A randomized controlled trial of an automated exercise coach for older adults.


OBJECTIVES:To compare the efficacy of a computer-based physical activity program (Embodied Conversational Agent-ECA) with that of a pedometer control condition in sedentary older adults. DESIGN:Single-blind block-randomized controlled trial stratified according to clinic site and health literacy status. SETTING:Three urban ambulatory care practices at Boston Medical Center between April 2009 and September 2011. PARTICIPANTS:Older adults (N = 263; mean age 71.3; 61% female; 63% African American; 51% high school diploma or less). INTERVENTION:ECA participants were provided with portable tablet computers with touch screens to use for 2 months and were directed to connect their pedometers to the computer using a data cable and interact with a computer-animated virtual exercise coach daily to discuss walking and to set walking goals. Intervention participants were then given the opportunity to interact with the ECA in a kiosk in their clinic waiting room for the following 10 months. Control participants were given a control pedometer intervention that only tracked step counts for an equivalent period of time. Intervention participants were also provided with pedometers. MEASUREMENTS:The primary outcome was average daily step count for the 30 days before the 12-month interview. Secondary outcomes were average daily step count for the 30 days before the 2-month interview. Outcomes were also stratified according to health literacy level. RESULTS:ECA participants walked significantly more steps than control participants at 2 months (adjusted mean 4,041 vs 3,499 steps/day, P = .01), but this effect waned by 12 months (3,861 vs 3,383, P = .09). For participants with adequate health literacy, those in the ECA group walked significantly more than controls at both 2 months (P = .03) and 12 months (P = .02), while those with inadequate health literacy failed to show significant differences between treatment groups at either time point. Intervention participants were highly satisfied with the program. CONCLUSION:An automated exercise promotion system deployed from outpatient clinics increased walking among older adults over the short-term. Effective methods for long-term maintenance of behavior change are needed.


J Am Geriatr Soc


Bickmore TW,Silliman RA,Nelson K,Cheng DM,Winter M,Henault L,Paasche-Orlow MK




Has Abstract


2013-10-01 00:00:00












  • A prospective study of the effect of hypertension and baseline blood pressure on cognitive decline and dementia in postmenopausal women: the Women's Health Initiative Memory Study.

    abstract:OBJECTIVES:To examine the relationship between baseline hypertension, blood pressure, and the development of cognitive decline in participants in the Women's Health Initiative Memory Study (WHIMS). DESIGN:Prospective analyses. SETTING:Thirty-nine centers. PARTICIPANTS:Seven thousand one hundred forty-nine women aged...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Johnson KC,Margolis KL,Espeland MA,Colenda CC,Fillit H,Manson JE,Masaki KH,Mouton CP,Prineas R,Robinson JG,Wassertheil-Smoller S,Women's Health Initiative Memory Study and Women's Health Initiative Investigators.

    更新日期:2008-08-01 00:00:00

  • Prevalence and Outcomes of Breathlessness in Older Adults: A National Population Study.

    abstract:OBJECTIVES:To determine the prevalence and outcomes of breathlessness in older Americans. SETTING:Community-dwelling older adults. PARTICIPANTS:Individuals aged 70 and older in the nationally representative Health and Retirement Study (2008, follow-up through 2012) (N = 3,671; mean age 78). MEASUREMENTS:Breathlessne...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章


    authors: Smith AK,Currow DC,Abernethy AP,Johnson MJ,Miao Y,Boscardin WJ,Ritchie CS

    更新日期:2016-10-01 00:00:00

  • Coronary artery disease is associated with cognitive decline independent of changes on magnetic resonance imaging in cognitively normal elderly adults.

    abstract:OBJECTIVES:To examine in cognitively normal elderly adults whether vascular factors predict cognitive decline and whether these associations are mediated by magnetic resonance imaging (MRI) measures of subclinical vascular brain injury. DESIGN:Prospective multisite longitudinal study of subcortical ischemic vascular d...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章,多中心研究


    authors: Zheng L,Mack WJ,Chui HC,Heflin L,Mungas D,Reed B,DeCarli C,Weiner MW,Kramer JH

