The effects of physical activity on anxiety, depression, and quality of life in elderly people living in the community

Functional training and Mat Pilates have a positive effect on non-motor symptoms improving cognition, depressive symptoms, anxiety, and happiness in people with Parkinson's disease: a randomized controlled clinical trial with follow-up

OBJECTIVES

To analyze the short-term (12-wk post-intervention) and long-term (6-month follow-up) effects of two exercise interventions (functional training or Mat Pilates) compared to a control group and a healthy reference group on non-motor symptoms in people with Parkinson's disease.

METHOD

35 individuals with Parkinson's disease were randomized into three groups: functional training, Mat Pilates, and control group, along with 11 age- and sex-matched healthy individuals for the healthy reference group. The exercise groups received twice-weekly 60-min sessions for 12 wk. The control group and healthy reference group maintained routine activities and also received educational lectures during the 12-wk period. Outcome measures included cognition (MoCA), depressive symptoms (BDI), anxiety (BAI), mood (BRUMS), and aging perspective (Sheppard Inventory).

RESULTS

Short-term effects were observed for the functional training group in the short term for depressive symptoms (p = 0.010) and cognition (p = 0.040), and in the short and long term for anxiety (p = 0.007) and happiness (aging perspective) (p = 0.002). For the Mat Pilates group, effects were observed in cognition (p = 0.048) and confusion (p = 0.049) in the short term, and in depressive symptoms (p < 0.001), anxiety (p = 0.033), happiness (p < 0.001), and loneliness (aging perspective) (p = 0.017) in the short and long term. The control group showed worsening in depressive symptoms (p = 0.030) and confusion (p = 0.033).

CONCLUSION

Mat Pilates and functional training classes were effective in improving cognition, depressive symptoms, anxiety, and happiness. The control group and healthy reference group did not show significant effects in most studied variables. Both types of exercise can be recommended by professionals working with people with Parkinson's disease.

REGISTRATION

ReBEC - RBR-6ckggn.

Effectiveness of an endurance exercise programme preceded by ischaemic preconditioning in older people

AIM

The objective of the present study was to determine the effectiveness of an endurance exercise programme preceded by ischaemic preconditioning (IPC) for improving functional capacity and quality of life in sedentary older adults.

METHODS

A randomised controlled trial was carried out on 31 sedentary older adults. The subjects were allocated to IPC group (n = 15) that performed a six-week programme based on IPC prior to walking, or sham IPC group (n = 16). Measurements of functionality, quality of life and patients' improvement perception were assessed before (T0) and after (T1) the intervention.

RESULTS

IPC group significantly improved endurance performance, general physical condition, tibialis anterior strength, health-related quality of life and perceived improvement compared to the sham IPC group. No significant changes in self-perceived exertion, heart rate or oxygen saturation in either of the two groups.

CONCLUSIONS

The implementation of an endurance exercise programme preceded by IPC improved functional capacity and quality of life in sedentary older adults. Clinical Trials gov identifier (NCT05144815).

The Effects of Time-Restricted Feeding on Handgrip Strength, Vigilance, and Perceived Anxiety and Depression in Older Adults: A Comparative Study Between Active and Sedentary Populations

Background and Aims

Ramadan intermittent fasting (RIF), a form of time-restricted feeding, influences various physiological and psychological functions. However, its effects on older adults remain insufficiently understood. This study examined the impact of RIF on physical and mental health parameters, comparing active and sedentary older individuals. Specifically, we assessed handgrip strength (HGS), vigilance performance, anxiety, and depression levels to determine whether regular physical activity mitigates potential adverse effects of RIF.

Methods

Fifty-eight older adults (mean age 62.93 ± 3.99 years; 50% female) participated in this study. They were classified into an active group (n = 26) and sedentary group (n = 32) based on self-reported physical activity levels. Assessments were conducted before and during RIF and included HGS measurement using a handheld dynamometer, a digital psychomotor vigilance test, and validated questionnaires (General Anxiety Disorder-7, Geriatric Depression Scale, and Physical Activity Scale for the Elderly).

Results

During RIF, both groups showed significant improvements in vigilance, anxiety, and depression scores, with more pronounced benefits in the active group. However, sedentary participants experienced a decline in HGS, whereas active individuals maintained stable muscle strength.

Conclusion

Regular physical activity during RIF appears to enhance vigilance and mental health while preventing muscle strength decline in older adults. These findings highlight the importance of maintaining an active lifestyle during RIF to support both physical and mental health in aging populations.

Strategies for person-centredness at meeting places arranging group exercises for community-dwelling older persons- A focus group study from a stakeholder perspective

BACKGROUND

Health-promotive interventions targeting older persons are important for active and healthy ageing. Hence, physical group exercises for community-dwelling older persons are arranged by various stakeholders via meeting places within the municipalities. Increased knowledge of how group exercises via meeting places can be arranged to promote health for the older population is needed. Therefore, the aim was to explore involved stakeholders' experiences of group exercises for older persons arranged via meeting places in municipalities in relation to health promotion.

METHODS

Six focus group interviews were conducted online with 25 stakeholders from seven municipalities in Sweden. The stakeholders were managers of prevention units, municipal coordinators for physical activity, group exercise leaders, stakeholders from study associations, sports associations and private stakeholders, and non-profit stakeholders who arranged group exercises via the meeting places. The data was analysed using focus group methodology, where the focus of the analysis was to obtain the stakeholders' collective understanding of the topic.

FINDINGS

The analysis resulted in two main themes and seven categories. In the main theme Strategies to strengthen empowerment and exercise habits among older persons, the stakeholders highlighted strategies on an individual level. Strategies of importance to attract new participants and supporting them in maintaining their exercise habits, empowering them through social belonging, adapting to older persons through responsiveness and evaluation, facilitating participation in decision-making, and enabling older persons to lead group exercises. The other main theme, Strategies to strengthen the arrangement of group exercises over time, highlighted strategies on an organisational level concerning financial resources, supportive environments, the importance of human resources, competence development as well as collaboration.

CONCLUSIONS

Person-centredness emerges in health-promoting strategies both at the individual and organisational level. The study contributes to an understanding of how person-centredness is significant when working with health-promotive interventions for healthy ageing. Thus, a potential implication is to use a person-centred approach in the encounter with older persons and in the organisation when arranging group exercises for community-dwelling older persons.

The Impact of Piano Game-Based Learning on the Mental Health of Elderly Individuals

ABSTRACT

The main research purpose was to investigate the impact of piano courses on the mental health of the elderly. The sample consisted of 30 individuals. The age range of the participants was from 60 to 70 years. For 6 months, the respondents had piano lessons two times a week. One lesson lasted 2 hours and included the development of playing skills and improvisation techniques. The results confirmed the validity of the proposed learning strategy. The Taylor anxiety scale decreased by 19 points. These results showed a decrease of more than half of its original value. The Beck test for depression decreased by 21.5 points. The result shows a decrease two times. The test on the emotional background (the WAM questionnaire) shows an improvement in Well-Being by 3.3 points. In the group of respondents, Activity increased by 3.3 points, and the Mood factor increased by 3.5 points. The direction of further research should be related to the study of the impact of musical practices on various components of the clinical picture of depression and negative emotional states. The results can find practical implementation in the practice of psychotherapeutic work in reducing anxiety and eliminating depression in the elderly in clinics, hospitals, and other medical institutions.

The effects of exercise on anxiety symptoms in women with gestational diabetes mellitus: a pilot study

PURPOSE

Anxiety is a common mental health issue during pregnancy. Moreover, women with gestational diabetes mellitus (GDM) seem to have to cope with higher levels of anxiety, being at higher risk for several health and mental complications. Women with GDM are recommended to undertake regular physical exercise to improve metabolic and reproductive outcomes. However, there are no specific guidelines for exercise in women with GDM and data on its relationship with mental health are scarce. The aim of this study was to investigate the effect of exercise on anxiety symptoms in pregnant women with GDM.

METHODS

The present non-randomized, open-label clinical trial was a pilot study intended to provide initial data on the effect of exercise on anxiety symptoms of pregnant women with GDM. Forty-three women were assigned to three the following three study groups, (a) Advice Group (n = 17), Walking Group (n = 14), and Mixed Exercise Group (n = 12), from GDM diagnosis to delivery.

RESULTS

Based on the Beck Anxiety Inventory (BAI) scores, all groups showed normal anxiety changes or mild anxiety levels pre- and post-intervention, ranging between 9.00 (1.00-32.00) (pre-intervention) and 7.5 (1.00-26.00) (post-intervention), but none experienced severe anxiety.

CONCLUSION

In the present study, a trend of self-selected pace walking to reduce the BAI scores was identified since the Walking Groups had lower scores after the intervention. However, this trend did not reach statistical significance. Brisk walking (30-45 min) three times per week may produce positive changes in both the treatment plan and the anxiety state of women with GDM. Moreover, the study confirms that routine medical care, counseling, and support by an interdisciplinary team are protective against anxiety in women with GDM.

Assessment of isokinetic trunk muscle parameters, postural control and quality of life in sedentary and active older adults

OBJECTIVE

The study intended to evaluate the differences between active and sedentary postural control and isokinetic trunk strength. The secondary aim was to evaluate the participants' total physical activity (PA) score regarding the specific quality of life domains assessed.

