scholarly journals The Association Between Physical Activity, Including Physical Activity Intensity, and Fear of Falling Differs by Fear Severity in Older Adults Living in the Community

2018 ◽  
Vol 75 (5) ◽  
pp. 953-960 ◽  
Author(s):  
Ryuichi Sawa ◽  
Tsuyoshi Asai ◽  
Takehiko Doi ◽  
Shogo Misu ◽  
Shunsuke Murata ◽  
...  

Abstract Objectives Fear of falling (FoF) is common in older adults. Physical activity decreases as FoF increases. However, this association between physical activity and FoF may vary depending on activity intensity. The current study was performed to explore the associations between FoF and step count, light-intensity physical activity (LPA), and moderate/vigorous-intensity physical activity (MVPA) in community-dwelling older adults. Methods This cross-sectional observational study was held at a local community association center, with 242 older adults living independently in the community (mean age: 75.1 ± 5.4 years). FoF was defined using the Falls Efficacy Scale-International and categorized into three levels (low, moderate, and high). Physical activity was measured using a uniaxial accelerometer worn for 7 consecutive days, and by calculating daily step count, LPA, and MVPA, over this period. Results Step count and physical activity intensity showed significant linear trends across FoF severity (p < .01, respectively). High FoF decreased step count by approximately 2,000 steps/day. Further, high FoF was significantly associated with short durations of both LPA and MVPA. In addition, moderate FoF was associated with decreased LPA duration, even after adjustment for confounding variables. Discussion Physical activity decreased concomitantly with a rise in FoF severity. Moreover, the association between physical activity and FoF differed by physical activity intensity level in community-dwelling older adults. Further studies are needed to investigate the causal relationship between FoF and objective physical activity in this population.

Pain Medicine ◽  
2018 ◽  
Vol 20 (9) ◽  
pp. 1702-1710 ◽  
Author(s):  
Keitaro Makino ◽  
Sangyoon Lee ◽  
Sungchul Lee ◽  
Seongryu Bae ◽  
Songee Jung ◽  
...  

Abstract Objective This study examined the association between daily physical activity and functional disability incidence in community-dwelling older adults with chronic pain. Design Prospective cohort study. Setting Japanese community. Subjects Of the 5,257 participants enrolled for baseline assessment, data on the 693 participants who had chronic lower back or knee pain and underwent daily physical activity assessment using an accelerometer were analyzed. Methods Participants were assessed for regular physical activity (step counts, moderate- to vigorous-intensity physical activity duration, and light-intensity physical activity duration) using an accelerometer at baseline and were followed up for monthly functional disability incidence, based on the national long-term care insurance system, for approximately two years. We determined the effect of physical activity cutoff points on functional disability incidence using receiver operating characteristic curves and Youden index. Cox proportional hazards regression models were used to analyze associations between the cutoff points and disability incidence. Results Among the 693 participants with chronic pain, 69 (10.0%) developed functional disability during the follow-up period. Participants with lower physical activity levels showed significantly higher risk of disability. After adjusting for all covariates, functional disability was associated with step counts (hazard ratio [HR] = 1.79, 95% confidence interval [CI] = 1.02–3.14) and moderate- to vigorous-intensity physical activity duration (HR = 2.02, 95% CI = 1.16–3.51) but had no relationship with light-intensity physical activity duration (HR = 1.72, 95% CI = 0.97–3.05). Conclusions Maintenance of physical activity with at least moderate intensity may be effective in preventing disability even among older adults with chronic pain.


2019 ◽  
Vol 27 (5) ◽  
pp. 703-710 ◽  
Author(s):  
Natalie Frost ◽  
Michael Weinborn ◽  
Gilles E. Gignac ◽  
Shaun Markovic ◽  
Stephanie R. Rainey-Smith ◽  
...  

Objectives: To examine the associations between physical activity duration and intensity, cardiorespiratory fitness, and executive function in older adults. Methods: Data from 99 cognitively normal adults (age = 69.10 ± 5.1 years; n = 54 females) were used in the current study. Physical activity (intensity and duration) was measured with the International Physical Activity Questionnaire, and fitness was measured by analysis of maximal aerobic capacity, VO2peak. Executive function was measured comprehensively, including measures of Shifting, Updating, Inhibition, Generativity, and Nonverbal Reasoning. Results: Higher levels of cardiorespiratory fitness were associated with better performance on Generativity (B = .55; 95% confidence interval [.15, .97]). No significant associations were found between self-reported physical activity intensity/duration and executive functions. Discussion: To our knowledge, this study is the first to identify an association between fitness and Generativity. Associations between physical activity duration and intensity and executive function requires further study, using objective physical activity measures and longitudinal observations.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 191-191
Author(s):  
Lorraine Phillips ◽  
Mary Bowen

