Adherence and aerobic exercise intensity in live online exercise sessions for older adults with mild cognitive impairment: Insights from the Japan-Multimodal Intervention Trial for the Prevention of Dementia.
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Abstract
Background: Intervention adherence is crucial to ensure cognitive benefits in trials designed to prevent cognitive decline. During the coronavirus disease 2019 (COVID-19) pandemic, the Japan-Multimodal Intervention Trial for the Prevention of Dementia offered live online exercise sessions to older adults with mild cognitive impairment (MCI).
Objectives: To assess adherence and aerobic exercise intensity through live online exercise sessions in older adults with MCI.
Design: Posthoc analysis of the 18-month, multi-center, randomized controlled trial.
Setting: The study was conducted across five institutions in Japan.
Participants: Older adults aged 65-85 years who were assigned to the intervention group and completed the intervention. Participants were stratified by region (Aichi and Tokyo), where the state of emergency duration due to COVID-19 varied.
Interventions: The intervention group participated in multidomain interventions, including 90-minute group-based physical exercise sessions held weekly for 78 sessions. During the state of emergency, live online sessions were conducted via video conferencing.
Measurements: Attendance rates and aerobic exercise intensity (based on heart rates) during online and onsite sessions were compared using the Wilcoxon signed-rank test.
Results: A total of 207 participants were analyzed. Over 18 months, 78 exercise sessions were conducted, including live online sessions. In the Aichi region, 2 online sessions were held, while in the Tokyo region, 24 online sessions were conducted. In the Tokyo region, adherence was higher in online sessions compared to onsite sessions (92 % vs. 86 %, p = 0.046), while exercise intensity showed no significant difference (49 % vs. 52 %, p = 0.279). No adverse events were reported.
Conclusions: Live online exercise sessions were safe, feasible, and demonstrated adherence and intensity comparable to onsite sessions.
Trial registration: The trial was registered at the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) on November 24, 2019 (UMIN000038671) (https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000044075).
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