Investigating the social and environmental contexts of habitual walking ACTIVities in older adult DYADs: a mixed methods protocol for the ActivDyad study

Background

Mobility-related ambulatory activity (e.g., walking) is essential to healthy cognitive and functional ageing. Wearable technology (e.g., accelerometers/inertial measurement units; IMUs) allows us to objectively and continuously capture digital mobility outcomes (DMOs), e.g. volume, pattern and variability of walking activities. Continuous digital mobility assessment has been shown as feasible and acceptable to older adults with and without dementia. However, interpretation of DMOs is limited as we do not yet understand the impact of different social and environmental contexts on walking activity. For example, DMOs may be influenced by the volume of walking that one’s partner participates in, or by the walkability of their local area. Understanding the impact of social and environmental contexts on DMOs will support development of socio-ecological strategies to support mobility in ageing. We aim to conduct a feasibility study in older adults with the following objectives: (1). Objectively assess DMOs in older adult dyads using digital mobility tools (i.e., IMUs/GPS); (2). Identify key social and environmental influences on DMOs through mixed-methods exploration; (3). Develop a novel analytical approach combining DMOs with GPS data to assess independence/interdependence in dyads’ walking activities.

Method

We will recruit 20 older adult dyads in North-East England for an observational cross-sectional study. Walking activities will be recorded continuously for seven days using an IMU attached to participants’ lower backs. DMOs include volume (e.g., daily steps), pattern (e.g. mean bout length) and variability (of bout length) of walking activities. Simultaneously, participants will carry a GPS device (i.e., smartphone) to monitor excursions outside the home. Questionnaires will capture information on cognition, function, falls risk, exercise motivation, wellbeing, relationship mutuality, spatial navigation, and walkability of local area. Participants will complete a “mobility diary” for the assessment period (e.g., daily journeys, motivations/perceptions/familiarity of journeys).

Result

Preliminary results will be presented regarding associations between social/environmental contexts with DMOs via flexible Bayesian statistical models and thematic qualitative analysis.

Conclusion

This study will assess the feasibility of the protocol and analysis strategies, with intentions of developing further research to examine the impact of social and environmental influences on DMOs in people with dementia and their carers.