scholarly journals Effects of Mobile Health App Interventions on Sedentary Time, Physical Activity, and Fitness in Older Adults: Systematic Review and Meta-Analysis (Preprint)

2019 ◽  
Author(s):  
Dharani Yerrakalva ◽  
Dhrupadh Yerrakalva ◽  
Samantha Hajna ◽  
Simon Griffin
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Mobile Health ◽  
Sedentary Time ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Functional Decline ◽  
Risk Of Bias ◽  
Community Dwelling ◽  
Increased Risk

BACKGROUND High sedentary time, low physical activity (PA), and low physical fitness place older adults at increased risk of chronic diseases, functional decline, and premature mortality. Mobile health (mHealth) apps, apps that run on mobile platforms, may help promote active living. OBJECTIVE We aimed to quantify the effect of mHealth app interventions on sedentary time, PA, and fitness in older adults. METHODS We systematically searched five electronic databases for trials investigating the effects of mHealth app interventions on sedentary time, PA, and fitness among community-dwelling older adults aged 55 years and older. We calculated pooled standardized mean differences (SMDs) in these outcomes between the intervention and control groups after the intervention period. We performed a Cochrane risk of bias assessment and Grading of Recommendations, Assessment, Development, and Evaluation certainty assessment. RESULTS Overall, six trials (486 participants, 66.7% [324/486] women; age mean 68 [SD 6] years) were included (five of these trials were included in the meta-analysis). mHealth app interventions may be associated with decreases in sedentary time (SMD=−0.49; 95% CI −1.02 to 0.03), increases in PA (506 steps/day; 95% CI −80 to 1092), and increases in fitness (SMD=0.31; 95% CI −0.09 to 0.70) in trials of 3 months or shorter and with increases in PA (753 steps/day; 95% CI −147 to 1652) in trials of 6 months or longer. Risk of bias was low for all but one study. The quality of evidence was moderate for PA and sedentary time and low for fitness. CONCLUSIONS mHealth app interventions have the potential to promote changes in sedentary time and PA over the short term, but the results did not achieve statistical significance, possibly because studies were underpowered by small participant numbers. We highlight a need for larger trials with longer follow-up to clarify if apps deliver sustained clinically important effects.

scholarly journals Effects of Mobile Health App Interventions on Sedentary Time, Physical Activity, and Fitness in Older Adults: Systematic Review and Meta-Analysis

10.2196/14343 ◽  
2019 ◽  
Vol 21 (11) ◽  
pp. e14343 ◽  
Author(s):  
Dharani Yerrakalva ◽  
Dhrupadh Yerrakalva ◽  
Samantha Hajna ◽  
Simon Griffin
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Mobile Health ◽  
Sedentary Time ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Functional Decline ◽  
Risk Of Bias ◽  
Community Dwelling ◽  
Increased Risk

Background High sedentary time, low physical activity (PA), and low physical fitness place older adults at increased risk of chronic diseases, functional decline, and premature mortality. Mobile health (mHealth) apps, apps that run on mobile platforms, may help promote active living. Objective We aimed to quantify the effect of mHealth app interventions on sedentary time, PA, and fitness in older adults. Methods We systematically searched five electronic databases for trials investigating the effects of mHealth app interventions on sedentary time, PA, and fitness among community-dwelling older adults aged 55 years and older. We calculated pooled standardized mean differences (SMDs) in these outcomes between the intervention and control groups after the intervention period. We performed a Cochrane risk of bias assessment and Grading of Recommendations, Assessment, Development, and Evaluation certainty assessment. Results Overall, six trials (486 participants, 66.7% [324/486] women; age mean 68 [SD 6] years) were included (five of these trials were included in the meta-analysis). mHealth app interventions may be associated with decreases in sedentary time (SMD=−0.49; 95% CI −1.02 to 0.03), increases in PA (506 steps/day; 95% CI −80 to 1092), and increases in fitness (SMD=0.31; 95% CI −0.09 to 0.70) in trials of 3 months or shorter and with increases in PA (753 steps/day; 95% CI −147 to 1652) in trials of 6 months or longer. Risk of bias was low for all but one study. The quality of evidence was moderate for PA and sedentary time and low for fitness. Conclusions mHealth app interventions have the potential to promote changes in sedentary time and PA over the short term, but the results did not achieve statistical significance, possibly because studies were underpowered by small participant numbers. We highlight a need for larger trials with longer follow-up to clarify if apps deliver sustained clinically important effects.

