Environmental factors that impact the eating behavior of home-living older adults

Abstract Objectives It is unclear how home environmental factors influence relocation decisions. We examined whether indoor accessibility, entrance accessibility, bathroom safety features, housing type, and housing condition were associated with relocations either within the community or to residential care facilities. Methods We used prospective data over 4 years from the nationally representative National Health and Aging Trends Study in the United States of Medicare beneficiaries 65 years and older living in the community (N = 7,197). We used multinomial regression analysis with survey weights. Results Over the 4 years, 8.2% of the population moved within the community, and 3.9% moved to residential care facilities. After adjusting for demographics and health factors, poor indoor accessibility was found to be associated with moves within the community but not to residential care facilities. No additional home environmental factors were associated with relocation. Discussion One-floor dwellings, access to a lift, or having a kitchen, bedroom, and bathroom on the same floor may help older adults age in place. Understanding which modifiable home environmental factors trigger late-life relocation, and to where, has practical implications for developing policies and programs to help older adults age in their place of choice.

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Predictors of Physical Activity Levels in Community-Dwelling Older Adults: A Multivariate Approach Based on a Socio-Ecological Framework

Journal of Aging and Physical Activity ◽

10.1123/japa.2016-0286 ◽

2018 ◽

Vol 26 (1) ◽

pp. 114-120 ◽

Cited By ~ 6

Author(s):

Koren L. Fisher ◽

Elizabeth L. Harrison ◽

Brenda G. Bruner ◽

Joshua A. Lawson ◽

Bruce A. Reeder ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Environmental Factors ◽

The Elderly ◽

Home Care Services ◽

Community Dwelling ◽

Nursing Home Care ◽

Activity Levels ◽

Inverse Association ◽

Cross Sectional

The purpose of this study was to explore cross-sectional relationships between self-reported physical activity (PA) and personal, social, and environmental factors in community-dwelling adults aged 50 years and older. Accounting for clustering by neighborhood, generalized estimating equations were used to examine associations between selected correlates and the Physical Activity Scale for the Elderly (PASE) score while adjusting for confounders. Data for 601 participants were analyzed: 79% female, 37% married, mean age 76.8 (± 8.7) years, mean PASE score 112.6 (± 64.8). Age, living in seniors’ housing, using nursing/home care services, receiving encouragement to be active, and having benches available in the neighborhood were inversely associated with PASE. Self-efficacy, SF-12 score, PA barriers, social support, and the presence of trails showed positive associations. Several personal, social, and environmental factors associated with PA were identified. The inverse association between PA and living in seniors’ housing units should be considered when developing PA programs for older adults.

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Use and effect of web-based embodied conversational agents for improving eating behavior and decreasing loneliness among community-dwelling older adults: A randomized controlled trial (Preprint)

10.2196/preprints.33974 ◽

2021 ◽

Author(s):

Lean L. Kramer ◽

Lex van Velsen ◽

Jenna L. Clark ◽

Bob C. Mulder ◽

Emely de Vet

Keyword(s):

