Impaired sleep, depressive symptoms, and pain as determinants of physical activity and exercise intervention adherence: an exploratory analysis of a randomized clinical trial
Abstract Background Physical activity (PA) and exercise interventions offer health benefits can reduce dementia risk. However, there might be barriers to engage in PA, such as sleep problems, depressive symptoms and pain, which are common complaints with older adults. We investigated sleep duration,...
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2025-03-01
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| Online Access: | https://doi.org/10.1186/s12877-025-05830-y |
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| author | Eija Kekkonen Anette Hall Riitta Antikainen Satu Havulinna Miia Kivipelto Jenni Kulmala Tiina Laatikainen Teemu I. Paajanen Shireen Sindi Hilkka Soininen Timo Strandberg Jaakko Tuomilehto Tiia Ngandu Alina Solomon |
| author_facet | Eija Kekkonen Anette Hall Riitta Antikainen Satu Havulinna Miia Kivipelto Jenni Kulmala Tiina Laatikainen Teemu I. Paajanen Shireen Sindi Hilkka Soininen Timo Strandberg Jaakko Tuomilehto Tiia Ngandu Alina Solomon |
| author_sort | Eija Kekkonen |
| collection | DOAJ |
| description | Abstract Background Physical activity (PA) and exercise interventions offer health benefits can reduce dementia risk. However, there might be barriers to engage in PA, such as sleep problems, depressive symptoms and pain, which are common complaints with older adults. We investigated sleep duration, sleep quality, depressive symptoms, and pain at baseline as potential determinants of: (i) adherence to the exercise intervention component of a 2-year multidomain lifestyle intervention; (ii) intervention’s effect on PA after 2 years; and (iii) overall PA after 2 years (exploratory analyses). Methods The FINGER trial included 1259 individuals at risk for dementia, aged 60–77 years who were randomized (1:1) to a multidomain lifestyle intervention (exercise, diet, cognitive training, vascular risk factor management) or a control (regular health advice) group. Logistic regression analyses were used with exercise adherence (adherent: ≥66% participation) or self-reported PA (active: ≥2 times/week) as outcomes, adjusted for relevant baseline characteristics. Data on PA at baseline and at 2-years were available for 1100 participants. Results Adherence to the exercise intervention was less likely with sleep duration < 6 h or ≥ 9 h per night compared with 7–8 h. OR (95% CI) were 0.46 (0.21–0.99) and 0.38 (0.20–0.74), respectively. The intervention group was more likely to be physically active than the control group at two years (OR 1.87, 95% CI 1.36–2.55). This intervention benefit did not significantly vary by baseline sleep duration, depressive symptoms, or pain (p > 0.3 for all interactions). Regardless of randomization group, those sleeping < 6 h were less likely to be physically active at two years, compared with participants sleeping 7–8 h (OR 0.36, 95% CI 0.18–0.72). Depressive symptoms or pain were not related to PA at two years. Conclusions Older adults with sleep problems, depressive symptoms, or pain may benefit from lifestyle interventions. However, both short and long sleep duration can pose barriers to engaging in exercise intervention and should be carefully considered when designing strategies to promote PA among older populations at risk for dementia. Trial registration The FINGER trial was registered at ClinicalTrials.gov with identifier NCT01041989 on 04/01/2010. |
| format | Article |
| id | doaj-art-c9aba4f5c9c14d5f8097b4d036f88fdf |
| institution | DOAJ |
| issn | 1471-2318 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
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| series | BMC Geriatrics |
| spelling | doaj-art-c9aba4f5c9c14d5f8097b4d036f88fdf2025-08-20T02:49:12ZengBMCBMC Geriatrics1471-23182025-03-0125111010.1186/s12877-025-05830-yImpaired sleep, depressive symptoms, and pain as determinants of physical activity and exercise intervention adherence: an exploratory analysis of a randomized clinical trialEija Kekkonen0Anette Hall1Riitta Antikainen2Satu Havulinna3Miia Kivipelto4Jenni Kulmala5Tiina Laatikainen6Teemu I. Paajanen7Shireen Sindi8Hilkka Soininen9Timo Strandberg10Jaakko Tuomilehto11Tiia Ngandu12Alina Solomon13Department of Neurology, Institute of Clinical Medicine, University of Eastern FinlandDepartment of Neurology, Institute of Clinical Medicine, University of Eastern FinlandCenter for Life Course Health Research/Geriatrics, University of OuluDepartment Public Health, Finnish Institute for Health and WelfareDivision of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska InstituteDivision of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska InstituteDepartment Public