Effects of an adapted physical activity program on psychophysical health in elderly women

Effect of physical activity interventions on physical and mental health of the elderly: a systematic review and meta-analysis

OBJECTIVE

This meta-analysis aimed to systematically assess whether physical activity (PA) can improve physical health(PH) and mental health(MH) in elderly.

METHOD

To conduct this meta-analysis, four databases were searched from the start to October 24, 2024 (Web of Science and PubMed in English, CNKI and Wanfang Data Knowledge Service Platform in Chinese). Eligibility criteria included (1) study populations aged ≥ 60 years of normal elderly, with no gender restrictions; (2) the experimental group included PA interventions; (3) the control group consisted of non-PA interventions or usual activities; (4) assessment results from health evaluation tools and psychological scales; (5) the research design was a controlled experimental study. The Cochrane bias risk tool was used to assess the quality of evidence for each study. Among 4,151 potential related articles, 9 met the criteria for inclusion in this review.

RESULTS

The PA intervention shows a high degree of statistical heterogeneity in the overall results for the PH of the elderly (I²=93.8%, p < 0.01). The effect size of the PA intervention on the PH of the elderly is 0.86 (95% CI: 0.08, 1.64), which is statistically significant. Subgroup analysis showed that in intervention frequency, the heterogeneity for interventions less than three times per week is low (I² = 25.6%); in intervention duration, interventions lasting less than 30 min is relatively high, the direction of the study results is quite consistent. The overall effect size is 2.32 (CI: 1.45, 3.20), indicating statistical significance; in overall intervention duration, the overall effect size for interventions lasting less than 12 weeks is (CI: 0.08, 1.59), while the effect sizes for the other two subgroups include 0, indicating non-significant results. The overall results for the MH of the elderly also exhibit a high degree of statistical heterogeneity (I²=95.3%, p < 0.01). The effect size of the PA intervention on the MH of the elderly is -0.22 (95% CI: -1.46, 1.03), which is not statistically significant. Subgroup analysis also showed no statistically significant differences. The PH and MH of the elderly may potentially improve through PA interventions, although further research is needed to clarify whether these benefits hold clinical significance beyond statistical significance.

CONCLUSION

PA interventions with a frequency of less than 3 times per week, each session lasting less than 30 min, and a total duration not exceeding 12 weeks may be more effective in improving the PH of the elderly. This study did not identify the optimal dosage for improving the MH of the elderly. These findings highlight the potential benefits of PA for PH in the elderly but underscore the need for more rigorous studies to determine optimal intervention parameters and to explore the clinical significance of PA for both PH and MH.

[Long-term effects of an assets-based, co-created physical activity intervention on health-related quality of life in older adults]

PURPOSE

The purpose of this study is to examine the long-term effects of a programme called Ser Mayor, un RETO («Being Older, a Challenge») aimed at improving quality of life in older adults over 60 living in the community.

METHODS

This programme used co-design principles to create sustainable opportunities to improve quality of life, connecting with the community, and empowering older adults to take responsibility for their own health. Ser Mayor, un RETO was based on Bronfenbrenner's bio-social-ecological perspective and the health assets model. Its design was complemented with leisure education and physical activity promotion-based guidelines, identified in the scientific literature. The study design was quasi-experimental, with control group, and was conducted over a period of 20-months (September 2017 to June 2019) in several municipalities near the city of Zaragoza (Spain), with the participation of 213 older adults (n=120 experimental group and n=93 control group). Data were analysed using generalised linear mixed models controlling for age and gender of participants and accounting for initial differences between groups in the study outcomes.

RESULTS

The results indicate that the experimental group experienced an improvement in levels of quality of life relative to the control group, which was sustained over the study period, especially in several physical dimensions of quality of life: physical function (P=.014), physical role (P=.027), physical component summary (P=.022) and in emotional role (P=.033).

CONCLUSION

The Ser Mayor, un RETO programme had a positive effect on the quality of life of older adults, showing potential for sustainability of its effects and for the service providers to develop a sense of ownership over the programme.

Physical exercise and mental health among older adults: the mediating role of social competence

Background

Healthy aging is crucial to the quality of life of older adults, of which mental health is an essential part. Physical exercise strongly affects their mental health and can alleviate psychological problems to a certain extent. Nevertheless, the correlation between physical exercise and the mental health of older adults individuals, as well as the underlying mechanism by which physical exercise impacts mental health, remains rather ambiguous.

