JMIR Publications

ABSTRACT

Background:

Walking is frequently recommended as a beneficial physical activity for older adults, as it can enhance both their physical and mental well-being and help prevent cognitive decline and dementia. While it is known that mobile health technology can help improve physical activity among the elderly, there is limited research on its effectiveness for older individuals with cognitive impairment.

Objective:

This study aimed to determine the effectiveness and feasibility of walking prescriptions using mobile health (mHealth) technology for older adults with cognitive impairment.

Methods:

Sixty older adults (76.1 ± 5.4 years; female, 56.7%) with mild cognitive impairment or mild dementia who visited the memory clinic were enrolled. They were randomly assigned into three groups: 1) group A was prescribed with a goal of daily steps based on their telemonitored activity using a smart band; 2) group B only wore a smart band without a prescription; and 3) group C took a monthly education to encourage their walking. Changes in daily steps (primary outcome), cognitive function, physical status, and depressive symptoms from baseline to post-intervention (12 weeks) and follow-up (24 weeks) were investigated. Linear mixed effect models with factors of group (reference: control), time (reference: baseline), and their interaction were used for data analysis. Post-hoc analyses using paired t-tests were also conducted.

Results:

For group A, there was a significant group × time interaction effect on daily steps both at 12-week and 24-week (β [SE] = 2205.88 [672.34], p = 0.001; β [SE] = 2194.63 [884.33], p = 0.015). Group B showed increased numbers of steps only at 12-week but not at 24-week. Group C showed a continuous decrease in daily steps during the study period. Regarding secondary outcomes, Group C showed a significant decline in cognitive function measured by the Mini-Mental State Examination (MMSE) both at 12 weeks and 24 weeks. However, groups A and B showed stationary MMSE scores during 24 weeks.

Conclusions:

Our findings suggest that walking prescription using mHealth technology can effectively increase physical activities and maintain cognitive health in older adults with cognitive impairment. Clinical Trial: Clinical Research Information Service (CRIS) of Republic of Korea; CRIS numbers, KCT0002610; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=10195&search_page=L