1
|
Gyasi RM, Yebo-Julius EB, Nketiah JOM, Bavemba J, Adevor BS, Ankapong JB, Arthur DD, Siaw LP, Abass K, Osei-Wusu Adjei P, Phillips DR. More Movement, Less Bodily Pain? Findings From a Large, Representative Multi-District Aging Study in Ghana. J Am Med Dir Assoc 2024; 25:105153. [PMID: 39009067 DOI: 10.1016/j.jamda.2024.105153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 07/17/2024]
Abstract
OBJECTIVE The association of physical activity (PA) with pain has been characterized. Although the literature largely comes from high-income countries, the mechanistic pathways underlying this association remain unknown, particularly in low- and middle-income countries (LMICs). We aim to examine the association between meeting the World Health Organization (WHO) PA guidelines and pain among aging adults and identify the factors that may mediate this association. DESIGN We used a quantitative cross-sectional study design. SETTING AND PARTICIPANTS Representative data from adults aged ≥50 years who participated in the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study were used. METHODS PA was defined using the International Physical Activity Questionnaire (IPAQ). Self-reported pain experience using a cross-culturally validated item over the past month assessed pain severity. Adjusted multivariable ordinal logistic regression and mediation models quantified the hypothesized associations. RESULTS The analysis included 1201 adults (mean 66.1 ± 11.9 years; 63.3% female). After adjusting for confounders, adhering to the WHO-recommended PA guidelines was associated with 42% lower odds for severe/extreme pain [odds ratio (OR) 0.58, 95% CI 0.44-0.77]. The association was much stronger among men (OR 0.52, 95% CI 0.31-0.85) than women (OR 0.60, 95% CI 0.42-0.87). The PA-pain association was explained by functional limitations (84.7%), self-rated health (76.6%), sleep problems (20.4%), and injury (6.6%). CONCLUSIONS AND IMPLICATIONS Moving more was associated with less pain in older adults from LMICs. Interventions for pain management in old age may focus on enhancing compliance with PA doses, particularly in LMICs. However, longitudinal data will need to confirm these findings.
Collapse
Affiliation(s)
- Razak M Gyasi
- Aging and Development Unit, African Population and Health Research Center, Nairobi, Kenya; National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, Australia.
| | - Emefa Baaba Yebo-Julius
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Jude Owusu Mensah Nketiah
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Jonathan Bavemba
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Boniface Smith Adevor
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joel Banor Ankapong
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Dominic Degraft Arthur
- Department of History and Political Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lawrencia Pokuah Siaw
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kabila Abass
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Prince Osei-Wusu Adjei
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - David R Phillips
- Department of Sociology and Social Policy, Lingnan University, Hong Kong, China
| |
Collapse
|
2
|
Jayawardena R, Weerasinghe K, Gamage M, Hills AP. Enhancing physical function and activity level in malnourished older adults through oral nutrition supplements: a randomized controlled trial. BMC Geriatr 2024; 24:566. [PMID: 38943086 PMCID: PMC11214258 DOI: 10.1186/s12877-024-05164-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 06/20/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND Malnutrition of older individuals, leads to significant functional decline, reducing their quality of life. Lifestyle interventions; dietary improvements and supplementation are explored to enhance the physical function of older adults. The current study aimed to assess the impact of oral nutritional supplements (ONS) on the functional and activity levels of Sri Lankan older adults. METHODS This randomized controlled trial included; an intervention group (IG) receiving 200 mL of ONS providing 247 kcal per serving, for 12 weeks and a control group (CG) receiving an equivalent volume of water. Changes in handgrip strength, knee extension strength, gait speed, functional and activity levels were assessed. RESULTS The IG showed significant improvements in handgrip strength (43.96 ± 18.61 kg vs. 32.81 ± 17.92 kg; p < 0.001) and knee extension strength (23.45 ± 2.29 kg vs. 16.41 ± 2.09 kg; p < 0.001) following 12 weeks compared to the CG. The IG also exhibited significant improvements in gait speed (1.31 ± 0.52 m/s vs. 0.87 ± 0.26 m/s), Barthel index score, (0.30 ± 0.47 vs. -0.18 ± 0.66), PASE score (0.52 ± 17.79 vs. -1.60 ± 21.77) and IPAQ categories. CONCLUSIONS ONS was found to be effective in improving the functional and physical activity levels of malnourished older adults. TRIAL REGISTRATION Sri Lanka Clinical Trial Registry SLCTR/2022/021. Registered on 06/10/2022.
Collapse
Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
- School of Exercise & Nutrition Sciences, Queensland University of Technology, Brisbane, Australia.
| | - Kalani Weerasinghe
- Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Manoja Gamage
- School of Exercise & Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Tasmania, Australia
| |
Collapse
|
3
|
Kraaijkamp JJM, Stijntjes M, De Groot JH, Chavannes NH, Achterberg WP, van Dam van Isselt EF. Movement Patterns in Older Adults Recovering From Hip Fracture. J Aging Phys Act 2024; 32:312-320. [PMID: 38215728 DOI: 10.1123/japa.2023-0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 09/05/2023] [Accepted: 10/30/2023] [Indexed: 01/14/2024]
Abstract
The aim of this study was to quantify physical activity and sedentary behavior in older adults recovering from hip fracture and to identify groups based on movement patterns. In this cross-sectional cohort study, older adults (≥70 years) were included 3 months after surgery for proximal femoral fracture. Patients received an accelerometer for 7 days. Demographics and outcomes related to physical function, mobility, cognitive functions, quality of life, and hip fracture were assessed. In total, 43 patients with sufficient accelerometer wear time were included. Across all groups, participants engaged in very low levels of physical activity, spending an average of 11 hr/day in prolonged sedentary behavior. Based on the extracted components from a principal component analysis, three groups with substantial differences in levels of physical activity and sedentary behavior could be distinguished.
Collapse
Affiliation(s)
- Jules J M Kraaijkamp
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
- ZZG Zorggroep, Nijmegen, the Netherlands
| | - Marjon Stijntjes
- Department of Rehabilitation Medicine, Leiden University Medical Center, Leiden, the Netherlands
- BioMechanical Engineering, Delft University of Technology, Delft, the Netherlands
| | - Jurriaan H De Groot
- Department of Rehabilitation Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | | |
Collapse
|
4
|
Yerrakalva D, Hajna S, Khaw KT, Griffin SJ, Brage S. Prospective associations between changes in physical activity and sedentary time and subsequent lean muscle mass in older English adults: the EPIC-Norfolk cohort study. Int J Behav Nutr Phys Act 2024; 21:10. [PMID: 38279174 PMCID: PMC10811887 DOI: 10.1186/s12966-023-01547-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 12/05/2023] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND The longitudinal associations between physical behaviours and lean muscle mass indices need to be better understood to aid healthy ageing intervention development. METHODS We assessed physical behaviours (total physical activity, moderate-to-vigorous physical activity (MVPA), light physical activity, total sedentary time and prolonged sedentary bout time) for 7 days using hip-worn accelerometers. We also assessed domain-specific physical behaviours (walking, cycling, gardening and housework time) with self-report questionnaires at baseline (2006-2011) and follow-up (2012-2016) in the European Prospective Investigation into Cancer (EPIC)-Norfolk study. We assessed body composition using dual-energy X-ray absorptiometry (DEXA) at follow-up in 1535 participants (≥ 60 years at baseline). From this, we derived appendicular lean muscle mass (ALM) indices (% relative ALM = (ALM/total body weight)*100), body mass index (BMI)-scaled ALM (ALM/BMI, kg/kg/m2) and height-scaled ALM (ALM/height2, kg/m2)). We evaluated the prospective associations of both baseline and change in physical behaviours with follow-up muscle mass indices using multivariable linear regression. RESULTS Over 5.5 years (SD 14.8) follow-up, higher baseline accelerometer-measured physical activity and lower sedentary time were associated with higher subsequent relative ALM and BMI-scaled ALM, but not height-scaled ALM (e.g. 0.02% higher subsequent relative ALM per minute/day of baseline MVPA for men). Greater increases in physical activity and greater declines in sedentary time variables were associated with higher subsequent relative ALM and BMI-scaled ALM, but not height-scaled ALM (e.g. 0.001 kg/kg/m2 subsequent BMI-scaled ALM and 0.04% subsequent relative ALM per min/day/year increases in LPA over follow-up; 0.001 kg/kg/m2 subsequent BMI-scaled ALM and -0.03% subsequent relative ALM per min/day/year less of total sedentary time over follow-up). Greater increases in women's cycling and gardening over follow-up were associated with greater subsequent relative ALM (cycling 0.9% per hour/week/year; gardening 0.2% per hour/week/year) and BMI-scaled ALM (cycling 0.03 kg/kg/m2 per hour/week/year; gardening 0.004 kg/kg/m2 per hour/week/year). CONCLUSION Physical behaviours across all intensities, and in women more specifically cycling and gardening, may help prevent age-related declines in muscle mass.
Collapse
Affiliation(s)
- Dharani Yerrakalva
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Samantha Hajna
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St Catharines, ON, Canada
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Simon J Griffin
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK.
| |
Collapse
|
5
|
Kwok WS, Khalatbari-Soltani S, Dolja-Gore X, Byles J, Tiedemann A, Pinheiro MB, Oliveira JS, Sherrington C. Leisure-Time Physical Activity and Falls With and Without Injuries Among Older Adult Women. JAMA Netw Open 2024; 7:e2354036. [PMID: 38294812 PMCID: PMC10831579 DOI: 10.1001/jamanetworkopen.2023.54036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 12/07/2023] [Indexed: 02/01/2024] Open
Abstract
Importance Falls and fall-related injuries are common among older adults. Older adults are recommended to undertake 150 to 300 minutes of physical activity per week for health benefits; however, the association between meeting the recommended level of physical activity and falls is unclear. Objectives To examine whether associations exist between leisure-time physical activity and noninjurious and injurious falls in older women. Design, Setting, and Participants This population-based cohort study used a retrospective analysis of the Australian Longitudinal Study on Women's Health (ALSWH). ALSWH participants born from 1946 to 1951 who completed follow-up questionnaires in 2016 (aged 65-70 years) and 2019 (aged 68-73 years) were included. Statistical analysis was performed from September 2022 to February 2023. Exposure Self-reported weekly amounts (0, 1 to <150, 150 to <300, ≥300 minutes) and types of leisure-time physical activity, including brisk walking and moderate- and vigorous-intensity physical activity, in the 2016 survey. Main outcome and measures Noninjurious and injurious falls in the previous 12 months reported in the 2019 survey. Associations between leisure-time physical activity and falls were quantified using directed acyclic graph-informed multinomial logistic regression and presented in odds ratios (ORs) and 95% CIs. Results This study included 7139 women (mean [SD] age, 67.7 [1.5] years). Participation in leisure-time physical activity at or above the level recommended by the World Health Organization (150 to <300 min/wk) was associated with reduced odds of noninjurious falls (150 to <300 min/wk: OR, 0.74 [95% CI, 0.59-0.92]; ≥300 min/wk: OR, 0.66 [95% CI, 0.54-0.80]) and injurious falls (150 to <300 min/wk: OR, 0.70 [95% CI, 0.56-0.88]; ≥300 min/wk: OR, 0.77 [95% CI, 0.63-0.93]). Compared with women who reported no leisure-time physical activity, those who reported brisk walking (OR, 0.83 [95% CI, 0.70-0.97]), moderate leisure-time physical activity (OR, 0.81 [95% CI, 0.70-0.93]), or moderate-vigorous leisure-time physical activity (OR, 0.84 [95% CI, 0.70-0.99]) had reduced odds of noninjurious falls. No statistically significant associations were found between the types of leisure-time physical activity and injurious falls. Conclusions and Relevance Participation in leisure-time physical activity at the recommended level or above was associated with lower odds of both noninjurious and injurious falls. Brisk walking and both moderate and moderate-vigorous leisure-time physical activity were associated with lower odds of noninjurious falls.
