PhD Scientific Days 2026

Health Sciences 3.

Effect of telemedicine-delivered lifestyle interventions in older adults during the COVID-19 pandemic: a nationwide two-arm randomized trial (PROACTIVE-19)

Name of the presenter

Váncsa, Szilárd

Institute/workplace of the presenter

Institute of Pancreatic Diseases and Centre for Translational Medicine, Semmelweis University

Authors

Szilárd Váncsa¹, Anett Nagy-Szakolczai², Roland Molontay², Emőke Miklós³, Andrea Szentesi³, Klementina Ocskay⁴, Péter Jenő Hegyi¹, Judit Hegyi⁵, Anna Hegyi⁵, Eszter Hegyi⁵, Dóra Czapári⁵, Zsolt Molnár⁶, Bálint Erőss¹, Péter Hegyi¹
1: Centre for Translational Medicine and Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
2: Institute of Biostatistics and Network Science, Semmelweis University, Budapest, Hungary
3: Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
4: Heim Pál National Pediatric Institute, Budapest, Hungary
5: Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
6: Centre for Translational Medicine and Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary

Text of the abstract

Introduction:
Older adults are at increased risk of severe COVID-19 outcomes, yet randomized evidence on structured lifestyle interventions in this context remains limited.
Aims:
We aimed to determine whether a personalized lifestyle intervention could improve health-related behaviours and reduce adverse outcomes among adults aged ≥60 years.
Methods:
PROACTIVE-19 was a nationwide, open-label, randomized trial conducted in Hungary. Participants aged ≥60 years were randomly assigned (1:1) to general (Group A) or personalized (Group B) lifestyle counselling delivered via telephone, targeting mental health, smoking, physical activity, diet, and alcohol consumption. The primary planned endpoint was a composite of COVID-19 severity outcomes; however, due to infection rates, all-cause mortality was assessed. Longitudinal lifestyle changes were evaluated using linear mixed-effects models with bootstrap confidence intervals (95% CI) in a modified intention-to-treat population.
Results:
Between March 26, 2020, and study closure, 441 participants were analyzed (214 Group A; 227 Group B). All-cause mortality was lower in Group B (HR=0·66, CI 0·28–1·53), but the difference was not statistically significant. Significant overall time effects were observed for fruit and vegetable consumption (β=0·052, CI 0·026–0·074), smoking reduction among current smokers (β=−0·372, CI −0·528 to −0·222), and psychological variables. A significantly greater reduction in estimated alcohol consumption was observed in Group B among baseline drinkers compared with Group A (β=−1·357, CI −2·425 to −0·187), particularly in women. However, BMI among participants with obesity increased in group B (β=0·068, CI 0·013–0·119). Seasonal and pandemic-wave effects significantly influenced physical activity and psychological distress.
Conclusion:
The personalized intervention was not associated with a significant reduction in all-cause mortality. Several lifestyle behaviours improved over time, however, the additional benefit of personalization was limited
Funding:
SV was supported by the EKÖP-2025-434 New National Excellence Program of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund.