Predictors of the Level of Physical Activity in Physically Active Older People

Fear of Falling Avoidance Behavior on Daily Living Activities and Physical Activity in Older Adults: A Cross-Sectional Study

The aim of this study was to investigate the effect of avoidance behavior due to fear of falling on dependency levels in activities of daily living and physical activity levels in older adults. This study is a cross-sectional research design. Data were collected between November 2023 and March 2024. A total of 506 individuals aged 65 years and over participated in the study (mean age 71.26). It was determined that the older adults had low level of fear of falling avoidance behaviors were fully independent in activities of daily living and had low level of physical activity. The multiple linear regression analysis showed that age, marital status, education, living with and fear of falling avoidance behavior affected daily living activities; age, place of residence, gender, income status, chronic disease status, and fear of falling avoidance behavior affected physical activity level (R2 = 0.183; R2 = 0.197, respectively). This study revealed the necessity of interventions to prevent fear of falling avoidance behaviors in order to increase the activities of daily living and physical activity levels among older adults.

Does education level affect the health status of the elderly? The chain mediating effect of internet use, health behavior and social class identity

BACKGROUND

China's aging population is gradually increasing, and the health status of the elderly has become the focus of social attention. Education level is one of the important factors affecting the health status of the elderly. However, there are few studies on how education level specifically affects the health status of the elderly in China. Therefore, the purpose of this study is to explore the influence path of education level on the health status of the elderly in China, and to further study the mediating effect of Internet use, health behavior and social class identity in this process.

METHODS

This study is based on the latest version of the Chinese General Social Survey data as the basis of empirical analysis. Through multiple linear regression analysis, structural equation model analysis, Bootstrap method and robustness test, the relationship between education level, Internet use, health behavior, social class identity and the health status of the elderly is verified.

RESULTS

(1) Education level has a significant positive impact on the health status of the elderly in China (p < 0.05), which is, education level has a positive effect on the health status of the elderly in China. (2) Internet use, health behavior and social class identity have a significant mediating effect between education level and health status of Chinese elderly, and the mediating effect values are 0.024, 0.002 and 0.011, respectively. (3) Internet use, health behavior and social class identity play a chain mediating role in the impact of education level on the health status of the elderly, and the chain mediating effect value is 0.004.

CONCLUSIONS

This study not only confirms the direct impact of education level on the health status of the elderly in China, but also reveals the indirect role of Internet use, healthy behavior and social class identity in this impact mechanism. These findings provide new perspectives and strategies for further improving the health status of the elderly in China.

Predictors of Physical Activity One Year After Moderate to Severe Traumatic Brain Injury

OBJECTIVES

To identify predictors of moderate to vigorous physical activity (MVPA) at 12-months post-moderate-severe traumatic brain injury (TBI).

SETTING

Four inpatient rehabilitation centers.

PARTICIPANTS

Individuals enrolled in the TBI Model Systems with moderate to severe TBI, admitted to inpatient rehabilitation, and able to ambulate without physical assistance from another person.

DESIGN

Prospective longitudinal cohort study. MVPA was measured by having participants wear an ActiGraph GT3X on their wrist for 7 consecutive days.

MAIN ANALYSES

We used multivariate regression to predict minutes per week of MVPA at 12 months after TBI. Three classes of predictors were entered hierarchically-demographic and clinical variables (age, sex, body mass index, education, TBI severity, neighborhood walkability score, and self-reported preinjury physical activity [PA] level), baseline TBI-related comorbid conditions (eg, measures of sleep, pain, mood, fatigue, and cognition), and intention to exercise and exercise self-efficacy assessed approximately 1 week after discharge from inpatient rehabilitation.

RESULTS

180 participants (ages 17.7-90.3 years) were enrolled, and 102 provided at least 5 days of valid accelerometer data at 12 months. At 12 months, participants recorded an average of 703 (587) minutes per week of MVPA. In univariate and multivariate analyses, age was the only significant predictor of 12-month MVPA ( r = -0.52). A sharp decline in MVPA was observed in the tertile of participants who were over the age of 61.

CONCLUSIONS

Older adults with TBI are at elevated risk of being physically inactive. Assuming PA may enhance health after TBI, older adults are a logical target for prevention or early intervention studies. Studies with longer outcomes are needed to understand the trajectory of PA levels after TBI.

Health-related outcomes of structured home-based rehabilitation programs among older adults: A systematic literature review

The aging population reveals the need to develop self-care interventions that promote autonomy and well-being. The current systematic review aimed to assess the association between the implementation of structured home-based rehabilitation programs to promote self-care in older adults and health-related outcomes among people aged 60 years or older. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature review was performed. Three electronic databases (MEDLINE, CINAHL and Psychology and Behavioral Sciences Collection) were searched. Randomized experimental studies, that implemented a home-based rehabilitation program to promote self-care in older adults, and were published between 2019 and 2024, were retrieved. Data on health-related outcomes were collected. Eight studies were included; all eight studies implemented a monitored, progressive and customized rehabilitation program. The studies varied greatly regarding the sample size, the duration of the intervention, the rehabilitation program implemented and the instruments used. The implementation of structured home-based rehabilitation programs may contribute to improve physical and psychological health-related outcomes among older adults by promoting functional capacity, self-care and knowledge.