METHODS

An analytical cross-sectional study involving 64 participants of both sexes aged ≥60 years (60-86 years) was conducted. Habitual PA was assessed using the Baecke Modified Questionnaire for older adults, and participants were classified as active or sedentary. Quality of life was assessed using the SF-36 questionnaire, postural control was evaluated using a bipedal force plate, and trunk muscle strength was measured using an isokinetic dynamometer. The independent t-test, Spearman correlation, and Generalized Linear Model were employed, with a significance level of 5%.

RESULTS

No significant differences were observed in postural control between active and sedentary participants. However, significant differences were observed in the peak touch and mean power of trunk extensors and flexors at speeds of 60 and 180°/s (p < 0.005), except for the ratio between flexor and extensor muscle peak torque assessed at both speeds. Quality of life showed significant correlations with PA level regarding the domains of functional capacity, vitality, and health conditions. The logistic model revealed an association with the domains of functional capacity and pain in relation to PA.

CONCLUSION

Our results underscore the importance of regular PA practice for the older adult population, indicating the enhancement of health-related quality of life and the strength of trunk extensors and flexors.

Enhancing Eldercare: Assessing Clinician's Perception of Linguistic Summaries in Health Monitoring Alert Systems

BACKGROUND

 With an aging population preferring to age in place, there's a need for efficient health monitoring systems in eldercare. This study assesses the effectiveness of a linguistic summary alert system compared with a standard health alert system requiring data visualization interpretation by clinicians.

METHODS

 A total of 110 older adults from seven facilities were monitored for health alerts throughout 2019. The study analyzed the frequency of email alert interactions and surveyed clinicians' perceptions before and after system-specific training.

RESULTS

 Linguistic alerts demonstrated a significant reduction in the need for data interface consultation, as indicated by a lower click-through rate for email alerts. Clinicians expressed a strong preference for linguistic alerts, which streamlined their decision-making process. Despite this, the post-training survey interval and limited participant demographic constrained the findings' generalizability.

CONCLUSION

 The linguistic summary alert system was found to improve nursing efficiency by succinctly communicating health trends, thus alleviating workload. The system's potential to augment care by preempting health declines was acknowledged. To fully realize its benefits, further research is warranted to explore its direct impact on health outcomes and the factors influencing technology acceptance in eldercare.

Effects of participation and learning in sports clubs on self-perceived health status, self-perceived physical strength status, and health behaviors

BACKGROUND

This study aimed to analyze the effect of participation and learning in sports clubs on self-perceived health status, self-perceived physical strength status, and health behaviors. More specifically, it examined the effect of participation in sports lessons, registration and continued participation in sports clubs, awareness of nearby sports facilities, and weekly frequency of participation in physical activities on self-perceived health status, self-perceived physical strength status, and health behaviors.

METHODS

We used the data of 9,000 individuals sourced from the "2022 Korea National Sports Survey," a survey conducted by the Korean Ministry of Culture, Sports and Tourism. This data was analyzed using frequency analysis, descriptive statistics analysis, independent t-tests, and one-way analysis of variance.

RESULTS

The results showed that participation in sports lessons, registration and continued participation in sports clubs, awareness of nearby sports facilities, and weekly frequency of participation in physical activities have a positive effect on self-perceived health and physical strength status as well as health behaviors.

CONCLUSIONS

There is a need for easily accessible and well-equipped sports clubs that can also provide sports lessons. Additionally, it is important to create an atmosphere in which people can easily access and continue to participate in sports clubs. Therefore, not only Korea but also other countries should focus on increasing sports participation and developing programs that bolster the utilization of sports club facilities.

A Neighbourhood-oriented approach to foster healthy ageing in low socioeconomic older adults: development and protocol for evaluation through intervention mapping

The rapid ageing of our society poses significant challenges, including an increase in chronic diseases and loneliness among older adults, leading to higher demands for care and support. Addressing these needs requires an integral approach, especially among older adults with low socioeconomic status (SES). This article details the development of the Neighbourhood Active & Connected (NAC) intervention, using the Intervention Mapping framework to expand an evidence-based physical activity intervention into a neighbourhood-oriented, holistic and systemic strategy for healthy ageing. NAC focuses on enhancing physical activity, social connectedness, and digital literacy. It was developed through co-creation with local stakeholders and low-SES older adults, ensuring optimal alignment with their needs and capabilities. Performance and change objectives were established based on literature consultation and an extensive need assessment, with intervention materials refined through engagement with the target group. The results of a large-scale cluster randomised controlled trial will be utilised to evaluate NAC's impact on physical activity, loneliness, social cohesion, health-related quality of life, and digital literacy among low-SES community-dwelling older adults. This paper aims to provide a detailed roadmap for researchers and practitioners to adapt, implement and evaluate similar interventions, promoting healthy ageing in low socio-economic contexts.

Living and neighborhood environments and anxiety symptoms among older adults in Anhui, China: evidence from a cross-sectional study

OBJECTIVE

This study aims to investigate the relationships between living and neighborhood environmental factors and anxiety symptoms among older adults residing in urban and rural areas of Anhui Province, China.

METHODS

Data were collected from 5876 participants in a cross-sectional study carried out in four cities located in Anhui, China. Anxiety symptoms were evaluated via the Generalized Anxiety Disorder scale (GAD-7), and participants with scores of 5 and above were defined as having anxiety symptoms. The presence of dust and noise in the context of daily life was used to evaluate the living environment of the participants. The neighborhood environment was assessed by the availability of barrier-free facilities, proximity to facilities (supermarkets, restaurants, hospitals, and parks), and green and blue space near participants' dwellings. Multilevel linear and logistic regression analyses were used to estimate the associations between these environmental factors and anxiety symptoms.

RESULTS

The participants who lived in dusty environments had elevated GAD-7 scores and higher odds of anxiety (dust: β = 0.754, 95% CI: 0.337, 1.171; OR = 1.451, 95% CI: 1.164, 1.809). Having barrier-free facilities and the existence of a neighboring park decreased the GAD-7 scores and the likelihood of having anxiety symptoms (barrier-free facilities: β=-0.503, 95% CI: -0.992, -0.085; OR = 0.768, 95% CI: 0.656, 0.899; park: β=-0.478, 95% CI: -0.830, -0.125; OR = 0.599, 95% CI: 0.440, 0.816). However, participants residing in close proximity to the hospital presented an increased likelihood of experiencing anxiety symptoms (OR = 1.377, 95% CI: 1.162, 1.631).

CONCLUSIONS

Participants who lived in dusty and noisy environments were more likely to suffer from anxiety, whereas those who lived near barrier-free facilities and parks were at lower risk. The findings emphasize the need for targeted interventions to create age-friendly communities, suggesting an integrated approach that combines environmental health strategies with mental health strategies for older adults.

The effect of the work-family conflict, subjective socio-economic status, and physical activity on the perceived quality of life of working women in Iran: the mediating role of quality of work life

INTRODUCTION

The conflict between work and family responsibilities has created many challenges for working women in Iran. This study aimed to examine the effect of work-family conflict (WFC), subjective socio-economic status (SSS), and physical activity (PA) and quality of working life (QWL) on the quality of life (QOL) of working women in Kermanshah, Iran.

METHODS

This cross-sectional study was conducted with 392 working women in Kermanshah, the most populous city in western Iran. The data gathering tool was a six-part questionnaire, including demographic checklist, PA scale, a question on SSS, WFC scale, QWL questionnaire, and QOL questionnaire. Data were analyzed by SPSS and AMOS software.

RESULTS

The majority of participants (69.4%) were inactive or had low levels of PA during their leisure times. The highest positive correlation was observed between QWL and QOL (r = 0.309, p-value < 0.001). The highest direct effect among the variables belonged to the SSS on QWL (β = 0.41, p-value = 0.001) and QOL (β = 0.20, p-value < 0.001). Furthermore, the analysis of indirect effects indicated that QWL played a mediating role between SSS and QOL (β = 0.092, p-value < 0.001).

CONCLUSION

The findings of this study revealed that variables such as SSS, PA, and QWL had significant direct effects on QOL. However, WFC had no significant effect on QOL. Moreover, QWL had a significant positive mediating role between SSS and QOL.

The Combined Effect of Multisensory Stimulation and Therapist Support on Physical and Mental Health of Older Adults Living in Nursing Homes: Pilot Randomized Controlled Trial

BACKGROUND

Increasing life expectancy has led to a rise in nursing home admissions, a context in which older adults often experience chronic physical and mental health conditions, chronic pain, and reduced well-being. Nonpharmacological approaches are especially important for managing older adults' chronic pain, mental health conditions (such as anxiety and depression), and overall well-being, including sensory stimulation (SS) and therapist support (TS). However, the combined effects of SS and TS have not been investigated.

OBJECTIVE

This randomized controlled trial examines the specific and combined effects of brief SS and TS interventions on older adults' physical and mental health and pain intensity levels, among individuals living in nursing homes.

METHODS

A total of 96 patients aged 65-99 years from a nursing home were randomly assigned to 3 groups: SS, TS, and combined SS+TS interventions, each delivered as four 20-minute sessions. SS was implemented using a multisensory Snoezelen room. Pain intensity levels (per a Visual Analog Scale), blood pressure, heart rate, blood oxygen saturation, and hand grip strength (using a Jamar hand dynamometer) were measured before and after each of the 4 weekly therapeutic sessions. In addition, life satisfaction (per the Satisfaction with Life Scale) and anxiety (per the 7-item General Anxiety Disorder Scale) were evaluated before and after the whole intervention. Mixed model analyses tested the relative efficacy of the 3 interventions, applying simple slope analysis with Tukey correction. Study rationale and analytical plans were preregistered.

