Journal of Aging and Physical Activity最新文献

Falls are a significant risk for older adults, often leading to severe injuries. Physical activity (PA) can reduce fall risk, but most studies focus on individual PA types rather than combined patterns. This study uses Latent Class Analysis to explore PA patterns among older adults and their relationship with falls, considering sex differences. Data were drawn from the 2023 Korean Community Health Survey (N = 68,996, aged ≥65 years). Participants' engagement in vigorous PA, moderate PA, walking, and flexibility exercises was used to classify latent subgroups separately by sex. Logistic regression examined associations between PA subgroups and fall experience, reporting adjusted odds ratios (aOR) and 95% confidence intervals (CIs). Four PA subgroups were identified for each sex. Among males, no significant differences in fall risk were observed across PA subgroups after adjusting for confounders (all aORs, p > .05). Among females, those engaging only in walking or walking plus flexibility exercises showed a significantly higher fall risk compared to the most active group (moderate PA, walking, and flexibility exercises). Specifically, the Walk-only group had an aOR of 1.13 (95% CI [1.00, 1.27]), and the Walk/Flex group had an aOR of 1.09 (95% CI [1.01, 1.16]). Participation in multiple types and intensities of PA was associated with a lower risk of falls, particularly among women. Sex-specific differences in PA patterns should inform fall prevention strategies. Encouraging older adults to engage in combinations of moderate-intensity PA, walking, and flexibility exercises may reduce falls and support healthy aging.

Background: Proprioceptive neuromuscular facilitation (PNF) is an exercise concept designed to enhance physical functions such as gait and sit-to-stand (STS) ability and could be useful in older adults with functional impairment. This randomized clinical trial (NCT06690944) evaluated the effects of a PNF-based intervention, incorporating resisted STS and walking exercises, compared with a control group performing the same activities without manual resistance, on functional capacity in older individuals with limited physical functioning.

Methods: Twenty-five older adults (Mage: 80.4 ± 6.0 years) were randomized into the PNF group or the control group. The interventions involved eight sessions over 4 weeks for both PNF and control. Functional capacity was measured using the Short Physical Performance Battery, habitual gait speed (GS), STS, timed up and go, and static balance tests. Strength was assessed by handgrip strength. Generalized estimating equations were applied to examine time, group, and Time × Group interaction effects, with statistical significance set at α = .05.

Results: Intention-to-treat analysis revealed significant Time × Group interactions for the Short Physical Performance Battery, GS, STS, and static balance (p < .05). The PNF group showed significant improvements in the Short Physical Performance Battery (Mchange = 1.9, 95% confidence interval [0.6, 3.2], p = .004), GS (Mchange = 0.20 m/s, 95% confidence interval [0.05, 0.37], p = .012), and STS (Mchange = -7.8 s, 95% confidence interval [-14.9, -0.6], p = .033). In contrast, the control group demonstrated significant declines in GS and handgrip strength (p < .05).

Conclusions and implications: The PNF concept is a promising exercise intervention to improve physical functioning in older adults at high risk of disability.

Background: Leisure-time physical activity (LTPA) provides many beneficial health outcomes for older adults. However, older adults often face challenges in engaging in LTPA due to declining physical functioning. Regular participation in LTPA has been significantly associated with improved life satisfaction and well-being, primarily through fostering a sense of independence and promoting enhanced physical and mental health. Despite this, there is a notable gap in research regarding the directional associations between LTPA participation, life satisfaction, and activities of daily living (ADL).

Methods: We investigated the mechanisms through which moderate levels of LTPA participation impact life satisfaction in older adults, focusing on its relationship with mobility and ADL performance. Utilizing data from the 2022 National Health Interview Survey, comprising a sample of 8,779 older adults, we examined levels of LTPA participation, mobility, ADL performance, and life satisfaction in older adults. Path analysis explored the associations between LTPA participation and life satisfaction while considering the mediating effects of mobility and ADL performance.

Results: Our findings revealed that participation in LTPA is significantly associated with both mobility and ADL performance, which in turn are strongly linked to life satisfaction.

Conclusion: The findings of our study underscore the importance of promoting LTPA participation by older adults to enhance life satisfaction, with mobility and ADL performance serving as key mediators in this association.

Implications: This study suggests exploring related causal pathways and developing targeted interventions that encourage older adults to integrate moderate LTPA participation into their daily lives.

Background: Novel options are needed to promote physical activity in the aging population. This study aimed to adapt intervention contents, determine implementation strategies and the mode of delivery for support materials of a targeted vigorous intermittent lifestyle physical activity (VILPA) intervention by consulting with key stakeholders (health professionals and adults transitioning to retirement).