Home-based resistance training performed at either fast or slow speeds improves power output in older adults

PURPOSE

We investigated the effect of an unsupervised, body mass- home-based resistance training program in older adults performed at either a fast or slow contractile speed on changes to muscle-power, -volume, -architecture, and fatigue resistance of the knee extensors.

METHODS

Thirty-two male older adults (age 65-88 years) were separated into 1) fast-speed exercise (Fast-group), 2) slow-speed exercise (Slow-group), and 3) no exercise (Control-group) groups. Participants in the exercise groups performed 30-45 repetitions of knee-extension and sit-to-stand exercises 3 times a week for 8 weeks with different exercise speed between the groups. Before and after the intervention period, the following variables were measured: Isotonic power, isometric strength, twitch contractile properties, muscle-activity, -architecture, and -quality, neuromuscular fatigue resistance of the knee extensors, and thigh muscle volume.

RESULTS

Peak power was increased in both the Fast-group (+24 %, P < 0.01, d = 0.65) and Slow-group (+12 %, P < 0.05, d = 0.33) but not in the Control-group. Training increased pennation angle of the vastus lateralis in both the Fast-group (+8 %, P < 0.01, d = 0.42) and Slow-group (+8 %, P < 0.01, d = 0.42), while only the Fast-group showed increase in pennation angle of the rectus femoris (+12 %, P < 0.01, d = 0.64) and thigh muscle volume (+16 %, P < 0.01, d = 0.52). There was no time × group interaction effect for the other neuromuscular measures.

CONCLUSIONS

Unsupervised, body mass- and home-based resistance training performed at either fast or slow speeds can improve muscle power in older adults, while fast-speed exercise may be preferable over slow-speed owing to the relatively greater improvement of muscle-power, -volume, -architecture, and better time efficiency.

Factors influencing gait performance in older adults in a dual-task paradigm

The aim of this study was to determine the effect of cognitive interference through a dual-task (DT) paradigm on gait parameters by sex or other predictive variables, such as physical fitness, health status, and cognition. A total of 125 older adults joined in this study (age, 72.42 ± 5.56 years old; 28 men and 97 women). The DT paradigm was evaluated through Comfortable Linear Gait (CLG) and Complex Gait Test (CGT). The gait parameters between single task (ST) vs. DT condition in men showed a significant reduction in speed (p < 0.001), cadence (p < 0.001), and step length (p = 0.049) and increased time to execute the CGT (p < 0.001), while women showed a decreased speed (p = 0.014), cadence (p < 0.001), and double support coefficient variation (CV) (p = 0.024) and increased single support time (p < 0.001) and CV step length (p < 0.05). In addition, women increased CGT time (p < 0.001). Furthermore, correlations between DT cost (DTC) cadence vs. Physical Activity for Elderly questionnaire (PASE) (r =  - 0.399; p = 0.008), DTC single support vs. 30 s Sit to Stand Test (r = - 0.356; 0.016), DTC single support vs. Rey Auditory Verbal Learning Test-Learning curve (r =  - 0.335; p = 0.023), DTC double support vs. 30 s Sit to Stand Test (r =  - 0.590; p < 0.001), DTC CV step length vs. 30 s Sit to Stand (r =  - 0.545; p = 0.003), and DTC CGT vs. 30 s Sit to Stand Test (r =  - 0.377; p = 0.048) were found. The results of our study indicate that the gait parameters within the DT condition decreased speed and cadence, while increasing CV step length and CGT time, causing slower gait with shortened steps in men and women.

A nationwide study of the impact of social quality factors on life satisfaction among older adults in rural China

In rural China, the aging population faces unique challenges that affect their life satisfaction. These challenges are compounded by disparities in access to resources compared to urban areas, making it crucial to address these issues to ensure a dignified and fulfilling later life. Understanding and improving life satisfaction for this demographic is essential, not only for the well-being of the elderly but also for the overall social stability and economic sustainability of these communities. Using a rural sample from the Chinese Social Survey (CSS), this study investigates the interplay between social quality factors and life satisfaction among older adults in rural China. It focuses on the roles of socioeconomic security, social cohesion, social inclusion, and social empowerment in shaping the well-being of this demographic. It was found that the four conditional factors of social quality-socioeconomic security, social cohesion, social inclusion, and social empowerment-have different influences on life satisfaction among older adults in rural areas. The statistical model shows that the influence of absolute family income on social and economic security does not have statistical significance. In contrast, housing, pension insurance participation, and public safety perception positively affect life satisfaction among older adults in rural areas. Among the social cohesion factors, higher social morality, legal system evaluation, social identity, grassroots government, and interpersonal trust contribute to the life satisfaction of older adults in rural areas. Regarding social inclusion factors, good social tolerance, social equity, and perception of government public services can significantly improve life satisfaction among older adults in rural areas. For social empowerment factors, social participation helps expand the social support network of older adults in rural areas, enhancing their life satisfaction. Paths to improving the quality of rural society should be explored to improve relative poverty in rural areas. They should continue to be pursued to strengthen the old-age security system for older adults in rural areas. Further, the National Medium- and Long-Term Plan for Actively Responding to Population Aging should be the base for forming an elderly-friendly society. A good atmosphere promotes the participation of people, families, and society; supports social cohesion; enhances inclusion; and promotes social participation, improving life satisfaction.