Older Adults ◽

Randomized Controlled Trial ◽

Eating Behavior ◽

Controlled Trial ◽

Community Dwelling ◽

Embodied Conversational Agents ◽

Conversational Agents ◽

Web Based ◽

Randomized Controlled ◽

Community Dwelling Older Adults

BACKGROUND Embodied conversational agents (ECAs) have been proposed as a promising interaction modality for the delivery of programs focused on promoting lifestyle changes. However, it is not understood which factors influence use of an ECA and their health effects. OBJECTIVE We aim to (1) identify whether ECAs can persuade community-dwelling older adults to change their dietary behavior and whether ECAs use can decrease loneliness, (2) test these pathways to effects, and (3) understand the use of an ECA. METHODS The web-based eHealth app PACO is a fully automated 8-week intervention in which 2 ECAs engage older adults in dialogue to motivate them to change their dietary behavior and decrease their loneliness. PACO was developed via a human-centered and stakeholder-inclusive design approach and incorporates Self-determination Theory and various behavior change techniques For this study, an unblinded web-based randomized controlled trial was conducted. Participants were recruited via social media, an online panel, flyers and advertorials. The intervention group received access to the PACO service for eight weeks. The waitlist group received PACO after waiting for four weeks. The primary outcomes, eating behavior and loneliness, were assessed via self-assesed online questionnaires at intake, waitlist, after 4 weeks, and after eight weeks. In addition, the primary outcome—use—was assessed via data logs. Secondary outcomes were measured at the same times, via questionnaires or an optional interview. RESULTS In total, 32 participants completed the intervention. We found a significant correlation between use in minutes on the one hand, and perceived usefulness (r = .39, P =.030) and enjoyment on the other (r = .38, P = .032). However, these did not predict use in the full regression model (F(2,29) = 1.98, P = .16, R2 = .12). Additionally, PACO use did not lead to improvements in eating behavior (χ2(2) = .34, = .85) or a decrease in loneliness (χ2(2) = .02, = .99). CONCLUSIONS Our study did not provide any concluding evidence about factors that are linked to the use or health effects of ECAs. Future service design could benefit from either creating a functional design catered towards the predominant stage of the targeted population, or by personalizing the service based on an intake in which the end-user’s stage is determined. CLINICALTRIAL ClinicalTrials.gov NCT04510883; https://clinicaltrials.gov/ct2/show/NCT04510883 INTERNATIONAL REGISTERED REPORT RR2-10.2196/22186

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Barriers and Motivators of Bicycling by Gender Among Older Adult Bicyclists in the Midwest

Health Education & Behavior ◽

10.1177/1090198119879731 ◽

2019 ◽

Vol 47 (1) ◽

pp. 67-77 ◽

Cited By ~ 1

Author(s):

Amanda Grimes ◽

Matthew Chrisman ◽

Joseph Lightner

Keyword(s):

Older Adults ◽

Environmental Factors ◽

Online Survey ◽

Ecological Model ◽

The United States ◽

Environmental Barriers ◽

Cross Sectional ◽

The Social ◽

Personal Level ◽

Barriers And Motivators

Introduction. Physical activity (PA), particularly low-impact activities like bicycling, can improve health in older adults. However, bicycling rates are lower in the Midwest than other regions in the United States. Therefore, it is important to identify unique social, personal, and environmental factors that inhibit or promote bicycling, and how these are associated with PA. The influences of these factors were explored using the social ecological model. Method. A cross-sectional online survey was developed using previously validated local and national bicycling questionnaires, then distributed to Midwestern bicyclists 50 years and older. Exploratory factor analysis was conducted to understand the influences of social, personal, and environmental barriers and promoters on bicycling patterns. All models were conducted separately by gender, and accounted for age, race, education, marital status, income, and employment. Results. Social promoters (B = 0.386, p = .002), such as having friends/family that bicycle were associated with greater PA. Personal promoters (B = −0.311, p = .006) such as needing to lose weight were associated with reduced PA. Environmental factors had no associations with PA. However, individual environmental components, such as number of vehicles on the roads, were significantly associated with PA for both males and females. Females reported more barriers than males. The overall model accounted for 16.1% of the total variance in PA levels. Conclusion. Interventions to promote PA via bicycling in older adults should focus on social factors, while also reducing personal-level factors for males. Interventions for females could focus on reducing specific personal, social, and environmental barriers.

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When Culture Influences Genes: Positive Age Beliefs Amplify the Cognitive-Aging Benefit of APOE ε2

The Journals of Gerontology Series B ◽

10.1093/geronb/gbaa126 ◽

2020 ◽

Vol 75 (8) ◽

pp. e198-e203

Author(s):

Becca R Levy ◽

Martin D Slade ◽

Robert H Pietrzak ◽

Luigi Ferrucci

Keyword(s):

Risk Factors ◽

Older Adults ◽

Cognitive Function ◽

Environmental Factors ◽

Cognitive Aging ◽

Self Perceptions ◽

Cognitive Benefit ◽

Study Participants ◽

The Impact ◽

Retirement Study

Abstract Objectives Most studies of aging cognition have focused on risk factors for worse performance and on either genetic or environmental factors. In contrast, we examined whether 2 factors known to individually benefit aging cognition may interact to produce better cognition: environment-based positive age beliefs and the APOE ε2 gene. Method The sample consisted of 3,895 Health and Retirement Study participants who were 60 years or older at baseline and completed as many as 5 assessments of cognition over 8 years. Results As predicted, positive age beliefs amplified the cognitive benefit of APOE ε2. In contrast, negative age beliefs suppressed the cognitive benefit of APOE ε2. We also found that positive age beliefs contributed nearly 15 times more than APOE ε2 to better cognition. Discussion This study provides the first known evidence that self-perceptions can influence the impact of a gene on cognition. The results underscore the importance of combined psychosocial and biological approaches to understanding cognitive function in older adults.

