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Objective: To investigate the effects of a dyadic intervention of mindfulness-based stress reduction (MBSR) for informal dementia caregivers and home-based balance and progressive resistance training (PRT) for their loved ones. Methods : The study was a two arm, randomized, controlled, single-blinded, parallel-group trial. Dyads were randomized to an intervention group: an 8-week MBSR course (daily) and an 8-week PRT and balance training (3 days/week) for their loved ones or a waiting list control group. Results : Nine dyads were randomized [caregivers: median age 75 (40–81) years, loved ones: 77 (73–88) years]. The intervention significantly improved caregiver mindfulness [relative effect size (95% confidence interval) 1.35 (−0.10, 2.81); p =.009] and functional mobility in their loved ones [mean difference (95% confidence interval) 1.53 (−3.09, 6.14)] with no significant effects on caregiver burden [relative effect size (95% confidence interval) 0.22 (−1.09, 1.54); p =.622]. Conclusion : The study appeared feasible in the home environment and future large and longer trials should test the efficacy of a more abbreviated MBSR intervention and to optimize adoption and sustain adherence over time. Trial registry name: HOMeCare: Caring for the Dementia Caregiver and their Loved One via the HOMeCare Exercise and Mindfulness for Health Program Trial URL: https://www.australianclinicaltrials.gov.au/anzctr/trial/ACTRN12617000347369 Registration number: ACTRN12617000347369 [ABSTRACT FROM AUTHOR]

Background: Variations in genotype may contribute to heterogeneity in functional adaptations to exercise. Methods: A systematic search of eight databases was conducted, and 9,696 citations were screened. Results: Eight citations from seven studies measuring 10 single-nucleotide polymorphisms and nine different functional performance test outcomes were included in the review. There was one observational study of physical activity and six experimental studies of aerobic or resistance training. The ACE (D) allele, ACTN3 (RR) genotype, UCP2 (GG) genotype, IL-6-174 (GG) genotype, TNF-α-308 (GG) genotype, and IL-10-1082 (GG) genotype all predicted significantly superior adaptations in at least one functional outcome in older men and women after prescribed exercise or in those with higher levels of physical activity. Conclusion: There is a small amount of evidence that older adults may have better functional outcomes after exercise/physical activity if they have specific alleles related to musculoskeletal function or inflammation. However, more robust trials are needed. [ABSTRACT FROM AUTHOR]

Background: Systematically evaluate the effects of structured exercise and behavioral intervention (physical activity [PA] alone/PA + diet) on long-term PA in type 2 diabetes. Methods: Systematic search of 11 databases (inception to March, 2017). Randomized controlled trials investigating structured exercise/behavioral interventions in type 2 diabetes reporting PA outcomes ≥6 months were selected. Results: Among 107,797 citations retrieved, 23 randomized controlled trials (including 18 behavioral programs and 5 structured exercise) met inclusion criteria (n = 9640, 43.6% men, age = 60.0 (4.0) y). All structured exercise trials demonstrated increased objective PA outcomes relative to control (pooling was inappropriate; I2 = 92%). Of 18 behavioral interventions, 10 increased PA significantly, with effect sizes ranging from 0.2 to 6.6 (pooling was inappropriate; I2 = 96%). After removing 1 outlier, the remaining 17 studies significantly improved PA (pooled effect size = 0.34), although smaller compared with structured exercise. After removing the outlier, meta-regression also revealed significant direct relationships between total contacts (r =.50, P <.01) and more face-to-face counseling (r =.75, P <.001) and increased PA. However, long-term changes in PA and HbA1c were not related. Conclusion: Both structured exercise and behavioral interventions increased PA in type 2 diabetes, although effect sizes were larger for supervised exercise. The effectiveness of behavioral programs was improved when delivery included more extensive and face-to-face contact. [ABSTRACT FROM AUTHOR]

The Maintain Your Brain (MYB) trial is one of the largest internet-delivered multidomain randomised controlled trial designed to target modifiable risk factors for dementia. It comprises four intervention modules: physical activity, nutrition, mental health and cognitive training. This paper explains the MYB Nutrition Module, which is a fully online intervention promoting the adoption of the 'traditional' Mediterranean Diet (MedDiet) pattern for those participants reporting dietary intake that does not indicate adherence to a Mediterranean-type cuisine or those who have chronic diseases/risk factors for dementia known to benefit from this type of diet. Participants who were eligible for the Nutrition Module were assigned to one of the three diet streams: Main, Malnutrition and Alcohol group, according to their medical history and adherence to the MedDiet at baseline. A short dietary questionnaire was administered weekly during the first 10 weeks and then monthly during the 3-year follow-up to monitor whether participants adopted or maintained the MedDiet pattern during the intervention. As the Nutrition Module is a fully online intervention, resources that promoted self-efficacy, self-management and process of change were important elements to be included in the module development. The Nutrition Module is unique in that it is able to individualise the dietary advice according to both the medical and dietary history of each participant; the results from this unique intervention will contribute substantively to the evidence that links the Mediterranean-type diet with cognitive function and the prevention of dementia and will increase our understanding of the benefits of a MedDiet in a Western country. [ABSTRACT FROM AUTHOR]

