Physical Activity Frequency Among Older Adults With Diabetes or Prediabetes: Associations With Sociodemographics, Comorbidity, and Medical Advice

To examine the differences in physical activity (PA) between older adults with and without diabetes/prediabetes and the correlates of PA frequency and associations between medical advice on PA and/or diet/weight loss and increasing PA among those with diabetes/prediabetes. Multinomial and binary logistic regression models using 2016–2017 National Health Interview Survey data (N = 4,860 aged 65+ years with diabetes/prediabetes). About 44.2% of those with diabetes/prediabetes, compared with 48.1% of a matched sample without, engaged in any PA three plus times a week. The low PA group (PA frequency was zero to two times a week) was more socioeconomically disadvantaged and had more chronic illnesses than the medium (three to four times a week) or high (five plus times a week) PA groups. Any PA and/or diet/weight loss medical advice was associated with two to three times higher odds of increasing PA. Health care providers should consider prescribing PA and/or diet/weight loss for patients with diabetes/prediabetes.

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Integration of physical activity in reablement for community dwelling older adults: a systematic scoping review

10.21203/rs.2.17945/v1 ◽

2019 ◽

Author(s):

Hanne Leirbekk Mjøsund ◽

Cathrine Fredriksen Moe ◽

Elissa Burton ◽

Lisbeth Uhrenfeldt

Keyword(s):

Physical Activity ◽

Older Adults ◽

Health Care Providers ◽

Data Extraction ◽

Community Dwelling ◽

Cochrane Central Register ◽

Care Providers ◽

Limited Evidence ◽

Individual Needs ◽

Community Dwelling Older Adults

Abstract Introduction: Reablement is a rehabilitative intervention provided to homecare receivers (mostly older adults) with the aim of improving function and independence. There is limited evidence of the effectiveness of reablement and the content of these interventions is variable. Physical activity (PA) is known to be important for improving and maintaining function among older adults, but it is unclear how PA is integrated in reablement.Objective: To map existing evidence of how PA strategies are integrated and explored in studies of reablement for community dwelling older adults and to identify knowledge gaps.Methods: An apriori protocol was published. Studies investigating or exploring time-limited (within 6 months), interdisciplinary reablement for community-dwelling older adults, published in English, Norwegian, Danish, Swedish and German were considered for inclusion. PubMed, Cochrane central register of controlled trials, Embase, PsycINFO, AMED, PEDro, CINAHL and Google Scholar were searched for studies published between 1996 and July 2019, in addition to reference and citation searches. Study selection and data extraction were made independently by two reviewers.Results: Forty-three studies were included. Exercise strategies and practice of daily activities were reported to be included in the majority of intervention studies, but in most cases, no information was provided about the degree or intensity of which PA was involved, or how PA interventions were targeted to individual needs. Interventions aiming to increase general PA levels or reduce sedentary behavior were rarely described. None of the studies explored older adults’, health care providers’ or family members’ experiences with PA in a reablement setting, but some of the studies touched upon themes related to PA experiences. Some studies reported outcomes of physical fitness, including mobility, strength and balance, but there was insufficient evidence for any synthesis of these results. None of the studies reported PA levels among older adults receiving reablement.Conclusion: There is limited evidence regarding how PA is integrated in reablement, including how PA strategies are targeted to older adults’ individual needs and preferences in a reablement setting. The feasibility, and effectiveness of PA interventions, as well as experiences or barriers related to PA in a reablement setting should be further investigated.

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Daily lifestyle behaviors and risks of sarcopenia among older adults

Archives of Public Health ◽

10.1186/s13690-020-00498-9 ◽

2020 ◽

Vol 78 (1) ◽

Author(s):

Pei-Lin Tzeng ◽

Chien-Yu Lin ◽

Ting-Fu Lai ◽

Wan-Chi Huang ◽

Evonne Pien ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Sleep Duration ◽

