Association between social class and cognitive health outcomes in older adults: Systematic review and meta‐analysis of longitudinal studies

The widespread adoption of digital health technologies such as smartphone-based mobile applications, wearable activity trackers and Internet of Things systems has rapidly enabled new opportunities for predictive health monitoring. Leveraging digital health tools to track parameters relevant to human health is particularly important for the older segments of the population as old age is associated with multimorbidity and higher care needs. In order to assess the potential of these digital health technologies to improve health outcomes, it is paramount to investigate which digitally measurable parameters can effectively improve health outcomes among the elderly population. Currently, there is a lack of systematic evidence on this topic due to the inherent heterogeneity of the digital health domain and the lack of clinical validation of both novel prototypes and marketed devices. For this reason, the aim of the current study is to synthesize and systematically analyse which digitally measurable data may be effectively collected through digital health devices to improve health outcomes for older people. Using a modified PICO process and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework, we provide the results of a systematic review and subsequent meta-analysis of digitally measurable predictors of morbidity, hospitalization, and mortality among older adults aged 65 or older. These findings can inform both technology developers and clinicians involved in the design, development and clinical implementation of digital health technologies for elderly citizens.

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The Impact of Protein Supplementation on Appetite and Energy Intake in Healthy Older Adults: A Systematic Review with Meta-Analysis

Advances in Nutrition ◽

10.1093/advances/nmaa115 ◽

2020 ◽

Author(s):

Sana Ben-Harchache ◽

Helen M Roche ◽

Clare A Corish ◽

Katy M Horner

Keyword(s):

Systematic Review ◽

Older Adults ◽

Longitudinal Studies ◽

Energy Intake ◽

Energy Content ◽

Meta Analysis ◽

Protein Supplementation ◽

Cochrane Library ◽

Healthy Older Adults ◽

The Impact

ABSTRACT Protein supplementation is an attractive strategy to prevent loss of muscle mass in older adults. However, it could be counterproductive due to adverse effects on appetite. This systematic review and meta-analysis aimed to determine the effects of protein supplementation on appetite and/or energy intake (EI) in healthy older adults. MEDLINE, The Cochrane Library, CINAHL, and Web of Science were searched up to June 2020. Acute and longitudinal studies in healthy adults ≥60 y of age that reported effects of protein supplementation (through supplements or whole foods) compared with control and/or preintervention (for longitudinal studies) on appetite ratings, appetite-related peptides, and/or EI were included. Random-effects model meta-analysis was performed on EI, with other outcomes qualitatively reviewed. Twenty-two studies (9 acute, 13 longitudinal) were included, involving 857 participants (331 males, 526 females). In acute studies (n = 8), appetite ratings were suppressed in 7 out of 24 protein arms. For acute studies reporting EI (n = 7, n = 22 protein arms), test meal EI was reduced following protein preload compared with control [mean difference (MD): −164 kJ; 95% CI: −299, −29 kJ; P = 0.02]. However, when energy content of the supplement was accounted for, total EI was greater with protein compared with control (MD: 649 kJ; 95% CI: 438, 861 kJ; P < 0.00001). Longitudinal studies (n = 12 protein arms) showed a higher protein intake (MD: 0.29 g ⋅ kg−1 ⋅ d−1; 95% CI: 0.14, 0.45 g ⋅ kg−1 ⋅ d−1; P < 0.001) and no difference in daily EI between protein and control groups at the end of trials (MD: −54 kJ/d; 95% CI: −300, 193 kJ/d; P = 0.67). While appetite ratings may be suppressed with acute protein supplementation, there is either a positive effect or no effect on total EI in acute and longitudinal studies, respectively. Therefore, protein supplementation may represent an effective solution to increase protein intakes in healthy older adults without compromising EI through appetite suppression. This trial was registered at PROSPERO as https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019125771 (CRD42019125771).

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A systematic review and meta-analysis of interventions to reduce sedentary behavior among older adults

Translational Behavioral Medicine ◽

10.1093/tbm/ibz189 ◽

2020 ◽

Vol 10 (5) ◽

pp. 1078-1085

Author(s):

Jo-Ana D Chase ◽

Jennifer Otmanowski ◽

Sheri Rowland ◽

Pamela S Cooper

Keyword(s):