Collapse
Affiliation(s)
- Wing S. Kwok
- Sydney Musculoskeletal Health, The University of Sydney, Sydney Local Health District and Northern Sydney Local Health District, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Saman Khalatbari-Soltani
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
- ARC Centre of Excellence in Population Aging Research (CEPAR), The University of Sydney, Sydney, New South Wales, Australia
| | - Xenia Dolja-Gore
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Julie Byles
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Anne Tiedemann
- Sydney Musculoskeletal Health, The University of Sydney, Sydney Local Health District and Northern Sydney Local Health District, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Marina B. Pinheiro
- Sydney Musculoskeletal Health, The University of Sydney, Sydney Local Health District and Northern Sydney Local Health District, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Juliana S. Oliveira
- Sydney Musculoskeletal Health, The University of Sydney, Sydney Local Health District and Northern Sydney Local Health District, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Catherine Sherrington
- Sydney Musculoskeletal Health, The University of Sydney, Sydney Local Health District and Northern Sydney Local Health District, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| |
Collapse
|
6
|
Zhang W, Liu X, Liu H, Zhang X, Song T, Gao B, Ding D, Li H, Yan Z. Effects of aerobic and combined aerobic-resistance exercise on motor function in sedentary older adults: A randomized clinical trial. J Back Musculoskelet Rehabil 2024; 37:25-36. [PMID: 37661865 DOI: 10.3233/bmr-220414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
BACKGROUND Sedentary behavior is widespread among older adults and accelerates the decline of motor function. Nevertheless, there is insufficient evidence concerning the effectiveness of regular exercise in enhancing the same in sedentary older adults. OBJECTIVE To compare the effects of 24 weeks of aerobic and combined aerobic-resistance exercise on the motor function of sedentary older adults. METHODS Sixty healthy sedentary older (65-80 years) were randomly enrolled. Participants were randomly divided into 3 groups (1:1:1): aerobic exercise group (AEG), combined aerobic-resistance exercise group (CEG), and health education group (HEG). The training group underwent a five-day-a-week regimen, with each session lasting for 40 minutes (including 10 min warm-up and cool-down). HEG received only monthly health lectures. We assessed lower limb muscle strength (30-second sit-to-stand ability), single-dual task gait, static and dynamic balance functions at baseline and after 24 weeks of intervention using per-protocol analysis. RESULTS Among 60 elderly healthy who were randomized (mean age 70.59 ± 3.31 years; 28 women (46%)), 42 (70%) completed the evaluation after 24 weeks. Both the aerobic exercise and combined aerobic-resistance exercise groups exhibited improved 30-second sit-to-stand ability, static balance in closed-eye standing mode, and dynamic balance (P< 0.05). However, there were no statistically significant changes in the single-task gait parameters of stride length, stride width, and stride speed (P> 0.05). Additionally, compared to the aerobic exercise group, the combined exercise group showed an increase in dual-task gait speed and medial and lateral dynamic stability indices (P< 0.05). CONCLUSION Both the aerobic exercise and combined aerobic-resistance exercise programs are effective in enhancing lower limb muscle strength, dynamic balance, and static balance while standing with eyes closed in sedentary older adults. Furthermore, the combined aerobic-resistance exercise program is more effective in improving dual-task gait speed as well as medial and lateral dynamic balance.
Collapse
Affiliation(s)
- Wang Zhang
- Provincial University Key Laboratory of Sport and Health Science, School of Physical Education and Sport Sciences, Fujian Normal University, Fuzhou, Fujian, China
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Provincial University Key Laboratory of Sport and Health Science, School of Physical Education and Sport Sciences, Fujian Normal University, Fuzhou, Fujian, China
| | - Xiao Liu
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, Guangdong, China
- Provincial University Key Laboratory of Sport and Health Science, School of Physical Education and Sport Sciences, Fujian Normal University, Fuzhou, Fujian, China
| | - Haibin Liu
- School of Kinesiology and Health Promotion, Dalian University of Technology, Liaoning, China
| | - Xiaowei Zhang
- Department of Rehabilitation and Health Care, Jinan Vocational College Of Nursing, Jinan, Shandong, China
| | - Tiangang Song
- Queen Mary College, Nanchang University, Nanchang, Jiangxi, China
| | - Bohua Gao
- School of Basic Medicine, Fujian Medical University, Fuzhou, Fujian, China
| | - Duoduo Ding
- School of Basic Medicine, Fujian Medical University, Fuzhou, Fujian, China
| | - Hengyi Li
- School of Basic Medicine, Fujian Medical University, Fuzhou, Fujian, China
| | - Zhiwei Yan
- Provincial University Key Laboratory of Sport and Health Science, School of Physical Education and Sport Sciences, Fujian Normal University, Fuzhou, Fujian, China
- Department of Sports Rehabilitation, College of Kinesiology, Shenyang Sport University, Shenyang, Liaoning, China
| |
Collapse
|
7
|
Smith MC, O'Loughlin J, Karageorgiou V, Casanova F, Williams GKR, Hilton M, Tyrrell J. The genetics of falling susceptibility and identification of causal risk factors. Sci Rep 2023; 13:19493. [PMID: 37945700 PMCID: PMC10636011 DOI: 10.1038/s41598-023-44566-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/10/2023] [Indexed: 11/12/2023] Open
Abstract
Falls represent a huge health and economic burden. Whilst many factors are associated with fall risk (e.g. obesity and physical inactivity) there is limited evidence for the causal role of these risk factors. Here, we used hospital and general practitioner records in UK Biobank, deriving a balance specific fall phenotype in 20,789 cases and 180,658 controls, performed a Genome Wide Association Study (GWAS) and used Mendelian Randomisation (MR) to test causal pathways. GWAS indicated a small but significant SNP-based heritability (4.4%), identifying one variant (rs429358) in APOE at genome-wide significance (P < 5e-8). MR provided evidence for a causal role of higher BMI on higher fall risk even in the absence of adverse metabolic consequences. Depression and neuroticism predicted higher risk of falling, whilst higher hand grip strength and physical activity were protective. Our findings suggest promoting lower BMI, higher physical activity as well as psychological health is likely to reduce falls.
Collapse
Affiliation(s)
- Matt C Smith
- Genetics of Complex Traits, College of Biomedical and Clinical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Jessica O'Loughlin
- Genetics of Complex Traits, College of Biomedical and Clinical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Vasileios Karageorgiou
- Genetics of Complex Traits, College of Biomedical and Clinical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Francesco Casanova
- Genetics of Complex Traits, College of Biomedical and Clinical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Genevieve K R Williams
- Public Health and Sports Sciences Department, University of Exeter Medical School, Exeter, UK
| | - Malcolm Hilton
- Clinical and Biomedical Science, University of Exeter Medical School, Exeter, UK
| | - Jessica Tyrrell
- Genetics of Complex Traits, College of Biomedical and Clinical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
| |
Collapse
|
8
|
Chan LLY, Arbona CH, Brodie MA, Lord SR. Prediction of injurious falls in older adults using digital gait biomarkers extracted from large-scale wrist sensor data. Age Ageing 2023; 52:afad179. [PMID: 37738170 DOI: 10.1093/ageing/afad179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVES To determine whether digital gait biomarkers captured by a wrist-worn device can predict injurious falls in older people and to develop a multivariable injurious fall prediction model. DESIGN Population-based longitudinal cohort study. SETTING AND PARTICIPANTS Community-dwelling participants of the UK Biobank study aged 65 and older (n = 32,619) in the United Kingdom. METHODS Participants were assessed at baseline on daily-life walking speed, quality, quantity and distribution using wrist-worn accelerometers for up to 7 days. Univariable and multivariable Cox proportional hazard regression models were used to analyse the associations between these parameters and injurious falls for up to 9 years. RESULTS Five percent of the participants (n = 1,627) experienced at least one fall requiring medical attention over a mean of 7.0 ± 1.1 years. Daily-life walking speed, gait quality, quantity of walking and distribution of daily walking were all significantly associated with the incidence of injurious falls (P < 0.05). After adjusting for sociodemographics, lifestyle factors, comorbidities, handgrip strength and reaction time; running duration, total step counts and usual walking speed were identified as independent and significant predictors of falls (P < 0.01). These associations were consistent in those without a history of previous fall injuries. In contrast, step regularity was the only risk factor for those with a previous fall history after adjusting for covariates. CONCLUSIONS Daily-life gait speed, quantity and quality, derived from wrist-worn sensors, are significant predictors of injurious falls in older people. These digital gait biomarkers could potentially be used to identify fall risk in screening programs and integrated into fall prevention strategies.
Collapse
Affiliation(s)
- Lloyd L Y Chan
- Neuroscience Research Australia, Sydney, Australia
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Carmen Herrera Arbona
- Neuroscience Research Australia, Sydney, Australia
- Getafe University Hospital, Madrid, Spain
| | - Matthew A Brodie
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia
| | - Stephen R Lord
- Neuroscience Research Australia, Sydney, Australia
- School of Population Health, University of New South Wales, Sydney, Australia
| |
Collapse
|
9
|
Gallibois M, Handrigan G, Caissie L, Cooling K, Hébert J, Jarrett P, McGibbon C, Read E, Sénéchal M, Bouchard DR. The Effect of a Standing Intervention on Falls in Long Term Care: a Secondary Analysis of a Randomized Controlled Trial. Can Geriatr J 2023; 26:247-252. [PMID: 37265979 PMCID: PMC10198682 DOI: 10.5770/cgj.26.656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
Background Older adults in long term care (LTC) spend over 90% of their day engaging in sedentary behaviour. Sedentary behaviour may exacerbate functional decline and frailty, increasing the risk for falls. The purpose of this study is to explore the impact of a 22-week standing intervention on falls among LTC residents at 12-month follow-up. Methods This was a planned secondary analysis of the Stand if You Can randomized controlled trial. The original trial randomized 95 participants (n = 47 control; n = 48 intervention) to either a sitting control or a supervised standing intervention group (100 minutes/week) for 22 weeks. Falls data were available to be collected over 12 months post-intervention for 89 participants. The primary outcome was a hazard of fall (Yes/No) during the 12-month follow-up period. Results A total of 89 participants (average age 86 years ± 8.05; 71.9% female) were followed for 12-months post-intervention. Participants in the intervention group (n=44) had a significantly greater hazard ratio of falls (2.01; 95% CI = 1.11 to 3.63) than the control group (n=45) when accounting for the history of falls, frailty status, cognition level, and sex. Conclusion Participants who received a standing intervention over 22 weeks were twice as likely to fall 12 months after the intervention compared with the control group. However, the prevalence of falls did not surpass what would be typically observed in LTC facilities. It is imperative that future studies describe in detail the context in which falls happen and collect more characteristics of participants in the follow-up period to truly understand the association between standing more and the risk of falls.
Collapse
Affiliation(s)
- Molly Gallibois
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
- Cardiometabolic Exercise & Lifestyles Laboratory (CELLAB), University of New Brunswick, Fredericton, NB
| | - Grant Handrigan
- Faculté des Sciences de la Santé et des Services Communautaires, Université de Moncton, Moncton, NB
| | - Linda Caissie
- Faculty of Social Science, Saint-Thomas University, Fredericton, NB
| | - Kendra Cooling
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
- Faculté des Sciences de la Santé et des Services Communautaires, Université de Moncton, Moncton, NB
| | - Jeffrey Hébert
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
- School of Psychology and Exercise Science, Murdoch University, Murdoch, Australia
| | - Pamala Jarrett
- Horizon Health Network, Department of Geriatric Medicine, Saint John, NB
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Chris McGibbon
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
- Institute of Biomedical Engineering, University of New Brunswick, Fredericton, NB
| | - Emily Read
- Faculty of Nursing, University of New Brunswick, Moncton, NB
| | - Martin Sénéchal
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
- Cardiometabolic Exercise & Lifestyles Laboratory (CELLAB), University of New Brunswick, Fredericton, NB
| | - Danielle R Bouchard
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
- Cardiometabolic Exercise & Lifestyles Laboratory (CELLAB), University of New Brunswick, Fredericton, NB
| |
Collapse
|
10
|
Baek SU, Lee WT, Kim MS, Lim MH, Yoon JH, Won JU. Association between long working hours and physical inactivity in middle-aged and older adults: a Korean longitudinal study (2006-2020). J Epidemiol Community Health 2023; 77:355-361. [PMID: 37028925 DOI: 10.1136/jech-2022-220129] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/23/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND We investigated associations for long working hours in relation to physical inactivity and high-level physical activity among middle-aged and older adults. METHODS Our study included 5402 participants and 21 595 observations from the Korean Longitudinal Study of Ageing (2006-2020). Logistic mixed models were used to estimate ORs and 95% CIs. Physical inactivity was defined as not engaging in any type of physical activity, while high-level physical activity was defined as engaging in ≥150 min per week of physical activity. RESULTS Working >40 hours weekly was positively related to physical inactivity (OR (95% CI) 1.48 (1.35 to 1.61)) and negatively related to high-level physical activity (0.72 (95% CI 0.65 to 0.79)). Exposure to long working hours consecutively for ≥3 waves was associated with the highest OR for physical inactivity (1.62 (95% CI 1.42 to 1.85)) and the lowest OR for high-level physical activity (0.71 (95% CI 0.62 to 0.82)). Furthermore, compared with persistent short working hours (≤40 hours → ≤40 hours), long working hours in a previous wave (>40 hours → ≤40 hours) were associated with a higher OR of physical inactivity (1.28 (95% CI 1.11 to 1.49)). Exposure to an increase in working hours (≤40 hours → >40 hours) was also associated with a higher OR of physical inactivity (1.53 (95% CI 1.29 to 1.82)). CONCLUSION We found that having working long hours was associated with a higher risk of physical inactivity and a lower likelihood of high-level physical activity. Moreover, accumulation of long working hours was associated with a higher risk of physical inactivity.
Collapse
Affiliation(s)
- Seong-Uk Baek
- Department of Occupational and Environmental Medicine, Severance Hospital, Seodaemun-gu, Seoul, Korea (the Republic of)
- The Institute for Occupational Health, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
- Graduate School, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
| | - Won-Tae Lee
- Department of Occupational and Environmental Medicine, Severance Hospital, Seodaemun-gu, Seoul, Korea (the Republic of)
- The Institute for Occupational Health, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
- Graduate School of Public Health, Yonsei University College of Medicine, Seodaemun-gu, Korea (the Republic of)
| | - Min-Seok Kim
- Department of Occupational and Environmental Medicine, Severance Hospital, Seodaemun-gu, Seoul, Korea (the Republic of)
- The Institute for Occupational Health, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
- Graduate School of Public Health, Yonsei University College of Medicine, Seodaemun-gu, Korea (the Republic of)
| | - Myeong-Hun Lim
- Department of Occupational and Environmental Medicine, Severance Hospital, Seodaemun-gu, Seoul, Korea (the Republic of)
- The Institute for Occupational Health, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
- Graduate School of Public Health, Yonsei University College of Medicine, Seodaemun-gu, Korea (the Republic of)
| | - Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
- Graduate School of Public Health, Yonsei University College of Medicine, Seodaemun-gu, Korea (the Republic of)
- Department of Preventive Medicine, Yonsei University College of Medicine, Seodaemun-gu, Korea (the Republic of)
| | - Jong-Uk Won
- Department of Occupational and Environmental Medicine, Severance Hospital, Seodaemun-gu, Seoul, Korea (the Republic of)
- The Institute for Occupational Health, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
- Graduate School of Public Health, Yonsei University College of Medicine, Seodaemun-gu, Korea (the Republic of)
| |
Collapse
|
11
|
Monteiro ELDF, Ikegami ÉM, Oliveira NGN, dos Reis EC, Virtuoso JS. Use of structural models to elucidate the occurrence of falls among older adults according to abdominal obesity: a cross-sectional study. SAO PAULO MED J 2023; 141:51-59. [PMID: 36102450 PMCID: PMC9808991 DOI: 10.1590/1516-3180.2021.0738.r1.07042022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 04/07/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Obesity is a risk factor for falls in older adults, but the effects of body fat distribution and its interaction with other factors are not well established. OBJECTIVES To verify the occurrence of falls among older adults with and without abdominal obesity and the effects of sociodemographic, health, and behavioral variables on this outcome. DESIGN AND SETTING A cross-sectional study in an urban area of Alcobaça, Brazil. METHODS Men and women older than 60 years with (270) and without (184) abdominal obesity were included. Sociodemographic, health, and behavioral data were collected using validated questionnaires in Brazil. Descriptive and path analyses were performed (P < 0.05). RESULTS The occurrence of falls was high in participants with abdominal obesity (33.0%). In both groups, a higher number of morbidities (β = 0.25, P < 0.001; β = 0.26, P = 0.002) was directly associated with a higher occurrence of falls. Among participants without abdominal obesity, a lower number of medications (β = -0.16; P = 0.04), a higher number of depressive symptoms (β = 0.15; P = 0.04), worse performance on the agility and dynamic balance tests (β = 0.37; P < 0.001), and lower functional disability for basic activities of daily living (β = -0.21; P = 0.006) were directly associated with the occurrence of falls. CONCLUSION Adults older than 60 years with abdominal obesity have a higher prevalence of falls. Different factors were associated with the occurrence of falls in both groups.
Collapse
Affiliation(s)
- Elma Lúcia de Freitas Monteiro
- MSc. Nutritionist and PhD Student, Postgraduate Program in Health Care, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba (MG), Brazil
| | - Érica Midori Ikegami
- MSc. Physiotherapist and PhD Student, Program in Health Care, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba (MG), Brazil
| | - Nayara Gomes Nunes Oliveira
- MSc, PhD. Nurse specialist in the health of older adults, Clinical Hospital, Universidade Federal de Uberlândia (UFU), Uberlândia (MG), Brazil
| | - Erika Cardoso dos Reis
- MSc, PhD. Nutritionist, Associate Professor, Department of Clinical and Social Nutrition, Universidade Federal de Ouro Preto (UFOP), Ouro Preto (MG), Brazil
| | - Jair Sindra Virtuoso
- MSc, PhD. Physical Education Professional and Associate Professor II, Department of Sports Science, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba (MG), Brazil
| |
Collapse
|
12
|
Jiang Y, Wang M, Liu S, Ya X, Duan G, Wang Z. The association between sedentary behavior and falls in older adults: A systematic review and meta-analysis. Front Public Health 2022; 10:1019551. [PMID: 36438277 PMCID: PMC9691853 DOI: 10.3389/fpubh.2022.1019551] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background It is generally believed that sedentary behavior (SB) increases the risk of falls among older adults, but the evidence for it remains inconsistent and scarce. Purpose Our study aims to provide a systematic review and meta-analysis of available evidence regarding the association of SB with falls in older adults. Method A comprehensive search strategy was conducted using several online databases from 1906 to March 2022. Cohort studies both concerning the association between SB and falls and involving participants over 60 years old were regarded as eligible for inclusion. Evidence was pooled by a random-effects meta-analysis. Quality assessment for individual studies was performed with the Newcastle-Ottawa Scale (NOS). Results Altogether seven publications were identified, and the age of the 24,750 individuals involved ranging from 60 to 99 years old. Overall quality of the included studies was rated as moderate-to-high quality. We found that SB was significantly associated with increased risk of falls compared with non-SB among older adults [Odds ratio (OR) = 1.17, 95% confidence interval (CI): 1.07-1.28; I 2 = 46.90%, P heterogeneity = 0.07, random model]. Subgroup analyses that stratified the studies according to NOS score showed significant differences between groups. Subgroup analysis stratified by SB measurement, sample size, region, publication year, and follow-up duration showed no significant differences between groups. Conclusion The findings provide reliable support for the hypothesis that sedentary lifestyles are strong predictors of falls among older adults, offering critical indications to develop strategies for fall prevention.
