Healthy ageing with an online coach
Older people can improve their lifestyle and adopt healthier behaviours with the support of an online coach. This can help improve risk factors related to cardiovascular disease and dementia. An international group of researchers, including the Division of Clinical Geriatrics and Aging Research Center at the Center for Alzheimer Research, has reported these findings today in The Lancet Digital Health.
Altogether 2724 people aged 65 or more with an increased risk of cardiovascular disease and dementia took part in the ‘Healthy Ageing Through Internet Counselling in the Elderly’ (HATICE) randomized controlled trial. Participants were recruited in the Netherlands, Finland, and France. Half of the participants, the intervention group, were in contact with a lifestyle coach through the Internet and could set goals to improve their health, as well as monitor their own progress towards a healthier lifestyle on a website developed specifically for this purpose. The main focus was to promote awareness and self-management of high blood pressure, high blood cholesterol, diabetes, and overweight, and supporting smoking cessation, physical activity, and healthy diet. The other half, the control group, had access to a website providing general health information, but no contact with a coach.
After 18 months, 90% of the participants in the intervention group set at least one goal related to their lifestyle with the support of their coach. The researchers investigated the effect on a composite measure for cardiovascular disease risk, including blood pressure, body mass index (BMI) and cholesterol. The research shows that the intervention group had a modest, but significant, improvement compared to the control group. This effect was the largest in those participants who were most active on the website: the cardiovascular disease risk score improved for each additional goal set.
“Overall this was a very positive experience and our team contributed significantly in the development of the intervention and analyses, says Professor Miia Kivipelto, lead investigator of the HATICE project at KI. Although these results are promising, the researchers stress that prevention requires a long-term effort. ‘This is a very interesting multinational prevention study following the successful FINGER trial, which earlier showed that multidomain lifestyle intervention can reduce the risk of cognitive decline. In HATICE we saw that modern technology, as self-management with an online coach, can be a valuable addition to regular health care also in older individuals. This type of intervention should be tested on a larger scale, to confirm whether the beneficial effects seen are sustainable over time and, in the long term, lead to fewer heart attacks, strokes and dementia’ says Professor Miia Kivipelto.
Assistant professor Francesca Mangialasche, co-investigator and research coordinator from KI says: ‘Even though the magnitude of the effect is relatively small, this type of approach requires time, and larger effects are more likely in people with a higher risk of cardiovascular disease or those with less access to health care, such as people in low- and middle-income countries, as well as people in Europe with lower socio-economic status’.
Healthy Ageing Through Internet Counselling in the Elderly (HATICE) - a multinational randomized controlled trial.
Richard E, Moll van Charante EP, Hoevenaar-Blom MP, Coley N, Barbera M, van der Groep A, Meiller A, Mangialasche F, Beishuizen CB, Jongstra S, van Middelaar T, Van Wanrooij LL, Ngandu N , Guillemont J, Brayne C, Andrieu SA, Miia Kivipelto M, Soininen H, Van Gool WA. Published in The Lancet Digital Health. doi: 10.1016/S2589-7500(19)30153-0
HATICE is a project co-funded by the European Union's Seventh Framework Programme (FP7, 2007-2013) under grant agreement No 305374. The study was carried out in collaboration between Karolinska Institutet, the University of Eastern Finland; the Academic Medical Center, University of Amsterdam; INSERM, University of Toulouse; and the Institute of Public Health, University of Cambridge.