Public Health ◽

Systematic Review ◽

Older Adults ◽

Health Outcomes ◽

Sedentary Behavior ◽

Sedentary Time ◽

Meta Analysis ◽

The United States ◽

Future Research ◽

Intervention Effects

Abstract Sedentary behavior (SB) is associated with numerous negative health outcomes, independent of physical activity behavior. Older adults are the most sedentary population in the United States. Understanding the effects and characteristics of existing interventions to reduce SB can inform practice, future research, and public health initiatives to improve older adults’ health. We conducted a systematic review and meta-analysis to examine existing SB intervention research among older adults and quantitatively synthesize intervention effects. Comprehensive searches were conducted to identify studies testing interventions to reduce SB time among adults at least 60 years old. Data on study design, intervention content and delivery, and participant characteristics were extracted from eligible studies. Standardized mean difference effect sizes (Cohen’s d) were synthesized using a random-effects model for two-group pretest–posttest design studies. Twenty-two reports describing 17 distinct studies were included in the narrative synthesis, with eight studies included in the meta-analysis (k = 8; n = 1,024). Most interventions were theory-driven and employed multiple strategies, including education, self-monitoring, and goal setting. Although SB interventions significantly reduced total sedentary time, the overall effect was small (d = −0.25, 95% confidence interval [−0.50, 0.00], p = .05). Studies were significantly heterogeneous (Q = 22.34, p < .01); however, the small number of comparisons prevented moderator analyses. Practitioners should employ diverse SB-specific strategies to encourage older adults to reduce time spent sedentary. To develop public health programs targeting SB in older adults, future research should include measures of time spent in specific SB and duration/number of breaks in sedentary time and investigate SB intervention effects on health outcomes.

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Impact of the COVID-19 Pandemic on Sedentary Time and Behaviour in Children and Adults: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182111286 ◽

2021 ◽

Vol 18 (21) ◽

pp. 11286

Author(s):

Adam Runacres ◽

Kelly A. Mackintosh ◽

Rachel L. Knight ◽

Liba Sheeran ◽

Rhys Thatcher ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Health Outcomes ◽

Sedentary Time ◽

Global Mental Health ◽

Meta Analysis ◽

Age Groups ◽

Age Group ◽

Behaviour Type

The aim of this meta-analysis was to quantify the change in sedentary time during the COVID-19 pandemic and its effect on health outcomes in the general population. One thousand six hundred and one articles published after 2019 were retrieved from five databases, of which 64 and 40 were included in the systematic review and meta-analysis, respectively. Studies were grouped according to population: children (<18 years), adults (18–64 years) and older adults (>65 years). Average sedentary time was calculated, with sub-analyses performed by country, behaviour type and health outcomes. Children were most affected, increasing their sedentary time by 159.5 ± 142.6 min day−1, followed by adults (+126.9 ± 42.2 min day−1) and older adults (+46.9 ± 22.0 min day−1). There were no sex differences in any age group. Screen time was the only consistently measured behaviour and accounted for 46.8% and 57.2% of total sedentary time in children and adults, respectively. Increases in sedentary time were negatively correlated with global mental health, depression, anxiety and quality of life, irrespective of age. Whilst lockdown negatively affected all age groups, children were more negatively affected than adults or older adults, highlighting this population as a key intervention target. As lockdowns ease worldwide, strategies should be employed to reduce time spent sedentary. Trial registration: PROSPERO (CRD42020208909).

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Combinations of physical activity, sedentary behavior, and sleep and health outcomes in older adults: a systematic review protocol

Revista Brasileira de Atividade Física & Saúde ◽

10.12820/rbafs.26e0198 ◽

2021 ◽

Vol 26 ◽

pp. 1-12

Author(s):

Antonio Henrique Germano-Soares ◽

Ozeas Lima Lins-Filho ◽

Caroline Ramos de Moura Silva ◽

José Francisco Silva ◽

Carla Menêses Hardman ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Older Adults ◽

Health Outcomes ◽

Sedentary Behaviour ◽

Meta Analysis ◽

Experimental Studies ◽

Research Field ◽

Eligibility Criteria ◽

Level Of Evidence

Recent systematic reviews highlighted important relationships between combinations of movement behaviors (ie. sleep, sedentary behaviour, and physical activity) and health outcomes among children and adolescents. However, it is unclear whether similar relationships occur in older adults. Therefore, the purpose of this protocol was to describe the aims and methods for a systematic review to summarize the studies examining the relationships between movement behaviors and health outcomes in older adults. A systematic review will be developed based on searches of articles in seven electronic databases and references of retrieved articles, contact with authors, and study repositories. Eligibility criteria: observational or experimental studies examining the association of at least two movement behaviours (sleep, sedentary behaviour, and physical activity) with health outcomes in older adults (≥60 years old). Selection of the studies and extraction of the data will be carried out by two reviewers independently. Characteristics of the study, participants, methods of combinations, and main results will be extracted and described. Risk of bias and level of evidence in the studies will be assessed according to the study quality tool of the US National Heart, Lung, and Blood Institute and the GRADE guidelines. The data will be synthesized using random effects meta-analysis for results that are sufficiently homogeneous in terms of statistical, clinical, and methodological characteristics. If not, then a narrative synthesis will be conducted. The results of this review may provide insights to improve current guidelines on 24-hour cycle in older adults, as well as guide future studies in this research field.

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