Changes in lifestyles, cognitive impairment, quality of life and activity day living after combined use of smartphone and smartband technology: a randomized clinical trial (EVIDENT-Age study)

José I Recio-Rodríguez, Susana Gonzalez-Sanchez, Olaya Tamayo-Morales, Manuel A Gómez-Marcos, Luis Garcia-Ortiz, Virtudes Niño-Martín, Cristina Lugones-Sanchez, Emiliano Rodriguez-Sanchez, José I Recio-Rodríguez, Susana Gonzalez-Sanchez, Olaya Tamayo-Morales, Manuel A Gómez-Marcos, Luis Garcia-Ortiz, Virtudes Niño-Martín, Cristina Lugones-Sanchez, Emiliano Rodriguez-Sanchez

Abstract

Background: The aim of this study was to assess the efficacy of the combined use of smartphone and smartband technology for 3-months alongside brief lifestyle counselling, versus counselling alone, in increasing physical activity. As secondary objectives, the effects of the intervention on dietary habits, body composition, quality of life, level of functionality and cognitive performance were assessed.

Methods: This study employed a randomized clinical trial of two-parallel groups design - control group (CG) and intervention group (IG). The study was conducted in 3 Spanish health-centres between October 2018-February 2020. Eligible participants were people of both sexes and aged between 65-80 years attending the health-centres with a score ≥ 24 points on the Mini-Mental State Examination. Key variables included physical activity, dietary pattern, body composition, cognitive performance, level of functionality and quality of life. All variables were measured at baseline and after 3-months. Both groups received a brief nutritional and physical activity advice. Intervention group participants were instructed to use a smartphone application for a period of 3-months. This application integrates information on physical activity received from a fitness bracelet and self-reported information on the patient's daily nutritional composition.

Results: The study population comprised 160 participants (IG = 81, CG = 79), with a mean age of 70.8 ± 4.0 years (61.3% women). No difference was found in the primary and secondary outcomes analyzed (physical activity (steps/min -0.4 (-1.0 to 0.2) p = 0.174), and dietary habits (Mediterranean diet score 0.0 (-0.6 to 0.6) p = 0.956) that could be attributed to either group after an ANCOVA test. A difference attributable to the intervention was observed in the total Clock test score (0.7 (0.1 to 1.2) p = 0.018.

Conclusions: In a sample of people over 65 years of age, the combined use of the EVIDENT 3 smartphone app and an activity tracking bracelet for 3-months did not result in lifestyles changes related to the amount and level of physical activity or the eating habits, compared to brief lifestyle advice. Other clinical parameters were not changed either, although at the cognitive level, a slight improvement was observed in the score on the Clock test assessing a variety of cognitive functions such as memory.

Trial registration: The study was registered in ClinicalTrials.gov Identifier: NCT03574480. Date of trial Registration 02/07/2018.

Keywords: Body composition; Nutrition; Older adult; Physical activity; Quality of life.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Study flowchart
Fig. 2
Fig. 2
Screenshots of the EVIDENT 3 smartphone application

