Effect of Inpatient and Outpatient Pneumonia on Mobility Disability, Gait Speed, and Physical Activity in Older Adults

Pathophysiological changes caused by pneumonia may influence physical functioning in older adults. This study was a secondary analysis of the Lifestyle Interventions and Independence for Elders (LIFE) Study. The LIFE Study included 1635 individuals over an average follow-up of 2.6 years at eight clinical sites during 2010–2013. Adults ≥ 70 years-old with mobility limitations (Short Physical Performance Battery score ≤ 9) were randomized to a physical activity (exercise) intervention or health education control arm. This analysis evaluated the association between pneumonia events and major mobility disability (MMD), gait speed, and physical activity levels. Pneumonia events, classified as inpatient or outpatient, were assessed by self-report during longitudinal follow-up. MMD was measured by the inability to complete a 400-m walk test, or other proxies, as a binary outcome and separately analyzed as “short-term” and “long-term” MMD. Short-term MMD was defined as MMD occurring in the assessment period immediately following (between 1-day to 6-months after) a pneumonia event and long-term was in the following assessment period (6 to 12 months after the event). Short- and long-term gait speed was similarly recorded during the walk test in meters per second (m/s) and measured on a linear scale. Physical activity levels were captured via accelerometry and shown visually. Mixed-effects repeated measures regression adjusted for intervention assignment, baseline demographics, comorbid conditions, and frailty. Among the 1635 participants, n = 174 (10.7%) had a pneumonia event of which 80 (46% of events) were hospitalized. Those with pneumonia during follow-up had higher baseline medication use, prior hospitalizations, and higher prevalence of lung disorders but similar baseline functioning. Pneumonia hospitalization was associated with a 4-fold increase [OR = 4.1 (3.2–5.0)] and outpatient events were associated with a 2-fold increase [OR = 2.6 (2.1–3.1)] in the odds of short-term MMD. Pneumonia hospitalizations, but not outpatient events, were associated with a nearly 10% decrement in short-term gait speed. Pneumonia events were not associated with either long-term MMD or gait speed outcomes. Physical activity levels decreased from baseline immediately following the pneumonia episode (10–30% reductions) and returned to baseline after 6 months. These results emphasize the importance of managing pneumonia risk factors to prevent disease in order to maintain physical independence and activity in older adults.

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Does Cardiac Rehabilitation After an Acute Cardiac Syndrome Lead to Changes in Physical Activity Habits? Systematic Review

Physical Therapy ◽

10.2522/ptj.20130509 ◽

2015 ◽

Vol 95 (2) ◽

pp. 167-179 ◽

Cited By ~ 31

Author(s):

Nienke ter Hoeve ◽

Bionka M.A. Huisstede ◽

Henk J. Stam ◽

Ron T. van Domburg ◽

Madoka Sunamura ◽

...

Keyword(s):

Physical Activity ◽

Randomized Clinical Trials ◽

Evidence Synthesis ◽

Activity Levels ◽

Long Term Effects ◽

Short Term ◽

Home Based ◽

Best Evidence Synthesis ◽

Physical Activity Levels

BackgroundOptimal physical activity levels have health benefits for patients with acute coronary syndrome (ACS) and are an important goal of cardiac rehabilitation (CR).PurposeThe purpose of this study was to systematically review literature regarding short-term effects (<6 months after completion of CR) and long-term effects (≥6 months after completion) of standard CR on physical activity levels in patients with ACS.Data SourcesPubMed, EMBASE, CINAHL, and PEDro were systematically searched for relevant randomized clinical trials (RCTs) published from 1990 until 2012.Study SelectionRandomized clinical trials investigating CR for patients with ACS reporting physical activity level were reviewed.Data ExtractionTwo reviewers independently selected articles, extracted data, and assessed methodological quality. Results were summarized with a best evidence synthesis. Results were categorized as: (1) center-based/home-based CR versus no intervention, (2) comparison of different durations of CR, and (3) comparison of 2 types of CR.Data SynthesisA total of 26 RCTs were included. Compared with no intervention, there was, at most, conflicting evidence for center-based CR and moderate evidence for home-based CR for short-term effectiveness. Limited evidence and no evidence were found for long-term maintenance for center-based and home-based CR, respectively. When directly compared with center-based CR, moderate evidence showed that home-based CR has better long-term effects. There was no clear evidence that increasing training volume, extending duration of CR, or adding an extra intervention to CR is more effective.LimitationsBecause of the variety of CR interventions in the included RCTs and the variety of outcome measures in the included RCTs, pooling of data was not possible. Therefore, a best evidence synthesis was used.ConclusionsIt would appear that center-based CR is not sufficient to improve and maintain physical activity habits. Home-based programs might be more successful, but the literature on these programs is limited. More research on finding successful interventions to improve activity habits is needed.