Collapse
Affiliation(s)
- YueShuai Jiang
- School of Sports Management and Communication, Capital Institute of Physical Education and Sports, Beijing, China
| | - Mei Wang
- School of Dance and Martial Arts, Capital Institute of Physical Education and Sports, Beijing, China
| | - Shuang Liu
- Department of Physical Education, Beijing International Studies University, Beijing, China
| | - Xiao Ya
- Department of Physical Education, Beijing No. 2 Middle School, Beijing Economic-Technological Development Area School, Beijing, China
| | - GuanTing Duan
- College of P.E. and Sports, Beijing Normal University, Beijing, China
| | - ZiPu Wang
- School of Sports Management and Communication, Capital Institute of Physical Education and Sports, Beijing, China,*Correspondence: ZiPu Wang
| |
Collapse
|
13
|
Yerrakalva D, Hajna S, Wijndaele K, Dempsey PC, Westgate K, Wareham N, Griffin SJ, Brage S. Bidirectional associations of accelerometer-assessed physical activity and sedentary time with physical function among older English adults: the EPIC-Norfolk cohort study. Eur J Ageing 2022; 19:1507-1517. [PMID: 36692782 PMCID: PMC9729509 DOI: 10.1007/s10433-022-00733-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2022] [Indexed: 01/26/2023] Open
Abstract
To develop healthy ageing interventions, longitudinal associations between objectively assessed physical behaviours and physical function need to be better understood. We assessed associations between accelerometer-assessed total physical activity (PA), moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary time and prolonged sedentary bout time, and clinically assessed physical function (grip strength, usual walking speed (UWS), chair stand speed) at two time-points in 3188 participants (≥ 60 years) of the EPIC-Norfolk study. Bidirectional associations were assessed using multivariable linear regression. Over an average of 6.1 years, baseline physical behaviours (greater total PA, MVPA and LPA, and less sedentary time) were associated with better subsequent walking and chair stand speed. Better baseline physical function was associated with better follow-up physical behaviours. There were no bidirectional associations between changes in physical behaviours and grip strength. Improvements in UWS were associated with improvements in all physical behaviours. Improvements in chair stand speed were associated with improvements in total PA, MVPA, and sedentary bout time. Improvements in physical behaviours were associated with improvements in UWS (3.1 cm/s/yr per 100 cpm/yr total PA, 3.6 cm/s/yr per hr/day/yr MVPA, 2.5 cm/s/yr per hr/day/yr LPA, - 2.9 cm/s/yr per hour/day/yr sedentary time, and - 1.6 cm/s/yr per hr/day/yr prolonged sedentary bout time). Only improvements in total PA, MVPA and sedentary bout time were associated with improvements in chair stand speed. In conclusion, we found bidirectional associations between changes in some physical behaviours and physical function and between baseline physical behaviours and subsequent physical function, highlighting the importance of considering the full range of physical behaviours to promote healthy ageing.
Collapse
Affiliation(s)
- Dharani Yerrakalva
- Department of Public Health and Primary Care, University of Cambridge, School of Clinical Medicine, Cambridge Institute of Public Health, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK.
| | - Samantha Hajna
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Katrien Wijndaele
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Paddy C. Dempsey
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK ,grid.1051.50000 0000 9760 5620Physical Activity and Behavioural Epidemiology Laboratories, Baker Heart and Diabetes Institute, Melbourne, Australia ,grid.9918.90000 0004 1936 8411Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
| | - Kate Westgate
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Nick Wareham
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Simon J. Griffin
- grid.5335.00000000121885934Department of Public Health and Primary Care, University of Cambridge, School of Clinical Medicine, Cambridge Institute of Public Health, Forvie Site, Robinson Way, Cambridge, CB2 0SR UK ,grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Soren Brage
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| |
Collapse
|
14
|
Nuwere E, Barone Gibbs B, Toto PE, Taverno Ross SE. Planning for a Healthy Aging Program to Reduce Sedentary Behavior: Perceptions among Diverse Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106068. [PMID: 35627604 PMCID: PMC9140959 DOI: 10.3390/ijerph19106068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 05/14/2022] [Accepted: 05/15/2022] [Indexed: 12/10/2022]
Abstract
Reducing prolonged engagement in sedentary behavior is increasingly considered a viable pathway to older-adult health and continued functional ability. Community-based programs that aim to increase physical activity can improve programs' acceptability by integrating older adults' perspectives on sedentary behavior and healthy aging into their design. The purpose of this study was to better understand the perceptions of a diverse group of community-dwelling older adults regarding sedentary behavior and its influence on healthy aging. Six focus group discussions with forty-six participants took place across two senior centers in New York City. Self-report questionnaires about daily activity patterns, general health status, and typical sedentary behaviors were also completed by the participants and analyzed using descriptive statistics. The focus group discussions were audio-recorded, transcribed, and analyzed using inductive and deductive approaches and an ecological framework to identify salient themes. A qualitative analysis revealed that the participants were aware of the physical costs of engaging in prolonged sedentary behavior. However, many routine sedentary activities were perceived to be health-promoting and of psychological, cognitive, or social value. The insights gained can inform the development of senior-center programs and health-promotion messaging strategies that aim to reduce older adults' sedentary behavior.
Collapse
Affiliation(s)
- Efekona Nuwere
- Department of Occupational Therapy, Long Island University, 1 University Plaza, Brooklyn, NY 11201, USA
- Correspondence:
| | - Bethany Barone Gibbs
- Department of Health and Human Development, University of Pittsburgh, 4200 Fifth Avenue, Pittsburgh, PA 15260, USA; (B.B.G.); (S.E.T.R.)
| | - Pamela E. Toto
- Department of Occupational Therapy, University of Pittsburgh, 4200 Fifth Avenue, Pittsburgh, PA 15260, USA;
| | - Sharon E. Taverno Ross
- Department of Health and Human Development, University of Pittsburgh, 4200 Fifth Avenue, Pittsburgh, PA 15260, USA; (B.B.G.); (S.E.T.R.)
| |
Collapse
|
15
|
Mattle M, Meyer U, Lang W, Mantegazza N, Gagesch M, Mansky R, Kressig RW, Egli A, Orav EJ, Bischoff-Ferrari HA. Prevalence of Physical Activity and Sedentary Behavior Patterns in Generally Healthy European Adults Aged 70 Years and Older—Baseline Results From the DO-HEALTH Clinical Trial. Front Public Health 2022; 10:810725. [PMID: 35493350 PMCID: PMC9046658 DOI: 10.3389/fpubh.2022.810725] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 03/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background Physical activity (PA) is important for healthy aging and disease prevention whereas sedentary behavior (SB) accelerates health deterioration. Aim To investigate activity profiles regarding PA and SB among generally healthy European older adults. Methods Meeting PA recommendations was defined as ≥150 min/week of moderate and/or ≥75 min/week of vigorous PA. A cut-off of ≥5.5 h/day was used to define time spent with SB. We present prevalence of PA and SB overall and by sex, age, BMI, and country. We examined correlates with multivariate logistic regression models. Results Two thousand one hundred and fifty-five DO-HEALTH participants completed baseline information on activity profiles [mean age 74.9 years (SD 4.5), 61.8% women]. Overall, 62.2% met PA recommendations and overall, 37.1% spent ≥5.5 h/day with SB. Younger participants (70–74 years), men, and those with BMI <25 kg/m2 met PA recommendations more often. Per country, prevalence of meeting PA recommendations were: Austria 74.4%, France 51.0%, Germany 65.6%, Portugal 46.5%, and Switzerland 66.7%. Regarding SB, prevalence did not differ in all subgroups. In multivariate logistic regression analyses, being male, younger age, lower MoCA scores, and higher SPPB score were associated with greater odds, whereas higher BMI, more years of education, higher GDS score, and residing in Portugal were associated with lower odds of meeting PA recommendations. High BMI and higher MoCA scores were associated with greater odds of high SB. Conclusion Individualized public health efforts may be warranted even in active older adults, as profiles were less favorable in subgroups of older age, female sex and higher BMI.
Collapse
Affiliation(s)
- Michèle Mattle
- Center on Aging and Mobility, University Hospital Zurich, City Hospital Zurich - Waid, and University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- *Correspondence: Michèle Mattle
| | - Ursina Meyer
- Center on Aging and Mobility, University Hospital Zurich, City Hospital Zurich - Waid, and University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Wei Lang
- Center on Aging and Mobility, University Hospital Zurich, City Hospital Zurich - Waid, and University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Noemi Mantegazza
- Center on Aging and Mobility, University Hospital Zurich, City Hospital Zurich - Waid, and University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Michael Gagesch
- Center on Aging and Mobility, University Hospital Zurich, City Hospital Zurich - Waid, and University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Richard Mansky
- Center on Aging and Mobility, University Hospital Zurich, City Hospital Zurich - Waid, and University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Reto W. Kressig
- University Department of Geriatric Medicine FELIX PLATTER, Basel University, Basel, Switzerland
| | - Andreas Egli
- Center on Aging and Mobility, University Hospital Zurich, City Hospital Zurich - Waid, and University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - E. John Orav
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Heike A. Bischoff-Ferrari
- Center on Aging and Mobility, University Hospital Zurich, City Hospital Zurich - Waid, and University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- University Clinic for Aging Medicine, City Hospital Zurich - Waid, Zurich, Switzerland
| |
Collapse
|
16
|
Aoyagi GA, Pinto RZ, Lemes ÍR, Pastre CM, Eto BY, Faria MS, Morelhão PK, Franco MR. Fear of falling does not predict self-reported physical activity: an observational study with community-dwelling older adults. Physiotherapy 2022; 116:50-57. [DOI: 10.1016/j.physio.2022.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 02/15/2022] [Accepted: 02/24/2022] [Indexed: 11/30/2022]
|
17
|
Yuan Y, Li J, Fu P, Jing Z, Wang Y, Zhou C. Association between physical activity and falls among older adults in rural China: are there gender and age related differences? BMC Public Health 2022; 22:356. [PMID: 35183149 PMCID: PMC8858519 DOI: 10.1186/s12889-022-12773-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/15/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The relationship between physical activity (PA) and falls among older adults is inconsistent, and little is known about the gender-specific association between falls and PA. Moreover, age may modify this relationship. This study aimed to test the association between PA and falls and to investigate the gender and age differences in the association among rural older adults. METHODS This cross-sectional data were derived from the baseline survey of Shandong Rural Elderly Health Cohort (SREHC). In total, 3,242 rural older adults aged 60 years and above were included in the analysis. PA was measured by the International Physical Activity Questionnaire Short Form (IPAQ-S). PA levels were classified as low, moderate, elevated and high according to quartiles. Volume of moderate-to-vigorous physical activity (MVPA) was categorized into low, moderate, elevated, and high level based on global recommendations. Information on falls was determined from in-person interviews. Falling was defined to participants as ending up on the floor or ground because they were unable to stop themselves. Logistic regression analysis was employed to explore the association between falls and PA. RESULTS Of 3,242 rural older adults, the incidence of falls was 13.1%. In older adults, high levels of PA [odds ratio (OR) = 0.65, 95% confidence interval (CI): 0.47-0.90] or MVPA (OR = 0.68, 95% CI: 0.50-0.94) were related to falls. Moderate (OR = 4.84, 95% CI: 1.68-13.94) or high (OR = 0.54, 95% CI: 0.30-0.99) levels of MVPA were associated with falls in older men. But elevated levels of PA were associated with falls (OR = 0.60, 95% CI: 0.42-0.87) in older women. Among older people younger than 75 years, elevated (OR = 0.54, 95% CI: 0.37-0.79) or high (OR = 0.68, 95% CI: 0.48-0.98) levels of PA were associated with falls. CONCLUSIONS Among Chinese rural older adults, PA and MVPA are associated with falls, and there are gender and age differences. To prevent falls, measures need to account for individuals' gender and age to encourage rural older adults to participate more actively in PA. We will conduct longitudinal studies to clarify the causal relationship between PA and fall.
