About this trial
The goal of this clinical trial is to promote positive views on aging and walking in Spanish partners aged 65 years and over. The trial will comprise three arms. In the first arm, both partners will undertake the intervention together. In the second arm, only one of the two partners will undertake the intervention. In the third arm (control) none of the partners will undertake the intervention. Collection of quantitative data will make it possible to test the following hypotheses:
1. Differently from arm three, those participants from arms one and two who undertake the intervention will experience changes in primary and secondary intervention outcomes between pre- and post-intervention and these changes will be maintained at follow-ups. 2. Compared to delivering the intervention to only one partner, delivering it to both partners will lead to a greater and more lasting change in primary and secondary intervention outcomes. 3. In the group where only one partner will undertake the intervention, their change in intervention outcomes is observed at least to a small extent in the other partner.
Qualitative data collected at the end of the intervention through interviews of ten couples from each of arms one and two will make it possible to test three additional research questions:
1. How do participants in Group one engage with the intervention tasks, and to what extent do they undertake these tasks jointly as a couple? 2. In what ways do participants in Group two involve their non-participating partner in the intervention activities? 3. What changes do participants in Groups one and two report in their views of themselves and their aging, as well as in their perceptions of and interactions with their partner?
Participants will undertake a multicomponent intervention comprising:
* Three in-person psychoeducational sessions aiming to promote positive views on aging, including positive self-perceptions of aging, and accurate facts about aging * Independent walking for 12 weeks Primary intervention outcomes are changes in participants' self-perceptions of aging and physical activity engagement. Secondary intervention outcomes are changes in ageism, subjective views of couple's joint aging, perceived age-related changes in one's partner, mood, physical fitness, and cognitive functioning.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
living in the community in Barcelona or nearby areas;
both partners being aged ≥ 65 years;
speaking fluent Catalan or Spanish;
being married, having a partner with whom they co-habit, or having had a partner for at least one year and with whom they meet at least twice a week;
Disqualifiers
having a self-reported or clinically diagnosed neurodegenerative disorder, and/or an Adult Lifestyles and Function Interview Mini Mental State Examination (ALFI-MMSE) score of < 15 out of 22, indicating mild cognitive impairment or dementia. The research team has considerable experience with the administration of the MMSE and will adjust scores for individuals with low cultural background;
currently having a clinical diagnosis of mental health disorder that significantly impacts on the daily functioning of the individual (i.e., a diagnosis that significantly impacts the participants ability to work, do house chores, and/or engage socially);
current substance use disorder (alcohol or drug abuse), or a history of substance abuse within the past five years that may interfere with study participation or adherence to the intervention;
having a physical condition or physical limitations that impair from starting a physical activity intervention consisting in walking between three to five times per week and to do some physical tasks such as stand up from and sit down on a chair and back scratch;
Trial design
Crossover
Treatments tested in this trial
Views on Aging Intervention
BehavioralThis intervention was developed by Wolff, Warner (47) in 2013-2014; refined by Beyer, Wolff (59) in 2017-2018; and further refined for this project. It will be delivered through three in-person one-hour sessions by two psychologists. it will include homework between sessions two and three. The first session will consist of a quiz on aging with questions about healthy aging and aging in general to detect own negative personal views on aging and misconceptions regarding aging. The second session will provide information on the benefits of more positive views on aging on health, functional and cognitive abilities, and longevity. During the third session participants are thought a technique to modify negative automatic thoughts about aging and asked/invited to put in practice this technique. Finally, the intervention ends with a focus on positive views on aging and their importance for one's health and wellbeing.
Projecte Moviment
BehavioralThe intervention lasts 12 weeks and is based on international guidelines of physical exercise. Participants will be instructed to walk briskly in one continuous bout (45 minutes for 5 days, 225 minutes per week). Intensity, duration, and times per week will be initiated in a stepwise manner to reduce the possibility of injury. During the first week participants will be asked to walk 30 minutes at 9-10 on the Borg Rating of Perceived Exertion Scale (i.e., light intensity). During the second week, participants will be asked to walk 45 minutes with the same intensity. During the remaining weeks, participants will be asked to maintain the duration of 45 minutes and increase the intensity of the activity to a moderate-high effort that corresponds with 12-14 in the Borg Rating of Perceived Exertion Scale.
Treatment groups
Trial outcomes
Primary outcomes
Awareness of Age-Related Change
This 10-item measure assesses self-perceptions of aging. More specifically, it assesses perceived age-related gains and losses. Each of the items of the perceived age-related gains and losses subscales represents one of the five AARC behavioral domains that are health and physical functioning; cognitive functioning; interpersonal relations; social-cognitive and social-emotional functioning; and lifestyle and engagement. Respondents rate how much each item applies to them on a five-point Likert scale (1= not at all; 2= a little bit; 3= moderately; 4= quite a bit; 5= very much). Higher scores indicate higher perceived age-related gains and losses, respectively (range: 5-25).
