Targeting High-Risk Older Adults into Exercise Programs for Disability Prevention

2003 ◽  
Vol 11 (2) ◽  
pp. 219-228 ◽  
Author(s):  
Jack M. Guralnik ◽  
Suzanne Leveille ◽  
Stefano Volpato ◽  
Marcia S. Marx ◽  
Jiska Cohen-Mansfield
Keyword(s):  
Older Adults ◽  
Functional Limitations ◽  
Exercise Program ◽  
Health Impact ◽  
Epidemiological Studies ◽  
Epidemiologic Studies ◽  
Community Dwelling ◽  
Disability Prevention ◽  
Exercise Interventions ◽  
The Impact

Epidemiological studies have demonstrated that, using objective performance measures of physical functioning, disability risk can be predicted in nondisabled older adults. This makes it possible to recruit a nondisabled but at-risk population for clinical trials of disability prevention. Successful disability prevention in this population, for example through an exercise program, would have a major public health impact. To enhance the development of exercise interventions in this group it would be valuable to have additional information not available from existing epidemiologic studies. This report examines the evidence that functional limitations preceding disability can be identified in a community-dwelling population and that it is feasible to recruit these people into studies. It introduces a series of articles examining the characteristics of this population: motivators and barriers to exercise, exercise habits and preferences, the impact of positive and negative affect, and the impact of pain and functional limitations on attitudes toward exercise.

scholarly journals Back Pain and Heart Failure in Older Adults: Findings From the Health ABC Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 203-203
Author(s):  
Jie Chen ◽  
Yiming Zhang ◽  
Eleanor Simonsick ◽  
Angela Starkweather ◽  
Ming-Hui Chen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Older Adults ◽  
Back Pain ◽  
Negative Impact ◽  
Smoking Status ◽  
The Elderly ◽  
Epidemiological Studies ◽  
Negative Influence ◽  
Epidemiologic Studies ◽  
The Impact

Abstract Both back pain and heart failure (HF) have negative influence on all aspects of life. Little is known about the impact of back pain on older adults with HF. We include 1295 older adults who had data collected in the 11th year (2007-2008) of the Health, Aging and Body Composition (Health ABC) study to evaluate the effect of back pain on health status among older adults with and without HF. The participants aged 79-91, 54.8% were female and 34.8% were African American. Among 94 participants with HF, 63 (67.0%) had back pain; among 1201 participants without HF, 649 (54.0%) had back pain. Females reporting back pain had 4.76 (95% CI: 1.83, 12.37) times the odds of having HF compared to those without back pain. Male with back pain, compared to those without back pain, had 1.14 times (95% CI: 0.65, 2.02) the odds of having HF. Depressive symptoms were measured by the Center for Epidemiological Studies-Depression (CES-D) scale. Performance and functions were measured by the Established Populations for Epidemiologic Studies in the Elderly (EPESE) performance score, the Health ABC performance battery score and self-reported difficulty with functional tasks. These symptom and performance measures were significantly associated with both back pain and HF, but not the interaction terms of back pain and HF after adjusting demographic variables including gender, race, smoking status and BMI category. The high incidence and negative impact of back pain highlighted the needs of developing strategies in pain management among older adults with and without HF.

Exergaming as a tool to enhance strength, balance, gait, mobility, participation, self-efficacy for exercise and adherence in older adults

2020 ◽  
Vol 30 (Supplement_2) ◽  
Author(s):  
A C Martins ◽  
J Quatorze ◽  
D Guia
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Functional Ability ◽  
Self Efficacy ◽  
Daily Living ◽  
Exercise Program ◽  
Community Dwelling ◽  
Step Test ◽  
Mobility Limitations ◽  
The Impact

