Dataset Information

The Impact of a Telehealth Intervention on Activity Profiles in Older Adults during the COVID-19 Pandemic: A Pilot Study.

ABSTRACT:

Background

Physical inactivity during the COVID-19 pandemic is a public health concern for older adults. Telehealth presents a safe platform for conducting health-related interventions that may have additional benefits such as widespread reach. Our pilot study sought to examine how a telehealth intervention changed activity profiles in older adults during the COVID-19 pandemic.

Methods

There were n =13 adults aged 70.6 ± 4.5 years that participated in a 6 week telehealth intervention during the COVID-19 pandemic. The didactic intervention contents were shared online, and participants worked with trained interviewers over the telephone to discuss physical activity. At baseline and post-intervention, the Multimedia Activity Recall for Children and Adults examined activity profiles, while accelerometry estimated time spent sedentary and in physical activity.

Results

Relative to the baseline measures, there was an 88 min/day (95% confidence interval (CI): 39, 137) increase in computer time and 36 min/day (CI: 10, 62) reduction in time spent in active transport at post-intervention. Moderate-to-vigorous physical activity participation also increased by an estimated 2 min/day (CI: -21, 26) and 12 min/week (CI: -154, 180), but this trend was not statistically significant.

Conclusion

We recommend that support be provided to older adults transitioning to telehealth, especially as migration to telehealth progresses.

SUBMITTER: Johnson N

PROVIDER: S-EPMC8293040 | biostudies-literature | 2021 Jun

REPOSITORIES: biostudies-literature

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Publications

The Impact of a Telehealth Intervention on Activity Profiles in Older Adults during the COVID-19 Pandemic: A Pilot Study.

Johnson Nathaniel N Bradley Adam A Klawitter Lukus L Johnson Jane J Johnson Lance L Tomkinson Grant R GR Hackney Kyle J KJ Stastny Sherri S Ehlers Diane K DK McGrath Ryan R

Geriatrics (Basel, Switzerland) 20210630 3

<h4>Background</h4>Physical inactivity during the COVID-19 pandemic is a public health concern for older adults. Telehealth presents a safe platform for conducting health-related interventions that may have additional benefits such as widespread reach. Our pilot study sought to examine how a telehealth intervention changed activity profiles in older adults during the COVID-19 pandemic.<h4>Methods</h4>There were <i>n</i> =13 adults aged 70.6 ± 4.5 years that participated in a 6 week telehealth in ...[more]

PMID: 34209416

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Project description:BackgroundThe COVID-19 pandemic has drastically changed the lives of countless members of the general population. Older adults are known to experience loneliness, age discrimination, and excessive worry. It is therefore reasonable to anticipate that they would experience greater negative outcomes related to the COVID-19 pandemic given their increased isolation and risk for complications than younger adults.ObjectiveThis study aims to synthesize the existing research on the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults. The secondary objective is to investigate the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults with Alzheimer disease and related dementias.MethodsA rapid review of the published literature was conducted on October 6, 2020, through a search of 6 online databases to synthesize results from published original studies regarding the impact of the COVID-19 pandemic on older adults. The Human Development Model conceptual framework-Disability Creation Process was used to describe and understand interactions between personal factors, environmental factors, and life habits. Methods and results are reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement.ResultsA total of 135 records were included from the initial search strategy of 13,452 individual studies. Of these, 113 (83.7%) studies were determined to be of level 4 according to the levels of evidence classification by the Centre for Evidence-Based Medicine. The presence of psychological symptoms, exacerbation of ageism, and physical deterioration of aged populations were reported in the included studies. Decreased social life and fewer in-person social interactions reported during the COVID-19 pandemic were occasionally associated with reduced quality of life and increased depression. Difficulties accessing services, sleep disturbances, and a reduction of physical activity were also noted.ConclusionsOur results highlight the need for adequate isolation and protective measures. Older adults represent a heterogeneous group, which could explain the contradictory results found in the literature. Individual, organizational, and institutional strategies should be established to ensure that older adults are able to maintain social contacts, preserve family ties, and maintain the ability to give or receive help during the current pandemic. Future studies should focus on specific consequences and needs of more at-risk older adults to ensure their inclusion, both in public health recommendations and considerations made by policy makers.

Project description:BackgroundTelehealth delivery expanded quickly during the COVID-19 pandemic after the reduction of payment and regulatory barriers, but older adults are the least likely to benefit from this expansion. Little is known about physician experiences initiating telehealth and factors that fostered or discouraged adoption during the COVID-19 pandemic with older adult patients. Therefore, our objective was to understand experiences of frontline physicians caring for older adults via telehealth during the COVID-19 pandemic.MethodsWe conducted semi-structured interviews from September 2020 to November 2020 with 48 physicians. We recruited a diverse sample of geriatricians (n = 18), primary care (n = 15), and emergency (n = 15) physicians from all United Stated (US) regions, rural-urban settings, and academic-community practices who cared for older adult patients during the pandemic using purposive sampling methods. We completed framework analysis of the transcribed interviews to identify emerging themes and used the Quadruple Aim to organize themes.ResultsFrontline physicians described telehealth as a more flexible, value-based, and patient-centered mode of health care delivery. Benefits of using telehealth to treat older adults included reducing deferred care and increasing timely care, improving efficiency for physicians, enhancing communication with caregivers and patients, reducing patient travel burdens, and facilitating health outreach and education. Challenges included unequal access for rural, older, or cognitively impaired patients. Physicians noted that payment parity with in-person visits, between video and telephone visits, and relaxation of restrictive regulations would enhance their ability to continue to offer telehealth.ConclusionsFrontline physicians who treated older adults during the COVID-19 pandemic were largely in favor of continuing telehealth use beyond the pandemic; however, they noted that sustainability would depend on enacting policies that address access inequities and reimbursement concerns. Our data provide policy insights that if placed into action could facilitate the long-term success of telehealth and encourage a more flexible healthcare delivery system in the US.

