Virtual Chair Yoga for Older Adults and Caregivers: Randomized Controlled Trial

Study Overview
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Brief Summary
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Over 700,000 Canadians are affected by dementia costing the health care system approximately $10 billion/year. Due to COVID-19, the government has urged individuals over the age of 70 to stay home, putting this population at risk of social isolation. Older adults with mild cognitive impairments (MCIs), dementia, and their caregivers are at an even higher risk of becoming stressed, anxious, and agitated while in lockdown. Unsurprisingly, caregiver burden is extremely common, and often precedes institutionalization of the patient, as the demands of the illness begin to exceed that which the caregiver can sustainably provide. Since social distancing measures have shut down activities and support groups for these individuals, there is an urgent need for scalable, cost-effective, non-pharmacological interventions that can be delivered remotely to improve stress and loneliness. Yoga may be a viable therapeutic modality to address the psychological challenges associated with dementia in patients and caregivers, as it has been shown to decrease stress and improve anxiety and depressive symptoms in various populations. For this reason, the investigators are conducting a randomized controlled trial (RCT) to assess the efficacy of an 8-week virtual chair yoga program to improve stress, psychological symptoms, and caregiver burden. This virtual chair yoga study will engage both older adults with dementia/MCI and caregivers (n=40-60 participants) during COVID-19, which is consistent with the need for decreasing costs and increasing accessibility of novel health interventions during and beyond the pandemic. The investigators will evaluate the effect of this program on stress, loneliness, and mental health related outcomes such as fear of COVID-19, depression, anxiety, and caregiver burden compared to a waitlist control group. There will also be a qualitative component in the form of semi-structured interviews. All quantitative outcomes will be assessed before the program starts and post-intervention and qualitative outcomes will be assessed post-intervention. Participants will be randomly assigned to the treatment group (virtual chair yoga 1 hour per week on Zoom) or the waitlist control group. The investigators hypothesize that after the 8-week yoga program, older adults and caregivers will report lower stress, loneliness, depression, anxiety, fear of COVID-19, and caregiver burden. Results will be available late-2021.

Official Title
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Virtual Chair Yoga for Stress in Older Adults (60+) With Mild/Moderate Dementia or Mild Cognitive Impairments and Caregivers (18+) During COVID-19

Conditions
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Dementia, Mild Cognitive Impairment

Intervention / Treatment
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* Behavioral: Chair-yoga program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria for Older Adults: Mild cognitive impairment or mild to moderate dementia (MoCA-BLIND score between 8-18 OR a diagnosis from his/her clinician of mild cognitive impairment) or mild to moderate dementia Sufficient hearing to follow verbal instructions Access to Zoom software and internet connection Ability to sit for 60 minutes without discomfort At least 60 years old Exclusion Criteria for Older Adults: Severe dementia (MoCA-BLIND score < 8) Acute psychotic symptoms Acute suicidal ideation or intent Resides outside of Quebec Inclusion Criteria for Caregivers: Providing care for someone with cognitive impairments (mild cognitive impairment or mild, moderate, or severe dementia) Sufficient hearing to follow verbal instructions Access to Zoom software and internet connection Ability to sit for 60 minutes without discomfort At least 18 years old Exclusion Criteria for Caregivers: Dementia (MoCA-BLIND score < 18) Acute psychotic symptoms Acute suicidal ideation or intent Resides outside of Quebec

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Chair Yoga Treatment Group<br>The chair-yoga session will occur for 8-weeks (60 minutes/week) on Zoom. The chair-yoga intervention will include gentle seated postures, relaxation using breathing techniques, and a mindfulness component. | Behavioral: Chair-yoga program<br>* 8-week chair yoga program with gentle postures, breathing techniques, and mindfulness.<br>|
| No Intervention: Waitlist Control Group<br>These participants will be on a waitlist to receive the chair yoga program after data collection has been completed (e.g., after 8-weeks). | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in perceived stress scores as measured by the Perceived Stress Scale (PSS) for treatment group versus control group | The 8-week randomized controlled trial (RCT) of the virtual chair yoga treatment versus the waitlist control group will assess the effects of the virtual chair yoga on perceived stress in older adults and caregivers, using the PSS. Scores on the PSS can range from 0-40, with higher scores indicating higher perceived stress. Hypothesis: Following participation in an 8-week RCT of the virtual chair yoga program, older adults with dementia and their caregivers will report lower perceived stress, as measured by the Perceived Stress Scale (PSS) compared to the waitlist control group. | Baseline, 8-weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in loneliness scores as measured by the 3-item UCLA Loneliness Scale for treatment group versus control group | The 8-week randomized controlled trial (RCT) of the virtual chair yoga treatment versus the waitlist control group will assess the effects of the virtual chair yoga on perceived stress in older adults and caregivers, using the PSS. | Baseline, 8-weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Dementia, Mild Cognitive Impairments, Caregiving, Stress, Loneliness, Depression, Anxiety, Chair-yoga