RESULTS

The combined intervention of SS and TS (SS+TS) resulted in reduced pain levels compared with SS (B=0.209, P=.006) and TS alone (B=0.23, P=.002) over 4 sessions (F6,266=2.62; P=.017; R2=0.23). Further, the combined SS+TS intervention resulted in reduced systolic blood pressure versus SS (B=0.09, P=.01) and TS alone (B=0.016, P<.001) groups (F6,272=5.42; P<.001; R2=0.29). In addition, the combined SS+TS intervention resulted in an increased grip strength versus SS (B=-0.35, P=.003) and TS alone (B=-0.032, P=.008) groups (F6,273=2.25; P=.04; R2=0.19). Moreover, combined SS+TS resulted in an improvement in life satisfaction (B=-4.29, P<.0001) compared with SS (B=-2.38, P=.0042) and TS alone (B=-1.20, P=.13) groups (F2,39=3.47; P=.04). Finally, SS+TS demonstrated greater improvement in symptoms of general anxiety disorder (B=10.64, P<.0001) compared with SS (B=3.30 P=.01) and TS alone (B=1.13, P=.37) (F2,38=13.5; P<.001) groups. No differences between the interventions were shown for blood oxygen saturation (F6,273=2.06; P=.06), diastolic blood pressure (F6,272=1.12; P=.35), and heart rate (F6,273=1.33; P=.23).

CONCLUSIONS

The combined intervention of SS and TS showed therapeutic benefits for pain management and physical and mental health of older adults living in nursing homes, relative to each therapeutic component in isolation. This brief intervention can be readily implemented to improve well-being and optimize therapeutic resources in nursing home settings.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05394389; https://clinicaltrials.gov/ct2/show/NCT05394389.

Internet Use and Depressive Symptoms among Older Adults in the U.S.: Unraveling the Differences by Gender

The daily Internet use among older adults has increased. This study examines how Internet usage affects depressive symptoms among older adults, focusing on gender differences. Using data from the 2015 National Health and Aging Trends Study (N = 6380), weighted multinomial logistic regression analysis was conducted. Men tended to access the Internet more for instrumental purposes and health-related matters compared to women. Conversely, women used social networking sites (SNSs) more frequently. Men were more inclined to use the Internet for personal tasks and health concerns than women. SNS use was positively associated with mild and major depression in men, while email or texting was negatively linked to their major depression. Internet use for health matters was negatively associated with major depression in women. The discussion emphasizes potential service and policy innovations aimed at leveraging digital technology to improve the mental health of older individuals, considering gender differences.

Is Physical Activity Related to Depression and Anxiety among Adults? Observations from a Noncommunicable Disease Screening Clinic in North India

Background

Physical activity (PA) offers innumerable benefits and is a promising intervention against common mental disorders, such as depression and anxiety. We examined the association between PA and depression or anxiety in adults.

Materials and Methods

A study was conducted between March 2021 and August 2022 using a cross-sectional study design. We recruited 334 participants >40 years of age from the noncommunicable disease (NCD) screening clinic of a tertiary care institute in North India. Health-enhancing PA (HEPA) was estimated using the International Physical Activity Questionnaire (IPAQ), while depression and anxiety were screened using the 9-item Patient Health Questionnaire (PHQ-9) and 7-item Generalized Anxiety Disorder scales. Bivariate and univariate analyses were performed using Statistical Package for the Social Sciences (SPSS) version 21 to depict our results.

Results

Engagement in HEPA was 23.4%. The HEPA depicted significant socioeconomic disparities. The mean total cholesterol and triglyceride levels were considerably higher in the HEPA active group, despite having lower GAD-7 and PHQ-9 scale scores. The prevalence of depressive and anxiety symptoms was 59.0% and 13.4%. PA depicted better odds against depression but not against anxiety symptoms.

Conclusions

Low HEPA engagement in adults is a matter of concern, and it is high time we look beyond NCDs toward the risk factors. It is essential to incorporate PA counseling universally and not be restricted to a particular clinical department to realize its full potential in restraining the growing NCD burden.

Effects of a 12-week digital training equipment program on cognitive function and mental health in older women: a randomized controlled trial

Objective

Combined interventions of physical activity and cognitive training have been shown to effectively enhance physical and mental factors in older adults. Digital-based tools offer various social advantages and may be more effective in improving the physical and mental well-being of older adults. As digital health content can simultaneously provide physical activity and cognitive training, this study aims to investigate the effects of a digital-based physical and cognitive training program on the physical and mental health of older women and to explore the potential of digital tools for older adults.

Methods

The participants, older women, engaged in the program three times a week for 12 weeks, with each session lasting 30 minutes (10 minutes for each of the three components). The content included digital health tools such as VR, motion tracking, and touchscreens designed for cognitive and physical fitness. Measurements were taken one week before and after the intervention for both groups, assessing body composition, cognitive function, depression, and quality of life.

Results

Data from 36 participants were analyzed. Interaction effects were observed in body fat mass (P = .011) and body fat percentage (P = .01), with improvements noted in the digital intervention group. Cognitive function (P = .017) and depression (P = .017) also showed significant improvements in the digital intervention group. Quality of life subdomains, including Physical Function (P = .009), Limitation of Physical Function (P = .004), and Pain (P = .002), demonstrated significant interaction effects, though no interaction effects were found in other subdomains.

Conclusion

This study found that digital-based combined interventions did not significantly impact body comb position but did improve cognitive function and depression in older women. These findings suggest that digital tools can be effectively utilized for the comprehensive management of cognitive function and mental health well-being. Such insights contribute to promoting healthy aging and provide an efficient method for managing the mental and physical health of older adults.

The relationship between active aging and healthy lifestyle behaviors of individuals aged 65 years and older: A cross-sectional study

BACKGROUND

With the increase in life expectancy in the world, active aging has become an important issue. This study aims to investigate the relationship between healthy lifestyle behaviors and active aging in the elderly.

METHODS

This study, which used a descriptive and correlational survey model, was conducted with the participation of 145 individuals aged 65 years and over enrolled in the University Hospital in a city center in Türkiye. Research data were collected with the Patient Information Form, Healthy Lifestyle Behaviors Scale-II (HLBS-II), and Active Aging Scale (AAS). Descriptive statistics, Shapiro Wilk test, Student t-test, ANOVA, Tukey test, Pearson correlation analysis, and multiple linear regression analysis were used in the analysis of the data.

RESULTS

A statistically significant positive correlation was found between the individuals' HLBS-II and the total score of AAS, at a normal level (r = 0.569). The participating elderlies' Active Aging Scale total mean score was 132.01 ± 27.13, and the Healthy Lifestyle Behaviors Scale-II total mean score was 154.96 ± 18.18. A significant negative correlation was found between age and the total score of the Active Aging Scale.

CONCLUSIONS

It was determined that healthy lifestyle behaviors contributed positively to the active aging of elderlies. Active aging is negatively affected with increasing age. For the elderly to have an active aging process, it is recommended to strengthen physical activity, nutrition, methods of coping with stress, and spiritual development as much as possible, and to organize applied training programs to protect and improve the health of the elderly and to increase their awareness.

Weight-Adjusted Waist Index (WWI)-A Promising Anthropometric Indicator of Depressive Symptoms in Hospitalized Older Patients

OBJECTIVES

The aim of this study was to evaluate which anthropometric index, either body mass index (BMI) or weight-adjusted waist index (WWI), is more accurately associated with the prevalence of the most common chronic diseases and components of geriatric assessment in hospitalized older adults.

METHODS

The study included a total of 2945 hospitalized older adults (median age 82 years). The associations between the presence of chronic diseases and Comprehensive Geriatric Assessment (CGA) results were compared with WWI and BMI values.

RESULTS

The WWI was significantly higher in both sex groups suffering from hypertension, diabetes, osteoarthritis, and depression. In women, the parameter was increased among individuals with previous myocardial infarction, who presented heart failure symptoms or had chronic kidney disease diagnosed, whereas in men, among those with pulmonary diseases and osteoporosis, WWI was related to many CGA parameters oftentimes where BMI proved to fail. There was a positive correlation of WWI with the presence of depressive symptoms assessed with the geriatric depression scale (GDS) but no significant correlation with BMI. In multiple logistic regression models, WWI was a stronger predictor of depression as compared to waist circumference or the waist-to-height ratio.

CONCLUSIONS

There is an association between a higher WWI and depression diagnosis as well as the presence of depressive symptoms according to the GDS in hospitalized older adults, both women and men. There is no such correlation between depression and BMI. Both high BMI and high WWI values seem to identify older patients with cardiometabolic diseases such as hypertension and diabetes. According to this study, WWI seems to be a promising indicator of depression risk and, similarly to BMI, a useful parameter for the assessment of cardiometabolic risk in older hospitalized adults.

The effect of activities of daily living on anxiety in older adult people: the mediating role of social participation

Objective

Anxiety is a serious psychiatric illness in older adult people. Activities of daily living and social participation are important factors influencing anxiety in older adult people. Using social participation as a mediating variable, this study explored the influence of activities of daily living on anxiety in older adult people to provide scientific evidence for improving the psychological health of older adult people.

