Journal of Aging and Physical Activity最新文献

This systematic review aims to identify the effectiveness of digital health applications (apps) to increase physical activity (PA) or prevent malnutrition in community-dwelling older adults. Searches were conducted in June 2023 across seven electronic databases (MEDLINE, PsycINFO, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica database, Allied and Complementary Medicine Database, and Cochrane Central Register of Controlled Trials), and grey literature were searched via google scholar. Data from studies that met the inclusion criteria were extracted. Risk of bias was assessed, and the quality of evidence was evaluated using Grading of Recommendations Assessment, Development, and Evaluation. Meta-analyses were undertaken where appropriate using DerSimonian and Laird random-effects model (Stata version 16.1), or data were described narratively. Twenty-seven studies met the eligibility criteria, although 23 of these had low or unclear risk of bias. Twelve studies considered PA outcomes only, two studies considered nutritional outcomes only, and three studies considered both PA and nutritional components. A meta-analysis comprising six studies (818 participants) showed that those using a digital health app had a higher step count compared with participants in the control group (mean difference = 799, 95% CI [48.76, 1550.08]). Studies looking at nutritional outcomes aimed to increase protein intake or adherence to dietary patterns with mixed findings. Digital health apps have the potential to increase PA in community-dwelling older adults. Digital health app interventions that aim to reduce the risk of malnutrition in older adults is a relatively unexplored area with mixed findings, so more high-quality studies should be prioritized.

Background/objectives: A globally aging population necessitates public health action that supports healthy aging. Although it is well established that participation in physical activity (PA), sport, and active recreation are important for healthy aging, PA levels remain generally lower among older adults. This study examines trends in physical activities that older adults engage in and identifies disparities in activities across subgroups as defined by age, gender, and socioeconomic status.

Methods: Data from two New South Wales survey data sets (New South Wales Population Health Survey and AusPlay) investigated patterns and trends of PA, sport, and active recreation between 2016 and 2021 among adults aged 65+ years. Weighted prevalence estimates of meeting PA guidelines (≥150 min/week of moderate to vigorous PA), weekly minutes spent walking and doing moderate to vigorous PA, and annual participation rates in specific activities were calculated as weighted proportions. Multivariable logistic regression models included age, gender, and socioeconomic status as independent variables.

Results: Between 2016 and 2021, the proportion of older adults meeting PA guidelines increased (37.8%-51.3%). Adults aged 75+ years, older men, and those living in the least disadvantaged areas experienced greater increases in moderate to vigorous PA.

Conclusions: Older adults' reported PA levels have increased in recent years, highlighting opportunities to prioritize PA promotion in the global agenda to support healthy and active aging. Significance/Implications: This study offers insights into recent trends and noteworthy increases in PA, sport, and active recreation among older Australian adults. These can assist policymakers in developing, evaluating, and implementing population-wide strategies to maintain improved activity levels.

Background/objectives: Mobile robotic telepresence could be used to remotely supervise physical activity programs. Our study aims to explore the feasibility, acceptance, and usability of a physical activity program offered synchronously via a mobile robotic telepresence platform.

Methods: For this interventional study, five Cutii robots were made available in two residences for older adults in Quebec. Participants received the exercise program, two sessions per week for 4-6 weeks, delivered remotely via the robot. The following feasibility indicators were collected during the study, as recommended by Thabane et al.: process, resources, management, and intervention. Acceptance and usability of the technology were measured using the extended version of the Unified Theory of Acceptance and Use of Technology-based questionnaire and the System Usability Scale, respectively.

Results: Eighty percent of participants completed the protocol, and 58% of participants attended 80% of the sessions. Various technical problems (internet connection and technology issues) limited the usability and acceptance of the technology.

Conclusion: The results revealed that the program was feasible according to the process, management, and intervention indicators but unsatisfactory in terms of resources. For some participants, minor modifications were needed to improve technology support and facilitate connection to the mobile robotic telepresence. Further studies will need to focus on the evaluation of the effectiveness of this type of intervention.

Implications: These results emphasize the importance of continuing research evaluating the opportunities provided by new technologies to enhance older adults' engagement in physical activity and inform clinicians and policymakers to improve future services in this domain.

Background: Research suggests associations between physical activity, sedentary behavior, sleep, and metabolic syndrome, but most has focused on healthy populations and individual behaviors. We investigated associations of 24-hr movement behavior compositions with cardiometabolic risk factors and metabolic syndrome in adults receiving rehabilitation for other health conditions.

Method: This cross-sectional study assessed 24-hr movement behaviors using thigh-worn accelerometers and metabolic outcomes via blood analyses in 145 adults attending outpatient rehabilitation. Regression models tested associations of five 24-hr time-use behaviors (time in bed, sedentary time, standing, light-intensity stepping, and moderate- to vigorous-intensity stepping) with cardiometabolic risk factors and metabolic syndrome severity score (a cumulative measure of risk derived from metabolic risk factors).

