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Klicnik I, Leadbetter B, Zdjelar M, Bouchard DR, Copeland JL, Dogra S. Inactivity is isolation: insights from a sedentary time intervention in assisted living. BMC Geriatr 2025; 25:281. [PMID: 40281497 PMCID: PMC12032736 DOI: 10.1186/s12877-025-05921-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/09/2025] [Indexed: 04/29/2025] Open
Abstract
BACKGROUND As Canada's aging population continues to grow, a larger number of older adults will be residing in assisted living (residences with some on-site care and services). Research is needed to understand how to support active aging - defined as a combination of movement and social behaviours-in this unique living environment. In this study, we explored insights generated about active aging from older residents of assisted living who participated in an intervention designed to encourage standing breaks. METHODS This was a multi-method exploratory study. Residents of three assisted living facilities participated in a 12-week intervention called Stand When You Can. The Keele Assessment of Participation (KAP) was used to assess perceived levels of participation in various domains of assisted living at pre- and post-intervention. Focus group sessions were conducted to explore insights on active aging. Transcripts were thematically analyzed to generate themes and sub-themes. RESULTS A total of 18 residents (84.4 ± 6.8 years, 72% female), participated in the focus groups. KAP scores at pre-intervention were indicative of a high level of social participation within the residences. Five primary themes emerged from the focus group sessions: 1) intervention effectiveness, 2) physical and social engagement go hand in hand, 3) the congregate living environment can influence movement behaviour, 4) congregate living supports interpersonal relationships, and 5) personal preferences for solitary activity. CONCLUSIONS The natural communal setting of assisted living, along with supportive staff, presents a valuable opportunity to promote active aging, which is a complex interplay of social and movement behaviour. Our preliminary findings suggest that in addition to supporting individual behaviour change, a comprehensive approach that addresses the environment, social engagement, and staff engagement is needed in this setting. Future interventions should consider addressing each of these components to facilitate successful behaviour change related to active aging.
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Affiliation(s)
- Irmina Klicnik
- Ontario Tech University, 2000 Simcoe St N, Oshawa, ON, L1G0 C5, Canada.
| | - Brianna Leadbetter
- University of New Brunswick, 90 Mackay Dr, Fredericton, NB, E3B 5 A3, Canada
| | - Milena Zdjelar
- University of Lethbridge, Lethbridge, AB, T1 K3M4, Canada
| | - Danielle R Bouchard
- University of New Brunswick, 90 Mackay Dr, Fredericton, NB, E3B 5 A3, Canada
| | | | - Shilpa Dogra
- Ontario Tech University, 2000 Simcoe St N, Oshawa, ON, L1G0 C5, Canada
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2
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Shimizu A, Maeda K, Ueshima J, Ishida Y, Inoue T, Murotani K, Nagano A, Mori N, Ohno T, Fujisima I. Association of GLIM-defined malnutrition with depressive mood in older adults undergoing rehabilitation. Eur J Clin Nutr 2025:10.1038/s41430-025-01584-3. [PMID: 39979698 DOI: 10.1038/s41430-025-01584-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/26/2025] [Accepted: 02/11/2025] [Indexed: 02/22/2025]
Abstract
BACKGROUND/OBJECTIVES Depressive mood is prevalent in geriatric patients who undergo rehabilitation. Malnutrition, which frequently coexists in this demographic group, likely affects mental health status significantly. This study examined the association between malnutrition and depressive mood at discharge in geriatric patients who were undergoing rehabilitation and identified the mediating roles of specific malnutrition components in this association. SUBJECTS/METHODS This prospective cohort study comprised 189 geriatric rehabilitation patients. Malnutrition was determined using the Global Leadership Initiative on Malnutrition (GLIM) criteria, and depressive mood was assessed using the Geriatric Depression Scale-15 (GDS-15). The potential mediation of the GLIM components in the relationship between malnutrition and depressive mood was evaluated using causal mediation analysis. RESULTS Malnutrition was positively associated with increased GDS-15 scores at both admission (p = 0.007) and discharge (p < 0.001). The severity of malnutrition corresponded with increased odds of depressive mood at discharge (moderate malnutrition: odds ratio [OR] 3.84, 95% confidence interval [CI] 1.48-9.94, p = 0.005; severe malnutrition: OR 5.11, 95% CI 1.52-15.17, p = 0.003). Notably, both muscle mass reduction (OR 1.51, 95% CI 1.01-2.27, p = 0.042) and disease burden (OR 1.37, 95% CI 1.00-1.89, p = 0.047) were identified as mediators in the association between malnutrition and depressive mood at discharge. CONCLUSIONS Nutritional status significantly influenced the mental health of geriatric rehabilitation patients, with muscle mass reduction and disease burden mediating this relationship. These findings emphasize the importance of a multidimensional geriatric rehabilitation approach that includes nutritional interventions.
