Journal of Aging and Physical Activity最新文献

Objectives: To reveal pathways through which physical exercise is associated with the specific depressive symptoms in older adults from the perspective of network analysis.

Methods: 8,931 participants were selected from the 2018 Chinese Longitudinal Healthy Longevity Survey database. Participants were divided into exercise and nonexercise groups using propensity score matching to minimize confounding effects. The 10-item Center for Epidemiologic Studies Depression Scale was used to assess depression in this cross-sectional survey. Treating each item of 10-item Center for Epidemiologic Studies Depression Scale as a node, depressive symptom networks were constructed for both groups. Network centrality, stability, accuracy, and intergroup differences were analyzed.

Results: Core symptoms in the exercise group were D3 (sad mood), D8 (felt lonely), and D1 (bothered by little things), whereas core symptoms in the nonexercise group were D3 (sad mood), D9 (cannot get going), and D6 (felt fearful). The expected influence of the D9 (cannot get going) node was higher in the nonexercise group compared with the exercise group; no differences in symptom network structure between the two groups were found.

Conclusions: Depressive symptom networks varied between older adults who participated in physical exercise and those who did not. Physical exercise was associated with the local features (centrality indexes) of the depressive network, rather than the global features (network structure invariance and overall network strength).

Clinical implications: The D9 (cannot get going) is crucial for the beneficial effects of exercise, providing a potential target for interventions aimed at efficiently alleviating depressive symptoms in older adults.

Background/objectives: Physical activity (PA) is essential for maintaining mobility, independence, and overall well-being in older adults; however, participation remains low due to barriers, such as chronic disease, social isolation, and limited access to structured programs. Community-based aging well programs aim to support older adults by offering health assessments and wellness resources, yet many lack tailored follow-up PA interventions that address individual needs.

Methods: This study conducted a comprehensive needs assessment through focus groups with older adults (aged 59-78) participating in an aging well program to identify key challenges and preferences for sustainable PA interventions.

Results: Thematic analysis revealed five major themes: health concerns related to aging, social connections, barriers to PA, the importance of PA (aerobic, strength, and flexibility), and feedback on aging well initiatives. Participants emphasized the necessity for fall prevention strategies, enhanced social engagement, accessible and varied PA options, and structured follow-up with individualized recommendations.

Conclusion: These findings offer a model for institutions and agencies seeking to develop or refine community-based PA programs, highlighting comprehensive health assessments, ongoing support, and tailored interventions that meet the diverse needs of older adults. Significance/Implications: This study underscores the crucial need for individualized, community-informed PA interventions to enhance mobility and well-being in older adults. By identifying key barriers and preferences, it provides a scalable model for developing aging well programs that are both sustainable and responsive to the unique challenges of this population.

Aim: Robotic suit-based exercises can be safely used for older adults. However, the effects of performing and discontinuing such programs on physical function remain unknown. We examined the long-term effects of a 5-week robotic suit-based exercise program on physical function in older adults with low fitness and assess the impact of exercise discontinuation during a 5-month follow-up period.

Methods: We conducted a follow-up analysis of a completed randomized controlled trial. Community-dwelling older adults (n = 75, mean age = 74.7 ± 4.4 years) participated in a 5-week hybrid assistive limb robotic suit-based exercise program. We measured six physical function tests (gait speed at usual pace, five times sit-to-stand test, timed up and go test, functional reach test, two-step test, and grip strength), and the five-question Geriatric Locomotive Function Scale score. Evaluations were conducted at baseline, postintervention, and after the 5-month follow-up. Participants were stratified into those who continued exercising during the follow-up at the intervention facility (facility-attending group) and those who discontinued (nonattending group).

Results: Significant improvements were observed postintervention in all physical function, especially gait speed (effect size: Cohen's d = 1.7), which remained higher than baseline after the follow-up period (Cohen's d = 1.2). Most physical function declined during the follow-up period. However, participants in the facility-attending group maintained their physical function levels, with no significant decline in most measures.