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The Impact of Isolation Measures Due to COVID-19 on Energy Intake and Physical Activity Levels in Australian University Students

Nutrients ◽

10.3390/nu12061865 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1865 ◽

Cited By ~ 10

Author(s):

Linda A. Gallo ◽

Tania F. Gallo ◽

Sophia L. Young ◽

Karen M. Moritz ◽

Lisa K. Akison

Keyword(s):

Physical Activity ◽

Energy Intake ◽

Activity Levels ◽

Physical Isolation ◽

Home Based ◽

Physical Activity Levels ◽

Reduced Physical Activity ◽

The Impact

The coronavirus disease 2019 (COVID-19) pandemic resulted in physical isolation measures in many parts of the world. In Australia, nationwide restrictions included staying at home, unless seeking medical care, providing care, purchasing food, undertaking exercise, or attending work in an essential service. All undergraduate university classes transitioned to online, mostly home-based learning. We, therefore, examined the effect of isolation measures during the early phase of the COVID-19 pandemic in Australia (March/April) on diet (24-h recall) and physical activity (Active Australia Survey) patterns in third-year biomedical students. Findings were compared with students enrolled in the same course in the previous two years. In females, but not males, energy intake was ~20% greater during the pandemic, and snacking frequency and energy density of consumed snacks also increased compared with 2018 and 2019. Physical activity was impacted for both sexes during the pandemic with ~30% fewer students achieving “sufficient” levels of activity, defined by at least 150 min over at least five sessions, compared with the previous two years. In a follow-up study six to eight weeks later (14–18% response rate), during gradual easing of nationwide restrictions albeit continued gym closures and online learning, higher energy intake in females and reduced physical activity levels in both sexes persisted. These data demonstrate the health impacts of isolation measures, with the potential to affect long-term diet and activity behaviours.

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THE SHORT- AND LONG-TERM EFFECTS OF A 24-MONTH HOME-BASED PHYSICAL ACTIVITY PROGRAM ON PHYSICAL ACTIVITY LEVELS AND BODY COMPOSITION OF OLDER ADULTS AT RISK OF ALZHEIMER’S DISEASE: THE AIBL ACTIVE TRIAL

Alzheimer s & Dementia ◽

10.1016/j.jalz.2017.07.305 ◽

2017 ◽

Vol 13 (7) ◽

pp. P895

Author(s):

Kay L. Cox ◽

Elizabeth V. Cyarto ◽

Kathryn A. Ellis ◽

David Ames ◽

Patricia Desmond ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Body Composition ◽

Activity Levels ◽

Long Term Effects ◽

Activity Program ◽

Home Based ◽

Physical Activity Levels ◽

Short And Long Term

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Understanding temporal relationships between depression, falls, and physical activity in a cohort of post-hospitalized older adults – a breakthrough or a conundrum?