Methods

We utilized multiple linear regression models to investigate the relationship between physical activity and mental health in 3,240 persons aged 60 and up. The propensity score matching (PSM) method was used to assess the robustness of the regression results. In addition, sequential recursive models were employed to investigate the mediating role of social competence in the link between physical activity and mental health.

Results and discussion

We discovered a strong favorable association between physical exercise and mental health, which was mediated by social competence. Furthermore, the effect of physical exercise on mental health differed across older persons from various socioeconomic backgrounds.

Conclusion

Older adults should strengthen their understanding of the role of physical exercise. Sports organizations that serve older adults by providing resources and services to help them maintain physical fitness and by hosting sports activities and competitions according to their needs should be established.

Predictors of Satisfaction With Life and Health Status of Older People in Brunei: A Gender Comparative Study

Objective: To investigate predictors of life satisfaction and healthy aging with focus on gender differences among older people in Brunei Darussalam.

Methods: A cross-sectional study on older people recruited by proportionate sampling. Multiple linear regression stratified by gender was applied.

Results: 45.6% of life satisfaction of older women were strongly associated with self-perceived health, social relationship, and education level. For older men, 26.3% of the variance of life satisfaction was predicted by physical functioning or disability, and social relationship. For older women, 38.9% of the variance of health status can be explained with satisfaction with life, and difficulty to do daily tasks. For older men, 33.1% of the variance of health status can be accounted by income, number of children, presence of chronic illness, and diabetes.

Conclusion: This paper discusses the unique gender differences of older people from a global perspective. Policymakers and stakeholders need to account for local and contextual differences before adopting international guideline. Particularly, on the maintenance or further promotion social interactions, active engaging elderly in health maintenance, and physical and mental functioning of the older population.

BMI, Body Image, and Quality of Life—Moderating Role of Physical Activity

Body mass index (BMI) and body image (BI) are constructs worth examining in the context of physical activity (PA), and they are both related to quality of life (QoL). PA, BMI, and BI should all be considered as associated parameters, and their effect on QoL should be examined and understood. This study aimed to determine the moderating role of PA in the relationship of BMI and BI with QoL. The sample of examinees consisted of 500 respondents (307 women; aged 39 ± 6 years). A physical activity self-evaluation questionnaire (IPAQ-SF) was used to estimate PA; BI was evaluated by using the Body Image Dimensional Assessment (BIDA) questionnaire, while QoL was determined with the WHOQOL-BREF questionnaire. The results showed that vigorous PA moderates the relationship between BMI and social relationships in adults (Sig. = 0.000). Walking and vigorous PA affect the relationship between BMI and environmental health (Sig. = 0.017 and Sig. = 0.049, respectively). Both walking (Sig. = 0.035) and moderate PA (Sig. = 0.032) alternate the relationships between BI and social relationships. Walking (Sig. = 0.000) and vigorous PA (Sig. = 0.016) moderate the relationship between BI and environmental health. The influence of PA on the moderation of the relationship of BMI and BI with physical and psychological health in the working population was not statistically significant.

Research on the Relationship between Chinese Elderly Health Status, Social Security, and Depression

(1) Background: To explore the relationship between health status, social security status, and the occurrence of depression in older adults and provide a basis for mental health care services for the elderly population; (2) Methods: This study used the 2018 China Health and Senior Care Tracking Survey (CHARLS) data to select 8383 older people aged over 60 years old as the research subjects. The two-category Logistic model was used to analyze the research problem; (3) Results: Older adults with depressive tendencies accounted for 34.1% of the total older adults. The incidence of depression among female older adults reached 41.51%. The risk of depression in the elderly population was 40.3% lower in males than in females (OR = 0.597, 95% CI: 0.539−0.662). Self-rated health status, physical disability, and receipt of pensions affected the incidence of depression in older adults (all p < 0.05); (4) Conclusions: Focus on and intervene in the mental status of elderly females and disabled elderly people. Provide mental and economic support and mental health care services to the elderly at the family and social levels. Promote the healthy development of the mental health of the elderly and promote active aging.

