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      The Agewell trial: a pilot randomised controlled trial of a behaviour change intervention to promote healthy ageing and reduce risk of dementia in later life

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          Abstract

          Background

          Lifestyle factors represent prime targets for behaviour change interventions to promote healthy ageing and reduce dementia risk. We evaluated a goal-setting intervention aimed at promoting increased cognitive and physical activity and improving mental and physical fitness, diet and health.

          Methods

          This was a pilot randomised controlled trial designed to guide planning for a larger-scale investigation, provide preliminary evidence regarding efficacy, and explore feasibility and acceptability. Primary outcomes were engagement in physical and cognitive activity. Participants aged over 50 living independently in the community were recruited through a community Agewell Centre. Following baseline assessment participants were randomly allocated to one of three conditions: control (IC) had an interview in which information about activities and health was discussed; goal-setting (GS n = 24) had an interview in which they set behaviour change goals relating to physical, cognitive and social activity, health and nutrition; and goal-setting with mentoring (GM, n = 24) had the goal-setting interview followed by bi-monthly telephone mentoring. Participants and researchers were blinded to group assignment. Participants were reassessed after 12 months.

          Results

          Seventy-five participants were randomised (IC n = 27, GS n = 24, GM n = 24). At 12-month follow-up, the two goal-setting groups, taken together (GS n = 21, GM n = 22), increased their level of physical (effect size 0.37) and cognitive (effect size 0.15) activity relative to controls (IC n = 27). In secondary outcomes, the two goal-setting groups taken together achieved additional benefits compared to control (effect sizes ≥ 0.2) in memory, executive function, cholesterol level, aerobic capacity, flexibility, balance, grip strength, and agility. Adding follow-up mentoring produced further benefits compared to goal-setting alone (effect sizes ≥ 0.2) in physical activity, body composition, global cognition and memory, but not in other domains. Implementation of the recruitment procedure, assessment and intervention was found to be feasible and the approach taken was acceptable to participants, with no adverse effects.

          Conclusions

          A brief, low-cost goal-setting intervention is feasible and acceptable, and has the potential to achieve increased activity engagement.

          Trial registration

          Current Controlled Trials ISRCTN30080637

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          Most cited references52

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          B. F. Skinner's Science and Human Behavior: its antecedents and its consequences.

          A Catania (2003)
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            Writing SMART rehabilitation goals and achieving goal attainment scaling: a practical guide.

            To describe a practical method of setting personalized but specific goals in rehabilitation that also facilitates the use of goal attainment scaling. Rehabilitation is a complex intervention requiring coordinated actions by a team, a process that depends upon setting interdisciplinary goals that are specific, clear and personal to the patient. Goal setting can take much time and still be vague. A practical and standardized method is needed for being specific. A novel approach to writing specific, measurable, achievable, realistic/ relevant and timed (SMART) goals is developed here. Each goal can be built up by using up to four parts: the target activity, the support needed, quantification of performance and the time period to achieve the desired state. This method can be employed as part of goal attainment scaling and the other levels can be easily and quickly formulated by adding, deleting and/or changing one or more of the (sub)parts. The success of goal setting and goal attainment scaling depends on the formulation of the goals. The method described here is a useful tool to standardize the writing of goals in rehabilitation. It saves time and simplifies the construction of goals that are sufficiently specific to be measurable.
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              The physical activity scale for the elderly (PASE): evidence for validity.

              We assessed the validity of the Physical Activity Scale for the Elderly (PASE) in a sample of sedentary adults (56 men, 134 women, mean age +/- [SD] 66.5+/-5.3 years) who volunteered to participate in a randomized controlled trial on the effect of aerobic conditioning on psychological function. Construct validity was established by correlating PASE scores with physiologic and performance characteristics: peak oxygen uptake, resting heart rate and blood pressure, percent body fat, and balance. The mean PASE scores were higher in men than in women (men = 145.8+/-78.0; women = 123.9+/-66.3, P<0.05), and in those age 55-64 years compared with those age 65 years and over (55-64 = 144.2+/-75.8; 65 and over = 118.9+/-63.9, P<0.05). PASE scores were also significantly higher in those who did not report a chronic health condition (cardiovascular disease, hypertension, cancer, or recent surgery). PASE scores were significantly associated (P<0.05) with peak oxygen uptake (r = 0.20), systolic blood pressure (r = -0.18) and balance score (r = 0.20). No significant associations of PASE score and diastolic blood pressure, resting heart rate, or percent body fat were noted. These results provide additional evidence for the validity of the PASE as a measure of physical activity suitable for use in epidemiology studies on the association of physical activity, health, and physical function in older individuals.
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                Author and article information

                Contributors
                l.clare@bangor.ac.uk
                s.nelis@bangor.ac.uk
                jonesir4@cardiff.ac.uk
                j.v.hindle@bangor.ac.uk
                j.thom@unsw.edu.au
                j.a.nixon@bangor.ac.uk
                j.cooney@bangor.ac.uk
                c.l.jones@bangor.ac.uk
                r.t.edwards@bangor.ac.uk
                c.j.whitaker@bangor.ac.uk
                Journal
                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central (London )
                1471-244X
                19 February 2015
                19 February 2015
                2015
                : 15
                : 25
                Affiliations
                [ ]Research in Ageing and Cognitive Health, School of Psychology, Bangor University, Bangor, Gwynedd LL57 2AS UK
                [ ]Wales Institute of Social & Economic Research, Data & Methods, Cardiff University, Cardiff, UK
                [ ]School of Medical Sciences, Bangor University, Bangor, UK
                [ ]School of Medicine, University of New South Wales, New South Wales, Australia
                [ ]School of Sports, Health and Exercise Sciences, Bangor University, Bangor, UK
                [ ]Centre for Health Economics and Medicines Evaluation, IMSCaR, Bangor University, Bangor, UK
                [ ]North Wales Organisation for Randomised Trials in Health, Bangor University, Bangor, UK
                Article
                402
                10.1186/s12888-015-0402-4
                4337106
                25880911
                b39d40e3-6bd3-41d5-b3f4-7a9eaa29c8fa
                © Clare et al.; licensee BioMed Central. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 13 October 2014
                : 2 February 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Clinical Psychology & Psychiatry
                goal-setting,cognition,cognitive activity,physical activity,physical fitness,diet,health

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