Journal of Aging and Physical Activity最新文献

Background/objective: This study aimed to test whether physical resilience moderated the association of physical function and physical activity among a sample of recently discharged older adults with dementia.

Methods: This was a descriptive substudy using data from a parent study titled Function Focused Care for Acute Care Using the Evidence Integration Triangle Study. We obtained data on 368 participants through care partners' report via phone call at 1 month post hospital discharge. We used linear mixed models, accounting for clustering of patients discharged from the same hospitals.

Results: Physical resilience negatively moderated the association of physical function and physical activity (b = -0.003, SE = 0.001, p ≤ .001), controlling for group status, comorbidities, cognitive impairment severity, and gender.

Conclusion: The greater the participants' physical resilience, the weaker the relationship between physical function and physical activity. Significance/Implications: The findings are consistent with the conceptualization of physical resilience as an important and distinct mental state that provides an individual determination to optimize their function to the best of their ability. This work supports physical resilience interventions for recently discharged older adults with dementia who demonstrate low physical resilience or low function.

Background: Social participation and physical activity are lifestyle factors that improve well-being and health. Older adult populations are at greater risk of inactivity and social isolation, both of which were exacerbated by COVID-19 restrictions (e.g., physical distancing, recreational program closures). Recreational programs that provide opportunities for physical activity and social interaction are important for addressing these concerns in communities. This research examined lived experiences with changes in physical activity and social participation among adults ≥65 years during the COVID-19 pandemic, their perspectives on precautionary measures and alternate forms of program delivery, and experiences and challenges service providers in the recreation sector faced in adapting programs for older adults during the pandemic.

Methods: Using interpretive description methodology, we interviewed older adults (n = 20) and service providers (n = 10).

Results: Four themes were identified: (a) concerns about safety and risk given heightened vulnerability, (b) alternate options helped with participation but inequities in access persist, (c) forging new routines after a major lapse, and (d) social connections supported resilience but sense of community dwindled.

Conclusion: It is important that organizations balance risks of participation with nonparticipation; address the compounding challenges and inequities of a disruption; understand the importance of social benefits of physical activity in this population; and plan to support resilience, cope with the aftermath of COVID-19, and prepare for future challenges.

Background/objectives: The purpose of this study was to investigate the longitudinal association of replacing stationary time (ST) with either light (LPA) or moderate-to-vigorous (MVPA) physical activity and replacing LPA with MVPA on 2-year clinical outcomes in individuals with varying severities of knee osteoarthritis.

Methods: This retrospective cohort study used isotemporal substitution models to investigate the association of replacing 10-60 min of ST with LPA or MVPA and of LPA with MVPA on Western Ontario and McMaster Universities Osteoarthritis Index pain, stiffness, function, and gait speed at 2 years. Device-based stationary and physical activities were monitored using accelerometry within the Osteoarthritis Initiative cohort (n = 848). All analyses were completed separately for mild-to-moderate (Kellgren-Lawrence grade = 1-2) and severe (Kellgren-Lawrence grade = 3-4) knee osteoarthritis groups.

Results: In individuals with mild-to-moderate osteoarthritis, substituting 30-60 min of ST or LPA with MVPA improved pain and gait speed at 2 years but worsened stiffness. Replacing 60 min of ST with LPA improved Western Ontario and McMaster Universities Osteoarthritis Index function. For severe osteoarthritis, substituting 30-60 min of ST or LPA with MVPA led to worsened Western Ontario and McMaster Universities Osteoarthritis Index pain and function at 2 years, whereas substituting ST or LPA with MVPA minimally impacted stiffness. Improvements in gait speed were observed with 10-to-60-min ST or LPA substitutions with MVPA.

Conclusion: Stationary and physical activity substitutions had varying longitudinal effects in individuals with mild-to-moderate versus severe knee osteoarthritis. Individuals with mild-to-moderate and severe knee osteoarthritis may require differing physical activity prescription to improve functional and overall health outcomes. Significance/Implications: These findings underscore the importance of severity-specific physical activity recommendations to support clinical outcomes in knee osteoarthritis management.

Background/objective: The American College of Sports Medicine preparticipation screening algorithm is designed to identify those with increased risk for adverse exercise-related cardiovascular events. Prior to engaging in an exercise program, individuals are advised to complete a health screening to identify the need for medical clearance. With the potential for referrals to deter exercise engagement, the purpose of this study was to examine the updated guideline's role in reducing unnecessary medical referrals.

Methods: Seventy-one participants (≥40 years of age and/or diagnosed with a chronic disease) were assessed for the need of medical clearance. Participants completed a questionnaire to identify cardiovascular risk factors and to report diagnosed cardiovascular, pulmonary, metabolic, or renal disease in addition to completing a biometric screening. Need for medical clearance was determined based on the criteria for the ninth and 11th editions of the American College of Sports Medicine Guidelines. Participants were assigned a standardized classification for comparison. Results were analyzed using cross tabulation and chi-square test.