Methods

A multistage stratified random sampling method was used in this study to recruit older adult people. T tests and variance analysis were used for single factor analysis, and a multiple linear regression model was used for multifactor analysis. Pearson correlation analysis was used to study the correlation between activities of daily living and social participation and anxiety. The Process program was used to perform the bootstrap test.

Results

The mean anxiety score of the interviewed older adult individuals was 3.028 ± 4.606 points, and 28.66% of the older adult individuals had anxiety. There was a statistically significant difference in the anxiety scores of older adult people across sex, age, marital status, education level, and health insurance status (p < 0.05). After controlling for other variables, each one-point increase in the activities of daily living score significantly increased the anxiety score by 0.122 points (𝛽=0.122, p < 0.001), and each one-point increase in the social participation score significantly decreased the anxiety score by 0.058 points (𝛽= - 0.058, p < 0.001). According to the results of the mediating effect analysis, there was a significant positive relationship between activities of daily living and anxiety, and the total effect was established (𝛽=0.1719, p < 0.001). After controlling for social participation, there was a significant direct effect of activities of daily living on anxiety in older adult people (𝛽=0.1255, p < 0.001). A partial mediating effect of social participation on the relationship between activities of daily living and anxiety in older adult people was found. The indirect effect of social participation was 26.99%.

Conclusion

Activities of daily living and social participation are important factors affecting anxiety in older adult people. Health education should be increased to enhance the physical activity of older adult people to improve their activities of daily living, create a good atmosphere for their social participation, improve their motivation for and continuity of social participation.

Effect of physical activity on depression, anxiety, and stress in women surviving breast cancer: A systematic review and meta-analysis of randomized clinical trials

Breast cancer treatment can lead to psychological distress, including depression, anxiety, and stress. We systematically investigated the effect of physical exercise on these factors in women surviving breast cancer (WSBC). Eight databases were searched to identify eligible randomized controlled trials (RCTs). Data extraction and bias risk analysis were conducted using standardized tools, with meta-analysis performed using RevMan® software. Out of 3529 documents initially identified, 15 RCTs were included, comprising 2756 WSBC (1284 in intervention groups and 1472 in control groups), with 2082 participants in depression analyses, 513 in anxiety analyses, and 161 in stress analyses. Meta-analyses showed that physical exercise promoted significant reduction in depression and anxiety. Subgroup analyses showed greater reduction in anxiety when aerobic and resistance exercise were combined. Only two studies investigated stress, with less robust data suggesting improvement when combining aerobic and resistance interventions. Future RCTs with standardized intervention protocols are needed to confirm these findings.

The Relation Between Deviation From the Balanced Time Perspective and Quality of Life Among Older People. The Mediating Role of Death Anxiety and the Moderating Role of Awareness of Aging

Our study aims to identify if the deviation from a balanced time perspective (DBTP) is a predictor of the quality of life among older adults. We also investigated whether awareness of aging moderated and death anxiety mediated the relationship between DBTP and quality of life. A sample of 436 participants was involved in the study (M = 68.27; SD = 6.56; 66.7% female, 33.3% male). They completed scales for measuring the study variables. The results showed that DBTP did not predict quality of life. Awareness of aging did not moderate the relationship between DBTP and quality of life, while death anxiety negatively predicts quality of life, and also mediated the relationship between DBTP and quality of life. Starting from the results obtained, promotion and intervention plans can be developed to improve mental and physical health services.

Physical Exercise for Treating the Anxiety and Depression Symptoms of Parkinson's Disease: Systematic Review and Meta-Analysis

BACKGROUND

Depression and anxiety are non-motor symptoms of Parkinson's disease (PD). Physical exercise is a promising approach to reducing neuropsychological burden. We aimed to comprehensively synthesize evidence regarding the use of exercise for treating depression and anxiety symptoms in PD.

METHODS

Systematic review and meta-analysis following PRISMA recommendations. Searches on PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Physiotherapy Evidence Database (PEDro) was conducted. The random-effects model was employed for all analyses with the standardized mean difference as the effect estimate.

RESULTS

Fifty records were retrieved, but only 17 studies met the criteria for the meta-analyses. A moderate to large effect was observed for depression (-.71 [95% CI = -.96 to -.46], 11 studies, 728 individuals), and a small to moderate effect for anxiety (-.39 [95% CI = -.65 to -.14], 6 studies, 241 individuals), when comparing exercise to non-exercise controls. Subgroup analysis revealed significant effects from aerobic (-.95 [95% CI = -1.60, -.31]), mind-body (-1.85 [95% CI = -2.63, -1.07]), and resistance modalities (-1.61 [95% CI = -2.40, -.83]) for depression, and from mind-body (-.67 [95% CI = -1.19 to -.15]) and resistance exercises (-1.00 [95% CI = -1.70 to -.30]) for anxiety.

CONCLUSION

Physical exercise has a relevant clinical impact on depression and anxiety in PD. We discuss the level of the evidence, the methodological limitations of the studies, and give recommendations.

The Relation between Parameters of Physical Performance and Depression in Consecutive Hospitalized Geriatric Patients with Heart Failure

BACKGROUND

In the geriatric population, the risk of cardiometabolic diseases is strongly influenced by comorbidities. The aim of the study was to estimate the prevalence of depression among hospitalized patients with heart failure (HF) and to assess the relation between physical performance and depression in this population.

METHODS

We included consecutive hospitalized patients with HF aged >65 years. The depression symptoms were evaluated using the Geriatric Depression Scale (GDS), the physical performance was assessed using the grip strength measurements, the Back Scratch Test, the Timed Up and Go Test (TUGT), the Five Times Sit to Stand Test (5 × SST), and the 6 min walk test.

RESULTS

We included 206 patients (134 females and 72 males, median age 82 years (77-86) years). Altogether, 33% of participants had signs of depression. The association was found between depression severity and economic status (p = 0.001), stressful events (p = 0.005), self-reported general health status (p = 0.001), and heart failure severity assessed by the New York Heart Association class (NYHA), p = 0.003. The Back Scratch Test, the TUGT, and the 5xSST were associated with depression severity in a univariable regression analysis (β coefficient 0.04 [95% CI 0.00-0.08], 0.20 [95% CI 0.12-0.27], 0.18 [95% CI 0.07-0.27], respectively); however, when adjusted for co-factors, the TUGT and the 5xSST (0.17 [95% CI 0.08-0.26] and 0.14 [95% CI 0.02-0.26], respectively) were significantly related to the GDS score. Grip strength and the 6 min walk test were not related to the GDS score in the univariable nor multivariable analysis. These findings were confirmed in the logistic analyses.

CONCLUSIONS

Our study indicated a high incidence of depression among elderly hospitalized patients with heart failure. Depression severity in older patients with HF is related to physical performance decline as assessed by the Timed Up and Go Test and the Five Times Sit to Stand Test. Grip strength and the 6 min walk test are not related to the GDS score in this population.

The Association of Social Support, Depression, and Loneliness with Health-Related Quality of Life in Over 50 Years Adults: Ardakan Cohort Study on Ageing (ACSA)

BACKGROUND AND AIM

Social factors play a crucial role in the quality of life of + 50 adults. This study aimed to investigate the association between social support, depression, and loneliness and the health-related quality of life in + 50 adults of Ardakan.

METHODS

This was a cross-sectional study from the first phase of Ardakan Cohort Study on Aging (ACSA) in 2019. Health-Related Quality of Life (HRQoL, SF-16), Duke Social Support Index (DSSI), and Center for Epidemiologic Studies Depression Scale (CES-D10) were used to assess the variables of interest. Multivariable linear regression was used to model the associated factors with the score of the SF-16 tool in two dimensions; physical (PCS) and mental (MCS).

FINDINGS

A total of 5197 over 50 years individuals included in this study; The mean age was 62.2 ± 7.3 years old, and 52% were male. The mean score for PCS and MCS subscales was 45.6 (95% CI 45.4 to 45.9) and 49.3 (95% CI 49.0 to 49.5), respectively. Adjusted for other variables, having less feeling level of loneliness, and not having depressive symptoms were related to better PCS and MCS scores.

CONCLUSION

The HRQoL for the mental aspect of HRQoL was better than the physical in elder populations. Also, much more focus should be paid to older adults who experience inadequate social support, higher levels of loneliness, and depressive symptoms.

Internet of things based smart framework for the safe driving experience of two wheelers

Several parameters affect our brain's neuronal system and can be identified by analyzing electroencephalogram (EEG) signals. One of the parameters is alcoholism, which affects the pattern of our EEG signals. By analyzing these EEG signals, one can derive information regarding the alcoholic or normal stage of an individual. Many road accident cases around the world, including drinking and driving scenarios, which result in loss of life, have been reported. Another reason for such incidents is that riders avoid wearing helmets while driving two-wheelers. Many road accident cases involving two-wheelers, including drinking, driving, overspeeding, and nonwearing helmets, have been reported. Therefore, to solve such issues, the present work highlights the features of an intelligent model that can predict the alcoholism level of the subject, wearing of a helmet, vehicle speed, location, etc. The system is designed with the latest technologies and is smart enough to make decisions. The system is based on multilayer perceptron, histogram of oriented gradients (HoG) feature extraction, and random forest to make decisions in real time. The accuracy of the proposed method is approximately 95%, which will reduce the fatality rate due to road accidents. The system is tested under different working environments, i.e., indoor and outdoor, and satisfactory outcomes are observed.

