Lifestyle Empowerment for Alzheimer's Prevention Prescribed by Physicians: Methods and Adaptations to COVID-19

The health care system is insufficiently capitalizing on the benefits of physical exercise in Americas aging population. Few practical tools exist to help clinicians incorporate physical activity into their clinical care, while significant barriers limit older adults from initiating and maintaining exercise programs. The Lifestyle Empowerment for Alzheimers Prevention (LEAP! Rx) Program will use two forms of participant enrollment: direct physician referrals through electronic health records (EHR) and self-referrals to test the efficacy of delivering a community-based exercise and healthy lifestyle program to older adults. After referral into the program, participants will be randomized to receive the LEAP! Rx Program or be placed on a standard of care waitlist. The LEAP! Rx program will consist of a personalized and structured exercise program combined with lifestyle education and mobile-health (m-Health) monitoring. This includes a 12-week Empowerment phase with intensive coaching and supervised exercise training, followed by a 40-week Lifestyle phase with intermittent supervised exercise and coaching. Lifestyle education includes monthly, evidence-based classes on optimal aging. This study will examine 1) the efficacy of the LEAP!Rx Program on increasing and sustaining cardiorespiratory fitness, 2) test the effect of the LEAP! Rx Program on secondary outcome measures of chronic disease risk factors, including insulin resistance, body composition, and lipids, and 3) assess the implementation and scalability of the LEAP!Rx Program for clinicians and patients and package best practices in implementation manuals. If successful, this studys findings could potentially revolutionize future healthcare practices, providing a new and practical approach to aging and chronic disease prevention.