The association between intensity-specific physical activity and the number of multiple chronic diseases among Chinese elderly: A study based on the China Health and Retirement Longitudinal study (CHARLS)

Background

With ageing, the elderly are facing a complex situation where multiple chronic diseases coexist. This paper aims to investigate the effect of intensity-specific physical activity on the number of multiple chronic diseases in the elderly.

Methods

Our data came from wave 4 of the China Health and Retirement Longitudinal Survey (CHARLS), which involved 10,341 residents aged ≥ 60 years. The intensity-specific physical activity was divided into two categories: moderate-intensity physical activity (MPA) lasting ≥ 150 min/week and vigorous-intensity physical activity (VPA) lasting ≥ 75 min/week. Data on 14 types of chronic diseases were collected. Propensity score matching (PSM) with controlling nine confounding factors were used to analyse the effects of intensity-specific physical activity.

Results

Among 10,341 samples, 40.12% of the elderly often participated in MPA and 25.72% participated in VPA. The PSM results showed that performing 150 min/week of MPA leads to 0.0675(P<0.05) fewer multiple chronic diseases than not achieving this standard, and VPA up to 75 min/week leads to 0.0785(P<0.05) fewer multiple chronic disease than that does not meet this criterion. Additionally, VPA is more effective than MPA.

Conclusion

Both MPA of at least 150 min/week and VPA of at least 75 min/week can significantly reduce the number of multiple chronic diseases in elderly. Elderly people should increase their exercise intensity as much as possible while ensuring safety.

Validation of the Barthel Index in Chinese nursing home residents: an item response theory analysis

BACKGROUND

The Barthel Index (BI) is used to standardize the grading of assessments for clinical needs, insurance support, and long-term care resource allocation in China. However, its psychometric properties among nursing home residents remain unclear. Therefore, this study aims to assess and modify the psychometric properties of BI in nursing home residents.

METHODS

A total of 1,402 individuals undergoing evaluation in a nursing home facility in China were included in this study from November 2021 to November 2022. Correlations between items were examined to identify the potential multicollinearity concerns. The unidimensional item response theory (IRT) was used to validate and modify the single structure of BI. Furthermore, the logistic regression/IRT hybrid DIF detection method was conducted to assess differential item functioning (DIF) between the dementia group and the normal group.

RESULTS

The pairing of items 5 ("bowl control") and 6 ("bladder control") revealed a local dependence issue, leading to their consolidation. Items 56 (bowel and bladder control) and 9 (mobility) both displayed poor fit indices and underwent category collapsing. Through the application of the generalized partial credit model, the adjusted scale displayed better fit indices, demonstrating a robust discriminative power (DC >1.5) and orderly thresholds. Furthermore, non-uniform DIF was identified in item 2 (bathing) between the dementia group and the normal group.

CONCLUSION

The modified BI demonstrated favorable psychometric properties and proved to be suitable for evaluating nursing home residents experiencing moderate functional impairment, which may provide a precise evaluation for long-term care resource allocation. Future studies could explore integrating supplementary measurements, such as objective indices, to assess a broader spectrum of functional statuses to potentially enhance the limited precision width observed in BI.

Pilates versus Zumba training effects on postural control under conflicting sensory conditions in postmenopausal women

The current study aimed to compare the effects of Pilates versus Zumba training on postural performance in middle-aged postmenopausal women. Fifty-seven eligible women, aged between 50 and 60 years, were randomized into three groups: Zumba (ZG) group, Pilates (PG) group or control (CG) group. Postural control was assessed using a force platform under 4 sensory manipulation conditions: on firm and foam surfaces with eyes opened (EO) and closed (EC). Our results showed more marked adaptations in favor of ZG concerning postural performance compared to PG. For the PG, postural control was significantly improved only in simple postural conditions on the firm surface with EO (p < 0.1) and EC (p < 0.05) conditions. However, postural control of the ZG significantly improved in both the simple and complex postural conditions, even under conflicting sensory situations (firm surface/EO (p < 0.001; 95 % CI: [1.34, 4.46]), EC (p < 0.001; 95 % CI: [2.13, 5.24])); foam surface/EO (p < 0.01; 95 % CI: [0.70, 8.57]), EC (p < 0.01; 95 % CI: [0.65, 8.52])). In conclusion, Zumba training seems to be more effective and a better strategy to promote postural control in daily living activities and autonomy in postmenopausal women than Pilates training. These findings are useful for public health practitioners in designing physical interventions for balance disorders.

Effects of a multicomponent training followed by a detraining period on metabolic syndrome profile of older adults

AIMS

The present study sought to analyze the effects of 6-month multicomponent training (MCT) combined with a 4-month detraining on metabolic syndrome (MetS) profile among older adults with decreased functional capacity.

METHODS

This quasi-experimental study included a total of 104 older adults (80.5 ± 6.0 years) and the sample was divided into a training (TRAIN, n = 55) or control group (CON). Harmonized definition was used to diagnose the MetS. Functional capacity, blood biochemical parameters, blood pressure, body composition and anthropometric measurements were assessed 3 times. Analysis of variance for repeated measures and Wilcoxon signed-rank test were used to check the differences within groups.

