Journal of Aging and Physical Activity最新文献

This study examined whether participants with poor activities of daily living (ADLs) at hospital discharge had increased weight loss after 6 months of follow-up and whether nutrition therapy can prevent this weight loss. This dietary randomized controlled trial (N = 104) examined community-dwelling older adults (66-95 years) discharged from hospital and at risk for malnutrition, receiving either 6 months of nutrition therapy (intervention) or only standard care (control). ADL was assessed using seven questions on self-care based on the Katz et al.'s method. At discharge, 45 (43%), 36 (35%), and 23 (22%) had high, medium, and poor ADL, respectively, with no differences between the control and intervention groups according to chi-square test. Participants in the control group with poor ADL had significantly higher weight loss than participants with high ADL (age- and sex-adjusted analysis of covariance: 3.6 kg; 95% confidence interval [1.0, 6.1] kg, p = .007). No such difference was observed in the intervention group. Participants with poor ADL at hospital discharge develop lower body weight by around 3.5 kg 6 months later when compared with participants with high ADL. Receiving nutrition therapy could help older adults with poor ADL to maintain body weight after hospital discharge.

Background: The lumbar extensor muscles (LEMs) play an important role in body posture and physical function in older adults. Because lumbar extensor strength decreases more rapidly than limb muscle strength with age, it should be evaluated to aid healthy aging. This study investigated the association between LEM strength and physical performance in community-dwelling older adults.

Methods: This prospective observational cohort study of spinal sarcopenia (SarcoSpine) was conducted at a single center. One hundred and ten consecutive individuals who completed the baseline survey, including conventional sarcopenic indices, lumbar spine three-dimensional magnetic resonance imaging, isokinetic lumbar extensor strength, and physical performance tests (Short Physical Performance Battery, Berg Balance Scale, and Back Performance Scale [BPS]), were enrolled. A multivariate linear regression analysis was performed to determine the variables for evaluating their association with LEM strength.

Results: Among the conventional sarcopenic indices, gait speed was significantly correlated with Short Physical Performance Battery results and Berg Balance Scale score in men and women. Handgrip strength was significantly correlated with the BPS score for both sexes. In the multivariable linear regression, age (β = -2.12, p < .01) and BPS score (β = -3.54, p = .01, R2 = .29) were independent indicators of LEM strength.

Conclusions: Our findings reveal the substantial association between LEM strength and BPS score in older women. The targeted intervention aimed at improving the LEMs strength would be needed to enhance physical performance in the aging population.

Background: The aims of this cross-sectional study were to (a) assess actigraphy-based sleep parameters (total sample and gender differences), (b) assess differences in morphological parameters and physical function between short- versus normal-sleepers and poor- versus good-sleepers, and (c) assess the possible correlations between sleep variables and morphological and physical function parameters in older subjects.

Methods: This study enrolled 42 healthy older participants (60-80 years). Participants completed the following clinical evaluations: (1) whole-body dual-energy X-ray absorptiometry to assess the appendicular skeletal muscle mass index; (2) magnetic resonance imaging acquisition to determine the cross-sectional muscle area of thigh muscles and intermuscular adipose tissue; (3) risk of fall assessment through the mini-Balance Evaluation Systems Test; (4) strength assessment: (a) chair stand test and (b) handgrip strength test; (5) sleep monitoring by actigraphy to assess total sleep time, sleep efficiency, wake after sleep onset, sleep latency, fragmentation index, mobile time, and subjective sleep quality.

Results: 31.0% of subjects were short-sleepers (total sleep time < 6 hr), 19.1% were poor-sleepers (sleep efficiency < 85%), and gender differences were detected in mobile time (males: 15.8 ± 6.0 and females: 13.4 ± 6.8; p < .001) and fragmentation index (males: 35.3 ± 14.3 and females: 29.6 ± 14.6; p < .001); no significant differences were observed between groups (short- vs. normal-sleepers and poor- vs. good-sleepers) in morphological and physical function variables; correlation analysis showed that sleep latency negatively correlated with Mini-Balance Evaluation Systems Test (r = -.352; p = .022) and a positive correlation was detected between cross-sectional muscle area and mobile time (r = .349, p = .023).

Conclusion: No differences were observed in morphological and function parameters between good- versus poor-sleepers, those subjects with worse sleep onset latency (i.e., longer time to fall asleep) registered higher for risk of fall. The potential role of sleep in the physiological mechanisms of muscular aging must be explored through cross-sectional cohort studies with a larger population.

