A Dyadic Approach for a Remote Physical Activity Intervention in Adults with Alzheimer's Disease and their Caregivers

项目总结/摘要 患有阿尔茨海默病（AD）的成年人及其照顾者代表了一个相当大的和服务不足的部分， 中度体力活动（MPA）水平低的人群。现有证据表明， MPA可以改善成年人的活动能力、日常生活活动能力、一般认知能力和平衡能力 与AD此外，MPA可以降低AD的发展风险，并改善健康和福祉， 照顾者然而，在社区居住的AD成人及其护理人员中增加MPA的选择是 有限公司没有专门设计试验来检查增加长期（≥12个月）每日 MPA在这一组。与当前选择相关的重大障碍（医疗诊所、社区站点， 家访，护理人员提供），包括与前往诊所或社区站点相关的时间和费用， 与个人家访相关的费用和照顾者指导的锻炼的额外负担减少 这些方法对MPA持续改善的潜力。提供的干预措施 通过实时视频会议远程与AD成年人及其家中的护理人员进行沟通 (RGV)这是一个潜在的有效的方法来增加MPA在这一组。这种方法消除 需要运输到医疗诊所或其他社区设施，并提供了潜在的同行 支持和社会化，这可能是重要的启动和维护MPA。我们建议 比较RVG方法与常规护理的有效性，并通过护理人员支持（EUC）进行增强， 在100名社区居住的轻度至中度AD成年人及其照顾者（二人组）中增加MPA。 两组受试者都将获得iPad®进行干预，Fitbit用于自我监测MPA， 并将被要求完成150分钟的总MPA/周。将提供两组中的成对件，并提供书面 关于锻炼和身体活动的材料，从国家老龄化研究所，并将被要求 完整的简短（15-20分钟）FaceTime®会议（0-6个月= 2/月; 7-12 mos.= 1/月;，13-18个月=0/月）与 健康教练讨论进展情况，提供支持并接受额外的指导， 增加/维持MPA。将要求RGV组中的二人组完成分组（5-8对二人组）运动 （有氧，阻力，平衡/协调）由训练有素的健康教练通过Zoom®软件提供， iPad®。小组会议（45分钟）将举行3天/周。在MOS期间，0-6，1天/周。在MOS期间，7-12，将 在无合同期间（mos.13-18）中止。EUC组中的对将提供 建议自己完成自己的锻炼计划。我们的主要目的是比较总MPA（min/wk.） 6个月内AD成人及其护理者的RGV和EUC组之间的差异。其次，我们将 比较总MPA和其他结局，例如，认知功能、日常生活活动、照顾者负担等。 RGV和EUC臂之间的18 mos。

Project Summary/Abstract Adults with Alzheimer’s disease (AD) and their caregivers represent a sizeable and underserved segment of the population with low levels of moderate physical activity (MPA). Available evidence suggests that regular MPA can improve mobility, performance of activities of daily living, general cognition, and balance in adults with AD. Additionally, MPA may reduce the risk of development of AD and improve health and well-being in caregivers. However, options for increased MPA in community dwelling adults with AD and their caregivers are limited. No trials have been designed specifically to examine strategies to increase long-term (≥12 mos.) daily MPA in this group. The significant barriers associated with current options (medical clinic, community site, home visits, caregiver delivered), including the time and cost associated with travel to clinic or community site, expense associated with individual home visits and the additional burden of caregiver directed exercise reduce the potential of these approaches to result in sustained improvements in MPA. An intervention delivered remotely via real-time video conferencing to groups of adults with AD and their caregivers in their homes (RGV), represents a potentially effective approach for increasing MPA in this group. This approach eliminates the need for transportation to a medical clinic or other community facility, and offers the potential for peer support and socialization, which may be important for initiation and maintenance of MPA. We propose to compare the effectiveness of the RVG approach with usual care, enhanced with caregiver support (EUC), for increasing MPA in 100 community dwelling adults with mild to moderate AD and their caregiver (dyads). Participants in both arms will be provided with an iPad® for intervention delivery, Fitbit for self-monitoring MPA, and will be asked to complete a 150 min of total MPA/wk. Dyads in both arms will be provided with written materials regarding exercise and physical activity from the National Institute on Aging, and will be asked to complete brief (15-20 min) FaceTime® meetings (0-6 mos.= 2/mo.; 7-12 mos.= 1/mo.;, 13-18 mos. =0/mo.) with the heath coach to discuss progress, provide support and receive additional guidance on increasing/maintaining MPA. Dyads in the RGV arm will be asked to complete group (5-8 dyads) exercise (aerobic, resistance, balance/coordination) delivered by a trained health coach via Zoom® software on an iPad®. Group sessions (45-min) will be held 3 d/wk. during mos. 0-6, 1 d/wk. during mos. 7-12, and will be discontinued during the no-contract period (mos.13-18). Dyads in the EUC arm, will be provided with a recommended exercise plan to complete own their own. Our primary aim is to compare total MPA (min/wk.) between the RGV and EUC arms in adults with AD and their caregiver across 6 mos. Secondarily we will compare total MPA and other outcomes, e.g., cognitive function, activities of daily living, caregiver burden etc. between the RGV and EUC arms across 18 mos.