Background: Cognitive impairment disproportionately affects older women with cardiovascular disease (CVD). Physical activity (PA) and cognitive training (CT) may have synergistic effects in combined interventions. However, no combined intervention has targeted women with CVD or utilized a sustainable and preferable lifestyle approach. The purpose was to test feasibility and acceptability of the 24-week MindMoves program, a lifestyle intervention that combined PA and CT developed for older women with CVD. Methods: The PA component included goal setting with Fitbits and 5 behavioral group meetings. The CT component was evidence-based BrainHQ delivered on a tablet in three 30-minute weekly sessions. Participants included 10 women aged ≥65 years with CVD. Exclusion criteria were cognitive impairment, regular PA, and CT use. Measures were feasibility (recruitment, attendance, participation, retention, and acceptability), change in PA (Fitbit min/steps), and change in cognitive function (NIH Toolbox®). Results: Of the 10 participants, 70% attended ≥4/5 group meetings, and overall attendance was 76%. Participants completed 2.3/3 CT sessions weekly. Participant retention was 100%. Over 90% of participants rated MindMoves with the highest levels of satisfaction. Participants had significant improvements in steps, light PA, and moderate PA, and there was a trend for improved cognition. Conclusions: Findings support testing MindMoves in an efficacy trial.
Shannon Halloway, JoEllen Wilbur, Lynne T. Braun, Michael E. Schoeny, and Annabelle Santos Volgman
Shannon Halloway, JoEllen Wilbur, Michael E. Schoeny, Pamela A. Semanik, and David X. Marquez
This study examined the combined effects of sedentary behavior and moderate-to-vigorous physical activity (MVPA) on cardiovascular health in older Latinos. In a cross-sectional sample of 147 older, community-dwelling Latinos, time spent in sedentary behavior and MVPA were obtained using accelerometers. Analyses examined the effects of a measure of physical activity that combined levels of sedentary behavior (± 10 daily hours) and MVPA (< 30, 30–150, or > 150 weekly minutes) on cardiovascular health outcomes (blood pressure, BMI, waist circumference, cardiorespiratory fitness). Results suggest that cardiovascular health benefits of MVPA on BMI (p = .005), waist circumference (p = .002), and cardiorespiratory fitness (p = .012) may depend on a participant’s level of sedentary behavior. For all three, health benefits of 30–150 weekly minutes of MVPA were found only for those without excessive sedentary behavior (≥ 10 hr). Sedentary behavior may negatively impact cardiovascular health despite moderate participation in MVPA. Health guidelines should suggest reducing sedentary behavior while increasing MVPA.
JoEllen Wilbur, Michael E. Schoeny, Susan W. Buchholz, Louis Fogg, Arlene Michaels Miller, Lynne T. Braun, Shannon Halloway, and Barbara L. Dancy
For interventions to be implemented effectively, fidelity must be documented. We evaluated fidelity delivery, receipt, and enactment of the 48-week Women’s Lifestyle Physical Activity Program conducted to increase physical activity and maintain weight in African American women.
Three study conditions all received 6 group meetings; 1 also received 11 motivational interviewing personal calls (PCs), 1 received11 automated motivational message calls (ACs), and 1 received no calls. Group meeting delivery was assessed for adherence and competence. PC delivery was assessed with the Motivational Interviewing Treatment Integrity Code. Receipt was defined as group meeting attendance, completion of PCs, and listening to ACs. Enactment was number of weeks an accelerometer was worn.
For group meeting delivery, mean adherence was 80.8% and mean competence 2.9 of 3.0. Delivery of PCs did not reach criterion for competence. Receipt of more than one-half the dose was achieved for 84.9% of women for group meetings, 85.5% for PCs, and 42.1% for ACs. Higher group meeting attendance was associated with higher accelerometer steps at 24 weeks and lower BMI at 24 and 48 weeks.
Fidelity measurement and examination of intervention delivery, receipt, and enactment are important to explicate conditions in which interventions are successful.
Pankaja Desai, Shannon Halloway, Klodian Dhana, Yanyu Zhang, Thomas Holland, Puja Agarwal, Christopher N. Ford, Carlos Mendes de Leon, Denis A. Evans, and Martha C. Morris
This study examined the relationship between walking and cognitive function among Chicago Health and Aging Project participants. Data collection occurred during six 3-year cycles, of which Cycles 4–6 were used for this specific analysis. Information was obtained regarding walking frequency and duration, demographics, chronic conditions, cognitive activities, apolipoprotein E4, physical function, and cognitive function (global and domains). A composite walking measure was developed and categorized as follows: no walking, ≤105 min/week, and >105 min/week. Mixed-effects regression analyses tested associations between walking and global cognitive function, episodic memory, and perceptual speed. The sample consisted of 4,320 participants (African American/Black: 65%; female: 65%; mean education: 13 years; mean age: 75 years). Composite or total walking had a statistically significant association with global cognitive function and perceptual speed, after adjustments were made.