International Psychogeriatrics ◽

10.1017/s104161021700103x ◽

2017 ◽

Vol 29 (10) ◽

pp. 1681-1692 ◽

Cited By ~ 6

Author(s):

Den-Ching A. Lee ◽

Aislinn F. Lalor ◽

Grant Russell ◽

Rene Stolwyk ◽

Ted Brown ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Depressive Symptoms ◽

Community Dwelling ◽

Baseline Survey ◽

Activity Levels ◽

Negatively Associated ◽

Temporal Relationships ◽

Physical Activity Levels

ABSTRACTBackground:Clinical depression affects approximately 15% of community-dwelling older adults, of which half of these cases present in later life. Falls and depressive symptoms are thought to co-exist, while physical activity may protect an older adult from developing depressive symptoms. This study investigates the temporal relationships between depressive symptoms, falls, and participation in physical activities amongst older adults recently discharged following extended hospitalization.Methods:A prospective cohort study in which 311 older adults surveyed prior to hospital discharge were assessed monthly post-discharge for six months. N = 218 completed the six-month follow-up. Participants were recruited from hospitals in Melbourne, Australia. The survey instrument used was designed based on Fiske's behavioral model depicting onset and maintenance of depression. The baseline survey collected data on self-reported falls, physical activity levels, and depressive symptoms. The monthly follow-up surveys repeated measurement of these outcomes.Results:At any assessment point, falls were positively associated with depressive symptoms; depressive symptoms were negatively associated with physical activity levels; and, physical activity levels were negatively associated with falls. When compared with data in the subsequent assessment point, depressive symptoms were positively associated with falls reported over the next month (unadjusted OR: 1.20 (1.12, 1.28)), and physical activity levels were negatively associated with falls reported over the next month (unadjusted OR: 0.97 (0.96, 0.99) household and recreational), both indicating a temporal relationship.Conclusion:Falls, physical activity, and depressive symptoms were inter-associated, and depressive symptoms and low physical activity levels preceded falls. Clear strategies for management of these interconnected problems remain elusive.

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Enhancing the Physical Activity Levels of Frail Older Adults with a Wearable Activity Tracker-Based Exercise Intervention: A Pilot Cluster Randomized Controlled Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph181910344 ◽

2021 ◽

Vol 18 (19) ◽

pp. 10344

Author(s):

Justina Y. W. Liu ◽

Rick Y. C. Kwan ◽

Yue-Heng Yin ◽

Paul H. Lee ◽

Judy Yuen-man Siu ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Exercise Intervention ◽

Community Dwelling ◽

Activity Levels ◽

Frail Older Adults ◽

Activity Tracker ◽

Physical Activity Levels ◽

Wearable Activity Tracker

A wearable activity tracker (WAT) incorporated with behavioral change techniques (BCTs) increases physical activity in younger adults; however, its effectiveness with frail older adults is unknown. The feasibility and preliminary effects of a WAT-based exercise intervention to increase physical activity levels in frail older adults was investigated in this pilot study involving 40 community-dwelling frail older adults. The experimental group received a 14-week WAT-based group exercise intervention and a 3-month follow-up, while the control group only received similar physical training and all BCTs. The recruitment rate was 93%, and the average attendance rate was 85.2% and 82.2% in the WAT and control groups, respectively, establishing feasibility. Adherence to wearing the WAT was 94.2% and 92% during the intervention and follow-up periods, respectively. A significant interaction effect between time and group was found in all physical assessments, possibly lasting for 3 months post-intervention. However, no significant difference between groups was observed in any daily activity level by the ActiGraph measurement. The majority of the WAT group’s ActiGraph measurements reverted to baseline levels at the 1-month follow-up. Thus, the WAT-based exercise program has potential for employment among community-dwelling frail older adults, but sustaining the effects after the intervention remains a major challenge.

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Changes in physical activity levels and relationship to balance performance, gait speed, and self-rated health in older Swedish women: a longitudinal study

Aging Clinical and Experimental Research ◽

10.1007/s40520-021-02016-5 ◽

2021 ◽

Author(s):

Marian E. Papp ◽

Ann Charlotte Grahn-Kronhed ◽

Hans Rauch Lundin ◽

Helena Salminen

Keyword(s):