    更新日期:2012-03-01 00:00:00

  • Compression of Morbidity Is Observed Across Cohorts with Exceptional Longevity.

    abstract:OBJECTIVES:To determine, in a sample of Ashkenazi Jewish aged 95 and older, whether there is a compression of morbidity similar to what has been reported in other cohorts with exceptional longevity. DESIGN:Case-control study. SETTING:Longevity Genes Project (LGP) and New England Centenarian Study (NECS). PARTICIPANT...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章


    authors: Ismail K,Nussbaum L,Sebastiani P,Andersen S,Perls T,Barzilai N,Milman S

    更新日期:2016-08-01 00:00:00

  • Rationale and design of a multi-center randomized trial of comprehensive geriatric assessment consultation for hospitalized patients in an HMO.

    abstract:OBJECTIVE:To describe the evaluation of an interdisciplinary comprehensive geriatric assessment (CGA) consultation program for targeted hospitalized patients. DESIGN:Multi-center randomized clinical trial (RCT) at four hospitals where patients were randomly assigned to CGA consultation or usual care by the attending p...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Borok GM,Reuben DB,Zendle LJ,Ershoff DH,Wolde-Tsadik G,Rubenstein LZ,Ambrosini VL,Fishman LK,Beck JC

    更新日期:1994-05-01 00:00:00

  • Left ventricular diastolic function in a population of healthy elderly subjects. An echocardiographic study.

    abstract::Diastolic left ventricular function was comparatively assessed in 19 healthy elderly individuals (mean age 71 years) and in 20 young normal subjects (mean age 26 years), using digitized echocardiograms. Peak and average filling rates were slower in the group of elderly subjects than in the younger population (128 +/- ...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章


    authors: Manyari DE,Patterson C,Johnson D,Belenkie I,Anderson P,Melendez L,Cape R

    更新日期:1985-11-01 00:00:00

  • The immune status of healthy centenarians.

    abstract::The immune status of 17 healthy individuals 100-103 years of age (centenarians) was investigated. Qualitative values for immunoglobulins IgG, IgM, IgA, and IgE were within normal ranges for subjects more than 60 years of age with the exception of elevated IgM in one individual. Cell marker studies employing a panel of...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章


    authors: Thompson JS,Wekstein DR,Rhoades JL,Kirkpatrick C,Brown SA,Roszman T,Straus R,Tietz N

    更新日期:1984-04-01 00:00:00

  • Freedom, dependency, and the care of the very old.

    abstract::Difficulties exist in making treatment decisions for the very old and dependent patient. In the years to come, these difficulties will increase. It is argued that such persons should not be abandoned to their "rights" as autonomous persons; yet quality of life judgments should also be avoided except in limited circums...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章


    authors: Thomasma DC

    更新日期:1984-12-01 00:00:00

  • Effect of Hospice Use on Costs of Care for Long-Stay Nursing Home Decedents.

    abstract:OBJECTIVES:To analyze the costs for long-stay (>90 days) nursing home (NH) decedents with and without hospice care. DESIGN:Retrospective cohort study using a 1999-2009 data set of linked Medicare and Medicaid claims and minimum data set (MDS) assessments. SETTING:Indiana NHs. PARTICIPANTS:Long-stay NH decedents (N =...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章


    authors: Unroe KT,Sachs GA,Dennis ME,Hickman SE,Stump TE,Tu W,Callahan CM

    更新日期:2016-04-01 00:00:00

  • Estrogen-androgen levels in aging men and women: therapeutic considerations.