References

    1. World Health Organization . Integrated care for older people: guidelines on community-level interventions to manage declines in intrinsic capacity. 2017.
    1. Cochrane SK, Chen S-H, Fitzgerald JD, Dodson JA, Fielding RA, King AC, et al. Association of Accelerometry-Measured Physical Activity and Cardiovascular Events in Mobility-Limited Older Adults: The LIFE (Lifestyle Interventions and Independence for Elders) Study. J Am Heart Assoc. 2017;6:e007215. doi: 10.1161/JAHA.117.007215.
    1. Klimova B, Novotny M, Schlegel P, Valis M. The Effect of Mediterranean Diet on Cognitive Functions in the Elderly Population. Nutrients. 2021;13:2067. doi: 10.3390/nu13062067.
    1. Free C, Phillips G, Galli L, Watson L, Felix L, Edwards P, et al. The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: a systematic review. PLoS Med. 2013;10:e1001362. doi: 10.1371/journal.pmed.1001362.
    1. Buyl R, Beogo I, Fobelets M, Deletroz C, Van Landuyt P, Dequanter S, et al. e-Health interventions for healthy aging: a systematic review. Syst Rev. 2020;9:128. doi: 10.1186/s13643-020-01385-8.
    1. Wilson J, Heinsch M, Betts D, Booth D, Kay-Lambkin F. Barriers and facilitators to the use of e-health by older adults: a scoping review. BMC Public Health. 2021;21:1556. doi: 10.1186/s12889-021-11623-w.
    1. Zhao X, Wang L, Ge C, Zhen X, Chen Z, Wang J, et al. Smartphone application training program improves smartphone usage competency and quality of life among the elderly in an elder university in China: A randomized controlled trial. Int J Med Inform. 2020;133:104010. doi: 10.1016/j.ijmedinf.2019.104010.
    1. Kampmeijer R, Pavlova M, Tambor M, Golinowska S, Groot W. The use of e-health and m-health tools in health promotion and primary prevention among older adults: a systematic literature review. BMC Health Serv Res. 2016;16 Suppl 5(Suppl 5):290. doi: 10.1186/s12913-016-1522-3.
    1. Ahmad NA, Mat Ludin AF, Shahar S, Mohd Noah SA, Mohd TN. Willingness, perceived barriers and motivators in adopting mobile applications for health-related interventions among older adults: a scoping review protocol. BMJ Open. 2020;10:e033870. doi: 10.1136/bmjopen-2019-033870.
    1. Recio-Rodríguez JI, Lugones-Sanchez C, Agudo-Conde C, González-Sánchez J, Tamayo-Morales O, Gonzalez-Sanchez S, et al. Combined use of smartphone and smartband technology in the improvement of lifestyles in the adult population over 65 years: study protocol for a randomized clinical trial (EVIDENT-Age study) BMC Geriatr. 2019;19:19. doi: 10.1186/s12877-019-1037-y.
    1. Alonso-Domínguez R, Patino-Alonso MC, Sánchez-Aguadero N, García-Ortiz L, Recio-Rodríguez JI, Gómez-Marcos MA. Effect of a multifactorial intervention on the increase in physical activity in subjects with type 2 diabetes mellitus: a randomized clinical trial (EMID Study) Eur J Cardiovasc Nurs J Work Gr Cardiovasc Nurs Eur Soc Cardiol. 2019;18:399–409.
    1. Epidat: programa para análisis epidemiológico de datos. Versión 4.2. Consellería de Sanidade, Xunta de Galicia, España; Organización Panamericana de la salud (OPS-OMS). Colombia: Universidad CES; 2016.
    1. Recio-Rodriguez JI, Gómez-Marcos MA, Agudo-Conde C, Ramirez I, Gonzalez-Viejo N, Gomez-Arranz A, et al. EVIDENT 3 Study: A randomized, controlled clinical trial to reduce inactivity and caloric intake in sedentary and overweight or obese people using a smartphone application: Study protocol. Medicine (Baltimore) 2018;97:e9633. doi: 10.1097/MD.0000000000009633.
    1. Melanson ELJ, Freedson PS. Validity of the Computer Science and Applications, Inc. (CSA) activity monitor. Med Sci Sports Exerc. 1995;27:934–40. doi: 10.1249/00005768-199506000-00021.
    1. Freedson PS, Melanson E, Sirard J. Calibration of the Computer Science and Applications, Inc accelerometer. Med Sci Sports Exerc. 1998;30:777–781. doi: 10.1097/00005768-199805000-00021.
    1. Román Viñas B, Ribas Barba L, Ngo J. Serra Majem L [Validity of the international physical activity questionnaire in the Catalan population (Spain)] Gac Sanit. 2013;27:254–257. doi: 10.1016/j.gaceta.2012.05.013.
    1. Marshall AL, Miller YD, Burton NW, Brown WJ. Measuring total and domain-specific sitting: a study of reliability and validity. Med Sci Sports Exerc. 2010;42:1094–1102. doi: 10.1249/MSS.0b013e3181c5ec18.