Project description:Aims and objectivesTo identify the most frequent determinants of contact limitation on older adults' mobility addressed by the recommendations to mitigate mobility limitation during the COVID-19 pandemic and identify the recommendations characteristics and means of dissemination that might guide coping actions.BackgroundMeasures for physical contact restriction were implemented to prevent COVID-19 spread. These measures directly impacted older people, reducing their mobility, especially outside home environment. Health systems worldwide need to be prepared to implement strategies to mitigate negative effects of reduced mobility in this population.DesignScoping review using Arksey and O'Malley's methodological framework.MethodTherefore, a scoping review was conducted in LILACS, CINAHL, MEDLINE, WEB OF SCIENCE and SCOPUS databases. Documents and reports with recommendations from government agencies were also consulted. Results were presented in a narrative synthesis based on a conceptual model of mobility proposed by Webber (The Gerontologist, 2010, 50, 443) regarding the most frequently addressed determinants, characteristics of the proposed interventions, and means of dissemination for the older person population.FindingsTwenty-eight studies were selected for the final sample. According to Webber's model, most articles (n = 14) presented the impacts on mobility from the perspective of physical determinants, relating this aspect to biological losses in the musculoskeletal system, and a minority assessed mobility in vital spaces, encompassing environmental (n = 3) and financial (n = 1) determinants. Also, the most frequent recommendation was that physical activity promotes maintenance of mobility and prevents the occurrence of adverse results, such as falls, fractures and functional decline. As to dissemination, digital technologies were recognised as a strategy to motivate, instruct and monitor exercise practice to increase mobility in older adults.ConclusionThe main conditions related to the decline in mobility of older adults during COVID-19 pandemic were physical inactivity and sedentary lifestyle. The practice of physical activity is widespread and needs to be adapted according to individual needs. Finally, digital technologies are essential tools in this period, but other alternatives should also be considered for low-income seniors.Implications for practiceIt is hoped that the gaps identified through this scoping review can help enhance the discussion on the broader assessment of mobility in older adults and the design of interventions when contact restriction is a reality.

Project description:IntroductionIdentifying intervention methods that target sleep characteristics involved in memory processing is a priority for the field of cognitive aging. Older adults with greater sleep efficiency and non-rapid eye movement slow-wave activity (SWA) (0.5-4 Hz electroencephalographic activity) tend to exhibit better memory and cognitive abilities. Paradoxically, long total sleep times are consistently associated with poorer cognition in older adults. Thus, maximizing sleep efficiency and SWA may be a priority relative to increasing mere total sleep time. As clinical behavioral sleep treatments do not consistently enhance SWA, and propensity for SWA increases with time spent awake, we examined with a proof-of concept pilot intervention whether a greater dose of time-in-bed (TiB) restriction (75% of habitual TiB) would increase both sleep efficiency and SWA in older adults with difficulties staying asleep without impairing memory performance.MethodsParticipants were adults ages 55-80 with diary-reported sleep efficiency <90% and wake after sleep onset (WASO) >20 min. Sleep diary, actigraphy, polysomnography (PSG), and paired associate memory acquisition and retention were assessed before and after a week-long TiB restriction intervention (n = 30). TiB was restricted to 75% of diary-reported habitual TiB. A comparison group of n = 5 participants repeated assessments while following their usual sleep schedule to obtain preliminary estimates of effect sizes associated with repeated testing.ResultsSubjective and objective sleep measures robustly improved in the TiB restriction group for sleep quality, sleep depth, sleep efficiency and WASO, at the expense of TiB and time spent in N1 and N2 sleep. As hypothesized, SWA increased robustly with TiB restriction across the 0.5-4 Hz range, as well as subjective sleep depth, subjective and objective WASO. Despite increases in sleepiness ratings, no impairments were found in memory acquisition or retention.ConclusionA TiB restriction dose equivalent to 75% of habitual TiB robustly increased sleep continuity and SWA in older adults with sleep maintenance difficulties, without impairing memory performance. These findings may inform long-term behavioral SWA enhancement interventions aimed at improving memory performance and risk for cognitive impairments.

Dataset Information

The Impact of a Telehealth Intervention on Activity Profiles in Older Adults during the COVID-19 Pandemic: A Pilot Study.

Background

Methods

Results

Conclusion

Publications

The Impact of a Telehealth Intervention on Activity Profiles in Older Adults during the COVID-19 Pandemic: A Pilot Study.

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