Effects of Intervention Using a Community‐Based Walking Program for Prevention of Mental Decline: A Randomized Controlled Trial

<jats:sec><jats:title>Objectives</jats:title><jats:p>To evaluate the efficacy of a municipality‐led walking program under the Japanese public Long‐Term Care Insurance Act to prevent mental decline.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>Randomized controlled trial.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>The city of <jats:styled-content style="fixed-case">T</jats:styled-content>akasaki.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>One hundred fifty community members aged 72.0 ± 4.0 were randomly divided into intervention (n = 75) and control (n = 75) groups.</jats:p></jats:sec><jats:sec><jats:title>Intervention</jats:title><jats:p>A walking program was conducted once a week for 90 minutes for 3 months. The program encouraged participants to walk on a regular basis and to increase their steps per day gradually. The intervention was conducted in small groups of approximately six, so combined benefits of exercise and social interaction were expected.</jats:p></jats:sec><jats:sec><jats:title>Measurements</jats:title><jats:p>Cognitive function was evaluated focusing on nine tests in five domains: memory, executive function, word fluency, visuospatial abilities, and sustained attention. Quality of life (<jats:styled-content style="fixed-case">QOL</jats:styled-content>), depressive state, functional capacity, range of activities, and social network were assessed using questionnaires, and motor function was evaluated.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Significant differences between the intervention and control groups were shown in word fluency related to frontal lobe function (<jats:italic>F</jats:italic>(1, 128) = 6.833, <jats:italic>P</jats:italic> = .01), <jats:styled-content style="fixed-case">QOL</jats:styled-content> (<jats:italic>F</jats:italic>(1,128) = 9.751, <jats:italic>P</jats:italic> = .002), functional capacity including social interaction (<jats:italic>F</jats:italic>(1,128) = 13.055, <jats:italic>P</jats:italic> < .001), and motor function (Timed Up and Go Test: <jats:italic>F</jats:italic>(1,127) = 10.117, <jats:italic>P</jats:italic> = .002). No significant differences were observed in other cognitive tests.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Walking programs may provide benefits in some aspects of cognition, <jats:styled-content style="fixed-case">QOL</jats:styled-content>, and functional capacity including social interaction in elderly community members. This study could serve as the basis for implementation of a community‐based intervention to prevent mental decline.</jats:p></jats:sec>