A preventative lifestyle intervention for older adults (lifestyle matters): a randomised controlled trial

Mountain, Gail; Windle, Gill; Hind, Daniel; Walters, Stephen; Keertharuth, Anju; Chatters, Robin; Sprange, Kirsty; Cook, Sarah; Lee, Ellen; Chater, Tim; Woods, R.; Newbould, Louise; Powell, Lauren; Shortland, Katy; Roberts, Jennifer

Abstract

Objectives

to test whether an occupation-based lifestyle intervention can sustain and improve the mental well-being of adults aged 65 years or over compared to usual care, using an individually randomised controlled trial.

Participants

288 independently living adults aged 65 years or over, with normal cognition, were recruited from two UK sites between December 2011 and November 2015.

Interventions

lifestyle Matters is a National Institute for Health and Care Excellence recommended multi-component preventive intervention designed to improve the mental well-being of community living older people at risk of decline. It involves weekly group sessions over 4 months and one to one sessions.

Main outcome measures

the primary outcome was mental well-being at 6 months (mental health (MH) dimension of the SF-36). Secondary outcomes included physical health dimensions of the SF-36, extent of depression (PHQ-9), quality of life (EQ-5D) and loneliness (de Jong Gierveld Loneliness Scale), assessed at 6 and 24 months.

Results


data on 262 (intervention = 136; usual care = 126) participants were analysed using intention to treat analysis. Mean SF-36 MH scores at 6 months differed by 2.3 points (95 CI: ?1.3 to 5.9; P = 0.209) after adjustments.

Conclusions

analysis shows little evidence of clinical or cost-effectiveness in the recruited population with analysis of the primary outcome revealing that the study participants were mentally well at baseline. The results pose questions regarding how preventive interventions to promote well-being in older adults can be effectively targeted in the absence of proactive mechanisms to identify those who at risk of decline.

Trial Registration
ISRCTN67209155.

Citation

Mountain, G., Windle, G., Hind, D., Walters, S., Keertharuth, A., Chatters, R., …Roberts, J. (2017). A preventative lifestyle intervention for older adults (lifestyle matters): a randomised controlled trial. Age and Ageing, 46(4), https://doi.org/10.1093/ageing/afx021

• Journal Article Type: Article
• Acceptance Date: Nov 11, 2016
• Online Publication Date: Feb 25, 2017
• Publication Date: Jul 1, 2017
• Deposit Date: Dec 12, 2017
• Publicly Available Date: Dec 12, 2017
• Journal: Age and Ageing
• Print ISSN: 0002-0729
• Electronic ISSN: 1468-2834
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 46
• Issue: 4
• DOI: https://doi.org/10.1093/ageing/afx021
• Keywords: Older people; Occupational health; Randomised controlled trial; Mental health
• Public URL: https://nottingham-repository.worktribe.com/output/869772
• Publisher URL: https://academic.oup.com/ageing/article/46/4/627/3052925