Food Selection ◽

Binary Logistic Regression ◽

Personal Characteristics ◽

Sitting Time ◽

Lifestyle Behaviors ◽

Logistic Regression Models ◽

Modifiable Factors

Abstract Background Lifestyle behaviors are modifiable factors that can provide information for designing intervention strategies for sarcopenia. The present study aimed to identify the relationships between a range of daily lifestyle behaviors and sarcopenia risks among older adults. Methods A nationwide telephone-based survey targeting older adults (≥65 years) was performed in Taiwan. Data based on self-reported daily lifestyle behaviors (food selection, physical activity, sitting time, and sleep duration), the presence or absence of sarcopenia (measured by SARC-F), and personal characteristics were obtained. Binary logistic regression models were applied. Results A total of 1068 older adults participated in this survey. In the adjusted model, older adults who selected unbalanced foods (odds ratio [OR] = 1.93, 95% confidence interval [CI] = 1.12–3.34), engaged in insufficient physical activity (OR = 5.14, 95% CI = 3.04–8.70), and sat for longer periods of time (OR = 1.98, 95% CI = 1.09–3.59) were more likely to have higher risks of sarcopenia. No significant association was observed for sleep duration. Conclusions The results of this study highlight that, among health behaviors, an unbalanced food selection (six nutrients), not meeting physical activity recommendations (150 min/week), and a higher sitting time (≥7 h/day) were risk factors for sarcopenia among older adults. Intervention programs for sarcopenia prevention in older adults should focus on promoting balanced food selection, sufficient physical activity, and reduced sitting time.

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Unintentional Weight Loss in Older Adults: A Geriatric Interprofessional Simulation Case Series for Health Care Providers

MedEdPORTAL ◽

10.15766/mep_2374-8265.10631 ◽

2017 ◽

Vol 13 (1) ◽

Author(s):

Rebekah Mulligan ◽

Melissa Gilmer-Scott ◽

Dana Kouchel ◽

Davia Nickelson ◽

Atousa Safavi ◽

...

Keyword(s):

Older Adults ◽

Health Care ◽

Weight Loss ◽

Health Care Providers ◽

Case Series ◽

Care Providers ◽

Unintentional Weight Loss

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CHALLENGES IN SELF-MANAGEMENT AMONG OLDER ADULTS WITH HYPERTENSION AND DIABETES

Innovation in Aging ◽

10.1093/geroni/igz038.1157 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S316-S317

Author(s):

Hyunkyoung Oh ◽

Yura Lee ◽

Wonchan Choi ◽

Zhi Zheng

Keyword(s):

Physical Activity ◽

Older Adults ◽

Health Care ◽

Health Care Providers ◽

Healthy Eating ◽

Kidney Diseases ◽

Management Program ◽

Self Management ◽

Care Providers ◽

Ongoing Research

Abstract This abstract introduces an ongoing research project that aimed to develop a patient-centered self-management program using health information and technologies for older adults with hypertension and diabetes. The purpose of the project in the first phase was to better understand challenges in self-management faced by older adults with both conditions. A semi-structured and face-to-face interview was conducted to explore the challenges in self-management of the target population living in Milwaukee areas, Wisconsin. Audio recordings were transcribed in verbatim; transcripts were analyzed; and themes were identified. A total of six individuals participated in this study by January 2019. Their age ranged from 56 to 75. Four of them were female; five of them were African Americans; and one was Caucasian. All participants reported more than two additional conditions that were arthritis, cardiovascular diseases, pain, kidney diseases, respiratory diseases, and depression. Most participants were self-managing their conditions mainly by taking prescribed medications. Several themes were emerged as challenges to self-management: monitoring blood pressure and glucose, engagement in physical activity, and healthy eating. Among these, participants reported healthy eating as the most difficult self-managing activity. Majority of participants expressed the need for physical activity support due to pain and/or vision problems known as one of diabetic complications. Understanding challenges and needs of a specific population is the first step for health care providers to support self-management of the patients appropriately. The results of this preliminary study will help health care providers develop effective self-management programs for older adults with both conditions.

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COVID-19 Vaccine Hesitancy Among Community-Dwelling Older Adults: The Role of Information Sources

Journal of Applied Gerontology ◽

10.1177/07334648211037507 ◽

2021 ◽

pp. 073346482110375

Author(s):

Divya Bhagianadh ◽

Kanika Arora

Keyword(s):

Older Adults ◽

Health Care Providers ◽

Information Sources ◽

Information Source ◽

Community Dwelling ◽

Vaccine Hesitancy ◽

Care Providers ◽

Logistic Regression Models ◽

Community Dwelling Older Adults

Despite high enthusiasm surrounding the rollout of the COVID-19 vaccine, some older adults continue to remain hesitant about its receipt. There is limited evidence on vaccine hesitancy among community-dwelling older adults. In this study, we examine the prevalence and predictors (particularly the role played by information sources) of vaccine hesitancy in this group. We use the Medicare Current Beneficiary Survey and employ multivariable logistic regression models to explore this. Relative to those relying on regular news, those depending on health care providers (HCPs), social media, other internet/webpages, and family/friends as the main information source on COVID-19 expressed higher negative vaccine intent. The high negative intent with HCPs as the main information source should be interpreted with caution. This could be reflective of the timing of the survey and changing attitude toward the vaccine among HCPs themselves.

