Skip to main content
SpringerLink
Log in

The Gray Matters App Targeting Health Behaviors Associated with Alzheimer’s Risk: Improvements in Intrinsic Motivation and Impact on Diet Quality and Physical Activity

  • Published:
The journal of nutrition, health & aging

Abstract

Objective

We examine if the Gray Matters intervention (education and behavioral self-monitoring app targeting lifestyle risks for Alzheimer’s disease [AD]) affected participants’ motivation for change and whether high motivation predicts improved diet and physical activity over 6 months.

Design

In this 6-month randomized controlled trial (treatment n=104; control n=42; assessed pre/post intervention) amotivation, external regulation, identified regulation, and intrinsic motivation were assessed via the Situational Motivation Scale (SIMS). Diet quality was assessed via adherence to the DASH diet, and physical activity was assessed in minutes.

Participants

Eligibility criteria included not having significant cognitive impairment. Participants were aged 39–64 (M = 54.17, SD = 6.9), 66% female, 81% married, 90% White, and 80% had a college degree.

Intervention

Treatment included an activity tracker, Gray Matters app, access to booster sessions, contact with a student health coach, and study website.

Setting

Participants were in the general community.

Results

Independent samples t-tests determined that intrinsic motivation (IM) increased significantly for the treatment group (M = 2.09 SD = 4.82), compared to the control group (M = 1.00 SD = 5.52; t (130) = -3.04, p =.003). Comparing subgroups of people with High vs Low IM we found that High IM males increased vigorous physical activity more than Lower IM males (F(1,42)=5.053, p=.030). Comparing persons aged 58–64 years with High vs Lower IM, High IM persons had less improvement in diet quality F(1,48)=4.538; p=0.038).

Conclusion

RCT results support that the Gray Matters AD-focused intervention increased IM, and IM was associated with improved physical activity and diet quality for some subgroups.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Alzheimer’s Association. Alzheimer’s disease facts & figures 2015. https://www.alz.org/facts/downloads/facts_figures_2015.pdf accessed November 10, 2017.

  2. Bekris LM, Yu C-E, Bird TD, Tsuang DW. Review Article: Genetics of Alzheimer Disease. Journal of Geriatric Psychiatry and Neurology;2010;23(4):213–227. doi: https://doi.org/10.1177/0891988710383571.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Ridge PG, Mukherjee S, Crane PK, Kauwe JS. Alzheimer’s disease: analyzing the missing heritability. PloS one 2013;8(11):e79771. doi https://doi.org/10.1371/journal.pone.0079771

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Barnes D, Yaffe K. The Projected impact of risk factor reduction on Alzheimers disease prevalence. Alzheimers & Dementia 2011;7(4) doi: https://doi.org/10.1016/j.jalz.2011.05.1429.

  5. Dimeco A, Pratico D, Joshi YB. Sleep deprivation impairs memory, Tau metabolism, and synaptic integrity of a mouse model of Alzheimer’s disease. Alzheimer’s & Dementia 2014; 10(4). doi: https://doi.org/10.1016/j.jalz.2014.04.433.

  6. Valenzuela M, Sachdev P. Can cognitive exercise prevent the onset of dementia? Systematic review of randomized clinical trials with longitudinal follow-up. The American Journal of Geriatric Psychiatry 2009; 17(3): 179–87.

    Article  PubMed  Google Scholar 

  7. Fratiglioni L, Wang H-X, Ericsson K, Maytan M, Winblad B. Influence of social network on occurrence of dementia: a community-based longitudinal study. The Lancet 2000;355(9212):1315–1319. doi:https://doi.org/10.1016/s0140-6736(00)02113-9.

    Article  CAS  Google Scholar 

  8. Gu Y, Scarmeas N. Dietary patterns in Alzheimer’s disease and cognitive aging. Current Alzheimer Research 2011;8(5):510–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Scarmeas N, Stern Y, Tang M-X, Mayeux R, Luchsinger JA. Mediterranean diet and risk for Alzheimer’s disease. Annals of Neurology 2006;59(6):912–921. https://doi.org/10.1002/ana.20854

    Article  PubMed  PubMed Central  Google Scholar 

  10. Scarmeas N, Luchsinger JA, Schupf N, Cosentino AM, Tang MX, Stern Y. Physical Activity, Diet, and Risk of Alzheimer Disease. Journal of the American Medical Association 2009;302(6):627. doi: https://doi.org/10.1001/jama.2009.1144.