Collapse
Affiliation(s)
- Yemin Yuan
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Jie Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Peipei Fu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Zhengyue Jing
- School of Health Policy and Management, Nanjing Medical University, Nanjing, 211166, China
| | - Yi Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
| |
Collapse
|
18
|
How Much Time in Sedentary Behavior Should Be Reduced to Decrease Fear of Falling and Falls in Community-Dwelling Older Adults? J Aging Phys Act 2021; 30:806-812. [PMID: 34911037 DOI: 10.1123/japa.2021-0175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 09/30/2021] [Accepted: 11/17/2021] [Indexed: 11/18/2022]
Abstract
Fear of falling and history of falls are frequent situations in older adults, which can be aggravated by sedentary behavior (SB). The objective was to establish SB cutoff values which discriminate falls and fear of falling in older adults and verify the association between these conditions. This was a cross-sectional study including 308 community-dwelling older adults. The SB was assessed by International Physical Activity Questionnaire. The outcomes were history of falling in the last 12 months and fear of falling (higher or equal than 23 points in Falls Efficacy Scale International-Brazil). The cutoff points found were >4.14 (area under curve = 0.60, 95% confidence intervals [CIs] [0.54, 0.65]) and >3.90 hr per day (area under curve = 0.59, 95% CI [0.53, 0.64]) for fear of falling and history of falls, respectively. Older adults with SB had 1.71 (95% CI [1.03, 2.84]) and 1.75 (95% CI [1.06, 2.89]) greater odds of having greater fear of falling and suffering falls, respectively.
Collapse
|
19
|
Rogers C. Audiologists should not fail with falls: A call to commit to prevention of falls in older adults. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2021; 68:e1-e5. [PMID: 34636596 PMCID: PMC8517736 DOI: 10.4102/sajcd.v68i1.841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/12/2021] [Accepted: 07/18/2021] [Indexed: 11/18/2022] Open
Abstract
Globally, falls are a serious economic and public health concern. While all age groups are impacted by falls, the threats to morbidity and mortality are most severe in older adults. Recent literature has linked hearing loss, and related issues such as an increase in sedentary behaviour, to a greater risk of falls. Therefore, this opinion article aims to raise audiologists’ awareness of falls in ageing patients or clients, and calls for change in terms of having these rehabilitation professionals embrace identification and management of fall risk.
Collapse
Affiliation(s)
- Christine Rogers
- Department of Health and Rehabilitation Sciences, Division of Communication Sciences and Disorders, Faculty of Health Sciences, University of Cape Town, Cape Town.
| |
Collapse
|
20
|
Feature Selection and Validation of a Machine Learning-Based Lower Limb Risk Assessment Tool: A Feasibility Study. SENSORS 2021; 21:s21196459. [PMID: 34640779 PMCID: PMC8512098 DOI: 10.3390/s21196459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 11/17/2022]
Abstract
Early and self-identification of locomotive degradation facilitates us with awareness and motivation to prevent further deterioration. We propose the usage of nine squat and four one-leg standing exercise features as input parameters to Machine Learning (ML) classifiers in order to perform lower limb skill assessment. The significance of this approach is that it does not demand manpower and infrastructure, unlike traditional methods. We base the output layer of the classifiers on the Short Test Battery Locomotive Syndrome (STBLS) test used to detect Locomotive Syndrome (LS) approved by the Japanese Orthopedic Association (JOA). We obtained three assessment scores by using this test, namely sit-stand, 2-stride, and Geriatric Locomotive Function Scale (GLFS-25). We tested two ML methods, namely an Artificial Neural Network (ANN) comprised of two hidden layers with six nodes per layer configured with Rectified-Linear-Unit (ReLU) activation function and a Random Forest (RF) regressor with number of estimators varied from 5 to 100. We could predict the stand-up and 2-stride scores of the STBLS test with correlation of 0.59 and 0.76 between the real and predicted data, respectively, by using the ANN. The best accuracies (R-squared values) obtained through the RF regressor were 0.86, 0.79, and 0.73 for stand-up, 2-stride, and GLFS-25 scores, respectively.
Collapse
|
21
|
Ramsey KA, Zhou W, Rojer AGM, Reijnierse EM, Maier AB. Associations of objectively measured physical activity and sedentary behaviour with fall-related outcomes in older adults: a systematic review. Ann Phys Rehabil Med 2021; 65:101571. [PMID: 34530151 DOI: 10.1016/j.rehab.2021.101571] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/23/2021] [Accepted: 07/11/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Higher physical activity (PA) and lower sedentary behaviour (SB) are associated with better muscle strength, balance, and functional ability, which are imperative for avoiding falls. This systematic review aimed to describe the association between objectively measured PA and SB with falls, fear of falling, and fractures. METHODS Six databases were searched from inception to July 21, 2020 for articles reporting the association of objectively measured PA/SB with falls, fear of falling, and/or fractures in community-dwelling older adults ≥60 years old. Results were synthesized in effect-direction heat maps and albatross plots expressed as Pearson's correlation coefficients (R). RESULTS A total of 43 articles were included, representing 27,629 (range 26 to 5,545) community-dwelling older adults (mean [SD] age 76.6 [8.4] years, 47% female). Longitudinal associations were reported in 13 articles and cross-sectional associations in 30. Falls were reported in 11 articles, fear of falling in 18 and fractures in 2. Higher PA and lower SB were associated with less fear of falling (median [interquartile range] Rs = steps: -0.214 [0.249; -0.148], total PA: -0.240 [0.267; -0.144], and moderate-to-vigorous PA: -0.180 [0.382; -0.121]), but these associations did not extend to falls or fractures, which showed inconsistent effect directions. CONCLUSION Fear of falling is associated with less engagement in PA and more SB, thus indicating that it is a psychological barrier to an active lifestyle. Varying effect directions for associations between PA and SB with falls and fractures may provide evidence for non-linear associations and require further research considering details of the fall or fracture incident. PROSPERO REGISTRATION NUMBER CRD42018103910.
Collapse
Affiliation(s)
- Keenan A Ramsey
- Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Waner Zhou
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Victoria, Australia
| | - Anna G M Rojer
- Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Victoria, Australia; Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Andrea B Maier
- Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Victoria, Australia; Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, National University Health System, Singapore.
| |
Collapse
|
22
|
Abstract
Smart walkers have been developed for assistance and rehabilitation of elderly people and patients with physical health conditions. A force sensor mounted under the handle is widely used in smart walkers to establish a human–machine interface. The interaction force can be used to control the walker and estimate gait parameters using methods such as the Kalman filter for real-time estimation. However, the estimation performance decreases when the peaks of the interaction force are not captured. To improve the stability and accuracy of gait parameter estimation, we propose an online estimation method to continuously estimate the gait phase and cadence. A multiple model switching mechanism is introduced to improve the estimation performance when gait is asymmetric, and an adaptive rule is proposed to improve the estimation robustness and accuracy. Simulations and experiments demonstrate the effectiveness and accuracy of the proposed gait parameter estimation method. Here, the average estimation error for the gait phase is 0.691 rad when the gait is symmetric and 0.722 rad when it is asymmetric.
Collapse
|
23
|
Bezold J, Krell-Roesch J, Eckert T, Jekauc D, Woll A. Sensor-based fall risk assessment in older adults with or without cognitive impairment: a systematic review. Eur Rev Aging Phys Act 2021; 18:15. [PMID: 34243722 PMCID: PMC8272315 DOI: 10.1186/s11556-021-00266-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 06/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Higher age and cognitive impairment are associated with a higher risk of falling. Wearable sensor technology may be useful in objectively assessing motor fall risk factors to improve physical exercise interventions for fall prevention. This systematic review aims at providing an updated overview of the current research on wearable sensors for fall risk assessment in older adults with or without cognitive impairment. Therefore, we addressed two specific research questions: 1) Can wearable sensors provide accurate data on motor performance that may be used to assess risk of falling, e.g., by distinguishing between faller and non-faller in a sample of older adults with or without cognitive impairment?; and 2) Which practical recommendations can be given for the application of sensor-based fall risk assessment in individuals with CI? A systematic literature search (July 2019, update July 2020) was conducted using PubMed, Scopus and Web of Science databases. Community-based studies or studies conducted in a geriatric setting that examine fall risk factors in older adults (aged ≥60 years) with or without cognitive impairment were included. Predefined inclusion criteria yielded 16 cross-sectional, 10 prospective and 2 studies with a mixed design. RESULTS Overall, sensor-based data was mainly collected during walking tests in a lab setting. The main sensor location was the lower back to provide wearing comfort and avoid disturbance of participants. The most accurate fall risk classification model included data from sit-to-walk and walk-to-sit transitions collected over three days of daily life (mean accuracy = 88.0%). Nine out of 28 included studies revealed information about sensor use in older adults with possible cognitive impairment, but classification models performed slightly worse than those for older adults without cognitive impairment (mean accuracy = 79.0%). CONCLUSION Fall risk assessment using wearable sensors is feasible in older adults regardless of their cognitive status. Accuracy may vary depending on sensor location, sensor attachment and type of assessment chosen for the recording of sensor data. More research on the use of sensors for objective fall risk assessment in older adults is needed, particularly in older adults with cognitive impairment. TRIAL REGISTRATION This systematic review is registered in PROSPERO ( CRD42020171118 ).