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Affiliation(s)
- Akio Shimizu
- Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, Japan.
- Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, Japan.
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, Japan.
| | - Keisuke Maeda
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, Japan
- Nutrition Therapy Support Center, Aichi Medical University Hospital, 1-1, Yazakokarimata, Nagakute, Aichi, Japan
| | - Junko Ueshima
- Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, Japan
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, Japan
- Department of Nutritional Service, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Tokyo, Japan
| | - Yuria Ishida
- Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, Japan
- Department of Nutrition, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Japan
| | - Tatsuro Inoue
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, Japan
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Niigata, Japan
| | - Kenta Murotani
- School of Medical Technology, Kurume University, Kurume, Fukuoka, Japan
- Biostatistics Center, Kurume University, 67 Asahimachi, Kurume, Japan
| | - Ayano Nagano
- Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, Japan
- Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, 11-1 Imazuyamanaka-cho, Nishinomiya, Japan
| | - Naoharu Mori
- Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, Japan
| | - Tomohisa Ohno
- Department of Dentistry, Hamamatsu City Rehabilitation Hospital, 1-6-1 Wago-kita, Hamamatsu, Japan
| | - Ichiro Fujisima
- Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, 1-6-1 Wago-kita, Hamamatsu, Japan
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3
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Becker ML, Hurkmans HL, Verhaar JA, Bussmann JB. Monitoring postures and motions of hospitalized patients using sensor technology: a scoping review. Ann Med 2024; 56:2399963. [PMID: 39239877 PMCID: PMC11382703 DOI: 10.1080/07853890.2024.2399963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 07/15/2024] [Accepted: 07/17/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND Sensor technology could provide solutions to monitor postures and motions and to help hospital patients reach their rehabilitation goals with minimal supervision. Synthesized information on device applications and methodology is lacking. OBJECTIVES The purpose of this scoping review was to provide an overview of device applications and methodological approaches to monitor postures and motions in hospitalized patients using sensor technology. METHODS A systematic search of Embase, Medline, Web of Science and Google Scholar was completed in February 2023 and updated in March 2024. Included studies described populations of hospitalized adults with short admission periods and interventions that use sensor technology to objectively monitor postures and motions. Study selection was performed by two authors independently of each other. Data extraction and narrative analysis focused on the applications and methodological approaches of included articles using a personalized standard form to extract information on device, measurement and analysis characteristics of included studies and analyse frequencies and usage. RESULTS A total of 15.032 articles were found and 49 articles met the inclusion criteria. Devices were most often applied in older adults (n = 14), patients awaiting or after surgery (n = 14), and stroke (n = 6). The main goals were gaining insight into patient physical behavioural patterns (n = 19) and investigating physical behaviour in relation to other parameters such as muscle strength or hospital length of stay (n = 18). The studies had heterogeneous study designs and lacked completeness in reporting on device settings, data analysis, and algorithms. Information on device settings, data analysis, and algorithms was poorly reported. CONCLUSIONS Studies on monitoring postures and motions are heterogeneous in their population, applications and methodological approaches. More uniformity and transparency in methodology and study reporting would improve reproducibility, interpretation and generalization of results. Clear guidelines for reporting and the collection and sharing of raw data would benefit the field by enabling study comparison and reproduction.
