Alzheimers disease (AD) is a common condition that affects over 5 million older adults in the US. AD inhibits self-care and is associated with an increase in comorbidities, including diabetes, congestive heart failure, and cerebrovascular disease. One of the most important factors in maintaining autonomy with AD and in reducing comorbidities is participation in regular physical activity. Unfortunately, for individuals with mild cognitive impairment (MCI) or mild dementia due to AD, routine participation in physical activity is difficult due to safety concerns and the need for supervision, reminders, or guidance. A guided exercise system could make it easier for individuals with MCI or mild dementia to remain active, however, to our knowledge, there is no commercially available exercise system that is specifically designed to safely encourage routine physical activity in individuals with these conditions. Flint Rehab has previously developed Cycli, a low-profile, Bluetooth-enabled exercise cycle that would be well-suited for use by individuals with MCI or mild dementia to exercise. Flint Rehab has also previously developed a 10 touchscreen tablet called the Flint Tablet that runs a customized operating system to increase the ease-of- use of our software for individuals that are unfamiliar with technology. Cycli was originally developed for general wellness, but we hypothesize that, with the addition of a guided exercise application designed specifically for individuals with MCI or mild dementia, Cycli can safely increase the amount of physical activity performed by these individuals in routine life. Thus, for this Phase I project we propose to develop a novel guided exercise application for Cycli that runs on the Flint Tablet and is specifically designed to support individuals with MCI or mild dementia and their caregivers as they work together to maintain regular exercise habits. This approach has three key advantages. First, it will provide easy access to a safe and effective exercise modality for older individuals: stationary cycling. Second, it will be able to monitor a users exercise performance, increasing accountability. Third, it will motivate users to maintain regular exercise habits by using automated reminders, immersive audio and visual feedback during exercise, and social networking features. Our specific aims are to: 1) Perform structured interviews with clinical experts (N=10) to optimize the design of the Cycli guided exercise system; 2) Develop a prototype exercise guidance application for the Flint Tablet based on design requirements from Aim 1 and iterative expert feedback; and 3) Perform a usability study of Cycli with 10 individuals with MCI or mild dementia due to AD to determine if it can safely promote unsupervised physical activity. If this project is successful, it would be the first step in developing Cycli as a home exercise tool that could promote a healthier and more autonomous lifestyle for individuals with AD, leading to lower rates of comorbidities.
Public Health Relevance Statement: This research is relevant to public health because it will increase the amount of physical activity performed by older individuals with mild cognitive impairment, thus reducing their risk of secondary complications. This will provide a pathway to a better life for millions of U.S citizens suffering from cognitive decline due to Alzheimers disease. Not only does regular physical activity improve an individuals overall health, it also improves functional ability, increasing the standard of living of individuals with cognitive impairment and reducing the burden on their caregivers.
Project Terms: Accountability; Activities of Daily Living; Affect; Alzheimer's Disease; Android; base; Bluetooth; Caregivers; Cellular Phone; Centers for Disease Control and Prevention (U.S.); Cerebrovascular Disorders; Clinical; Comorbidity; Computer software; Congestive Heart Failure; cost; County; Custom; Data; Dementia; design; Development; Devices; Diabetes Mellitus; Elderly; Exercise; experience; Feedback; Habits; Health; Heart Rate; Home environment; Immersion Investigative Technique; Impaired cognition; improved; Individual; Interview; Life; Life Style; Living Standards; Maximum Heart Rate; mild cognitive impairment; mode of exercise; Monitor; novel; Operating System; Oranges; Participant; Pathway interactions; Performance; Phase; Physical activity; Population; Privatization; programs; prototype; Public Health; Race; Research; Resources; Risk; Running; Safety; Schedule; Scientist; Self Care; smartphone Application; Social Network; Structure; Supervision; System; Tablets; Technology; tool; touchscreen; usability; visual feedback; web server; Work