Results: Participants (64 [SD 12] years old; 52% women; 66% with metabolic syndrome, with 6 [SD 0.7] days of 24-hr data) spent 41% of a 24-hr day sedentary, 15% standing, 3% in light-intensity stepping, 2% in moderate- to vigorous-intensity stepping, and 38% in bed. Adjusted models indicated that a higher proportion of light-intensity stepping was associated with lower triglycerides, more time in bed was associated with a higher metabolic syndrome severity score, and more time stepping was associated with a lower metabolic syndrome severity score. There was no evidence of associations between the overall compositions and outcomes.

Conclusion: The consistently observed small proportions of physical activity, with lack of variation between participants, may not be sufficient to counteract the impact of high sedentary time on metabolic outcomes in adults attending outpatient rehabilitation.

Implications: Future research may focus on exploring ways to increase light-intensity stepping in sedentary older adults with various health conditions.

Background: Subjective cognitive decline (SCD) is an important time window for early prevention of Alzheimer's disease. Regular physical activity (PA) has positive effects on cognitive functions. Little is known about the actual PA levels and social-ecological correlates in people with SCD. This study aimed to describe PA level and examine the individual, interpersonal, and neighborhood environmental correlates of PA among older adults with SCD in the Chinese community.

Methods: A total of 246 older adults with SCD who participated in community physical examinations in three community health service centers in Baoding City from May to July 2023 were selected as the investigation subjects through convenience sampling. Questionnaires were conducted on PA, self-efficacy, self-regulation, social support, and community environment of older adults. Multivariate logistic regression was employed to analyze the factors influencing PA in older adults with SCD.

Results: Only 25.2% of older adults with SCD were physically active enough. Multivariate logistic regression analysis showed that PA was positively correlated with self-reported health status, self-efficacy, self-regulation, social support, and community facilities. It was negatively associated with age, income, and overweight/obesity.

Conclusions: Factors on three levels were all significantly associated with PA. Interventions that incorporate individual, interpersonal, and social factors may be considered to promote PA in older adults with SCD. However, only a few older adults achieve the goal of 150 min/week of moderate activity.

Background/objectives: There is a notable lack of evidence regarding the long-term effects of rehabilitation services, particularly concerning functional recovery and daily living activities of patients following discharge from convalescent rehabilitation wards. This study aimed to clarify the longitudinal changes in activities of daily living and instrumental activities of daily living of patients after discharge from a convalescent rehabilitation ward and the association between the use of rehabilitation services and clinical outcomes.

Methods: Patients discharged from Japanese convalescent rehabilitation wards in August 2021 were included. They were classified into two groups (rehabilitation and nonrehabilitation services use) based on whether they used rehabilitation services (outpatient rehabilitation, older adult day care, or home-based rehabilitation) after discharge. The primary outcomes, including the Barthel Index, functional independence measure, Frenchay Activities Index, and life-space assessment scores at 6 months after discharge, were analyzed by multivariate analysis.

Results: A total of 293 patients (median age: 75 years; 148 females) were included in the analysis. The use of rehabilitation services was independently associated with the Barthel Index (partial regression coefficient [B]: 7.224; 95% confidence interval [CI]: [1.760, 12.688]), functional independence measure (B: 2.659; 95% CI: [0.194, 5.125]), Frenchay Activities Index (B: 2.351; 95% CI: [0.5088, 4.192]), and life-space assessment at 6 months after discharge (B: 8.226, 95% CI: [3.902, 12.550]).

Conclusions: The use of rehabilitation services was independently associated with patients' Barthel Index, functional independence measure, Frenchay Activities Index, and life-space assessment after discharge from a convalescent rehabilitation ward. This study emphasizes crucial role of postdischarge interventions for improved patient outcomes.

Background/objectives: Accurate assessment of physical activity is essential in hospital settings, but difficult for geriatric rehabilitation patients who have slow walking speed and rely on walking aids. This study conducted an external validation of the MOX activity monitor accuracy in distinguishing between sedentary (lying, sitting), standing, and dynamic activities among hospitalized geriatric rehabilitation patients. Additionally, the study assessed clinical tolerance and ease of use of the monitor.

Methods: Inclusion criteria were being hospitalized on the geriatric rehabilitation ward, aged 70 years or older, and using a walking aid. The monitor was placed on the upper leg, and remained in place for 1 week. In a test-session, four activities of 4 min each (lying, sitting, standing, and walking) were filmed. Video analyses created a direct observation timeline. Daily skin irritation assessments were conducted and participants noted their discomfort level at the week's end.