Background: Executive function (EF) deficits are a significant risk factor for falls among older adults (OAs). However, relationship between EF subdomains (shifting, updating, and inhibition), postural balance (PB), and fall risk in healthy OAs, remains poorly understood.

Objective: This study aimed to investigate the relationship between EF subdomains (shifting, updating, and inhibition) and PB, and to assess their impact on risk of falls in community-dwelling OAs.

Methods: A cross-sectional study involving 50 OAs aged over 60 years (average age of 72 years) was conducted. Participants underwent assessments of EF subdomains and PB using validated tests. A correlation analysis was employed to examine the relationships between EF and PB.

Results: The study revealed significant correlations between subdomains and PB. Mental set shifting (r = -.539; p < .001) and inhibition (r = -.395; p = .050) exhibited inverse relationships with PB. Stepwise multiple linear regression showed that Trail Making Test Part B was associated with the PB (R2 = .42, p < .001).

Conclusion: These findings highlight the importance of assessing EF subdomains, particularly shifting and inhibition, to identify risk of falls. Trail Making Test Part B largely explains the variability of the PB. Integrating PB assessments and EF training, such as the Mini-BESTest, into routine care can be vital for fall prevention strategies. Significance/Implications: This knowledge underscores the need for cognitive training interventions focusing on shifting and inhibition to enhance PB and potentially reduce falls. Additionally, incorporation of EF assessment tools as Trail Making Test Part B and the Mini-BESTest into routine clinical practice for community-dwelling OAs is recommended to address fall prevention strategies.

Background/objectives: Orthostatic hypotension (OH) is a common condition among older adults that increases the risk of falls. The study objectives are to determine the influence of distinct environments (water vs. land) on OH and the consequent effects of walking in these environments in older adults. Additionally, we aimed to assess the differences in response between two groups: older adults with OH and those without OH.

Methods: A randomized crossover design was utilized including one session involving water walking and the other session involving land walking, with a 1- to 3-day washout period. Orthostatic hemodynamic measurements were obtained before, immediately after, and 2 hr after a 15-min walking session. Two subgroups were formed for analysis: participants with OH (n = 14, 81 ± 7 years) and participants without OH (n = 11, 84 ± 7 years).

Results: Compared with the land environment, an 86% reduction in the frequency of OH episodes was noted when the older adults were immersed in water. This reduction was accompanied by greater mean arterial pressure, while participants without OH showed no such changes. The frequency of OH episodes was similar when assessed immediately after emerging from the pool following water-based walking or after land-based walking. All participants exhibited elevated mean arterial pressure immediately after water-based walking, but not after land-based walking. Two hours after walking, all participants demonstrated similar mean arterial pressure and frequency of OH episodes, regardless of the environment.

Conclusions: Water immersion resulted in a substantial reduction in the frequency of OH episodes among older adults. Additionally, the frequency of OH episodes was not affected by prior walking exercise in either environment. Significance/Implication: These findings underscore the safety and potential advantages of water-based exercise for older adults dealing with OH.

Background: Cadence-controlled walking may be a desirable approach for older adults to self-monitor exercise intensity and achieve physical activity guidelines. We examined the acute effects of cadence-controlled walking on cognition and vascular function in physically inactive older adults.

Methods: In a randomized crossover design, 26 participants (65% females, 67.8 ± 11.3 years) underwent 30-min acute exercise (walking at 100 steps/min) and control (sitting) conditions. We measured cognition, central blood pressure (BP), and arterial stiffness before, and immediately, after each condition.

Results: We observed significant Time × Condition interactions in the Flanker Inhibitory Control and Attention (Flanker) test and Dimensional Change Card Sort (DCCS) test scores, and in central systolic BP, central pulse pressure, and carotid to femoral pulse wave velocity (p < .05). The Flanker and DCCS scores significantly increased after walking (d = 0.4 and 0.5, respectively), but not after sitting. Central systolic BP, central pulse pressure, and carotid to femoral pulse wave velocity significantly increased after sitting but remained unchanged after acute walking (d = 0.4-0.2), with p-values < .05. After walking, significant correlations were observed between DCCS and diastolic BP and central pulse pressure change scores and change scores in central pulse wave velocity, Flanker, and DCCS (rs = -0.45 to -0.52).

Conclusion: These findings suggest that a single bout of cadence-controlled walking elicited an immediate improvement in cognition and might have mitigated increases in arterial stiffness and central BP observed in the seated control condition. Further research is needed to examine the association between cognition and vascular function following acute exercise compared to control conditions.