Conclusion: Hybrid assistive limb-based exercise improved physical function, especially gait speed. Continuous exercise postintervention is essential to maintain these improvements.

Background: Results from the Health and Human Services' 2023 Physical Activity Guidelines Midcourse Systematic Review indicated that the varying methodological and instrumental approaches to evaluate older adult physical activity interventions created difficulty in evaluating intervention efforts for their midcourse report. Therefore, this secondary review sought to take stock of current physical activity intervention outcome evaluations among older adults and establish recommendations for unifying measurement in the field.

Methods: Using PubMed, CINHAL, and PsychInfo databases, relevant information was obtained from 45 articles pertaining to study design, study location, type of physical activity, assessment approaches, reliability, and validity.

Results: Studies often used either self-report or device-measured approaches, with most utilizing self-report measures. Self-report measures used were often not tailored to older adult populations. Cutoff points for device-measured approaches frequently varied when assessing physical activity levels. Studies utilizing self-report and device-measured approaches seldom reported their own assessments of reliability and validity.

Conclusion: Patterns identified in the present investigation provide some insight into the current state of physical activity intervention assessment measurement and can be used to help demonstrate the urgent need to unify measurements of physical activity for older adults.

Implications: These results suggest that there was a lack of standardization among physical activity measurements, hindering researchers' ability to draw conclusions about effective intervention strategies. Future work should use these results to establish practices and standardization guidelines for determining the best methodological approaches, adapting established self-report measures for older adults, and establishing cutoff categorizations for device-measured methods.

Background:  Cardiac rehabilitation (CR) is a secondary prevention program that is associated with a decrease all-cause mortality. Physical inactivity is a major risk factor for disease, and long-term physical activity (PA) adherence is an essential component of CR.  The purpose of this study is to assess self-reported PA adherence 1 year after CR completion. We hypothesize that individuals would not meet nationally recommended Physical Activity Guidelines (PAG) 1-year post-CR, but males would meet PAG at higher rates than females.

Methods:  Using a prospective, cross-sectional design, 172 CR graduates completed the International Physical Activity Questionnaire-Short Form telephone survey on self-reported PA and sitting time. Meeting PAG was defined as ≥150 minutes of moderate PA, ≥75 minutes of vigorous PA, or any combination of ≥150 minutes of moderate to vigorous PA.

Results:  The cohort (n = 172; 38 [19%] female; mean age 67 ± 11 y, range 35-90) attended 31 ± 8 (of 36) CR sessions and were surveyed 13.6 (2.7) months post-CR (76.1% response rate). Participants reported an average of 97 ± 125 min/week of moderate to vigorous PA, with 32% (n = 55, 80% male) meeting PAG and 5.3 ± 3.3 hr/day of sitting. There were no sex differences in how PAG was met or in minutes per day, days per week, or sitting time.

Conclusion:  Only 32% of CR graduates met PAG 1-year post-CR, with both sexes failing to achieve national guidelines. Significance/Implications: Providers should recognize that patients often fail to meet PAG after CR, undermining CR's long-term goals. Continued interventions targeting both sexes are needed to promote sustained long-term PA to support disease prevention.

Objective:  The purpose of this systematic review is to examine the effects of multicomponent training (MCT) on functional fitness in older adults.

Methods:  Primary sources were sourced from four databases: Scopus, PubMed, CENTRAL, and Web of Science. The search period spanned from the inception of these databases up to February 10, 2025. Standardized mean differences, weighted mean differences, and 95% confidence intervals (CIs) were computed using either random or fixed-effect models for the outcomes.