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Multilevel Perspectives on Diffusing a Physical Activity Promotion Program to Reach Diverse Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.14.3.270 ◽

2006 ◽

Vol 14 (3) ◽

pp. 270-287 ◽

Cited By ~ 14

Author(s):

Anita L. Stewart ◽

Melanie Grossman ◽

Nathalie Bera ◽

Dawn E. Gillis ◽

Nina Sperber ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Health Care Providers ◽

Large Scale ◽

Task Force ◽

Physical Activity Promotion ◽

Care Providers ◽

Promotion Program ◽

Activity Promotion ◽

Physical Activity Promotion Program

Diffusing research-based physical activity programs in underserved communities could improve the health of ethnically diverse populations. We utilized a multilevel, community-based approach to determine attitudes, resources, needs, and barriers to physical activity and the potential diffusion of a physical activity promotion program to reach minority and lower-income older adults. Formative research using focus groups and individual interviews elicited feedback from multiple community sectors: community members, task force and coalition members, administrators, service implementers, health care providers, and physical activity instructors. Using qualitative data analysis, 47 transcripts (N= 197) were analyzed. Most sectors identified needs for culturally diverse resources, promotion of existing resources, demonstration of future cost savings, and culturally tailored, proactive outreach. The program was viewed favorably, especially if integrated into existing resources. Linking sectors to connect resources and expertise was considered essential. Complexities of such large-scale collaborations were identified. These results may guide communities interested in diffusing health promotion interventions.

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Older Patients’ Recall of Lifestyle Discussions in Primary Care

Journal of Applied Gerontology ◽

10.1177/0733464815574095 ◽

2016 ◽

Vol 36 (4) ◽

pp. 386-400 ◽

Cited By ~ 2

Author(s):

Shoshana H. Bardach ◽

Nancy E. Schoenberg ◽

Britteny M. Howell

Keyword(s):

Physical Activity ◽

Older Adults ◽

Primary Care ◽

Health Care Providers ◽

Physical Inactivity ◽

Primary Care Visit ◽

Care Providers ◽

Care Visit ◽

Patient Recall ◽

Diet And Physical Activity

Despite the known benefits of engaging in healthy diet and physical activity across the life span, suboptimal diet and physical inactivity are pervasive among older adults. While health care providers can promote patients’ engagement in health behaviors, patient recall of recommendations tends to be imperfect. This study sought to better understand older adults’ recall of dietary and physical activity discussions in primary care. One hundred and fifteen adults aged 65 and older were interviewed immediately following a routine primary care visit on whether and what they recalled discussing pertaining to diet and physical activity. Compared against transcripts, most patients accurately recalled their diet and physical activity discussions. The inclusion of a recommendation, and for diet discussions longer duration, increased the likelihood of patient recall for these health behavior discussions. These findings suggest that specific recommendations and an extra minute of discussion, at least for dietary discussions, increase the likelihood of accurate patient recall.

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Interdisciplinary Therapy Assessments for the Older Adult

Perspectives on Gerontology ◽

10.1044/gero17.1.11 ◽

2012 ◽

Vol 17 (1) ◽

pp. 11-16

Author(s):

Lynn Chatfield ◽

Sandra Christos ◽

Michael McGregor

Keyword(s):

Older Adults ◽

Health Care ◽

Standardized Testing ◽

Health Care Providers ◽

Outcome Measurement ◽

Care Providers ◽

Patient Centered ◽

Screening Process ◽

Evidenced Based ◽

Changing Economy

In a changing economy and a changing industry, health care providers need to complete thorough, comprehensive, and efficient assessments that provide both an accurate depiction of the patient's deficits and a blueprint to the path of treatment for older adults. Through standardized testing and observations as well as the goals and evidenced-based treatment plans we have devised, health care providers can maximize outcomes and the functional levels of patients. In this article, we review an interdisciplinary assessment that involves speech-language pathology, occupational therapy, physical therapy, and respiratory therapy to work with older adults in health care settings. Using the approach, we will examine the benefits of collaboration between disciplines, an interdisciplinary screening process, and the importance of sharing information from comprehensive discipline-specific evaluations. We also will discuss the importance of having an understanding of the varied scopes of practice, the utilization of outcome measurement tools, and a patient-centered assessment approach to care.

