What Motivates Older Adults to Improve Diet and Exercise Patterns?

Eating preferences and behaviors of older immigrants in Oslo: A qualitative study

Norway's population of older, first-generation immigrants is expected to almost triple by the year 2060 due to decreased mortality and continued immigration. Studies indicate that older immigrants in Norway have a higher rate of non-communicable disease than older non-immigrants. Eating a health-supporting diet is important for reducing disease risk and maintaining independence in older adults. The purpose of this study was to increase understanding of the eating preferences and behaviors of older, home-dwelling, first-generation immigrants in Oslo, and to identify influences on their eating preferences and behaviors. This qualitative study took a phenomenological approach to understand older immigrants' shared experience of changing eating behaviors with aging. Fourteen home-dwelling, older immigrants were recruited using a combination of purposeful random sampling and snowball sampling. In-depth interviews were conducted then analyzed according to reflexive thematic analysis. Study findings indicate that older immigrants eat a bi-cultural diet pattern. In addition, they seek out information about nutrition, and incorporate many health-supporting eating habits for disease management and prevention. In this way, older immigrants in Oslo share much in common with older non-immigrants. Hopes and worries for the future motivate older immigrants to eat more healthfully in order to maintain independence and cultural identity as long as possible. These results can be useful for designing culturally tailored programs which support eating habits for health maintenance and disease prevention among older immigrants.

Clean-label products: Factors affecting liking and acceptability by Portuguese older adults

Consumers are preferring more "natural" foods, made of "healthier" and "familiar" components - the "clean-label" trend. As the population ages, understanding the older adult consumer segment becomes increasingly important. This study aims to identify the factors influencing the acceptability and liking of clean-label products in older adults living in the community. A convenience sample of 100 older adults was used for this cross-sectional study. Socio-demographic data, health status, independence level, lifestyle characteristics, nutritional status, and food and nutrient intake data were collected. The acceptability and liking for clean-label products comprised two parts: Sensory analysis with overall liking evaluation of three pairs of products, using a 9-point hedonic scale and free comments; Willingness to eat and preference assessment of nine pairs of products using the Food Action scale and a simple preference test. The participants were 80% female with a mean age of 75 years old. The overall liking for clean-label versions of cookies and mayonnaise was lower than for traditional versions. However, participants were more willing to eat the clean-label versions of products, particularly ham and yogurt. Most of the participants would prefer buying the clean-label version of all nine pairs of products, especially for ham, loaf bread, sausages, and yogurt. In sum, older adults living in the community exhibit a lower liking but, a greater willingness to eat and a higher preference for buying clean-label products. Older adults who favor clean-label products have higher levels of education and are reported to have a more adequate diet.

Sleep Quality as a Critical Pathway Between Adverse Childhood Experiences and Multimorbidity and the Impact of Lifestyle

OBJECTIVES

This study aims to establish the effects of ACEs on multimorbidity through sleep quality and investigate whether lifestyle factors (e.g., eating habits and exercise) may influence this relationship among middle-aged and older adults.

METHODS

Participants were drawn from a cross-sectional sample of community dwelling older adults (N = 276, 55+) and three waves of data from the Midlife in the United States study (MIDUS, N = 843). We examined the direct and indirect effects of ACEs, sleep quality, and health conditions, as well as the conditional effects of physical activity and eating habits.

RESULTS

Across both samples, sleep quality mediated the relationship between ACEs and chronic health conditions. Moderating effects of unhealthy eating and physical activity differed between samples.

DISCUSSION

Sleep quality is an important pathway connecting ACEs and adult multimorbidity, and health behaviors may provide targets for intervention particularly in older adults.

