Abstract
Background: The purpose of this pilot study was to examine the effects of lifestyle physical activity in caregivers (CGs) of persons with Alzheimer's disease. Methods: Fifteen CGs engaged in lifestyle physical activity during a 6-month, home-based health promotion program. Mean changes in self-reported physical activity were compared using repeated-measures analysis of variance. Results: Fifty percent of CGs increased total self-reported minutes and 42% increased total moderate minutes of physical activity from preintervention to postintervention; however, no CG engaged in vigorous physical activity and there were no significant improvements in self-reported physical activity for the total group. Hot summer weather, heavy noncaregiving responsibilities, heavy caregiving responsibilities, and feelings of anxiety, depressive symptoms, and fatigue were the most frequently identified physical activity barriers. Conclusion: Incorporating an individualized, home-based program of lifestyle physical activity appears feasible; however, attention needs to be given in the future to physical activity barriers identified by this select group of CGs.
Keywords: caregiver, physical activity, tailored intervention
Full Text
The Full Text of this article is available as a PDF (88.4 KB).
Contributor Information
Carol J. Farran, College of Nursing, Rush University Medical Center, Carol_J_Farran@rush.edu .
Beth A. Staffileno, College of Nursing, Rush University Medical Center.
David W. Gilley, Rush Institute for Healthy Aging Rush University Medical Center, Chicago, Illinois.
Judith J. McCann, College of Nursing, Rush University Medical Center, Rush Institute for Healthy Aging Rush University Medical Center, Chicago, Illinois.
Yan Li, University of California, San Diego, California.
Cynthia M. Castro, Stanford University, Stanford, California.
Abby C. King, Stanford University, Stanford, California.
References
- National Alliance for Caregiving and American Association of Retired Persons. Family Caregiving in the U.S.: Findings from a National Survey. Washington, DC: National Alliance for Caregiving and American Association of Retired Persons; ; 2004. [Google Scholar]
- Schulz R., O'Brien AT, Bookwala J., Fleissner K. Psychiatric and physical morbidity effects of dementia caregiving: prevalence, correlates, and causes. Gerontologist. 1995. ; 35:771-791. [DOI] [PubMed] [Google Scholar]
- Schulz R., Beach SR Caregiving as a risk factor for mortality: the caregiver health effects study . JAMA. 1999;282: 2215-2219. [DOI] [PubMed] [Google Scholar]
- National Institutes of Health/National Institute on Aging. 2003. Progress Report on Alzheimer's Disease. Washington, DC: : US Department of Health and Human Services; 2004. [Google Scholar]
- Kiecolt-Glaser JK, Dura J., Speicher C., Trask J., Glaser R. Spousal caregivers of dementia victims: longitudinal changes in immunity and health. Psychosom Med. 1991; 53:345-362. [DOI] [PubMed] [Google Scholar]
- Bourgeois MS , Schultz R., Burgio L. Interventions for caregivers of patients with Alzheimer's disease: a review and analysis of content, process, and outcomes . Int J Aging Hum Dev. 1996;43:35-92. [DOI] [PubMed] [Google Scholar]
- Mittelman M. , Roth D., Haley W., Zarit S. Effects of a caregiver intervention on negative caregiver appraisals of behavior problems in patients with Alzheimer's disease: results of a randomized trial. J Gerontol B Psychol Sci Soc Sci. 2004;59B:P27-P34. [DOI] [PubMed] [Google Scholar]
- Schulz R., Newsom J., Mittelmark M., Burton L., Hirsch C., Jackson S. Health effects of caregiving: the caregiver health effects study: an ancillary study of the cardiovascular health study. Ann Behav Med. 1997;19:110-116. [DOI] [PubMed] [Google Scholar]
- US Department of Health and Human Services. Physical Activity and Health: A Report of the Surgeon General . Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention, and Health Promotion, International Medical Publishing; 1996. [Google Scholar]
