REducing SEDENTary Behavior Among Mild to Moderate Cognitively Impaired Assisted Living Residents: A Pilot Randomized Controlled Trial (RESEDENT Study)

in Journal of Aging and Physical Activity

Click name to view affiliation

K. Dillon
Search for other papers by K. Dillon in
Current site
Google Scholar
PubMed
Close
and
Harry Prapavessis
Search for other papers by Harry Prapavessis in
Current site
Google Scholar
PubMed
Close
Restricted access

Older adults in assisted living spend most of their day in sedentary behaviors, which may be detrimental to cognitive function. The primary purpose of this pilot study was to assess the feasibility of using a prompting device to reduce sitting time with light walking among older adults with mild to moderate cognitive impairment residing in an assisted living setting. A secondary purpose was to examine the effectiveness of the intervention on the residents’ cognitive function, physical function, and quality of life. The participants (n = 25, mean age = 86.7 [5.3] years) were assigned in clusters into a two-arm 10-week single-site pilot randomized controlled trial. The intervention group was prompted with a watch to interrupt sedentary behaviors and partake in 10 min of light physical activity (i.e., walking) three times a day after a meal. The assessments included hip-worn accelerometers (Actical) and diaries, the Alzheimer’s disease assessment scale—cognitive, Timed Up and Go, and the short-form 36 health survey. Adherence was high, as there were no dropouts, and over 70% of the participants completed over 80% of the prescribed physical activity bouts. Significant effects favoring the intervention were shown for all outcomes.

The authors are with the Exercise and Health Psychology Laboratory, Faculty of Health Sciences, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada.

Dillon (kdillon9@uwo.ca) is corresponding author.
  • Collapse
  • Expand
  • Ahlborg, G., & Björkman, O. (1987). Carbohydrate utilization by exercising muscle following pre-exercise glucose ingestion. Clinical Physiology, 7(3), 181195. doi:10.1111/j.1475-097X.1987.tb00160.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Arain, M., Campbell, M.J., Cooper, C.L., & Lancaster, G.A. (2010). What is a pilot or feasibility study? A review of current practice and editorial policy. BMC Medical Research Methodology, 10, Article 67. PubMed ID: 20637084 doi:10.1186/1471-2288-10-67

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Auchus, A.P., Brashear, H.R., Salloway, S., Korczyn, A.D., De Deyn, P.P., & Gassmann-Mayer, C. (2007). Galantamine treatment of vascular dementia: A randomized trial. Neurology, 69(5), 448458. PubMed ID: 17664404 doi:10.1212/01.wnl.0000266625.31615.f6

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Barone Gibbs, B., Brach, J.S., Byard, T., Creasy, S., Davis, K.K., McCoy, S., … Jakicic, J.M. (2017). Reducing sedentary behavior versus increasing moderate-to-vigorous intensity physical activity in older adults: A 12-week randomized, clinical trial. Journal of Aging and Health, 29(292), 247267. doi:10.1177/0898264316635564

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Benatti, F.B., Larsen, S.A., Kofoed, K., Nielsen, S.T., Harder-Lauridsen, N.M., LyngbÆk, M.P., … Ried-Larsen, M. (2017). Intermittent standing but not a moderate exercise bout reduces postprandial glycemia. Medicine & Science in Sports & Exercise, 49(11), 23052314. doi:10.1249/MSS.0000000000001354

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Buchman, A.S., Boyle, P.A., Yu, L., Shah, R.C., Wilson, R.S., Bennett, D.A., … Bennett, D.A. (2012). Total daily physical activity and the risk of AD and cognitive decline in older adults. Neurology, 78(17), 13231329. PubMed ID: 22517108 doi:10.1212/WNL.0b013e3182535d35

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Buman, M.P., Winkler, E.A.H., Kurka, J.M., Hekler, E.B., Baldwin, C.M., Owen, N., … Gardiner, P.A. (2014). Reallocating time to sleep, sedentary behaviors, or active behaviors: Associations with cardiovascular disease risk biomarkers, NHANES 2005–2006. American Journal of Epidemiology, 179(3), 323334. PubMed ID: 24318278 doi:10.1093/aje/kwt292

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Chastin, S.F.M., De Craemer, M., De Cocker, K., Powell, L., Van Cauwenberg, J., Dall, P., … Chastin, F.M. (2019). How does light-intensity physical activity associate with adult cardiometabolic health and mortality? Systematic review with meta-analysis of experimental and observational studies. British Journal of Sports Medicine, 53(6), 370376. PubMed ID: 29695511 doi:10.1136/bjsports-2017-097563