Aim: Nutrition‐based applications ("apps") offer enormous research potential, however evidence of their use and acceptability among older adults is limited. We compared self‐reported and dietitian‐adjusted dietary intake records among adults aged 55 to 75 years using the Research Food Diary (RFD) app. Methods: Participants were recruited from the 45 and Up Study and completed a 3‐day food record using the RFD. A follow‐up dietetic telephone interview was performed to confirm the electronic dietary data. Independent of these interviews, a set of adjustments based on dietetic skills, nutritional database knowledge, food composition and dietary assessment was established to resolve probable reporting errors. The "adjusted" and "dietitian‐assisted" records were compared to self‐reported records for nutrient intakes and serves of The Five Food Groups using one‐way repeated measures analysis of variance. Results: Sixty‐two participants were recruited, with 48 using the RFD app which included eight records without any identified errors. Reporting errors contained in the raw self‐reported records included: food items with missing/implausible quantities or insufficient descriptions to allow automatic coding. After removal of unusable records, 44 records were analysed. Differences were found between the self‐reported and adjusted records for protein, calcium, vitamin B12, zinc and dairy food serves (all P <.001; differences up to 8%). No significant differences were found between the adjusted and dietitian‐assisted measures. Conclusions: Similarities between adjusted and dietitian‐assisted records suggest carefully applied dietetic assumptions are likely to improve accuracy of self‐reported intake data where dietitian interviews are not possible. We provide four key recommendations to guide this process. [ABSTRACT FROM AUTHOR]

Objective: Resistance training (RT) improves walking ability in persons with peripheral artery disease. We conducted a meta-analysis of randomised controlled trials (RCTs) investigating the effect of RT on peripheral artery disease (as measured by walking ability).Design: We included RCTs that investigated the effect of RT on treadmill and/or 6 min walk (6-MWT) distances. RT intensity was assessed according to the American College of Sports Medicine guidelines by 1 repetition maximum or rating of perceived exertion. Standardised mean (SMD) and mean differences (MD) were calculated using a random-effects inverse variance model. Heterogeneity and bias were assessed using RevMan V.5.3. Meta-regression and meta-analysis of variance were performed as moderator analyses.Data Sources: Databases (Medline, Embase, Web of Science, Cinahl and Google Scholar) were searched until July 2018.Results: Fifteen trials isolated RT; 7 trials compared RT with aerobic exercise. We analysed 826 patients (n=363 completing RT), with a mean age of 67.1±3.8 years. Training ranged from low-high intensity, 2-7 times per week for 17±7 weeks, with a mix of upper, lower or whole body training. Overall RT significantly improved constant load treadmill claudication onset (COD) (SMD 0.66 [0.40, 0.93], p<0.00001) and total walking distance (WD) (SMD 0.51 [0.23, 0.79], p=0.0003), progressive treadmill COD (SMD 0.56 [0.00, 1.13], p=0.05) and total WD (SMD 0.45 [0.08, 0.83], p=0.02), and 6-MWT COD (MD 82.23 m [40.91, 123.54], p<0.0001). Intensity played a role in improvement, with high-intensity training yielding the greatest improvement (p=0.02).Conclusions: RT clinically improved treadmill and flat ground walking ability in persons with peripheral artery disease. Higher intensity training was associated with better outcomes. Our study makes a case for clinicians to include high-intensity lower body RT in the treatment of peripheral artery disease.Trial Registration Number: CRD42017081184. [ABSTRACT FROM AUTHOR]

Maintain Your Brain (MYB)i is a randomised controlled trial (RCT) of multiple online interventions designed to target modifiable risk factors for Alzheimer's disease and dementia. Traditional clinical trial management systems (CTMS) requirements consist of features such as management of the study, site, subject (participant), clinical outcomes, external and internal requests, education, data extraction and reporting, security, and privacy. In addition to fulfilling these traditional requirements, MYB has a specific set of features that needs to be fulfilled. These specific requirements include: (i) support for multiple interventions within a study, (ii) flexible interoperability options with third-party software providers, (iii) study participants being able to engage in online activities via web-based interfaces throughout the trial (from screening to follow-up), (iv) ability to algorithmically personalize trial activities based on the needs of the participant, and (v) the ability to handle large volumes of data over a long period. This paper outlines how the existing CTMSs fall short in meeting these specific requirements. The presented system architecture, development approach and lessons learned in the implementation of the MYB digital platform will inform researchers attempting to implement CTMSs for trials comparable to MYB in the future. [ABSTRACT FROM AUTHOR]