Physical and cognitive activity and exercise for older adults: a review

African American Women's beliefs, coping behaviors, and barriers to seeking mental health services

Little is known about African American women's beliefs about mental illness. In this qualitative study we employed the Common Sense Model (CSM) to examine African American women's beliefs about mental illness, coping behaviors, barriers to treatment seeking, and variations in beliefs, coping, and barriers associated with aging. Fifteen community-dwelling African American women participated in individual interviews. Dimensional analysis, guided by the CSM, showed that participants believed general, culturally specific, and age-related factors can cause mental illness. They believed mental illness is chronic, with negative health outcomes. Participants endorsed the use of prayer and counseling as coping strategies, but were ambivalent about the use of medications. Treatment-seeking barriers included poor access to care, stigma, and lack of awareness of mental illness. Few age differences were found in beliefs, coping behaviors, and barriers. Practice and research implications are discussed.

Factors associated with cognition in adults: the Seattle Longitudinal Study

A better understanding of factors that affect cognition could lead to improved health and greater independence for older adults. We examined the association of four modifiable factors (leisure-time physical activity, leisure-time cognitive activity, self-directed work, and hypertension) with changes in two aspects of fluid intelligence (verbal memory and inductive reasoning). Data for 626 adults collected over 14 years (three time points) were analyzed by multi-level modeling. A component of self-directed work, higher work control, was associated with better verbal memory (p < .05) and inductive reasoning (p < .01). There were no significant interactions among these factors. The findings suggest that a strong sense of control at work may be protective for fluid intelligence in adults.

A review of clinical trials of tai chi and qigong in older adults

Initiation and maintenance of physical activity (PA) in older adults is of increasing concern as the benefits of PA have been shown to improve physical functioning, mood, weight, and cardiovascular risk factors. Meditative movement forms of PA, such as tai chi and qigong (TC & QG), are holistic in nature and have increased in popularity over the past few decades. Several randomized controlled trials have evaluated TC & QG interventions from multiple perspectives, specifically targeting older adults. The purpose of this report is to synthesize intervention studies targeting TC & QG and identify the physical and psychological health outcomes shown to be associated with TC & QG in community dwelling adults older than 55. Based on specific inclusion criteria, 36 research reports with a total of 3,799 participants were included in this review. Five categories of study outcomes were identified, including falls and balance, physical function, cardiovascular disease, and psychological and additional disease-specific responses. Significant improvement in clusters of similar outcomes indicated interventions utilizing TC & QG may help older adults improve physical function and reduce blood pressure, fall risk, and depression and anxiety. Missing from the reviewed reports is a discussion of how spiritual exploration with meditative forms of PA, an important component of these movement activities, may contribute to successful aging.

Optimal time-of-day and consolidation of learning in younger and older adults

The current study investigated the relationship between intraindividual variability and associative learning in younger and older adults. The authors hypothesized that higher levels of intraindividual variability would be associated with a reduction in the benefits of practice during learning, and that nonoptimal testing times would magnify these effects. Results indicated that older adults showed an increase in reaction time (RT) standard deviation (SD) relative to mean RT in the evening. Although time-of-day did not have a significant effect on rate of learning or total learning, intraindividual variability did predict learning rate of younger adults at nonoptimal testing times. Results are discussed in light of theoretical models of aging and learning.

Why don't you exercise? Development of the Amotivation Toward Exercise Scale among older inactive individuals

This article reports on the development and initial validation of the Amotivation Toward Exercise Scale (ATES), which reflects a taxonomy of older adults' reasons to refrain from exercise. Drawing on work by Pelletier, Dion, Tuson, and Green-Demers (1999) and Legault, Green-Demers, and Pelletier (2006), these dimensions were the outcome beliefs, capacity beliefs, effort beliefs, and value amotivation beliefs toward exercise. The results supported a 4-factor correlated model that fit the data better than either a unidimensional model or a 4-factor uncorrelated model or a hierarchical model with strong internal reliability for all the subscales. Evidence also emerged for the discriminant validity of the subscale scores. Furthermore, the predictive validity of the subscale scores was supported, and satisfactory measurement invariance was demonstrated across the calibration and validation samples, supporting the generalizability of the scale's measurement properties.