The Association Between Level of Physical Activity and Body Mass Index, and Quality of Life Among Elderly Women

The process of aging leads to changes in functional abilities, fitness levels, level of physical activity, and body mass index (BMI), all of which causes changes in the quality of life. The current study aims to determine the association between the level of physical activity (PA) and BMI, and quality of life (QoL) among elderly women. The total sample numbered 156 women, with an average age of 67.7 ± 5.6 years. To determine the level of physical activity, the self-reported International Physical Activity Questionnaire Long Form (IPAQ-LF), was used. To calculate the values of the BMI, the standard procedure recommended by the World Health Organization was used. Quality of life was evaluated using the short form of the WHOQOL-BREF questionnaire designed by the World Health Organization. All the data were processed using the statistical package for data analysis SPSS 20.0. Pearson's correlation analysis shows statistically significant relations at the level of p < 0.01 between PA and Physical health in Housework = 0.36, Leisure time PA = 0.27, Walking = 0.24, Moderate PA 0.43, Total PA = 0.43, while the correlations between the variables at the significance level of p < 0.05 were determined in PA in transportation = 0.19 and High-intensity PA = 0.16. Multiple linear regression analysis of different levels of PA as independent variables on individual domains of QoL shows that there is an association of PA and Physical health (Sig = 0.000), more precisely, Total PA is statistically the most closely related to Physical health (Sig = 0.000), and then follows PA at work and Social relations (Sig = 0.036). Similar results were obtained when BMI is added to model A. In contrast to model A, model B shows a statistically significant association between PA and BMI with the environmental domain of QoL (Sig = 0.001). The results of the current study indicate that high- and moderate-intensity physical activity both have benefits for physical health, whereas moderate PA showed higher significance levels. Results also show that elderly women with higher BMI values achieve better results in the environmental domain of QoL.

Effect of Neuromuscular Training Program on Quality of Life After COVID-19 Lockdown Among Young Healthy Participants: A Randomized Controlled Trial

Study in the period of coronavirus disease 2019 (COVID-19) lockdown and the effect of different exercise training programs on the quality of life (QoL) dimension are limited. This randomized control study as a part of which the impact of an 8-week neuromuscular training program on the 90 healthy young individuals' QoL after COVID-19 lockdown was assessed using a short form of the WHOQOL-BREF questionnaire comprising of four domains (physical health, psychological health, social relations, and the environment). The intervention group (NT) (n = 47) took part in a neuromuscular training program consisting of dynamic neuromuscular stabilization and whole-body vibration training. In contrast, the control group (CG) (n = 43) did not participate in any programmed physical activity. From pre- to post-intervention test, the NT group significantly and substantially improved [mean change (95% CI)] all the QoL domains, physical for 12.78 scores (8.89, 16.64), psychological for 13.12 scores (9.51, 16.74), social relationships for 20.57 scores (16.12, 25.02), and environmental for 24.40 scores (21.45, 27.35). These results suggest that the NT program could enhance QoL in young and healthy participants following COVID-19 lockdown.

Psychological Effects of Motivational Aquatic Resistance Interval Training and Nutritional Education in Older Women

Several studies have demonstrated the positive effects of physical exercise programs on physical and mental health throughout life. It is necessary to know the factors that contribute to the well-being of older adults in order to achieve healthy aging. The aim of this study was to evaluate the relationship between well-being perception and the use of autonomy supportive coaching behaviours across a motivational aquatic resistance interval training program. Thirty-four women over 65 years of age from the province of Alicante, Spain, participated, and were randomly assigned to: motivational aquatic resistance interval training group (MART; age: 69.6 ± 5.01 years, height: 1.62 ± 7.88 m, weight: 75.3 ± 12.8 kg) and control group (CG; age: 67.7 ± 3.60 years, height: 1.54 ± 5.47 m, weight: 66.9 ± 10.2 kg). The MART program was conducted for 14 weeks, with three training sessions/week. The CG did not perform any physical activity during the study. Perception of autonomy support was assessed through the Autonomy-Supportive Coaching Questionnaire (ASCQ), Psychological needs by the Basic Psychological Needs in Exercise Scale (BPNES), Intrinsic motivation to exercise was assessed through Intrinsic Motivation Inventory (IMI) and Perception of Physical Activity by the International physical activity questionnaire (IPAQ). In MART, compared to CG, significant differences were observed in BPNS, IMI and IPAQ questionnaires used, except in the ASCQ. The differences were significant in all three cases in BPNS (p < 0.05 in autonomy and competence and p = 0.001 in relationship with others), obtaining better scores after intervention than previously. As for the IMI scale, significant differences were also obtained in both subscales. The level of physical activity also improved significantly, with higher scores on the IPAQ after the intervention than before (p < 0.001). In conclusion, when practitioners perceive greater well-being, satisfaction of their basic psychological needs, greater self-selection, volition, and autonomy instead of pressure, demand and control, the result is better behaviour with greater psychological well-being, adherence and consequent health benefits.

