Effects of Intervention Using a Community-Based Walking Program for Prevention of Mental Decline: A Randomized Controlled Trial

OBJECTIVES: To evaluate the efficacy of a municipalityled walking program under the Japanese public Long-Term Care Insurance Act to prevent mental decline. DESIGN: Randomized controlled trial. SETTING: The city of Takasaki. PARTICIPANTS: One hundred fifty community members aged 72.0 +/- 4.0 were randomly divided into intervention (n = 75) and control (n = 75) groups. INTERVENTION: A walking program was conducted once a week for 90 minutes for 3 months. The program encouraged participants to walk on a regular basis and to increase their steps per day gradually. The intervention was conducted in small groups of approximately six, so combined benefits of exercise and social interaction were expected. MEASUREMENTS: Cognitive function was evaluated focusing on nine tests in five domains: memory, executive function, word fluency, visuospatial abilities, and sustained attention. Quality of life (QOL), depressive state, functional capacity, range of activities, and social network were assessed using questionnaires, and motor function was evaluated. RESULTS: Significant differences between the intervention and control groups were shown in word fluency related to frontal lobe function (F(1, 128) = 6.833, P = .01), QOL (F(1,128) = 9.751, P =.002), functional capacity including social interaction (F(1,128) = 13.055, P <.001), and motor function (Timed Up and Go Test: F(1,127) = 10.117, P =.002). No significant differences were observed in other cognitive tests. CONCLUSION: Walking programs may provide benefits in some aspects of cognition, QOL, and functional capacity including social interaction in elderly community members. This study could serve as the basis for implementation of a community-based intervention to prevent mental decline. J Am Geriatr Soc 60:505-510, 2012.