Two-Year Outcomes From a Cessation of Smoking Intervention in Older Adults

AbstractThis study evaluated a cessation of smoking program for older (≥ 65 years) smokers. We recruited 215 community-dwelling smokers who selected either an intervention (n = 165) (brief intervention, telephone support, access to nicotine replacement therapy [NRT]) or ongoing smoking (continuing smokers) (n = 50). Primary outcomes at 12 and 24 months were (a) total abstinence and (b) cessation for the previous 30+ days, all validated via expired carbon monoxide (ECO). We interviewed 183 (85%) participants at 12 months and 165 (77%) at 24 months. Total abstinence was reported by 29 (18%) and 21 (13%) of the intervention group and none of the continuing smokers at 12 and 24 months. At 12 months, a greater prevalence of 30+ day cessation was observed for the intervention (24.2%) than the continuing smokers (4.0%): by 24 months this difference was 23.6% versus 12.0%. Those totally abstinent for 24 months predominantly used NRT (81%). Of the 30+ day quitters at 24 months, 74% of the intervention group used NRT and 100% of the continuing smokers used ‘cold turkey’. Cessation programs can be successfully delivered to older smokers, with outcomes comparable to the general population. NRT is commonly used by successful quitters, but ‘cold turkey’ can also be successful.

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Effectiveness of a Care Delivery Model for High-Need Older Adults in Communities

Research on Social Work Practice ◽

10.1177/1049731520982355 ◽

2020 ◽

pp. 104973152098235

Author(s):

Kuei-Min Chen ◽

Hui-Fen Hsu ◽

Li-Yen Yang ◽

Chiang-Ching Chang ◽

Yu-Ming Chen ◽

...

Keyword(s):

Older Adults ◽

Repeated Measures ◽

Comparison Group ◽

Care Delivery ◽

Intervention Group ◽

Community Dwelling ◽

Delivery Model ◽

Positive Effects ◽

Repeated Measures Design ◽

Care Delivery Model

Purpose: This study aimed to test the effectiveness of High-Need Community-Dwelling Older Adults Care Delivery Model (HCOACDM) in Taiwan. Methods: A cluster randomized controlled trial with repeated measures design was conducted in eight community care centers, involving 145 high-need older adults who were assigned to the intervention group or comparison group. The HCOACDM was provided over 6 months. Functional ability, quality of life, depressive symptoms, and health care and social service utilizations were measured at baseline, at 3 months, and 6 months into the intervention. The participants’ satisfaction was measured at the end of 6-month intervention. Results: Positive effects were shown on all variables in the intervention group at both the 3-month and 6-month intervals (all p < .05). The intervention group had a higher satisfaction with care delivery than the comparison group ( p < .05). Discussion: The promising findings supported a long-term implementation of the HCOACDM as applicable and beneficial.

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Short-term balance training and acute effects on postural sway in balance-deficient older adults: a randomized controlled trial

BMC Sports Science Medicine and Rehabilitation ◽

10.1186/s13102-021-00251-x ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Niklas Sörlén ◽

Andreas Hult ◽

Peter Nordström ◽

Anna Nordström ◽

Jonas Johansson

Keyword(s):

Older Adults ◽

Postural Sway ◽

Intervention Group ◽

Community Dwelling ◽

Control Group ◽

Positive Effects ◽

Randomized Controlled ◽

Eyes Closed ◽

Balance Exercise

Abstract Background We aimed to determine the effectiveness of 4 weeks of balance exercise compared with no intervention on objectively measured postural sway. Methods This was a single-center parallel randomized controlled, open label, trial. A six-sided dice was used for allocation at a 1:1-ratio between exercise and control. The trial was performed at a university hospital clinic in Sweden and recruited community-dwelling older adults with documented postural instability. The intervention consisted of progressively challenging balance exercise three times per week, during 4 weeks, with follow-up at week five. Main outcome measures were objective postural sway length during eyes open and eyes closed conditions. Results Sixty-five participants aged 70 years (balance exercise n = 32; no intervention n = 33) were randomized. 14 participants were excluded from analysis because of early dropout before follow-up at week five, leaving 51 (n = 22; n = 29) participants for analysis. No significant differences were detected between the groups in any of the postural sway outcomes. Within-group analyses showed significant improvements in hand grip strength for the intervention group, while Timed Up & Go improvements were comparable between groups but only statistically significant in the control group. Conclusions Performing balance exercise over a four-week intervention period did not acutely improve postural sway in balance-deficient older adults. The lower limit in duration and frequency to achieve positive effects remains unclear. Trial registration Clinical trials NCT03227666, July 24, 2017, retrospectively registered.

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Effectiveness of a Care Delivery Model for High-Need Community-Dwelling Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.893 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 279-279

Author(s):

Kuei-Min Chen ◽

Hui-Fen Hsu

Keyword(s):

Older Adults ◽

Comparison Group ◽

Care Delivery ◽

Care Service ◽

Intervention Group ◽

Community Dwelling ◽

Delivery Model ◽

Care Services ◽

Care Delivery Model ◽

Community Dwelling Older Adults

Abstract The effectiveness of sufficient care coordination for high-need community-dwelling older adults has not been discussed. This study aimed to examine the effectiveness of a newly-developed care delivery model for high-need community-dwelling older adults. A cluster randomized controlled trial with repeated measures design was employed. A total of 145 high-need older adults participated in the study and were randomly assigned to either the intervention group or comparison group. A categorized list of care services based on the types of high-need older adults as the intervention allowed care coordinators to make adequate care service linkages. The intervention period ranged over 6 months with regulated home visits and assesssments. Functional ability, quality of life, depressive symptoms, and healthcare and social service utilizations were measured at baseline, and at 3 and 6 months into the intervention. The participants’ satisfaction with care delivery was measured at the end of 6-month intervention. Results showed that the intervention group had a better functional ability, a higher quality of life, reduced depressive symptoms, and more efficient healthcare and social service utilizations than the comparison group at both the 3-month and 6-month intervals (all p < .05). By the end of the 6-month study, the intervention group were more satisfied with the care service linkages than the comparison group (p < .05). The positive effects of providing a categorized list of care services for care coordinators to make service linkages have been evidenced by the outcomes. The promising findings supported a further longer-term implementation of the care delivery model.

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A Web-based versus a Print-based Physical Activity Intervention for Community-dwelling Older Adults: Randomized Trial With a Cross-over Design (Preprint)

10.2196/preprints.32212 ◽

2021 ◽

Author(s):

Claudia Pischke ◽

Claudia Voelcker-Rehage ◽

Tiara Ratz ◽

Manuela Peters ◽

Christoph Buck ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Randomized Trial ◽

Physical Activity Intervention ◽

Intervention Group ◽

Community Dwelling ◽

Significant Group ◽

Web Based ◽

Group Sessions ◽

Community Dwelling Older Adults

BACKGROUND Despite the crucial role of regular physical activity (PA) for preventing chronic non-communicable diseases, fewer than half of older adults in Germany engage in the recommended levels of endurance training. OBJECTIVE The aim of this study was to compare acceptance and effectiveness of two interventions (web- vs. print-based) for PA promotion among initially inactive community-dwelling older adults aged 60 years and above in a nine-month randomized trial with a cross-over design. METHODS Participants were recruited offline and randomized to one of the following interventions for self-monitoring PA: (a) a print-based intervention (PRINT n=113), (b) a web-based intervention (WEB, n=129). Thirty percent (n=38) of those in group (b) received a PA tracker in addition to WEB (WEB+, (c)). After randomization, participants and researchers were not blinded. Participants’ intervention preferences at baseline were assessed retrospectively. All intervention groups were offered ten weekly face-to-face group sessions led by trained assistants. Afterwards, participants could choose to stay in their group or cross over to one of the other groups and group sessions were continued monthly for another six months. Three-dimensional accelerometers to assess PA and sedentary behavior (SB) at baseline (T0), three-month (T1) and nine-month follow-ups (T2) were employed. Adherence to PA recommendations, attendance of group sessions, and acceptance of the interventions were assessed via self-administered paper-based questionnaires. Linear mixed models were used to calculate differences in moderate-to-vigorous PA (MVPA) and SB between time points and intervention groups. RESULTS One-hundred and ninety-five participants completed T1. Only n=1 changed from WEB to PRINT and n=15 moved from PRINT to WEB (WEB-WEB: n=103, PRINT-PRINT: n=76) when offered to cross over at T1. One-hundred and sixty participants completed T2. MVPA in min per day increased between baseline and T1, but these within-group changes in time disappeared after adjusting for covariates. MVPA decreased by 9 min per day between baseline and T2 (βtime = -9.37, 95% CI: [-18.58; -0.16]), regardless of intervention group (WEB vs. PRINT: βgroup*time = -3.76, 95% CI: [-13.33; 5.82], WEB+ vs. PRINT: βgroup*time = 1.40, 95% CI: [-11.04; 13.83]). Nineteen percent of the participants met PA recommendations at T0, 20% at T1, and 20% at T2. For SB, there were no significant group differences and group-by-time interactions, neither at T1 nor at T2. Intervention acceptance was generally high. Use of intervention material was high to moderate at T1 (e.g., the PA diary was used by over 65% at least once a week) and decreased by T2 (40-50% in PRINT and in WEB used the PA diary at least once a week, and 58% in WEB+). CONCLUSIONS Despite high levels of acceptance of web- and print-based interventions for PA promotion and little movement between groups at T1, when given the choice, participation was not associated with increases in PA or decreases in SB over time. CLINICALTRIAL German Clinical Trials Register DRKS00016073 (Date of registration 10–01-2019).

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Beneficial Effects of Interactive Physical-Cognitive Game-Based Training on Fall Risk and Cognitive Performance of Older Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17176079 ◽

2020 ◽

Vol 17 (17) ◽

pp. 6079

Author(s):

Kochaphan Phirom ◽

Teerawat Kamnardsiri ◽

Somporn Sungkarat

Keyword(s):

Older Adults ◽

Cognitive Performance ◽

Fall Risk ◽

Intervention Group ◽

Significant Risk ◽

Community Dwelling ◽

Cognitive Outcome ◽

Timed Up And Go ◽

Cognitive Improvement ◽

Risk Factors For Falls

Physical and cognitive declines are significant risk factors for falls. Promising evidence suggests that combined physical-cognitive training would be an effective fall risk reduction and cognitive improvement intervention. However, a limited number of studies have been conducted and findings have been inconclusive. This study investigated the effects of interactive physical-cognitive game-based training on the fall risk and cognitive performance of older adults. Forty participants were randomly allocated to the intervention (n = 20) and control (n = 20) groups. Participants in the intervention group performed a 1 h session, 3 times a week for 12 weeks of the interactive physical-cognitive game-based training program. Fall risk (Physiological Profile Assessment, PPA; and Timed Up and Go, TUG) and cognitive outcome (Montreal Cognitive Assessment, MoCA) were assessed at pre- and post-intervention. Thirty-nine participants (mean age = 69.81 ± 3.78 years) completed the study (97.5%). At the end of the trial, participants in the intervention group demonstrated significant improvement in the PPA fall risk score (p = 0.015), postural sway (p = 0.005), MoCA score (p = 0.001), and TUG-dual task (p = 0.045) compared to controls. In conclusion, the interactive physical-cognitive, game-based training was effective in reducing physiological fall risk and improving cognitive function in community-dwelling older adults.

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Trajectories of self-rated health in an older general population and their determinants: the Lifelines Cohort Study

BMJ Open ◽

10.1136/bmjopen-2019-035012 ◽

2020 ◽

Vol 10 (2) ◽

pp. e035012

Author(s):

Marlies Feenstra ◽

Barbara C van Munster ◽

Janet L MacNeil Vroomen ◽

Sophia E de Rooij ◽

Nynke Smidt

Keyword(s):

Older Adults ◽

Cohort Study ◽

General Population ◽

Health Risk ◽

Chronic Diseases ◽

Community Dwelling ◽

Endocrine Function ◽

Self Rated Health ◽

Physiological Markers ◽

Community Dwelling Older Adults

ObjectivesPoor self-rated health (SRH) is a strong predictor of premature mortality in older adults. Trajectories of poor SRH are associated with multimorbidity and unhealthy behaviours. Whether trajectories of SRH are associated with deviating physiological markers is unclear. This study identified trajectories of SRH and investigated the associations of trajectory membership with chronic diseases, health risk behaviours and physiological markers in community-dwelling older adults.Study design and settingProspective general population cohort.ParticipantsTrajectories of SRH over 5 years were identified using data of 11 600 participants aged 65 years and older of the Lifelines Cohort Study.Outcome measuresTrajectories of SRH were the main outcome. Covariates included demographics (age, gender, education), chronic diseases, health-risk behaviour (physical activity, smoking, drinking) and physiological markers (body mass index, cardiovascular function, lung function, glucose metabolism, haematological condition, endocrine function, renal function, liver function and cognitive function).ResultsFour stable trajectories were identified, including excellent (n=607, 6%), good (n=2111, 19%), moderate (n=7677, 65%) and poor SRH (n=1205, 10%). Being women (OR: 1.4; 95% CI: 1.0 to 1.9), low education (OR: 2.1; 95% CI: 1.5 to 3.0), one (OR: 10.4; 95% CI: 7.4 to 14.7) or multiple chronic diseases (OR: 37.8; 95% CI: 22.4 to 71.8), smoking (OR: 1.8; 95% CI: 1.0 to 3.2), physical inactivity (OR: 3.1; 95% CI: 1.8 to 5.2), alcohol abstinence (OR: 2.2; 95% CI: 1.4 to 3.2) and deviating physiological markers (OR: 1.5; 95% CI: 1.1 to 2.0) increase the odds for a higher probability of poor SRH trajectory membership compared with excellent SRH trajectory membership.ConclusionSRH of community-dwelling older adults is stable over time with the majority (65%) having moderate SRH. Older adults with higher probabilities of poor SRH often have unfavourable health status.