Results:  After the screening process, a total of 20 studies comprising 1,217 participants were included in the systematic review. The results of the meta-analysis showed that MCT improved Short Physical Performance Battery test (1.20 [95% CI: 0.98-1.42], p = .001), arm curl (0.89 [95% CI: 0.51-1.24], p = .001), 30-s chair stand (1.28 [95% CI: 0.81-1.74], p = .001), chair sit-and-reach (0.62 [95% CI: 0.38-0.87], p = .001), back scratch (0.44 [95% CI: 0.25-0.63], p = .001), timed up and go (0.80 [95% CI: 0.38-1.22], p = .001), 6-min walk (1.24 [95% CI: 0.62-1.86], p = .001), and 2-min step (0.52 [95% CI: 0.21-0.84], p = .001). Additionally, the results of the meta-analysis demonstrated that there was a significant difference (0.35 [95% CI: 0.25-0.46], p = .001) between MCT and conventional training (CT) on functional fitness in older adults, favoring MCT.

Conclusion:  The findings of this systematic review and meta-analysis revealed that MCT significantly and positively improved functional fitness in older adults; also, the results of current meta-analysis showed that MCT has a significantly better effect on the functional fitness in older adults than CT.

Background/objectives: Women 65 and older experience nearly three-fourths of the 2 million osteoporotic fractures annually in the United States. We investigated associations of accelerometer-measured total physical activity, light physical activity, moderate-to-vigorous physical activity (MVPA), steps, total sitting time, and mean sitting bout duration with incident osteoporotic fracture.

Methods: Women from the Objective Physical Activity and Cardiovascular Health cohort (N = 6,122; mean age: 78.7; SD: 6.7) without prior hip fracture wore the ActiGraph GT3X+ up to 7 days and were followed up to 8 years for incident osteoporotic fractures (n = 982). Cox regression models estimated hazard ratios and 95% confidence intervals (CI) additionally containing age, race/ethnicity, education, alcohol, smoking, height, weight, falls, physical functioning, diabetes, thiazide use, and anti-osteoporosis medication use.

Results: Multivariable HRs (95% CI) were 1 (ref), 1.10 [0.93, 1.31], 0.93 [0.77, 1.13], and 0.87 [0.70, 1.07] across MVPA minutes/quartiles (p-trend = .03) and 1 (ref), 1.10 [0.90, 1.33], 1.21 [1.00, 1.47], and 1.27 [1.04, 1.57] across total sitting time quartiles (p-trend = .02). The hazard ratios (95% CI) for a one-SD increment in MVPA (33 min/day) and total sitting time (103 min/day) were 0.92 [0.85, 0.99] and 1.09 [1.01, 1.18], respectively. The hazard ratios (95% CI) for MVPA and osteoporotic fracture was 0.82 [0.73, 0.93] among women not using anti-osteoporosis medication and 1.06 [0.90, 1.24] among women using anti-osteoporosis medication (p-interaction = .02).

Conclusions: More MVPA and less total sitting time, but not other accelerometer measures, were associated with lower osteoporotic fracture risk. Significance/Implications: These data support interventions and physical activity guidelines aimed at promoting moderate- or vigorous-intensity movement and decreased sitting for osteoporotic fracture prevention.

Objectives: To investigate the effects of water-based aerobic exercises on the physical fitness of older adults.

Methods: PubMed, LILACS, and EMBASE were searched in April 2024. Eligibility criteria included randomized and nonrandomized trials focused on water-based aerobic exercise programs for older adults assessing physical fitness. Random-effects meta-analyses were conducted to compare water-based aerobic exercise programs with (a) control groups, (b) land-based aerobic exercise, and (c) water-based combined exercises. Mean difference (MD) and standardized mean difference (SMD), with a 95% confidence interval (CI), were used for studies with the same measurement scale and different scales, respectively. The methodological quality of the studies was assessed using the Tool for the Assessment of Study Quality and Reporting in Exercise (TESTEX).