- Mazzeo RS, Cavanagh P., Evans WJ, et al. Exercise and physical activity for older adults. Med Sci Sports Exerc. 1998;30:992-1008. [PubMed] [Google Scholar]
- King AC, Rejeski WJ, Buchner DM Physical activity interventions targeting older adults. Am J Prev Med. 1998;15:316-333. [DOI] [PubMed] [Google Scholar]
- Connell CM, Janevic MR Effectiveness of a telephone-based exercise program for dementia caregivers: results at 6-month follow-up. Paper presented at: GSA's 56th Annual Scientific Meeting; San Diego, CA; 2003. [Google Scholar]
- King AC, Brassington G. Enhancing physical and psychological functioning in older family caregivers: the role of regular physical activity. Ann Behav Med. 1997; 19:91-100. [DOI] [PubMed] [Google Scholar]
- Castro CM, King AC Telephone-assisted counseling for physical activity. Exerc Sport Sci Rev. 2002;30:64-68. [DOI] [PubMed] [Google Scholar]
- King AC, Baumann K., O'Sullivan P., Wilcox S., Castro CM Effects of moderate-intensity exercise on physiological, behavioral, and emotional responses to family caregiving: a randomized controlled trial . J Gerontol A Biol Sci Med Sci. 2002;57A:M26-M36. [DOI] [PubMed] [Google Scholar]
- 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: 458-468. [DOI] [PubMed] [Google Scholar]
- Knight BG, Lutzky SM, Macofsky-Urban F. A meta-analytic review of interventions for caregiver stress: recommendations for future research. Gerontologist. 1993; 33:240-248. [DOI] [PubMed] [Google Scholar]
- Sörensen S. , Pinquart M., Duberstein P. How effective are interventions with caregivers? An updated meta-analysis. Gerontologist. 2002. ;42:356-372. [DOI] [PubMed] [Google Scholar]
- Brown WS, Lipsker LE, Murdock GA, Strawn BD, Hester SJ The Impact of Care Coordination-Case Facilitation on Stress and Health in Family Caregivers of Alzheimer's Disease Victims. Seattle, WA: US Public Health Service; 1993. . [Google Scholar]
- Czaja S., Eisdorfer C., Schultz R. Future directions in caregiving: implications for intervention research . In: Schulz R, ed. Handbook on Dementia Caregiving. New York, NY: Springer; 2000:283-319. [Google Scholar]
- DeFriese GH , Konrad TR The self-care movement and the gerontological healthcare professional. Generations. 1993. ;17:37-40. [Google Scholar]
- Friedman LM, Furberg CD, DeMets DL Fundamentals of Clinical Trials. 2nd ed. New York, NY: Springer; 1998. [Google Scholar]
- Christopherson D., Gillis D., Bortz WMI, King AC, Stewart AL Health screening procedures for a medicare HMO physical activity promotion program [abstract 1349]. Med Sci Sports Exerc. 1997;29(5, supplement):236. [Google Scholar]
- Stewart AL, Mills KM, King AC, Haskell WL, Gillis D., Ritter PL CHAMPS physical activity questionnaire for older adults: outcomes for interventions . Med Sci Sports Exerc. 2001;33:1126-1141. [DOI] [PubMed] [Google Scholar]
- Pratt M. Benefits of lifestyle activity vs. structured exercise. JAMA . 1999;281:375-376. [DOI] [PubMed] [Google Scholar]
- Stewart BJ, Archbold PG Nursing intervention studies require outcome measures that are sensitive to change: part two. Res Nurs Health. 1993. ;16:77-81. [DOI] [PubMed] [Google Scholar]
- Teri L., Truax P., Logsdon R., Uomoto J., Zarit SH, Vitaliano PP Assessment of behavioral problems in dementia: the revised memory and behavior problems checklist. Psychol Aging. 1992;7:622-631. [DOI] [PubMed] [Google Scholar]
- Bandura A. Human agency in social cognitive theory. Am Psychol . 1989;44:1175-1184. [DOI] [PubMed] [Google Scholar]
- Bandura A. Self-efficacy: The Exercise of Control. New York, NY: W. H. Freeman; 1997. [Google Scholar]
- National Institute on Aging. Exercise: A Video from the National Institute on Aging. Gaithersburg, MD: National Institute on Aging; 2001. [Google Scholar]