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Cheng, G., Huang, C., Deng, H., & Wang, H. (2012). Diabetes as a risk factor for dementia and mild cognitive impairment: A meta-analysis of longitudinal studies. Internal Medicine Journal, 42(5), 484491. PubMed ID: 22372522 doi:10.1111/j.1445-5994.2012.02758.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Colley, R.C., Garriguet, D., Janssen, I., Craig, C.L., Clarke, J., & Tremblay, M.S. (2011). Physical activity of Canadian adults: Accelerometer results from the 2007 to 2009 Canadian health measures survey. Health Reports, 22(1), 714. PubMed ID: 21510585 doi:10.1016/j.yspm.2011.03.006

    • Search Google Scholar
    • Export Citation
  • Dipietro, L., Gribok, A., Stevens, M.S., Hamm, L.F., & Rumpler, W. (2013). Three 15-min bouts of moderate postmeal walking significantly improves 24-h glycemic control in older people at risk for impaired glucose tolerance. Diabetes Care, 36(10), 32623268. PubMed ID: 23761134 doi:10.2337/dc13-0084

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Dixon, W.J., & Tukey, J.W. (1968). Approximate behavior of the distribution of winsorized T (trimming/winsorization 2). Technometrics, 10(1), 8398. doi:10.1080/00401706.1968.10490537

    • Search Google Scholar
    • Export Citation
  • Dogra, S., Ashe, M.C., Biddle, S.J.H., Brown, W.J., Buman, M.P., Chastin, S., … Copeland, J.L. (2017). Sedentary time in older men and women: An international consensus statement and research priorities. British Journal of Sports Medicine, 51(21), 15261532. PubMed ID: 28724710 doi:10.1136/bjsports-2016-097209

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Dogra, S., & Stathokostas, L. (2012). Sedentary behavior and physical activity are independent predictors of successful aging in middle-aged and older adults. Journal of Aging Research, 2012, 190654. PubMed ID: 22997579 doi:10.1155/2012/190654

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Dunstan, D.W., Kingwell, B.A., Larsen, R., Healy, G.N., Cerin, E., Hamilton, M.T., … Owen, N. (2012). Breaking up prolonged sitting reduces postprandial glucose and insulin responses. Diabetes Care, 35(5), 976983. PubMed ID: 22374636 doi:10.2337/dc11-1931

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Duvivier, B.M.F.M., Schaper, N.C., Koster, A., van Kan, L., Peters, H.P.F., Adam, J.J., … Savelberg, H.H.C.M. (2017). Benefits of substituting sitting with standing and walking in free-living conditions for cardiometabolic risk markers, cognition and mood in overweight adults. Frontiers in Physiology, 8, Article 353. PubMed ID: 28642713 doi:10.3389/fphys.2017.00353

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Edwardson, C.L., Henson, J., Bodicoat, D.H., Bakrania, K., Khunti, K., Davies, M.J., & Yates, T. (2017). Associations of reallocating sitting time into standing or stepping with glucose, insulin and insulin sensitivity: A cross-sectional analysis of adults at risk of type 2 diabetes. BMJ Open, 7, 14267. doi:10.1136/bmjopen-2016-014267

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Falck, R.S., Davis, J.C., & Liu-Ambrose, T. (2016). What is the association between sedentary behaviour and cognitive function? A systematic review. British Journal of Sports Medicine, 51(10), 800811. PubMed ID: 27153869 doi:10.1136/bjsports-2015-095551

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Falck, R.S., Landry, G.J., Best, J.R., Davis, J.C., Chiu, B.K., & Liu-Ambrose, T. (2017). Cross-sectional relationships of physical activity and sedentary behavior with cognitive function in older adults with probable mild cognitive impairment. Physical Therapy, 97(10), 975984. PubMed ID: 29029554 doi:10.1093/ptj/pzx074

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). Mini-mental-state. Zeitschrift Für Gerontopsychologie & Psychiatrie, 22(1), 1116. PubMed ID: 19349661 doi:10.1024/1011-6877.22.1.11

    • Search Google Scholar
    • Export Citation
  • Gardiner, P.A., Eakin, E.G., Healy, G.N., & Owen, N. (2011). Feasibility of reducing older adults’ sedentary time. American Journal of Preventive Medicine, 41(2), 174177. doi:10.1016/j.amepre.2011.03.020

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hallal, P.C., Andersen, L.B., Bull, F.C., Guthold, R., Haskell, W., Ekelund, U., & Lancet Physical Activity Series Working Group. (2012). Global physical activity levels: Surveillance progress, pitfalls, and prospects. The Lancet, 380(9838), 247257. doi:10.1016/S0140-6736(12)60646-1