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Associations between individual factors, environmental factors, and outdoor independence in older adults

European Journal of Ageing ◽

10.1007/s10433-020-00553-y ◽

2020 ◽

Vol 17 (3) ◽

pp. 291-298

Author(s):

Barbara Schehl ◽

Joerg Leukel

Keyword(s):

Older Adults ◽

Environmental Factors ◽

Individual Factors

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Bathing and toileting difficulties of older adults in rural China: the role of environment

BMC Geriatrics ◽

10.1186/s12877-020-01919-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Changxi Liu ◽

Joelle H. Fong ◽

Jasmon W. T. Hoh ◽

Hailin Wu ◽

Yunsheng Dong ◽

...

Keyword(s):

Older Adults ◽

Environmental Factors ◽

Functional Disability ◽

Rural China ◽

Geographic Location ◽

Northern China ◽

Public Facilities ◽

Functional Capabilities ◽

The Disabled

Abstract Background For older adults, difficulties in bathing and toileting are often the most prevalent in the index of Activities of daily living (ADL). This study aims to examine how environmental factors are associated with difficulty of bathing and toileting among older adults in rural China. Method The data are from the 2014 Thousand-Village Survey (TVS), a national survey of Chinese rural residents of old age. The sample consists of 10,689 subjects, 55 years or older, from 536 villages across all provinces of China. Logistic regressions were applied to examine how difficulty of bathing and toileting was related to environmental factors such as geographic location, neighbourhood amenity, and related facilities of bathing and toileting. Results Older adults living in the Southern regions of China had lesser difficulty in bathing and toileting than those living in Northern China, controlling for other confounders. Better neighbourhood conditions also reduced the likelihood of having such disabilities. Persons who bathed indoors without showering facilities, in public facilities, and outdoors were significantly more likely to have bathing disability than those who showered indoors with facility. Rural older adults who used pedestal pans and indoor buckets for toileting were more likely to have toileting disability than those who used indoor squatting facilities. Conclusion Environmental barriers were associated with functional disability among older adults in rural China, but the disabled individuals may change their environments to adapt to their functional capabilities. Our findings suggest that it is imperative to promote the use of showering facilities and pedestal pans for toileting in rural China.

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Using Walk-Along Interviews to Identify Environmental Factors Influencing Older Adults’ Out-of-Home Behaviors in a High-Rise, High-Density Neighborhood

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16214251 ◽

2019 ◽

Vol 16 (21) ◽

pp. 4251 ◽

Cited By ~ 1

Author(s):

Yuxin Cao ◽

Chye Kiang Heng ◽

John Chye Fung

Keyword(s):

Older Adults ◽

Environmental Factors ◽

Traffic Safety ◽

Social Contact ◽

High Density ◽

Physical Factors ◽

Safety Behavior ◽

High Rise ◽

Road Users ◽

Pedestrian Infrastructure

Older adults’ out-of-home behaviors (OOHBs) are critical for maintaining health and quality of life. Taking Singapore’s Yuhua East as a case, this study applied a qualitative approach to explore what neighborhood environmental factors influence older adults’ OOHBs. Twelve older adults were recruited for walk-along interviews through the use of purposeful convenience sampling. A content analysis was conducted using NVivo 11 via an inductive approach. Research results revealed 12 categories of environmental factors that affected older adults’ OOHBs: access to facilities (shops and services, public transit, and connectivity), pedestrian infrastructure (sidewalk quality, sheltered walkways, universal design, crossings, benches, and public toilets), aesthetics (natural elements, buildings, noise, and cleanliness), traffic safety (behavior of other road users and road width), safety from crime, wayfinding, familiarity (long-term residency and routine activities), weather, social contact, high-rise, high-density (lifts, population density, flat size, and privacy), affordability (shops and services, as well as transportation), and maintenance and upgrading. This analysis concluded that access to facilities and pedestrian infrastructure are important for older adults’ OOHBs. Considering Singapore’s weather, sheltered walkways, the proximity of facilities and connectivity should be given serious emphasis. In addition to physical factors, social contacts and the affordability of shops and services are also important.

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