Abstract Introduction It is projected that the number of adults aged 60 or above will be 1.4 billion in 2030 and 2.1 billion in 2050. With aging, mobility limitations can cause severe difficulties on being independent during activities of daily living. Exercise has been shown as effective to counteract the impact of aging, although it is hard to create adherence. Exergames, as they increase the appeal of exercise, show promising results in terms of participation and promotion of healthy behaviours. Objectives This study aimed at assessing the effectiveness of the Otago Exercise Program incorporated in FallSensing Exergames. Methodology Community-dwelling older adults aged 60 or over, were recruited from facilities in Coimbra, Portugal and randomized in two groups, 27 allocated to the intervention (IG) and 34 to the control (CG). Regular activities of daily living (CG) were compared to an Exergame program (IG). Assessments were made at baseline and re-assessments at 8 weeks/16 sessions, regarding strength, balance, walking speed, participation and self-efficacy for exercise. Results 61 older adults (77% female), mean ages were 82.22 (IG) and 87.26 (CG) years. After 8 weeks, CG demonstrated a decrease in functional ability. IG got improvement in Step test (p = 0.001), 4 Stage Balance Modified test (p = 0.001), Self-Efficacy for Exercise (p = 0.009) and Activities and Participation Profile Related to Mobility (p < 0.001) questionnaires. Conclusion Exergaming was safe and effective in improving functional ability, participation and self-efficacy. Nevertheless, some considerations are necessary when prescribing an Exergames, mainly concerning frequency and intensity of the exercise program and participants’ age.

scholarly journals Conceptualizing Food Insecurity Among Older Adults: Development of a Summary Indicator in the National Health and Aging Trends Study

2020 ◽  
Author(s):  
Emma L Tucher ◽  
Tamra Keeney ◽  
Alicia J Cohen ◽  
Kali S Thomas
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Food Insecurity ◽  
National Health ◽  
Regression Models ◽  
Functional Limitations ◽  
Community Dwelling ◽  
Financial Barriers ◽  
Logistic Regression Models ◽  
The Impact

Abstract Objectives Measurement of food insecurity in older adults is focused on financial barriers to food access. Given that older adults are particularly susceptible to additional access-related barriers including functional limitations and lack of social support, the objective of this study was to construct a summary indicator of food insecurity incorporating these domains. Methods We used nationally representative survey data from Round 5 of the National Health and Aging Trends Study (NHATS; n = 7,070). We constructed a summary indicator of food insecurity using factors within the following three domains: functional, social support, and financial limitations. First, we identified the prevalence of food insecurity among the sample as defined by the new summary indicator. Then, we estimated unadjusted and adjusted logistic regression models to assess the association between the expanded measure of food insecurity and biopsychosocial factors. Results In 2015, 4.3% (95% confidence interval [CI] 3.75–4.94) of community-dwelling older adults, approximately 1,673,775 million people, were characterized as having food insecurity. Multivariable-adjusted regression models identified that being homebound (odds ratio [OR] 3.49, 95% CI 2.03, 6.00), frail (OR 9.50, 95% CI 4.92–18.37), and experiencing community disability (OR 5.19, 95% CI 3.90–6.90) was associated with food insecurity. Discussion Food insecurity among older adults is broader than lacking adequate financial resources to obtain food; it is also associated with social and functional limitations. A more comprehensive conceptualization will aid future study on the impact of food insecurity on health status, utilization, and outcomes to inform senior nutrition program targeting and services.

scholarly journals Home-Based Exercise Program With Telephone Coaching: A Feasibility Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 403-403
Author(s):  
Emma Gulley ◽  
Joe Verghese ◽  
Emmeline Ayers ◽  
Tanya Verghese ◽  
Anne Felicia Ambrose
Keyword(s):  
Older Adults ◽  
Feasibility Study ◽  
Functional Decline ◽  
Exercise Program ◽  
Implementation Strategies ◽  
Control Program ◽  
Community Dwelling ◽  
Home Based ◽  
Telephone Coaching ◽  
The Impact