Abstract Early identification of functional decline in older adults with mild cognitive impairment (MCI) provides the opportunity to initiate behavioral interventions to slow decline. More frequent breaks in sedentary time has been associated with greater lower extremity function. This longitudinal study examined the effect of 6-month change in cognitive function on monthly sedentary time, controlling for lower extremity function, among community-dwelling older adults with MCI. Twenty adults with Montreal Cognitive Assessment Score (MoCA) between 19-25, who were age ≥ 60 years old, and ambulatory, wore an actigraph for 6 months and participated in monthly in-person assessments. Measures included MoCA change (baseline to month 6), Short Physical Performance Battery (SPPB; baseline, months 3 and 6); sedentary time and physical activity intensity; and falls (monthly). The sample was 70% female, 60% non-Hispanic white, with a mean age of 77 years. Sixteen participants provided complete data for mixed-model analysis. Over 6 months, 11 falls occurred among 7 participants. The mean MoCA score declined from 22.7 to 21.9 while SPPB remained stable. Overall time spent in sedentary behavior was high (71%) and physical activity intensity was low (light and moderate combined= 26.1%). Results of multi-level analysis with sedentary time as a continuous Level-1 variable and MoCA change scores, SPPB scores, and age in Level-2 showed that negative change in MoCA (β=-0.11; p≤0.05) was associated with increased sedentary time. Given sedentary time increases as cognitive function declines, older adults with MCI could benefit from interventions designed to interrupt sedentary time as well as increase physical activity.


Author(s):  
Catrine Tudor-Locke ◽  
Jose Mora-Gonzalez ◽  
Scott W. Ducharme ◽  
Elroy J. Aguiar ◽  
John M. Schuna ◽  
...  

Abstract Background Heuristic (i.e., evidence-based, rounded) cadences of ≥100 and ≥ 130 steps/min have consistently corresponded with absolutely-defined moderate (3 metabolic equivalents [METs]) and vigorous (6 METs) physical activity intensity, respectively, in adults 21–60 years of age. There is no consensus regarding similar thresholds in older adults. Purpose To provide heuristic cadence thresholds for 3, 4, 5, and 6 METs in 61–85-year-old adults. Methods Ninety-eight community-dwelling ambulatory and ostensibly healthy older adults (age = 72.6 ± 6.9 years; 49% women) walked on a treadmill for a series of 5-min bouts (beginning at 0.5 mph with 0.5 mph increments) in this laboratory-based cross-sectional study until: 1) transitioning to running, 2) reaching ≥75% of their age-predicted maximum heart rate, or 3) reporting a Borg rating of perceived exertion > 13. Cadence was directly observed and hand-tallied. Intensity (oxygen uptake [VO2] mL/kg/min) was assessed with indirect calorimetry and converted to METs (1 MET = 3.5 mL/kg/min). Cadence thresholds were identified via segmented mixed effects model regression and using Receiver Operating Characteristic (ROC) curves. Final heuristic cadence thresholds represented an analytical compromise based on classification accuracy (sensitivity, specificity, positive and negative predictive value, and overall accuracy). Results Cadences of 103.1 (95% Prediction Interval: 70.0–114.2), 116.4 (105.3–127.4), 129.6 (118.6–140.7), and 142.9 steps/min (131.8–148.4) were identified for 3, 4, 5, and 6 METs, respectively, based on the segmented regression. Comparable values based on ROC analysis were 100.3 (95% Confidence Intervals: 95.7–103.1), 111.5 (106.1–112.9), 116.0 (112.4–120.2), and 128.6 steps/min (128.3–136.4). Heuristic cadence thresholds of 100, 110, and 120 were associated with 3, 4, and 5 METs. Data to inform a threshold for ≥6 METs was limited, as only 6/98 (6.0%) participants achieved this intensity. Conclusions Consistent with previous data collected from 21–40 and 41–60-year-old adults, heuristic cadence thresholds of 100, 110, and 120 steps/min were associated with 3, 4, and 5 METs, respectively, in 61–85-year-old adults. Most older adults tested did not achieve the intensity of ≥6 METs; therefore, our data do not support establishing thresholds corresponding with this intensity level. Trial registration Clinicaltrials.gov NCT02650258. Registered 24 December 2015.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christopher Olusanjo Akosile ◽  
Charles Kenechukwu Igwemmadu ◽  
Emmanuel Chiebuka Okoye ◽  
Adesola Christiana Odole ◽  
Ukamaka Gloria Mgbeojedo ◽  
...  

