Development of a Novel Mind-Body Activity and Pain Management Program for Older Adults With Cognitive Decline

• Published in: The Gerontologist Vol. 61; no. 3; p. 449
• Main Authors: Mace, Ryan A, Gates, Melissa V, Bullard, Breanna, Lester, Ethan G, Silverman, Ilyssa H, Quiroz, Yakeel T, Vranceanu, Ana-Maria
• Format: Journal Article
• Language: English
• Published: United States 03.04.2021
• Subjects: Aged; Cognition; Cognitive Dysfunction; Humans; Pain Management; Self Efficacy; Walking; Walking; Activity; Cognition; Focus groups; Chronic pain; Mind–body
• ISSN: 1758-5341
• DOI: 10.1093/geront/gnaa084

Chronic pain (CP) and cognitive decline (CD) often co-occur in older adults, which can reinforce a "disability spiral." Early interventions teaching pain coping skills and gradual increases in activity (walking) are needed to promote overall well-being and potentially delay further decline of cognition and daily functioning. The goal of this mixed-methods study was to guide the development of two mind-body activity programs for CP and CD which focus on increasing walking using time goals (Active Brains) or step count reinforced by a Fitbit (Active Brains-Fitbit). Older adults with CP and CD (N = 23) participated in a one-time focus group (four total) and completed measures of physical, emotional, and cognitive functioning. Qualitative analyses identified population-specific needs, preferences, and perceptions of proposed program skills. Quantitative analysis compared clinical characteristics to population norms and explored intercorrelations among treatment targets. Thematic analyses revealed six main themes: (1) challenges living with CP and (2) CD, (3) current walking, (4) technology (Fitbit) to increase walking, (5) perceptions of proposed program skills (e.g., mind-body, pain, and increased walking), and (6) program barriers and facilitators. Quantitative analyses showed that (a) participants had physical function below reference values and (b) higher self-efficacy correlated with higher cognitive, emotional, and physical functioning. Focus group participants were enthusiastic about the proposed program skills. Current work includes open pilot testing, qualitative interviews, and a small randomized controlled trial to optimize the programs and methodology in preparation for efficacy testing against an educational control.