Adherence to a lifestyle intervention - just a question of self-efficacy? Analysis of the AgeWell.de-intervention against cognitive decline.

Autor: Wittmann FG; Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Phillip-Rosenthal-Str. 55, 04103, Leipzig, Germany. felix.wittmann@medizin.uni-leipzig.de., Pabst A; Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Phillip-Rosenthal-Str. 55, 04103, Leipzig, Germany., Zülke A; Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Phillip-Rosenthal-Str. 55, 04103, Leipzig, Germany., Luppa M; Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Phillip-Rosenthal-Str. 55, 04103, Leipzig, Germany., Oey A; Institute for General Practice, Work Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany., Boekholt M; Institute for Community Medicine, University Medicine Greifswald (UMG), Greifswald, Germany., Weise S; Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany., Fankhänel T; Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany., Kosilek RP; Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Munich, Germany., Brettschneider C; Department of Health Economics and Health Service Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany., Döhring J; Institute of General Practice, University of Kiel, Kiel, Germany., Lunden L; Institute of General Practice, University of Kiel, Kiel, Germany., Wiese B; Institute for General Practice, Work Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany., Hoffmann W; Institute for Community Medicine, University Medicine Greifswald (UMG), Greifswald, Germany.; German Centre for Neurodegenerative Diseases (DZNE), Site Rostock/ Greifswald, Greifswald, Germany., Frese T; Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany., Gensichen J; Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Munich, Germany., König HH; Department of Health Economics and Health Service Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany., Kaduszkiewicz H; Institute of General Practice, University of Kiel, Kiel, Germany., Thyrian JR; Institute for Community Medicine, University Medicine Greifswald (UMG), Greifswald, Germany.; German Centre for Neurodegenerative Diseases (DZNE), Site Rostock/ Greifswald, Greifswald, Germany.; Faculty V: School of Life Sciences, University of Siegen, Siegen, Germany., Riedel-Heller SG; Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Phillip-Rosenthal-Str. 55, 04103, Leipzig, Germany.
Jazyk: angličtina
Zdroj: Alzheimer's research & therapy [Alzheimers Res Ther] 2024 Jun 22; Vol. 16 (1), pp. 133. Date of Electronic Publication: 2024 Jun 22.
DOI: 10.1186/s13195-024-01499-4
Abstrakt: Background: Aim of this study was to detect predictors of better adherence to the AgeWell.de-intervention, a two-year randomized multi-domain lifestyle intervention against cognitive decline.
Methods: Data of 317 intervention group-participants comprising a risk group for dementia (Cardiovascular Risk Factors, Ageing and Dementia (CAIDE) score of  ≥ 9; mean age 68.9 years, 49.5% women) from the AgeWell.de intervention study were analysed. Regression models with four blocks of predictors (sociodemographic, cognitive and psychosocial, lifestyle factors and chronic conditions) were run on adherence to the components of nutrition, enhancement of social and physical activity and cognitive training. Adherence to each component was operationalised by assessing the degree of goal achievement per component at up to seven time points during the intervention period, measured using a 5-point Likert scale (mean score of goal achievement).
Results: Increasing age was negatively associated with adherence, while higher education positively predicted adherence. Participants with better mental state (Montreal Cognitive Assessment (MoCA)-score > 25) at baseline and higher self-efficacy adhered better. Diabetes and cardiovascular conditions were not associated with adherence, whereas smoking negatively affected adherence. Highest education and quitting smoking in the past were the only predictors associated with all four intervention components.
Conclusion: Results identified predictors for better and worse adherence. Particularly self-efficacy seems to be of considerable influence on adherence. This should be considered when designing future intervention trials.
Trial Registration: German Clinical Trials Register (ref. number: DRKS00013555).
(© 2024. The Author(s).)
Databáze: MEDLINE
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