Results: Compared with the ninth edition, the updated 11th edition reclassified three participants (10%) from high to moderate risk, and 29 participants (100%) from moderate to low risk reducing medical referrals by 41% (χ2 = 70.0; p < .001).

Conclusion: Results suggest the updated guidelines significantly reduce medical referrals as intended but also increase the prevalence of cardiovascular disease risk factors for physical inactivity and hypertension. Significance/Implications: Findings of the present study further support the updated prescreening guidelines in the reduction of medical referrals for those already engaging in physical activity despite having multiple cardiovascular risk factors or various known diseases.

Background: Both sedentary behavior and mental health issues are highly prevalent among older adults. Observational data indicate positive associations between high sedentary behavior and conditions like depression and anxiety. However, it is not known if reducing sedentary behavior leads to changes in mental health.

Purpose: We conducted an exploratory analysis of a sedentary behavior reduction intervention's effect on self-reported mental health outcomes and quality of life in older adults with obesity.

Methods: The Health Aging Resources to Thrive trial (clinicaltrials.gov # NCT03739762) enrolled older adults aged 60-89 years with a body mass index of 30-50 kg/m2, who self-reported sitting >6 hr/day. Participants were randomized to a sedentary behavior reduction intervention or a healthy living attention-control group. The intervention included 10 behavioral coaching sessions, sitting reduction goals, a standing desk, and a fitness tracker. The attention-control group received 10 coaching contacts to set general healthy living goals excluding physical activity or sedentary behavior. Mental health and quality of life outcomes (depressive symptoms, anxiety symptoms, loneliness, quality of life, sleep disturbance, and pain interference) were measured at baseline, 3 months, and 6 months. We used linear regression models with generalized estimating equations to estimate adjusted mean changes from baseline for each outcome and mean change difference between groups.

Results: Participants (N = 283, n = 140 intervention, n = 143 control; mean age = 68.8 years, 65.7% women, 68.9% White non-Hispanic, 55.5% retired) in the intervention group had significant reductions in perceived loneliness score compared with the control group at 6 months (-0.27; 95% confidence interval [-0.52, -0.02]). Depressive symptoms, pain, sleep disturbance, and quality of life improved in both the intervention and control groups, but differences between groups were not statistically significant at 3 or 6 months.

Conclusions: Sedentary behavior reduction may positively impact loneliness in older adults.

Background/objectives: Older adults often face daily problems that can interfere with physical activity. Although individual self-efficacy (confidence in one's own abilities) is known to promote physical activity, it overlooks the social influences in older adults' lives. Relation-inferred self-efficacy (the belief that a close other has confidence in one's abilities) may provide additional insight. This study explored associations between daily problems, individual self-efficacy, and relation-inferred self-efficacy with physical activity (moderate to vigorous physical activity and steps). It also examined whether individual and relation-inferred self-efficacy moderate the relationship between daily problems and physical activity.

Methods: A sample of 226 community-dwelling older adults (109 couples and eight individuals) wore accelerometers for up to 7 days to track daily physical activity. Participants also reported daily problems and levels of self-efficacy. Multilevel models were used to examine the associations of self-efficacy and daily challenges with physical activity and to test moderation effects of self-efficacy on the problem-physical activity relationship.

Results: Both individual and relation-inferred self-efficacy were positively associated with physical activity when examined separately. However, when modeled together, only relation-inferred self-efficacy remained a significant predictor. Daily problems were not significantly related to physical activity, and there were no significant moderation effects of self-efficacy on the problem-physical activity relationship.

Conclusion: These findings suggest that relation-inferred self-efficacy might be more important than individual self-efficacy for physical activity among older adults, emphasizing the role of social context. Significance/Implications: Interventions promoting physical activity in older adults may benefit from incorporating support from close others to enhance relation-inferred self-efficacy.

Background: This study evaluated the effects of chair-based exercises (CBEs) on pain, function, balance, quality of life, and exercise perception in inactive older adults with knee osteoarthritis and explored social policy implications.

Methods: A single-blind, parallel-group, randomized controlled trial, included 40 participants (≥65 years, Kellgren-Lawrence Grade 2-3 knee osteoarthritis, and no regular exercise in the last 3 months). The intervention group (IG; n = 20) performed CBE twice weekly for 8 weeks, while the control group (n = 20) maintained usual activities. Outcomes were assessed using the Western Ontario and McMaster Universities Osteoarthritis index (pain, stiffness, and function), Timed Up-and-Go test (balance/mobility), Exercise Benefits/Barriers Scale, and Nottingham Health Profile. Data were analyzed using analysis of covariance to compare postintervention outcomes while controlling for baseline scores, and qualitative comparative analysis explored factors affecting quality of life.