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Affiliation(s)
- Marlissa L. Becker
- Department of Orthopaedics and Sports Medicine - Physical Therapy, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Henri L. Hurkmans
- Department of Orthopaedics and Sports Medicine - Physical Therapy, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Jan A.N. Verhaar
- Department of Orthopaedics and Sports Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Johannes B.J. Bussmann
- Department of Rehabilitation Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
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Lu JK, Guan L, Wang W, Rojer AGM, Galkin F, Goh J, Maier AB. The association between blood biological age at rehabilitation admission and physical activity during rehabilitation in geriatric inpatients: RESORT. GeroScience 2024; 46:4505-4515. [PMID: 38589672 PMCID: PMC11336003 DOI: 10.1007/s11357-024-01152-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 04/02/2024] [Indexed: 04/10/2024] Open
Abstract
Geriatric rehabilitation inpatients have high levels of sedentary behaviour (SB) and low levels of physical activity (PA). Biological age predicted by blood biomarkers is indicative of adverse outcomes. The objective was to determine the association between blood biological age at rehabilitation admission and levels of SB and PA during rehabilitation in geriatric inpatients. Inpatients admitted to geriatric rehabilitation wards at the Royal Melbourne Hospital (Melbourne, Australia) from October 22, 2019, to March 29, 2020, in the REStORing health of acute unwell adulTs (RESORT) observational cohort were included. Blood biological age was predicted using SenoClock-BloodAge, a hematological ageing clock. Patients wore an inertial sensor to measure SB and PA. Logistic regression analyses were conducted. A total of 111 patients (57.7% female) with mean age 83.3 ± 7.5 years were included in the analysis. The mean blood biological age was 82.7 ± 8.4 years. Patients with 1-year higher blood biological age had higher odds of having high SB measured as non-upright time greater than 23 h/day (odds ratio (OR): 1.050, 95% confidence interval (CI): 1.000-1.102). Individuals having 1-year higher age deviation trended towards lower odds of having high levels of PA measured as stepping time greater than 7.4 min/day (OR: 0.916, CI: 0.836-1.005) and as greater than 19.5 sit-to-stand transitions/day (OR: 0.915, CI: 0.836-1.002). In conclusion, higher biological age was associated with higher levels of SB and trended towards lower PA. Incorporating blood biological age could facilitate resource allocation and the development of more tailored rehabilitation plans.
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Affiliation(s)
- Jessica K Lu
- Centre for Healthy Longevity, National University Health System, Singapore, Singapore
- Healthy Longevity Translational Research Program, @Age Singapore, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Lihuan Guan
- Centre for Healthy Longevity, National University Health System, Singapore, Singapore
- Healthy Longevity Translational Research Program, @Age Singapore, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Weilan Wang
- Centre for Healthy Longevity, National University Health System, Singapore, Singapore
- Healthy Longevity Translational Research Program, @Age Singapore, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Anna G M Rojer
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van Der Boechorstsraat 7, 1081 BT, Amsterdam, The Netherlands
| | | | - Jorming Goh
- Centre for Healthy Longevity, National University Health System, Singapore, Singapore
- Healthy Longevity Translational Research Program, @Age Singapore, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Andrea B Maier
- Centre for Healthy Longevity, National University Health System, Singapore, Singapore.
- Healthy Longevity Translational Research Program, @Age Singapore, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van Der Boechorstsraat 7, 1081 BT, Amsterdam, The Netherlands.
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Nishioka S, Kokura Y, Momosaki R, Taketani Y. Measures for Identifying Malnutrition in Geriatric Rehabilitation: A Scoping Review. Nutrients 2024; 16:223. [PMID: 38257116 PMCID: PMC10820477 DOI: 10.3390/nu16020223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Malnutrition is a common condition in geriatric rehabilitation settings; however, the accuracy and predictive validity of the measures to identify malnutrition have not been established. The current scoping review followed the Joanna Briggs Institute's evidence synthesis manual and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews checklist. Literature published through September 2023 was searched using MEDLINE and CINAHL. The inclusion criteria selected studies reporting malnutrition measures, which include static body weight and weight loss. Identified tools were classified as nutritional screening tools, nutritional assessment tools, or diagnostic criteria. The domains of each tool/criterion and their accuracy and predictive validity were extracted. Fifty-six articles fulfilled the inclusion criteria, and six nutritional screening tools, three nutritional assessment tools, and three diagnostic criteria for malnutrition were identified. These measures consisted of various phenotypes, e.g., weight loss, causes such as inflammation/disease, and risk factors of malnutrition, e.g., functional impairment. The predictive validity of nutritional screening tools (n = 6) and malnutrition diagnostic criteria (n = 5) were inconsistently reported, whereas those for nutritional assessment tools were scarce (n = 1). These findings highlight the need to distinguish the functional impairment of nutritional origin from that of non-nutritional origin in nutritional assessment procedures, and the need to study the accuracy and the predictive validity of these measures in geriatric rehabilitation patients.