Results: The study included 20 participants who relied on walking aids, with 10 requiring additional physical support while walking. The MOX activity monitor exhibited excellent accuracy in classifying the four activities, with a zero mean percentage error for sedentary activity, 2.2% for standing, and 2.7% for walking. Participants reported minimal hindrance, and the monitor proved user-friendly.

Conclusion: The MOX activity monitor demonstrated remarkable accuracy in distinguishing between these four activities in a test-session and displayed strong clinical applicability.

Significance: The monitor shows substantial promise as a valuable tool for assessing physical activity in hospitalized geriatric rehabilitation patients using walking aids.

Background: Sedentary behavior is highly prevalent in older adults transitioning to retirement. Sedentary time is all of the time spent in sedentary behavior, and prolonged sedentary time is associated with an increased risk of noncommunicable diseases. The aim of this study was to explore perceptions among older adults transitioning from working life to retirement regarding self-management strategies for reducing sedentary time and adhering to the reduced sedentary time.

Methods: Twenty-eight older adults, age 60-75 years, participated in one of four focus group interviews. Qualitative content analysis was used to analyze the data.

Results: The analysis resulted in the theme "It has to be my way," and the three categories "Activities scattered with joyfulness," "Support for changes in everyday life," and "Health affects willingness and ability, and is affected by adherence."

Conclusions: Interpreted from the perspective of self-determination theory, self-management strategies for reducing sedentary time should be adaptable as every individual is unique, indicating a need for autonomy. Sedentary time was said to be reduced by activities that evoked joyfulness, and joyfulness was considered to increase adherence. Support for changes to one's everyday life was considered necessary. The support that was mentioned primarily involved targeting cognitive determinants such as self-efficacy and attitudes. This new knowledge can be included when designing self-management interventions; however, more research is needed in order to evaluate whether self-management strategies targeting autonomous motivation and affective determinants, such as affective judgment and cognitive determinants, can reduce sedentary time in those who are in the transition to retirement.

Background/objectives: The aim of this systematic review was to evaluate the available evidence regarding the impact of breaks in sedentary time on cardiovascular, metabolic, functional, and psychosocial health of adults aged 60 years and older.

Methods: A systematic search of databases was performed in May 2024. This review was registered with PROSPERO (#374311) and has been reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.

Results: A total of seven articles (five unique studies) were included. The available evidence suggests minimal changes in health-related variables. Specifically, changes to cardio-metabolic and psychosocial variables were limited. Changes to physical function appear to show the most promise. While only one of the studies included focused solely on reducing sedentary behavior, all others focused on reducing sedentary behavior by increasing physical activity. Two of the seven articles showed significant changes compared with the control group to sedentary time ranging from 32 to 58 min. Mean sedentary bout time and number of sedentary bouts longer than 30 min were reduced in two of the seven articles. No changes in sit-to-stand transitions were reported.

Conclusion: There is limited evidence focusing on the impact of breaks or interruptions to sedentary time on the physical and mental health of community-dwelling adults 60+ years. Significance/Implications: This systematic review examines recent research aimed to disrupt sedentary behavior and positively impact health in community-dwelling older adults. Results show the difficulty of increasing sit-to-stand transitions/breaks in sedentary behavior, and highlight the challenge of disentangling the effects of sedentary behavior, and physical activity on health.

Background/objectives: Sleep seems to be associated with worse low back pain (LBP) outcomes in older adults; however, studies investigating the association of objective sleep with future changes in LBP outcomes are lacking. The objectives of this study are as follows: (a) to investigate the association between objectively measured sleep with changes in clinical outcomes in older adults with LBP receiving physical therapy care and (b) to examine the cross-sectional association between sleep and pain catastrophizing.

Methods: This was a prospective cohort study. We recruited older adults (≥60 years old) with chronic LBP undergoing physical therapy treatment. At baseline, we assessed participants' sleep (actigraphy for 10-14 days), pain intensity, disability, pain catastrophizing, and covariates. After 8 weeks, we reassessed pain intensity, disability, and self-perceived recovery. We ran linear regression models and Spearman coefficient tests.

Results: Fifty-eight participants were included, and 51 completed follow-up assessments (60.8% women; mean age 70.1 ± 5.6 years). We found no associations between sleep quantity and efficiency with changes in pain intensity, disability, and self-perceived recovery after 8 weeks of physical therapy care. We found a correlation between sleep fragmentation and pain catastrophizing (r = .30; 95% confidence interval: [.03, .54]).

Conclusion: Objective sleep quantity and efficiency may not be associated with changes in LBP outcomes after physical therapy care in older adults. Among the sleep domains evaluated, sleep fragmentation may be the sleep domain with the strongest association with pain catastrophizing. Significance/Implications: Objectively measured sleep might not be a prognostic factor for LBP improvement in older adults. Future studies should explore the association between sleep fragmentation and pain catastrophizing.