Aim 1: To evaluate a 12-week gamification intervention to increase activity for adults age ≥ 55 at risk for ADRD. H1: intervention will have increased mean steps/day and minutes of moderate-to-vigorous physical activity (MVPA)
Aim 2: To evaluate the sustainability of increased physical activity during a 6-week follow-up period. H2: physical activity will remain higher for the intervention group during follow up (6 weeks after end of gamification intervention).
Aim 3: To explore effect of risk perception on physical activity during 12-week intervention and follow-up period. H3: intervention participants who know they are at elevated genetic risk for ADRD will have greater uptake (largest increase in steps) at 12 weeks and highest sustained step levels during the 6-week follow-up period.
Aim 4: To assess feasibility of collecting cognitive and functional measures remotely. H4: These measures can be collected with high fidelity to inform longitudinal outcomes including cognitive and functional changes in future studies.
Increased physical activity by walking further or more vigorously may delay the development of Alzheimer’s Disease and Related Dementias (ADRD) and associated cognitive decline but reaching higher levels of activity and maintaining it as a long-term habit is difficult to do. This project will use concepts from behavioral science to create a mobility game that people at risk for developing ADRD can play in order to increase their levels of activity while having fun doing it. The game is played with a support partner who is a spouse, family member, or close friend who provides feedback and encouragement to help the game-player reach activity goals and maintain them as habits over time. Participants in the game will use their own smartphone and a wristwatch that tracks activity (such as a FitBit, provided by this study) to set goals, get feedback, and play the game for 12 weeks. Participants will be asked to continue wearing the wristwatch for another 6 weeks to track activity after the game is over. To determine the effectiveness of this game, we will randomly assign 50 people to the game and 50 people to only get the wristwatch but no game component. All participants in this study will be recruited from the GeneMatch registry which offers genetic testing on risk for ADRD to all participants. We will recruit participants to our study who have elevated genetic risk as well as those without specific genetic risks to see if either group responds differently to the game. The short-term goal of this study is to determine the feasibility of remotely recruiting and engaging older adults at high risk for developing ADRD from an existing Alzheimer’s cohort study. We hypothesize that we will be able demonstrate the efficacy of gamification to increase physical activity in this pilot population as well as explore differential effects of high-risk genotypes and demonstrate the ability to collect functional and cognitive measures remotely. These results will enable competitive applications for larger studies (NIA R01) immediately after the completion of this pilot. The long-term goal for this project is to launch a successful new line of inquiry into physical activity in patients with ADRD by adapting and applying behavioral economics approaches such as gamification which have been successfully developed for other populations.