    abstract::The influence of aging on serum levels of gonadotropins (FSH and LH), testosterone and estradiol was studied in the following groups: 4 normal men (ages 30 to 50), 38 men with symptoms of the male climacteric (ages 51 to 84), 25 men with relative impotence (ages 31 to 50), 10 normal women (ages 24 to 31), and 6 menopa...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章


    authors: Greenblatt RB,Oettinger M,Bohler CS

    更新日期:1976-04-01 00:00:00

  • Tongue strength is associated with jumping mechanography performance and handgrip strength but not with classic functional tests in older adults.

    abstract:OBJECTIVES:To determine whether classic muscle function tests and jumping mechanography (JM) are related to tongue strength. DESIGN:Cross-sectional. SETTING:Community. PARTICIPANTS:Ninety-seven community-dwelling individuals aged 70 and older (49 female, 48 male, mean age 80.7, range 70-95) with and without identifi...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章


    authors: Buehring B,Hind J,Fidler E,Krueger D,Binkley N,Robbins J

    更新日期:2013-03-01 00:00:00

  • Risk factors for disability subtypes in older persons.

    abstract:OBJECTIVES:To identify risk factors for five different subtypes of disability. DESIGN:Prospective cohort study. SETTING:Greater New Haven, Connecticut. PARTICIPANTS:Seven hundred fifty-four community-living residents aged 70 and older and initially nondisabled in four essential activities of daily living (bathing, d...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章


    authors: Gill TM,Murphy TE,Barry LC,Allore HG

    更新日期:2009-10-01 00:00:00

  • The cross-sectional relationship between body mass index, waist-hip ratio, and cognitive performance in postmenopausal women enrolled in the Women's Health Initiative.

    abstract:OBJECTIVES:To determine whether body mass index (BMI) is independently associated with cognitive function in postmenopausal women and the relationship between body fat distribution as estimated by waist-hip ratio (WHR). DESIGN:Cross-sectional data analysis. SETTING:Baseline data from the Women's Health Initiative (WH...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章


    authors: Kerwin DR,Zhang Y,Kotchen JM,Espeland MA,Van Horn L,McTigue KM,Robinson JG,Powell L,Kooperberg C,Coker LH,Hoffmann R

    更新日期:2010-08-01 00:00:00

  • The renal effects of nonsteroidal anti-inflammatory drugs in older people: findings from the Established Populations for Epidemiologic Studies of the Elderly.

    abstract:OBJECTIVE:To determine whether older people who use nonsteroidal anti-inflammatory agents (NSAIDs) have increased levels of blood urea nitrogen (BUN), serum creatinine, and BUN:serum creatinine ratio. DESIGN:Cross-sectional, secondary data analysis. SETTING:Older people living in the communities of East Boston, MA, N...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章


    authors: Field TS,Gurwitz JH,Glynn RJ,Salive ME,Gaziano JM,Taylor JO,Hennekens CH

    更新日期:1999-05-01 00:00:00

  • Mortality in Incident Cognitive Impairment: Results of the Prospective AgeCoDe Study.

    abstract:OBJECTIVES:To investigate mortality risk and survival time in new-incident cases of cognitive impairment (CI) in old age. DESIGN:Prospective cohort study in six German cities. SETTING:German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe). PARTICIPANTS:Two thousand eighty-nine nondemented...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章,多中心研究


    authors: Luck T,Riedel-Heller SG,Roehr S,Wiese B,van der Leeden C,Heser K,Bickel H,Pentzek M,König HH,Werle J,Mamone S,Mallon T,Wolfsgruber S,Weeg D,Fuchs A,Brettschneider C,Scherer M,Maier W,Weyerer S,AgeCoDe study group.