Balance Strategy Exercise versus Lower Limb-ROM Exercise for Reducing the Risk of Falls among Older People

Background: Falls are a significant health problem and the most common cause of injuries in older people. Different types of exercise have been recommended to prevent falls, including balance exercise and range of motion. However, there is a lack of evidence to compare the effect of the two exercises.Purpose: This study aimed to compare the effect of Balance Strategy Exercise (BSE) and Lower Limb-Range of Motion (ROM) exercise on reducing the risk of falls among older people living in long-term care facilities. Methods: This was a quasi-experimental study using a pre-post design without a control group. A total of 30 older adults from two nursing homes who met the inclusion and exclusion criteria participated in the study. A cluster randomization technique was used to assign the older people into either BSE or Lower-Limb ROM groups evenly. Treatment was given for 30 minutes per session, three sessions per week for three weeks. The risk of falls was measured using the Timed Up and Go (TUG) test. The paired t-test, Wilcoxon and Mann-Whitney U-test were used to analyze the data. Results: Results showed significant differences in the TUG scores before and after the intervention within both the BSE (p=0.001) and the Lower Limb-ROM group (p=0.001). However, the Lower Limb-ROM group demonstrated a significantly higher reduction in TUG score than the BSE group after the intervention (p=0.008).Conclusion: Lower Limb-ROM exercise is better to reduce the risk of falls among older people living in institutional care than BSE. This exercise can be applied as part of a fall prevention program in nursing homes.

Influence of the COVID-19 Pandemic on Mood and Training in Australian Community Tennis Players

The COVID-19 outbreak has led to the implementation of strict restrictions in Australia, which have severely impacted sporting activities. Tennis is played by 6.2% of the population within the Oceania region, and is a valuable sport for maintaining social, mental, and physical health. Current literature indicates the COVID-19 pandemic has negatively affected the mental health of Australian residents. The aim of this study was to investigate changes in training and match play due to the outbreak, and its effects on emotional well-being of Australian senior tennis players. Additionally, explore any differences between middle aged (41–60 years) and senior (61 years and over) Australian tennis players. An online survey was used to assess training and match play habits, as well as ascertain the emotional well-being of tennis players. The survey was active from 24th April 2020 until 6th June 2020. Participants were adult (41+ years) tennis players from Australia. Wilcoxon signed rank tests were performed to check for differences in training hours and tennis matches played. Mann–Whitney U tests were used to assess the difference in Brief Emotional Experience Scale (BEES) scores, employment status as well as the training hours and tennis matches played between the two age groups. A Kendall's Tau B correlation test was performed to assess the associations of training, match play and demographic characteristics with BEES scores. Kruskal–Wallis tests assessed differences in BEES scores between participants of differing match play formats, tennis experience and cessation of tennis training time periods. There were 245 respondents who met our inclusion criteria. Tennis training hours along with the tennis matches played significantly decreased during COVID-19 compared to pre-COVID-19, 85.09 and 88.48%, respectively. No significant (p > 0.05) differences were observed between age groups for any of the training modality hours, nor was there any significant difference in number of tennis matches played. The participants average BEES score was 0.99 ± 1.27, indicating that respondents had a positive emotional well-being during the COVID-19 pandemic. The emotional well-being of the senior group was significantly (P = 0.002) higher than the middle aged group. Together, our results show that training and tennis match play decreased during the COVID-19 pandemic, however the emotional well-being of senior tennis players in Australia appeared to not be negatively affected.

Impact on Health-Related Quality of Life after Different Aerobic Exercise Programs in Physically Inactive Adults with Overweight/Obesity and Primary Hypertension: Data from the EXERDIET-HTA Study

Primary hypertension (HTN) and obesity are associated with a worse health-related quality of life (QoL). This research was carried out to analyze the health-related QoL measurements in a physically inactive and obese population with HTN (n = 253) in comparison to a HEALTHY sample (n = 30), to determine the HTN sample changes in QoL following different (high-volume moderate-intensity continuous training, high-volume high-intensity interval training (HIIT), low-volume HIIT) 16-week supervised aerobic exercise training (ExT) programs compared to attention control, and to assess the differences in QoL variables between the different ExT programs. The SF-36 questionnaire was used to assess health-related QoL. At baseline, HTN showed lower scores (p < 0.05) in physical function (88.6 vs. 99.2), general health (63.3 vs. 82.4), vitality (58.2 vs. 68.7), social functioning (88.5 vs. 95.2), and mental health (76.1 vs. 81.8) compared to HEALTHY. Following intervention, all HTN subgroups showed higher (p < 0.05) vitality, but physical functioning and general health significantly improved only in the ExT groups, with even better values in general health for both HIIT subgroups. Only the low-volume HIIT showed positive changes (p < 0.05) in social functioning (∆ = 6.9%) and mental health (∆ = 6.4%) domains after the intervention. These results highlight the important role of supervised exercise in improving physical and psychological health.

