Twelve-Month Retention in and Impact of Enhance®Fitness on Older Adults in Hawai‘i

Introduction. Enhance®Fitness is a low-cost group exercise program designed specifically for older adults (60+ years) to improve physical performance. The Hawai‘i Healthy Aging Partnership, a statewide health promotion initiative, has continuously offered Enhance®Fitness to Hawai‘i’s multicultural population since 2007. This study examined 12-month participation in and impact of Enhance®Fitness on physical performance among older adults in Hawai‘i. Method. Linear mixed-effects models were applied to analyze the physical performance measures (chair-stands, arm curls, and the up-and-go test) collected at baseline (month 0) and at 4, 8, and 12 months. We also compared the characteristics of participants who participated in the program for 12 months with those who dropped out in order to gain insights on participant retention. Results. Of 1,202 older adults with baseline data, 427 (35.5%) were continuously enrolled in Enhance®Fitness for 12 months and participated in follow-up data collection. On average, participants attended 63.7% of thrice-weekly classes each month. Participants’ physical performance measures improved after 4 months, continued to improve until 8 months, and were maintained thereafter. Besides continuous attendance, performance-measure improvements were associated with younger age, male gender, living with others (vs. alone), and fewer chronic conditions. Compared to those who completed 12 months of the program, the 775 who left the program over the course of the year were more likely to be younger, to be Caucasian (vs. Asian or Pacific Islander), to self-report depression as a chronic condition, and to have lower levels of fitness at baseline. Common reasons for dropping out were illness, relocation, time conflicts, lost interest, and transportation issues. Conclusions. Long-term participants in Enhance®Fitness initially improved and then maintained physical performance. Future research is needed to identify strategies to maintain enrollment of older adults in the exercise programs over time.

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Cross-Sectional Examination of Musculoskeletal Pain and Physical Function in a Racially and Socioeconomically Diverse Sample of Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa251 ◽

2020 ◽

Author(s):

Angie L Sardina ◽

Alyssa A Gamaldo ◽

Ross Andel ◽

Shanthi Johnson ◽

Tamara A Baker ◽

...

Keyword(s):

Physical Function ◽

Physical Performance ◽

Musculoskeletal Pain ◽

Performance Measures ◽

Healthy Aging ◽

Functional Limitation ◽

Future Research ◽

Middle Aged ◽

Cross Sectional ◽

Middle Aged Adults

Abstract Background Musculoskeletal pain alters physiological function, which may be evidenced as early as middle age. Previous research has concluded that middle-aged adults are a high-risk group for musculoskeletal pain and report functional limitations similar to older adults. However, few studies have examined the relationships between musculoskeletal pain and physical function, using objective performance measures in a sample of racially and socioeconomically diverse adults. Thus, this study examined musculoskeletal pain in relation to physical function in middle-aged (30–64 years) White and Black adults and investigated whether the relationship varied by sociodemographic characteristics. Methods This cross-sectional examination incorporated data from the Healthy Aging in Neighborhoods of Diversity across the Life-Span Study. Participants (n = 875) completed measures of musculoskeletal pain and objective measures of physical performance (ie, lower and upper body strength, balance, and gait abnormalities). Physical performance measures were standardized to derive a global measure of physical function as the dependent variable. Results Approximately, 59% of participants identified at least 1 pain sites (n = 518). Multivariable regression analyses identified significant relationships between greater musculoskeletal pain and poorer physical function (β = −0.07, p = .031), in mid midlife (β = −0.04, p = .041; age 40–54) and late midlife (β = −0.05, p = .027; age 55–64). Conclusions This study observed that musculoskeletal pain was associated with poorer physical function within a diverse group of middle-aged adults. Future research should longitudinally explore whether chronic musculoskeletal pain identified at younger ages is associated with greater risk for functional limitation and dependence in later life.

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Assessing physical functioning on pain management programmes: the unique contribution of directly assessed physical performance measures and their relationship to self-reports

British Journal of Pain ◽

10.1177/2049463716680559 ◽

2016 ◽

Vol 11 (1) ◽

pp. 46-57 ◽

Cited By ~ 11

Author(s):

Beth J Guildford ◽

Clair M Jacobs ◽

Aisling Daly-Eichenhardt ◽

Whitney Scott ◽

Lance M McCracken

Keyword(s):

Pain Management ◽

Physical Performance ◽

Performance Measures ◽

Physical Functioning ◽

Significant Degree ◽

Self Report ◽

Future Research ◽

Unique Contribution ◽

Outcome Domain ◽

The Many

Physical functioning is a recommended outcome domain for pain management programmes. It can be assessed by self-report and by direct assessment of performance. Although physical performance measures may provide unique and useful information about patient functioning over and above self-report measures, it is not entirely clear which of the many possible performances to assess. This study investigated a battery of three directly assessed physical performance measures and their relationship to three currently used self-report measures of general health and functioning. The three performance measures were sensitive to treatment; patients performed significantly better on all three measures following completion of the pain management programme. The three performance measures were shown to represent a single underlying dimension, and there was a significant degree of overlap between them. The performance measures were shown to be relevant in explaining variation in the self-report measures, as well as to offer a clinically relevant different dimension of assessment to self-report. Future research could focus on developing performance-based measures that capture quality of movement and that are sensitive to relevant processes of therapeutic change.

