None listed
Conditions
Brief summary
This study aims to produce an Aboriginal Health Practitioner coordinated risk factor management program to reduce cognitive decline and functional impairment in Aboriginal Australians aged 45 years and over. The Dementia prevention and risk management program for Aboriginal Australians (DAMPAA) program will include AHP coordination and care planning of a) an exercise program including falls prevention strategies; b) cardiovascular risk management. This will be achieved through a 5 year research project in partnership with three ACCHS’s by: 1) Refining and piloting an intervention program (DAMPAA) that targets key dementia risk factors for Aboriginal people, and is based on existing best practice guidelines and cultural and service provider recommendations. 2) Completing a randomized controlled trial (RCT) comparing the DAMPAA program with usual care; 3) Evaluating the efficacy and cost-effectiveness of the DAMPAA. Significance: Given the rapid ageing of the Aboriginal population, the impact that dementia has on Aboriginal communities, and the resulting financial cost to society, there is a pressing need to develop and translate programs capable of reducing dementia in Aboriginal Australians. This project will produce a prevention program designed to meet the needs of Aboriginal Australians at risk of dementia.
Interventions
For the DAMPAA group (name of intervention group) a group centre-based balance, strengthening and moderate level exercise program will be delivered twice a week for 6 months following intervention protocol, with home/community based exercise to be completed 1 day a week. Group sessions (10 -15 participants) will be delivered primarily at the 3 Aboriginal Community Controlled Health Services sites by exercise physiologists or physiotherapists and Aboriginal health workers (Aboriginal care coordin
For the DAMPAA group (name of intervention group) a group centre-based balance, strengthening and moderate level exercise program will be delivered twice a week for 6 months following intervention protocol, with home/community based exercise to be completed 1 day a week. Group sessions (10 -15 participants) will be delivered primarily at the 3 Aboriginal Community Controlled Health Services sites by exercise physiologists or physiotherapists and Aboriginal health workers (Aboriginal care coordinators), with home programs tailored to participants’ needs. The target exercise program will consist of 3 x 50 minutes of moderate level exercise per week (such as brisk walking) and standing balance and strengthening items. Exercise intensity will be monitored with heart rate monitors during the sessions. Home-based exercise compliance will be monitored by asking participants to self-rate on a visual scale. Both exercise programs will be progressive in terms of duration of the sessions and the intensity of the exercise over the first 8 weeks until the target exercise is reached. The home-based program will be a continuation of the program devised by the exercise physiologist/physiotherapist for the centre-based program. The weekly home-based session will be a repeat of the centre-based session with the balance and strengthening exercises prescribed by the exercise physiologist/physiotherapist based on the individual's exercise capacity, mobility and fitness needs. The main exercise component of aerobic or circuit work will also be selected based on the individual's exercise needs and for the home-based program availability of space and community programs. Progress on both centre and home-based programs will be monitored (as above) and by written and verbal reports from the participants at the centre-based sessions and the text replies for the home-based sessions. The individual’s programs will revised weekly by the exercise physiologist/physiotherapist with any necessary adjustments made to the individual's program re exercises, duration and intensity. General educational materials relating to the risk factors for dementia will be developed in house and presented in printed form to both DAMPAA and control groups at the start of the study. For the DAMPAA intervention group additional education will be delivered face-to-face by the Aboriginal Health Worker/exercise specialist/health professional in a series of 1-hour workshops over a 6-month period with sessions conducted at 3-4 weekly intervals. Individually tailored incidental education will also be provided by the Aboriginal Health Worker and/or the exercise specialist over the 6 month action stage (e.g. falls risk, smoking cessation, medication adherence). Motivational care planning and goal setting will be used to tailor the program to DAMPAA group participants, and to maximise adherence to the intervention. Adherence to the exercise program will be monitored by the exercise physiologist and Aboriginal Health worker for both centre-based sessions (via attendance records) and home based sessions (via phone or query at subsequent centre-based session). Reviews of blood pressure, blood glucose levels, and medications will occur at centre-based sessions for the DAMPAA program participants in between the key data collection stages. Referrals will be made as required, and discussed with the GP.
Sponsors
The University of Western Australia
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
45 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
1) Aboriginal Australian and/or Torres Strait Islander 2) aged between 45 and 90 years; 3) community dwelling; 4) cognitive impairment with no dementia (defined by score of 31-37 out of 39 on KICA Cog and no functional decline due to cognitive impairment) and no cognitive impairment (38-39 out of 39 on KICA Cog);
Exclusion criteria
1) dementia 2) presence of medical condition that restricts walking without assistance; 3) unstable or life threatening medical condition; 4) medical condition that contra-indicates moderate physical activity.
Outcome results
None listed