Role of personal aptitudes as determinants of incident morbidity, lifestyles, quality of life, use of health services, and mortality (DESVELA cohort): quantitative study protocol for a prospective cohort study in a hybrid analysis

Introduction

The healthcare and well-being of the population depend on multiple factors and should adapt to societal changes. The opposite is also occurring; society has evolved concerning the individuals' approach to their care, which includes participation in decision-making processes. In this scenario, health promotion and prevention become crucial to provide an integrated perspective in the organization and management of the health systems.Health status and well-being depend on many aspects, determinants of health, which in turn may be modulated by individual behavior. Certain models and frameworks try to study the determinants of health and individual human behaviors, separately. However, the interrelation between these two aspects has not been examined in our population.Our main objective is to analyze whether personal aptitudes related to behaviors are independently associated with the incidence of morbidity. A secondary objective will enquire whether these personal aptitudes are independently associated with lower all-cause mortality, enhanced adoption of healthy lifestyles, higher quality of life, and lower utilization of health services during follow-up.

Methods

This protocol addresses the quantitative branch of a multicenter project (10 teams) for the creation of a cohort of at least 3,083 persons aged 35 to 74 years from 9 Autonomous Communities (AACC). The personal variables to evaluate are self-efficacy, activation, health literacy, resilience, locus of control, and personality traits. Socio-demographic covariates and social capital will be recorded. A physical examination, blood analysis, and cognitive evaluation will be carried out.Several sets of six Cox models (one for each independent variable) will analyze the incidence of morbidity (objective 1); all-cause mortality and the rest of the dependent variables (objective 2). The models will be adjusted for the indicated covariates, and random effects will estimate Potential heterogeneity between AACC.

Discussion

The analysis of the association of certain behavioral patterns and determinants of health is essential and will contribute to improving health promotion and prevention strategies. The description of the individual elements and interrelated aspects that modulate the onset and persistence of diseases will allow the evaluation of their role as prognostic factors and contribute to the development of patient-tailored preventive measures and healthcare.Clinical Trial Registration: ClinicalTrials.gov, NCT04386135. Registered on April 30, 2020.

To Eat or Not to Eat-A Qualitative Exploration and Typology of Restrictive Dietary Practices among Middle-Aged and Older Adults

Favorable diets often include restrictive practices that have proven health benefits, even if initiated later in life. The aim of this qualitative study is to gain a comprehensive understanding of Restrictive Dietary Practices (RDPs) among a sample of middle-aged and older German adults (aged 59-78 years). We conducted 24 narrative in-depth interviews and analyzed the data using qualitative content analysis (Kuckartz). Following an inductive thematic approach, a typology was reconstructed comprising four typical RDP characteristics: I. The Holistically Restraining Type, II. The Dissonant-savoring Restraining Type, III. The Reactively Restraining Type, and IV. The Unintentionally Restraining Type. These types differed regarding the practical implementation of, e.g., restrictive food choice into everyday routines, barriers to do so, as well as with respect to attitudes and motives underlying RDPs. The major motives for adopting a RDP involved health, well-being, ethical, and ecological concerns. The most prominent barriers to a 'successful' adoption of RDPs were the enjoyment of food and the desire for spontaneity and freedom of (food) choice. Our study offers an in-depth understanding of the aspects that shape the widespread practice of dietary restriction among middle-aged and older adults. Lifeworld-related changes in RDPs and possible 'type shiftings' are discussed as well as the meaning and chances of RDPs for public health promotion.

Likeability and perceived effectiveness of messages designed to encourage physical activity participation among older adults

ISSUE ADDRESSED

Older adults are significantly less likely than their younger counterparts to engage in physical activity. Comprehensive policies to support healthy ageing thus need to include components encouraging greater participation in physical activity in later life. This study tested potential messages for use in health communication campaigns aimed at increasing physical activity among older adults.

METHODS

Twelve written messages designed to encourage older adults to increase their levels of physical activity were rated by Australians aged 60-92 years (n = 369; 54% female) on the variables of likeability and perceived effectiveness.

RESULTS

Ratings for all the tested messages were high across both outcome variables. The message Move more, live longer scored most favourably, with large majorities of participants liking this message (87%) and considering it effective (81%). Messages featuring rhyming or alliteration were rated significantly higher on both outcomes than messages without these attributes (all Ps < .001).

