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

Sarianna Sipilä, Anna Tirkkonen, Tuomo Hänninen, Pia Laukkanen, Markku Alen, Roger A Fielding, Miia Kivipelto, Katja Kokko, Jenni Kulmala, Taina Rantanen, Sanna E Sihvonen, Elina Sillanpää, Anna Stigsdotter-Neely, Timo Törmäkangas, Sarianna Sipilä, Anna Tirkkonen, Tuomo Hänninen, Pia Laukkanen, Markku Alen, Roger A Fielding, Miia Kivipelto, Katja Kokko, Jenni Kulmala, Taina Rantanen, Sanna E Sihvonen, Elina Sillanpää, Anna Stigsdotter-Neely, Timo Törmäkangas

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 .

Keywords: Aging; Executive function; Physical activity; Prevention; Sedentary.

Conflict of interest statement

Ethics approval and consent to participate

Ethics approval for the study was received from the review board of the Ethical Committee of Central Finland Health Care District on December 2016 (14/12/2016, ref.: 11/2016).

Written informed consent will be requested from subjects before the study start.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart of the PASSWORD study

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