Collapse
Affiliation(s)
- Jelena Bezold
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Janina Krell-Roesch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN USA
| | - Tobias Eckert
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Darko Jekauc
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| |
Collapse
|
24
|
Stutzbach JA, Gustavson AM, Derlein DL, Forster JE, Boxer RS, Stevens-Lapsley JE. Older adults in skilled nursing facilities demonstrate low physical activity during and after discharge. Disabil Rehabil 2021; 44:3909-3914. [PMID: 33836134 DOI: 10.1080/09638288.2021.1892838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE This study sought to quantify physical activity and sedentary time among older adults during a skilled nursing facility (SNF) stay and after the transition home, a critical period when patients are at high risk for adverse events. MATERIALS AND METHODS We performed an observational cohort study of physical activity and sedentary behavior during the last 3-5 days before discharge from SNF and the initial 3-5 days at home using accelerometers. Participants answered questions about perceived physical activity in the SNF and at home. RESULTS A convenience sample of thirty-one residents from two SNFs were included. Participants spent a median 12.2% (interquartile range [IQR], 17.3%) of time upright in the SNF and 16.8% (IQR, 15.2%) of their time upright at home (p = 0.002) and took a median of 849 steps (IQR, 1772) in the SNF and 922 steps (IQR, 1906) at home (p = 0.57), per day. Participants averaged fewer sitting bouts at home (p = 0.03), but there was no difference in sit-to-stand transitions (p = 0.32) or activity scores (p = 0.67). Subjective perceptions of physical activity appeared to be higher than objective measurements. CONCLUSION In an exploratory study, SNF residents demonstrated profoundly low levels of physical activity both during and after their SNF stay. Future studies using larger sample sizes should examine physical activity during the SNF to home transition as well as barriers and facilitators to physical activity in post-acute care environments.IMPLICATIONS FOR REHABILITATIONSNF residents in this study demonstrated low levels of physical activity and high rates of sedentary behavior that persisted after discharge home.Interventions to improve physical activity levels in the SNF are sorely needed, and those interventions should include a plan for progressing physical activity after the transition home.Objective measurement of physical activity using activity monitors may prove clinically useful for older adults following hospitalization in the SNF and home settings.
Collapse
Affiliation(s)
- Julie A Stutzbach
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA
| | - Allison M Gustavson
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA
| | - Danielle L Derlein
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA
| | - Jeri E Forster
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA
| | - Rebecca S Boxer
- Kaiser Permanente Colorado Institute for Health Research, Aurora, CO, USA
| | - Jennifer E Stevens-Lapsley
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA.,Eastern Colorado VA Geriatric Research Education and Clinical Center (GRECC), Aurora, CO, USA
| |
Collapse
|
25
|
Rosenberg DE, Rillamas-Sun E, Bellettiere J, LaMonte M, Buchner DM, Di C, Hunt J, Marshall S, Stefanick M, Zhang Y, LaCroix AZ. Accelerometer-Measured Sedentary Patterns are Associated with Incident Falls in Older Women. J Am Geriatr Soc 2021; 69:718-725. [PMID: 33252141 PMCID: PMC8020891 DOI: 10.1111/jgs.16923] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/25/2020] [Accepted: 10/15/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVE Falls cause significant problems for older adults. Sedentary time is associated with lower physical function and could increase the risk for falls. DESIGN Prospective study. SETTING Sites across the United States. PARTICIPANTS Older women (N = 5,545, mean age 79 years) from the Women's Health Initiative Objective Physical Activity and Cardiovascular Health study. MEASUREMENTS Accelerometers worn at the hip for up to 1 week collected measures of daily sedentary time and the mean sedentary bout duration, a commonly used metric for sedentary accumulation patterns. For up to 13 months after accelerometer wear, women reported daily whether they had fallen on monthly calendars. RESULTS In fully adjusted models, the incident rate ratios (95% confidence interval) for quartiles 1 (lowest), 2, 3, and 4 of sedentary time respectively were 1.0 (ref.), 1.07 (0.93-1.24), 1.07 (0.91-1.25), and 1.14 (0.96-1.35; P-trend = .65) and for mean sedentary bout duration was 1.0 (ref.), 1.05 (0.92-1.21), 1.02 (0.88-1.17), and 1.17 (1.01-1.37; P-trend = .01), respectively. Women with a history of two or more falls had stronger associations between sedentary time and falls incidence compared with women with a history of no or one fall (P for interaction = .046). CONCLUSIONS Older women in the highest quartile of mean sedentary bout duration had a significantly increased risk of falling. Women with a history of frequent falling may be at higher risk for falling if they have high sedentary time. Interventions testing whether shortening total sedentary time and/or sedentary bouts lowers fall risk are needed to confirm these observational findings.
Collapse
Affiliation(s)
- Dori E Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | | | - John Bellettiere
- Family Medicine and Public Health, University of California, San Diego, California, USA
| | - Michael LaMonte
- Department of Epidemiology and Environmental health, State University of New York, Buffalo, New York, USA
| | - David M Buchner
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, Illinois, USA
| | - Chongzhi Di
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Julie Hunt
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Stephen Marshall
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Marcia Stefanick
- Medicine - Stanford Prevention Research Center, Stanford University, Stanford, California, USA
| | - Yuzheng Zhang
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Andrea Z LaCroix
- Family Medicine and Public Health, University of California, San Diego, California, USA
| |
Collapse
|
26
|
To Q, Huynh VA, Do D, Do V, Congdon N, Meuleners L, Vandelanotte C, Hong H, Nguyen H, To K. Falls and Physical Activity among Cataract Patients in Vietnam. Ophthalmic Epidemiol 2021; 29:70-77. [PMID: 33627039 DOI: 10.1080/09286586.2021.1893341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To investigate the relationship between falls, physical activity, and other socio-demographic and visual factors among cataract patients in Ho Chi Minh City, Vietnam. METHODS A cross-sectional study was conducted between April and November 2018. Patients presenting to two hospitals with age-related unilateral or bilateral cataract, aged ≥50 years, literate, and scheduled for a first-eye cataract surgery were recruited. The International Physical Activity Questionnaires short form was used to measure physical activity. Visual disability score was self-reported using the Catquest-9SF. The number of falls in the last 12 months prior to data collection were self-reported. Visual acuity and contrast sensitivity were measured using standard protocols. RESULTS A total of 340 patients had complete data, the majority of whom were women (62.4%), living with a spouse (66.5%), had an education level of Grade 5 or below (68.2%), and a monthly income from medium to high (58.5%). Average age was 65.7 years. A total of 135 falls were reported in the last 12 months with 27.6% reporting ≥1 fall and 7.1% ≥2 falls. Persons with high (adjusted Prevalence Ratio (aPR) = 2.4, 95%CI = 1.2, 4.7) and low (aPR = 2.4, 95%CI = 1.2, 4.6) physical activity levels had more falls compared to those with moderate levels. Women (aPR = 1.7, 95%CI = 1.04, 2.7) and those with medium income (aPR = 2.9, 95%CI = 1.2, 6.9) were more likely to fall. Poor binocular logMAR visual acuity with habitual correction (aPR = 2.3, 95%CI = 1.1, 4.6) and poor visual disability scores (aPR = 1.4, 95%CI = 1.02, 2.0) were associated with falling. CONCLUSION Patients with a moderate level of physical activity were less likely to fall compared to those with low or high levels although this U-shape relationship needs to be further investigated in prospective interventional trials. Men and those with high monthly income, better visual acuity and visual disability score were also less likely to fall. Cataract patients might be advised to maintain a moderate level of physical activity while waiting for surgery. Strategies to prevent falls may also prioritise cataract surgery for women and those with lower income.
Collapse
Affiliation(s)
- Quyen To
- Postdoctoral Research Fellow, Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Australia.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.,Physical Activity Research Group, Appleton Institute, Central Queensland University, Australia
| | - Van-Anh Huynh
- Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Dung Do
- Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Vu Do
- Military Hospital 175, Ho Chi Minh City, Vietnam
| | - Nathan Congdon
- Centre for Public Health, Queen's University Belfast, Belfast, UK.,Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Lynn Meuleners
- School of Population and Global Health, University of Western, Australia
| | - Corneel Vandelanotte
- Physical Activity Research Group, Appleton Institute, Central Queensland University, Australia.,Research Professor, Physical Activity Research Group Leader, Appleton Institute School of Health, Medical and Applied Sciences, Central Queensland University, Australia
| | - Hiep Hong
- University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Ho Nguyen
- Trung Vuong Hospital, Ho Chi Minh City, Vietnam
| | - Kien To
- Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| |
Collapse
|
27
|
Silva LPD, Biernaski VM, Santi PM, Moreira NB. Idosos caidores e não caidores: Associação com características sociais, fatores econômicos, aspectos clínicos, nível de atividade física e percepção do risco de quedas: um estudo transversal. FISIOTERAPIA E PESQUISA 2021. [DOI: 10.1590/1809-2950/21005928032021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO As quedas em idosos são capazes de impactar negativamente sobre diversos aspectos biopsicossociais. O objetivo deste estudo foi verificar a associação de quedas com características sociais, fatores econômicos, aspectos clínicos, nível de atividade física e percepção do risco de quedas em idosos caidores e não caidores. A amostra foi composta por 520 idosos (71,7±7,4 anos) de ambos os sexos (83,7% feminino) que foram entrevistados em relação às características sociais, fatores econômicos, aspectos clínicos, histórico de quedas, nível de atividade física (Minnesota) e percepção do risco de quedas (falls risk awareness questionnaire, PRQ). Para comparação foram utilizados os testes de Mann-Whitney e qui-quadrado e para associação os testes de regressão logística binária e multivariada. Após a análise de dados, identificamos que idosos caidores apresentaram menor escolaridade, classe econômica e PRQ. A escolaridade (OR: 1,35 a 1,28), classe econômica (OR: 1,62) e PRQ (OR: 1,46) apresentaram associação com as quedas, semelhante foi observado em idosos com duas ou mais quedas (escolaridade, OR: 2,44 a 1,92; PRQ, OR: 0,84). A análise de idosos com apenas uma queda evidenciou associação apenas com a PRQ (OR: 0,87). Conclui-se que idosos caidores apresentaram menor percepção do risco de quedas, nível de escolaridade e classe econômica. A PRQ demonstrou-se uma ferramenta importante para programas de prevenção de quedas, pois foi capaz de identificar fatores perceptuais sobre o risco de quedas que podem ser utilizados para avaliação e acompanhamento, bem como direcionar estes programas em idosos da comunidade.