Systematic review and meta-analysis of smart-technology vs. face-to-face physical activity interventions in older adults (Preprint)

2022 ◽  
Author(s):  
Cassandra D'Amore ◽  
Julie C Reid ◽  
Matthew Chan ◽  
Samuel Fan ◽  
Amanda Huang ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Community Dwelling ◽  
Smart Technology ◽  
Face To Face ◽  
Meta Analyses ◽  
Community Dwelling Older Adults

BACKGROUND This is a systematic review of randomized controlled trials and a meta-analysis comparing smart-technology to face-to-face physical activity (PA) interventions, in community-dwelling older adults, mean age greater than or equal 60 years. OBJECTIVE To determine the effect of smart-technology interventions compared to face-to-face PA interventions on PA and physical function in older adults. Our secondary outcomes were depression, anxiety, and health-related quality of life. METHODS We searched four electronic databases from inception to February 2021. Two independent reviewers screened titles/abstracts, full texts, and performed data extraction and risk of bias assessments using the Cochrane risk of bias tool. GRADE was used to evaluate the quality of the evidence. We provided a narrative synthesis on all included studies and, where possible, we performed meta-analyses for similar outcomes. RESULTS 19 studies with a total of 3455 patients were included. Random-effects meta-analyses showed that smart-technology interventions resulted in improved step count (mean difference 1440 steps, 95% confidence interval (CI) 500, 2390) and total PA (standardized mean difference 0.17, 95% CI 0.02, 0.32) compared to face-face interventions. The quality of the evidence for the effects of smart-technology interventions was very low based on GRADE criteria. There was no difference between groups for measures of physical function. CONCLUSIONS Interventions that include smart-technology may improve daily step counts by an average of 1440 steps in community dwelling older adults, however the quality of the evidence was very low. Future studies are needed to improve the certainty of results.

scholarly journals Changes in Health Behaviors, Mental and Physical Health among Older Adults under Severe Lockdown Restrictions during the COVID-19 Pandemic in Spain

2021 ◽  
Vol 18 (13) ◽  
pp. 7067
Author(s):  
Esther García-Esquinas ◽  
Rosario Ortolá ◽  
Iago Gine-Vázquez ◽  
José A. Carnicero ◽  
Asier Mañas ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Older Adults ◽  
Social Isolation ◽  
Community Dwelling ◽  
Housing Conditions ◽  
Older Individuals ◽  
Lifestyle Risk Factors ◽  
Increased Risk ◽  
Lifestyle Risk

We used data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain collected through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning of the COVID-19 lockdown. On average, the confinement was not associated with a deterioration in lifestyle risk factors (smoking, alcohol intake, diet, or weight), except for a decreased physical activity and increased sedentary time, which reversed with the end of confinement. However, chronic pain worsened, and moderate declines in mental health, that did not seem to reverse after restrictions were lifted, were observed. Males, older adults with greater social isolation or greater feelings of loneliness, those with poorer housing conditions, as well as those with a higher prevalence of chronic morbidities were at increased risk of developing unhealthier lifestyles or mental health declines with confinement. On the other hand, previously having a greater adherence to the Mediterranean diet and doing more physical activity protected older adults from developing unhealthier lifestyles with confinement. If another lockdown were imposed during this or future pandemics, public health programs should specially address the needs of older individuals with male sex, greater social isolation, sub-optimal housing conditions, and chronic morbidities because of their greater vulnerability to the enacted movement restrictions.

scholarly journals Changes in Objectively Measured Lifestyle Factors During the COVID-19 Pandemic in Community-Dwelling Older Adults

2021 ◽  
Author(s):  
Takuya Ataka ◽  
Noriyuki Kimura ◽  
Atsuko Eguchi ◽  
Etsuro Matsubara
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Sedentary Time ◽  
Vigorous Physical Activity ◽  
Wearable Sensors ◽  
Lifestyle Factors ◽  
Community Dwelling ◽  
Activity Level ◽  
Objectively Measured ◽  
Community Dwelling Older Adults