Significance: Our findings may have practical implications for developing daily physical activity recommendations for improving the cognitive health for successful aging.

We investigated whether dosed failure motivates older adults to perform more repetitions in an exergame that involves hitting targets with stepping movements. The effect of dosed failure was studied in a within-participants design in which all participants performed this exergame in both a Standard condition, in which one never fails, and in a Dosed Failure condition, in which we introduced about 30% failures. The order of conditions (Standard First or Dosed Failure first) was chosen randomly for each participant. Results showed that participants performed more repetitions in the Dosed Failure condition compared with the Standard condition, while play duration and subjective motivation at the moment of quitting did not differ. This shows that dosed failure motivated older adults to put a greater amount of effort to perform the exercise without affecting play duration or subjective motivation.

Physical activity program interventions often lack sensitivity to the needs of older immigrant adults. The objective of this systematic realist review is to explain how, why, for whom, and under which circumstances community group-based physical activity programs work for immigrant older adults. The initial program theory was developed using prior research, team expertise, social cognitive theory, and knowledge user consultations. The program theory was tested and refined via a systematic review of the literature. Database searches were conducted in MEDLINE, EMBASE, CINAHL, Scopus, Cochrane Library, Sports Medicine and Education Index, and SPORTDiscus. A total of 22 sources of evidence met inclusion criteria and included intervention studies, systematic reviews, and a discussion paper. Intervention studies were appraised using the Mixed Methods Appraisal Tool. The final program theory constituted eight context-mechanism-outcome configurations that highlight the importance of facilitator characteristics, access to safe spaces, group dynamics, and social support. A limitation was the small number and variable quality of included evidence. Physical activity programs that target immigrant older adults must strengthen physical and psychological safety and maximize opportunities for role modeling and socialization. This research was supported by the Alberta Health Services Seniors Health Strategic Clinical Network and is registered in PROSPERO (ID#258179).

Masters rowing has seen a measurable increase in participation, with masters rowers engaged in the sport for competition, health, and recreation reasons. Unlike other masters sports, masters rowing has a unique high level of synchronous, cooperative, and interdependent elements. To better understand the benefits and challenges of participation in competitive masters rowing, the purpose of this study was to explore the lived experiences of competitive masters rowers. Twelve competitive masters rowers were recruited and interviewed. Utilizing an interpretative phenomenological analysis approach to guide data collection, analysis, and interpretation, the analysis revealed four major themes: navigating community relationships, finding a reason to row, growing opportunities, and seeking considerate coaches. Utilizing self-determination theory as a framework for interpreting the findings, the identified themes illustrate the varying motivations, needs, and preferences of competitive masters rowers, as well as how their experiences are influenced by their coaches and peers. Efforts should be made by masters rowing coaches and administrators to better understand the needs of their athletes to ensure the maximum benefits of participation, commitment, and enjoyment of the sport.

Physical activity levels during skilled nursing facility (SNF) rehabilitation fall far below what is needed for successful community living and to prevent adverse events. This feasibility study's purpose was to evaluate the feasibility, acceptability, and preliminary effectiveness of an intervention designed to improve physical activity in patients admitted to SNFs for short-term rehabilitation. High-Intensity Rehabilitation plus Mobility combined a high-intensity (i.e., high weight, low repetition), progressive (increasing in difficulty over time), and functional resistance rehabilitation intervention with a behavioral economics-based physical activity program. The behavioral economics component included five mobility sessions/week with structured goal setting, gamification, and loss aversion (the idea that people are more likely to change a behavior in response to a potential loss over a potential gain). SNF physical therapists, occupational therapists, and a mobility coach implemented the High-Intensity Rehabilitation plus Mobility protocol with older Veterans (n = 18) from a single SNF. Participants demonstrated high adherence to the mobility protocol and were highly satisfied with their rehabilitation. Treatment fidelity scores for clinicians were ≥95%. We did not observe a hypothesized 40% improvement in step counts or time spent upright. However, High-Intensity Rehabilitation plus Mobility participants made clinically important improvements in short physical performance battery scores and gait speed from admission to discharge that were qualitatively similar to or slightly higher than historical cohorts from the same SNF that had received usual care or high-intensity rehabilitation alone. These results suggest a structured physical activity program can be feasibly combined with high-intensity rehabilitation for SNF residents following a hospital stay.