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BEDREHELSE-Bedre helse og livskvalitet

REinventing STrategies for healthy Ageing; Recommendations and Tools (RESTART) A randomized controlled trial (RCT)

Alternative title: RESTART

Awarded: NOK 16.0 mill.

Can we improve the health of older adults at high risk of disease? The population is aging, weight and sedentary behavior increase, and so does the need for health care services. The transition from working life to retirement is a window of opportunity to prevent disease. However, research shows that many individual measures to improve lifestyle do not produce long-term health effects. We must therefore develop and test complex interventions to strengthen health of elderly at high risk, with a great potential among elderly with a low socio-economic status. RESTART is developed by researchers at UiT in collaboration with Tromsø municipality and the Nat. Assoc. for Heart and Lung Disease. RESTART aims to establish lasting lifestyle changes and prevent disease among older adults. In an experiment, we will test if RESTART can permanently improve fitness, increase muscle strength and physical activity, and reduce obesity after two years. A total of 110 study participants aged 60-75, who are inactive, have obesity and an increased risk of cardiovascular disease, are recruited from the Tromsø Study and randomly allocated to an intervention or a control group. Both groups receive updated advice on healthy choices (Directorate of Health's recommendations) and an activity tracker for continuous measurement of physical activity and energy expenditure. The intervention group also receives guided group exercise twice a week, advice on diet and habit change in smaller groups and is gradually transferred to exercise in the municipality's Healthy Life Center and further to self-selected physical activity. Tailored digital tools reinforce health-promoting habits and support group activities. All study participants are followed up with comprehensive examination and data collection and compared to the Tromsø Study population as reference group. If the RESTART model proves effective, we will develop manuals for implementing RESTART in municipalities and local communities.

Norway faces rising health care expenditures, an ageing population burdened with obesity and sedentary lifestyle and social inequality in health. How can we support healthy aging, prevent disease among high-risk older adults and mitigate social inequality in health? The retirement age is a transition phase and window of opportunity for lifestyle change. The RESTART trial will test a novel collaborative model for sustainable lifestyle change and expand our knowledge on healthy ageing. An interdisciplinary team has conducted a feasibility study as basis for the RESTART model. The project is developed and will be conducted by a collaborating team of researchers, Tromsø municipality and NGO’s, supported by feasibility study participants. We will recruit sedentary older adults with obesity and high risk of cardiovascular disease (CVD) from the ongoing population based Tromsø Study into a randomized controlled trial. Participants will be randomized into two groups to test the effect of adding personalised high-intensity exercise, dietary and ACT behavioral counselling (intervention group) to physical activity monitoring and access to National health guidelines alone (control group). The intervention lasts for 18 months and forms basis for subsequent self-selected exercise and re-start eTools offered by the project, Tromsø municipality and NGO’s. At 24 months, we will measure aerobic capacity (primary endpoint and strong CVD risk factor), muscle strength, daily physical activity, and obesity (secondary endpoints) and conduct a health economic evaluation. Interviews will provide data on participant experiences and motivation throughout the trial. All trial participants are followed up and contrasted to the Tromsø Study cohort reflecting time-trends in the general population. If successful, we will manualize and communicate the RESTART model as a tool for primary prevention in Norwegian municipal primary health care.

Funding scheme:

BEDREHELSE-Bedre helse og livskvalitet