The effect of remotely delivered lifestyle interventions on cognition in older adults without dementia: A systematic review and meta-analysis

Whitfield, Tim; McConnell, Brittany; Renouf, Philippa; Mansour, Hassan; Zabihi, Sedigheh; Aguirre, Elisa; Walker, Zuzana; Cooper, Claudia; Marchant, Natalie L.

doi:10.1016/j.arr.2021.101505

Cited by 7 publications

(6 citation statements)

References 56 publications

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“…The positive effect found here deviates from the results summarized by Whitfield et al’s [ 5 ] meta-analysis of four RCTs consisting of remotely delivered multidomain interventions, which reported no cognitive improvement. However, Whitfield et al’s results should be interpreted with caution given the small number of studies.…”

Section: Discussioncontrasting

confidence: 99%

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Pre-frail older adults show improved cognition with StayFitLonger computerized home–based training: a randomized controlled trial

et al. 2022

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Multidomain interventions have shown tremendous potential for improving cognition in older adults. It is unclear if multidomain interventions can be delivered remotely and whether remote intervention is beneficial for older adults who are vulnerable or at risk of cognitive decline. In a 26-week multi-site, home-based, double-blind, randomized controlled trial, 120 cognitively healthy older adults (75 robust, 45 pre-frail; age range = 60–94) recruited from Switzerland, Canada, and Belgium were randomized to receive either the StayFitLonger (SFL) computerized multidomain training program or an active control intervention. Delivered on tablets, the SFL intervention combined adapted physical exercises (strength, balance, and mobility), cognitive training (divided attention, problem solving, and memory), opportunities for social and contributive interactions, and psychoeducation. The active control intervention provided basic mobilization exercises and access to video games. Cognitive outcomes were global cognition (Z-scores of attention, verbal fluency, and episodic memory for nondemented older adults; ZAVEN), memory, executive function, and processing speed. Linear mixed model analyses indicated improved performance on the ZAVEN global cognition score in the SFL group but not in the active control group. Stratified analyses by frailty status revealed improved ZAVEN global cognition and processing speed scores following SFL in the pre-frail group but not in the robust group. Overall, the study indicates that a computerized program providing a multidomain intervention at home can improve cognition in older adults. Importantly, pre-frail individuals, who are at higher risk of cognitive decline, seem to benefit more from the intervention. Trial registration: ClinicalTrials.gov, NCT037519 Registered on January 22, 2020—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04237519.

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Section: Discussioncontrasting

confidence: 99%

“…Computerized programs allow for real-time feedback on performance, control of item timing, and gamification, among other advantages. Surprisingly, only a few studies have evaluated at-home physical activity training or multidomain programs [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Pre-frail older adults show improved cognition with StayFitLonger computerized home–based training: a randomized controlled trial

et al. 2022

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“…The second strategy (n=65) is to conceptualize technology by the purpose of the technology in relation to a disease or type of health challenge that the technology addresses or is believed to be able to address, for instance, by using terms such as “technology for dementia” [ 61 - 70 ], “technologies for social connectedness” [ 71 - 75 ], “technology for frailty” [ 76 - 78 ], “technology for safety” [ 79 ], or “technology for falls” [ 60 , 80 - 84 ]. Most of the reviews that relied on this strategy dealt with assistive technologies (n=28).…”

Section: Resultsmentioning

confidence: 99%

Characteristics and Range of Reviews About Technologies for Aging in Place: Scoping Review of Reviews