Abstract Exercise is crucial to maintain mobility, reduce falls and delay functional decline in older adults, but effective implementation strategies are lacking. Self-directed home-based exercise therapy is recommended by clinicians to overcome barriers such as cost, travel and availability. However, non-adherence is a major challenge due to lack of motivation, real time feedback or social support. To overcome these barriers, we conducted a feasibility study to evaluate a home-based exercise program with telephone coaching to improve mobility in frail older adults. Four non-demented, frail community-dwelling older adults were taught one of two exercise routines at our research center. The first involved complex exercises with internal and external cueing techniques that have been associated with neuroplasticity in previous studies (N=3). The second was a lesser cognitively demanding control program that included aerobic, balance and strengthening exercises (N=1). One week later, the participants were asked to repeat the exercises in their own home. The research assistant coached the patient over the telephone. A board-certified physiatrist was present during the home session to monitor adherence and fidelity to the protocol as well as address safety. The study produced qualitative findings regarding recruitment strategies, exercise feasibility, and other logistical issues relating to participant understanding, safety, and monitoring. Based on direct observation of participants at home, safety assessment protocols, instructions, and exercises were all refined. Building on this data, we plan to design a clinical trial to evaluate the impact of complex exercises designed to promote neuroplasticity and reduce cognitive and motoric decline in older adults.

scholarly journals ASSESSING THE IMPACT OF A GAME-CENTERED MOBILE APP ON COMMUNITY-DWELLING OLDER ADULTS’ HEALTH ACTIVATION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S339-S339
Author(s):  
Jason Crandall ◽  
Matthew Shake ◽  
Uta Ziegler
Keyword(s):  
Older Adults ◽  
Health Education ◽  
Patient Activation ◽  
Exercise Program ◽  
Mobile App ◽  
Community Dwelling ◽  
Group Setting ◽  
Post Intervention ◽  
The Impact ◽  
Community Dwelling Older Adults

Abstract The objective of this investigation was to evaluate the impact of a game-centered mobile app (Bingocize®) on older adults’ knowledge, skill, and confidence for managing aspects of their healthcare. Rural community-dwelling older adults (N=85) with mobility, not engaged in any structured exercise program, used the app in a group setting for 10 weeks, twice per week, for one hour. Participants were randomly assigned to (a) a version that included health education, or (b) health education and an exercise component. The Patient Activation Measure (PAM-10) was used to assess group changes in knowledge, skill, and confidence for managing aspects of their healthcare. Two (Group: Exercise + Health Education vs. Health Education-only) x Two (Time: Pre- vs. Post-intervention) analyses of variance, with significance p<.05, was used for statistical analysis. Results: PAM-10 values significantly increased from pre- to post-intervention for both groups, as did knowledge of the health topics (all p < 0.05). Attendance was >93% in both groups. Bingocize® engendered high attendance and improved health activation of older adults; however, additional research is needed to examine whether changes in activation result in long-term changes in health behavior. The Bingocize® mobile app is an enjoyable and effective way to increase health activation in community-dwelling older adults.

One-Year Adherence to the Otago Exercise Program With or Without Motivational Interviewing in Community-Dwelling Older Adults

2018 ◽  
Vol 26 (3) ◽  
pp. 390-395 ◽  
Author(s):  
Marina Arkkukangas ◽  
Anne Söderlund ◽  
Staffan Eriksson ◽  
Ann-Christin Johansson
Keyword(s):  
Older Adults ◽  
Confidence Interval ◽  
Motivational Interviewing ◽  
Odds Ratio ◽  
Exercise Program ◽  
Exercise Adherence ◽  
Community Dwelling ◽  
Behavioral Factors ◽  
Exercise Interventions ◽  
Community Dwelling Older Adults

This study investigated if behavioral factors, treatment with behavioral support, readiness to change, fall self-efficacy, and activity habits could predict long-term adherence to an exercise program. Included in this study were 114 community-dwelling older adults who had participated in one of two home-based exercise interventions. Behavioral factors associated with adherence to the exercise program over 52 weeks were analyzed. The behavioral factors, specifically activity habits at baseline, significantly predicted adherence to the exercise program, with an odds ratio = 3.39, 95% confidence interval [1.38, 8.32], for exercise and an odds ratio = 6.11, 95% confidence interval [2.34, 15.94], for walks. Being allocated to a specific treatment including motivational interviewing was also significantly predictive: odds ratio = 2.47, 95% confidence interval [1.11, 5.49] for exercise adherence. In conclusion, activity habits and exercise in combination with motivational interviewing had a significant association with adherence to the exercise program at a 1-year follow-up.