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Harvey, J.A., Chastin, S.F.M., & Skelton, D.A. (2015). How sedentary are older people? A systematic review of the amount of sedentary behavior. Journal of Aging & Physical Activity, 23(3), 471487 doi:10.1123/japa.2014-0164

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Jia, J., Wei, C., Liang, J., Zhou, A., Zuo, X., Song, H., … Huang, L. (2016). The effects of DL-3-n-butylphthalide in patients with vascular cognitive impairment without dementia caused by subcortical ischemic small vessel disease: A multicentre, randomized, double-blind, placebo-controlled trial. Alzheimer’s and Dementia, 12(2), 8999. PubMed ID: 32368966 doi:10.1016/j.jalz.2015.04.010

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Johnson, L.G., Butson, M.L., Polman, R.C., Raj, I.S., Borkoles, E., Scott, D., … Jones, G. (2016). Light physical activity is positively associated with cognitive performance in older community dwelling adults. Journal of Science and Medicine in Sport, 19(11), 877882. PubMed ID: 26922133 doi:10.1016/j.jsams.2016.02.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lautenschlager, N.T., Almeida, O.P., van Bockxmeer, F.M., Greenop, K.R., Cox, K.L., Xiao, J., … Foster, J.K. (2008). Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease. Journal of the American Medical Association, 300(9), 1027. PubMed ID: 18768414 doi:10.1001/jama.300.9.1027

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Leung, P.-M., Ejupi, A., van Schooten, K.S., Aziz, O., Feldman, F., Mackey, D.C., … Robinovitch, S.N. (2017). Association between sedentary behaviour and physical, cognitive, and psychosocial status among older adults in assisted living. BioMed Research International, 2017, 9160504. PubMed ID: 28913360 doi:10.1155/2017/9160504

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Liu-Ambrose, T., Best, J.R., Davis, J.C., Eng, J.J., Lee, P.E., Jacova, C., … Hsiung, G.Y.R. (2016). Aerobic exercise and vascular cognitive impairment. Neurology, 87(20), 20822090. PubMed ID: 27760869 doi:10.1212/WNL.0000000000003332

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Loh, R., Stamatakis, E., Folkerts, D., Allgrove, J.E., & Moir, H.J. (2019). Effects of interrupting prolonged sitting with physical activity breaks on blood glucose, insulin and triacylglycerol measures: A systematic review and meta-analysis. Sports Medicine, 50(2), 295330. PubMed ID: 31552570 doi:10.1007/s40279-019-01183-w

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Maher, J.P., Sliwinski, M.J., & Conroy, D.E. (2017). Feasibility and preliminary efficacy of an intervention to reduce older adults’ sedentary behavior. Translational Behavioral Medicine, 7(1), 5261. PubMed ID: 27734281 doi:10.1007/s13142-016-0394-8

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McGowan, L., Devereux-Fitzgerald, A., Powell, R., & French, D.P. (2017). How acceptable do older adults find the concept of being physically active? A systematic review and meta-synthesis. International Review of Sport and Exercise Psychology, 11(1), 124. PubMed ID: 20577058 doi:10.1080/1750984X.2016.1272705

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ojagbemi, A., & Akin-Ojagbemi, N. (2019). Exercise and quality of life in dementia: A systematic review and meta-analysis of randomized controlled trials. Journal of Applied Gerontology, 38(1), 2748. PubMed ID: 28380725 doi:10.1177/0733464817693374

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Owen, N., Healy, G.N., Matthews, C.E., & Dunstan, D.W. (2010). Too much sitting: The population-health science of sedentary behavior. Exercise and Sport Sciences Reviews, 38(3), 105113. PubMed ID: 20577058 doi:10.1097/JES.0b013e3181e373a2

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Petersen, R.C., Smith, G.E., Waring, S.C., Ivnik, R.J., Tangalos, E.G., & Kokmen, E. (1999). Mild cognitive impairment: Clinical characterization and outcome. Archives of Neurology, 56(3), 303308. PubMed ID: 10190820 doi:10.1001/archneur.56.3.303

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Potter, R., Ellard, D., Rees, K., & Thorogood, M. (2011). A systematic review of the effects of physical activity on physical functioning, quality of life and depression in older people with dementia. International Journal of Geriatric Psychiatry, 26(10), 10001011. PubMed ID: 21905096 doi:10.1002/gps.2641

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Puffer, S., Torgerson, D.J., & Watson, J. (2005). Cluster randomized controlled trials. Journal of Evaluation in Clinical Practice, 11(5), 479483. PubMed ID: 16164589 doi:10.1111/j.1365-2753.2005.00568.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rawlins, M.D. (2015). National Institute for Clinical Excellence: NICE works. Journal of the Royal Society of Medicine, 108(6), 211219. PubMed ID: 26085559 doi:10.1177/0141076815587658