Results: Analysis of covariance revealed that the IG demonstrated statistically significant and clinically substantial improvements in pain, stiffness, and function (Western Ontario and McMaster Universities Osteoarthritis), as well as dynamic balance and mobility (Timed Up and Go), with large treatment effects observed across all measures compared with the control group. Perceived exercise benefits increased, and barriers decreased in the IG. Nottingham Health Profile scores also improved significantly in the IG. Qualitative comparative analysis indicated that quality-of-life improvements resulted from pain reduction, functional gains, and enhanced exercise perception.

Conclusion: This study provides robust evidence that an 8-week CBE program significantly improves pain, function, balance, and quality of life in older adults with knee osteoarthritis while enhancing exercise motivation.

Significance: As a cost-effective and safe intervention, CBE can support active aging, reduce health care costs, and enhance older adults' social participation. Integrating CBE into public health policies and community programs may promote well-being and independence.

Background: Aging-related neuromuscular decline impairs balance and gait, increasing fall risk. While physical activity can mitigate these effects, adherence to traditional programs remains low. Pickleball was chosen for its moderate intensity, ease of learning, social engagement, and growing popularity among older adults, making it an accessible and enjoyable alternative. This study investigated the effects of an 8-week pickleball program on balance, gait parameters (stride length, velocity, cadence), and social capital in older adult women.

Methods: A single-blind, randomized controlled trial was conducted with 36 women aged 60-75 years (mean age: 65.5 ± 4.5). Participants were assigned to an intervention group (n = 20), completing supervised pickleball training three times per week, or a control group (n = 16), continuing routine activities. Balance was assessed using the Mini Balance Evaluation Systems Test, gait via motion capture, and social capital through a validated questionnaire.

Results: The intervention group demonstrated significant improvements in Mini Balance Evaluation Systems Test scores (+28.48%, p < .001, d = 2.74), stride length (+5.40%, p = .013, d = 0.54), stride velocity (+13.13%, p = .008, d = 0.67), cadence (+7.19%, p = .006, d = 0.57), and reduced double support duration (-23.80%, p = .003, d = 0.36). Social capital also increased (+12.59%, p = .005, d = 0.71). The control group showed a decline in balance and gait.

Conclusion: An 8-week pickleball program significantly improved balance, gait, and social engagement in older adult women. Future research should explore long-term effects and compare pickleball with other interventions for fall prevention.

Background: Older adults frequently encounter barriers to exercise, including limited social support, inadequate guidance, and a fear of falling. Tai Chi is a safe, low-impact activity that can improve balance, strength, and memory. However, without professional instruction, older adults may struggle to accurately assess their movements, which can reduce exercise effectiveness and adherence. This study compared the effects of multimodal sensory feedback of Tai Chi on task performance and perceptual experience in older adults.

Methods: A Tai Chi exercise video was used as the intervention material in an experiment conducted in a senior community. Thirty-eight older adults were recruited, with 20 in the experienced group and 18 in the inexperienced group. Each person participated in an experimental task with four feedback modalities (visual, visual-auditory, visual-haptic, and visual-auditory-haptic), and the order of feedback modalities experienced by each participant was random. Measures included reaction time, number of misses, workload, and satisfaction.

Results: Regardless of experience, the lowest task performance scores were observed in the visual feedback modality, followed by the visual-haptic modality. Multimodal feedback did improve older adults' reaction time and number of misses. However, no significant differences in workload and satisfaction were found for participants.

Conclusion: Designing multimodal sensory feedback in exercise is more beneficial than visual-only feedback, but haptic feedback may increase the workload of older adults.

Significance: This study offers valuable insights for optimizing exercise feedback modalities for older adults, providing a theoretical foundation for more effective interventions, particularly in enhancing cognitive function and exercise adherence.

Background/objective: Walking is essential for maintaining functional independence, and understanding gait changes due to aging is crucial, as chronic conditions often overlap with normal aging. The objective of this study was to describe gait characteristics in adults aged 50 and over and to identify differences between age groups and between sexes.

Methods: The study included 34 adults aged 50-59, 38 adults aged 60-69, and 28 adults aged 70+ years. Participant characteristics (age, sex, height, weight, and comorbidities) were collected. Participants walked a 30-m round trip at a self-selected pace. Gait was measured using inertial measurement units.

Results: Results showed that stride length, stride velocity, push-off ratio, and minimal toe clearance decreased with age (p < .03) and flat-foot ratio increased with age (p < .01), while cadence, walking phases (stance, swing, double support, and loading ratio), and maximal heel clearance were similar across age groups (p > .05). Males had a lower cadence, a longer stride, and a higher maximal heel clearance than females (p < .04). Stride velocity and minimal toe clearance were similar between sexes (p > .05).

Conclusions: This study found that stride length and velocity decrease with age, and notable sex differences exist in stride length and maximal heel clearance. These findings underscore the importance of considering both age and sex when assessing walking and functional capacity in older adults. Significance/Implications: Aging impacts gait, and inertial measurement units offer a valuable tool to examine how age and sex affect walking. This is an initial step toward a deeper understanding of gait characteristics in older adults.