Methods: A two-phase approach was undertaken. In Phase 1, semistructured interviews were conducted with 10 health professionals. The intervention was amended, and implementation strategies were drafted according to findings from the health professional interviews. In Phase 2, the amended VILPA intervention was presented and discussed in two focus groups with 15 adults transitioning to retirement. The participants were consulted regarding the feasibility, acceptability, and appropriateness of the amended intervention and the implementation strategies and mode of delivery for the support materials. Qualitative content analysis was performed across both phases.

Findings: Key implementation strategies adults transitioning to retirement recommended were education, social support, self-monitoring, rewards, and regular prompts. Participants preferred paper-based delivery of the intervention materials, as they thought the visual of a hard-copy material would act as a reminder to follow the intervention. Stakeholders believed the VILPA intervention could be delivered with a printed booklet that contained weekly checklists allowing participants to self-monitor and track their progress. Significance/Implications: This is the first attempt to translate evidence-based research on VILPA to an intervention in real-world settings. The novel intervention could provide new opportunities for older adults to engage in physical activity anywhere and anytime.

Background/objectives: Prolonged sedentary time poses health risks for older adults, and residents in assisted living spend more time sedentary than peers who live independently. The purpose of this study was to examine the feasibility of Stand When You Can, a sedentary behavior intervention designed to encourage residents of assisted living to stand and move throughout the day without requiring structured program delivery or additional staff time.

Methods: Five assisted-living residences in three provinces volunteered to use the Stand When You Can toolkit for 12 weeks. Feasibility outcomes included recruitment capability for ambassadors and participants, participant characteristics, and pre-post assessment of target outcome measures. Intervention fidelity was assessed at 6 weeks using on-site observations and informal interviews with staff and participants. Target outcomes included movement behaviors, physical function, and health status.

Results: Sixty-eight older adults volunteered to participate, and a staff ambassador volunteered from each site. Only one site demonstrated good intervention fidelity by implementing a variety of different strategies to reduce sedentary time. Assessment of target outcomes was feasible, although there was significant attrition and >50% of individual participants did not complete follow-up testing at 12 weeks.

Conclusion: While Stand When You Can was designed to be embedded in normal daily activities and require minimal staff time, it may not be feasible for most assisted-living residences to implement without additional staff.

Significance: To help residents maintain function and quality of life, assisted-living residences must invest in adequate staff with the time and tools to promote a culture of movement.

Background/objectives: Sarcopenia, characterized by age-related muscle loss, impacts functional performance and mobility. This study compares sarcopenia prevalence and physical fitness outcomes among older adults using four criteria from European and Asian Working Groups.

Methods: A total of 377 community-dwelling older adults all of Taiwanese ethnicity, were recruited for this study. They completed seven functional assessment tests. Descriptive statistics and various tests were used to compare variables between older adults with and without sarcopenia. Correlation and logistic regression analyses, along with the area under the curve, were performed to evaluate relationships between sarcopenia criteria and functional assessments, as well as the impact of functional performance on sarcopenia classification. Statistical significance was set at p < .05.

Results: The prevalence of sarcopenia varied with different criteria: European Working Group on Sarcopenia in Older People (EWGSOP)-2 (3.7%), EWGSOP-1 (39.0%), Asian Working Group for Sarcopenia (AWGS)-2 (11.1%), and AWGS-1 (6.6%). The study found generally low but statistically significant correlations between functional tests and sarcopenia factors. The receiver operating characteristic analysis results indicated that the functional test set by logistic regression model achieved an area under the curve of 0.787 under EWGSOP-2, 0.686 under EWGSOP-1, 0.728 under AWGS-2, and 0.751 under AWGS-1. Patients with sarcopenia consistently performed worse in functional tests, and area under the curve values indicated the effectiveness of functional tests in distinguishing sarcopenia.

Conclusion: This study highlights the variability in sarcopenia prevalence and functional implications among older adults using different European and Asian criteria, emphasizing the importance of context-driven diagnostic criteria. Significance/Implications: The findings of this study can highlight the need for selecting appropriate sarcopenia criteria to enhance screening accuracy, functional assessment, and targeted interventions for older adults in clinical practice.

Background/objective: Manual dexterity is critical for maintaining functional independence and quality of life in older adults, yet limited research has explored training interventions to enhance this skill. This study examined the effect of rhythmic gymnastics (RG) exercise programs, with and without apparatus, on the manual dexterity of older women.

Methods: Seventy-six women, aged over 65 (68.47 ± 3.34), without serious health or mobility issues, and no prior RG experience, were randomly assigned to two experimental and one control group. Each experimental group followed a 12-week intervention program (three sessions/week, 1 hr each). The first group (A) followed an RG program with the use of sport's apparatus and the second one (B) an RG exercise program using only body movements, without any apparatus. The control group (C) followed their typical everyday schedule. Manual dexterity was assessed three times (before the intervention, immediately after, and 20 weeks later for retention) using the Pegboard and Box and Blocks Tests.

