|SIPILA, SARIANNA - University Of Jyvaskyla|
|TIRKKONEN, ANNA - University Of Jyvaskyla|
|HANNINEN, TOUMO - Kuopio University Hospital|
|LAUKKANEN, PIA - University Of Jyvaskyla|
|ALEN, MARKKU - University Of Oulu|
|FIELDING, ROGER - Jean Mayer Human Nutrition Research Center On Aging At Tufts University|
|KIVIPELTO, MIIA - National Institute For Health And Welfare (HELSINKI)|
|KOKKO, KATJA - University Of Jyvaskyla|
|KULMALA, JENNI - National Institute For Health And Welfare (HELSINKI)|
|RANTANEN, TAINA - University Of Jyvaskyla|
|SIHVONEN, SANNA - Jamk University Of Applied Sciences|
|SILLANPAA, ELINA - University Of Jyvaskyla|
|STIGSDOTTER-NEELY, ANNA - Karlstad University|
|TORMAKANGAS, TIMO - University Of Jyvaskyla|
Submitted to: BMC Geriatrics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/30/2018
Publication Date: 9/15/2018
Citation: Sipila, S., Tirkkonen, A., Hanninen, T., Laukkanen, P., Alen, M., Fielding, R.A., Kivipelto, M., Kokko, K., Kulmala, J., Rantanen, T., Sihvonen, S.E., Sillanpaa, E., Stigsdotter-Neely, A., Tormakangas, T. 2018. 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 study. BMC Geriatrics. 18:215. https://doi.org/10.1186/s12877-018-0906-0.
Interpretive Summary: Walking safely is a complex process involving the interaction of the motor, sensory and cognitive systems in the brain. As physical and cognitive functions worsen with aging, training of both functions may have more beneficial effects on walking and fall prevention than either alone. This article describes the study design, recruitment strategies and interventions of the PASSWORD study investigating whether a combination of exercise and cognitive training has greater effects on walking speed, dual-task cost in walking speed, fall incidence and executive functions compared to physical training alone among 70-85-year-old community-dwelling adults. Study participants will be recruited and assigned to exercise training or exercise plus cognitive training. The main study outcome measure is the change in walking speed between the two interventions. Secondary outcome measures include the 6-minute walking distance (a test of endurance) and measures of cognitive/memory function. The results of this study may be helpful in informing strategies designed to promote safe walking among older people and may have a significant health and socio-economic impact.
Technical 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 Jyvaskyla 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-meter walking speed. Secondary outcomes include 6-minute 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.