Developing an Online Tai Ji Program to Improve Health Outcomes in Older Adults

项目摘要/摘要 背景资料。正在进行的新冠肺炎公共卫生危机对美国老年人产生了重大影响 新型冠状病毒感染导致严重疾病的风险更高。落实就地就地安置和 社交距离虽然是减少病毒传播的重要一步，但却在无意中强加了 个人生活障碍和认知障碍老年人的主要社会制约。其中许多 个人依赖基于社区的服务来获得护理和支持，因此面临着巨大的 进行基本的社会活动，包括参加以社区为基础的锻炼课程的挑战。 鉴于疫情减弱的迹象仍不明确，今年有可能出现新的疫情 冬季，持续的强制社会隔离将加剧 体力活动水平已经很低，身心健康状况不佳。目标。这 申请行政补充，以支持开发和测试基于互联网的 运动干预(太极拳运动改善大脑健康[TJQMIBH])使用实时 为患有轻度认知障碍(MCI)的老年人举行视频会议。拟议的工作与 我们的母项目(AG059546)的范围，旨在评估面对面、小组- 以认知运动为基础的太极拳干预，针对这一脆弱和高危人群。这些资金 本行政补编将支持与以下四个具体目标有关的研究工作： 具体目标1：将面对面TJQMIBH干预方案转变为可交付的在线课程 协议；具体目标2：在患有以下疾病的老年人中试行TJQMIBH在线虚拟班级交付协议 MCI；具体目标3：制定有效和受保护的在线评估和数据确定 包括认知和身体表现衡量的程序；和具体目标4：进行 虚拟TJQMIBH干预与拉伸干预效果的随机对照试验 运动对照组：老年MCI患者。意义和影响。就地避难所和社交场所- 新冠肺炎的疏远政策让认知障碍的老年人很少或根本没有认知障碍 有机会继续在他们的社区中进行体育活动。有证据表明，有限的或没有身体上的 活动可能会导致风险增加，并有可能使这种高危人群的慢性健康状况恶化 人口。与此同时，几乎没有基于互联网的锻炼计划可以让老年人保持活跃 在具有高度传染性的新冠肺炎环境中保持健康。我们的项目解决了这一紧迫的公共卫生问题 通过互联网在家中开发和提供虚拟锻炼计划来满足您的需求。如果成功，则 该项目的成果将通过以下方式对疾病预防领域产生持续、强大的影响 为有认知障碍的老年人提供安全、方便和有效的运动干预 无论是在当前的极端条件下还是在新冠肺炎大流行之后都可以实施。

Project Summary/Abstract Background. The ongoing COVID-19 public health crisis is significantly impacting older Americans who are at higher risk for severe illness from novel coronavirus infection. The implementation of shelter-in-place and social distancing, though an essential step in reducing transmission of the virus, has imposed unintended personal life hurdles and major social constraints on cognitively impaired older adults. Many of these individuals are dependent on community-based services for care and support and therefore face great challenges to performing essential social activities, including attending community-based exercise classes. Given that the signs of the outbreak abating are still vague and that there is the likelihood of new outbreak this winter, the continued enforced societal isolation will exacerbate sedentary behaviors in a population with already low levels of physical activity and poor physical and mental health outcomes. Objectives. This application requests Administrative Supplement to support the development and testing of an Internet-based exercise intervention (Tai Ji Quan Moving to Improve Brain Health [TJQMIBH]) using real-time videoconferencing for older adults with mild cognitive impairment (MCI). The proposed work aligns with the scope of our parent project (AG059546), which is designed to evaluate the efficacy of an in-person, group- based, cognitive-motor-integrated Tai Ji Quan intervention for this vulnerable and at-risk population. The funds from this Administrative Supplement will support research work related to the following four specific aims: Specific Aim 1: to transform the in-person TJQMIBH intervention protocol into a deliverable online class protocol; Specific Aim 2: to pilot test the online TJQMIBH virtual class delivery protocol in older adults with MCI; Specific Aim 3: To develop effective and protected online assessment and data ascertainment procedures encompassing the cognitive and physical performance measures; and Specific Aim 4: to conduct a randomized controlled trial comparing the effectiveness of the virtual TJQMIBH intervention with a stretching exercise control group among older adults with MCI. Significance and Impact. Shelter-in-place and social- distancing policies in response to COVID-19 have left older adults with cognitive impairment with few or no opportunities to continue physical activity in their community. Evidence suggests that limited or no physical activity may lead to an increased risk and potential worsening of chronic health conditions for this at-risk population. Meanwhile, there are few Internet-based exercise programs available to keep older adults active and healthy in the highly contagious COVID-19 environment. Our project addresses this urgent public health need by developing and delivering a virtual exercise program at home through the Internet. If successful, the outcome from this project will exert a sustained, powerful influence on the field of disease prevention by providing a safe, accessible, and effective exercise intervention for older adults with cognitive impairment that can be implemented both under current extreme conditions and in the aftermath of the COVID-19 pandemic.