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Disseminating the Otago Exercise Program in the United States: Perceived and Actual Physical Performance Improvements From Participants

Journal of Applied Gerontology ◽

10.1177/0733464816675422 ◽

2016 ◽

Vol 37 (1) ◽

pp. 79-98 ◽

Cited By ~ 18

Author(s):

Tiffany E. Shubert ◽

Matthew Lee Smith ◽

Luohua Jiang ◽

Marcia G. Ory

Keyword(s):

United States ◽

Older Adults ◽

Physical Performance ◽

Functional Performance ◽

Exercise Program ◽

The United States ◽

Functional Mobility ◽

Self Report ◽

Timed Up And Go ◽

Logistic Regression Models

The Otago Exercise Program (OEP) is an evidence-based fall prevention program disseminated internationally. Little is known about the implementation or effectiveness of the OEP in the United States. The purposes were to (a) identify characteristics of older adults enrolled in OEP, and (b) examine perceived and actual functional performance changes after participation in 8 weeks of the program. Baseline and 8-week functional and self-report data were collected on 210 older adults from 2013 to 2015. Linear mixed models and general estimating equations logistic regression models adjusted for socio-demographic factors were performed to assess changes. At 8 weeks, scores dramatically improved on self-report and physical performance tests: Timed Up-and-Go ( p < .001), 30-Second Chair Rise ( p < .001), and Four-Stage Balance ( p < .001). Findings support that participation in the U.S. OEP as part of a plan of care can result in significant improvements in objective functional mobility, balance measures, and self-reported ability.

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Associations between Tactile Sensory Threshold and Postural Performance and Effects of Healthy Aging and Subthreshold Vibrotactile Stimulation on Postural Outcomes in a Simple Dual Task

Current Gerontology and Geriatrics Research ◽

10.1155/2016/9797369 ◽

2016 ◽

Vol 2016 ◽

pp. 1-11 ◽

Cited By ~ 6

Author(s):

Marius Dettmer ◽

Amir Pourmoghaddam ◽

Beom-Chan Lee ◽

Charles S. Layne

Keyword(s):

Older Adults ◽

Performance Measures ◽

Dual Task ◽

Healthy Aging ◽

Control Measures ◽

Future Research ◽

Sensory Threshold ◽

Vibrotactile Stimulation ◽

And Performance ◽

Postural Performance

Specific activities that require concurrent processing of postural and cognitive tasks may increase the risk for falls in older adults. We investigated whether peripheral receptor sensitivity was associated with postural performance in a dual-task and whether an intervention in form of subthreshold vibration could affect performance. Ten younger (age: 20–35 years) and ten older adults (70–85 years) performed repeated auditory-verbal 1-back tasks while standing quietly on a force platform. Foot sole vibration was randomly added during several trials. Several postural control and performance measures were assessed and statistically analyzed (significance set toα-levels of .05). There were moderate correlations between peripheral sensitivity and several postural performance and control measures (r=.45to .59). Several postural performance measures differed significantly between older and younger adults (p<0.05); addition of vibration did not affect outcome measures. Aging affects healthy older adults’ performance in dual-tasks, and peripheral sensitivity may be a contributor to the observed differences. A vibration intervention may only be useful when there are more severe impairments of the sensorimotor system. Hence, future research regarding the efficacy of sensorimotor interventions in the form of vibrotactile stimulation should focus on older adults whose balance is significantly affected.

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Relationship between SHARE-FI Frailty Scores and Physical Performance Measures in Older Adult Medicaid Recipients

Geriatrics ◽

10.3390/geriatrics3030051 ◽

2018 ◽

Vol 3 (3) ◽

pp. 51 ◽

Cited By ~ 1

Author(s):

Margaret Danilovich ◽

Laura Diaz ◽

Daniel Corcos ◽

Jody Ciolino

Keyword(s):