RESULTS

TRAIN decreased diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDLC) and total fat mass during training period, whereas CON did not show any significant changes. During detraining, TRAIN increased HDLC, systolic blood pressure (SBP), waist circumference (WC) and total fat mass; and decreased glucose and fat free mass, whereas CON increased the concentration of glucose and HDLC. From baseline to post-detraining assessment, CON increased the concentration of triglycerides and the WC, while TRAIN only increased the WC (all p < 0.05).

CONCLUSIONS

Exercise can be a key component in the treatment of the MetS, since MCT seems to be effective to decrease DBP and total fat mass. Nevertheless, 4-months of detraining could cause a drop of total fat mass, but no in DBP. To avoid reversibility of the benefits obtained, it could be beneficial to promote continuing exercise programs.

TRIAL REGISTRATION

ClinicalTrial.gov identifier: NCT03831841.

Factors Associated with Elderly Health-Related Quality of Life in Tibet: A Cross-Sectional Study from a Health Ecological Perspective

Background

Aging and its consequences are receiving considerable global attention in developed and developing countries. The health-related quality of life (HRQoL) of elderly individuals is crucial for public health and social welfare. Despite advances in understanding the health status of the elderly population in Tibet, a region located on China's southwest border, a significant research gap remains regarding their HRQoL.

Methods

We conducted a cross-sectional study in Tibet, China, in 2018, which thoroughly examined HRQoL and its determinants in individuals aged 60 and above. The EQ-5D-VAS instrument, consisting of two standardized scales (EQ-5D-3L and EQ-VAS), was utilized to measure HRQoL. We based the selection of potential determinants on a novel health ecological model encompassing various environmental and personal factors. We employed the Least Absolute Shrinkage and Selection Operator regression to systematically pinpoint key predictive factors for dimensionality reduction. The Tobit regression analysis further elucidated the relationship between these factors and the EQ-VAS and EQ-5D-index scores.

Results

Our study encompassed 1604 elderly participants. They presented varying severity levels across all five dimensions of the EQ-5D-3L. The most commonly observed issue was pain/discomfort, with a prevalence of 40.27%. The average EQ-VAS score was 56.15 (SD=21.15), and the mean EQ-5D-index score was 0.78 (SD=0.25). Our multivariate analysis revealed that determinants such as age, sex, number of chronic illnesses, vision problems, hearing problems, physical activity, employment status, social participation, place of residence, and insurance type were significantly associated with HRQoL.

Conclusion

The HRQoL of Tibet's elderly population presents significant concerns, especially given the region's challenging natural conditions. This underscores the urgent need for focused policy interventions at the socio-economic strata to extend vital support and aid.

Exploring Factors Associated with Physical Activity in the Elderly: A Cross-Sectional Study during the COVID-19 Pandemic

The COVID-19 pandemic negatively influenced individuals' physical activity levels (PALs) and particularly the PAL of the elderly. However, few studies have examined the correlates of PALs in this population during the pandemic. This study aimed to evaluate the residence-specific correlates of PALs in elderly people from Croatia and Bosnia and Herzegovina during the COVID-19 pandemic. The participants were 211 persons older than 65 years (101 females), of whom 111 were community-dwelling residents, and 110 were nursing home residents (71.11 ± 3.11 and 72.22 ± 4.01 years of age, respectively; t-test = 0.91, p < 0.05). The variables included health status, residential status sociodemographic factors, anthropometrics (body mass, height, and body mass index), and PAL. PAL was evaluated using a translated version of the Physical Activity Scale for the Elderly (PASE), and was validated in this study. PASE showed good test-retest reliability (51% of the common variance) and validity (57% of the common variance, with the step count measured using pedometers). Apart from participants' health status and age, PAL was positively correlated with (i) community-dwelling residence (OR = 1.93, 95% CI: 1.60-2.23), and (ii) a lower BMI (OR = 0.85, 95% CI = 0.71-0.98). The pre-pandemic physical activity was positively correlated with the PAL of the nursing home residents (OR = 1.2, 95% CI: 1.02-1.45). A higher education level was positively correlated with the PAL of community-dwelling residents (OR = 1.31, 95% CI: 1.04-1.66). This study evidenced the residence-specific correlates of PALs, and enabled the identification of specific groups that are at risk of having low PALs during the pandemic. Future studies examining this problem during a non-pandemic period are warranted.

Daily Functional Characteristics and Health Among Older Adults During COVID-19: A Structural Equation Modeling Approach

Within a few years, 1 in 6 people will be aged 60 years or older. Extreme situations, such as the COVID-19 crisis, constitute a challenge to older adults. However, the literature on the daily functional characteristics of older adults in the past and during the COVID-19 crisis and their relationships to their physical and mental health is scarce. This study aimed to examine the past and present daily functional factors associated with physical and mental health in older adults. Using an online platform, 204 Israelis aged 60 years and older reported their physical health symptoms and anxiety levels. They completed questionnaires about past (negative life events and childhood daily functional self-actualization) and present (adulthood daily functional self-actualization, functional cognition and sleep quality) factors. Structural equation modeling revealed correlations between functional cognition and childhood daily functional self-actualization (β = -.18) and anxiety (β = .15); adulthood daily functional self-actualization and past negative life events (β = -.18), anxiety (β = -.50), and physical symptoms (β = -16); and sleep quality and past childhood daily functional self-actualization (β = -.19), negative life events (β = .22), anxiety (β = .18), and physical symptoms (β = .40). These findings shed light on potential functional factors for older adults' health, indicating that these functional factors play a vital role in reducing health problems in later life.