Results: Group A showed a significant improvement in manual dexterity from pre to postintervention, with performance maintained at the retention test. Group B and the control group did not exhibit significant improvements across all measures.

Conclusion: The RG program with apparatus significantly improved manual dexterity in older women and maintained these improvements over time. Significance/Implications: RG programs with apparatus can enhance manual dexterity in older women and, in turn, promote functional independence in older adults, supporting its inclusion in exercise programs for this population. Future studies should also include male participants and frail populations.

Background/objective: Adherence rates to supervised gym-based exercise programs traditionally decline over time, highlighting the need to understand participants' perceptions regarding barriers and facilitators to long-term participation. To explore the experiences of people with one or more chronic conditions participating in an ongoing, supervised, gym-based exercise program in regional Australia.

Method: Semistructured interviews were completed with 40 participants and were analyzed thematically using a descriptive qualitative approach.

Results: Forty participants were stratified by age (over and under 65 years) and exercise frequency (regular vs. irregular) with 10 in each classification group. Five themes were identified that appeared to explain adherence: (1) A safe space for oneself, (2) Role modeling and social networking, (3) Seeing the value in exercise, (4) Accredited exercise physiologist support, and (5) Prioritizing exercise ahead of family responsibilities. Many participants over 65 years described the ways that the exercise program had positive benefits for arresting age-related decline in their day-to-day function, whereas participants under 65 years reported positive mental and physical benefits such as feeling happier, getting stronger, and having a more positive outlook on life.

Conclusion: Successful long-term adherence was facilitated by accredited exercise physiologists who invested time in establishing shared goals with participants and maintained regular, quality interactions. This professional support created accountability and enabled progressive program modification based on individual needs and progress. Professionals should focus on these to build effective therapeutic relationships in gyms-based exercise programs. Having a space for oneself and peer motivation enable participation, while role and family commitments can hinder it. Significance/Implications: Findings highlight specific strategies for exercise professionals to enhance long-term program adherence: building strong therapeutic relationships through regular support and individualized attention, creating safe and supportive exercise environments, and implementing flexible scheduling to accommodate family commitments. The identified role of peer support and professional supervision provides a framework for designing sustainable exercise programs in regional community settings. Exercise physiologists should focus on fostering these elements while addressing practical barriers to participation. This study received ethical clearance from The Monash Health Medical Research Ethics Committee; Number: 58571.

Background: This study examined the relationship between two abilities in terms of age-related changes, namely, the dynamic balance ability and the force-generating capacity of the three lower limb joints.

Methods: A group of 149 middle-aged to older adults (38 men and 111 women aged 74.1 ± 11.6 years) had their dynamic balance ability and the force-generating capacity of their three lower limb joints measured in the stepping test and the chair sit-to-stand test, respectively. The number of steps, the double-leg support time, and the single-leg support time were evaluated to show dynamic balance ability in the step test. The peak reaction force per body weight (F/w) and rate of force development were evaluated for the force-generating capacity of the three lower limb joints.

Results: The results showed that none of the parameters of dynamic balance ability in the stepping test had any age-related changes, but F/w and rate of force development showed age-related changes, decreasing with age.

Conclusion: No association was seen between dynamic balance ability in the stepping test and the force-generating capacity of three lower limb joints.

Significance: Age-related changes in dynamic balance do not correspond to changes in muscle strength, suggesting that evaluating dynamic balance ability solely through the stepping test at a self-selected speed may be challenging.

Background: Body composition changes during the aging process leads to an increase in fat mass and a decline in lean mass. Physical exercise can cause changes in body composition, but it is unclear whether reducing sedentary behavior (SB) also produces positive effects.

Objective: To assess whether adopting self-management strategies (SMS) to reduce SB along with multicomponent training (MT) compared with a MT alone can improve the body composition of older adults who were physically active before the pandemic.

Methods: A single-blind, randomized, controlled clinical trial was performed. Forty-five older adults (73.6 ± 6.3 years, 73.3% females) were divided into two groups: MT, who only performed exercise, and MT + SMS group, who performed exercise along with SMS to reduce SB. MT included aerobic, resistance, balance and flexibility components three times a week, for a duration of 50 min/session. The SMS consisted of goals and weekly telephone follow-up calls for 16 weeks. Body composition was assessed by dual-energy X-ray absorptiometry and the time spent in SB using the ActivPAL3 accelerometer. A generalized mixed linear model was performed in the software JAMOVI.

Results: Both groups reduced time in SB (p < .001), increased lean mass index (p = .038), and reduced the fat mass index (p < .001) and fat mass percentage (p < .001).

Conclusion: Implementing MT for older adults with characteristics similar to our study population may be sufficient to reduce SB and enhance body composition, as well as increase lean mass index, and decrease fat mass index. However, SMS to reduce SB did not potentiate the effects of MT on the body composition of older adults. Significance/Implications: Older adults can benefit from regular physical exercise.