Results: Fifteen studies were included in the meta-analyses. Water-based aerobic exercises significantly improved cardiorespiratory capacity (MD = 5.18 ml·kg-1·min-1; 95% CI [2.51, 7.85]; I2 = 91%), muscle strength (MD = 3.03 kg; 95% CI [1.62, 4.44]; I2 = 11%), and agility/dynamic balance (SMD = 0.63; 95% CI [0.11, 1.16]; I2 = 77%) compared to control groups. The significant effect favoring aquatic aerobic exercise for agility/dynamic balance was observed only in nonrandomized clinical trials. Cardiorespiratory capacity improvements were similar between water- and land-based aerobic exercise programs (MD = 3.23 ml·kg-1·min-1; 95% CI [-2.45, 8.91]; I2 = 91%). Additionally, water-based aerobic exercise was superior to water-based combined exercise programs in improving cardiorespiratory capacity (SMD = 0.58; 95% CI [0.15, 1.01]; I2 = 36%), while muscle strength (SMD = -0.04; 95% CI [-0.38, 0.30]; I2 = 0%) and agility/dynamic balance (SMD = 0.17; 95% CI [-0.18, 0.51]; I2 = 0%) were similar. The quality of included studies ranged from 6 to 13 points on the TESTEX scale.

Conclusion: Besides improved cardiorespiratory fitness, water-based aerobic exercise programs promote increased muscle strength and agility/dynamic balance in older adults.

Background/objective: Knee pain is a reversible condition that can be alleviated with appropriate interventions. Although physical activity (PA) is known to reduce knee pain, the long-term effects of different activity intensities are not well understood. This study examined the associations of moderate- and vigorous-intensity PA with the incidence and recovery from knee pain over 3 years.

Methods: A longitudinal study from 2016 to 2019 in a remote area of Japan included 3,683 older adults aged ≥ 65 without functional disabilities. Knee pain was self-reported, and PA was evaluated using the International PA Questionnaire. Logistic regression analyses were conducted for participants with or without knee pain at baseline.

Results: At baseline, 32.7% reported knee pain. Among those without knee pain at baseline, 16.0% developed knee pain during follow-up. By contrast, 43.8% of those with knee pain at baseline no longer reported it 3 years later. Multivariable analyses showed that older adults, both with and without baseline knee pain, who engaged in moderate-intensity PA for ≥ 300 min/week were less likely to experience knee pain in 2019. No association was found between vigorous-intensity PA and knee pain.

Conclusion: Increasing moderate-intensity PA significantly decreases the risk of onset and persistence of knee pain among community-dwelling older adults. Significance/Implications: Given that knee pain is a common condition that can severely affect mobility and quality of life, encouraging a more active lifestyle, particularly with moderate-intensity activities, can have substantial public health benefits.

Background: The 24-hr movement cycle is associated with health, but less is known about factors associated with differences in cycle composition.

Methods: Data from 1,297 Study of Women's Health Across the Nation participants (ages 60-72 years; Mage = 65.4 ± 2.6 years) who concurrently wore hip (waking) and wrist (sleep) accelerometers at Visit 15 (2015-2017) to quantify differences in sleep, sedentary, and physical activity across sociodemographic and health factors are used, including age, race and ethnicity, educational attainment, body mass index, financial strain, self-rated health, body pain, vasomotor symptoms, depression symptoms, anxiety, obstructive sleep apnea, and multimorbidity. We used compositional data analysis to characterize movement cycles and multivariate analysis of variance to examine the difference in the proportion of the day spent in cycle components by subgroup, controlling for Study of Women's Health Across the Nation site, age, race and ethnicity, and body mass index.

Results: On average, women spent 34.6% (8.3 hr) in sleep and 31.4% (7.5 hr), 30.5% (7.3 hr), and 3.5% (50 min) in sedentary, light-intensity, or moderate- or vigorous-intensity physical activities (MVPA), respectively. Black and Hispanic women; smokers; and those who reported moderate/severe financial strain, moderate/severe bodily pain, poor health, or living with multimorbidity spent 19%-34% less time in MVPA relative to the overall mean composition. Women with depression and anxiety symptoms spent 10%-19% less time in MVPA relative to the mean composition.

Conclusion: Variations in compositions were driven by differences in the proportion of time spent in MVPA. Significance/Implications: Identifying persons with inadequate movement profiles could help inform targeted strategies for intervention and policies.