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The effect of group exercises on balance, mobility, and depressive symptoms in older adults with mild cognitive impairment: a randomized controlled trial

Clinical Rehabilitation ◽

10.1177/0269215518815218 ◽

2018 ◽

Vol 33 (3) ◽

pp. 439-449 ◽

Cited By ~ 4

Author(s):

Chandra da Silveira Langoni ◽

Thais de Lima Resende ◽

Andressa Bombardi Barcellos ◽

Betina Cecchele ◽

Juliana Nunes da Rosa ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Depressive Symptoms ◽

Mild Cognitive Impairment ◽

Intervention Group ◽

Depression Scale ◽

Community Dwelling ◽

Effect Sizes ◽

Control Group ◽

Community Dwelling Older Adults

Objective: To determine the effects of group exercises on balance, mobility, and depressive symptoms in community-dwelling older adults with mild cognitive impairment. Design: Single blinded, randomized, matched pairs clinical trial. Setting: Four primary healthcare units. Subjects: Fifty-two sedentary subjects with mild cognitive impairment were paired (age, sex, body mass index, and Addenbrooke’s Cognitive Examination Revised score), tested, and then randomized into an intervention group ( n = 26) and a control group ( n = 26). Intervention: The intervention group performed strength (ankle weights, elastic bands, and dumbbells) and aerobic exercises (walking) in their communities’ public spaces, twice a week (60 minutes each), during 24 weeks. The control group maintained its usual routine. Main measures: Balance (Berg Balance Scale (BBS)), mobility (Timed Up and Go Test (TUG)), and depressive symptoms (Geriatric Depression Scale-15) were assessed before and after the intervention. Results: Before the intervention, the two groups did not differ statistically. After, the intervention group showed significant improvement ( P < 0.05) in balance (before: 53 ± 3; after: 55.1 ± 1.1 points), mobility (before: 10.7 ± 2.9 seconds; after: 8.3 ± 2 seconds), and depressive symptoms (median punctuation (interquartile range) before: 4 (1.8–6); after: 2.5 (1–4)). The control group presented a significant increase in their depressive symptoms (median before: 3.5 (2–7.3); after: 4 (2–5.3)), while their balance and mobility showed no significant modification. Small effect sizes were observed in the intervention group and control group depressive symptoms, as well as in the control group’s mobility and balance. Large effect sizes were observed the intervention group’s mobility and balance. Conclusion: Group exercises improved balance, mobility, and depressive symptoms in community-dwelling older adults with mild cognitive impairment.

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86 Developing the Adapted Lifestyle - Integrated Functional Exercise Programme in Thai Context (TLIFE) to Prevent Falls among Older Adults in Thailand: A Mixed Methods Study

Age and Ageing ◽

10.1093/ageing/afz164.86 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv18-iv27

Author(s):

Sasiporn Ounjaichon ◽

Chris Todd ◽

Emma Stanmore ◽

Elisabeth Boulton

Keyword(s):

