Smartphone App to Improve Physical Activity in Older Adults With MCI/Mild Dementia

Study Overview
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Brief Summary
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The purpose of this study is to develop and test a physical activity-tracking smartphone app designed to facilitate physical activity in older adults with mild cognitive impairments or mild dementia. The app targets provides tips, messages, and strategies to overcome common barriers older adults face to being physically active. Participants will include older adults with memory or thinking problems or those diagnosed with mild cognitive impairment or mild forms of dementia who are smartphone users age 65 years or older and who are not meeting nationally recommended levels of physical activity. In the clinical trial phase of this study, 15 participant-study partner dyads will be oriented to the app and use it for a two-month period. Dyads will keep a diary to document their experiences and participants' activity patterns will also be tracked at the beginning and end of the study. After the two-month app trial is complete, dyads will return for a follow-up interview to discuss their experiences and provide suggestions for app improvements. Findings from this stage of the overall study will be combined with previous study phases to derive specifications for an optimized app for older people with mild cognitive impairments or mild dementia.

Official Title
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A Smartphone Application to Improve Physical Activity in Underactive Older Adults With Mild Cognitive Impairment/Mild Dementia

Conditions
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Sedentary Lifestyle, Dementia, Mild, Mild Cognitive Impairment, Memory and Thinking Problems

Intervention / Treatment
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* Behavioral: Moving Up - A


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria - Target User: 65+ years old English speaking; resides in local Los Angeles area or the Pacific Time Zone; self-reported memory or thinking problems that score within a range of mildly impaired on a cognitive test or a clinical diagnosis of cognitive impairment ranging from mild cognitive impairment (MCI) or mild dementia (of any form). Mild dementia is the top end of this clinical diagnosis range. MCI is the low end of the range. reports <150 minutes of moderate to vigorous physical activity per week as per a single-item screener; self-reported ability to safely engage in regular walking; smartphone owner of a compatible smartphone for ≥1 month; willing and available second family member/friend/caregiver who owns a smartphone and can attend training sessions; and observed ability to reliably access and operate a smartphone during training. Exclusion Criteria - Target User: unwillingness to meet at local community venues and/or via online meetings unwillingness to comply with study procedures for the length of the study inability to participate in English. residing outside of the local Los Angeles (LA) area and do not have the capacity to participate remotely or commuting to the University of Southern California (USC) study site recent cognitive status does not fall within an acceptable MCI/mild dementia range as determined through Montreal Cognitive Assessment (MoCA) if diagnosis was unverified by health care provider or by ADRC or memory and thinking problems were self-reported recent cognitive status is below what is acceptable for MCI/mild dementia as determined through MoCA if diagnosis was verified by health care provider or ADRC Inclusion Criteria - Study Partner: English-speaking Family member/friend/caregiver of target user Owns a smartphone Willing to attend training sessions Note: age limit criterion for target users does not apply to study partners

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Target Users - Moving Up-A app<br>In this single-arm trial, target users (participants) will use a physical activity smartphone app for a two-month period. The app includes motivational messages, tips to increase the intensity level of everyday activities, and strategies to reduce sedentary behaviors. Users can also track their physical activity levels and sedentary activity. | Behavioral: Moving Up - A<br>* Moving Up - A is a physical activity smartphone app for persons with mild cognitive impairment or mild forms of dementia. The app includes a personally tailored set of messages, tips, strategies, and tasks designed to increase physical activity levels and disrupt extended periods of sedentary time. Users also have the ability to track their steps and and sedentary behavior time as well as their progress towards activity goals.<br>|
| Other: Study Partners - Moving Up-A app<br>In this single-arm trial, study partners were invited to support target users (participants) in using a physical activity smartphone app for a two-month period. The app includes motivational messages, tips to increase the intensity level of everyday activities, and strategies to reduce sedentary behaviors. Users can also track their physical activity levels and sedentary activity. | Behavioral: Moving Up - A<br>* Moving Up - A is a physical activity smartphone app for persons with mild cognitive impairment or mild forms of dementia. The app includes a personally tailored set of messages, tips, strategies, and tasks designed to increase physical activity levels and disrupt extended periods of sedentary time. Users also have the ability to track their steps and and sedentary behavior time as well as their progress towards activity goals.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Daily Steps Change From Baseline to Month 2 | Step counts (objective physical activity) were measured using the activPAL thigh-worn accelerometer during a 96-hour monitoring period. Change is computed as the activPAL-tracked mean daily steps at Month 2 minus that value at baseline | baseline and 2 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Daily Sitting Time (activPAL) Change From Baseline to Month 2 | Objective sedentary activity time was measured using the activPAL thigh-worn accelerometer during a 96-hour monitoring period. Expressed as average minutes/day. Change is computed as the activPAL-tracked mean minutes/day of sitting time at Month 2 minus that value at baseline. | baseline and 2 months | 
| App Usability Measured Using the User Version of the Mobile Application Rating Scale (uMARS) | The Mobile App Rating Scale User Version (uMARS) was used to measure user satisfaction with the app, particularly participant's ratings for app quality. The uMARS includes a usability feedback subindex which is comprised of the average of item responses for 4 subsections (engagement, functionality, aesthetics, information), to yield a total quality score. Ratings are on a scale of 1 (low perceived quality, min) to 5 (high perceived quality, max). | Month 2 | 
| App Usage Behavior | Usage behavior is defined as the percentage of days the app was opened at least once across the 2-month trial period | from baseline through Month 2 (daily) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Smartphone app, Physical activity, Older adults