CONCLUSIONS

Results provide insights into the types of messages that are likely to be accepted by older adults. Statements that use the phonological patterns of rhyming or alliteration are likely to be especially well received. SO WHAT?: Increasing participation in physical activity among older adults is critical to promoting the sustainability of health care systems and enhancing quality of life. The specific messaging attributes identified in the present study as being effective could be used by public health practitioners to inform their approach to physical activity messaging to older adults and incorporated into future health communication campaigns to increase their potential effectiveness with this target group.

Web-Based Interventions to Promote Healthy Lifestyles for Older Adults: Scoping Review

Background

With the aging of the population and rising rates of chronic diseases, web-based interventions could be considered to support older adults in adopting healthy lifestyles. To date, published knowledge syntheses have focused on quantitative studies among older adults aged ≥50 years. However, those aged ≥65 years may have different needs to be met by these interventions because of the biological and physiological changes associated with aging, and qualitative studies could help advance knowledge in this field.

Objective

The objective of this scoping review is to explore the extent of the literature on web-based interventions aimed at promoting healthy lifestyles among people aged ≥65 years.

Methods

A scoping review was conducted based on the framework proposed by Levac et al. Six databases (ie, MEDLINE, CINAHL, PsycINFO, Web of Science, the Cochrane Database of Systematic Reviews, and the Joanna Briggs Library) and gray literature (ie, Google Scholar and OpenGrey) were searched. The final search was conducted on June 23, 2021. The studies were selected by 2 persons (AL and ML) independently. The included studies were systematic reviews and qualitative and quantitative studies focusing on web-based interventions to promote healthy lifestyles in people aged ≥65 years that were published in French or English between 1990 and 2021. Data were extracted in a table and synthesized based on the conceptualization of web-based interventions (ie, according to the use parameters, behavior change techniques, delivery modes, and theories). A thematic analysis was performed.

Results

In total, 20 articles were included in this review, which represents studies focused on 11 distinct interventions. All of the interventions (11/11, 100%) aimed to promote physical activity among older adults. The number of intervention sessions varied from 5 to 16, with a frequency from daily to once every 2 weeks. Diverse delivery modes such as electronic diary, video, and phone call were found. The most used behavior change techniques were instruction, feedback, and self-monitoring. Few interventions (6/11, 55%) were based on a theory. A favorable trend was observed in increasing physical activity, and 5 themes emerged that appeared to be central to behavior change among older adults: motivation, support, tailoring, barriers, and perceptions.

Conclusions

This scoping review provides a better understanding of the components of web-based interventions and their outcomes on the healthy lifestyles of people aged ≥65 years. These findings could provide important guidance for the design and development of future web-based interventions in this field. Further research is needed to continue the development and evaluation of innovative and accessible interventions to promote healthy lifestyles among older adults.

International Registered Report Identifier (IRRID)

RR2-10.2196/23207

Communicating with older people about physical activity

OBJECTIVE

Little is known about how to effectively encourage higher levels of activity among older people. This study tested the effectiveness of a public service advertisement designed according to recommendations for communicating with older audiences and featuring five types of moderate-to-vigorous physical activity: tennis, line dancing, cycling, swimming and jogging.

METHODS

A survey administered to 1,200 Australians aged 50+ years assessed effects of the public service advertisement on: motivation (intrinsic and extrinsic); perceived believability, relevance, and effectiveness; and feelings elicited (e.g. interest, hope, guilt). Open-ended questions enabled respondents to describe aspects of the ad they considered to be most and least effective.

RESULTS

Moderate to high scores were obtained on the motivation measures and the ad evaluation criteria of perceived effectiveness, likeability, believability and personal relevance. Mean scores for the feelings measures were generally low, with the exception of the positive feelings of being interested, inspired, hopeful and determined.