Chronic stress in old age: Psychometric properties of the Trier Inventory of Chronic Stress (TICS), based on a general population sample aged 60 and over

BACKGROUND

Chronic stress results from an imbalance of personal traits, resources and the demands placed upon an individual by social and occupational situations. This chronic stress can be measured using the Trier Inventory for Chronic Stress (TICS). The aims of the present study are to test the factorial structure of the TICS in a sample of elderly people, report its psychometric properties, and give norm values for elderly individuals.

METHODS

The TICS was answered by N = 790 healthy participants aged 60 to 99 years. The sample was selected by random-route sampling. Confirmatory factor analyses applying Robust Maximum Likelihood estimations (MLM) tested model fit and factorial structure. Reliability estimations and norm values are reported.

RESULTS

Confirmatory factor analyses replicate the reported nine-factor as well as the higher-order two-factor solution. Additionally, a general one-factor model was identified. All models provide acceptable model fit, with model comparison fit statistics corroborating the superiority of the nine-factor model. Reliability coefficients were good to very good.

CONCLUSION

The TICS can now also be used reliably in samples with elderly people. Its proposed nine-factor structure could be factorially validated and results in good scale reliability. Norm values for an elderly sample are now available.

Intrinsic capacity and risk of death: Focus on the impact of using different diagnostic criteria for the nutritional domain

OBJECTIVE

We aimed to estimate the ability of intrinsic capacity (IC) to predict death in community-dwelling older people using different diagnostic criteria to define the nutritional domain.

METHODS

Participants from the Belgian SarcoPhAge cohort were followed from 2013 to the present. Four IC domains were assessed at baseline (data on the sensorial domain were not collected), and considered unsatisfactory below some specific thresholds. The nutritional domain was considered unsatisfactory if baseline malnutrition was present, defined by: 1) MNA-SF ≤11 points; 2) seven versions of the GLIM criteria, varying by the technique used to identify a reduced muscle mass; or 3) the combination of MNA-SF ≤11 points + GLIM criteria. The association between baseline unsatisfactory IC and 9-year mortality was calculated using the odds ratio (OR) adjusted for cofounders.

RESULTS

Among the 534 participants (73.5 ± 6.2 years old; 60.3 % women at baseline), 157 (29.4 %) were dead after 9.3 ± 0.3 years of follow-up. Patients with baseline unsatisfactory IC in the locomotor domain (adjusted OR = 2.31 [95%CI 1.38-3.86]) or psychological domain (adjusted OR = 1.78 [1.12-2.83]) were at higher mortality risk. Regarding malnutrition, unsatisfactory IC in the nutrition domain was strongly associated with a higher mortality risk, whatever the criteria used to identify a reduced muscle mass. The highest association with mortality was found in participants with a baseline unsatisfactory nutritional domain defined by the combination of MNA-SF + GLIM criteria (adjusted OR = 3.27 [95%CI 1.72-6.23]).

CONCLUSIONS

Presenting any unsatisfactory IC at baseline was associated with a higher 9-year mortality risk in community-dwelling older people. The sequential incorporation of MNA-SF and GLIM criteria as the IC nutritional domain would be helpful to guide public health actions towards healthy ageing.

Frailty in relation to the risk of carotid atherosclerosis and cardiovascular events in Chinese community-dwelling older adults: A five-year prospective cohort study

OBJECTIVE

To investigate the frailty, as estimated by accumulated health deficits, in association with the symptomatic carotid atherosclerosis and in relation to five-year cardiovascular (CVD) outcomes.

METHODS

This is a five-year prospective cohort study. Secondary analysis of data from the Beijing Longitudinal Study on Aging. Community-dwelling people aged 55+ years (n = 1257) have been followed between 2009 and 2014, and having carotid ultrasonography examinations with no CVD events at baseline. Frailty was quantified using the deficit accumulation-based frailty index (FI), constructed from 37 health deficits assessed at baseline. The association between the degree of frailty and carotid atherosclerosis was examined using odds ratios (OR) with multivariate logistic regression analyses. Effects of frailty on the probability of five-year cardiovascular events and mortality were evaluated using Cox proportional hazard ratios (HR). The analyses were adjusted for demographics, baseline carotid atherosclerosis status, and CVD risk factors.

RESULTS

The FI showed characteristic properties and was independently associated with the major carotid atherosclerosis symptoms, including carotid artery intima-media thickening (the most frail vs. the least frail: OR = 4.39: 1.98-7.82), carotid plaque (OR = 3.41: 1.28-6.54), and carotid plaque stability (OR = 1.19, 95 % CI: 1.01-3.59). Compared with the least frail, the most frail individuals were more likely to develop a cardiovascular event in five years, including myocardial infarction (HR = 3.38, 95 % CI = 1.84-6.19), stroke (HR = 1.26, 95 % CI = 1.00-5.87), CVD death (HR = 6.33, 95 % CI = 1.69-11.02), and all-cause death (HR = 5.95, 95 % CI = 2.74-8.95).

