addition, I garnered a Sigma Theta Tau International research award, along with internal funding, to develop and pilot test a multimodal, lifestyle intervention ( MindMoves). MindMoves is comprised of physical activity and cognitive training that aim to prevent memory loss in older women with cardiovascular diseas e (Halloway eta l., 2019). In October 2018, I transitioned to an assistant professor role at Rush University College of Nursing and I am pursuing funding to test the MindMoves program in a clinical trial.…”