Physical Activity ◽

Older Women ◽

Gait Speed ◽

Activity Levels ◽

Balance Performance ◽

Self Rated Health ◽

Eyes Closed ◽

Physical Activity Levels ◽

Eyes Open

Abstract Background and aim Physical activity levels in older people often decrease and may mean impaired physical functioning leading to an increased fall risk. The aim of this study was to investigate self-reported change in physical activity dose and deterioration in balance performance, gait speed, and self-rated health (SRH) in older women between two time points in a follow-up study. Methods A cohort of community-living women, aged 69–79 years (n = 351) were evaluated by questionnaire and clinical tests on balance, gait speed, and SRH at baseline. One hundred and eighty-six women were followed-up by these tests 8.5 years after inclusion. The non-parametric Wilcoxon signed-rank test and Mann–Whitney U test were used for the analysis. Results The greatest changes were seen in one-leg standing time (OLST) with eyes closed (− 60%) and eyes open (− 42%). The population was divided into high exercise (HE, n = 49) and low exercise (LE, n = 51) groups. At baseline the HE group had an OLST of 19 s with eyes open and 3 s with eyes closed. In the LE group, these values were 7.3 s and 2 s. At follow-up, differences between HE and LE concerning tandem walk forwards (steps) (HE = 8.5; LE = 2.5) and backwards (HE = 11; LE = 3.5) emerged. The HE group estimated SRH (VAS-scale) 30 mm higher at baseline and 17 mm higher at follow-up than the LE group. Conclusion Greater physical activity seems to be an important predictor for maintaining physical function and SRH in older women.

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F1-03-04: The predictors of short- and long-term physical activity levels of older adults from FABS (Fitness for the Aging Brain Study)

Alzheimer s & Dementia ◽

10.1016/j.jalz.2012.05.200 ◽

2012 ◽

Vol 8 (4S_Part_2) ◽

pp. P82-P83

Author(s):

Kay Cox ◽

Leon Flicker ◽

Osvaldo Almeida ◽

Kathryn R. Greenop ◽

Jacqueline Hendricks ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Aging Brain ◽

Activity Levels ◽

Physical Activity Levels ◽

Short And Long Term ◽

Brain Study

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Impact of physical activity on the risk of cardiovascular disease in middle-aged and older adults: EPIC Norfolk prospective population study

European Journal of Preventive Cardiology ◽

10.1177/2047487317737628 ◽

2017 ◽

Vol 25 (2) ◽

pp. 200-208 ◽

Cited By ~ 36

Author(s):

Sangeeta Lachman ◽

S Matthijs Boekholdt ◽

Robert N Luben ◽

Stephen J Sharp ◽

Soren Brage ◽

...

Keyword(s):

Physical Activity ◽

Cardiovascular Disease ◽

Older Adults ◽

Population Study ◽

Health Benefits ◽

Activity Levels ◽

Inverse Association ◽

Middle Aged ◽

Physical Activity Levels

Background There is broad consensus that regular physical activity yields major health benefits. However, current guidelines on physical activity are mainly aimed at middle-aged adults. It is unclear whether physical activity also translates into cardiovascular health benefits in older adults. Therefore, we aimed to compare the association between different levels of physical activity and the risk of cardiovascular disease (CVD) in elderly to middle-aged individuals. Methods We analysed data from the EPIC Norfolk prospective population study. Cox proportional hazards models were used to analyse the association between physical activity levels and time to CVD events in three age categories (<55, 55–65 and >65 years). Interaction between age categories and physical activity levels was assessed. Results Analyses were based on 24,502 study participants aged 39–79 years. A total of 5240 CVD events occurred during 412,954 person-years follow-up (median follow-up was 18.0 years). Among individuals aged over 65 years, hazard ratios for CVD were 0.86 (95% confidence interval (CI) 0.78–0.96), 0.87 (95% CI 0.77–0.99) and 0.88 (95% CI 0.77–1.02) in moderately inactive, moderately active and active people, respectively, compared to inactive people. Among people aged 55–65 and less than 55 years, the associations were directionally similar, but not statistically significant. The interaction term between physical activity levels and age categories was not significant ( P = 0.38). Conclusion The inverse association between physical activity and the risk of CVD was significant in elderly and comparable with middle-aged individuals. In addition, we observed that modest levels of physical activity confer benefits in terms of CVD risk, compared to being completely inactive.

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