Bergschöld,

Gunnes,

Eide

et al. 2024

JMIR Aging

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Background It is a contemporary and global challenge that the increasing number of older people requiring care will surpass the available caregivers. Solutions are needed to help older people maintain their health, prevent disability, and delay or avoid dependency on others. Technology can enable older people to age in place while maintaining their dignity and quality of life. Literature reviews on this topic have become important tools for researchers, practitioners, policy makers, and decision makers who need to navigate and access the extensive available evidence. Due to the large number and diversity of existing reviews, there is a need for a review of reviews that provides an overview of the range and characteristics of the evidence on technology for aging in place. Objective This study aimed to explore the characteristics and the range of evidence on technologies for aging in place by conducting a scoping review of reviews and presenting an evidence map that researchers, policy makers, and practitioners may use to identify gaps and reviews of interest. Methods The review was conducted in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Literature searches were conducted in Web of Science, PubMed, and Scopus using a search string that consisted of the terms “older people” and “technology for ageing in place,” with alternate terms using Boolean operators and truncation, adapted to the rules for each database. Results A total of 5447 studies were screened, with 344 studies included after full-text screening. The number of reviews on this topic has increased dramatically over time, and the literature is scattered across a variety of journals. Vocabularies and approaches used to describe technology, populations, and problems are highly heterogeneous. We have identified 3 principal ways that reviews have dealt with populations, 5 strategies that the reviews draw on to conceptualize technology, and 4 principal types of problems that they have dealt with. These may be understood as methods that can inform future reviews on this topic. The relationships among populations, technologies, and problems studied in the reviews are presented in an evidence map that includes pertinent gaps. Conclusions Redundancies and unexploited synergies between bodies of evidence on technology for aging in place are highly likely. These results can be used to decrease this risk if they are used to inform the design of future reviews on this topic. There is a need for an examination of the current state of the art in knowledge on technology for aging in place in low- and middle-income countries, especially in Africa.

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“…We had developed a relatively short (15 h + follow-ups) face to face group intervention prior to the pandemic, and piloted it in a form adapted for group video calls [ 10 ]. Previous remotely delivered dementia prevention interventions have been individually delivered, using internet platforms or telephone contact, and such interventions are yet to demonstrate effectiveness [ 42 ]. The HATICE trial, yet to report, is testing an interactive Internet platform, designed to encourage lifestyle changes with the remote support of a lifestyle coach to improve cardiovascular health, with cognition as a secondary outcome [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

The APPLE Tree programme: Active Prevention in People at risk of dementia through Lifestyle, bEhaviour change and Technology to build REsiliEnce—randomised controlled trial

Poppe

Duffy

Marchant

et al. 2022

Trials

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Background Large-scale trials of multidomain interventions show that modifying lifestyle and psychological risk factors can slow cognitive decline. We aim to determine if a lower intensity, personally tailored secondary dementia prevention programme for older people with subjective or mild objective memory decline, informed by behaviour change theory, reduces cognitive decline over 2 years. Methods A multi-site, single-blind randomised controlled trial recruiting 704 older adults at high dementia risk due to mild cognitive impairment (MCI) or subjective cognitive decline (SCD). Participants are randomised using 1:1 allocation ratio to the APPLE Tree intervention versus control arm (dementia prevention information), stratified by site. The intervention explores and implements strategies to promote healthy lifestyle, increase pleasurable activities and social connections and improve long-term condition self-management. Two facilitators trained and supervised by a clinical psychologist deliver ten, 1-h group video call sessions over 6 months (approximately every fortnight), video-call ‘tea breaks’ (less structured, facilitated social sessions) in intervening weeks and individual goal-setting phone calls every 2 weeks. From 6 to 12 months, participants meet monthly for ‘tea breaks’, with those not attending receiving monthly goal-setting phone calls. Participants receive a food delivery, pedometer and website access to cognitive training and information about lifestyle modification. Follow-ups for all outcome measures are at 12 and 24 months. The primary outcome is cognition (Neuropsychological Test Battery (NTB) score) at 24 months. Secondary outcomes are quality of life, cost per quality-adjusted life year (QALY) and wellbeing and lifestyle factors the intervention targets (diet, vascular risk, body weight, activity, sleep, anxiety, depression, social networks and loneliness, alcohol intake and smoking). Participants from purposively selected sites participate in qualitative process evaluation interviews, which will be analysed using thematic analytic methods. Discussion If effective, the intervention design, involving remote delivery and non-clinical facilitators, would facilitate intervention roll-out to older people with memory concerns. Trial registration ISRCTN17325135. Registration date 27 November 2019

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The effect of remotely delivered lifestyle interventions on cognition in older adults without dementia: A systematic review and meta-analysis

Cited by 7 publications

References 56 publications

Pre-frail older adults show improved cognition with StayFitLonger computerized home–based training: a randomized controlled trial

Pre-frail older adults show improved cognition with StayFitLonger computerized home–based training: a randomized controlled trial

Characteristics and Range of Reviews About Technologies for Aging in Place: Scoping Review of Reviews

The APPLE Tree programme: Active Prevention in People at risk of dementia through Lifestyle, bEhaviour change and Technology to build REsiliEnce—randomised controlled trial

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