Collapse
|
28
|
Ghram A, Briki W, Mansoor H, Al-Mohannadi AS, Lavie CJ, Chamari K. Home-based exercise can be beneficial for counteracting sedentary behavior and physical inactivity during the COVID-19 pandemic in older adults. Postgrad Med 2020; 133:469-480. [PMID: 33275479 DOI: 10.1080/00325481.2020.1860394] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The novel pandemic called coronavirus disease 2019 (COVID-19), as a global public health emergency, seems to be having a major impact on physical activity (PA) behaviors. Older adults are at high risk of death from the severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). Health authorities around the world have been implementing preventive health measures, including quarantine and self-isolation, to mitigate the COVID-19 outbreak. This period is characterized by the cessation of outdoor exercising. During this period of lockdown, PA has been one of the rare reasons for going out in some countries. To avoid the harmful effects of periods of exercise cessation, PA could be prescribed to older adults, which is of great importance for breaking their sedentary lifestyle and improving their immunity. The present review discusses the potential impacts of the COVID-19 pandemic on sedentary behavior and physical inactivity in older adults. The importance of performing PA to reduce the harmful effects of the COVID-19 pandemic is discussed, and useful recommendations on home-based exercise for the older adults to maintain their level of independence, physical and mental health as well as their well-being are provided.
Collapse
Affiliation(s)
- Amine Ghram
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran.,Department of Cardiac Rehabilitation, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Walid Briki
- Sport Science Program, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Hend Mansoor
- College of Health and Life Sciences,Hamad Bin Khalifa University, Doha, Qatar
| | - Abdulla Saeed Al-Mohannadi
- Research and Scientific Support Department, Aspetar Orthopaedic and Sports Medicine Hospital, Qatar.,World Innovation Summit for Health (WISH), Qatar Foundation, Doha, Qatar
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School the University of Queensland School of Medicine, New Orleans, Louisiana, USA
| | - Karim Chamari
- Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| |
Collapse
|
29
|
Levels of Physical Activity and Sedentary Behavior During and After Hospitalization: A Systematic Review. Arch Phys Med Rehabil 2020; 102:1368-1378. [PMID: 33347891 DOI: 10.1016/j.apmr.2020.11.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/09/2020] [Accepted: 11/20/2020] [Indexed: 01/24/2023]
Abstract
OBJECTIVES To systematically review and synthesize the evidence on physical activity and sedentary behavior during and after hospitalization. DATA SOURCES Electronic databases and reference lists of relevant articles were searched from 2000 to April 2020. STUDY SELECTION Studies which continuously monitored physical activity and/or sedentary behavior in hospitalized adults across 2 settings (ie, without a break in measurement between settings). Monitoring could occur from an acute to a subacute or rehabilitation hospital setting, an acute setting to home, or from a subacute or rehabilitation setting to home. DATE EXTRACTION Data extraction and methodological quality assessments were independently performed by 2 reviewers using standardized checklists. DATA SYNTHESIS A total of 15 of the 5579 studies identified were included. The studies were composed of heterogenous patient populations. All studies monitored patients with either an accelerometer and/or pedometer and reported a variety of measures, including steps per day, sedentary time, and activity counts. The majority of studies (12 of 15) showed that patients engaged in 1.3 to 5.9 times more physical activity and up to 67% less daily sedentary behavior at home after discharge from acute or subacute settings. CONCLUSIONS Patients engaged in more physical activity and less sedentary behavior at home compared to both the acute and subacute hospital settings. This may reflect the natural course of recovery or the effect of setting on activity levels. Enabling early discharge home through the implementation of home-hospitalization models may result in increased patient physical activity and reduced sedentary behavior. Further experimental studies are required investigating the effect of home-based models of care on physical activity and sedentary behavior.
Collapse
|
30
|
Grant D, Tomlinson D, Tsintzas K, Kolić P, Onambélé-Pearson G. Minimizing sedentary behavior (without increasing medium-to-vigorous exercise) associated functional improvement in older women is somewhat dependent on a measurable increase in muscle size. Aging (Albany NY) 2020; 12:24081-24100. [PMID: 33276345 PMCID: PMC7762509 DOI: 10.18632/aging.202265] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 10/19/2020] [Indexed: 12/17/2022]
Abstract
The optimal pattern of sedentarism displacement and mechanisms underlying its health effects are poorly understood. Therefore, the aim of this study was to quantify muscle-tendon adaptation in response to two different sedentarism displacement interventions and relate any adaptations to functional outcomes. Thirty-four older women (73±5yrs) underwent skeletal muscle-tendon size and functional assessments. Participants were randomly allocated to: Sedentary behavior fragmentation (SBF), Light intensity physical activity (LIPA), or Control groups. Measures were taken at weeks 0 and 8. Gait speed significantly increased (p=0.003), in both experimental groups (SBF: 0.06 ± 0.08m/s, 6±10%, LIPA: 0.06 ± 0.07m/s, 6±6%), but not control (-0.02 ± 0.12m/s, -2±9%). Accordingly, the relative change in Vastus Lateralis muscle volume, accounted for 30% (p=0.027), and 45% (p=0.0006) of the explained variance in the relative change in gait speed, for SBF and LIPA respectively. Gastrocnemius Medialis fascicle length changes were positively associated with gait speed changes, following LIPA exclusively (R2= 0.50, p=0.009). This is the first study to show SBF and LIPA are adequate loading in older women, with related muscle adaptation and clinically relevant gait speed improvements. Such adaptations appear similar irrespective of whether sedentarism displacement is prescribed in a single bout (LIPA) or in frequent micro-bouts (SBF).
Collapse
Affiliation(s)
- Dale Grant
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Sports and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
| | - David Tomlinson
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Sports and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
| | - Kostas Tsintzas
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, Faculty of Medicine and Health Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
| | - Petra Kolić
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Sports and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
| | - Gladys Onambélé-Pearson
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Sports and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
| |
Collapse
|
31
|
Lu Z, Lam FMH, Leung JCS, Kwok TCY. The U-Shaped Relationship Between Levels of Bouted Activity and Fall Incidence in Community-Dwelling Older Adults: A Prospective Cohort Study. J Gerontol A Biol Sci Med Sci 2020; 75:e145-e151. [PMID: 32115656 PMCID: PMC7518560 DOI: 10.1093/gerona/glaa058] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND It remains uncertain whether the association between physical activity (PA) and falls is U-shaped, and few studies have explored the potential mediation of PA accumulation pattern. METHODS We measured PA in 671 community-dwelling older adults (82.7 ± 3.8 years) using wrist-worn accelerometer for 7 days. PA was further classified to bouted PA (≥10 minutes bout length) and sporadic PA (<10 minutes bout length) for subanalysis. Fall incidence in the following 12-month was recorded through tri-monthly telephone interviews. Classification and Regression Tree analysis was used to identify two optimal cutoff values of each PA measurement to predict falls. Participants were then divided into "inactive," "moderately active," and "highly active" groups accordingly. Negative binomial regression models were used to estimate the association between the PA measures and fall incidence. RESULTS Six hundred and thirty-nine participants completed 12-month follow-up. Ninety-three (14.6%) experienced a total of 118 falls. Inactive and highly active older adults had higher falls per person month relative to the moderately active group (inactive: incidence rate ratios [IRR] = 2.372, 95% confidence interval [CI] = 1.317-4.271; highly active: IRR = 2.731, 95% CI = 1.196-6.232). Subanalyses found similar significant finding with bouted PA (p < .001) but not sporadic PA (p ≥ .221). The association between bouted PA and falls remained significant even after adjusting fall incidence for bouted activity time (inactive: IRR = 3.636, 95% CI = 2.238-5.907; highly active: IRR = 1.823, 95% CI = 1.072-3.1). Further adjustments for fall-related risk factors did not meaningfully change the results. CONCLUSION A U-shaped relationship was identified between bouted but not sporadic PA and fall incidence. There is an approximately twofold increase in fall rate in highly active older adults even after adjusting for activity time.
Collapse
Affiliation(s)
- Zhihui Lu
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, China
| | - Freddy M H Lam
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, China
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, China
| | - Jason C S Leung
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, China
| | - Timothy C Y Kwok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, China
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, China
| |
Collapse
|
32
|
Muhaidat J, Al-Yahya E, Mohammad MT, Qutishat D, Okasheh R, Al-Khlaifat L, Lawrie S, Esser P, Dawes H. Dual-tasking in older women: physical activity or else? J Women Aging 2020; 34:101-111. [PMID: 32926645 DOI: 10.1080/08952841.2020.1819177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The interplay between gender, Physical Activity (PA), and Dual Tasking (DT) in older adults is unclear. This study aimed to address DT based on gender and PA level. One-hundred and twenty older adults (81 women and 39 men) participated. Timed up and go test and spatiotemporal gait measures were collected in single and DT conditions. Participants were grouped according to gender and PA level. Physical activity did not explain gender differences, women were slower and had shorter stride lengths when DT regardless of PA level. Findings indicate the necessity for tailored PA and functional interventions to improve women's performance.
Collapse
Affiliation(s)
- Jennifer Muhaidat
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Emad Al-Yahya
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan.,Centre for Movement, Occupational, and Rehabilitation Sciences (MORES), Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Maha T Mohammad
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Dania Qutishat
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Rasha Okasheh
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Lara Al-Khlaifat
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Sophie Lawrie
- Centre for Movement, Occupational, and Rehabilitation Sciences (MORES), Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Patrick Esser
- Centre for Movement, Occupational, and Rehabilitation Sciences (MORES), Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Helen Dawes
- Centre for Movement, Occupational, and Rehabilitation Sciences (MORES), Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK.,Department of Clinical Neurology, University of Oxford, Oxford, UK
| |
Collapse
|
33
|
Auerswald T, Meyer J, von Holdt K, Voelcker-Rehage C. Application of Activity Trackers among Nursing Home Residents-A Pilot and Feasibility Study on Physical Activity Behavior, Usage Behavior, Acceptance, Usability and Motivational Impact. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6683. [PMID: 32937840 PMCID: PMC7559724 DOI: 10.3390/ijerph17186683] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/27/2020] [Accepted: 09/05/2020] [Indexed: 11/17/2022]
Abstract
The aim of this study was to assess physical activity and sedentary behavior, as well as the usage behavior, usability, acceptance, and motivational impact of an applied activity tracker among nursing home residents. Physical activity and usage behavior were measured among 22 residents (68 to 102 years) by use of a commercial activity tracker worn during waking hours for 77 days on average. Usability, acceptance, and motivational impact of the tracker were examined using an adapted questionnaire. Participants walked, on average, 1007 ± 806 steps per day and spent, on average, more than 9 h (77.2% of their waking time) sedentary. The average steps/day increased significantly within the first five weeks of wearing the activity tracker. The acceptance rate was high (94.4%). The tracker was used for 65.4% of the individual study period, and usage behavior did not significantly change during the first five wearing weeks. Participants with a usage time of ≥50% walked significantly more steps per day than those with a lower usage. Overall, we were able to reveal that the residents were highly inactive and sedentary. The results support the feasibility of a long-term application of activity trackers to assess or even increase physical activity behavior.