The impact of fear of falling on health-related quality of life in community-dwelling older adults: mediating effects of depression and moderated mediation effects of physical activity

BACKGROUND

The fear of falling is a common issue among older adults that negatively affects physical and psychological aspects of health-related quality of life, regardless of actual fall events. Interventions aimed at reducing fear of falling, independent of falls, may improve older adults' quality of life. This study examined the moderated mediation effect of physical activity in how fear of falling affects health-related quality of life through depression in community-dwelling older adults.

METHODS

This study used secondary data from the Korea Centers for Disease Control and Prevention's 2019 Community Health Survey. The study included 73,738 adults aged 65 years or older. The researchers used the fear of falling scale, International Physical Activity Questionnaire, Patient Health Questionnaire-9, and EuroQol 5 Dimension as research tools, and performed descriptive statistics, Pearson's correlation coefficient, and SPSS PROCESS macro analysis. The study used the bootstrapping method to assess the adjusted mediating effect by resampling 5,000 times, and determined statistical significance with a 95% confidence interval.

RESULTS

In the model in which fear of falling affects health-related quality of life by mediating depression, the moderated mediation effect of physical activity was statistically significant, as the bootstrapping result did not include 0 in the 95% confidence interval (Index of moderated mediation [95% CI] = 0.006 [0.004-0.007], 0.008 [0.006-0.009]). Depression and health-related quality of life impairment decreased as the level of physical activity increased through inactivity, minimal activity, and health promotion activities, as the negative mediating effects decreased.

CONCLUSION

Physical activity reduces depression and improves health-related quality of life by influencing older adults' fear of falling. Community-based programs are needed to encourage and support older adults in maintaining moderate physical activity to manage the depression caused by fear of falling, which is common among older adults, and to improve their health-related quality of life.

The impact of quality of life on the survival of elderly patients with end-stage renal disease: a prospective multicenter cohort study in Korea

Background

Quality of life (QOL) is associated with mortality in dialysis patients. However, the impact of QOL index or score on elderly patients undergoing maintenance dialysis is unclear. We analyzed the relationship between QOL domains and survival in elderly end-stage renal disease (ESRD) patients on dialysis.

Methods

We included 492 incident ESRD patients aged ≥65 years from a Korean nationwide prospective cohort study who were assessed for QOL with a follow-up duration of 67.3 ± 34.6 months after dialysis initiation. Their QOL was evaluated using the Kidney Disease Quality of Life (KDQOL) instrument, and the effect of each QOL domain on mortality was analyzed. Multivariable Cox regression analysis was performed to identify independent risk factors for death after adjusting for confounding factors.

Results

Low physical component summary (PCS) and Short Form-36 score were significantly associated with low survival rate (P < .001 and P = .017, respectively), whereas the mental component summary and ESRD-targeted item scores were not correlated with survival rate. Multivariable Cox regression analysis confirmed that only a high PCS score was associated with better survival (hazard ratio 0.71; 95% confidence interval 0.52-0.97; P = .031). Linear regression analysis revealed that age, sex, modified Charlson comorbidity index, albumin and intact parathyroid hormone were associated with PCS. Among the PCS items, only the physical functioning score was significantly associated with mortality (P = .017).

Conclusion

PCS was an independent risk factor for death in elderly ESRD patients. A higher physical functioning score was associated with a better outcome, suggesting the importance of physical condition in elderly dialysis patients.

The effect of comprehensive psychological interventions on the mental health of the community elderly

Objective

To observe the intervention effect of comprehensive psychological interventions on the mental health of the elderly population.

Methods

133 elderly aged 60 and above in two urban districts of Tianshui City from January 2020 to December 2020 were selected and divided into the intervention group (n=67) and the control group (n=66). The intervention group received comprehensive psychological interventions, with no intervention given to the control group. The anxiety rate, depression rate, loneliness rate and happiness rate of the two groups were collected and compared pre- and post-intervention. Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), University of California, Los Angeles Loneliness Scale (UCLA) and Memorial University of Newfoundland Scale of Happiness (MUNSH) were used to compare the psychological status of the elderly pre- and post-intervention.

Results

Differences in the inter-group main effects and time-point main effects for SAS, SDS, UCLA, and MUNSH scores of the intervention group were significant (all p<0.05). The SAS, SDS, and UCLA scores of the intervention group were higher than those of the control group after intervention. Meanwhile, the SAS and SDS scores of the intervention group were lower than those of the control group after intervention (all p<0.05). Moreover, the MUNSH score of the intervention group was higher than that of the control group at 1-year follow-up post-intervention (p<0.05). Compared with pre-intervention values, the proportions of anxiety, depression loneliness, and happiness in the intervention group were improved at 1-year follow-up post-intervention (all P<0.05).

Conclusion

This study provides basis and important support for further investigations and the monitoring of health indicators in a population as fragile as the elderly. Targeted comprehensive psychological interventions can improve the negative emotions of community-dwelling elderly and maintain their physical and mental health. The "community-hospital linkage" mental health service model can improve the mental health status of community-dwelling elderly.

Psychotherapeutic interventions for depressive symptoms in older adults in a community setting: a systematic review protocol

Depression is a prevalent illness among the elderly, so psychotherapeutic interventions are needed to promote health and quality of life. This literature review aims to identify trials of any psychotherapeutic interventions aimed at reducing depressive symptoms in older adults. A systematic literature review with a meta-analysis will be carried out. The following databases will be searched: CINAHL Plus with Full Text, MedicLatina, MEDLINE with Full Text, and Psychology and Behavioral Sciences Collection. To minimize bias, four reviewers will independently assess the inclusion of studies. The fifth reviewer will be responsible for disaggregating inclusion and exclusion between two authors. The results of the analysis will be grouped in a table with the characteristics of the included studies, including author, year, sample, objectives, methods, assessment instruments, psychotherapeutic interventions, results, follow-up and a data compilation scheme. This scientific article is a systematic review protocol for which the data has already been extracted and is being analyzed. Examples of possible strategies to include cognitive restructuring and mental health programs for older adults in community settings. With this clear and direct identification of psychotherapeutic interventions, it will be clearer for mental health professionals to be able to intervene effectively to promote the mental health and well-being of older adults.

PROSPERO registration number

CRD42023449190.

The effectiveness of the TRACE online nutrition intervention in improving dietary intake, sleep quality and physical activity levels for Australian adults with food addiction: a randomised controlled trial

BACKGROUND

Few interventions for food addiction (FA) report on dietary intake variables. The present study comprised a three-arm randomised controlled trial in adults with symptoms of FA. The aim was to evaluate dietary intake, sleep and physical activity resulting from a dietitian-led telehealth intervention at 3 months.

METHODS

Adults with ≥3 symptoms of FA and a body mass index > 18.5 kg/m2 were recruited. Dietary intake including energy, nutrients and diet quality were assessed by a validated food frequency questionnaire in addition to sleep quality and physical activity (total min) and compared between groups and over time. Personalised dietary goals set by participants were examined to determine whether improvements in percent energy from core and non-core foods were reported.

RESULTS

The active intervention group was superior compared to the passive intervention and control groups for improvements in percent energy from core (6.4%/day [95% confidence interval (CI) -0.0 to 12.9], p = 0.049), non-core foods (-6.4%/day [95% CI -12.9 to 0.0], p = 0.049), sweetened drinks (-1.7%/day [95% CI -2.9 to -0.4], p = 0.013), takeaway foods (-2.3%/day [95% CI -4.5 to -0.1], p = 0.045) and sodium (-478 mg/day [95% CI -765 to -191 mg], p = 0.001).

CONCLUSIONS

A dietitian-led telehealth intervention for Australian adults with FA found significant improvements in dietary intake variables. Setting personalised goals around nutrition and eating behaviours was beneficial for lifestyle change.

Prior Engagement in Physical Activity Correlates with Enhanced Quality of Life Perceptions among Older Adults during COVID-19 Lockdown

BACKGROUND

This longitudinal study aimed to evaluate whether prior engagement in a physical exercise program correlated with enhanced perceptions of quality-of-life components among older adults during the COVID-19 lockdown period.

METHODS

The cohort comprised elderly individuals (aged ≥ 65 years) who had previously partaken in a 12-week randomized controlled trial investigating the effects of a mixed aerobic-anaerobic, moderate-intensity exercise program. Participants' health-related quality of life was assessed using the Short Form Health Survey-12 item (SF-12) at the beginning of the initial trial and, again, one year later during the COVID-19 lockdown. In the exercise group, 44 participants were included, while the control group consisted of 49 participants, with computer-based, double-blind randomization conducted in Cagliari, Italy. The differences in scores for each SF-12 item between the two groups from T0 to T1 were compared using one-way ANOVA with Bonferroni corrections. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 27.

RESULTS

No statistically significant differences were observed on average by age (exercise group vs. control group 72.20 ± 4.78 vs. 72.91 ± 4.77; F = 0.513, p = 0.476). A decrease from T0 to T1 towards a better score on the SF-12 was observed in the exercise group compared to the control group in item 1 (F = 67.463, p < 0.0001); in item 5 (F = 4.319, p = 0.041); item 8 (F = 4.269, p = 0.041); item 9 (F = 10.761, p = 0.001); item 10 (F = 170.433, p < 0.001); and item 11 (F = 4.075, p = 0.046).

