Lessened decline in physical activity and impairment of older adults with diabetes with telemedicine and pedometer use: results from the IDEATel study
Abstract
OBJECTIVE: to examine the effects of the Informatics for Diabetes Education and Telemedicine (IDEATel) telemedicine intervention and pedometer use on physical activity (PA) and impairment in older adults with diabetes. DESIGN: randomised clinical trial. Subjects ethnically diverse medically underserved Medicare beneficiaries with diabetes (n= 1,650). METHODS: participants received home videovisits with a diabetes educator every 4-6 weeks or usual care. All received a pedometer. Annual measurements included hemoglobin A1c, Comprehensive Assessment and Referral Evaluation Activities of Daily Living, Diabetes Self-Care Activities, Charlson Comorbidity Index, Luben Social Support and pedometer use. Mixed model analyses were performed using random effects to adjust for clustering within primary care physicians. RESULTS: in the telemedicine group compared with the usual care group, the rate of decline in PA (P= 0.0128) and physical impairment (PI) (P= 0.0370) was significantly less over time. Significant mean endpoint differences were observed for PA (P= 0.003). Pedometer use was significantly associated with PA (P= 0.0006) and PI (P< 0.0001). Baseline characteristics associated with greater PA included having fewer comorbid conditions (P= 0.0054), less depression (P< 0.0001), more social networking (P< 0.0001), lower BMI (P< 0.0001), male gender (P< 0.0001) and lower hemoglobin A1c level (P= 0.0045). Similar predictors were observed for PI, except duration of diabetes also predicted increased impairment (P< 0.0001). Significant indirect effects were observed through use of the pedometer on reduced decline in PA (P= 0.0024, 0.0013) and PI (P= 0.0024, P< 0.0001). CONCLUSIONS: this telemedicine intervention reduced rates of decline in PA and impairment in older adults with diabetes. Pedometers may be a helpful inexpensive adjunct to diabetes initiatives delivered remotely with emerging technologies. ClinicalTrials.gov identifier NCT 00271739.
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The pattern of initial responsiveness followed by regression to baseline activity levels likely reflects diminishing adherence to digitally-promoted exercise protocols over extended periods.
“This pattern of initial responsiveness followed by regression to baseline activity levels likely reflects diminishing adherence to digitally-promoted exercise protocols over extended periods (46, 47).”
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- Authors
- Weinstock, R. S., Brooks, G., Palmas, W., Morin, P. C., Teresi, J. A., Eimicke, J. P., Silver, S., Izquierdo, R., Goland, R., & Shea, S.
- Affiliations
- SUNY Upstate Medical University (US)
- Columbia University (US)
- Hebrew Home (US)
- Corresponding author
- Weinstock, Ruth S.
- Venue
- Age and Ageing
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-11-16
- Volume
- 40
- Issue
- 1
- Pages
- 98-105
- ISSN
- 0002-0729 (ISSN-L)
- 1468-2834
- OpenAlex
- W1997732158
- Cited by
- 72
- References
- 30
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 3 · 2022: 3 · 2021: 5 · 2020: 5 · 2019: 3 · 2018: 8 · 2017: 3 · 2016: 4 · 2015: 5 · 2014: 8 · 2013: 13 · 2012: 7
- FWCI
- 4.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Age and Ageing (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- telemedicine, pedometers, physical activity, physical impairment, older adults, diabetes mellitus, diabetes self-management education, activities of daily living, comorbidities, depression, social support, social networking, HbA1c
- MeSH terms
- Aged, Aged, 80 and over, Depression, Diabetes Mellitus, Equipment and Supplies, Female, Glycated Hemoglobin, Humans, Male, Motor Activity, Obesity, Patient Education as Topic, Walking, Telemedicine, Mobility Limitation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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