Effects Of Telehealth Program On Physical Activity Level In Older Adults With Dementia During The Pandemic: Randomized Clinical Trial

INTRODUCTION: Multidisciplinary Telehealth Programs have been consolidated worldwide as a viable and efficient intervention strategy for older populations. However, the effect of multimodal exercises applied to older adults with dementia, through a Multidisciplinary Telehealth Program, remains unclear in the literature. OBJECTIVE: To analyze the effect of a Multidisciplinary Telehealth Program composed of multimodal exercises on the Physical Activity Level (PAL) of older adults with dementia during the COVID-19 pandemic. METHODS: A randomized, controlled, and blinded clinical trial was conducted with 80 older adults with mild to moderate dementia (Clinical Dementia Assessment Score - CDR). Assessments were conducted at three time points: a) Pre – at the start of the study; b) Post – after 3 months of intervention; and c) Follow-up – 6 months post-intervention. Participants were randomly assigned to two groups: Intervention Group (IG) and Control Group (CG). The IG participated of intervention protocol included multimodal physical exercises and cognitive stimulation in 50-minute sessions, three times per week, for 3 months, with professional monitoring. The CG received unsystematic guidance during the protocol period. PAL was assessed using the Modified Baecke Questionnaire for the Elderly (MBQE). Generalized Estimating Equations (GEE) were adopted to evaluate the effects of the program on Groups (IG and CG), on the Moments (Pre, Post, and Follow-up), and on the interaction (Groups x Moments). The Bonferroni post hoc test was used. RESULTS: The test session results were analyzed using a GEE with a gamma distribution, identity link function, and unstructured covariance matrix. A significant effect on the PAL among older adults with dementia was found between Groups [Wald (1, 193) = 173.2; p = 0.002] and in the Groups x Moments interaction [Wald (2, 193) = 8.3; p = 0.016]. However, no significant values were found for the moments. The PAL was significantly higher in the IG at the Post Moment (5.3 ± 0.5 points) compared to the CG at the Pre (3.0 ± 0.4 points; p = 0.024) and Post (2.0 ± 0.2 points; p = 0.000) Moments. CONCLUSION: The Multidisciplinary Telehealth Program composed of multimodal exercises had a positive effect on maintaining physical activity levels in older adults with dementia during the COVID-19 pandemic. Supported by: The authors would like to thank the Foundation for the Improvement of Higher Education Personnel - CAPES is linked to the Academic Excellence Program (PROEX). Additionally, thanks to the São Paulo Research Foundation (FAPESP n°. 2022/04912-3 and n°2020/08779-0) that has supported this project until December of 2023, providing financial support for achieving positive outcomes. Additionally, I declare that I used Chatgpt to assist in translating the abstract into English.