CONCLUSION

Deficit accumulation was closely associated with carotid atherosclerosis risks and strongly predicted five-year CVD events. The frailty index can be used to help identify older adults at high risks of CVD for improved preventive healthcare.

Comparison of traditional vs. lighter load strength training on fat-free mass, strength, power and affective responses in middle and older-aged adults: A pilot randomized trial

OBJECTIVES

Strength training is widely recommended to improve strength, muscle mass and power. However, the feasibility and potential efficacy of strength training using lighter loads near failure on these outcomes in middle and older-aged adults remains unclear.

METHODS

23 community-living adults were randomized into two groups: Traditional strength training (ST) (8-12 repetitions) or a lighter load, higher repetitions (LLHR) (20-24 repetitions) group. Participants performed a full-body workout (twice a week) with 8 exercises at a perceived exertion of 7-8 (0-10 scale) for 10 weeks. Post-testing was performed by an assessor blinded to group assignments. An analysis of covariance (ANCOVA) was used to examine between group differences using baseline values as a covariate.

RESULTS

The study involved individuals with a mean age of 59 years, of which 61 % were women. The LLHR group demonstrated a high attendance rate of 92 % (9.5 %) and reported leg press exercise RPE of 7.1 (0.53), along with a session feeling scale of 2.0 (1.7). There was a trivial difference in fat free mass (FFM) favoring LLHR vs ST [0.27 kg 95 % CI (-0.87, 1.42)]. The ST group exhibited superior increases in leg press 1 repetition maximum (1RM) strength [-14 kg (-23, -5)], while the LLHR group showed greater strength endurance increases (65 % 1RM) [8 repetitions (2, 14)]. Leg press power [41 W (-42, 124)] and exercise efficacy [-3.8 (-21.2, 13.5)] demonstrated trivial between-group differences.

CONCLUSION

A pragmatic, full-body strength training program with lighter loads taken close to failure appears to be a viable option for promoting muscular adaptations in middle- and older-aged adults. These results are exploratory and require a larger trial for confirmation.

Health Support for At-Risk Older Adults during COVID-19

Older adults are highly susceptible to COVID-19 infection and at the highest risk for severe disease and death. Yet, older adults lacked access to accurate and easy-to-use COVID-19 information and support early in the pandemic. This prospective, experimental cohort study sought to examine whether older adults could be engaged during the pandemic through a community partner and if a low-touch intervention, designed with health literacy best practices, could positively impact COVID-19 knowledge, mitigation behaviors, telehealth/doctor visits, exercise, and loneliness. A senior resource kit was distributed to older adults sheltering at home through food assistance program agents from October 2020 to February 2021; the kit was developed using health literacy best practices. Simple random assignment was used to divide program participants into treatment and control groups. Both groups received senior kits, but the treatment group also received telephonic health coaching. The primary outcome was COVID-19 knowledge and mitigation behaviors as derived from self-reported surveys at baseline and after four months. Secondary outcomes included a telehealth or doctor visit, exercise frequency, and a loneliness score (3-Item Loneliness Scale). Health literacy was assessed using the BRIEF screening tool. Ninety-eight older adults consented to participate in the study and 87 completed the study (88.7% completion rate). Participants had moderate clinical risk, one-third preferred the Spanish language, and 52% were categorized as having inadequate or marginal health literacy. Significant changes were found for increasing COVID-19 mitigation behaviors and the frequency of exercise across the cohort, but not for COVID-19 knowledge, telehealth visits, or decreasing loneliness. Conclusions: Partnering with a trusted entity in the community is a feasible and important strategy to reach older adults during a lockdown and provide them with easy-to-read health information and resources. If the time horizon had been longer, improvements in other outcome variables may have been achieved.

Effects of cognitive stimulation therapy on patients with dementia: An umbrella review of systematic reviews and meta-analyses

BACKGROUND

Dementia is characterized by significant cognitive decline that results in disturbance of daily activities. Increasing number of meta-analyses has examined the efficacy of cognitive stimulation therapy (CST) for dementia. However, there is a lack of comprehensive reports that specifically discuss the strength of evidence to support CST for dementia.

PURPOSE

This study aimed to summarize evidence regarding the efficacy of CST on people with dementia.

DESIGN

Umbrella review of systematic reviews and meta-analyses.

METHODS

We searched Cochrane Library, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, China Biology Medicine disc (CBMdisc), and VIP databases from inception to December 31, 2022. The methodological quality of the identified studies was assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). Studies scoring 9-12 (moderate quality) points or higher were further analyzed using Grades of Recommendations Assessment, Development and Evaluation (GRADE) principles.

RESULTS

A total of 14 systematic reviews and meta-analyses were included in the umbrella review. The methodological quality of most included reviews was rated as moderate according to AMSTAR 2 rating system. In these studies, we summarized the characteristics of the content, providers, frequency, period and setting of CST, and examined eight health outcomes related to CST, including cognition, depression, behavioral symptoms, quality of life (QoL), activities of daily living (ADL), language and communication, anxiety, and memory. Eleven studies with low to high rating of overall confidence (OC) consistently reported that CST could significantly improve cognition of people with dementia, including high-quality supporting evidence. However, the effect of CST on other health outcomes for people with dementia (e.g., depression, behavioral symptoms, QoL, ADL) is inconsistent, with low- to moderate-quality evidence ratings. Compared with the above results, few studies have reported the effects of CST on communication, anxiety, and memory for people with dementia.

