A Preventative Lifestyle Intervention for Older Adults (Lifestyle Matters):  A Randomised Controlled Trial

Gail Mountain; Gillian Windle; Daniel  Hind; Stephen Walters; Anju Keertharuth; Robin  Chatters; Kirsty  Sprange; Claire Craig; Sarah Cook; Ellen Lee; Tim Chater; Robert Woods; Louise Newbould; Lauren  Powell; Katy Shortland; Jennifer Roberts

doi:10.1093/ageing/afx021

A Preventative Lifestyle Intervention for Older Adults (Lifestyle Matters): A Randomised Controlled Trial

Gail Mountain, Gillian Windle, Daniel Hind, Stephen Walters, Anju Keertharuth, Robin Chatters, Kirsty Sprange, Claire Craig, Sarah Cook, Ellen Lee, Tim Chater, Robert Woods, Louise Newbould, Lauren Powell, Katy Shortland, Jennifer Roberts

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Abstract

To test whether an occupation based lifestyle intervention can sustain and improve the mental wellbeing of adults aged 65 years or over compared to usual care, using an individually randomised controlled trial.
Participants
288 independently living adults aged 65 years or over, with normal cognition were recruited from two UK sites between December 2011 and November 2015.
Interventions
Lifestyle Matters is a NICE recommended multi-component preventive intervention designed to improve the mental wellbeing of community living older people at risk of decline. It involves weekly group sessions over four months and one to one sessions.
Main outcome measures
The primary outcome was mental wellbeing at 6 months (mental health dimension of the SF-36). Secondary outcomes included physical health dimensions of the SF-36, extent of depression (PHQ-9), quality of life (EQ-5D) and loneliness(de Jong Gierveld Loneliness Scale),assessed at 6 and 24 months.
Results
Data on 262 (intervention =136; usual care =126) participants were analysed using intention to treat analysis. Mean SF-36 mental health scores at six months differed by 2·3 points (95 CI -1·3 to 5·9; P=0·209) after adjustments.
Conclusions
Analysis shows little evidence of clinical or cost effectiveness in the recruited population with analysis of the primary outcome revealing that the study participants were mentally well at baseline. The results pose questions regarding how preventive interventions to promote wellbeing in older adults can be effectively targeted in the absence of proactive mechanisms to identify those who at risk of decline.
Trial registration
ISRCTN67209155

Original language	English
Pages (from-to)	627-634
Journal	Age and Ageing
Volume	46
Issue number	4
DOIs	https://doi.org/10.1093/ageing/afx021
Publication status	Published - 25 Feb 2017

Keywords

Occupational health, randomised controlled trial, mental health.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1093/ageing/afx021

2016 Preventative LifestyleAccepted author manuscript, 461 KB
2017 A preventative lifestyle intervention for older adultsFinal published version, 355 KBLicence: CC BY

Cite this

Mountain, G., Windle, G., Hind, D., Walters, S., Keertharuth, A., Chatters, R., Sprange, K., Craig, C., Cook, S., Lee, E., Chater, T., Woods, R., Newbould, L., Powell, L., Shortland, K., & Roberts, J. (2017). A Preventative Lifestyle Intervention for Older Adults (Lifestyle Matters): A Randomised Controlled Trial. Age and Ageing, 46(4), 627-634. https://doi.org/10.1093/ageing/afx021

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title = "A Preventative Lifestyle Intervention for Older Adults (Lifestyle Matters): A Randomised Controlled Trial",

abstract = " To test whether an occupation based lifestyle intervention can sustain and improve the mental wellbeing of adults aged 65 years or over compared to usual care, using an individually randomised controlled trial. Participants 288 independently living adults aged 65 years or over, with normal cognition were recruited from two UK sites between December 2011 and November 2015. Interventions Lifestyle Matters is a NICE recommended multi-component preventive intervention designed to improve the mental wellbeing of community living older people at risk of decline. It involves weekly group sessions over four months and one to one sessions. Main outcome measures The primary outcome was mental wellbeing at 6 months (mental health dimension of the SF-36). Secondary outcomes included physical health dimensions of the SF-36, extent of depression (PHQ-9), quality of life (EQ-5D) and loneliness(de Jong Gierveld Loneliness Scale),assessed at 6 and 24 months. Results Data on 262 (intervention =136; usual care =126) participants were analysed using intention to treat analysis. Mean SF-36 mental health scores at six months differed by 2·3 points (95 CI -1·3 to 5·9; P=0·209) after adjustments. Conclusions Analysis shows little evidence of clinical or cost effectiveness in the recruited population with analysis of the primary outcome revealing that the study participants were mentally well at baseline. The results pose questions regarding how preventive interventions to promote wellbeing in older adults can be effectively targeted in the absence of proactive mechanisms to identify those who at risk of decline. Trial registration ISRCTN67209155 ",