Association between Health Indicators and Health-Related Quality of Life according to Physical Activity of Older Women

The purpose of this study was to compare sociodemographic factors, health factors and nutritional status according to the physical activity of older women, and to analyze the factors affecting their quality of life. The subjects of this study were 5661 older women aged 60 or older who participated in the Korean National Health and Nutrition Survey (KNHANES) from 2008 to 2013. The socioeconomic factors, subjective health status and disease status, lifestyle and dietary quality, and life quality were compared among two groups (active group and inactive group). The inactive group had significantly higher rates of obesity and unemployment, comorbidities, numbers without spouses, experiencing stress, poor subjective health status, depression or suicidal thoughts, and also higher rates of skipping meals. The life quality index and dietary quality was also significantly lower in the inactive group, and subjects experienced significantly higher pain or discomfort and problems in mobility and the usual activities. The results of multivariate analysis after adjusting for age in groups engaging in physical activities showed the life quality index to increase in accordance with the diet quality, economic income, and education level. It was confirmed that life quality was significantly low if the participant showed a poor subjective health evaluation, obese with many diseases, spouseless, and experienced high levels of stress. Considering the rapid aging and high life expectancy of women, regular physical activity is very important for maintaining health and improving the life quality of older women, and it is believed that comprehensive attention and management of lifestyle and diet quality are necessary.

[Risk of dependence and self-esteem in elderly people according to physical activity and drug consumption]

OBJECTIVE

Despite knowing that the practice of physical activity can positively influence the health of older people, there are variables such as the risk of dependency and the level of self-esteem that can mediate people´s quality of life. The objective of this study was to know the relationship between the risk of dependence and level of self-esteem in older people.

METHODS

515 seniors between 60 and 90 years old were interviewed. A single measurement was made, using different scales and validated questionnaires (Rosenberg personal self-esteem scale, Barber test and Modified Baecke PAQ questionnaire). Statistical analyzes (with the SPSS v. 23.0 program) descriptive, ANOVA, linear regression analysis and correlations were performed.

RESULTS

89.1% had dependency risk, 32.6% were physically active and 43.3% had low self-esteem. The level of physical activity practice showed significant differences (p<0.001) favorable to active people, who had a lower risk of dependence, better self-esteem and lower consumption of medications than sedentary ones.

CONCLUSIONS

The practice of physical activity helps reduce drug consumption, which improves the self-esteem of the elderly and decreases the risk of dependence.

Effect of an Integrated Healthcare Program for Korean Rural Older Adults: A Quasi-Experimental Study

Studies have been conducted on the development of healthcare programs for older adults in rural areas, not only in Asia but also in Europe and the United States. However, these reports have been limited by largely non-comprehensive results, lack of demand surveys, or programs with no systematic development. The purpose of this study was to develop an integrated healthcare program for rural older adults and investigate the effects of the program. A nonequivalent control group pretest–posttest design was used. Subjects were aged over 65 and lived in the rural community. The integrated healthcare program involved 12 three-hour sessions over 12 weeks. Compared with the control group, the experimental group demonstrated significant differences in both upper extremities strengths (t = 2.74, p = 0.008; t = 2.03, p = 0.047), static balance (z = −2.38, p = 0.017), dynamic balance (t = −4.82, p < 0.001), loneliness (t = −3.02, p = 0.003), and role self-efficacy (t = 2.39, p = 0.020), but no differences for ego integration (t = 1.51, p = 0.137). To improve physical, mental, and social health of the rural older adults, we developed an integrated healthcare program. The program improved physical functions, loneliness, and role self-efficiency of the rural older adults. Therefore, it is recommended that healthcare professionals actively apply this program in primary healthcare institutes and elsewhere.

