Mediating Factors Associated With Physical Activity in Older Adults at Increased Dementia Risk.

Maria Isabel Cardona, Melanie Luppa, Andrea Zülke, Eric S Kroeber, Alexander Bauer, Juliane Döhring, Catharina Escales, Christian Brettschneider, Thomas Frese, Robert P Kosilek, Jochen Gensichen, Wolfgang Hoffmann, Hanna Kaduszkiewicz, Hans-Helmut König, Birgitt Wiese, Steffi G Riedel-Heller, Jochen René Thyrian
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Abstract

While regular physical-activity (PA) is beneficial, multimorbid individuals at increased dementia risk may exhibit reduced PA levels. Thus, a more comprehensive understanding of mediating factors responsible for inactivity in this population is needed. This study investigated the impact of a multimodal intervention on PA changes at 24-month follow-up and associated mediating factors among community-dwelling patients aged 60-77, with increased dementia risk determined by the CAIDE Dementia Risk Score. Of 1030 participants recruited, 819 completed the assessment. Thus, a generalized estimating equations model initially assessed differences in PA over 24 months, followed by a tree analysis identifying mediating factors influencing PA changes post-intervention. While no significant effect on regular PA was found during the follow-up (P = .674), subgroup analysis revealed improved self-efficacy (P = .000) associated with increased engagement in PA. Incorporating self-efficacy elements into future strategies is crucial for promoting PA among individuals with multimorbidity and at increased dementia risk.

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与痴呆症风险增加的老年人体育活动相关的中介因素。
虽然定期进行体育锻炼(PA)有益,但痴呆症风险增加的多病人群的体育锻炼水平可能会降低。因此,需要更全面地了解造成这一人群缺乏运动的中介因素。本研究调查了多模式干预在 24 个月随访期间对活动量变化的影响以及相关的中介因素,研究对象为 60-77 岁的社区居民患者,他们的痴呆风险增加是由 CAIDE 痴呆风险评分决定的。在招募的 1030 名参与者中,有 819 人完成了评估。因此,广义估计方程模型首先评估了 24 个月内 PA 的差异,然后进行树状分析,确定影响干预后 PA 变化的中介因素。虽然在随访期间没有发现对常规 PA 有明显影响(P = .674),但亚组分析显示,自我效能的提高(P = .000)与 PA 参与度的增加有关。在未来的策略中融入自我效能元素对于促进多病和痴呆症风险增加人群的体育锻炼至关重要。
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