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

项目摘要/摘要 患有阿尔茨海默病(AD)的成年人和他们的照顾者是相当大的一部分，而且没有得到足够的服务 中等体力活动水平低的人群(兆帕)。现有证据表明，有规律的 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 使用AD。此外，甲孕酮可降低阿尔茨海默病的发病风险，并改善健康和福祉。 照顾者。然而，在社区居住的患有AD的成年人及其照顾者中，增加MPA的选择是 有限的。没有专门设计试验来检查增加长期疗效的策略(≥12个月)每天 本组均为甲孕酮。与当前选择相关的重大障碍(医疗诊所、社区站点、 家访，护理者提供)，包括与前往诊所或社区地点旅行相关的时间和费用， 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 这些方法的潜力，以导致持续改善的最低成本。一次干预行动 通过实时视频会议远程访问成群的AD患者及其家中的照顾者 (RGV)，是在这一群体中增加MPA的潜在有效方法。这种方法消除了 需要运送到医疗诊所或其他社区设施，并为同龄人提供了潜力 支持和社会化，这可能是启动和维持MPA的重要因素。我们建议 比较RVG方法与常规护理的有效性，并通过照顾者支持(EUC)增强 100名患有轻中度AD的社区成年人及其照顾者(DADS)的MPA值增加。 两个手臂的参与者都将获得用于干预交付的iPad®，用于自我监控的Fitbit， 并且将被要求完成150分钟的总兆帕/周。双臂上的双臂将提供书面 国家老龄研究所提供的有关锻炼和体力活动的材料，并将被要求 完整的简短(15-20分钟)FaceTime®会议(0-6个月=2个月；7-12个月=1个月；13-18个月=0/mo。)使用 健康教练讨论进展情况，提供支持，并接受关于 增加/维持兆帕。RGV手臂中的二人将被要求完成小组(5-8个二人)练习 (有氧、阻力、平衡/协调)由训练有素的健康教练通过Zoom®软件在 IPad®。小组会议(45分钟)将举行3天/周。在MOS期间。0-6，1d/wk。在MOS期间。7-12，并将成为 在无合同期间(月13至18日)停产。EUC臂中的DUADS将配备 推荐自己的锻炼计划，自己完成。我们的主要目标是比较总兆帕(分钟/周) 成人AD患者的RGV和EUC手臂与其照顾者之间跨越6个月。其次，我们会 比较总分和其他结果，如认知功能、日常生活能力、照顾者负担等。 在RGV和EUC的手臂之间跨越18个月。

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.