Development of strategies for changing in physical activity behaviors on older adults with disabilities

Incorporating Physical Activity Assessments and Behavior Change Techniques Into Geriatrics

Ninety-one percent of adults 65 years and older do not perform the recommended levels of physical activity (PA), resulting in increased risk of disability, morbidity, and mortality. Despite knowing the benefits of PA and acknowledging the importance of assessing and addressing inadequate PA levels, 50%-75% of health care providers do not incorporate behavior change techniques into clinical practice. This clinical gap can be explained by a lack of knowledge or confidence in (1) assessing PA levels; (2) addressing inadequate PA levels; and (3) justifying the time needed to use these techniques in clinical practice. In this special communication, we address this gap by providing a 3-step theoretical-based clinical decision pathway that guides health care providers on how to identify older adults with inadequate PA levels, determine readiness to increase PA, and empower patents to develop an action plan that will increase their PA levels. We also provide a conceptual model that supports the use of techniques that assess and address inadequate PA by tying PA to the Age-Friendly Health System's 4Ms (ie, What Matters to the older adult, Mentation, Mobility, and Medications).

Older Adults' Views and Attitudes on Physical Activity; Reasons to Participate and Abstain

Purpose: Despite numerous established benefits of exercise, many older adults do not get enough. The purpose of this study was to identify facilitators and barriers to physical activity/exercise; gain greater understanding of older adults' physical activity self-efficacy; and increase understanding of how to reduce sedentary behavior.Design: Cross-sectional descriptiveMethods: Quantitative with convenience sample of 66 older adultsFindings: Nearly one third of participants reported engaging in regular physical activity. They tended to have rather strong physical activity self-efficacy and limited barriers to being active.Conclusions: The sample had limited involvement in physical activity or exercise, despite feeling confident in their ability to be active. There could be additional barriers or motivating factors that are preventing them from being more active.Clinical Evidence: Honest and directed conversation about older adults' understanding and attitudes towards exercise, paired with an individualized plan tailored to their interests and lifestyle could help increase physical activity/exercise.

Transtheoretical Model for Physical Activity in Older Adults: Systematic Review

Healthy aging makes the practice of physical activity (PA) a necessity. However, PA guidelines achievement in older adults is scarce. The use of behavioral theories such as Transtheoretical Model (TTM), helps in older adults PA promotion. The aim of this review was to identify the use of TTM for PA in older adults (>60 years). PubMed, SPORTdiscus, and Medline databases were used to conduct the search. All steps of the process followed the recommendations of the PRISMA flow-diagram. We identified eight studies: Six were descriptive cross-sectional studies, one prospective-cohort study and one with a quasi-experimental design. Only two papers evaluated the four behavior change dimensions within the same study, three evaluated the processes of change and the decisional balance, four evaluated the exercise self-efficacy and all assessed the stages of change for PA behavior. From this review, we can conclude that TTM is a useful and suitable behavior model in creating, developing, and evaluating interventions with the aim of acquiring and improving PA habits in the older adults. However, there is paucity of research in this area, and more studies including the four behavioral change dimensions are needed to analyze the effect of TTM on the promotion of PA in the older adults.

Health promotion of frail elderly individuals and at risk of frailty

OBJECTIVE

To identify interventions for the health promotion of frail elderly individuals and those at risk of frailty.

METHOD

Integrative review of the literature performed in the following databases: LILACS, CINAHL, MEDLINE, Web of Science, COCHRANE and Scopus, using the.

DESCRIPTORS

"frail elderly", "aging", "health services for the aged" and "health promotion" combined with Boolean operators "AND" and "OR".

RESULTS

Randomized controlled clinical trials (RCTs) classified as level of evidence II represented 82.6% of studies. Interventions were analyzed according to the following categories: Interventions for the elderly at risk of frailty and Interventions for the frail elderly.

CONCLUSION

The following interventions were identified: educational multiprofessional group meetings, physical training, home visit/home care program, nutrition assessment and supplementation, health maintenance programs and cognitive training; models/programs of management and monitoring, use of assistive technology devices and hospitalization program for geriatric rehabilitation.

Fatores associados à qualidade de vida dos idosos

Resumo Objetivo: Examinar as relações entre qualidade de vida, nutrição e fragilidade em indivíduos não institucionalizados com idade acima de 75 anos. Método: Estudo observacional, transversal e analítico realizado através da aplicação de um questionário com uma amostra de indivíduos com mais de 75 anos de idade residentes na comunidade e selecionados através de amostragem por conveniência durante o ano de 2015. Resultados: Uma proporção maior de mulheres apresentou baixa qualidade de vida em relação aos homens: 20,9% contra 9% (p<0,01). O risco de desnutrição foi associado a baixa qualidade de vida (35%) (23,4%) (p<0,000). Uma proporção maior de indivíduos fragilizados apresentou baixa qualidade de vida: 55,7% contra 17,4% (p<0.000). Conclusão: A qualidade de vida dos idosos é influenciada pela presença de sintomas de depressão, estado nutricional, sexo, fragilidade e incapacidade básica e instrumental.