Purpose: Recent research shows that combined physical activity and cognitive activity might have a synergistic, positive influence on brain plasticity, which is important in the prevention of dementia. The purpose of this study is to investigate how an existing walking intervention for older adults can be enriched with cognitive tasks, so that the intervention is safe and easily accessible to the majority of the older population.

Methods: An iterative development process combining knowledge from scientific literature, experts and feedback from older adult end-users, will be used to define optimal cognitive tasks while walking. Older adults and Healthy Walk coaches will be actively involved through co-creation methods. To have insight into their preferences, concerns and suggestions about how to practically and safely embed cognitive activities into the Healthy Walks, we will use focus groups and walk-along interviews. Each session consists of 2 parts: 1,5 hour of focus group in a local service center followed by a 30 min neighborhood walk with the researcher. While walking, older adults are prompted with questions similar to the focus group but because of the real-time experience, previous ideas can now be evaluated and new themes may emerge. Sessions are repeated with a new group in another neighborhood until no new themes/ideas emerge. Based on previous literature, we expect this will be the case after 6-12 iterations. For the current presentation, the first 6 sessions with groups of 6-8 participants (to be held between February and March 2020) will be analyzed, using NVIVO.

Results: These focus groups and walk along interviews will result in a set of cognitive tasks, considered feasible to perform while walking in older adults. 

Conclusions: A set of feasible tasks to cognitively enrich walking is developed. Further study is needed to explore the effects on cognitively enriched walking on cognitive function in older adults. 

Purpose: Physical activity (PA) seems to positively influence cognitive functioning (CF). However, elderly people with chronic illness(es) (ECI) often do not meet PA guidelines. PA programs for the elderly exist, but these are not easily accessible to ECI. Also, the beneficial effects of these PA programs on CF have never been specifically tested in ECI. Hence, this RCT tests whether Active-Plus, a proven effective PA intervention, is able to improve CF of ECI or to slow down cognitive decline. 

Methods: ECI (≥65 years) with at least one chronic condition are recruited from 7 municipalities. Comparable neighborhoods within a municipality were randomly allocated to the intervention (N=276) or waitinglist control group (N=347). Baseline and follow-up measurements after 6 and 12 months assess objectively measured MVPA min/week, and four CF domains: Learning (RVTL; number of correct words recalled trial 5 - trial 1), inhibition (SST; Stop Signal Reaction Time), shifting (TMT; time part B - part A), processing speed (LDST; number of correct iterations in 60s). Multilevel linear regression analyses were conducted to assess intervention effects on CF on complete cases. 

Results: After 12 months, 432 participants completed follow up (dropout =30.7%). Preliminary analyses show a significant intervention effect for shifting (B=674.93, p=.04). Participants in both conditions improved their scores over time for processing speed (B=0.04, p=.01) and shifting (B=-860.18, p<.001), however for learning the scores declined (B=0.04, p=.001). The difference in MVPA between start and 6 months was a significant predictor for processing speed (B=0.46, p=.01), where participants with an improved MVPA scored better on processing speed. However, no clear interventions effects on MVPA were found after 6 months.

Conclusions: The Active-Plus intervention was only able to significantly improve shifting in elderly with chronic illness(es), possibly because the intervention only had limited effects on MVPA in this specific group (contrary to previous studies). More in depth analyses will be presented. 

Purpose: Blue spaces, including waterways such as river and canals are part of the fabric of most cities in the world, with 50% of the global population living within 3 km of Urban Waterways by 2050. Rapid urbanisation together with ageing of the population and climate change mean that cities world-wide are faced  with increased challenges that affect the health and wellbeing of their older adult citizens and increase the burden of ageing related conditions. “Blue Care” is a programme of research aimed at understanding how urban blue infrastructure can be used for co-benefits between older adults physical and mental health and the environment. 

Methods: “Blue Care” is a mixed method research programme that include systematic reviews of the impact of urban blue space on health of older adults, big data analysis of the impact of the regeneration of blue space on physical and mental health of older adults and development of a “blue gym” intervention programme using environmental conservation as a mean to increase physical activity combined with cognitive loading.

Results: The systematic reviews and big data analysis show that there is a clear association between mortality risk, feeling of wellbeing and improvement in cognitive function for those living near or spending time near urban blue infrastructure. They indicate that pathways between exposure to urban blue space and health are potentially physical activity, access to healthier environment and mental restorative properties of blue spaces. There is a potential to use blue spaces as a modality of intervention combining physical activity and cognitive training to boost cognitive function. 

Conclusions: There is good evidence that engaging with or living near blue space in urban area increase feeling of wellbeing and is associated with better physical and mental health. The mechanism and how this can be harnessed to fight chronic diseases and in particular cognitive decline amongst older adults is not yet fully understood.