CONCLUSIONS

The results suggest physical activity promotion ads can be motivating across age and socioeconomic subgroups of older people. Implications for public health: Ads aiming to encourage older people to be more physically active may be accepted and effective if they depict everyday older people enjoying a range of relevant activities.

Exercise Experiences of Older Adults with Diabetes and Sarcopenia: A Phenomenological Study

Sarcopenia is a common and progressive skeletal muscle condition, often described as an intermediate stage in the development of frailty and disability in patients with diabetes. This can be improved through physical activity and exercise. This descriptive phenomenological study explored the exercise experiences of older adults with diabetes and sarcopenia. Individual interviews were conducted following semi-structured interview guidelines, and narratives were analyzed using Giorgi's method. Data saturation was achieved after interviewing 14 purposively sampled older patients with diabetes and sarcopenia. The study identified three main themes: encountering difficulty during exercise, recognizing the advantages of exercise, and constructing a suitable exercise model. While older adults with diabetes and sarcopenia may encounter difficulty during exercise, they also experience positive feedback from exercise. Understanding the limitations of older adults, individualizing exercise models based on their exercise experiences, and providing appropriate interventions and necessary emotional support can effectively prevent diabetes and sarcopenia.

"Eating healthy": Distrust of expert nutritional knowledge among elderly adults

Elderly adults in southern Ecuador often distrust nutritionists' advice when implementing changes to their dietary practices. This distrust is no overt disregard for expert nutritional knowledge but rather the result of structural and situated practices that combine suspicion, misinformation, financial limitations, and family care. In this article, we examine eating practices among elderly adults in southern Ecuador in order to understand how nutrition distrust is constructed. In doing so, our aim is to understand how elderly adults incorporate-or not-expert nutritional knowledge into their eating practices. By ethnographically documenting daily eating practices among elderly adults in their homes, alongside expert nutritional discourses, our findings reveal that there is first, a local understanding of "eating healthy" connected to lived realities (e.g. farming practices, agricultural toxicity, age, education, polypharmacy, kinship ties), and second, a disconnect between expert nutritional knowledge and eating practices linked to how knowledge is produced and disseminated (e.g. power relations, scientific vocabulary, perceptions of health). Understanding how elderly adults build trust around eating can be a fertile ground for promoting more effective and suitable dietary advice among specific communities or groups like elderly adults.

Older Adults' Socio-Demographic Determinants of Health Related to Promoting Health and Getting Preventive Health Care in Southern United States: A Secondary Analysis of a Survey Project Dataset

Background: This exploratory survey study examined the relationship between older adults’ five socio-demographic determinants (urban/rural residence, gender, age, marital status, and education) and their self-reported perception of importance, desire to perform, and ability to perform nine self-care behaviors related to promoting health and getting preventive health care. Methods: We reported a secondary analysis of a dataset from an exploratory survey project; we analyzed 2015–2016 retrospective data collected from a cross-sectional survey study, including 123 adults aged 65 years and older living in southern United States. Data were collected from the Patient Action Inventory for Self-Care and a demographic questionnaire and analyzed using binary and multiple logistic regression analyses. Results: Advancing age, marital separation, and holding less than a high school education were significantly associated with at least one of the unfavorable perceptions of the importance, the desire to perform, and the ability to perform three self-care behaviors. These three behaviors were: (1) creating habits that will improve health and prevent disease, (2) discussing the use of health screening tests with healthcare providers, and (3) joining in local health screening or wellness events. Gender and urban/rural residence were not significant. Conclusions: Comprehensive health care should include an individual’s socio-demographic context and self-care perception of importance, desire, and ability.

Positive Self-perceptions of Aging Promote Healthy Eating Behavior Across the Life Span via Social-Cognitive Processes

OBJECTIVES

Negative self-perceptions of aging (SPA) have been shown to result in lower levels of preventive behavior, health, and longevity. This study focuses on the understudied SPA effects on healthy eating across the life span. Moreover, it aims to provide longitudinal evidence of the psychological mechanisms behind this relationship.