CONCLUSIONS

In the future, the design and reporting of systematic reviews and meta-analyses should incorporate high-quality research metrics in accordance with AMSTAR 2 criteria. The current review supports CST as an effective treatment for improving cognitive function in patients with dementia. Multi-component interventions are more effective than single-component interventions and need to be delivered regularly.

REGISTRATION

The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42022364259).

Domain-specific physical activity, sedentary behavior, subjective health, and health-related quality of life among older adults

PURPOSE

This study aims to investigate the association between domain-specific physical activity (PA), sedentary behavior, subjective health perception, and health-related quality of life (HR-QoL) in Korean adults aged ≥ 65 years.

METHODS

This cross-sectional study analyzed 6,004 older adults from the Korean National Health and Nutrition Examination Survey 2017-2020. PA and sedentary behavior were measured using a global PA questionnaire, and HR-QoL was assessed using the EuroQol-5 Dimension (EQ-5D, three-level version). Multiple logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) after adjusting for confounding parameters.

RESULTS

Older adults who were physically active at work showed a negative association with subjectively good health and HR-QoL, whereas those physically active in transport or leisure time showed a positive association with subjectively good health and HR-QoL. Older adults highly engaged in sedentary behavior showed a worse perception of health and HR-QoL. Compared to high sedentary behavior and physical activity during leisure time or transport, the EQ-5D index was higher than that of their counterparts.

CONCLUSION

Both domain-specific PA and sedentary behavior were significantly associated with older adults' perception of health and HR-QoL. Interventions are needed to improve HR-QoL by reducing sedentary behavior and encouraging physical activity in transportation or leisure time among adults aged 65 years and above.

"Geriatric Proximity" Intervention in COVID-19 Context: Contribution to Reducing Loneliness and Improving Affectivity

(1) Background: The pandemic context has limited the social and family contacts of institutionalized older adults, and intervention is urgently needed. The aim of this study is to assess the impact of the implementation of a "Geriatric Proximity" intervention on the functioning, satisfaction with social support, affective experience, and feelings of loneliness of institutionalized older adults in the times of the pandemic. (2) Methods: This is a pilot study. An experimental group (subject to the "Geriatric Proximity" intervention) and a control group were constituted. Four assessment instruments were applied to both groups: the satisfaction with social support scale; the elderly nursing core set; the positive and negative affect schedule; and the UCLA loneliness scale. (3) Results: The control group shows no differences between the three measurement instants, while the experimental group shows between first and third measurements (all p < 0.05). We observed a reduction in the scores of loneliness scale, negative affect, and cognition functioning and an increase in satisfaction with social support and positive affect. (4) Conclusions: The intervention "Geriatric Proximity" showed a positive contribution by decreasing loneliness and increasing affectivity, satisfaction with social support, and cognitive function during the pandemic period.

Predictors of Health Satisfaction in Spanish Physically Active Older Adults: A Cross-Sectional Observational Study

Studies that analyze the predictors of satisfaction with the health of the elderly are scarce. That is the reason why the objective of this study is to analyze whether the physical-psychological state, sports practice, and the use of socio-health resources are factors that predict satisfaction with health status in physically active elderly people. The Physical Activity and Quality of Life questionnaires were applied to a sample of 397 elderly people in this cross-sectional observational study. The data have been analyzed using Student's t-test chi-square test, Cohen's d, Phi Coefficient and Cramer's V. The results have shown that the lack of physical illnesses (OR = 3.920; p < 0.001) and psychological problems (OR = 1.940; p = 0.032), practicing a high level of physical activity (OR = 2.049; p = 0.001), having high scores in functional skills (OR = 8.059; p < 0.001) and using little social and health services (OR = 2.595; p < 0.001) are all predictors of being highly satisfied with one's health. In conclusion, predictors associated with high health satisfaction of active older people have been found, such as functional abilities, the existence of physical illness, psychological problems, level of physical activity, frequency of use of health and social services and satisfaction with health and social services; but it is not associated with gender or age of participants.

Dyadic Conversation between Mandarin-Chinese-Speaking Healthy Older Adults: From Analyses of Conversation Turns and Speaking Roles

Older adults' daily conversations with other older adults enable them to connect to their surrounding communities and improve their friendships. However, typical aging processes and fluctuations in family caring might cause conversation changes. The purpose of this study was to explore the quantitative contributions of conversation turns (CTs) and speaking roles (SRs) in Mandarin-Chinese-speaking conversation dyads between mutually familiar healthy older adults (HOAs). A total of 20 HOAs aged 65 or over were recruited. Each dyad conversed for ten minutes once a week for five weeks, five sessions per dyad, for a total of 50 sessions. The frequency and percentages of the coded CTs and SRs contributed by each HOA were individually tallied and calculated. Quantitatively symmetrical contributions of CTs and SRs occurred in Mandarin-Chinese-speaking conversation dyads between mutually familiar HOAs. Although typical aging processes might change conversations, both Mandarin-Chinese-speaking HOAs serve as active interlocutors to each other in taking CTs and SRs to co-construct their conversation processes and content in their dyadic conversation. Sufficient knowledge of conversation co-constructions might lead them to have more supportive environments to connect to surrounding communities and improve their friendships.