Abstract Background: In this manuscript, we aimed at investigating whether objectively measured lifestyle factors, including walking steps, sedentary time, amount of unforced physical activity, level of slight and energetic physical activity, conversation time, and sleep parameters altered before and during the COVID-19 pandemic among community-dwelling older adults.Methods: Data were obtained from a prospective cohort study conducted from 2015 to 2019 and a subsequent dementia prevention study undertaken in September 2020. Community-dwelling adults aged ≥65 years wore wearable sensors before and during the pandemic.Results: A total of 56 adults were enrolled in this study. The mean age was 74.2±3.9 years, and 58.9% (n=33) of the participants were female. The moderate and vigorous physical activity time significantly decreased and sedentary time significantly increased during the pandemic. Conclusions: This is the first study to demonstrate differences in objectively assessed lifestyle factors before and during the COVID-19 pandemic among community-dwelling older adults. The findings show that the pandemic has adversely affected physical activity among older adults living on their own in Japan.

scholarly journals Exploring Cognitively Loaded Physical Activity Compared With Control to Improve Global Cognitive Function in Older Community-Dwelling Adults With Mild Cognitive Impairment: Systematic Review With Meta-Analysis

2019 ◽  
pp. 155982761987688
Author(s):  
Kristina Zawaly ◽  
Richard Fortier ◽  
Stephen Buetow ◽  
Lynette Tippett ◽  
Ngaire Kerse
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Meta Analysis ◽  
Community Dwelling ◽  
Controlled Trials ◽  
Global Cognitive Function ◽  
Global Cognition

Objective. A systematic review with a meta-analysis explored effects of cognitively loaded physical activity interventions on global cognition in community-dwelling older adults (≥65 years of age) experiencing mild cognitive impairment (MCI), compared to any control. Methods. A literature search was conducted in 4 databases (MEDLINE [OvidSP], PubMed, CINAHL, and the Cochrane Central Register of Controlled Trials [Wiley]) from inception until January 30, 2018. The meta-analysis was conducted with Review Manager 5.3. Results. Six randomized controlled trials (RCTs) with 547 participants were identified. The interventions ranged from 4 to 52 weeks. Baseline and initial follow-up assessments were used. The primary pooled analysis of all RCTs demonstrated a nonsignificant trivial effect (standardized mean difference [SMD] 0.07, 95% confidence interval [CI] −0.44 to 0.58) favoring the intervention. In pooled subanalysis of 4 RCTs (n = 405) using the same global cognition measure (Mini-Mental State Examination) and duration of intervention >12 weeks, the intervention group achieved a small but significant improvement for global cognition (SMD 0.45, 95% CI 0.14 to 0.75). Conclusion. When all the RCTs were pooled, the effect of cognitively loaded physical activity intervention on global cognitive function in older adults with MCI remained unclear. The subgroup analysis provides translation evidence for future RCT study designs.

scholarly journals META-ANALYSIS OF INTERVENTIONS TO REDUCE SEDENTARY BEHAVIOR AMONG OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S867-S868
Author(s):  
Jennifer A Otmanowski ◽  
Sheri A Rowland ◽  
Pamela S Cooper ◽  
Jo-Ana D Chase
Keyword(s):  
Older Adults ◽  
Sedentary Behavior ◽  
Meta Analysis ◽  
Community Dwelling ◽  
Future Research ◽  
High Risk Population ◽  
Significant Heterogeneity ◽  
Sedentary Population ◽  
Increased Risk ◽  
Post Test

Abstract ABSTRACT BODY Sedentary behavior (SB) is associated with substantial health risks such as increased risk of cardiovascular mortality, diabetes, and cognitive and physical functioning decline. Older adults are particularly at risk as they are the most sedentary population. The purpose of this meta-analysis was to determine the overall effects of interventions designed to reduce SB among older adults. A comprehensive literature search of online databases, bibliographies, and author searches located published and unpublished studies. Included studies tested interventions to reduce SB time, were written in English, and focused on community-dwelling adults age 60 years or older. Data were extracted on sample, study design, and intervention characteristics using an investigator-developed tool. Study effect sizes were synthesized using a random effects model. Heterogeneity of effects across studies was examined; however, moderator analyses were not conducted due to the small number of included studies. Of the 2,408 reviewed citations, 22 reports were included representing 17 distinct studies, eight of which were included in the two-group post-test meta-analysis (n= 1,024 participants). Interventions overall modestly reduced SB time among older adults (d=-.25, 95% CI [-.50, .00], p=.05); however, significant heterogeneity of effect size was observed across studies (Q=22.34, p<.01). Our findings demonstrate a need for more research targeting SB reduction in this high-risk population. Future research should include measures of breaks in sedentary time and types of SB (e.g., watching TV, reading) which are also critical indicators of health risk. Moreover, further exploration of relationships between health outcomes and SB intervention effects is needed.