Menopause, the metabolic syndrome, and mind-body therapies

Cardiovascular disease risk rises sharply with menopause, likely due to the coincident increase in insulin resistance and related atherogenic changes that together comprise the metabolic or insulin resistance syndrome, a cluster of metabolic and hemodynamic abnormalities strongly implicated in the pathogenesis and progression of cardiovascular disease. A growing body of research suggests that traditional mind-body practices such as yoga, tai chi, and qigong may offer safe and cost-effective strategies for reducing insulin resistance syndrome-related risk factors for cardiovascular disease in older populations, including postmenopausal women. Current evidence suggests that these practices may reduce insulin resistance and related physiological risk factors for cardiovascular disease; improve mood, well-being, and sleep; decrease sympathetic activation; and enhance cardiovagal function. However, additional rigorous studies are needed to confirm existing findings and to examine long-term effects on cardiovascular health.

Self-efficacy and participation in physical and social activity among older adults in Spain and the United States

PURPOSE

We explored Bandura's self-efficacy theory as applied to older adult (aged 63-92) participation in physical and social activity in a cross-cultural study.

DESIGN AND METHODS

Older adults in Spain (n = 53) and the United States (n = 55) completed questions regarding self-efficacy, outcome expectancy, and participation in physical and social activities.

RESULTS

Self-efficacy significantly predicted both physical and social activity in both Spain and the United States. Outcome expectancy did not significantly predict either activity, nor did education, gender, or overall health. Modified and new self-efficacy measures proved reliable in both samples.

IMPLICATIONS

This study enhances understanding of how self-efficacy motivates participation in physical activity, as noted in previous studies, as well as provides a new understanding of what motivates participation in social activities. The high reliability of the new measures used in this study provides evidence for further use of these measures in other contexts. It is important to note that this study further supports the use of Bandura's theory of self-efficacy for cross-cultural applications.

Physical, social and productive leisure activities, cognitive decline and interaction with APOE-epsilon 4 genotype in Chinese older adults

BACKGROUND

We evaluated the combined and differential effects of physical, social and productive activities on cognitive decline and whether they were modified by the presence of the APOE-epsilon 4 allele.

METHODS

In a prospective cohort study of 1635 community-dwelling Chinese older adults aged 55 or older participating in the ongoing Singapore Longitudinal Aging Study, physical, social and productive leisure activities were assessed at baseline, and cognitive decline (at least one point drop) in MMSE scores between baseline and follow-up after one year.

RESULTS

Cognitive decline was observed in 30% of the respondents. Controlling for age, gender, education and other risk factors, odds ratios (ORs) were significantly reduced in those with medium (OR: 0.60, 95% CI: 0.45-0.79) and high activity levels (OR: 0.62, 95% CI: 0.46-0.84). A stronger association was shown for productive activity (OR = 0.36), than for physical (OR = 0.78) and social activities (OR = 0.85). These associations showed statistically significant interactions with APOE genotype, being more pronounced in those with the APOE-epsilon 4 allele.

CONCLUSION

Increased leisure activity, especially productive activities more than physical or social activities, was associated with a lowered risk of cognitive decline. APOE-epsilon 4 genotype individuals appeared to be more vulnerable to the effects of low and high levels of leisure activities.

Positive effects of a qigong and aerobic exercise program on physical health in elderly Japanese women: an exploratory study

OBJECTIVE

To determine the effects of a 12-week qigong and aerobic exercise program on the physical well-being of relatively healthy elderly Japanese women.

METHODS

In the first study, 72 elderly Japanese women who were relatively healthy and naive to qigong completed the 12-week qigong and aerobic exercise program. Physical function, body composition, and abdominal fat were evaluated. In the second study, we examined the effects of qigong alone on physical function. Twenty-nine participants in each of two groups (divided according to their residences) underwent a 12-week program: qigong and aerobic exercise (residents in Yura Town) or qigong exercise alone (residents in Mihama Town).

RESULTS

In the first study, physical function including lung capacity, trunk bending, normal walking for 30 m, and rising from a supine position significantly improved after the 12-week program. In addition, body fat diminished significantly during the program. In the second study, both exercise programs ("qigong and aerobic" and "qigong alone") similarly increased walking speed (normal and maximum walking) and rising speed.