Older Adults ◽

Randomised Controlled Trial ◽

Retention Rate ◽

Controlled Trial ◽

Intervention Group ◽

Exercise Programme ◽

Community Dwelling ◽

Control Group ◽

Functional Exercise ◽

Randomised Controlled

Abstract Introduction Falls are the leading cause of injuries in older Thai adults. There is a need to develop a fall prevention exercise programme to encourage participation and adherence. The adapted Lifestyle-integrated Functional Exercise (aLiFE) programme may be suitable by integrating exercise into daily routines as opposed to attending an exercise class. This study aimed to explore the acceptability and feasibility of the aLiFE programme in Thai context (TLiFE) among older Thai adults. Methods Based on the findings of a prior qualitative study, a feasibility randomised controlled trial (RCT) of TLiFE was conducted among community-dwelling older adults, comparing the TLiFE intervention group with a usual care control group. Outcome measures were analysed at baseline, 3 months, and after 6 months of the intervention. Results We recruited a total of 72 older adults into the RCT, randomised to TLiFE (n=36) and control (n=36). The retention rate at 6 months was 91.7%. Attendance in the intervention group (3 home visits and 4 follow-up calls) was 82.9%. There were no differences in fall incidence between the groups. The acceptability survey reveals TLiFE is easy to perform in daily life, safe, and useful. No adverse events were reported. Conclusion The TLiFE programme appears to be acceptable and feasible to deliver to community-dwelling older Thai adults. This feasibility study was not powered to detect a difference between groups. A further fully powered definitive randomised controlled trial of TLiFE is needed to evaluate long-term outcomes and cost-effectiveness before it is integrated within the healthcare system in Thailand.

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AN MHEALTH BEHAVIORAL INTERVENTION FOR PROMOTING PHYSICAL ACTIVITY AND SLEEP IN COMMUNITY-DWELLING OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.603 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S169-S169

Author(s):

Junxin Li ◽

Sarah Szanton ◽

Minhui Liu ◽

Nada Lukkahatai ◽

Junxin Li ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Sleep Quality ◽

Behavioral Intervention ◽

Intervention Group ◽

Community Dwelling ◽

Control Group ◽

Post Intervention ◽

Tnf Α ◽

Community Dwelling Older Adults

Abstract Evidence suggests physical activity (PA) improves sleep in older adults. This study examined the preliminary effect of a personalized mHealth behavioral intervention on PA and sleep in older adults. We conducted a randomized controlled pilot trial in 21 community-dwelling older adults with sleep complaints. The 24-week mHealth behavioral intervention included a 2-hour in person training session, personalized exercise prescription, real time PA self-monitoring, interactive prompts, phone consultation, and weekly financial incentives. PA and sleep were measured objectively using Actiwatch 2.0 and subjectively using questionnaires. Peripheral blood was drawn for measuring Plasma inflammatory biomarkers [interleukin 1β, 6, 8, Tumor Necrosis Factor- alpha (TNF-α), and c-reactive protein (CRP)]. Data were collected at baseline, 8-week, 16-week, and post intervention. Repeated measures ANOVA (time*group) was used to examine differences of PA and sleep across times between the two groups. Majority of participants are women (71.4%) with mean age of 73.7 (SD = 6.9). Repeated measure ANOVA showed significant (p <0.05) improvement of objective and subjective PA, objective nocturnal sleep duration, self-report sleep quality (measured by Pittsburg Sleep Quality Index and Insomnia Severity Index) and decreasing of sedentary time over times in the intervention group (n=11), compared to the control group. The intervention group showed significant reduction of plasma TNF-α and CRP levels at 16-week and post intervention. Interventions combining personalized PA and mHealth strategies may positively affect physical activity and sleep in older adults. A larger study is needed to test the efficacy of this intervention and the mechanisms associated with it.

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Effectiveness of a Treadmill Training Programme in Improving the Postural Balance on Institutionalized Older Adults

Journal of Aging Research ◽

10.1155/2020/4980618 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Natalia Moya Pereira ◽

Marcel Jean Pierre Massè Araya ◽

Marcos Eduardo Scheicher

Keyword(s):

Older Adults ◽

Gait Speed ◽

Postural Balance ◽

Intervention Group ◽

Community Dwelling ◽

Treadmill Walking ◽

Control Group ◽

Timed Up And Go ◽

Positive Effects ◽

Before And After

Background. Institutionalized older adults have increased gait and balance impairment compared with community-dwelling older adults. The use of the treadmill for the rehabilitation process has been studied in different groups, but not in the institutionalized elderly. Objectives. The objective of this study was to assess the effects of a treadmill walking workout program on the postural balance of institutionalized older adults. Methods. Postural balance was assessed by the Berg Balance Scale (BBS), Short Physical Performance Battery (SPPB), gait speed, and Timed Up and Go Test (TUG) on 37 institutionalized older adults (23 in the intervention group and 14 in the control group). Training consisted of a 20-minute treadmill walking workout carried out twice a week for 10 weeks. Measurements were obtained before and after 10 weeks and with 1 month of follow-up for the intervention group. For the control group, the data were obtained before and after the training period. Results. Significant improvement occurred in all motor function parameters (BBS: p<0.01; gait speed: p<0.001; SPPB: p<0.001; and TUG: p<0.001). Conclusions. The present results permit us to conclude that a treadmill walking program had positive effects on the postural balance of institutionalized older adults.

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