Implementation of an intervention concept for the prevention of dementia in Bavaria that promotes physical activity

GESTALT is testing the transfer of a multimodal physical activity programme for the prevention of dementia to the practical work of prevention providers in Erlangen. Within the framework of cooperative planning group meetings, the physical activity programme is to be planned, implemented and evaluated together with the partners, and health promotion structures are to be set up successfully. Participants with an increased risk of dementia should learn within the six-month intervention period to involve themselves independently and sustainably.

Brief summary

Period: 2010-2013
Project coordinator: Prof. Dr. Alfred Rütten
Project staff: Andrea Wolff
Sponsor: Bavarian State Ministry of the Environment and Health

Aims

The main aims of GESTALT are the improvement of physical, cognitive and psychosocial resources in older people, as well as the cooperative development of health promotion structures for the prevention of dementia with prevention providers from Erlangen.

Another aim is to test the transfer of the physical activity programme into the practical work of local prevention providers and to ensure the sustainability of the programme with the cooperation partners involved.

Target group

• Older adults (65-75 years) who have an increased risk of dementia but who have not been diagnosed with it. Risk factors include genetic disposition, lack of exercise, increased body weight, high blood pressure, decreased social contact, low educational status or depression.
• Older adults (65-75 years) with mild cognitive impairment (MCI), but no dementia, and their spouses or relatives.

Project duration

The pilot project GESTALT comprises five phases.

Phase 1

In the first phase of the project, organisations relevant to the project will be contacted in Erlangen.

Phase 2

In the second phase, programme implementation is planned and a catalogue of measures drawn up within four cooperative planning group meetings with the active participation of the local partners and organisations involved.

Phase 3 und Phase 4

In phases three and four, cooperative planning is to be continued in order to control implementation.

• In the third project phase the intervention of GESTALT will be implemented in the respective organisations. The process of implementation will be evaluated.
• In the fourth phase the institutionalisation of the programme in the respective organisational context will be initiated.

Phase 5

In the fifth and final phase of the project, the sustainable involvement by the participants and the institutionalisation of GESTALT will be evaluated.

Further developments

At two of the original five locations, follow-up offers for participants in the first programme run will continue to take place once a week.

Intervention concept

The intervention involves sustained physical involvement of the subjects. The participants should be enabled to maintain a physically active lifestyle even after the end of the intervention. The intervention includes an integrated exercise programme that takes place 1-3 times a week and a telephone physical activity consultation that takes place 1-2 times a month (in the intervention months 3-6).

The exercise programme is divided into a physical training programme lasting 60 minutes and a subsequent moderated group discussion of 30 minutes. The exercise programme will take place three times a week in months 1 and 2 of the intervention period and once or twice a week in the following months.

The contents of the integrated training programme are based on the following topics:

• Dance and movement to music,
• Sports and games,
• Physical activity in everyday life.

The aim is to integrate cognitive, physiological and social-emotional stimulation in the participants. The exercises achieve a heart rate load of about sixty percent for the participants.

In order to ensure that the participants continue to train independently, external providers or trainers of sports and exercise programmes are invited to the group meetings. The training group also visits sports facilities that are specialised in the training program.

Telephone coaching

Telephone counselling begins from the third month of intervention. It is intended to support the physical involvement of the participants with regard to their sustainability. The telephone counselling includes the creation of weekly physical activity plans, the discussion of problems and successes as well as the teaching of action competences in relation to physical activity.