Faisabilité, tolérabilité et efficacité psychocognitive préliminaire d’un entrainement cardiovasculaire et d’un entrainement musculaire chez des personnes âgées présentant un trouble cognitif léger avec des symptômes neuropsychiatriques

Authors: Gagnon, Marie-Ève
Advisor: Hudon, Carol; Desgagné, Pierre
Abstract: Alzheimer's disease (AD) is a major public health issue. The key to reducing the burden ofdementia in the coming decades lies in large part in primary and secondary prevention.Prevention interventions target lifestyle habits and modifiable risk factors for AD, includingphysical inactivity. Interventions in physical activity (PA) have been studied in the last fewyears in older aduts with mild cognitive impairment (MCI). For a high proportion of MCIcases, MCI is a prodromal phase of AD and could represent a favorable window of action toprevent AD. PA interventions in MCI are promising, but research on the subject is limited,presents challenges in terms of participants' adherence to the intervention, pays little attentionto the psychological effects of these interventions and generally excludes people withdepressive symptoms. Yet, depressive symptoms are frequent in MCI cases and they increasethe risk of progressing to AD. This thesis aims to study a 12-week PA intervention in olderadults with MCI and concomitant neuropsychiatric symptoms (NPS, including depressivesymptoms). The first objective of this thesis is to investigate the feasibility and tolerance ofthis intervention. The attrition rate and adhesion rate are documented for this purpose. Focusgroup interviews explore how the implementation of the PA program contributes toadherence of seniors with MCI and NPS. These data are the subject of a thematic analysis.The second objective is to make a preliminary comparison of the effects of two PA programs(cardiovascular, resistance). The effects of PA are objectively measured on cognition,psychological state, and quality of life. The outcome variables are subjected to principalcomponent analysis (PCA) in order to derive composite scores. A repeated measures Anova(Treatment x Time) is performed for each composite score. Effect sizes (partial eta-square)are calculated for each Anovas’result. The results of this thesis suggest that a PA programpresents a challenge in terms of recruitment, but that the program is feasible and tolerable interms of adherence to the intervention. The thematic analysis helps identify several factorsthat may contribute to participant adherence. The factors facilitating participation include thefollowing sub-themes: (a) social relationships with the group and the instructors, (b) theservices offered or sought regarding evaluation and intervention (c) the effects of the trainingprogram on physical and psychocognitive states, (d) favorable attitudes and realisticexpectations towards the study and (e) a fixed PA schedule that fits easily into the weeklyschedule. The dissatisfaction factors group together the following sub-themes: (a) vinsufficient communication of information, (b) difficult request upon their memory and (c)imposed quantity and type of PA. Regarding the preliminary psychocognitive effects of thetwo PA programs, it should be noted that the present study focuses primarily on effect sizesand not on the significance level. The effect sizes suggest that the cardiovascular trainingprogram leads to greater improvements than the resistance training program regarding: (a)the two composite scores of executive functions (Component 1, significant effect, large effectsize; Component 2, moderate effect size) and (b) the composite score of episodic memory(small effect size). The resistance training program leads to greater improvements than thecardiovascular training program regarding the two composite scores of NPS and quality oflife (Component 1, moderate effect size; Component 2, large effect size). Conclusions aboutthe programs’effects on attention are limited and discussed in more details in this thesis. Insum, these results will allow adjustment of the PA interventions for a further large scale studywith the aim of demonstrating the benefits of PA in secondary prevention of AD.
Document Type: Thèse de doctorat
Issue Date: 2021
Open Access Date: 28 June 2021
Permalink: http://hdl.handle.net/20.500.11794/69489
Grantor: Université Laval
Collection:Thèses et mémoires

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