Walking in Natural Environments as Geriatrician’s Recommendation for Fall Prevention: Preliminary Outcomes from the “Passiata Day” Model

Background: The Geriatric Unit of the University of Palermo developed the “Passiata Day” model, a green exercise intervention consisting of a one-hour walk, once/week, in a city park. The purpose of this study was to assess body balance in older people who walked regularly compared to sedentary people. Methods: 106 older people (75 women and 31 men; mean age: 72.3 ± 8.2 years) without fall history were invited to participate voluntarily in this natural environment walking program. After six months, both the participants who had taken part regularly in the walk (i.e., the physical activity group (PAG; n = 72; 54 women and 18 men; mean age: 70.7 ± 7.2 years)), and who had not accepted to be included in the outdoor walking program (i.e., the sedentary group (SG; n = 34; 21 women and 13 men; mean age: 75.5 ± 9.4 years)), performed a stabilometric test with open eyes (OE) and with closed eyes (CE). Results: Our preliminary results showed significant differences between groups on the ellipse sway area both in the OE (p < 0.05) and in CE condition (p < 0.01). Moreover, we found a significant difference on sway along the frontal plane both in the OE (p < 0.05) and in the CE condition (p < 0.01), and on sway along the sagittal plane for the test with CE (p < 0.01). Conclusion: Based on our preliminary findings, we suggest that walking regularly in an outdoor setting could lead to a greater body balance in older people and could be recommended by geriatricians for preventing the risk of falls. The next step will be to investigate the effect of an experimental outdoor walking program structured in terms of intensity, frequency and volume.

Psychomotor Abilities of Elderly People and Their Motivation to Participate in Organized Physical Activity

Background: Functional training has an effect on the physical parameters of people, but the motivation of the elderly people practicing sports varies depending on the events taking place in their close environment and the specifics of their relationships.Methods: Participants were recruited in the City Leisure Center for Elderly People and Social Care Home for Elderly People and randomly assigned to two groups: a study group and control group. The survey sample consisted of 40 respondents (aged 68 ± 8 years), who met the inclusion criteria. Respondents exercised to the Adapted Physical Activity Program, which consisted of a study of motivation to exercise, testing of physical parameters and adaptation of functional training to respondents physical needs.Results: Before starting functional training, the balance of study group was 44% (p < .05) lower if compared to the control group. We determined statistically significant change of coordination after FT - 17.75% (p < .05). The data of semi-structured interview were coded and attributed to specific subcategories, four categories were established: self-expression, self-awareness, body image, and self-esteem.Conclusions: Certain living environments may limit the need and possibility for the elderly people to exercise while enjoying the sense of communion through physical activity.

Physical Exercise Training Improves Quality of Life in Healthy Older Adults: A Meta-Analysis

The current meta-analysis first aimed to quantify the overall effect of physical exercise training on the quality of life (QoL) in healthy older adults. Second, the effects on the social, physical, and psychological QoL were assessed. In total, 16 randomized controlled trials were included. The primary analysis showed a medium effect of physical exercise training on QoL in healthy older adults (standard mean difference [SMD] = 0.38, confidence interval, CI, [0.18, 0.59], p < .05). The secondary analyses showed a positive medium effect of physical exercise training on the physical component of QoL (SMD = 0.39, CI [0.17, 0.60], p < .05), and a positive medium effect of physical exercise training on the psychological component of QoL (SMD = 0.348, CI [0.125, 0.570], p < .05), and no significant effect of physical exercise training on the social component of QoL was observed (SMD = 0.16, CI [-0.07, 0.38], p = .17). These findings warrant implementation efforts pertaining to exercise training for older adults to improve the QoL in our aging societies.

Exercise Instructors for Older Adult Fitness: A Review of the Literature

Group-exercise instructors are a vital social determinant of exercise enjoyment, attendance, and adherence. Instructors also affect the degree to which physical cultures are socially inclusive. In order to elucidate the roles that instructors play in affecting these outcomes, we conducted a scoping review. Scoping reviews are a preliminary method for assessing the breadth and depth of existing literature in order to identify key themes and gaps therein. Based on Arksey and O'Malley's (2005) framework, we identified 52 articles and book chapters, 33 of which were older-adult specific, using a university search engine that simultaneously searches multiple databases. We conceptually mapped the literature, which revealed instructors' vital roles as: (1) constructors of group social cohesion, (2) cultural intermediaries, (3) competent practitioners, (4) leaders and communicators, and (5) educators. Of these, the instructor's educative role lacks empirical attention. We conclude with implications for future research, practice, and policy.