CONCLUSIONS

The findings of this exploratory study demonstrated that a 12-week qigong and aerobic exercise program was associated with improvements in physical function and a reduction in body fat. The qigong exercise program alone positively influenced physical function. The qigong program appears to be an appealing means of improving the physical health of elderly persons.

Physical activity and the elderly

Functional ageing processes are characterized by a loss of performance capabilities regarding coordination, flexibility, strength, speed, and endurance. The effects of ageing processes on the cardiovascular system and skeletal muscle are the foci of attention. After age 30, the maximum aerobic dynamic performance capacity decreases by an average of 8% per decade. The causes are mainly a reduction in the maximum cardiac output and decreases in capillarization and in the skeletal muscle mass. An improvement in the maximum oxygen uptake by 18% and in the aerobic-anaerobic threshold by 22% was achieved in untrained men aged 55-70 years, in a 12-week-long bicycle ergometer-training programme. The strength of the skeletal muscle decreases particularly after 50-60 years of age. The main cause is the reduction in the number of motor units and muscle fibres. Further, modifications of the endothelial function and the development of sarcopenia are of particular importance in ageing processes. General aerobic dynamic training can improve the endothelial function in old age and thus help prevent cardiovascular diseases. Strength training is most appropriate for the prevention of sarcopenia. Imaging techniques over the last 20 years have provided new findings on the influence and the significance of physical activity on the brain. We call this new interdisciplinary area 'Exercise Neuroscience'. Demands on coordination and aerobic dynamic endurance are suitable in counteracting age-related neuronal cellular loss, synapsis hypotrophy, and in improving neurogenesis and capillarization. Adjusted physical activity is thus capable of counteracting age-related changes and performance loss not only in the cardiovascular system but also in the brain.

Motor imagery: The relation between age and imagery capacity

The imagination of motor actions forms not only a theoretical challenge for cognitive neuroscience but may also be seen as a novel therapeutic tool in neurological rehabilitation, in that it can be used for relearning motor control after damage to the motor system. However, since the majority of rehabilitation patients consist of older individuals it is relevant to know whether the capacity of mental imaging is compromised by age. Scores on the vividness of movement imagery questionnaire were obtained for 333 participants, divided in three age groups. Results showed that elderly participants were slightly worse in motor imagery capacity than younger participants, particularly in relation to motor imagery from an internal (first person) perspective. Furthermore, a possible relation between the level of physical activities and motor imagery capacity is discussed.

Frequency of going outdoors as a good predictors for incident disability of physical function as well as disability recovery in community-dwelling older adults in rural Japan

BACKGROUND

The clinico-epidemiologic relevance of the reduction in the frequency of going outdoors in older adults has not been well characterized. This study examined whether the frequency of going outdoors has predictive values for incident physical disability and recovery among community-dwelling elderly.

METHODS

One thousand, two hundred and sixty-seven persons aged 65+ years who lived in a rural community in Niigata, Japan, and participated in the baseline survey were assessed again 2 years later in terms of mobility, and instrumental and basic activities of daily living (IADL and BADL). We compared the incident disability and recovery at follow-up among three subgroups classified by the baseline frequency of going outdoors: once a day or more often, once per 2-3 days, and once a week or less often. Multivariate analyses tested associations between the frequency of going outdoors and functional transition, independent of potential confounders.

RESULTS

A lower frequency of going outdoors at baseline was associated with a greater incident disability, and a lower recovery at the two-year follow-up. Even after adjustment, the effects of going outdoors remained significant. Adjusted risks of incident mobility and IADL disabilities were significantly higher (odds ratio[OR]=4.02, 95% confidence interval [CI]: 1.77-9.14 and OR=2.65, 95% CI: 1.06-6.58), respectively, and recovery from mobility disability was significantly lower (OR=0.29, 95% CI: 0.08-0.99) for “once a week or less often” subgroup compared with “once a day or more often” subgroup.

CONCLUSION

The frequency of going outdoors is a good predictor for incident physical disability and recovery among community-living elderly. Public health nurses and clinicians should pay more attention how often their senior clients usually go outdoors.