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Promoting safe walking among older people: the effects of a physical and cognitive training intervention vs. physical training alone on mobility and falls among older community-dwelling men and women (the PASSWORD study): design and methods of a randomized controlled trial.
BMC Geriatr. 2018 09 15; 18(1):215.BG

Abstract

BACKGROUND

Safe and stable walking is a complex process involving the interaction of neuromuscular, sensory and cognitive functions. As physical and cognitive functions deteriorate with ageing, training of both functions may have more beneficial effects on walking and falls prevention than either alone. This article describes the study design, recruitment strategies and interventions of the PASSWORD study investigating whether a combination of physical and cognitive training (PTCT) has greater effects on walking speed, dual-task cost in walking speed, fall incidence and executive functions compared to physical training (PT) alone among 70-85-year-old community-dwelling sedentary or at most moderately physically active men and women.

METHODS

Community-dwelling sedentary or at most moderately physically active, men and women living in the city of Jyväskylä will be recruited and randomized into physical training (PT) and physical and cognitive training (PTCT). The 12-month interventions include supervised training sessions and home exercises. Both groups attend physical training intervention, which follows the current physical activity guidelines. The PTCT group performes also a web-based computer program targeting executive functions. Outcomes will be assessed at baseline and at 6 and 12 months thereafter. Falls data are collected during the interventions and the subsequent one-year follow-up. The primary outcome is 10-m walking speed. Secondary outcomes include 6-min walking distance, dual-task cost in walking speed, fall incidence and executive function assessed with color Stroop and Trail Making A and B tests. Explanatory outcomes include e.g. body composition and bone characteristics, physical performance, physical activity, life-space mobility, fall-related self-efficacy, emotional well-being and personality characteristics.

DISCUSSION

The study is designed to capture the additive and possible synergistic effects of physical and cognitive training. When completed, the study will provide new knowledge on the effects of physical and cognitive training on the prevention of walking limitations and rate of falls in older people. The expected results will be of value in informing strategies designed to promote safe walking among older people and may have a significant health and socio-economic impact.

TRIAL REGISTRATION

ISRCTN52388040 .

Authors+Show Affiliations

Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland. sarianna.sipila@jyu.fi.Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.Department of Neurology, Kuopio University Hospital, Kuopio, Finland.Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.Department of Medical Rehabilitation, Oulu University Hospital, Oulu, Finland.Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.Department of Public Health Solutions, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland. Division of Clinical Geriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden. Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland. Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, UK.Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.Department of Public Health Solutions, Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland. Division of Clinical Geriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden.Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.School of Health and Social Studies, Jyväskylä University of Applied Sciences, Jyväskylä, Finland.Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden. Department of Psychology, Umeå University, Umeå, Sweden.Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