Change in physical activity and health-related quality of life in old age-A 10-year follow-up study

The aim of the study was to examine the association between change in leisure-time physical activity (LTPA) and change in health-related quality of life (HRQoL) and symptoms of depression during a 10-year follow-up. This prospective study included 1036 men and women (mean age at baseline = 61.2 years) from the Helsinki Birth Cohort Study. Leisure-time physical activity was measured with a questionnaire, HRQoL with SF36 and depression symptoms with Beck's depression inventory (BDI). The association between the change in LTPA and change in HRQoL and BDI were investigated with sex-stratified general linear models adjusted for age, smoking, educational attainment, comorbidity score, and baseline value of outcomes. One standard deviation (SD) increase in LTPA was associated with increase in physical summary component of HRQoL in women (B = 0.7 unit, 95% CI = 0.1-1.3, P = 0.032) and in men (B = 0.8 unit, 95% CI = 0.2-1.5, P = 0.014). In women, the 1SD increase in LTPA was also associated with an increase in mental summary component score (B = 1.0, 95% CI = 0.3-1.7, P = 0.005) and a reduction in depressive symptoms (B = -0.7, 95% CI = -1.1 to -0.2, P = 0.003). In conclusion, increase in the volume of LTPA over a 10-year period in late adulthood was associated with improved HRQoL in both men and women, and also diminished depressive symptoms in women. The findings support the promotion of physical activity in later years to enhance HRQoL and mental well-being.

Association of physical activity with body mass index, waist circumference and incidence of obesity in older adults

BACKGROUND

There is limited, and inconsistent, data on the prospective association between physical activity and surrogate markers of adiposity in older adults. We aim to determine the prospective association of leisure time physical activity (LTPA) with body mass index (BMI), waist circumference (WC) and the incidence of obesity.

METHODS

This prospective analysis included 7144 individuals with a mean age of 67 ± 6.2 years, from the PREvención con DIeta MEDiterránea (PREDIMED) study. BMI and WC were measured and LTPA was recorded using the Minnesota Leisure Time Physical Activity Questionnaire. Exposure and outcome variables were calculated as cumulative average of repeated measurements.

RESULTS

Total LTPA was inversely associated (P < 0.001) with BMI and WC. The difference in BMI and WC between extreme quintiles of LTPA (Q1-Q5) was 2.1 kg/m2 (95% confidence interval (CI) 1.68; 2.49, P < 0.001) and 4.8 cm (CI 2.28; 7.25, P < 0.001), respectively. Low-intensity LTPA was inversely associated with BMI but not with WC, while moderate/vigorous LTPA showed an inverse relationship with BMI and WC. The hazard of general and abdominal obesity incidence decreased across quintiles of total and moderate/vigorous LTPA (P < 0.001 for both), whereas low-intensity LTPA was inversely associated with the incidence of general obesity (P < 0.001).

CONCLUSION

LTPA was inversely associated with BMI, WC and incidence of general and abdominal obesity. The finding that low-intensity LTPA was inversely related to BMI and the incidence of obesity is of particular importance because this level of physical activity could be a feasible option for many older adults.

Physical activity, cardiovascular health, quality of life and blood pressure control in hypertensive subjects: randomized clinical trial

BACKGROUND

Physical activity (PA) promotes cardiovascular health and health related quality of life (HRQoL), although the effect of that on blood pressure (BP) control has rarely been studied in hypertensive subjects. Our aim was to evaluate the effectiveness of a PA intervention programme on cardiovascular disease (CVD) risk, HRQoL and BP control in hypertensive subjects.

METHODS

A randomized clinical trial, with a PA intervention programme of 9 months duration, comprising a walking group of 120 min/week, supervised, and with socio-cultural activities. Participants were 207 hypertensive subjects (68.2 years, 76.8% women). PA (IPAQ-s), diet, CVD risk, BP, BMI, smoking, and HRQoL (SF-36) were assessed at baseline and at the end of the intervention. Changes in CVD risk and in HRQoL during the intervention was calculated (end-baseline score). Multivariate models were applied.

RESULTS

In multivariate models, the PA intervention programme, with no modification of the diet, decreased CVD risk (- 1.19 points) and the systolic BP (- 8.68 mmHg), and increased some areas of HRQoL (4.45 to 14.62 points). An increase in the percentage of subjects with controlled BP was observed by the PA programme itself (OR 5.395 to 5.785 according to multivariate models), and by the changes during the intervention in the decrease in CVD risk (OR 0.609) and in the increase in the HRQoL in physical component summary (OR 1.041), role physical (OR 1.010), and bodily pain (OR 1.014), independently of controlled BP at baseline.

