Using Digital Technology to Quantify Habitual Physical Activity in Community Dwellers With Cognitive Impairment: Systematic Review

BackgroundParticipating in habitual physical activity (HPA) can support people with dementia and mild cognitive impairment (MCI) to maintain functional independence. Digital technology can continuously measure HPA objectively, capturing nuanced measures relating to its volume...

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Main Authors: Ríona Mc Ardle, Khalid Abdul Jabbar, Silvia Del Din, Alan J Thomas, Louise Robinson, Ngaire Kerse, Lynn Rochester, Michele Callisaya
Format: Article
Language:English
Published: JMIR Publications 2023-05-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2023/1/e44352
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author Ríona Mc Ardle
Khalid Abdul Jabbar
Silvia Del Din
Alan J Thomas
Louise Robinson
Ngaire Kerse
Lynn Rochester
Michele Callisaya
author_facet Ríona Mc Ardle
Khalid Abdul Jabbar
Silvia Del Din
Alan J Thomas
Louise Robinson
Ngaire Kerse
Lynn Rochester
Michele Callisaya
author_sort Ríona Mc Ardle
collection DOAJ
description BackgroundParticipating in habitual physical activity (HPA) can support people with dementia and mild cognitive impairment (MCI) to maintain functional independence. Digital technology can continuously measure HPA objectively, capturing nuanced measures relating to its volume, intensity, pattern, and variability. ObjectiveTo understand HPA participation in people with cognitive impairment, this systematic review aims to (1) identify digital methods and protocols; (2) identify metrics used to assess HPA; (3) describe differences in HPA between people with dementia, MCI, and controls; and (4) make recommendations for measuring and reporting HPA in people with cognitive impairment. MethodsKey search terms were input into 6 databases: Scopus, Web of Science, Psych Articles, PsychInfo, MEDLINE, and Embase. Articles were included if they included community dwellers with dementia or MCI, reported HPA metrics derived from digital technology, were published in English, and were peer reviewed. Articles were excluded if they considered populations without dementia or MCI diagnoses, were based in aged care settings, did not concern digitally derived HPA metrics, or were only concerned with physical activity interventions. Key outcomes extracted included the methods and metrics used to assess HPA and differences in HPA outcomes across the cognitive spectrum. Data were synthesized narratively. An adapted version of the National Institute of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies was used to assess the quality of articles. Due to significant heterogeneity, a meta-analysis was not feasible. ResultsA total of 3394 titles were identified, with 33 articles included following the systematic review. The quality assessment suggested that studies were moderate-to-good quality. Accelerometers worn on the wrist or lower back were the most prevalent methods, while metrics relating to volume (eg, daily steps) were most common for measuring HPA. People with dementia had lower volumes, intensities, and variability with different daytime patterns of HPA than controls. Findings in people with MCI varied, but they demonstrated different patterns of HPA compared to controls. ConclusionsThis review highlights limitations in the current literature, including lack of standardization in methods, protocols, and metrics; limited information on validity and acceptability of methods; lack of longitudinal research; and limited associations between HPA metrics and clinically meaningful outcomes. Limitations of this review include the exclusion of functional physical activity metrics (eg, sitting/standing) and non-English articles. Recommendations from this review include suggestions for measuring and reporting HPA in people with cognitive impairment and for future research including validation of methods, development of a core set of clinically meaningful HPA outcomes, and further investigation of socioecological factors that may influence HPA participation. Trial RegistrationPROSPERO CRD42020216744; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=216744  