Older Adult ◽

Physical Performance ◽

Performance Measures ◽

Gait Speed ◽

Fall Risk ◽

Assessment Tool ◽

Performance Measure ◽

Self Report ◽

Timed Up And Go ◽

Cross Sectional

The Survey of Health, Ageing and Retirement in Europe-Frailty Instrument (SHARE-FI) is a frailty assessment tool designed for primary care settings comprised of four self-report questions and grip strength measurement, yet it is not known how SHARE-FI scores relate to objective physical performance measures that assess physical functioning, fall risk, and disability. This cross-sectional, observational study examined the association between SHARE-FI scores and a battery of physical performance measures in a sample of older adult, Medicaid waiver recipients (n = 139, mean age = 74.19 ± 8.36 years). We administered the SHARE-FI, Timed Up and Go (TUG), gait speed, and Short Physical Performance Battery (SPPB) in participants’ homes. Among clients, 45% were frail, 35% pre-frail, and 20% non-frail. There were significant differences in all physical performance measure scores with respect to SHARE-FI category. SHARE-FI continuous scores significantly predicted TUG time, all domains of the SPPB, gait speed, and inability to complete the chair rise test. Self-reported walking difficulty and objectively measured gait speed were significantly correlated. The SHARE-FI continuous frailty score predicts scores on a variety of validated physical performance measures. Given the fast administration time, the SHARE-FI could potentially be used to serve as a surrogate for physical performance measures with known association with physical function, fall risk, and disability.

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Current Evidence and Possible Future Applications of Creatine Supplementation for Older Adults

Nutrients ◽

10.3390/nu13030745 ◽

2021 ◽

Vol 13 (3) ◽

pp. 745

Author(s):

Darren G. Candow ◽

Scott C. Forbes ◽

Ben Kirk ◽

Gustavo Duque

Keyword(s):

Older Adults ◽

Physical Performance ◽

Healthy Aging ◽

Creatine Supplementation ◽

Sarcopenic Obesity ◽

Current Evidence ◽

Future Research ◽

Physical Frailty ◽

Age Related ◽

Aging Muscle

Sarcopenia, defined as age-related reduction in muscle mass, strength, and physical performance, is associated with other age-related health conditions such as osteoporosis, osteosarcopenia, sarcopenic obesity, physical frailty, and cachexia. From a healthy aging perspective, lifestyle interventions that may help overcome characteristics and associated comorbidities of sarcopenia are clinically important. One possible intervention is creatine supplementation (CR). Accumulating research over the past few decades shows that CR, primarily when combined with resistance training (RT), has favourable effects on aging muscle, bone and fat mass, muscle and bone strength, and tasks of physical performance in healthy older adults. However, research is very limited regarding the efficacy of CR in older adults with sarcopenia or osteoporosis and no research exists in older adults with osteosarcopenia, sarcopenic obesity, physical frailty, or cachexia. Therefore, the purpose of this narrative review is (1) to evaluate and summarize current research involving CR, with and without RT, on properties of muscle and bone in older adults and (2) to provide a rationale and justification for future research involving CR in older adults with osteosarcopenia, sarcopenic obesity, physical frailty, or cachexia.

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Visualization approaches to support healthy aging: A systematic review

Journal of Innovation in Health Informatics ◽

10.14236/jhi.v23i3.860 ◽

2016 ◽

Vol 23 (3) ◽

pp. 600 ◽

Cited By ~ 4

Author(s):

Uba Backonja ◽

Nai-Ching Chi ◽

Yong Choi ◽

Amanda K Hall ◽

Thai Le ◽

...

Keyword(s):

Older Adults ◽

Health Behaviors ◽

Healthy Aging ◽

A Priori ◽

Aging In Place ◽

Future Research ◽

Health Technologies ◽

Data Visualizations ◽

Informatics Tools

Background: Health technologies have the potential to support the growing number of older adults who are aging in place. Many tools include visualizations (data visualizations, visualizations of physical representations). However, the role of visualizations in supporting aging in place remains largely unexplored.Objective: To synthesize and identify gaps in the literature evaluating visualizations (data visualizations and visualizations of physical representations), for informatics tools to support healthy aging.Methods: We conducted a search in CINAHL, Embase, Engineering Village, PsycINFO, PubMed, and Web of Science using a priori defined terms for publications in English describing community-based studies evaluating visualizations used by adults aged ≥65 years.Results: Six out of the identified 251 publications were eligible. Most studies were user studies and varied methodological quality. Three visualizations of virtual representations supported performing at-home exercises. Participants found visual representations either (a) helpful, motivational, and supported their understanding of their health behaviors or (b) not an improvement over alternatives. Three data visualizations supported understanding of one’s health. Participants were able to interpret data visualizations that used precise data and encodings that were more concrete better than those that did not provide precision or were abstract. Participants found data visualizations helpful in understanding their overall health and granular data.Conclusions: Studies we identified used visualizations to promote engagement in exercises or understandings of one’s health. Future research could overcome methodological limitations of studies we identified to develop visualizations that older adults could use with ease and accuracy to support their health behaviors and decision-making.