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Affiliation(s)
- Shinta Nishioka
- Department of Clinical Nutrition and Food Service, Nagasaki Rehabilitation Hospital, 4-11, Gin-yamachi, Nagasaki 850-0854, Japan
- Department of Clinical Nutrition and Food Management, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15, Kuramoto-cho, Tokushima 770-8503, Japan;
| | - Yoji Kokura
- Department of Nutrition Management, Keiju Hatogaoka Integrated Facility for Medical and Long-Term Care, 15-39-8, Mugigaura, Anamizu, Hosu-gun 927-0023, Japan;
| | - Ryo Momosaki
- Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu 514-8507, Mie, Japan;
| | - Yutaka Taketani
- Department of Clinical Nutrition and Food Management, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15, Kuramoto-cho, Tokushima 770-8503, Japan;
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Goonan R, Mohandoss E, Marston C, Kay J, De Silva AP, Maier AB, Reijnierse E, Klaic M. Is there a relationship between 'getting up and dressed' and functional and physical outcomes in geriatric rehabilitation inpatients? A quasi-experimental study. Clin Rehabil 2024; 38:119-129. [PMID: 37644886 DOI: 10.1177/02692155231197510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
OBJECTIVES To evaluate the physical and functional outcomes of the 'Ending Pyjama Paralysis' intervention in an inpatient geriatric rehabilitation unit. DESIGN Quasi-experimental mixed-methods design nested within the 'REStORing health of acutely unwell adulTs' (RESORT) prospective, observational, longitudinal cohort of geriatric rehabilitation inpatients study. SETTING Geriatric rehabilitation wards in a major metropolitan public hospital between June 2019 and March 2020. INTERVENTION The 'Ending Pyjama Paralysis' movement originated in the UK. Its aim was to encourage patients to 'Get up, Get dressed and Get moving' to reduce hospital-associated functional decline. However, the physical and functional benefits of this campaign have not yet been evaluated. The 'Ending Pyjama Paralysis' was adopted as an integrated intervention on two out of four geriatric rehabilitation wards. The two control wards received usual care. MAIN MEASURES Physical measures included the Short Physical Performance Battery, and functional measures included the Katz Index of Independence in Activities of Daily Living and Lawton and Brody's Instrumental Activities of Daily Living, which were completed on admission and discharge. A linear mixed-effects model was used to analyse the results. RESULTS A total of 833 admissions were included in this study. Of these, 512 patients were in the control group, and 321 were in the intervention group. There were no significant differences in both physical and functional measures between the intervention and control groups. CONCLUSION The 'Ending Pyjama Paralysis' campaign did not result in enhanced functional or physical benefits in geriatric rehabilitation inpatients in this setting when applied in addition to usual care.