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Effects of Cardiovascular Disease and Related Risk Factors on Neurocognition

The Oxford Handbook of Adult Cognitive Disorders ◽

10.1093/oxfordhb/9780190664121.013.5 ◽

2019 ◽

pp. 83-116

Author(s):

Spencer W. Liebel ◽

Lawrence H. Sweet

Keyword(s):

Cardiovascular Disease ◽

Older Adults ◽

Cognitive Processing ◽

Health Care Providers ◽

The United States ◽

Research Literature ◽

Neurocognitive Functioning ◽

Care Providers ◽

Cardiac Events ◽

Related Risk

Cardiovascular disease (CVD) affects approximately 44 million American adults older than age 60 years and remains the leading cause of death in the United States, with approximately 610,000 each year. With improved survival from acute cardiac events, older adults are often faced with the prospect of living with CVD, which causes significant psychological, social, and economic hardship. The various disease processes that constitute CVD also exert a deleterious effect on neurocognitive functioning. Although existing knowledge of neurocognitive functioning in CVD and its subtypes is substantial, a review of these findings by CVD type and neurocognitive domain does not exist, despite the potential impact of this information for patients, health care providers, and clinical researchers. This chapter provides a resource for clinicians and researchers on the epidemiology, mechanisms, and neurocognitive effects of CVDs. This chapter includes a discussion of neurocognitive consequences of CVD subtypes by neuropsychological domain and recommendations for assessment. Overall, the CVD subtypes that have the most findings available on specific neurocognitive domains are heart failure, hypertension, and atrial fibrillation. Despite a large discrepancy between the number of available studies across CVD subtypes, existing literature on neurocognitive effects by domain is consistent with the literature on the neurocognitive sequelae of unspecified CVD. Specifically, the research literature suggests that cognitive processing speed, attention, executive functioning, and memory are the domains most frequently affected. Given the prevalence of CVDs, neuropsychological assessment of older adults should include instruments that allow consideration of these potential neurocognitive consequences of CVD.

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Association between religious beliefs and discussions regarding advance care planning: A nationwide survey

Palliative Medicine ◽

10.1177/02692163211029508 ◽

2021 ◽

pp. 026921632110295

Author(s):

Jun Miyashita ◽

Sayaka Shimizu ◽

Shunichi Fukuhara ◽

Yosuke Yamamoto

Keyword(s):

Health Care Providers ◽

Advance Care Planning ◽

Religious Beliefs ◽

Nationwide Survey ◽

Care Planning ◽

Care Providers ◽

Logistic Regression Models ◽

Japanese Buddhism ◽

Advance Care ◽

Quota Sampling

Background: The relationship between advance care planning and religious beliefs, which are important for palliative care, is controversial in Western countries and has not been verified in Asian countries. Aim: To investigate the association between advance care planning discussions and religious beliefs in Japan. Design: A nationwide survey conducted in 2016 using a quota sampling method to obtain a representative sample of Japan’s general population. Setting/participants: We analyzed responses from 3167 adults aged 20–84 years (mean age ± standard deviation, 50.9 ± 16.8 years). The outcome was measured by asking whether the respondents had ever discussed advance care planning, and the main exposure by whether they had any religious beliefs or affiliations, and if so, their degree of devoutness. We analyzed religious beliefs, affiliations, and devoutness in relation to the occurrence of discussions using multivariable logistic regression models adjusted for possible sociodemographic covariates. Results: Compared with respondents without, those with religious beliefs had significantly higher odds of having had discussions (adjusted odds ratio: 1.45, 95% confidence interval: 1.22–1.73). The devoutness of religious belief was proportional to the propensity of the occurrence of discussions ( p for trend < 0.001). In addition, Buddhists and Christians had higher odds of having had discussions than did nonbelievers. Conclusion: The results suggest that holding religious beliefs, especially in Japanese Buddhism and Christianity, facilitates advance care planning discussions among Japanese adults, and thus, may help health-care providers identify those prioritized for facilitating engagement in advance care planning, especially in palliative and spiritual care settings.

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