    更新日期:2017-04-01 00:00:00

  • Utilization of essential medications by vulnerable older people after a drug benefit cap: importance of mental disorders, chronic pain, and practice setting.

    abstract:OBJECTIVE:To identify specific characteristics of patients, physicians, and treatment settings associated with decreased receipt of essential medications in a chronically ill, older population following a Medicaid three-prescription monthly reimbursement limit (cap). DESIGN:Quasi-experiment with bivariate and multivar...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章


    authors: Fortess EE,Soumerai SB,McLaughlin TJ,Ross-Degnan D

    更新日期:2001-06-01 00:00:00

  • Withholding versus withdrawing life-sustaining treatment: patient factors and documentation associated with dialysis decisions.

    abstract:OBJECTIVE:We evaluated prospectively the use of acute hemodialysis among hospitalized patients to identify demographic and clinical predictors of and chart documentation concerning dialysis withheld and withdrawn. DESIGN:Prospective cohort study. SETTING:Five teaching hospitals. PATIENTS:Five hundred sixty-five seri...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 临床试验,杂志文章,多中心研究


    authors: Wenger NS,Lynn J,Oye RK,Liu H,Teno JM,Phillips RS,Desbiens NA,Sehgal A,Kussin P,Taub H,Harrell F,Knaus W

    更新日期:2000-05-01 00:00:00

  • Factors Influencing Outcomes of Older Adults After Undergoing Rehabilitation for Hip Fracture.

    abstract:OBJECTIVES:To determine the contribution of cognitive impairment, prefracture functional impairment, and treatment as predictors of functional status and mobility 6 months after discharge from rehabilitation for older adults with hip fracture. DESIGN:Longitudinal. SETTING:Inpatient rehabilitation units of two communi...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章


    authors: McGilton KS,Chu CH,Naglie G,van Wyk PM,Stewart S,Davis AM

    更新日期:2016-08-01 00:00:00

  • Validity of the Patient Health Questionnaire 2 (PHQ-2) in identifying major depression in older people.

    abstract:OBJECTIVES:To determine the performance of the Patient Health Questionnaire 2 (PHQ-2) against the criterion standard for diagnosing major depression, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and to examine its performance across age, sex, and racial/ethnic groups. DESIGN:Cros...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章


    authors: Li C,Friedman B,Conwell Y,Fiscella K

    更新日期:2007-04-01 00:00:00

  • Effect of nonsteroidal anti-inflammatory drug use on the rate of gastrointestinal hospitalizations among people living in long-term care.

    abstract:OBJECTIVES:Gastrointestinal (GI) complications are the most-common serious adverse reactions associated with nonsteroidal anti-inflammatory drugs (NSAIDs). We quantified the effect of specific NSAIDs on the rate of GI hospitalizations among older people living in long-term care. DESIGN:Retrospective cohort study. SET...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章


    authors: Lapane KL,Spooner JJ,Mucha L,Straus WL

    更新日期:2001-05-01 00:00:00

  • The dynamics of disability and functional change in an elderly cohort: results from the Alameda County Study.

    abstract:OBJECTIVE:To examine changes in functional status over time by age, gender, and ethnicity in a representative sample of older persons. DESIGN:Six-year prospective cohort study. SETTING:Alameda County, California. PARTICIPANTS:508 persons 65 years old and older at baseline in 1984. MAIN OUTCOME MEASURES:Activities o...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章


    authors: Strawbridge WJ,Kaplan GA,Camacho T,Cohen RD

    更新日期:1992-08-01 00:00:00

  • Mild cognitive impairment and 10-year trajectories of disability in the Iowa Established Populations for Epidemiologic Studies of the Elderly cohort.

    abstract:OBJECTIVES:To apply diagnostic criteria for mild cognitive impairment (MCI) to a geographically representative sample, to estimate the prevalence of MCI, and to estimate 10-year trajectories of incident disability for cognitively intact participants and subgroups with MCI. DESIGN:Prospective cohort; 10 years of follow...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章


    authors: Purser JL,Fillenbaum GG,Pieper CF,Wallace RB

    更新日期:2005-11-01 00:00:00

  • Rating the importance of nursing home residents' quality of life.