CONCLUSIONS

This PA intervention programme improved cardiovascular health and HRQoL, and favoured BP control in primary care users with hypertension.

TRIAL REGISTRATION

Clinicaltrials.gov ID NCT02767739 ; Trial registered on May 5th, 2016. Retrospectively registered.

Promoting Well-Being in Old Age: The Psychological Benefits of Two Training Programs of Adapted Physical Activity

In the last few decades, the relationship between physical conditions and mental health has increasingly attracted the interest of researchers and professionals across disciplines. This relationship is especially relevant in old age, as the challenges posed by aging at various levels represent crucial concerns for policy makers. Due to the remarkable increase in life expectancy across countries, sustainable prevention strategies are needed to help individuals preserve psychophysical well-being in old age. In particular, the regular practice of a moderately intense physical activity is recommended by the World Health Organization to enhance balance, prevent falls, strengthen muscles, and promote psychophysical well-being. Daily physical exercise represents a beneficial and low-cost strategy, easily accessible to the general population and potentially customizable to specific needs through brief training programs. Based on these premises, the present research aimed at longitudinally evaluating mental well-being among 58 Italian people aged 67-85, who were involved in two Adapted Physical Activity (APA) training programs. Inclusion criteria for participation comprised high autonomy levels in daily activities, no cognitive impairment, sedentary habits or only occasional performance of moderate physical activity. Based on physical and functional assessment, 39 participants joined a program of adapted motor activity (PoliFit; Study 1), while 19 participants attended a variant program specifically designed for people with osteoporosis (OsteoFit; Study 2). Well-being dimensions were assessed through the Mental Health Continuum-Short Form, the Emotion Regulation Questionnaire and the Satisfaction with Life Scale. Physical functioning were evaluated before and after the programs through the Short Physical Performance Battery and the Handgrip Dynamometer Jamar Test. Findings highlighted that, besides physical benefits, participants reported significantly more adaptive emotion regulation strategies after both training programs; in addition, participants attending OsteoFit reported significantly higher levels of emotional well-being. Results suggest the potential of moderate physical activity in promoting mental health, emphasizing the additional role of training programs as cost-effective opportunities for elderly people to socialize and improve emotional functioning. Overall, the findings support the view of old age as a stage of competence development and adaptive adjustment, rather than a phase of mere psychophysical decline.

Quality of life of participants and non-participants of public physical exercise programs

Abstract Objective: to compare the quality of life of elderly participants and non-participants of public physical exercise programs. Method: a control, analytical and cross-sectional study analyzing 108 elderly participants of public exercise programs (SG) and 126 non-participants (CG) in the city of Goiânia, Goias, Brazil, was performed. An initial Assessment Form, the Mental State Mini-Exam, the short version of the International Physical Activity Questionnaire, the World Health Organization Quality of Life - Bref (Whoqol-Bref) and the World Health Organization Quality of Life - Old (Whoqol-Old) were used. Comparison of socio-demographic profile and health conditions was performed using the Chi-squared test, while comparison of the quality of life of the SG and the CG was performed using covariance analysis (ANCOVA), followed by the post-hoc Tukey test. Results: the elderly persons in the SG had higher mean scores than those of the CG in all the Whoqol-Bref and Whoqol-Old domains (p<0.05). The active elderly in the CG did not exhibit differences in relation to the insufficiently active or sedentary members of the CG for any Whoqol-Bref or Whoqol-old domain (p≥0.05). Conclusion: the elderly participants in public physical exercise programs had a better perception of quality of life than non-participating elderly persons, and it was found that simply being active may not be enough to guarantee a better quality of life.

Social representations of older adults regarding quality of life

ABSTRACT Objective: to identify the social representations of older adults regarding quality of life, and to analyze the care practices adopted to promote it. Method: qualitative, exploratory, descriptive research, applying the Theory of Social Representations. Thirty older people from a Health Academy of Rio de Janeiro participated in the study. The software Alceste was used, and lexical analysis of data was performed. Results: social representations of quality of life are based on the social determinants of health; they evidence knowledge and practices of care by valuing physical activities. The practices promoting quality of life comprise healthy eating habits, daily physical exercise, social participation, interaction and socialization, accomplishment of leisure activities and daily tasks with independence and autonomy, and support and family contact. Final considerations: the elderly have a global understanding of the concept of quality of life, coordinate knowledge built in daily life and knowledge coming from the technical-professional field, which evidences the multidimensionality of the concept.