CONCLUSIONS

The results suggest that participation in a moderate physical exercise program one year prior may have equipped older adults with better coping mechanisms to navigate the stress and isolation imposed by the COVID-19 lockdown, as reflected by their enhanced scores on quality-of-life components pertaining to mental well-being. Exercise may confer a protective effect against the adverse psychological impacts of stressful events like the pandemic, even among older adults with chronic conditions. This study underscores the potential benefits of exercise interventions for promoting quality of life and preventing mood disorders in the elderly population.

Effect of physical activity for reducing anxiety symptoms in older adults: a meta-analysis of randomized controlled trials

BACKGROUND

Anxiety symptoms in older adults can significantly impact their well-being. Physical activity is increasingly recognized as a potential intervention to alleviate anxiety in this population. We conducted a systematic review and meta-analysis to explore the impact of physical activity on anxiety symptoms in geriatric individuals.

METHODS

A systematic search was conducted in MEDLINE (via PubMed), Scopus, and Embase databases until November 29, 2023. Two independent reviewers screened articles based on predefined inclusion criteria.

RESULTS

Eleven randomized controlled trials were included. These trials, involving 770 geriatric participants, demonstrated a significant overall effect of physical activity on reducing anxiety symptoms (SMD =-0.60, 95% CI: -0.88 to -0.32). Subgroup analysis based on type of intervention and duration of follow-up was performed. The results showed all types of exercises reduced anxiety symptoms compared to the control group. Furthermore, those studies with shorter follow-up (less than 10 weeks) did not show a statistically significant reduction in anxiety symptoms. Moderate heterogeneity was observed (I2 = 67%). Sensitivity analyses confirmed the robustness of the overall effect size. Funnel plot inspection and Egger's test (p = 0.36) suggested no signs of publication bias or small study effects.

CONCLUSION

This meta-analysis provides strong evidence that physical activity significantly reduces anxiety symptoms in older adults. The study highlights the differential effects of cardio and strength exercises and underscores the high quality of evidence supporting the anxiolytic benefits of physical activity in geriatric populations.

A Nurse-Led App-Based Home Exercise Program After Total Knee Arthroplasty: A Quasi-Experimental Study

PURPOSE

Reduced activity because of pain is a major health issue associated with total knee arthroplasty. This study evaluated the effectiveness of a nurse-led app-based home exercise program for patients who underwent total knee arthroplasty.

METHODS

A nonequivalent control group of pretest-posttest design was used. Data from 45 patients were collected. The control group received individualized face-to-face exercise education, whereas the experimental group received training on the use of app-based home exercise education, including exercise videos and app push notifications to encourage exercise after discharge. Pain, range of motion, exercise self-efficacy, and quality of life were measured at baseline and 3 and 12 weeks after surgery. Nursing care satisfaction was evaluated 12 weeks after surgery.

RESULTS

There were significant overall reductions in pain intensity ( p = .001), improvements in limited range of motion ( p < .001), and increases in exercise self-efficacy ( p = .034) and quality of life ( p = .033) in the experimental group ( n = 22) compared with those in the control group ( n = 23). Nursing care satisfaction was significantly higher in the experimental group than in the control group ( p < .001).

CONCLUSIONS

Rehabilitation nurses can offer app-based home exercise education with push notifications to alleviate pain, enhance range of motion, improve exercise self-efficacy, and increase nursing care satisfaction for patients who have had a knee arthroplasty.

[Correlation between physical activity and the symptoms of depression in senior centers in Lima, Peru]

BACKGROUND AND OBJECTIVE

Depression in the elderly is a growing problem, and exercise is a strategy to prevent it. We aim to identify the correlation between scores obtained in the Geriatric Depression Scale - 15 items (GDS-15) for depressive symptomatology and Metabolic equivalent of task (MET) obtained in the International Physical Activity Questionnaire - Short Form (IPAQ-S) for physical activity in aged attending senior centers in a district of Lima, Peru.

METHODS

We conducted a cross-sectional study in three senior centers in Miraflores, Lima, Peru. Participants (n=158) completed a three-part questionnaire, including a sociodemographic survey to collect general participant data, the GDS-15 to assess the level of depressive symptomatology, and the IPAQ-S to evaluate the amount of physical activity performed in the last week.

RESULTS

A mild but significant inverse linear correlation was identified between the GDS-15 score and METs obtained in the IPAQ-S (rho=-0.213, p=0.007). Moderate to severe depressive symptomatology decreased with a higher level of physical activity: 4.3% low level, 3.3% moderate level, and no cases in those with vigorous activity; however, these differences were not significant (p=0.541, Kendall's Tau B test). CONCLUSIóN: The results showed that individuals with moderate to severe depressive symptoms show a lower level of depressive symptoms in relation to the degree of physical activity carried out in the last week.

Effects of lower limb muscle strengthening on interface pressure in older adults undergoing inelastic compression: Randomized controlled clinical trial

OBJECTIVE

To analyze the effects of lower limb muscle strengthening on interface pressure (IP), static stiffness index (SSI), dynamic stiffness index (DSI), and walking pressure amplitude (WPA) in older adults undergoing inelastic compression therapy.

METHOD

Forty-three healthy older adults of both sexes (Age: 66.2 ± 4.4 years) met the eligibility criteria and completed all stages of the study (Resistance Training - RT: N = 20; Control - CONT: N = 23). Body composition, strength and functional mobility of lower limbs, IP, SSI, DSI, and WPA were evaluated before and after intervention.

RESULTS

The two-way ANOVA with repeated measures demonstrated a significant time-group interaction effect on muscular strength for 1-RM [F (1, 41) = 21.091; p ≤ 0.001], IP in the orthostatic position [F (1, 41) = 5.124; p ≤ 0.05], minimum WPA [F (1, 41) = 10.999; p ≤ 0.05], maximum WPA [F (1, 41) = 8.315; p ≤ 0.05], DSI minimum (F (1, 41) = 4.608; p ≤ 0.05), DSI maximum (F (1, 41) = 8.926; p ≤ 0.05), and on the delta DSI (F (1, 41) = 7.891; p ≤ 0.05).

CONCLUSIONS

In RT group, the increase in lower limb muscle strength was accompanied by an increase in IP in foot dorsiflexion and plantar flexion maneuvers, both in the standing position (DSI) and during gait (WPA).

Effectiveness of Physical Activity Programs for Older Adults during COVID-19 across Districts with Different Healthcare Resource: A Case Study of Keelung City in Taiwan

While past research has largely supported the importance of physical activity for the health of older adults, during the COVID-19 pandemic, older individuals may have reduced their opportunities and levels of physical activity to lower the risk of infection by minimizing outings or interactions with others. Additionally, the adequacy of medical resources in a region is often closely related to factors such as infrastructure and economic resources. Therefore, it is important to consider whether there are differences in health promotion among older adults living in areas with varying levels of medical resources. This study aimed to implement a physical activity program for older adults, selecting Keelung City, Taiwan, as the implementation area, and comparing the differences in implementation effectiveness among administrative districts with different levels of medical resources in the city. The study employed a two-way analysis of variance to examine the differences in the effectiveness of the physical activity program among administrative districts, where the average service population in medical institutions was higher or lower than the city average. The results revealed significant improvements in participants' right-hand grip strength and the number of sit-to-stand repetitions in the overall sample after the program intervention. Moreover, in administrative districts where the average service population in medical institutions was higher than the city average, participants showed greater improvement in grip strength, while in districts where it was lower than the city average, participants demonstrated greater improvement in sit-to-stand repetitions. Future research could draw upon these findings to design physical activity programs tailored to different regions with distinct allocations of medical resources. Tailored program designs considering local medical resources are necessary to optimize effectiveness. Governments and organizations should focus on elderly health, especially in resource-scarce areas, by increasing investment and support for these programs to promote well-being and bridge disparities.

The Effectiveness of Digital Interactive Intervention on Reducing Older Adults' Depressive and Anxiety Symptoms: A Systematic Review and Meta-Analysis

INTRODUCTION

Anxiety and depression are prevalent among older adults, and digital interactive interventions have shown promise in promoting their mental well-being. However, limited research has explored the effects of different types of digital interactive interventions across various devices on anxiety and depression in older adults with different health conditions.

METHODS

A systematic literature review and meta-analysis were conducted using seven selected databases to identify relevant studies up to July 19, 2023. Two reviewers independently conducted study selection, data extraction, and quality appraisals. The risk of bias in the included studies was assessed using the Cochrane risk-of-bias tool. For the meta-analysis, the effect size was calculated as the standardized mean difference (SMD) using a random-effects model.

RESULTS

A total of 20 randomized control trails involving 1,309 older adults fulfilled inclusion criteria. The meta-analysis results demonstrates that the digital interactive intervention technologies had a significance on depression (SMD = -0.656 s, 95% confidence interval [CI] = -0.992 to -0.380, p < 0.001) and anxiety (SMD = -0.381 s, 95% CI = -0.517 to -0.245, p < 0.001). Physical interactive interventions demonstrated a significant effect on depression and anxiety (SMD = -0.711 s, 95% CI = -1.102 to -0.319, p < 0.001) and (SMD = -0.573 s, 95% CI = -0.910 to -0.236, p = 0.001). Similarly, immersive interactive interventions also showed a significant effect on depression and anxiety (SMD = -0.699 s, 95% CI = -1.026 to -0.373, p < 0.001) and (SMD = -0.343 s, 95% CI = -0.493 to -0.194, p < 0.001). Additionally, in the internal medicine group, significant intervention effects were observed for depression (SMD = -0.388, 95% CI = -0.630 to -0.145, p = 0.002) and anxiety (SMD = -0.325, 95% CI = -0.481 to -0.169, p < 0.001). Similarly, in the neurocognitive disorders group, significant intervention effects were found for depression (SMD = -0.702, 95% CI = -0.991 to -0.413, p < 0.001) and anxiety (SMD = -0.790, 95% CI = -1.237 to -0.342, p = 0.001).