METHOD

We investigated whether SPA (T1) can predict changes in eating behavior (T3) over 1 year in 1,321 participants (T1), aged 18-92 years. The explanatory role of social-cognitive processes (T1, T2) was tested via a two-step mediation analysis with multigroup modeling for different age and education levels.

RESULTS

Baseline positive SPA predicted more healthy eating at T3 (b = 0.68, SE = 0.24, p = .01), controlling for baseline eating (T1), age, education, gender, BMI, and illnesses. Self-efficacy (T1) and intention to eat healthily (T2) serially mediated this effect, indirect effect: b = 0.04, p = .02, 95% CI (0.02, 0.08). SPA had stronger effects in older and less educated participants.

DISCUSSION

This study provides important insights into the mechanisms behind positive SPA fueling successful health behavior change dynamics. Fostering more positive SPA through interventions might be especially important for vulnerable groups. Addressing SPA already in younger ages might help establish health-promoting life-span dynamics.

Identity, civic engagement, and altruism: a phenomenological exploration of activity engagement in older adults

BACKGROUND

Older adults' health and quality of life, proxies for aging well, are tied to activity engagement. Recent research indicates studying the perspective of older adults through their personal stories is key to understanding the phenomenon of occupational engagement as experienced day-to-day.

AIM

To uncover the lived experience of older adults within their natural settings to better understand the phenomenon of activity engagement. This new knowledge informs programming options suited to older adults' wants and needs.

MATERIALS/METHODS

Ten community-dwelling older adults (5 female, 5 male mean 79 years) were studied. Researchers performed phenomenological interpretive analysis (IPA) with multiple coders and member cheques to triangulate findings.

RESULTS

Daily activities revolved around three themes: 1) Perspectives of self-identity are viewed as consistent throughout the lifespan; 2) Civic engagement is beneficial for social support and self-efficacy; and 3) Philosophical outlook influences activity choices and outlooks centred on altruism are critical to continued activity engagement. Seven of the ten participants expressed an overall positive outlook on aging. Three participants described a negative outlook on aging, expressed more difficulty with activity engagement, but reported desire to help others.

CONCLUSIONS AND SIGNIFICANCE

These themes provide a basis for programming to increase activity engagement with older adults in the community.

The Relation of Volunteering and Subsequent Changes in Physical Disability in Older Adults

Objectives

To describe the association between initiating volunteering and changes in physical disability in older adults, and whether intensity and gender modify this relationship.

Methods

Employing propensity score weighted regression adjustment, we calculate changes in disability using a sample of U.S. adults (n = 7,135) in the Health and Retirement Study (1996-2012) not volunteering at baseline but later initiating volunteering (1-99 hr/year or 100+ hours per year) or remaining a nonvolunteer.

Results

Relative to continuous nonvolunteers, low-intensity volunteering is related to 34% lower disability in the low-intensity group (average treatment effect [ATE] = -0.12) and 63% lower in the higher-intensity group (ATE = -0.23). For men, progression was lower only in the highest intensity group (ATE = +0.02), but women experienced similarly less progression of disability (38%-39%) at either level of new engagement (ATE = -0.17 and -0.18).

Discussion

Initiating a new volunteer role in later life is related to decreased progression of disability, at low or high levels for women and only at higher levels for men. This study suggests that volunteer intervention programs may represent a major public health strategy to delay the progression of physical disability for older adults.

Diet as a Risk Factor for Cognitive Decline in African Americans and Caucasians with a Parental History of Alzheimer's Disease: A Cross-Sectional Pilot Study Dietary Patterns

BACKGROUND

African Americans (AA) are more likely to develop Alzheimer's disease (AD) than Caucasians (CC). Dietary modification may have the potential to reduce the risk of developing AD.

OBJECTIVE

The objective of this study is to investigate the relationship between Southern and Prudent diet patterns and cognitive performance in individuals at risk for developing AD.

DESIGN

Cross-sectional observational study.

