Effectiveness of a behavioral lifestyle intervention on weight management and mobility improvement in older informal caregivers: a secondary data analysis

Xinran Liu, Jennifer King, Brandi Boak, Michelle E Danielson, Robert M Boudreau, Anne B Newman, Elizabeth M Venditti, Steven M Albert, Xinran Liu, Jennifer King, Brandi Boak, Michelle E Danielson, Robert M Boudreau, Anne B Newman, Elizabeth M Venditti, Steven M Albert

Abstract

Background: Older informal caregivers are prone to sedentary behavior and obesity. With great caregiving burdens and frequent physical and mental distress, older informal caregivers may have low adherence and poor results in behavioral intervention for weight management. This study examined whether overweight or obese older informal caregivers could benefit from a behavioral weight management program as much as non-caregivers.

Methods: The Mobility and Vitality Lifestyle Program (MOVE UP) was a pre-post, community-based, 13-month lifestyle intervention study to help older adults improve physical function performance and lose weight. We identified a subset of informal caregivers (n = 29) and non-caregivers (n = 65) from the MOVE UP participants retrospectively. Changes in lower extremity function, weight, depressive symptoms, and self-efficacy from baseline were compared between caregivers and non-caregivers using paired t-tests and ANCOVA.

Results: Older informal caregivers had significantly lower session attendance rates than non-caregivers (67.7% vs 76.8%, P < 0.05), however, both informal caregivers and non-caregivers improved significantly in lower extremity function, weight loss, and self-efficacy in diet (Ps < 0.05). For each outcome, changes from baseline to the 13-month endpoint were the same among informal caregivers and non-caregivers.

Conclusion: This study provides evidence that older informal caregivers can benefit from behavioral weight management interventions despite the challenge caregiving poses for effective self-care. Future behavioral intervention studies for older informal caregivers should adopt self-monitoring tools and extend the on-site delivery to home-based settings for higher adherence and greater flexibility.

Trial registration: Registered at clinicaltrials.gov (NCT02657239).

Keywords: Aged; Caregiver; Community dwelling; Community health workers; Exercise; Health promotion; Healthy lifestyle; Weight loss programs.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Derivation of MOVE UP Follow-up Caregiver Interview Sample
Fig. 2
Fig. 2
Change in SPPB Score, Gait Speed, Chair Stands, and Weight by Caregiver Status