CONCLUSION

The results indicated that various digital interactive devices, including physical and immersive interactive devices, have a positive impact on depression and anxiety among older adults. However, mobile games were not effective in addressing depression. Digital interactive technologies did not significantly influence anxiety intervention, except for elderly individuals undergoing surgical procedures. Nevertheless, these interventions effectively addressed depression and anxiety in older individuals with neurocognitive disorders, internal medical issues, and those without health issues.

The effect of outdoor activities on the medical expenditure of older people: multiple chain mediating effects of health benefits

BACKGROUND

With the global aging population, attention to the health and medical issues of older adults is increasing. By analyzing the relationship between older people's participation in outdoor activities and medical expenditure, this study aims to provide a scientific basis for improving their quality of life and reducing the medical burden.

METHODS

Data on outdoor activity participation, medical expenditures, and relevant variables were collected through questionnaires and databases. A multi-chain mediation effect model was established to analyze the impact of outdoor activities on the medical expenditure of older people, considering mediation effects and heterogeneity.

RESULTS

Results revealed that increased participation in outdoor activities among older adults correlated with lower medical expenditures. Outdoor activities positively influenced their health by improving mental health, cognition, eating habits, and activities of daily living, resulting in reduced medical expenditures. Robustness tests confirmed the consistent effect of outdoor activities on older people's medical expenditure.

CONCLUSION

These findings contribute to understanding the relationship between outdoor activities, health, and medical expenditure in older people, guiding policy formulation and interventions. Encouraging and supporting older adults in outdoor activities can enhance their quality of life and alleviate medical resource strain. The study's conclusions can also inform health promotion measures for other populations and serve as a basis for future research in this area.

Effectiveness of multi-modal home-based videoconference interventions on sleep in older adults: study protocol for a randomized controlled trial

Aging is characterized by substantial changes in sleep architecture that negatively impact fitness, quality of life, mood, and cognitive functioning. Older adults often fail to reach the recommended level of physical activity to prevent the age-related decline in sleep function, partly because of geographical barriers. Implementing home-based interventions could surmount these obstacles, thereby encouraging older adults to stay active, with videoconference administration emerging as a promising solution. Increasing the availability of biological rhythms synchronizers, such as physical activity, light exposure, or vestibular stimulation, represents a viable non-pharmacological strategy for entraining circadian rhythms and potentially fortifying the sleep-wake cycle, thereby enhancing sleep in aging. This study aims to (1) assess the impact of remote physical exercise training and its combination with bright light exposure, and (2) investigate the specific contribution of galvanic vestibular stimulation, to sleep quality among healthy older adults with sleep complaints. One hundred healthy older adults aged 60-70 years with sleep complaints will be randomly allocated to one of four groups: a physical exercise training group (n = 25), a physical exercise training combined with bright light exposure group (n = 25), a galvanic vestibular stimulation group (n = 25) or a control group (i.e., health education) (n = 25). While physical exercise training and health education will be supervised via videoconference at home, bright light exposure (for the physical exercise training combined with bright light exposure group) and vestibular stimulation will be self-administered at home. Pre-and post-tests will be conducted to evaluate various parameters, including sleep (polysomnography, subjective questionnaires), circadian rhythms (actigraphy, temperature), fitness (physical: VO2 peak, muscular function; and motor: balance, and functional mobility), cognition (executive function, long-term memory), quality of life and mood (anxiety and depression). The findings will be anticipated to inform the development of recommendations and non-pharmaceutical preventive strategies for enhancing sleep quality in older adults, potentially leading to improvements in fitness, cognition, quality of life, and mood throughout aging.

Effectiveness of a Sustainable Training Program Combining Supervised Outdoor Exercise with Telecoaching on Physical Performance in Elderly People

The decrease in functional abilities can negatively influence quality of life and autonomy in elderly people, and physical exercise plays a crucial role regardless of the type. Among the latter, also due to the COVID-19 pandemic, outdoor exercise and telecoaching are settings that have been widely implemented. Hence, the aim of this study was to investigate the effectiveness of a sustainable training program combining supervised outdoor exercise with telecoaching on physical performance in elderly people. A total of 60 participants were recruited and divided into two groups: a trained group (TG) and an untrained group (UG), based on their participation in an 8-week sustainable training program consisted of five sessions/week, which included two sessions/week of supervised outdoor exercise and three sessions/week of telecoaching. Participants were evaluated before and at the end of the training program using the handgrip test, Timed Up and Go (TUG) test, short physical performance battery (SPPB), and Tinetti scale. In the TG, we found a significant improvement in the following tests: right handgrip (p < 0.001); left handgrip (p < 0.001); TUG (p < 0.001); SPPB (p = 0.01); and Tinetti scale (p = 0.006). A detailed analysis of the SPPB and Tinetti scale showed the lack of significant changes in walking ability: gait speed (p > 0.05) and walking parameters in the Tinetti scale (p > 0.05). Based on our results, we suggest that a sustainable training program combining supervised outdoor exercise with telecoaching could be effective in the elderly population for improving balance capacity and strength.

Associations between regular physical exercise and physical, emotional, and cognitive health of older adults in China: an 8-year longitudinal study with propensity score matching

Background

The importance of healthy aging is growing in China as it has the largest number of older adults in the world and is one of the fastest-aging countries. This study aimed to examine the predictive value of regular physical exercise in relation to the physical, emotional, and cognitive health among samples of adults aged ≥60 years in China during an 8-year period.

Methods

A total of 10,691 older adults were extracted from two waves of national data from the China Family Panel Studies in 2010 and 2018. To minimize the impact of selection bias on the findings, a longitudinal propensity score matching (LPSM) method was used to examine the relationships between regular physical exercise and emotional health (depression), between regular physical exercise and physical health (instrumental activities of daily living), and between regular physical exercise and cognitive health (cognitive ability) of older adults. After LPSM, 856 older adults were included in the study. In the regular physical exercise group, the average age of participants at baseline year was 65.67 years, with an average age of 65.90 years for 238 men and 65.45 years for 190 women, and in the non-physical exercise group, their average age at baseline year was 65.70 years, with an average age of 65.45 years for 253 men and 65.98 years for 175 women.

Results

LPSM indicated that regular physical exercise has been found to be effective in improving physical function and reducing depressive symptoms in old adults, even after controlling for background differences. However, the sensitivity analysis suggests that the positive association between regular physical exercise and cognitive function may not be sufficiently valid.

Conclusion

The findings of this study indicate that engaging in long-term structured and repetitive physical exercise can have a significant positive effect on reducing depressive symptoms and improving the physical function of older adults. As a result, incorporating regular physical exercise into the lifestyle of older adults is recognized as an effective strategy for promoting healthy aging and reducing the strain on public health resources.

The impact of food insecurity on mental health among older adults residing in low- and middle-income countries: A systematic review

Over the past few years, food insecurity has been increasing globally due to the COVID-19 pandemic, climate change, economic downturns and conflict and a number of other intersecting factors. Older adults residing in low- and middle-income countries are more vulnerable to food insecurity. While the impacts of food insecurity on physical health outcomes have been thoroughly researched, the effect on mental health outcomes remains under-researched, especially among older adults. Hence, this systematic review aims to investigate existing literature to assess how food insecurity impacts the mental health of older persons residing in LMICs. A systematic search of six databases and Google for studies was conducted. The search was limited to studies written in English and published between 2000 to the present. We identified 725 studies, out of which 40 studies were selected for a full-text review and 12 studies were included for a final analysis. The significant finding in all the included studies was that food insecurity is associated with the worsening mental health of older adults. We also found a complex interplay of factors such as gender, age, rural/urban and health conditions associated with the aggravation of several mental health outcomes. The findings of this study illuminate the need for improved food programs to improve food security and, consequently, mental health among older adults.

Evaluating the impact of aerobic and resistance green exercises on the fitness, aerobic and intrinsic capacity of older individuals

OBJECTIVE

Our study determined the impact of 12-week aerobic exercise (AE) and aerobic + resistance exercises (AE + RE) within the green exercise concept, on senior fitness, aerobic capacity, and intrinsic capacity (IC).

METHODS

The study was a multicenter, randomized controlled study conducted at two senior living facilities with individuals aged 65 and above whose cardiorespiratory and musculoskeletal conditions are suitable for moderate exercise and who have normal cognition levels. Block randomization was applied to 96 participants in a ratio of 1:1:1 to be assigned to AE, AE + RE, and control (C) groups. Intervention groups received exercise sessions led by physiotherapists within the senior living facilitiy gardens, with a frequency of once a week for 50 min, for 12 weeks. Also, they were prescribed additional exercise sessions on two additional days of the week. At the commencement of the study and 12th week, shuttle walking test, senior fitness test (SFT), intrinsic capacity assessment (with Timed Up and Go test, Mini Mental State Examination, Geriatric Depression Scale-15, Mini Nutritional Assessment, handgrip strength test) was conducted of all participants. The primary outcome was the Z score of IC, secondary outcomes were VO2max and SFT subparameters. The study was registered in the Protocol Registry and Results System (Clinicaltrials.gov PRS) with the registration number NCT05958745.

