Cognitive functioning (CF) is important for wellbeing and an independent life. However, older adults with chronic diseases are at a higher risk of poorer CF levels. Although, research suggests that physical activity (PA) could play an essential role in maintaining good CF, older adults with chronic diseases have low levels of PA. PA interventions to prevent cognitive decline for this specific group exist. Yet, until now these interventions focused on a single specific chronic disease. Active Plus is a proven effective computer-tailored PA stimulating intervention focused on increasing PA in daily life for the older adult population suffering from a broad range of chronic diseases. This study tests the cognitive effects of Active Plus in older adults with chronic diseases. In this RCT older adults with at least one chronic disease (≥65 years) were allocated to the intervention group (N = 260, mean age = 74.2) or waiting list control group (N = 325, mean age = 74.5). In total, intervention group participants received three times computer-tailored PA stimulating advice within four months (i.e., at baseline, after two months, and after three to four months). The online and print delivered advice were tailored to the specific needs and wishes of the participant and focused on incorporating PA in daily life. Baseline and follow-up measurements of the CF verbal memory (Verbal Learning Test), shifting (Trailmaking Test), inhibition (Stop-signal Task) and processing speed (Letter Digit Substitution Test) were assessed after six and 12 months. Intervention effects were analyzed with multilevel linear mixed-effects models adjusted for the clustered design and confounding variables. The dropout rate was 19.1% after 6 months and 25.1% after 12 months. Although both conditions improved on all verbal memory outcomes after 6 months, and all CF outcomes except inhibition after 12 months, no intervention effects were found, not even in subgroups (p > .05). To our knowledge this is the first study to test the cognitive effects of a computer-tailored PA stimulating intervention in older adults suffering from a broad range of chronic diseases. The effects of the Active Plus intervention were not strong enough to improve CF or prevent cognitive decline. A blended approach, in which this computer-tailored intervention is combined with a face-to-face PA intervention and / or cognitive training, might be a good suggestion to increase the effects of Active Plus on PA and CF in older adults with chronic diseases. Netherlands Trial Register NL6005; Date of Registration 03-21-2017; https://www.trialregister.nl/trial/6005

中文翻译：

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一项针对计算机量身定做的身体活动干预措施对患有慢性疾病的老年人的认知效果的随机对照试验

认知功能（CF）对于幸福和独立生活很重要。但是，患有慢性疾病的老年人患CF水平较低的风险较高。尽管研究表明，体育锻炼（PA）可能在维持良好CF方面起重要作用，但患有慢性疾病的老年人的PA含量较低。存在针对该特定人群的预防PA干预的干预措施。但是，到目前为止，这些干预措施仅针对一种特定的慢性疾病。Active Plus是一种经过验证的有效的计算机量身定制的PA刺激干预措施，致力于增加患有多种慢性疾病的老年人的日常生活中的PA。这项研究测试了Active Plus对患有慢性疾病的老年人的认知效果。在该RCT中，将患有至少一种慢性疾病（≥65岁）的老年人分配到干预组（N = 260，平均年龄= 74.2）或等待名单对照组（N = 325，平均年龄= 74.5）。总体而言，干预组参与者在四个月内（即在基线，两个月后以及三到四个月后）接受了三次计算机量身定制的PA刺激建议。在线和印刷版提供的建议是针对参与者的特定需求和愿望而量身定制的，并且侧重于将PA纳入日常生活。在6和12个月后，评估了CF言语记忆（言语学习测试），移动（追踪测试），抑制（停止信号任务）和处理速度（字母替代测试）的基线和后续测量。使用针对集群设计和混淆变量进行调整的多级线性混合效应模型来分析干预效应。6个月后辍学率为19.1％，12个月后为25.1％。尽管两种情况在6个月后所有言语记忆结局和12个月后所有CF结局均有改善（抑制作用除外），但未发现干预效果，即使在亚组中也没有发现（p> .05）。据我们所知，这是第一项测试计算机量身定制的PA刺激干预措施对患有多种慢性疾病的老年人的认知效果的研究。Active Plus干预的效果不足以改善CF或预防认知能力下降。一种混合方法，其中将这种计算机量身定制的干预措施与面对面的PA干预措施和/或认知训练相结合，可能是增加Active Plus对老年慢性病患者PA和CF的作用的好建议。荷兰审判注册簿NL6005；注册日期03/21/2017; https://www.trialregister.nl/trial/6005