Sedentary Behavior and Physical Activity Patterns in Older Adults After Hip Fracture: A Call to Action

2016 ◽  
Vol 24 (1) ◽  
pp. 79-84 ◽  
Author(s):  
Lena Fleig ◽  
Megan M. McAllister ◽  
Penny Brasher ◽  
Wendy L. Cook ◽  
Pierre Guy ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Hip Fracture ◽  
Sedentary Behavior ◽  
Sedentary Time ◽  
Activity Patterns ◽  
Community Dwelling ◽  
Call To Action ◽  
Light Activity

Objectives:To characterize patterns of sedentary behavior and physical activity in older adults recovering from hip fracture and to determine characteristics associated with activity.Methods:Community-dwelling, Canadian adults (65 years+) who sustained hip fracture wore an accelerometer at the waist for seven days and provided information on quality of life, falls self-efficacy, cognitive functioning, and mobility.Results:There were 53 older adults (mean age [SD] 79.5 [7.8] years) enrolled in the study; 49 had valid data and demonstrated high levels of sedentary time (median [p10, p90] 591.3 [482.2, 707.2] minutes/day), low levels of light activity (186.6 [72.6, 293.7]), and MVPA (2 [0.1, 27.6]), as well as few daily steps (2467.7 [617.1, 6820.4]). Regression analyses showed that age, gender, gait speed, and time since fracture were associated with outcomes.Conclusions:Older adults have long periods of sedentary time with minimal activity. Results are a call to action to encourage people to sit less and move more.

scholarly journals The Relationship Between Cognitive Decline and Sedentary Time

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 191-191
Author(s):  
Lorraine Phillips ◽  
Mary Bowen
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cognitive Function ◽  
Lower Extremity ◽  
Sedentary Time ◽  
Community Dwelling ◽  
Physical Activity Intensity ◽  
Lower Extremity Function ◽  
Activity Intensity ◽  
Extremity Function

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.

scholarly journals The Effect of Chair-Based Exercise on Physical Function in Older Adults: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (4) ◽  
pp. 1902
Author(s):  
Natalie Klempel ◽  
Nicole E. Blackburn ◽  
Ilona L. McMullan ◽  
Jason J. Wilson ◽  
Lee Smith ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Older Adults ◽  
Physical Function ◽  
Handgrip Strength ◽  
Meta Analysis ◽  
Later Life ◽  
Risk Of Bias ◽  
Exercise Programmes ◽  
The Impact

Physical activity is an important determinant of health in later life. The public health restrictions in response to COVID-19 have interrupted habitual physical activity behaviours in older adults. In response, numerous exercise programmes have been developed for older adults, many involving chair-based exercise. The aim of this systematic review was to synthesise the effects of chair-based exercise on the health of older adults. Ovid Medline, EMBASE, CINAHL, AMED, PyscInfo and SPORTDiscus databases were searched from inception to 1 April 2020. Chair-based exercise programmes in adults ≥50 years, lasting for at least 2 weeks and measuring the impact on physical function were included. Risk of bias of included studies were assessed using Cochrane risk of bias tool v2. Intervention content was described using TiDieR Criteria. Where sufficient studies (≥3 studies) reported data on an outcome, a random effects meta-analysis was performed. In total, 25 studies were included, with 19 studies in the meta-analyses. Seventeen studies had a low risk of bias and five had a high risk of bias. In this systematic review including 1388 participants, results demonstrated that chair-based exercise programmes improve upper extremity (handgrip strength: MD = 2.10; 95% CI = 0.76, 3.43 and 30 s arm curl test: MD = 2.82; 95% CI = 1.34, 4.31) and lower extremity function (30 s chair stand: MD 2.25; 95% CI = 0.64, 3.86). The findings suggest that chair-based exercises are effective and should be promoted as simple and easily implemented activities to maintain and develop strength for older adults.

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