RESULTS

90 participants successfully completed the study, with 30 individuals in each of the AE, AE + RE, and C groups. By the end of the 12th week, the arm curl score was significantly higher in the AE + RE compared to the C (mean difference: 3.96, 95 % CI= 2.47 to 5.46, p = 0.01). There were significant differences in chair stand, two-minute step, 8-foot up-and-go, chair sit and reach, and back scratch tests in both AE and AE + RE compared to C. AE and AE + RE exhibited significantly higher shuttle test distances and VO2max values compared to the C (p < 0.0001). AE + RE achieved a significantly higher total IC score than the C (mean difference: 0.59, %95 CI= -0.07 to 1.26, p = 0.025).

CONCLUSION

In this study within the green exercise concept, both AE and AE + RE led to similar improvements in strength, flexibility, mobility, endurance, and aerobic capacity. Notably, AE + RE demonstrated an additional benefit by increasing the total IC, while AE alone did not exhibit the same effect.

To assess the contributing factors of nutritional and health status amongst elderlies residing in the nursing homes of fars province, Iran: A cross sectional study

Background and Aims

In line with the global trend, the number of elderly is rising in Iran. It should be noted that the nutritional and health needs of these people, especially those living in nursing houses, are extremely significant. The present study aimed to identify the nutritional and health status and uncover their relationship with received care services by elderlies residing in nursing homes.

Methods

All 373 elderlies living in the nursing homes in Shiraz entered the study, and the requisite data were collected by references to elderlies' files, respective nurses, and elderlies themselves.

Results

The majority of the elderlies were at risk of malnutrition (62.5% of the total population, 55.4% of females, and approximately 44.6% of males). Elderlies with no insurance coverage mainly fell into the at-risk and malnutrition categories. There was a significant relationship between the needs assessment scores, reflecting the need for physical and psychological actions, and elderlies' malnutrition (odds ratio = 1.87, 95% confidence interval: 1.79-1.95). For each unit increase in the Physical and psychological need score, the odds of exposure to malnutrition (vs. nonmalnourished and at risk of malnutrition) was 1.87 times after adjustment for confounders.

Conclusion

The results of our study revealed that most of the elderlies living in the nursing homes of Shiraz had some levels of malnutrition such as at-risk for malnutrition (62.5%) and malnourished (18.9%). Based on these results, it is suggested that health policy-makers take practical steps toward promoting the nutritional care of old people and direct extra supervision to nursing homes and all healthcare provisions.

Physical Activity Is Associated with the Incidence of Depression in United States Adults from the NHANES 2013-18: A Cross-Sectional Study

The number of depression sufferers is rising globally. In the United States, 8% of adults over 20 years of age suffer from it, making it the most prevalent mental disorder in the country. Some lifestyle habits have been shown to favor or prevent the onset of depression; for instance, physical inactivity is associated with an increased likelihood of suffering depression, whilst multiple benefits have been attributed to performing physical activity (PA). This study aims to test whether there is a dependence between the prevalence of depression and PA, age, gender and educational level. The secondary objective was to identify the differentiating variables for depression and non-depression. This cross-sectional study is based on data from the NHANES 2013-2014, 2015-2016 and 2017-2018 editions. Some of the items in this survey were taken from preexisting questionnaires: the Patient Health Questionnaire-9 for depression screening and the Global Physical Activity Questionnaire (GPAQ) for the PA groups. The final sample was formed of 15,574 United States residents over 18 years old. After testing the data normality (p < 0.001), a descriptive analysis and the non-parametric chi-square test was conducted, as well as discriminant analysis. The results showed that there was an association between depression prevalence and PA (p < 0.001) in the general population and for both genders. Inactive participants had the highest prevalence of major depression and other depressive disorders. The discriminant analysis identified PA group (0.527), education level (0.761) and gender (-0.505) as significant variables that differentiate between participants with and without depression. The results of this research confirmed that a dependency relationship between PA group according to the GPAQ and depression prevalence according to the PHQ-9 existed in the United States adult population, and that PA group is a relevant variable to differentiate between depression sufferers and non-sufferers.

Systematic design of health monitoring systems centered on older adults and ADLs

BACKGROUND

Older adults face unique health challenges as they age, including physical and mental health issues and mood disorders. Negative emotions and social isolation significantly impact mental and physical health. To support older adults and address these challenges, healthcare professionals can use Information and Communication Technologies (ICTs) such as health monitoring systems with multiple sensors. These systems include digital biomarkers and data analytics that can streamline the diagnosis process and help older adults to maintain their independence and quality of life.

METHOD

A design research methodology is followed to define a conceptual model as the main artifact and basis for the systematic design of successful systems centered on older adults monitoring within the health domain.

RESULTS

The results include a conceptual model focused on older adults' Activities of Daily Living (ADLs) and Health Status, considering various health dimensions, including social, emotional, physical, and cognitive dimensions. We also provide a detailed instantiation of the model in real use cases to validate the usefulness and feasibility of the proposal. In particular, the model has been used to develop two health systems intended to measure the degree of the elders' frailty and dependence with biomarkers and machine learning.

CONCLUSIONS

The defined conceptual model can be the basis to develop health monitoring systems with multiple sensors and intelligence based on data analytics. This model offers a holistic approach to caring for and supporting older adults as they age, considering ADLs and various health dimensions. We have performed an experimental and qualitative validation of the proposal in the field of study. The conceptual model has been instantiated in two specific case uses, showing the provided abstraction level and the feasibility of the proposal to build reusable, extensible and adaptable health systems. The proposal can evolve by exploiting other scenarios and contexts.

Effects of aquatic high intensity interval training on parameters of functional autonomy, mental health, and oxidative dysfunction in elderly subjects with type 2 diabetes

The present study investigated the effects of aquatic exercise on parameters of functional autonomy, mental health, and oxidative dysfunction in elderly patients with DM2. A total of 130 elderly were included in the longitudinal clinical study and were attributed to the non-diabetic group (n = 27) and diabetes the group (n = 22). Both groups participated in 24 sessions of Hydro-HIIT, 48 h before and after Hydro-HIIT, the GDLAM index, depression, and anxiety scores and markers of oxidative dysfunction were quantified. After intervention, GI decreased in both groups (non-diabetes group = -24%; diabetes group = -22%) (p < 0.05), markers of depression (-46%), anxiety (-60%), DCFH-DA (-55%), SOD (+59%), TNF-α (-37%) and IL-1 (-48%) in diabetes group (p < 0.05). The intervention with Hydro-HIIT improves aspects related to functional autonomy, mental health, and exerts consequently, a modulating effect on oxidative stress and inflammatory response in elderly people diagnosed with DM2.

Gender Differences Regarding Self-Perceived Physical and Mental Health in Spanish University Sports and Physical Therapy Students after Termination of the COVID-19 Lockdown Period

The COVID-19 pandemic was an unprecedented situation that raised concerns about the physical and mental health of adolescents. Several surveys demonstrated that post-lockdown, women reported more complaints and lower perceived quality of life compared to men. The aim of this study was to analyze gender differences in self-reported physical and mental health immediately after the second lock-down restrictions (July 2020 to December 2020) were suspended and physical exercise classes resumed after a break of several months. This was achieved using a comparative cross-sectional survey of over-18-year-old students from the faculties of Sports Science and Physical Therapy at the University of Cadiz (UCA) in Spain. Quality of life was assessed using two types of questionnaires. The first covered quality of nutrition (PREDIMED), and the second assessed emotional impact (SF12). Physical activity level was estimated using the International Physical Activity Questionnaire (IPAQ). Of the 166 participants in this study, about two-thirds were men. Men had a better perception of their overall health quality than women. In addition, men had significantly fewer limitations in performing activities of daily living than their female counterparts. In contrast, female university students had better coping strategies, that is, they were better able to handle the problems of daily life and did so with more composure, attention, and concentration. These findings highlight the differences in post-release recovery between men and women and can be used to develop programs to promote better living standards and services to reduce gender disparities, which can ultimately improve quality of life.

Physical Activity and Neuropsychological Functioning in Older Adults

Research has identified a positive relationship between physical activity and neuropsychological functioning across the lifespan. The present study further examined the relationship between physical activity, depression, anxiety, and cognitive functioning in community-dwelling older adults (ages 65-96) who completed an outpatient neuropsychological evaluation (N = 526). Psychometrically sound and validated measures were used to assess depression, anxiety, and cognitive functioning. Analyses of covariance (ANCOVA) were conducted to examine differences between individuals who reported regularly engaging in physical activity and those who did not, after adjusting for demographic variables (age, education, and gender). Results indicated that physical activity was associated with better scores on measures of depression, anxiety, and cognitive functioning. Effect sizes for total scores on all measures were large, but there was a sizeable range of effect sizes (from small to large) for various cognitive domains. Smallest effect sizes were observed for subtests measuring language skills and visuospatial abilities, whereas largest effect sizes were seen in processing speed and memory. Results suggest that engaging in physical activity may be a beneficial non-pharmacological intervention for older adults. These findings underscore the importance of integrating physical activity programs in community and healthcare settings to foster mental and cognitive health in older populations.