NIV 2014

Background: Lack of physical activity leads to detrimental changes in body composition and metabolism, functional decline and increased risk of disease in old age. The potential of Web-assisted interventions for increasing physical activity and improving metabolism in older individuals holds great promise, but has thus far not been studied.

Aim of the study: To assess whether a web-based intervention increases physical activity and improves metabolic health in inactive older adults.

Methods:  We conducted a 3-month randomized, waitlist-controlled trial in a volunteer sample of 235 inactive adults aged 60 - 70 years without diabetes. The intervention group received the Internet program Philips DirectLife, which was directed at increasing physical activity using monitoring and feedback by accelerometer and digital coaching. The primary outcome was relative increase in physical activity measured objectively using ankle- and wrist-worn accelerometers. Secondary outcomes of metabolic health included anthropometric measures and parameters of glucose metabolism. Sub-analyses included the effectiveness of the intervention in those who successfully completed the intervention study, and a dose-response analysis.

Results: Two-hundred and twenty-six participants (97%) completed the study. At the ankle, activity counts increased by 46% (standard error (SE) 7%) in the intervention group, compared to 12% (SE 3%) in the control group (p_difference<0.001). Measured at the wrist, activity counts increased by 11% (SE 3%) in the intervention group and 5% (SE 2%) in the control group (p_difference = 0.11). After processing of the data, this corresponded to a daily increase of 11 minutes in moderate-to-vigorous activity in the intervention group versus 0 minutes in the control group (p_difference = 0.001). Weight decreased significantly more in the intervention group compared to controls (-1.5 kg vs. -0.8 kg respectively, p=0.046), as did waist circumference (-2.3 cm vs. -1.3 cm respectively, p=0.036) and fat mass (-0.6% vs. 0.07% respectively, p =0.025). Furthermore, insulin and Hba1c levels were significantly more reduced in the intervention group compared to controls (both p < 0.05). Of the 34% of participants who successfully reached their personal physical activity target, all results were more outspoken compared to the total intervention group.

Conclusion: This was the first study to show that in inactive older adults, a 3-month Web-based physical activity intervention was effective in increasing objectively measured daily physical activity and improving metabolic health. Findings demonstrate the large potential of web-based interventions for improving health in the aging population by increasing physical activity.