Health, Finnish Institute for Health and WelfareWork Ability and Working Careers, Finnish Institute of Occupational HealthDivision of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska InstituteDepartment of Neurology, Institute of Clinical Medicine, University of Eastern FinlandCenter for Life Course Health Research/Geriatrics, University of OuluDepartment Public Health, Finnish Institute for Health and WelfareDivision of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska InstituteDepartment of Neurology, Institute of Clinical Medicine, University of Eastern FinlandAbstract Background Physical activity (PA) and exercise interventions offer health benefits can reduce dementia risk. However, there might be barriers to engage in PA, such as sleep problems, depressive symptoms and pain, which are common complaints with older adults. We investigated sleep duration, sleep quality, depressive symptoms, and pain at baseline as potential determinants of: (i) adherence to the exercise intervention component of a 2-year multidomain lifestyle intervention; (ii) intervention’s effect on PA after 2 years; and (iii) overall PA after 2 years (exploratory analyses). Methods The FINGER trial included 1259 individuals at risk for dementia, aged 60–77 years who were randomized (1:1) to a multidomain lifestyle intervention (exercise, diet, cognitive training, vascular risk factor management) or a control (regular health advice) group. Logistic regression analyses were used with exercise adherence (adherent: ≥66% participation) or self-reported PA (active: ≥2 times/week) as outcomes, adjusted for relevant baseline characteristics. Data on PA at baseline and at 2-years were available for 1100 participants. Results Adherence to the exercise intervention was less likely with sleep duration < 6 h or ≥ 9 h per night compared with 7–8 h. OR (95% CI) were 0.46 (0.21–0.99) and 0.38 (0.20–0.74), respectively. The intervention group was more likely to be physically active than the control group at two years (OR 1.87, 95% CI 1.36–2.55). This intervention benefit did not significantly vary by baseline sleep duration, depressive symptoms, or pain (p > 0.3 for all interactions). Regardless of randomization group, those sleeping < 6 h were less likely to be physically active at two years, compared with participants sleeping 7–8 h (OR 0.36, 95% CI 0.18–0.72). Depressive symptoms or pain were not related to PA at two years. Conclusions Older adults with sleep problems, depressive symptoms, or pain may benefit from lifestyle interventions. However, both short and long sleep duration can pose barriers to engaging in exercise intervention and should be carefully considered when designing strategies to promote PA among older populations at risk for dementia. Trial registration The FINGER trial was registered at ClinicalTrials.gov with identifier NCT01041989 on 04/01/2010.https://doi.org/10.1186/s12877-025-05830-yPhysical activityExerciseSleepMoodPainLifestyle intervention |
| spellingShingle | Eija Kekkonen Anette Hall Riitta Antikainen Satu Havulinna Miia Kivipelto Jenni Kulmala Tiina Laatikainen Teemu I. Paajanen Shireen Sindi Hilkka Soininen Timo Strandberg Jaakko Tuomilehto Tiia Ngandu Alina Solomon Impaired sleep, depressive symptoms, and pain as determinants of physical activity and exercise intervention adherence: an exploratory analysis of a randomized clinical trial BMC Geriatrics Physical activity Exercise Sleep Mood Pain Lifestyle intervention |
| title | Impaired sleep, depressive symptoms, and pain as determinants of physical activity and exercise intervention adherence: an exploratory analysis of a randomized clinical trial |
| title_full | Impaired sleep, depressive symptoms, and pain as determinants of physical activity and exercise intervention adherence: an exploratory analysis of a randomized clinical trial |
| title_fullStr | Impaired sleep, depressive symptoms, and pain as determinants of physical activity and exercise intervention adherence: an exploratory analysis of a randomized clinical trial |
| title_full_unstemmed | Impaired sleep, depressive symptoms, and pain as determinants of physical activity and exercise intervention adherence: an exploratory analysis of a randomized clinical trial |
| title_short | Impaired sleep, depressive symptoms, and pain as determinants of physical activity and exercise intervention adherence: an exploratory analysis of a randomized clinical trial |
| title_sort | impaired sleep depressive symptoms and pain as determinants of physical activity and exercise intervention adherence an exploratory analysis of a randomized clinical trial |
| topic | Physical activity Exercise Sleep Mood Pain Lifestyle intervention |
| url | https://doi.org/10.1186/s12877-025-05830-y |
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