Association between Dietary Zinc Intake, Serum Zinc Level and Multiple Comorbidities in Older Adults

Zinc is one of the essential micronutrients in the geriatric population, but the importance of zinc status and dietary zinc intake has been poorly characterized. We aimed to explore the relationships among dietary zinc intake, serum zinc concentrations and multimorbidity in a cross-sectional study of 300 employees of Electric Generating Authority of Thailand aged ≥ 60 years. Comprehensive questionnaires were completed, and clinical and laboratory assessments were performed. Factors associated with low serum zinc concentrations were identified using multivariate multinomial logistic regression analyses. The mean serum zinc level was 80.5 (12.8) µg/dL. After adjustment for baseline characteristics, being female and having been in education for ≤12 years were independent risk factors for the lowest tertile (T1) of serum zinc. After additional adjustment for clinical and biochemical parameters, there was a significant association between depression (Thai Geriatric Depression Scale-15 score > 5) and low serum zinc levels (T1 vs. T3, odds ratio (OR): 2.24; 95% confidence interval (CI): 1.06−4.77). Furthermore, as serum albumin increased, serum zinc concentration substantially increased (T1 vs. T3, OR: 0.01; 95% CI: 0.002−0.070). Therefore, the early detection of risk factors and the further management of depression and low serum albumin may assist physicians in preventing low serum concentrations.

Active Leisure Time Predicts Happiness among Iranian Adults: A Study Comparing Adults with Physically Active versus Inactive Lifestyle

Physical activity (PA) has been shown to have positive effects on mental well‐being. However, previous research has mostly concentrated on the negative effects of inactivity on mental well‐being and examined the use of PA as a preventive or therapeutic treatment for mental disorders, rather than a proactive method of enhancing mental well‐being. Therefore, there is a need to consider the connection between PA and enhanced mental well‐being, such as happiness. The current study sought to examine the levels of happiness among active and inactive adults. The study’s participants were Iranian adults between 18 and 60 years. Data were gathered using a modified version of the 29‐item Oxford 2002 Happiness Questionnaire and a researcher‐developed leisure and PA questionnaire. N = 541 individuals completed the online survey, including n = 373 (68.9%) women and n = 168 (31.1%) men. More than half of Iranians (55.1%) reported low or moderate levels of happiness, and that those who engaged in active leisure pursuits reported significantly higher levels of happiness than those who were inactive during leisure time. The results of this cross‐sectional study suggest that engaging in PA during leisure time predicts happiness. Encouraging Iranian adults to be more physically active during leisure time could increase happiness levels and thus contribute to the sustainable happiness and well‐being of society.

Association of Co-Living and Age on the Type of Sports Practiced by Older People

Introdution: The environment and the type of co-living of older people are crucial to understanding how the nature of their context influences a healthy lifestyle. However, no studies have investigated to what extent their type of co-living may be associated with the sports and the profile practice according to their age. Objective: This study aimed to assess the association between the types of co-living and the age of the physically active elderly and the sports they practice. Hypothesis: It is thought that the age, situation, and satisfaction with the way of living in physically active older people differ according to the type of sport they practice. Methods: Cross-sectional study. We included 358 individuals aged between 61 and 93 years old (M = 69.66, SD = 4.74). Type of co-living was classified as living alone or living with others. The sports activities evaluated were: gym, dance, water activities, and yoga/pilates. Differences in the type of co-living and sports practiced were evaluated by ANOVA or Chi2. Results: Among the elderly who practice gymnastics, most of them live alone and in a tight core (p < 0.001) (Phi = 0.244). Furthermore, those who practice aquatic activities are more frequently the youngest (p < 0.001) (Phi = 0.198). Conclusion: Older people who do gymnastics have smaller living groups, those under 69 opt for gymnastics and aquatic activities, while those aged 70 and over prefer dance, yoga, and pilates.

Healthy Lifestyle Behavior, Goal Setting, and Personality among Older Adults: A Synthesis of Literature Reviews and Interviews

BACKGROUND

Despite the well-known health benefits of adopting a healthy lifestyle, older adults' self-determination, goals, and motivation, as well as other personality factors, are known to influence their healthy lifestyle behaviors, yet these interactions have rarely been discussed.

METHOD

The literature that investigated and discussed the interaction of personality, goals, and healthy lifestyle behaviors among older adults was reviewed. In addition, interview responses from older adults regarding their experiences in participating in a real-life physical activity intervention and its relationship with their personality traits and goal setting were synthesized using content analysis.

RESULTS

The current review highlights the relationship between healthy living practices, goal setting, and personalities, and it is backed up and expanded upon by interviews with participants. People with different personality types are likely to have diverse views on HLBs. Individuals who are more conscientiousness or extraverted are more likely to adopt HLBs than those who are not.

DISCUSSION

It is suggested that a meta-analysis should be conducted on the relationship between personality, goal setting, and physical exercise or other specific HLBs. In addition, future research should focus on various types of HLB therapies that take into account personality and goal setting.