The ACE (Active, Connected, Engaged) study

Physical inactivity is one of the strongest predictors of physical disability in older adults. An older person who remains fit and active is more likely to retain physical and cognitive function, prevent disease and disability, and enjoy independence, mental well-being and a higher quality of life. A key to successful ageing is to find effective ways of helping older people to maintain greater levels of physical activity to break the downward spiral into disability that is increasingly characteristic of old age. This in turn would provide considerable benefit in terms of human welfare and savings in social and health care cost.

Active ageing programmes help older people who are at risk of such decline to improve or maintain their mobility through physical activity. Yet, nationally and locally resources to support such programmes are scarce. The voluntary sector however, is ideally placed to mobilise older adults to act as volunteers to deliver these programmes. Unfortunately, little evidence exists as to whether volunteer-driven, community-based active ageing programmes actually work and are cost-effective. This is what the Active, Connected and Engaged (ACE) study is designed to test.

ACE is a low-cost programme where older volunteers (55yrs +) support older people (65yrs +) to improve their mobility by becoming more active within their communities. The 515 older people recruited to the study will be sedentary and community living, with functional limitations (i.e. who are at risk of major mobility limitations), but who can still walk independently (including with a walking stick). This will be measured using a physical function test to assess balance, walking speed and the ability to go from a sitting to a standing position. We are targeting a non-disabled, but at-risk population. Participants will mainly be recruited via invitations sent by GPs to patients who meet the ACE inclusion criteria.

A small-scale feasibility study conducted several years ago confirmed that ACE was well-received by both participants and volunteers and appeared to deliver a positive impact on the physical and mental well-being of both groups.

During the ACE programme, volunteers (n=150) will meet with participants twice to get to know each other, find out about and discuss local community-based activities that the participant would like to join, and identify and address any barriers to taking part (weeks 1 and 2). Then, over a 3-month period, the volunteer-participant pair will attend at least three local activities chosen by the participant, together. Over the following three months volunteers will support the participant to continue attending these activities independently through regular phone calls, with further joint visits to activities scheduled if needed. Volunteers will attend a two day ACE training course prior to taking part.

Participants will be randomly assigned to either the ACE programme or a comparison group who will receive information about local initiatives but will not be paired with a volunteer. All participants and volunteers will complete a set of measures at the start of the study and then 6 and 18 months later. These measurements will include tests of mobility (a balance test, a ‘sit-to-stand’ test and a walking speed test), physical activity and questionnaires to measure mental wellbeing and quality of life. The results from those taking part in the ACE programme and those in the comparison group will be compared so we can assess whether the programme is effective and cost effective. 

The Royal Voluntary Service (RVS), a UK-wide volunteering organisation, will recruit and manage the ACE volunteers in the three study areas: West Midlands, Manchester and Wales. If successful, RVS will then deliver ACE nationally.

This research is important because mobility makes a huge difference to older people’s quality of life and ability to live independently. We currently have no peer-volunteering programmes targeting mobility in older people that are known to be effective and provide good value for money.

ACE is funded by a £1.74m grant from the National Institute for Health Research - Public Health Research Programme.