Abstract Background Physical activity (PA), fear of falling (FOF) and quality of life (QOL) are very important constructs in geriatrics. The interplay among these constructs may vary between community-dwelling and assisted-living older adults. However, studies comparing the wellbeing of community-dwelling older adults with those residing in the assisted-living facilities (ALFs) are rather rare especially from developing countries. This study was aimed at comparing PA, FOF and QOL between assisted-living and community-dwelling older adults and also determining the correlations amongst the constructs for each group. Methods This cross-sectional survey involved consecutively sampled 114 older adults (≥65 years, ambulant and well-oriented in time, place and person) residing in conveniently selected ALFs (11.3% males) and adjoining communities (54.1% males). PA, FOF and QOL were evaluated using the Physical Activity Scale for the Elderly, the Modified Fall Efficacy Scale and the Short-form Health Survey (SF-36) questionnaire respectively. Data was analysed using descriptive statistics, analysis of covariance and Spearman rank-order correlation test at 0.05 level of significance. Results Participants from the ALFs had significantly lower domain and overall PA (F=5.6–103.34; p< 0.05) and QOL (F=11.12–118.05; p< 0,05) scores than community-dwelling groups. FOF was significantly more prevalent in assisted-living group (p< 0.05). There were significant positive correlations (p< 0.05) between each pair of PA, FOF and QOL for both assisted-living and community-dwelling groups. Conclusions Older adults in the ALFs had lower PA and QOL scores with higher prevalence of FOF than their community-dwelling counterparts. Significant relationships existed between PA, FOF and QOL for participants in either group. Present results may be suggesting that ageing in place ensures better health outcomes than institutionalised ageing. Whenever possible, older adults should therefore be encouraged to age in place rather than moving into ALFs.


2021 ◽  
pp. 105477382110339
Author(s):  
Bei Li ◽  
Xiuxiu Huang ◽  
Chenchen Meng ◽  
Qiaoqin Wan ◽  
Yongan Sun

Dementia is prevalent in worldwide, and increases the care burden and potential costs. Physical activity (PA) has been increasingly shown to be beneficial for them. This was a cross-sectional observational study aiming to investigate the status of PA among community-dwelling older adults with dementia in Beijing or Hangzhou, China, and verify the relationships between neuropsychiatric symptoms, activities of daily living (ADL), caregivers’ fear of patients’ falling and their PA using a path analysis approach. The level of PA among 216 included people with dementia was low. PA was related to the neuropsychiatric symptoms, with ADL and caregivers’ fear of patients’ falling have mediation roles. The findings indicated that person-centered strategies related to the management of these symptoms might be helpful to improve ADL, relieve caregivers’ concerns about them falling and consequently foster positive participation in PA.


2021 ◽  
Author(s):  
K Makino ◽  
S Lee ◽  
S Bae ◽  
I Chiba ◽  
K Harada ◽  
...  

Abstract Objective The present study aimed to examine the prospective associations of physical frailty with future falls and fear of falling (FOF) among community-dwelling older adults. Methods A prospective cohort study with a 48-month follow-up was conducted in a Japanese community. Participants were 2469 community-dwelling older adults aged 65 years or older who completed baseline and follow-up assessments at intervals of 48±2 months. Primary outcomes were recent falls (defined as at least one fall within the past year) and FOF (determined by response to “Are you afraid of falling?”) at follow-up survey. Physical frailty, operationalized by the frailty phenotype (slowness, weakness, exhaustion, weight loss, and low activity) based on the criteria of the Japanese version of the Cardiovascular Health Study (J-CHS), was also assessed as a predictor of future falls and FOF. Results Multivariate logistic regression showed that pre-frailty or frailty increase the risk of not only future falls (OR: 1.57; 95%CI = 1.20-2.05) but also FOF (OR: 1.33; 95%CI = 1.05-1.69). In addition, the relationship between baseline frailty status and future falls remained significant after adjusting for baseline FOF (OR: 1.55; 95%CI = 1.19-2.02), and the relationship between baseline frailty status and future FOF also remained significant after adjusting for baseline falls (OR: 1.32; 95%CI = 1.04-1.68). Conclusions Frailty status may predict future falls and FOF among community-dwelling older adults. Strategies to prevent frailty may be beneficial to prevent not only future falls but also future FOF in a community setting. Impact Falls and FOF have a close relationship but a different clinical meaning. Older adults with physical frailty may require monitoring as high-risk not only for falls but also for FOF.


Sign in / Sign up

Export Citation Format

Share Document