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author = "Gail Mountain and Gillian Windle and Daniel Hind and Stephen Walters and Anju Keertharuth and Robin Chatters and Kirsty Sprange and Claire Craig and Sarah Cook and Ellen Lee and Tim Chater and Robert Woods and Louise Newbould and Lauren Powell and Katy Shortland and Jennifer Roberts",

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doi = "10.1093/ageing/afx021",

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Mountain, G, Windle, G, Hind, D, Walters, S, Keertharuth, A, Chatters, R, Sprange, K, Craig, C, Cook, S, Lee, E, Chater, T, Woods, R, Newbould, L, Powell, L, Shortland, K & Roberts, J 2017, 'A Preventative Lifestyle Intervention for Older Adults (Lifestyle Matters): A Randomised Controlled Trial', Age and Ageing, vol. 46, no. 4, pp. 627-634. https://doi.org/10.1093/ageing/afx021

TY - JOUR

T1 - A Preventative Lifestyle Intervention for Older Adults (Lifestyle Matters)

T2 - A Randomised Controlled Trial

AU - Mountain, Gail

AU - Windle, Gillian

AU - Hind, Daniel

AU - Walters, Stephen

AU - Keertharuth, Anju

AU - Chatters, Robin

AU - Sprange, Kirsty

AU - Craig, Claire

AU - Cook, Sarah

AU - Lee, Ellen

AU - Chater, Tim

AU - Woods, Robert

AU - Newbould, Louise

AU - Powell, Lauren

AU - Shortland, Katy

AU - Roberts, Jennifer

PY - 2017/2/25

Y1 - 2017/2/25

N2 - To test whether an occupation based lifestyle intervention can sustain and improve the mental wellbeing of adults aged 65 years or over compared to usual care, using an individually randomised controlled trial. Participants 288 independently living adults aged 65 years or over, with normal cognition were recruited from two UK sites between December 2011 and November 2015. Interventions Lifestyle Matters is a NICE recommended multi-component preventive intervention designed to improve the mental wellbeing of community living older people at risk of decline. It involves weekly group sessions over four months and one to one sessions. Main outcome measures The primary outcome was mental wellbeing at 6 months (mental health dimension of the SF-36). Secondary outcomes included physical health dimensions of the SF-36, extent of depression (PHQ-9), quality of life (EQ-5D) and loneliness(de Jong Gierveld Loneliness Scale),assessed at 6 and 24 months. Results Data on 262 (intervention =136; usual care =126) participants were analysed using intention to treat analysis. Mean SF-36 mental health scores at six months differed by 2·3 points (95 CI -1·3 to 5·9; P=0·209) after adjustments. Conclusions Analysis shows little evidence of clinical or cost effectiveness in the recruited population with analysis of the primary outcome revealing that the study participants were mentally well at baseline. The results pose questions regarding how preventive interventions to promote wellbeing in older adults can be effectively targeted in the absence of proactive mechanisms to identify those who at risk of decline. Trial registration ISRCTN67209155

AB - To test whether an occupation based lifestyle intervention can sustain and improve the mental wellbeing of adults aged 65 years or over compared to usual care, using an individually randomised controlled trial. Participants 288 independently living adults aged 65 years or over, with normal cognition were recruited from two UK sites between December 2011 and November 2015. Interventions Lifestyle Matters is a NICE recommended multi-component preventive intervention designed to improve the mental wellbeing of community living older people at risk of decline. It involves weekly group sessions over four months and one to one sessions. Main outcome measures The primary outcome was mental wellbeing at 6 months (mental health dimension of the SF-36). Secondary outcomes included physical health dimensions of the SF-36, extent of depression (PHQ-9), quality of life (EQ-5D) and loneliness(de Jong Gierveld Loneliness Scale),assessed at 6 and 24 months. Results Data on 262 (intervention =136; usual care =126) participants were analysed using intention to treat analysis. Mean SF-36 mental health scores at six months differed by 2·3 points (95 CI -1·3 to 5·9; P=0·209) after adjustments. Conclusions Analysis shows little evidence of clinical or cost effectiveness in the recruited population with analysis of the primary outcome revealing that the study participants were mentally well at baseline. The results pose questions regarding how preventive interventions to promote wellbeing in older adults can be effectively targeted in the absence of proactive mechanisms to identify those who at risk of decline. Trial registration ISRCTN67209155

KW - Occupational health, randomised controlled trial, mental health.

U2 - 10.1093/ageing/afx021

DO - 10.1093/ageing/afx021

M3 - Article

SN - 0002-0729

VL - 46

SP - 627

EP - 634

JO - Age and Ageing

JF - Age and Ageing

IS - 4

ER -