- International Longevity Center, USA. Maintaining Healthy Lifestyles: A Lifetime of Choices. New York, NY: International Longevity Center, USA; 2000. [Google Scholar]
- Lorig K. Self-management of chronic illness: a model for the future. Generations. 1993;17:11-18. [Google Scholar]
- Pollock ML, Wilmore JH Exercise in Health and Disease: Evaluation and Prescription for Prevention and Rehabilitation. 2nd ed. Philadelphia, PA: W. B. Saunders; 1990. [Google Scholar]
- Manson JE, Hu FB, Rich-Edwards JW, et al. A prospective study of walking as compared with vigorous exercise in the prevention of coronary heart disease in women. New Engl J Med. 1999;341:650-658. [DOI] [PubMed] [Google Scholar]
- Gwyther L. Managing challenging behaviors at home. Alzheimer Dis Assoc Disorder. 1994;8:110-112. [PubMed] [Google Scholar]
- Hellen C. Alzheimer's Disease: Activity-Focused Care. 2nd ed. Boston, MA: Butterworth-Heinemann; ; 1998. [Google Scholar]
- Kovach CR, Meyer-Arnold EA Coping with conflicting agendas: the bathing experience of cognitively impaired older adults. Sch Inq Nurs Pract. 1996; 10:23-42. [PubMed] [Google Scholar]
- Rabins PV The phenomenology of behavior: an overview of behavioral principles . Alzheimer Dis Assoc Disord. 1994;8:61-65. [PubMed] [Google Scholar]
- Harada ND, Chiu V., King AC, Stewart AL An evaluation of three self-report physical activity instruments for older adults. Med Sci Sports Exerc. 2001;33:962-970. [DOI] [PubMed] [Google Scholar]
- Mini Mitter Company Inc. Actical: Physical Activity Monitoring System Instruction Manual. Bend, OR: Mini Mitter Company Inc; 2003. [Google Scholar]
- Bennett T., Campagna P. The utility of the CSA accelerometer to assess daily step count activity [abstract] . Can J Appl Physiol. 2002. [Google Scholar]
- Focht B., Sanders W., Brubaker P., Rejesk W. Initial validation of the CSA activity monitor during rehabilitative exercise among older adults with chronic disease. J Aging Phys Act . 2003;11:293-304. [Google Scholar]
- Sirard J., Melanson E., Freedson P. Field evaluation of the Computer Science and Applications, Inc physical activity monitor. Med Sci Sports Exerc. 2000. ;32:695-700. [DOI] [PubMed] [Google Scholar]
- Tudor-Locke C. , Ainsworth B., Thompson R., Matthews C. Comparison of pedometer and accelerometer measures of free-living physical activity. Med Sci Sports Exerc. 2002;34:2045-2051. [DOI] [PubMed] [Google Scholar]
- Welk GJ Use of accelerometry-based activity monitors for the assessment of physical activity. In: Welk GJ, ed. Physical Activity Assessments in Health-Related Research. Champaign, IL: Human Kinetics; 2002. :125-142. [Google Scholar]
- New Lifestyles, Inc. Digiwalker. Lee's Summit, MO: New Lifestyles, Inc; 2003. [Google Scholar]
- Bassett DR Jr, Strath SJ Use of pedometers to assess physical activity . In Welk GJ , ed. Physical Activity Assessments in Health-Related Research . Champaign, IL: Human Kinetics; 2002:163-177. [Google Scholar]
- Treuth MS Applying multiple methods to improve the accuracy of activity assessments . In: Welk GJ, ed. Physical Activity Assessments for Health-Related Research. Champaign, IL: Human Kinetics; 2002. :213-225. [Google Scholar]
- American Heart Association. The Healthy Heart Walking Book. New York, NY: Simon & Schuster; 1995. [Google Scholar]
- Conn VS, Valentine JC Interventions to increase physical activity among aging adults: a meta-analysis . Ann Behav Med. 2002;24:190-200. [DOI] [PubMed] [Google Scholar]
- SAS Institute Inc. SAS OnlineDoc® 9.1.3 Cary, NC: SAS Institute Inc; 2004. . [Google Scholar]
- Welk GJ, Differding JA, Thompson RW, et al. The utility of the Digi-Walker step counter to assess daily physical activity patterns. Med Sci Sports Exerc. 2000;32: S481-S488. [DOI] [PubMed] [Google Scholar]
- Centers for Disease Control and Prevention; Merck Company Foundation. The State of Aging and Health in America. Whitehouse Station, NJ: Merck Company Foundation; 2007. [Google Scholar]