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Richardson, S. (1991). The timed “Up & Go”: A test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39(2), 142148. doi:10.1111/j.1532-5415.1991.tb01616.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ries, J.D., Echternach, J.L., Nof, L., & Gagnon Blodgett, M. (2009). Test–retest reliability and minimal detectable change scores for the timed “Up & Go” test, the six-minute walk test, and gait speed in people with Alzheimer disease. Physical Therapy, 89(6), 569579. PubMed ID: 19389792 doi:10.2522/ptj.20080258

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Roberts, R.O., Geda, Y.E., Knopman, D.S., Christianson, T.J.H., Pankratz, V.S., Boeve, B.F., … Petersen, R.C. (2008). Association of duration and severity of diabetes mellitus with mild cognitive impairment. Archives of Neurology, 65(8), 10661073. PubMed ID: 18695056 doi:10.1001/archneur.65.8.1066

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rosen, W.G., Mohs, R.C., & Davis, K.L. (1984). A new rating scale for Alzheimer’s disease. American Journal of Psychiatry, 141(11), 13561364. PubMed ID: 6496779 doi:10.1176/ajp.141.11.1356

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Rosenberg, D.E., Gell, N.M., Jones, S.M.W., Renz, A., Kerr, J., Gardiner, P.A., & Arterburn, D. (2015). The feasibility of reducing sitting time in overweight and obese older adults. Health Education & Behavior, 42(5), 669676. PubMed ID: 25794518 doi:10.1177/1090198115577378

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sardinha, L.B., Santos, D.A., Silva, A.M., Baptista, F., & Owen, N. (2015). Breaking-up sedentary time is associated with physical function in older adults. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 70(1), 119124. doi:10.1093/gerona/glu193

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Schnaider Beeri, M., Goldbourt, U., Silverman, J.M., Noy, S., Schmeidler, J., Ravona-Springer, R., … Davidson, M. (2004). Diabetes mellitus in midlife and the risk of dementia three decades later. Neurology, 63(10), 19021907. PubMed ID: 15557509 doi:10.1212/01.wnl.0000144278.79488.dd

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Schrag, A., & Schott, J.M. (2012). What is the clinically relevant change on the ADAS-Cog? Journal of Neurology, Neurosurgery & Psychiatry, 83(2), 171173. doi:10.1136/jnnp-2011-300881

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Stephenson, A., McDonough, S.M., Murphy, M.H., Nugent, C.D., & Mair, J.L. (2017). Using computer, mobile and wearable technology enhanced interventions to reduce sedentary behaviour: A systematic review and meta-analysis. The International Journal of Behavioral Nutrition and Physical Activity, 14(1), 105. PubMed ID: 28800736 doi:10.1186/s12966-017-0561-4

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Thorp, A.A., Kingwell, B.A., Sethi, P., Hammond, L., Owen, N., & Dunstan, D.W. (2014). Alternating bouts of sitting and standing attenuate postprandial glucose responses. Medicine & Science in Sports & Exercise, 46(11), 20532061. doi:10.1249/MSS.0000000000000337

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tremblay, M.S., Aubert, S., Barnes, J.D., Saunders, T.J., Carson, V., Latimer-Cheung, A.E., … Chinapaw, M.J.M. (2017). Sedentary Behavior Research Network (SBRN)—Terminology consensus project process and outcome. International Journal of Behavioral Nutrition and Physical Activity, 14(1), 75. PubMed ID: 28599680 doi:10.1186/s12966-017-0525-8

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Vreugdenhil, A., Cannell, J., Davies, A., & Razay, G. (2012). A community-based exercise programme to improve functional ability in people with Alzheimer’s disease: A randomized controlled trial. Scandinavian Journal of Caring Sciences, 26(1) 1219. PubMed ID: 21564154 doi:10.1111/j.1471-6712.2011.00895.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ware, J.E., & Sherbourne, C.D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30(6), 473483. PubMed ID: 1593914

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wheeler, M.J., Dempsey, P.C., Grace, M.S., Ellis, K.A., Gardiner, P.A., Green, D.J., & Dunstan, D.W. (2017). Sedentary behavior as a risk factor for cognitive decline? A focus on the influence of glycemic control in brain health. Alzheimer’s and Dementia: Translational Research and Clinical Interventions, 3(3), 291300. PubMed ID: 32368966 doi:10.1016/j.trci.2017.04.001

    • Search Google Scholar
    • Export Citation
  • Yesavage, J., Brink, T., Rose, T., Lum, O., Huang, V., Adey, M., & Leirer, V.O. (1982). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research17(1), 3749.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 3454 1398 39
Full Text Views 187 70 4
PDF Downloads 105 41 0