Longitudinal Effects of Active Learning Education on Lifestyle Behavior and Physical Function in Older Adults

Sustaining benefits of an exercise program is difficult as adherence is often poor after supervised intervention is over. This study aimed to determine whether the effects of active learning education on physical activity, dietary habits, and physical function were maintained 24 weeks after intervention termination in older adults.

Non-randomized controlled trial.

Community-dwelling older adults aged ≥65 years who were independent in activities of daily living.

The intervention group (n = 36) underwent 24 weeks of active learning education. The control group (n = 59) attended a health education class didactically. In both groups, the education program focused on exercise, diet and nutrition, and cognitive activity for health promotion. Active learning included exploratory learning, group work, and self-planning for behavior change that promoted healthy lifestyles. Outcome measures were obtained at baseline (pre), 24 weeks (post), and 48 weeks (follow-up). Physical activity was objectively measured as physical activity level (PAL) using a triaxial accelerometer. Food intake was assessed by obtaining a dietary variety score. Physical function, including gait speed and Timed Up & Go score, was tested as secondary outcome. We used a linear mixed model to estimate the effects of intervention in intention-to-treat analyses.

All outcomes in the intervention group significantly improved compared with the control group at 24 weeks, and the improvements were sustained over a 48-week follow-up period. For PAL, between-group difference in change from baseline was 0.043 (95% confidence interval = 0.007, 0.080) at 24 weeks and 0.061 (0.023, 0.099) at 48 weeks.

Active learning education is effective in enhancing healthy lifestyles and physical function sustainability beyond intervention cessation. A randomized controlled trial with a larger sample size is needed to conclusively clarify the beneficial effects of active health education learning on sustainable behavior change and functional improvement.