    abstract:OBJECTIVES:To assess how various stakeholders involved with nursing home care rate the importance of various quality-of-life (QoL) items for hypothetical residents with varying types of impairment. DESIGN:A community-based exploratory description of a convenience sample. SETTING:Eleven nursing homes in Florida, New J...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章,多中心研究


    authors: Kane RL,Rockwood T,Hyer K,Desjardins K,Brassard A,Gessert C,Kane R

    更新日期:2005-12-01 00:00:00

  • Isolated systolic hypertension in the elderly. A placebo-controlled, dose-response evaluation of chlorthalidone.

    abstract::One hundred seventy-one patients, 60 years of age or older with isolated systolic hypertension, were randomly assigned to receive chlorthalidone 12.5, 25.0, or 50.0 mg or placebo once daily for 12 weeks. The majority of the patients receiving chlorthalidone 12.5 mg achieved therapeutic success with no clinically signi...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Morledge JH,Ettinger B,Aranda J,McBarron F,Barra P,Gorwit J,Davidov M

    更新日期:1986-03-01 00:00:00

  • Public opinion regarding consent to treatment.

    abstract:OBJECTIVE:To examine public opinion regarding certain elements of consent: disclosure, advance directives, substitute decisions, emergency treatment, and advocacy. DESIGN:Cross-sectional random-digit-dialing telephonic survey. SETTING:General public. PARTICIPANTS:One thousand randomly-selected adults living in Ontar...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章


    authors: Singer PA,Choudhry S,Armstrong J

    更新日期:1993-02-01 00:00:00

  • The neglected half of Alzheimer disease: cognitive and functional concomitants of severe dementia.

    abstract:OBJECTIVE:Traditional mental status and psychometric assessments bottom out in the late stages of Alzheimer disease (AD). A method adapted from cognitive testing in infants, the Ordinal Scales of Psychological Development was modified (M-OSPD) and applied to a severely demented population. The concurrent validity of th...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 临床试验,杂志文章


    authors: Auer SR,Sclan SG,Yaffee RA,Reisberg B

    更新日期:1994-12-01 00:00:00

  • Psychotropic medication withdrawal and a home-based exercise program to prevent falls: a randomized, controlled trial.

    abstract:OBJECTIVE:To assess the effectiveness of psychotropic medication withdrawal and a home-based exercise program in reducing falls in older people. DESIGN:A randomized controlled trial with a two by two factorial design. SETTING:Seventeen general practices in Dunedin, New Zealand. PARTICIPANTS:Women and men aged 65 yea...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Campbell AJ,Robertson MC,Gardner MM,Norton RN,Buchner DM

    更新日期:1999-07-01 00:00:00

  • The Ones We Seldom See: Old Folks in Young Countries.

    abstract::It has long been thought that demographic aging and its attendant implications for health and social services is primarily a problem for industrialized wealthy countries. Nothing could be further from the truth since most older persons (and an increasingly higher number) reside in low-income countries. Through a descr...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章,评审


    authors: Clarfield AM

    更新日期:2019-11-01 00:00:00

  • Dementia family caregiver training: affecting beliefs about caregiving and caregiver outcomes.

    abstract:OBJECTIVES:Family caregiving is an integral part of the care system for persons with dementing disorders, such as Alzheimer's disease. This study tested role-training intervention as a way to help family caregivers appreciate and assume a more clinical belief set about caregiving and thereby ameliorate the adverse outc...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Hepburn KW,Tornatore J,Center B,Ostwald SW

    更新日期:2001-04-01 00:00:00

  • Effect of the Tool to Reduce Inappropriate Medications on Medication Communication and Deprescribing.

    abstract:OBJECTIVES:To examine the effect of the Tool to Reduce Inappropriate Medications (TRIM), a web tool linking an electronic health record (EHR) to a clinical decision support system, on medication communication and prescribing. DESIGN:Randomized clinical trial. SETTING:Primary care clinics at a Veterans Affairs Medical...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章,随机对照试验


    authors: Fried TR,Niehoff KM,Street RL,Charpentier PA,Rajeevan N,Miller PL,Goldstein MK,O'Leary JR,Fenton BT

    更新日期:2017-10-01 00:00:00