30219032

Citation

Sipilä, Sarianna, et al. "Promoting Safe Walking Among Older People: the Effects of a Physical and Cognitive Training Intervention Vs. Physical Training Alone On Mobility and Falls Among Older Community-dwelling Men and Women (the PASSWORD Study): Design and Methods of a Randomized Controlled Trial." BMC Geriatrics, vol. 18, no. 1, 2018, p. 215.
Sipilä S, Tirkkonen A, Hänninen T, et al. Promoting safe walking among older people: the effects of a physical and cognitive training intervention vs. physical training alone on mobility and falls among older community-dwelling men and women (the PASSWORD study): design and methods of a randomized controlled trial. BMC Geriatr. 2018;18(1):215.
Sipilä, S., Tirkkonen, A., Hänninen, T., Laukkanen, P., Alen, M., Fielding, R. A., Kivipelto, M., Kokko, K., Kulmala, J., Rantanen, T., Sihvonen, S. E., Sillanpää, E., Stigsdotter-Neely, A., & Törmäkangas, T. (2018). Promoting safe walking among older people: the effects of a physical and cognitive training intervention vs. physical training alone on mobility and falls among older community-dwelling men and women (the PASSWORD study): design and methods of a randomized controlled trial. BMC Geriatrics, 18(1), 215. https://doi.org/10.1186/s12877-018-0906-0
Sipilä S, et al. Promoting Safe Walking Among Older People: the Effects of a Physical and Cognitive Training Intervention Vs. Physical Training Alone On Mobility and Falls Among Older Community-dwelling Men and Women (the PASSWORD Study): Design and Methods of a Randomized Controlled Trial. BMC Geriatr. 2018 09 15;18(1):215. PubMed PMID: 30219032.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Promoting safe walking among older people: the effects of a physical and cognitive training intervention vs. physical training alone on mobility and falls among older community-dwelling men and women (the PASSWORD study): design and methods of a randomized controlled trial. AU - Sipilä,Sarianna, AU - Tirkkonen,Anna, AU - Hänninen,Tuomo, AU - Laukkanen,Pia, AU - Alen,Markku, AU - Fielding,Roger A, AU - Kivipelto,Miia, AU - Kokko,Katja, AU - Kulmala,Jenni, AU - Rantanen,Taina, AU - Sihvonen,Sanna E, AU - Sillanpää,Elina, AU - Stigsdotter-Neely,Anna, AU - Törmäkangas,Timo, Y1 - 2018/09/15/ PY - 2018/01/23/received PY - 2018/08/30/accepted PY - 2018/9/17/entrez PY - 2018/9/17/pubmed PY - 2019/7/10/medline KW - Aging KW - Executive function KW - Physical activity KW - Prevention KW - Sedentary SP - 215 EP - 215 JF - BMC geriatrics JO - BMC Geriatr VL - 18 IS - 1 N2 - BACKGROUND: Safe and stable walking is a complex process involving the interaction of neuromuscular, sensory and cognitive functions. As physical and cognitive functions deteriorate with ageing, training of both functions may have more beneficial effects on walking and falls prevention than either alone. This article describes the study design, recruitment strategies and interventions of the PASSWORD study investigating whether a combination of physical and cognitive training (PTCT) has greater effects on walking speed, dual-task cost in walking speed, fall incidence and executive functions compared to physical training (PT) alone among 70-85-year-old community-dwelling sedentary or at most moderately physically active men and women. METHODS: Community-dwelling sedentary or at most moderately physically active, men and women living in the city of Jyväskylä will be recruited and randomized into physical training (PT) and physical and cognitive training (PTCT). The 12-month interventions include supervised training sessions and home exercises. Both groups attend physical training intervention, which follows the current physical activity guidelines. The PTCT group performes also a web-based computer program targeting executive functions. Outcomes will be assessed at baseline and at 6 and 12 months thereafter. Falls data are collected during the interventions and the subsequent one-year follow-up. The primary outcome is 10-m walking speed. Secondary outcomes include 6-min walking distance, dual-task cost in walking speed, fall incidence and executive function assessed with color Stroop and Trail Making A and B tests. Explanatory outcomes include e.g. body composition and bone characteristics, physical performance, physical activity, life-space mobility, fall-related self-efficacy, emotional well-being and personality characteristics. DISCUSSION: The study is designed to capture the additive and possible synergistic effects of physical and cognitive training. When completed, the study will provide new knowledge on the effects of physical and cognitive training on the prevention of walking limitations and rate of falls in older people. The expected results will be of value in informing strategies designed to promote safe walking among older people and may have a significant health and socio-economic impact. TRIAL REGISTRATION: ISRCTN52388040 . SN - 1471-2318 UR - https://www.unboundmedicine.com/medline/citation/30219032/Promoting_safe_walking_among_older_people:_the_effects_of_a_physical_and_cognitive_training_intervention_vs__physical_training_alone_on_mobility_and_falls_among_older_community_dwelling_men_and_women__the_PASSWORD_study_:_design_and_methods_of_a_randomized_controlled_trial_ L2 - https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-018-0906-0 DB - PRIME DP - Unbound Medicine ER -