PARTICIPANTS

Sixty-six cognitively normal AA and CC individuals aged 46-77 years with a parental history of AD were enrolled.

MEASUREMENTS

Participants completed a Food Frequency questionnaire, cognitive function testing, which consisted of 8 neuropsychological tests, and cardiovascular risk factor assessments, including evaluation of microvascular and macrovascular function and ambulatory blood pressure monitoring.

RESULTS

Results revealed a relationship between the Southern diet and worse cognitive performance among AAs. AAs who consumed pies, mashed potatoes, tea, and sugar drinks showed worse cognitive performance (p<0.05) compared with CCs. In addition, gravy (p=0.06) and cooking oil/fat (p=0.06) showed negative trends with cognitive performance in AAs. In both CC and AA adults, greater adherence to a Prudent dietary pattern was associated with better cognitive outcomes. Cardiovascular results show that participants are overall healthy. AAs and CCs did not differ on any vascular measure including BP, arterial stiffness and endothelial function.

CONCLUSION

Research shows that dietary factors can associate with cognitive outcomes. This preliminary cross-sectional study suggests that foods characteristic of the Southern and Prudent diets may have differential effects on cognitive function in middle-aged individuals at high risk for AD. Results suggest that diet could be a non-pharmaceutical tool to reduce cognitive decline in racially diverse populations. It is possible that the increased prevalence of AD in AA could be partially reduced via diet modification.

Motivational Interviewing and Fat Consumption in Older Adults: A Meta-Analysis

Diets high in fat increase the risks for obesity and chronic diseases, even for older adults, the largest growing population in the United States. In the current study, a meta-analysis was performed to examine the effects of motivational interviewing (MI) dietary interventions on fat consumption in older adults. Electronic databases, journals, and unpublished literature were searched. Six primary studies were retrieved, providing seven comparisons between intervention and control groups and a total of 1,351 participants. MI had a moderate effect on fat intake in older adults (effect size = 0.354, p < 0.01). Studies with indicators of higher design quality showed greater MI effects. Nurses and providers can incorporate MI into health education and counseling to improve older adults' dietary health behaviors. [Journal of Gerontological Nursing, 44(11), 33-43.].

Visualizing Physical Activity Patterns among Community-Dwelling Older Adults: A Pilot Study

Regular physical activity relates to physical and mental functioning in older people, and promoting physical activity has the potential to substantially reduce functional decline and improve well-being. Despite this, investigations of the physical activity quotient through participation in functional activities in everyday life have traditionally gained limited focus among older populations compared to leisure-time physical activity and exercise. Considering the accumulated evidence of the health benefits of low-intensity physical activity, exploring and measuring such activities in this population is highly relevant. The aim of this study was to visualize and describe older people’s physical activity patterns in daily life using a time-geographic approach in combination with the estimation of metabolic equivalents (METS). To exemplify the new method, a sample of nine retired men (65–82 years old, mean age 76.4 ± 5.8) with no homecare services from the municipality was recruited. In order to enable a visual analysis of the physical activity patterns in daily life, we developed the VISUAL-PA software, which is a visual analysis tool that includes METS to account for intensity and enables the analysis of distinct types and domains of physical activity. The VISUAL-PA software creates graphic outputs of physical activity patterns that enable the identification, visualization, and analysis of distinct types and intensities of physical activity in addition to sedentary behavior. The use of VISUAL-PA can contribute to a broader understanding of the complexity in physical activity patterns among older adults in terms of dimensions such as activity patterns and habits, domains, and intensity level. To strengthen the public health strategies that promote health and an active lifestyle, additional knowledge about physical activity patterns is necessary. Moreover, the visualization of physical activity can enable reflections on and awareness of activity habits and preferences, and thus facilitate behavior changes in older individuals.