Felt Age
This measure assesses self-perceptions of aging. Felt age (FA) will be assessed with a single-item question asking participants to write the age (in years) that they feel most of the time. A proportional discrepancy score will be calculated by subtracting the participants' chronological age from their felt age, and by dividing this difference score by participants' chronological age. A positive value indicates an older felt age, whereas a negative value indicates a younger felt age. Typically, in western countries the majority of older individuals feel between 13% and 18% younger than their age, and a younger felt age is used as indicator of more positive self-perceptions of aging.
Subjective Nearness to Death
This measure assesses self-perceptions of aging. Subjective Nearness to Death will be assessed with the one-item question: I have a feeling that my life is approaching its end. Answer options range from 1 (not at all) to 5 (very much).
International Physical Activity Questionnaire
This measure assesses self-reported physical activity. Participants are asked to refer to the past seven days and to report how much time they spent sitting during a day; how many days they walked for at least ten minutes at a time; how many days they did moderate physical activities like gardening, cleaning, and bicycling; and how many days they did vigorous physical activities like heavy lifting, heavier garden or construction work, and aerobics. Separate scores can be obtained for walking, moderate intensity physical activities, and vigorous physical activities as follows: (1) Walking metabolic equivalent of task (MET)-minutes/week = 3.3 \* walking minutes \* walking days. (2) Moderate MET-minutes/week = 4.0 \* moderate-intensity activity minutes \* moderate days. (3) Vigorous MET-minutes/week = 8.0 \* vigorous-intensity activity minutes \* vigorous-intensity days. The International Physical Activity Questionnaire total score derives from the sum of the scores for walking, moderate-inten
Secondary outcomes
World Health Organization - Ageism Scale
Experienced ageism will be assessed with 15-items covering self-directed ageism: self-stereotypes (two items), self-prejudice (one item), self-discrimination (two items; interpersonal ageism: interpersonal stereotypes (two items), interpersonal prejudices (two items), interpersonal discrimination (three items) and institutional ageism: institutional discrimination (three items). Answer options for all items are 1= strongly disagree; 2= disagree; 3= neither agree nor disagree; 4= agree; 5= strongly agree. The total score is obtained from the sum of items scores. Higher scores indicate greater ageism. Other directed-ageism will be assessed with 23 additional questions developed by the Word Health Organization. Answer options for all items are 1= totally agree; 2= agree; 3= neither agree nor disagree; 4= disagree; 5= strongly disagree. The total score is obtained from the sum of items scores. Higher scores indicate less other-directed ageism.
Subjective Views of Couple's Joint Aging
The 14-item Subjective Views of Couple's Joint Aging (SVoCJA) scale will be used to assess positive and negative subjective views of couple's joint aging. Seven items capture positive subjective views of couple's joint aging and a sample item is the thought that our time together is limited will make us want to love each other more. The remaining seven items capture negative subjective views of couple's joint aging and a sample item is Dealing with health issues will take a heavy toll on our relationship. Each item is answered on a five-point Likert scale: 1= strongly disagree; 2= slightly disagree; 3= neither agree nor disagree; 4= slightly agree; 5= very much agree. Subscales scores are obtained by summing up the scores of their respective items. In the validation sample, Cronbach's alpha coefficients were 0.77 for positive and 0.78 for negative subjective views of couples' joint aging.
Patient Health Questionnaire - 4
This measure assesses core symptoms of depression and anxiety over the past two weeks. A sample item is Over the last two weeks, how often have you felt little interest or pleasure in doing things? Answer options are on a four-point Likert scale: 1= not at all; 2= several days; 3= more than half the days; 4= nearly every day. The total score is obtained from the sum of items scores. Higher total scores (range: 4-16) indicate more non-specific mood problems. Cronbach's alpha was above 0.80 for both depression and anxiety subscales in the validation sample, indicating good internal reliability.
Body Mass Index
Participants will self-report their height in cm and weight in kg.
Sponsors and contacts
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University of Barcelona
Lead sponsor
Catholic University of the Sacred Heart
Collaborator
Ecole Normale Supérieure de Rennes
Collaborator
University of Padova
Collaborator
University of Kaiserslautern-Landau
Collaborator
Flinders University
Collaborator
University of Greifswald
Collaborator
Federico II University
Collaborator
North Carolina State University
Collaborator
Humboldt-Universität zu Berlin
Collaborator