    Article  CAS  PubMed  Google Scholar 

  11. Tangney CC, Kwasny MJ, Li H, Wilson RS, Evans DA, Morris MC. Adherence to a Mediterranean-type dietary pattern and cognitive decline in a community population. The American journal of clinical nutrition 2011;93(3):601–7.

    Article  CAS  PubMed  Google Scholar 

  12. Andel R, Crowe M, Pedersen NL, Fratiglioni L, Johansson B, Gatz M. Physical exercise at midlife and risk of dementia three decades later: a population-based study of Swedish twins. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2008;63:1, 62–66.

    Article  Google Scholar 

  13. Wengreen H, Munger RG, Cutler A, Quach A, Bowles A, Corcoran C, Tschanz JT, Norton MC, Welsh-Bohmer KA. Prospective study of Dietary Approaches to Stop Hypertension-and Mediterranean-style dietary patterns and age-related cognitive change: The Cache County Study on Memory, Health and Aging. The American journal of clinical nutrition 2013;98(5):1263–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Fishbein M, Yzer MC. Using Theory to Design Effective Health Behavior Interventions. Communication Theory 2003; 13(2): 164–183. doi: https://doi.org/10.1111/j.l468-2885.2003.tb00287.x.

    Article  Google Scholar 

  15. Anstey KJ, Bahar-Fuchs A, Herath P, Rebok GW, Cerbuin NA. 12-week multidomain intervention versus active control to reduce risk of Alzheimer’s disease: study protocol for a randomized controlled trial. Trials 2013; 14:60.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Ngandu T, Lehtisalo J, Solomon A, Levälahti E, Ahtiluoto S, Antikainen R, Bäckman L, Hänninen T, Jula A, Laatikainen T, Lindström J. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. The Lancet 2015;385(9984):2255–63.

    Article  Google Scholar 

  17. Ryan RM, Deci EL. Intrinsic and Extrinsic Motivations: Classic Definitions and New Directions. Contemporary Educational Psychology 2000;25(1):54–67. doi:https://doi.org/10.1006/ceps.1999.1020.

    Article  CAS  PubMed  Google Scholar 

  18. Grouzet FME, Vallerand RJ, Thill EE, Provencher PJ. From Environmental Factors to Outcomes: A Test of an Integrated Motivational Sequence. Motivation and Emotion 2004;28(4):331–346. doi:https://doi.org/10.1007/s11031-004-2387-z.

    Article  Google Scholar 

  19. Guay F, Vallerand RJ, Blanchard C. On the assessment of situational intrinsic and extrinsic motivation: The Situational Motivation Scale (SIMS). Motivation and emotion 2000;24(3):175–213.

    Article  Google Scholar 

  20. Zuckerman M, Porac J, Lathin D, Deci, E. On the importance of self-determination for intrinsically-motivated behavior. Personality and Social Psychology Bulletin 1978;4:443–446. doi:https://doi.org/10.1177/014616727800400317.

    Article  Google Scholar 

  21. Dacey M, Baltzell A, Zaichkowsky L. Older adults’ intrinsic and extrinsic motivation toward physical activity. American journal of health behavior. 2008;32(6):570–82.

    Article  PubMed  Google Scholar 

  22. Molanorouzi K, Khoo S, Morris T. Motives for adult participation in physical activity: type of activity, age, and gender. BMC public health 2015; 15(1):66

    Article  PubMed  PubMed Central  Google Scholar 

  23. Norton MC, Clark CJ, Tschanz JT, et al. The design and progress of a multidomain lifestyle intervention to improve brain health in middle-aged persons to reduce later Alzheimers disease risk: The Gray Matters randomized trial. Alzheimers & Dementia: Translational Research & Clinical Interventions 2015;1(1):53–62. doi:https://doi.org/10.1016/j.trci.2015.05.001.