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spelling doaj.art-1fc72b40305e4dfebbbf13156bbb234b2023-08-28T23:56:41ZengJMIR PublicationsJournal of Medical Internet Research1438-88712023-05-0125e4435210.2196/44352Using Digital Technology to Quantify Habitual Physical Activity in Community Dwellers With Cognitive Impairment: Systematic ReviewRíona Mc Ardlehttps://orcid.org/0000-0001-7959-3563Khalid Abdul Jabbarhttps://orcid.org/0000-0002-9620-2875Silvia Del Dinhttps://orcid.org/0000-0003-1154-4751Alan J Thomashttps://orcid.org/0000-0002-6667-9533Louise Robinsonhttps://orcid.org/0000-0003-0209-2503Ngaire Kersehttps://orcid.org/0000-0002-5992-3681Lynn Rochesterhttps://orcid.org/0000-0001-5774-9272Michele Callisayahttps://orcid.org/0000-0003-2122-1622 BackgroundParticipating in habitual physical activity (HPA) can support people with dementia and mild cognitive impairment (MCI) to maintain functional independence. Digital technology can continuously measure HPA objectively, capturing nuanced measures relating to its volume, intensity, pattern, and variability. ObjectiveTo understand HPA participation in people with cognitive impairment, this systematic review aims to (1) identify digital methods and protocols; (2) identify metrics used to assess HPA; (3) describe differences in HPA between people with dementia, MCI, and controls; and (4) make recommendations for measuring and reporting HPA in people with cognitive impairment. MethodsKey search terms were input into 6 databases: Scopus, Web of Science, Psych Articles, PsychInfo, MEDLINE, and Embase. Articles were included if they included community dwellers with dementia or MCI, reported HPA metrics derived from digital technology, were published in English, and were peer reviewed. Articles were excluded if they considered populations without dementia or MCI diagnoses, were based in aged care settings, did not concern digitally derived HPA metrics, or were only concerned with physical activity interventions. Key outcomes extracted included the methods and metrics used to assess HPA and differences in HPA outcomes across the cognitive spectrum. Data were synthesized narratively. An adapted version of the National Institute of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies was used to assess the quality of articles. Due to significant heterogeneity, a meta-analysis was not feasible. ResultsA total of 3394 titles were identified, with 33 articles included following the systematic review. The quality assessment suggested that studies were moderate-to-good quality. Accelerometers worn on the wrist or lower back were the most prevalent methods, while metrics relating to volume (eg, daily steps) were most common for measuring HPA. People with dementia had lower volumes, intensities, and variability with different daytime patterns of HPA than controls. Findings in people with MCI varied, but they demonstrated different patterns of HPA compared to controls. ConclusionsThis review highlights limitations in the current literature, including lack of standardization in methods, protocols, and metrics; limited information on validity and acceptability of methods; lack of longitudinal research; and limited associations between HPA metrics and clinically meaningful outcomes. Limitations of this review include the exclusion of functional physical activity metrics (eg, sitting/standing) and non-English articles. Recommendations from this review include suggestions for measuring and reporting HPA in people with cognitive impairment and for future research including validation of methods, development of a core set of clinically meaningful HPA outcomes, and further investigation of socioecological factors that may influence HPA participation. Trial RegistrationPROSPERO CRD42020216744; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=216744  https://www.jmir.org/2023/1/e44352
spellingShingle Ríona Mc Ardle
Khalid Abdul Jabbar
Silvia Del Din
Alan J Thomas
Louise Robinson
Ngaire Kerse
Lynn Rochester
Michele Callisaya
Using Digital Technology to Quantify Habitual Physical Activity in Community Dwellers With Cognitive Impairment: Systematic Review
Journal of Medical Internet Research
title Using Digital Technology to Quantify Habitual Physical Activity in Community Dwellers With Cognitive Impairment: Systematic Review
title_full Using Digital Technology to Quantify Habitual Physical Activity in Community Dwellers With Cognitive Impairment: Systematic Review
title_fullStr Using Digital Technology to Quantify Habitual Physical Activity in Community Dwellers With Cognitive Impairment: Systematic Review
title_full_unstemmed Using Digital Technology to Quantify Habitual Physical Activity in Community Dwellers With Cognitive Impairment: Systematic Review
title_short Using Digital Technology to Quantify Habitual Physical Activity in Community Dwellers With Cognitive Impairment: Systematic Review
title_sort using digital technology to quantify habitual physical activity in community dwellers with cognitive impairment systematic review
url https://www.jmir.org/2023/1/e44352
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