The impact of functional limitations on disability and the moderating effects of psychological attributes in community-dwelling older persons

1998 ◽  
Author(s):  
G. I. J. M. Kempen ◽  
M. J. G. van Heuvelen ◽  
E. van Sonderen ◽  
R. H. S. van den Brink ◽  
A. C. Kooijman ◽  
...  
Keyword(s):  
Older Persons ◽  
Functional Limitations ◽  
Community Dwelling ◽  
Moderating Effects ◽  
Psychological Attributes ◽  
The Impact

scholarly journals The Impact of Work Hours on Depressive Symptoms among Koreans Aged 45 and Over

2021 ◽  
Vol 18 (3) ◽  
pp. 853
Author(s):  
Juyeong Kim ◽  
Eun-Cheol Park
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Social Services ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Work Hours ◽  
Middle Aged ◽  
Health Studies ◽  
Males And Females ◽  
The Impact

Background: Given the documented importance of employment for middle-aged and older adults’ mental health, studies of the association between their number of work hours and depressive symptoms are needed. Objectives: To examine the association between the number of work hours and depressive symptoms in Korean aged 45 and over. Methods: We used data from the first wave to fourth wave of the Korea Longitudinal Study of Aging. Using the first wave at baseline, data included 9845 individuals. Depressive symptoms were measured using the 10-item Center for Epidemiological Studies Depression scale. We performed a longitudinal analysis to estimate the prevalence of depressive symptoms by work hours. Results: Both unemployed males and females aged 45–65 years were associated with higher depressive symptoms (β = 0.59, p < 0.001; β = 0.32, p < 0.001). Females working ≥ 69 h were associated with higher depressive symptoms compared to those working 41–68 h (β = 0.25, p = 0.013). Among those both middle-aged and older adults, both males and females unemployed were associated with higher depressive symptoms. Those middle-aged female working ≥69 h were associated with higher depressive symptoms. Conclusions: An increase in depressive symptoms was associated with unemployed males and females working ≥69 h compared to those working 41–68 h. Although this association was found among middle-aged individuals, a decrease in depressive symptoms in both sexes was associated with working 1–40 h. Depressive symptoms should decrease by implementing employment policies and social services to encourage employers to support middle-aged and older adults in the workforce considering their sex and age differences.

scholarly journals Impact of Malnutrition Status on Muscle Parameter Changes over a 5-Year Follow-Up of Community-Dwelling Older Adults from the SarcoPhAge Cohort

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 407
Author(s):  
Laetitia Lengelé ◽  
Olivier Bruyère ◽  
Charlotte Beaudart ◽  
Jean-Yves Reginster ◽  
Médéa Locquet
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Physical Performance ◽  
Community Dwelling ◽  
Timed Up And Go ◽  
P Values ◽  
Student’S T ◽  
The Impact ◽  
Community Dwelling Older Adults

This study aimed to assess the impact of malnutrition on the 5-year evolution of physical performance, muscle mass and muscle strength in participants from the SarcoPhAge cohort, consisting of community-dwelling older adults. The malnutrition status was assessed at baseline (T0) according to the “Global Leadership Initiatives on Malnutrition” (GLIM) criteria, and the muscle parameters were evaluated both at T0 and after five years of follow-up (T5). Lean mass, muscle strength and physical performance were assessed using dual X-ray absorptiometry, handgrip dynamometry, the short physical performance battery test and the timed up and go test, respectively. Differences in muscle outcomes according to nutritional status were tested using Student’s t-test. The association between malnutrition and the relative 5-year change in the muscle parameters was tested using multiple linear regressions adjusted for several covariates. A total of 411 participants (mean age of 72.3 ± 6.1 years, 56% women) were included. Of them, 96 individuals (23%) were diagnosed with malnutrition at baseline. Their muscle parameters were significantly lower than those of the well-nourished patients both at baseline and after five years of follow-up (all p-values < 0.05), except for muscle strength in women at T5, which was not significantly lower in the presence of malnutrition. However, the 5-year changes in muscle parameters of malnourished individuals were not significantly different than those of well-nourished individuals (all p-values > 0.05).

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