    1. Schroder H, Fito M, Estruch R, Martinez-Gonzalez MA, Corella D, Salas-Salvado J, et al. A short screener is valid for assessing Mediterranean diet adherence among older Spanish men and women. J Nutr. 2011;141:1140–1145. doi: 10.3945/jn.110.135566.
    1. Karelis AD, Chamberland G, Aubertin-Leheudre M, Duval C. Validation of a portable bioelectrical impedance analyzer for the assessment of body composition. Appl Physiol Nutr Metab Physiol Appl Nutr Metab. 2013;38:27–32. doi: 10.1139/apnm-2012-0129.
    1. Lobo A, Saz P, Marcos G, Zarademp G. MMSE: Examen Cognoscitivo Mini-Mental. Madrid: TEA Ediciones; 2002.
    1. Cacho J, García-García R, Arcaya J, Vicente JL. Lantada N [A proposal for application and scoring of the Clock Drawing Test in Alzheimer’s disease] Rev Neurol. 1999;28:648–655.
    1. Goodglass H, Kaplan E. Evaluación de la afasia y de trastornos relacionados. Madrid: Ed. Panamericana; 1986.
    1. Olazarán J, Mouronte P. Bermejo F [Clinical validity of two scales of instrumental activities in Alzheimer’s disease] Neurologia. 2005;20:395–401.
    1. Pfeffer RI, Kurosaki TT, Harrah CHJ, Chance JM, Filos S. Measurement of functional activities in older adults in the community. J Gerontol. 1982;37:323–329. doi: 10.1093/geronj/37.3.323.
    1. Caballero FF, Miret M, Power M, Chatterji S, Tobiasz-Adamczyk B, Koskinen S, et al. Validation of an instrument to evaluate quality of life in the aging population: WHOQOL-AGE. Health Qual Life Outcomes. 2013;11:177. doi: 10.1186/1477-7525-11-177.
    1. Badia X, Schiaffino A, Alonso J, Herdman M. Using the EuroQoI 5-D in the Catalan general population: feasibility and construct validity. Qual life Res an Int J Qual life Asp Treat care Rehabil. 1998;7:311–322. doi: 10.1023/A:1008894502042.
    1. Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O’Neal L, et al. The REDCap consortium: Building an international community of software platform partners. J Biomed Inform. 2019;95:103208. doi: 10.1016/j.jbi.2019.103208.
    1. Recio-Rodriguez JI, Agudo-Conde C, Martin-Cantera C, Gonzalez-Viejo MN, Fernandez-Alonso MDC, Arietaleanizbeaskoa MS, et al. Short-Term Effectiveness of a Mobile Phone App for Increasing Physical Activity and Adherence to the Mediterranean Diet in Primary Care: A Randomized Controlled Trial (EVIDENT II Study) J Med Internet Res. 2016;18:e331. doi: 10.2196/jmir.6814.
    1. Lugones-Sanchez C, Recio-Rodriguez JI, Agudo-Conde C, Repiso-Gento I, Adalia EG, Ramirez-Manent JI, et al. Long-term Effectiveness of a Smartphone App Combined With a Smart Band on Weight Loss, Physical Activity, and Caloric Intake in a Population With Overweight and Obesity (Evident 3 Study): Randomized Controlled Trial. J Med Internet Res. 2022;24:e30416. doi: 10.2196/30416.
    1. Alonso-Dominguez R, Garcia-Ortiz L, Patino-Alonso MC, Sanchez-Aguadero N, Gomez-Marcos MA, Recio-Rodriguez JI. Effectiveness of A Multifactorial Intervention in Increasing Adherence to the Mediterranean Diet among Patients with Diabetes Mellitus Type 2: A Controlled and Randomized Study (EMID Study) Nutrients. 2019;11:162. doi: 10.3390/nu11010162.
    1. King AC, Hekler EB, Grieco LA, Winter SJ, Sheats JL, Buman MP, et al. Effects of Three Motivationally Targeted Mobile Device Applications on Initial Physical Activity and Sedentary Behavior Change in Midlife and Older Adults: A Randomized Trial. PLoS ONE. 2016;11:e0156370. doi: 10.1371/journal.pone.0156370.
    1. Krebs P, Prochaska JO, Rossi JS. A meta-analysis of computer-tailored interventions for health behavior change. Prev Med (Baltim) 2010;51:214–221. doi: 10.1016/j.ypmed.2010.06.004.
    1. Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983;51:390–395. doi: 10.1037/0022-006X.51.3.390.
    1. Astasio-Picado Á, Cobos-Moreno P, Gómez-Martín B, Verdú-Garcés L, Zabala-Baños MDC. Efficacy of Interventions Based on the Use of Information and Communication Technologies for the Promotion of Active Aging. Int J Environ Res Public Health. 2022;19:1534. doi: 10.3390/ijerph19031534.
    1. Oh SJ, Seo S, Lee JH, Song MJ, Shin M-S. Effects of smartphone-based memory training for older adults with subjective memory complaints: a randomized controlled trial. Aging Ment Health. 2018;22:526–534. doi: 10.1080/13607863.2016.1274373.

Source: PubMed

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