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| Name | Class |
|---|---|
| Sengkang General Hospital | OTHER |
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This study intends to determine if smart watches and mobile phone application prompts can complement physical activity as a preventive intervention by motivating participants to exercise, so as to improve their physical and cognitive outcomes.
The investigators hypothesize that technology will help increase engagement in physical activity for the intervention group relative to the control group and subsequently improve cognitive and physical outcomes.
This study aims to explore the role of technology -- in the form of smart watches and mobile phone application -- in physical activity enhancement on cognitive frailty outcomes. Cognitive frailty is defined here as having both physical frailty and cognitive impairment but does not satisfy criteria for Major Neurocognitive Disorder. The investigators postulate that for older adults, such technology will help increase engagement in physical activity with subsequent improvement in cognitive and physical outcomes at follow up. This is with the aim of preventing this particular group from deteriorating to cognitive frailty because of the accompanying increased risk for adverse outcomes and morbidity.
This pilot study will be a randomized control trial with 2 treatment arms. Assessments will be done prior to and following the intervention period. During the period of intervention, the wearable will act as a tracking device and will be paired with a mobile application to issue prompts to the participant when necessary. The independent variable explored in the study is the use of the wearable while the levels of physical and cognitive improvements are the dependent measures. These will be tracked at baseline, 3 months and 6 months. Additionally, the mediating variable measured is the levels of physical activity to ensure that the proposed outcomes are affected through an increased level of physical activity encouraged by the use of the device.
If innovations like technology and the role of self-management proves efficacious, the future of healthcare in the context of a rapidly aging population will be more sustainable. Furthermore, this supporting role of technology in positive behavioral modification amongst older adults can have a multitude of applications in subsequent healthcare interventions.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention Group | Experimental | Participants in the intervention group will be given the wearables which they will use together with the accompanying mobile application for the period of the study (6 months). During the period of intervention, the wearable will track the physical activity of the older adults via the number of steps taken and number of hours of moderate physical work (based on heart rate). Heart rate and steps will be tracked whenever participants are wearing the watch, which is when they are awake. The watch is to be charged every night when they are sleeping. Participants will have to log down their physical activity by activating the physical activity tracker either on the watch or on the mobile application. If they did not hit the required level of physical activity, they will be sent a notification prompt through the mobile application with details of nearby workout locations as recommendation. |
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| Control Group | No Intervention | For the control group, they will wear the wearables as a tracking device for the period of the study (6 months). No prompts will be given and the mobile application will only be installed but not used for this group. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mobile phone application and smart watch | Device | Mobile phone application prompts |
|
| Measure | Description | Time Frame |
|---|---|---|
| Mean Change from Baseline in frailty screening scores on the FRAIL questionnaire at 3 and 6 months | 5 questions on fatigue, resistance, ambulation, illness and loss of weight. It is a simple screening test for frailty. Scores of 0 (non-frail), 1-2 (pre-frail) and 3-5 (frail). | At 3 months and 6 months |
| Mean Change from Baseline in physical frailty as measured by physical performance tests at 3 months and 6 months | Hand grip strength in kilograms | At 3 months and 6 months |
| Mean Change from Baseline in physical frailty as measured by physical performance tests at 3 months and 6 months | Gait speed, time taken to walk a specified distance as fast as possible, in seconds | At 3 months and 6 months |
| Mean Change from Baseline in physical frailty as measured by physical performance tests at 3 months and 6 months | Timed Up and Go (TUG), time taken to stand up from a chair, walk 3 meters, turn around and sit back down, in seconds | At 3 months and 6 months |
| Mean Change from Baseline in physical frailty as measured by physical performance tests at 3 months and 6 months | Chair Stand Test, time taken to stand up fully 5 times from a chair in seconds | At 3 months and 6 months |
| Mean Change from Baseline in cognitive scores as measured on the Neurocognitive Assessment test battery at 3 and 6 months | Rey Auditory Verbal Learning Test (RAVLT) assesses verbal learning and memory | At 3 months and 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Mean Change from Baseline in Steps Taken measured by the smart watch at 3 months and 6 months | Number of steps taken daily | At 3 months and 6 months |
| Mean Change from Baseline in moderate exercise measured by the smart watch at 3 months and 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Control variable of sleep quality as measured on the Pittsburgh Sleep Quality Index (PSQI) at 3 and 6 months | Self-reported questionnaire on sleep quality in the last month. Global score ranges from 0-21 with a score of 5 and above indicating poor sleep quality. The higher the score, the poorer the sleep quality. | At 3 months and 6 months |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Savannah Siew, BSc (Hons) | Contact | 90697618 | savannahsiew@nus.edu.sg | |
| Rathi Mahendran, MMed (Psych) | Contact | pcmrathi@nus.edu.sg |
| Name | Affiliation | Role |
|---|---|---|
| Rathi Mahendran, MMed (Psych) | National University of Singapore | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hannah Senior Activity Center | Recruiting | Singapore | 590021 | Singapore |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38394113 | Derived | Kiah Hui Siew S, Yu J, Teo TL, Chua KC, Mahendran R, Rawtaer I. Technology and physical activity for preventing cognitive and physical decline in older adults: Protocol of a pilot RCT. PLoS One. 2024 Feb 23;19(2):e0293340. doi: 10.1371/journal.pone.0293340. eCollection 2024. |
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| ID | Term |
|---|---|
| D060825 | Cognitive Dysfunction |
| D000073496 | Frailty |
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D003072 | Cognition Disorders |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D010335 | Pathologic Processes |
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Intervention and control group design
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Randomization will be carried out by a research assistant not involved in the study.
The assessors will be blind to the treatment assignment of the participant when administering the questionnaires.
| Mean Change from Baseline in cognitive scores as measured on the Neurocognitive Assessment test battery at 3 and 6 months | Digit Span Forward and Backward (DS) assesses working memory capacity | At 3 months and 6 months |
| Mean Change from Baseline in cognitive scores as measured on the Neurocognitive Assessment test battery at 3 and 6 months | Colour Trails Test (CTT) assesses visual-spatial skills and attention | At 3 months and 6 months |
| Mean Change from Baseline in cognitive scores as measured on the Neurocognitive Assessment test battery at 3 and 6 months | Wechsler's Block Design (WBS) assesses visuospatial ability | At 3 months and 6 months |
| Mean Change from Baseline in cognitive scores as measured on the Neurocognitive Assessment test battery at 3 and 6 months | Semantic Fluency - animals (SFA) assesses semantic memory | At 3 months and 6 months |
Minutes of moderate exercise in a week
| At 3 months and 6 months |
| Mean Change from Baseline in levels of physical activity measured by the "International Physical Activity Questionnaire" at 3 months and 6 months | Self-reported minutes and hours of vigorous or moderate exercise | At 3 months and 6 months |
| Control variable of levels of motivation as measured on the Barriers Self-efficacy Scale at 3 and 6 months |
Self-reported questionnaire on levels of motivation specific to exercising. Scores ranges from 0-100. The higher the score, the higher the level of self-efficacy. |
| At 3 months and 6 months |
| Control variable of depression as measured on the Geriatric Depression Scale at 3 and 6 months | Self-reported screening test for depression. Scores ranges from 0-15 and a higher score reflect more depressive symptoms. | At 3 months and 6 months |
| Control variable of anxiety as measured on the Geriatric Anxiety Inventory at 3 and 6 months | Self-reported screening test for anxiety. Scores ranges from 0-20 and a higher score reflect more anxiety symptoms. | At 3 months and 6 months |
| D013568 |
| Pathological Conditions, Signs and Symptoms |
| D001519 | Behavior |