Waiting Room Education in a Community Health System: Provider Perceptions and Suggestions

The increasing burden of chronic diseases in the United States presents a major challenge to the nation's primary care systems, so improving the efficacy and efficiency of patient education is an important goal. Understanding the current perspectives, practices, and needs of primary care providers should guide innovation towards this end. As a part of the authors' ongoing quality improvement work, a short internet survey was an effective method of enhancing this understanding in one health care system. With a response rate of 24.6 %, the survey revealed that primary care waiting rooms in the health system studied are not conceived of or used by providers as spaces to engage patients in health education. To change this, providers suggested using both printed and technological methods for delivering health information, primarily related to medications, diabetes, and healthy lifestyle practices. Common barriers to improvement cited by providers included diverse language and literacy backgrounds in the patient population, as well as difficulty sustaining change due to infrastructural and administrative barriers. These results suggest steps for development, implementation, and investigation of new educational interventions for patients in the local primary care context.

Development of a physical literacy model for older adults - a consensus process by the collaborative working group on physical literacy for older Canadians

BACKGROUND

Arguably the uptake and usability of the physical activity (PA) guidelines for older adults has not been effective with only 12% of this population meeting the minimum guidelines to maintain health. Health promoters must consider innovative ways to increase PA adoption and long-term sustainability. Physical literacy (PL) is emerging as a promising strategy to increase lifelong PA participation in younger age-groups, yet there is relatively little evidence of PL being used to support older adults in achieving the PA guidelines.

METHODS

An iterative and mixed-methods consensus development process was utilized over a series of six informed processes and meetings to develop a model of physical literacy for adults aged 65 years and older.

RESULTS

A multi-disciplinary collaborative working group (n = 9) from diverse practice settings across Canada, and representative and reflective of the full range of key elements of PL, was assembled. Three consensus meetings and two Delphi surveys, using an international cohort of 65 expert researchers, practitioners, non-government organizations and older adults, was conducted. 45% responded on the first round and consensus was achieved; however, we elected to run a second survey to support our results. With 79% response rate, there was consensus to support the new PL model for older adults.

CONCLUSION

Older adults are a unique group who have yet to be exposed to PL as a means to promote long-term PA participation. This new PL model uses an ecological approach to integrate PL into the lifestyles of most older adults. Understanding the interactions between components and elements that facilitate PL will ultimately provide a new and effective tool to target PA promotion and adherence for all older Canadians.

Association of Healthy Habits Beliefs and Mortality in Older Adults: A Longitudinal Analysis of the Mexican Health and Aging Study

OBJECTIVE

The aim of this article is to establish the association between beliefs about healthy habits and mortality in a group of Mexican older adults.

METHOD

This is an 11-year follow-up secondary analysis of the Mexican Health and Aging Study.

RESULTS

There was a significant difference ( p < .001) in survival rate between those participants who believed that healthy habits have the potential to improve health compared with those who did not. After adjustment for confounders, Cox regression models showed a hazard ratio (HR) of 0.17 (95% confidence interval [CI] [0.07, 0.38], p < .001) for the group that believed in healthy habits.

DISCUSSION

Although the mechanism is not completely clear, according to our results, believing that healthy habits can improve health was associated with lower rates of mortality. Further research should elucidate potential strategies for changing beliefs in older adults with the goal of improving their overall health.

Motivational Interviewing and Fruit/Vegetable Consumption in Older Adults

Evidence supports the relationship between fruit and vegetable consumption (FVC) and risk reduction for several illness conditions, even for older adults. Thus, we examined the effects of motivational interviewing (MI) on FVC in adults with a mean age ≥60. We chose MI because of its growing popularity as an effective behavior change strategy and because the person-centered MI principles are a good fit for older adults. We searched 10 electronic databases, several journals, and unpublished and fugitive literature. We retrieved seven primary studies, providing nine comparisons, with 1,978 participants. The overall MI effect size (ES) was .221 ( p = .002). When the percentage of women was greater, ES was lower; when interventionists had more training, ES was higher; and when sessions were longer, ES was stronger. Future researchers might test longer sessions with trained interventionists and examine gender differences. Practitioners should be well trained and offer sessions that are 30 to 40 min in length.