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Physical Performance Measures for Characterizing High Functioning Older Persons

Journal of Aging and Physical Activity ◽

10.1123/japa.4.4.338 ◽

1996 ◽

Vol 4 (4) ◽

pp. 338-348 ◽

Cited By ~ 13

Author(s):

Takashi Kinugasa ◽

Hiroshi Nagasaki ◽

Taketo Furuna ◽

Hajime Itoh

Keyword(s):

Older Adults ◽

Physical Performance ◽

Performance Measures ◽

Older Persons ◽

Discriminant Validity ◽

Age Groups ◽

High Functioning ◽

Eyes Open ◽

Interdisciplinary Study ◽

Tokyo Metropolitan Institute

The goal of this study was to identify methods for characterizing high-functioning older adults living in the community. The subjects were 495 older adults from the Longitudinal Interdisciplinary Study on Aging conducted by the Tokyo Metropolitan Institute of Gerontology. Physical performance measures included grip strength, walking at preferred and maximum speeds, one-leg standing with eyes open, and finger tapping rate. Performance scores were created by summing each categorical score. Consistent differences were found among age groups and genders. Scores were lower in subjects who had stroke or diabetes than in those without these conditions. These results suggest that physical performance measures have both discriminant validity and construct validity, which make them useful methods for characterizing high-functioning older persons.

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Rapid Transition to Telehealth Group Exercise and Functional Assessments in Response to COVID-19

Gerontology and Geriatric Medicine ◽

10.1177/2333721420980313 ◽

2020 ◽

Vol 6 ◽

pp. 233372142098031

Author(s):

Stephen C. Jennings ◽

Kenneth M. Manning ◽

Janet Prvu Bettger ◽

Katherine M. Hall ◽

Megan Pearson ◽

...

Keyword(s):

Older Adults ◽

Physical Performance ◽

Exercise Program ◽

Performance Testing ◽

Group Exercise ◽

Health Maintenance ◽

Functional Assessments ◽

Wide Scale ◽

Rapid Transition ◽

Exercise Classes

Exercise is critical for health maintenance in late life. The COVID-19 shelter in place and social distancing orders resulted in wide-scale interruptions of exercise therapies, placing older adults at risk for the consequences of decreased mobilization. The purpose of this paper is to describe rapid transition of the Gerofit facility-based group exercise program to telehealth delivery. This Gerofit-to-Home (GTH) program continued with group-based synchronous exercise classes that ranged from 1 to 24 Veterans per class and 1 to 9 classes offered per week in the different locations. Three hundred and eight of 1149 (27%) Veterans active in the Gerofit facility-based programs made the transition to the telehealth delivered classes. Participants’ physical performance testing continued remotely as scheduled with comparisons between most recent facility-based and remote testing suggesting that participants retained physical function. Detailed protocols for remote physical performance testing and sample exercise routines are described. Translation to remote delivery of exercise programs for older adults could mitigate negative health effects.

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BROODING MODERATES THE RELATIONSHIP BETWEEN CEREBROVASCULAR BURDEN AND VASCULAR DEPRESSION

Innovation in Aging ◽

10.1093/geroni/igz038.3216 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S877-S878

Author(s):

Manuel Herrera Legon ◽

Daniel Paulson

Keyword(s):

Older Adults ◽

Depressive Symptomatology ◽

Depression Scale ◽

Late Life ◽

Community Dwelling ◽

Self Report ◽

Future Research ◽

Late Life Depression ◽

Vascular Depression ◽

The Relationship

Abstract Objective: The vascular depression hypothesis posits that cerebrovascular burden confers risk for late-life depression. Though neuroanatomical correlates of vascular depression (prefrontal white matter hyperintensities) are well established, little is known about cognitive correlates; the identification of which may suggest therapeutic targets. Aims of this study are to examine the hypothesis that the relationship between cerebrovascular burden and depressive symptoms is moderated by brooding, a type of rumination. Method: A sample of 52 community-dwelling, stroke-free, individuals over the age of 70, without history of severe mental illness or dementia completed the Ruminative Responses Scale, and provided self-report (cardiac disease, hypertension, diabetes, high cholesterol) CVB data. The Geriatric Depression Scale was used to assess depressive symptomatology. Results: Results of a bootstrapped model were that self-reported measures of CVB predicted depressive symptomatology. This relationship was significantly moderated by brooding. Among older adults, those who self-reported high CVB and medium to elevated levels of rumination experienced disproportionately more depressive symptomatology. Conclusions: These findings suggest that brooding rumination may be one correlate of the vascular depression syndrome. Future research should examine neuroanatomical correlates of rumination among older adults, and further explore brooding as a therapeutic target for those with late-life depression.

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