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Affiliation(s)
- Rose Goonan
- Allied Health, The Royal Melbourne Hospital, Melbourne, Australia
| | - Edward Mohandoss
- Allied Health, The Royal Melbourne Hospital, Melbourne, Australia
| | - Celia Marston
- Allied Health, The Royal Melbourne Hospital, Melbourne, Australia
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - Jaqueline Kay
- Allied Health, The Royal Melbourne Hospital, Melbourne, Australia
| | - Anurika Priyanjali De Silva
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- MISCH (Methods and Implementation Support for Clinical and Health research Hub), Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Andrea B Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Department of Internal Medicine, Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, Amsterdam Neuroscience and Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Victoria, Australia
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore, Singapore
| | - Esmee Reijnierse
- Department of Rehabilitation Medicine, Amsterdam Neuroscience and Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Victoria, Australia
| | - Marlena Klaic
- Allied Health, The Royal Melbourne Hospital, Melbourne, Australia
- Melbourne School of Health Science, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
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Muurling M, Badissi M, de Boer C, Legdeur N, Barkhof F, van Berckel BNM, Maier AB, Pijnappels M, Visser PJ. Physical activity levels in cognitively normal and cognitively impaired oldest-old and the association with dementia risk factors: a pilot study. BMC Geriatr 2023; 23:129. [PMID: 36882690 PMCID: PMC9993554 DOI: 10.1186/s12877-023-03814-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 02/08/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Research assessing the relationship of physical activity and dementia is usually based on studies with individuals younger than 90 years of age. The primary aim of this study was to determine physical activity levels of cognitively normal and cognitively impaired adults older than 90 years of age (oldest-old). Our secondary aim was to assess if physical activity is associated with risk factors for dementia and brain pathology biomarkers. METHODS Physical activity was assessed in cognitively normal (N = 49) and cognitively impaired (N = 12) oldest-old by trunk accelerometry for a 7-day period. We tested physical performance parameters and nutritional status as dementia risk factors, and brain pathology biomarkers. Linear regression models were used to examine the associations, correcting for age, sex and years of education. RESULTS Cognitively normal oldest-old were on average active for a total duration of 45 (SD 27) minutes per day, while cognitively impaired oldest-old seemed less physically active with 33 (SD 21) minutes per day with a lower movement intensity. Higher active duration and lower sedentary duration were related to better nutritional status and better physical performance. Higher movement intensities were related to better nutritional status, better physical performance and less white matter hyperintensities. Longer maximum walking bout duration associated with more amyloid binding. CONCLUSION We found that cognitively impaired oldest-old are active at a lower movement intensity than cognitively normal oldest-old individuals. In the oldest-old, physical activity is related to physical parameters, nutritional status, and moderately to brain pathology biomarkers.
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Affiliation(s)
- Marijn Muurling
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
| | - Maryam Badissi
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Casper de Boer
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Nienke Legdeur
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Institutes of Neurology and Healthcare Engineering, University College London, London, UK
| | - Bart N M van Berckel
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, The University of Melbourne, The Royal Melbourne Hospital, Parkville, 3050, VIC, Australia
- Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Healthy Longevity Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore, Singapore
| | - Mirjam Pijnappels
- Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Pieter Jelle Visser
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
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8
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Tolley APL, Reijnierse EM, Maier AB. Characteristics of geriatric rehabilitation inpatients based on their frailty severity and change in frailty severity during admission: RESORT. Mech Ageing Dev 2022; 207:111712. [PMID: 35905797 DOI: 10.1016/j.mad.2022.111712] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 06/28/2022] [Accepted: 07/23/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND Frailty is prevalent amongst geriatric inpatients and worsens clinical outcomes. Determinants of admission frailty and changes in frailty severity are potential targets for intervention. OBJECTIVE To identify characteristics associated with frailty severity at admission and change in frailty severity during geriatric rehabilitation. METHODS The observational, prospective, longitudinal inception cohort REStORing health of acutely unwell adulTs (RESORT) includes geriatric rehabilitation inpatients. Demographic, medical, nutritional, functional, and psychological characteristics were analysed according to admission Clinical Frailty Scale. Linear and multinomial logistic regression prediction models identified admission characteristics predicting change in frailty severity during rehabilitation. RESULTS A total 1716 inpatients (median age [IQR] 83.4 [77.7-88.6] years, 56.4 % females) were included. Poorer admission medical, nutritional, functional, and psychological status was associated with more severe frailty. Cardiac admissions, higher Cumulative Illness Rating Scale, greater number of medications, and better Short Physical Performance Battery at admission predicted improved frailty severity. Admission cognitive impairment, delirium, higher Charlson Comorbidity Index, and Hospital Anxiety and Depression Scale anxiety predicted worsened frailty severity. Explained variation was low. CONCLUSIONS Frailer geriatric rehabilitation inpatients have more complicated disease and impaired nutritional, physical, and psychological markers. Admission cognitive impairment, delirium, comorbidity, and anxiety predict worsening frailty during rehabilitation, and require prompt management.
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Affiliation(s)
- Alec P L Tolley
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia; Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia; Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, the Netherlands; Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, @AgeSingapore, National University Health System, Singapore.
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