References

    1. National Alliance for Caregiving, AARP . Caregiving in the U.S. 2020.
    1. Anderson LA, Edwards VJ, Pearson WS, Talley RC, McGuire LC, Andresen EM. Adult caregivers in the United States: characteristics and differences in well-being, by caregiver age and caregiving status. Prev Chronic Dis. 2013;10:E135.
    1. Carpenter CA, Miller MC, Sui X, West DS. Weight status and sedentary behavior of Alzheimer's disease caregivers. Am J Health Behav. 2020;44(1):3–12. doi: 10.5993/AJHB.44.1.1.
    1. Castro CM, Wilcox S, O’sullivan P, Baumann K, King AC. An exercise program for women who are caring for relatives with dementia. Psychosom Med. 2002;64(3):458–468. doi: 10.1097/00006842-200205000-00010.
    1. Connell CM, Janevic MR. Effects of a telephone-based exercise intervention for dementia caregiving wives: a randomized controlled trial. J Appl Gerontol. 2009;28(2):171–194. doi: 10.1177/0733464808326951.
    1. Cuthbert CA, King-Shier KM, Ruether JD, Tapp DM, Wytsma-Fisher K, Fung TS, Culos-Reed SN. The effects of exercise on physical and psychological outcomes in cancer caregivers: results from the RECHARGE randomized controlled trial. Ann Behav Med. 2018;52(8):645–661. doi: 10.1093/abm/kax040.
    1. Gary R, Dunbar SB, Higgins M, Butts B, Corwin E, Hepburn K, Butler J, Miller AH. An intervention to improve physical function and caregiver perceptions in family caregivers of persons with heart failure. J Appl Gerontol. 2020;39(2):181–191. doi: 10.1177/0733464817746757.
    1. Hirano A, Suzuki Y, Kuzuya M, Onishi J, Ban N, Umegaki H. Influence of regular exercise on subjective sense of burden and physical symptoms in community-dwelling caregivers of dementia patients: a randomized controlled trial. Arch Gerontol Geriatr. 2011;53(2):e158–e163. doi: 10.1016/j.archger.2010.08.004.
    1. James EL, Stacey FG, Chapman K, Boyes AW, Burrows T, Girgis A, Asprey G, Bisquera A, Lubans DR. Impact of a nutrition and physical activity intervention (ENRICH: exercise and nutrition routine improving Cancer health) on health behaviors of cancer survivors and carers: a pragmatic randomized controlled trial. BMC Cancer. 2015;15(1):1–6. doi: 10.1186/s12885-015-1775-y.
    1. King AC, Baumann K, O'Sullivan P, Wilcox S, Castro C. Effects of moderate-intensity exercise on physiological, behavioral, and emotional responses to family caregiving: a randomized controlled trial. J Gerontol Ser A Biol Med Sci. 2002;57(1):M26–M36. doi: 10.1093/gerona/57.1.M26.
    1. Winters-Stone KM, Lyons KS, Dobek J, Dieckmann NF, Bennett JA, Nail L, Beer TM. Benefits of partnered strength training for prostate cancer survivors and spouses: results from a randomized controlled trial of the exercising together project. J Cancer Surviv. 2016;10(4):633–644. doi: 10.1007/s11764-015-0509-0.
    1. Hill K, Smith R, Fearn M, Rydberg M, Oliphant R. Physical and psychological outcomes of a supported physical activity program for older carers. J Aging Phys Act. 2007;15(3):257–271. doi: 10.1123/japa.15.3.257.
    1. Teri L, Logsdon RG, McCurry SM, Pike KC, McGough EL. Translating an evidence-based multicomponent intervention for older adults with dementia and caregivers. The Gerontologist. 2020;60(3):548–557. doi: 10.1093/geront/gny122.
    1. Lorig K, Ritter PL, Laurent DD, Yank V. Building better caregivers: a pragmatic 12-month trial of a community-based workshop for caregivers of cognitively impaired adults. J Appl Gerontol. 2019;38(9):1228–1252. doi: 10.1177/0733464817741682.
    1. Venditti EM, Zgibor JC, Vander Bilt J, Kieffer LA, Boudreau RM, Burke LE, Glynn NW, Jakicic JM, Smith KJ, Semler LN, Rager JR. Mobility and Vitality Lifestyle Program (MOVE UP): a community health worker intervention for older adults with obesity to improve weight, health, and physical function. Innov Aging. 2018;2(2):igy012. doi: 10.1093/geroni/igy012.
    1. Albert SM, Venditti EM, Boudreau RM, Kieffer LA, Rager JR, Zgibor JC, et al. Weight loss through lifestyle intervention improves mobility in older adults. Gerontologist. 2022;62(6):931–941. doi: 10.1093/geront/gnab048.
    1. Jowsey T, McRae I, Gillespie J, Banfield M, Yen L. Time to care? Health of informal older carers and time spent on health related activities: an Australian survey. BMC Public Health. 2013;13(1):1–0. doi: 10.1186/1471-2458-13-374.
    1. Trivedi R, Beaver K, Bouldin ED, Eugenio E, Zeliadt SB, Nelson K, Rosland AM, Szarka JG, Piette JD. Characteristics and well-being of informal caregivers: results from a nationally-representative US survey. Chronic Illness. 2014;10(3):167–179. doi: 10.1177/1742395313506947.
    1. Newman AB, Bayles CM, Milas CN, McTigue K, Williams K, Robare JF, Taylor CA, Albert SM, Kuller LH. The 10 keys to healthy aging: findings from an innovative prevention program in the community. J Aging Health. 2010;22(5):547–566. doi: 10.1177/0898264310363772.
    1. Wadden TA, West DS, Neiberg RH, Wing RR, Ryan DH, Johnson KC, Foreyt JP, Hill JO, Trence DL, Vitolins MZ. Look AHEAD research group. One-year weight losses in the look AHEAD study: factors associated with success. Obesity. 2009;17(4):713–722. doi: 10.1038/oby.2008.637.
    1. American Diabetes Association The translating research into action for diabetes (TRIAD) study: a multicenter study of diabetes in managed care. Diabetes Care. 2002;25(2):386–389. doi: 10.2337/diacare.25.2.386.
    1. Diabetes Prevention Program (DPP) Research Group The diabetes prevention program (DPP): description of lifestyle intervention. Diabetes Care. 2002;25(12):2165–2171. doi: 10.2337/diacare.25.12.2165.
    1. Pahor M, Guralnik JM, Ambrosius WT, Blair S, Bonds DE, Church TS, Espeland MA, Fielding RA, Gill TM, Groessl EJ, King AC. Effect of structured physical activity on prevention of major mobility disability in older adults: the LIFE study randomized clinical trial. JAMA. 2014;311(23):2387–2396. doi: 10.1001/jama.2014.5616.
    1. Venditti EM. Behavior change to prevent or delay type 2 diabetes: psychology in action. Am Psychol. 2016;71(7):602. doi: 10.1037/a0040433.
    1. Venditti EM, Wylie-Rosett J, Delahanty LM, Mele L, Hoskin MA, Edelstein SL. Short and long-term lifestyle coaching approaches used to address diverse participant barriers to weight loss and physical activity adherence. Int J Behav Nutr Phys Act. 2014;11(1):1–2. doi: 10.1186/1479-5868-11-16.
    1. Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King AC, Macera CA, Castaneda-Sceppa C. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116(9):1094. doi: 10.1161/CIRCULATIONAHA.107.185650.
    1. National Institute on Aging, National Institutes of Health . Workout to go. Washington D.C.: Department of Health and Human Services, National Institutes of Health, National Institute on Aging; 2018.
    1. Lorig KR, Sobel DS, Stewart AL, Brown BW, Jr, Bandura A, Ritter P, et al. Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial. Med Care. 1999;37(1):5–14. doi: 10.1097/00005650-199901000-00003.
    1. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85–M94. doi: 10.1093/geronj/49.2.M85.
    1. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385–401. doi: 10.1177/014662167700100306.
    1. Clark MM, Abrams DB, Niaura RS, Eaton CA, Rossi JS. Self-efficacy in weight management. J Consult Clin Psychol. 1991;59(5):739. doi: 10.1037/0022-006X.59.5.739.
    1. McAuley E. Self-efficacy and the maintenance of exercise participation in older adults. J Behav Med. 1993;16(1):103–113. doi: 10.1007/BF00844757.
    1. CDC . Behavioral Risk Factor Surveillance System (BRFSS) Caregiver Module. 2020.
    1. CDC . Behavioral Risk Factor Surveillance System (BRFSS) 2015.
    1. R Core Team. R: A . Language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2018.
    1. StataCorp . Stata statistical software: release 16. College Station: StataCorp LLC; 2019.
    1. Adelman RD, Tmanova LL, Delgado D, Dion S, Lachs MS. Caregiver Burden. JAMA. 2014;311:1052. doi: 10.1001/jama.2014.304.

Source: PubMed

3
Se inscrever