    Google Scholar 

  24. Hartin PJ, Nugent CD, McClean SI, Cleland I, Tschanz JT, Clark CJ, Norton MC. The empowering role of mobile apps in behavior change interventions: The Gray Matters randomized controlled trial. JMIR mHealth and uHealth. 2016;4(3).

  25. Centers for Disease Control. Current physical activity guidelines 2016. https://www.cdc.gov/cancer/dcpc/prevention/policies_practices/physical_activity/guidelines.htm accessed on October 13, 2017.

  26. Subar AF, Thompson FE, Kipnis V, et al. Comparative Validation of the Block, Willett, and National Cancer Institute Food Frequency Questionnaires. American Journal of Epidemiology 2001; 154(12): 1089–1099. doi:https://doi.org/10.1093/aje/154.12.1089.

    Article  CAS  PubMed  Google Scholar 

  27. Johnson RK, Appel LJ, Brands M, Howard BV, Lefevre M, Lustig RH, Sacks F, Steffen LM, Wylie-Rosett on behalf of the American Heart Association Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism and the Council on Epidemiology and Prevention. Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association. Circulation 2009;120:1011–1029.

    Article  CAS  PubMed  Google Scholar 

  28. Clark C. Perceived Alzheimer’s disease threat as a predictor of behavior change to lower disease risk: The Gray Matters Study. [doctoral dissertation]. Logan, UT. Utah State University, 2016.

    Google Scholar 

  29. Ryan RM, Patrick H, Deci EL, Williams GC. Facilitating health behaviour change and its maintenance: Interventions based on self-determination theory. European Health Psychologist 2008;10(1):2–5.

    Google Scholar 

  30. Pelletier LG, Dion SC, Slovinec-D’Angelo M, Reid R. Why do you regulate what you eat? Relationships between forms of regulation, eating behaviors, sustained dietary behavior change, and psychological adjustment. Motivation and Emotion 2004;28(3):245–77.

    Article  Google Scholar 

  31. Oftedal BCB, Bru E, Karlsen B. Motivation for diet and exercise management among adults with type 2 diabetes. Scandinavian Journal of Caring Sciences 2011;25(4):735–744. doi:https://doi.org/10.1111/j.l471-6712.2011.00884.x.

    Article  PubMed  Google Scholar 

  32. Deci EL, Ryan RM. Facilitating optimal motivation and psychological well-being across life’s domains”: Correction to Deci and Ryan (2008). Canadian Psychology/Psychologie canadienne 2008;49(3):262–262. doi: https://doi.org/10.1037/0708-5591.49.3.262.

    Article  Google Scholar 

Download references

Funding

Funding: This project was funded by the Vice President for Research seed grant, Utah State University, and the Department for Employment and Learning, Northern Ireland.

Author information

Authors and Affiliations

  1. Department of Human Development and Family Studies, Utah State University, Logan, UT, USA

    Alex Schiwal, E. B. Fauth & M. Norton

  2. Department of Nutrition, Dietetics and Food Sciences, Utah State University, Logan, UT, USA

    H. Wengreen

  3. 6800 Old Main Hill, Logan, UT, 84322-2905, USA

    Alex Schiwal

Authors
  1. Alex Schiwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. B. Fauth
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. Wengreen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Norton
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alex Schiwal.

Ethics declarations

Ethical Standards: This research was approved through Utah State University’s Institutional Review Board for the protection of human subjects and complies with all laws governing research in the United States.

Conflicts of Interest: Alex Schiwal reports no conflicts of interest. Elizabeth Fauth reports no conflicts of interest. Heidi Wengreen Reports no conflicts of interest. Maria Norton Reports no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Schiwal, A., Fauth, E.B., Wengreen, H. et al. The Gray Matters App Targeting Health Behaviors Associated with Alzheimer’s Risk: Improvements in Intrinsic Motivation and Impact on Diet Quality and Physical Activity. J Nutr Health Aging 24, 893–899 (2020). https://doi.org/10.1007/s12603-020-1421-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-020-1421-5

Key words

Search

Navigation