Collapse
Affiliation(s)
- Tina Auerswald
- Institute of Human Movement Science and Health, Faculty of Behavioural and Social Sciences, Chemnitz University of Technology, Thüringer Weg 11, 09126 Chemnitz, Germany;
| | - Jochen Meyer
- OFFIS—Institute for Information Technology Oldenburg, Escherweg 2, 26121 Oldenburg, Germany; (J.M.); (K.v.H.)
| | - Kai von Holdt
- OFFIS—Institute for Information Technology Oldenburg, Escherweg 2, 26121 Oldenburg, Germany; (J.M.); (K.v.H.)
| | - Claudia Voelcker-Rehage
- Institute of Human Movement Science and Health, Faculty of Behavioural and Social Sciences, Chemnitz University of Technology, Thüringer Weg 11, 09126 Chemnitz, Germany;
- Department of Neuromotor Behavior and Exercise, University of Münster, Horstmarer Landweg 62 b, 48149 Münster, Germany
| |
Collapse
|
34
|
Mattig T. Falls in the elderly: a major public health challenge with some encouraging developments. A mini review. JOURNAL OF GERONTOLOGY AND GERIATRICS 2020. [DOI: 10.36150/2499-6564-428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
35
|
Fitzsimons CF, Nicholson SL, Morris J, Mead GE, Chastin S, Niven A. Stroke survivors’ perceptions of their sedentary behaviours three months after stroke. Disabil Rehabil 2020; 44:382-394. [DOI: 10.1080/09638288.2020.1768304] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Claire F. Fitzsimons
- Physical Activity for Health Research Centre, The University of Edinburgh, Edinburgh, UK
| | - Sarah L. Nicholson
- Physical Activity for Health Research Centre, The University of Edinburgh, Edinburgh, UK
| | - Jacqui Morris
- School of Nursing and Health Sciences, University of Dundee, Dundee, UK
| | | | - Sebastien Chastin
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Ailsa Niven
- Physical Activity for Health Research Centre, The University of Edinburgh, Edinburgh, UK
| |
Collapse
|
36
|
Lee J. The association between physical activity and risk of falling in older adults: A systematic review and meta-analysis of prospective cohort studies. Geriatr Nurs 2020; 41:747-753. [PMID: 32507370 DOI: 10.1016/j.gerinurse.2020.05.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 05/07/2020] [Accepted: 05/11/2020] [Indexed: 02/07/2023]
Abstract
This study investigated the association between physical activity (PA) and risk of falling in older adults and suggests effective PA guidelines based on intensity and amount of PA. We found 10 prospective cohort studies with a total of 58,241 older adult participants and summarized the relative ratio of risk of falling. Older adults who participated in PA had a decreased risk of falling [0.976 (95% CI: 0.957-0.996, p = 0.019)], and inactive older adults had an increased risk of falling [1.082 (95% CI: 1.007-1.163, p = 0.031)]. Older adults who participated in moderate to vigorous intensity PA with low amount of PA had an increased risk of falling [1.217 (95% CI: 1.055-1.403, p<0.007)], when older adults who participated in moderate (3 Metabolic Equivalent: METs or higher) to vigorous intensity PA (6 METs or higher) with very high amount of PA were used as a reference. We recommend participating in PA, including moderate to vigorous intensity PA and a more than medium amount of PA, and avoiding inactivity for older adults to reduce the risk of falling.
Collapse
Affiliation(s)
- Junga Lee
- Graduate School of Sport Science, KyungHee University, 1732 Deogyeong-daero, Giheung-gu, Yongin-si, Gyeonggi-do 17104, Republic of Korea.
| |
Collapse
|
37
|
Epilepsy and aging. HANDBOOK OF CLINICAL NEUROLOGY 2020. [PMID: 31753149 DOI: 10.1016/b978-0-12-804766-8.00025-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
The intersection of epilepsy and aging has broad, significant implications. Substantial increases in seizures occur both in the elderly population, who are at a higher risk of developing new-onset epilepsy, and in those with chronic epilepsy who become aged. There are notable gaps in our understanding of aging and epilepsy at the basic and practical levels, which have important consequences. We are in the early stages of understanding the complex relationships between epilepsy and other age-related brain diseases such as stroke, dementia, traumatic brain injury (TBI), and cancer. Furthermore, the clinician must recognize that the presentation and treatment of epilepsy in the elderly are different from those of younger populations. Given the developing awareness of the problem and the capabilities of contemporary, multidisciplinary approaches to advance understanding about the biology of aging and epilepsy, it is reasonable to expect that we will unravel some of the intricacies of epilepsy in the elderly; it is also reasonable to expect that these gains will lead to further improvements in our understanding and treatment of epilepsy for all age groups.
Collapse
|
38
|
Zusman EZ, Dawes M, Fleig L, McAllister MM, Cook WL, Guy P, Brasher PMA, McKay HA, Khan KM, Ashe MC. Older Adults' Sedentary Behavior and Physical Activity After Hip Fracture: Results From an Outpatient Rehabilitation Randomized Controlled Trial. J Geriatr Phys Ther 2020; 42:E32-E38. [PMID: 30028352 DOI: 10.1519/jpt.0000000000000193] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND PURPOSE Prolonged sedentary time and limited physical activity can result in deleterious effects on health and mobility, especially for older adults with fall-related hip fracture. Therefore, the purpose of this study was to examine the effect of a multidisciplinary clinic on sedentary behavior and physical activity (prespecified secondary outcomes) and provide descriptions of activity patterns over 1 year for men and women. METHODS We conducted a parallel-group, single-blinded randomized controlled trial comparing a multidisciplinary clinic and usual care (intervention) with usual care (control). We recruited 53 community-dwelling older adults aged 65+ years who were 3 to 12 months postfracture and collected data at baseline, 6, and 12 months; study staff were blinded to group allocation. The clinic included a geriatric assessment by the geriatrician, physiotherapist, and occupational therapist. Referrals were made to other professionals, when indicated. We collected the accelerometer-measured sedentary behavior and physical activity at 3 time points. We used linear mixed-effects models to compare groups at 6 and 12 months and mixed models to compare outcomes between men and women. RESULTS Participants were sedentary for more than 10 hours of a 13-hour day, and there were no significant differences between the study groups at 6 months (2.4 [95% confidence interval: -22.4 to 27.2] minutes) or 12 months (-3.7 [95% confidence interval: -33.6 to 26.1] minutes). Compared with women, men spent 47.2 min/d more in sedentary time (P = .052) and 43.8 min/d less in light physical activity (P = .047). DISCUSSION Older adults after hip fracture spend prolonged periods of waking hours sedentary with very little activity.
Collapse
Affiliation(s)
- Enav Z Zusman
- Centre for Hip Health and Mobility, The University of British Columbia, Vancouver, Canada.,Department of Family Practice, The University of British Columbia, Vancouver, Canada
| | - Martin Dawes
- Department of Family Practice, The University of British Columbia, Vancouver, Canada
| | - Lena Fleig
- Health Psychology/Social, Organizational and Economic Psychology, Freie Universität Berlin, Berlin, Germany
| | - Megan M McAllister
- Centre for Hip Health and Mobility, The University of British Columbia, Vancouver, Canada.,Department of Family Practice, The University of British Columbia, Vancouver, Canada
| | - Wendy L Cook
- Division of Geriatric Medicine, Department of Medicine, The University of British Columbia, Vancouver, Canada.,Providence Healthcare, Toronto, Ontario, Canada
| | - Pierre Guy
- Centre for Hip Health and Mobility, The University of British Columbia, Vancouver, Canada.,Department of Orthopaedics, The University of British Columbia, Vancouver, Canada
| | - Penelope M A Brasher
- Centre for Clinical Epidemiology and Evaluation, Vancouver, British Columbia, Canada
| | - Heather A McKay
- Centre for Hip Health and Mobility, The University of British Columbia, Vancouver, Canada.,Department of Family Practice, The University of British Columbia, Vancouver, Canada.,Department of Orthopaedics, The University of British Columbia, Vancouver, Canada
| | - Karim M Khan
- Centre for Hip Health and Mobility, The University of British Columbia, Vancouver, Canada.,Department of Family Practice, The University of British Columbia, Vancouver, Canada.,School of Kinesiology, The University of British Columbia, Vancouver, Canada
| | - Maureen C Ashe
- Centre for Hip Health and Mobility, The University of British Columbia, Vancouver, Canada.,Department of Family Practice, The University of British Columbia, Vancouver, Canada
| |
Collapse
|
39
|
Effects of A "Modified" Otago Exercise Program on the Functional Abilities and Social Participation of Older Adults Living in the Community-The AGA@4life Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041258. [PMID: 32075307 PMCID: PMC7068357 DOI: 10.3390/ijerph17041258] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/12/2020] [Accepted: 02/13/2020] [Indexed: 11/17/2022]
Abstract
Strength and balance exercises form part of multifactorial programs to reduce the risk of falling and promote active ageing. The aim of this study was to evaluate the effect of a strength and balance exercise program, adapted from the traditional Otago Exercise Program (OTAGO) into a technological system. A non-randomized experimental study enrolled 34 participants (83.24 ± 6.89 years) from a daycare center in Portugal, who were distributed into an intervention group (IG; 18 participants) and a control group (CG; 16 participants). The IG underwent a "modified" OTAGO incorporated in a technological system using pressure and inertial sensors, feedback, and Exergames for 8 weeks, 3 times a week. The CG continued their regular activities. Outcome measures were evaluated at baseline and after 8 weeks of intervention. After the program, differences were observed between the groups in handgrip strength (p = 0.03), step test (p = 0.03), 4stage balance test "modified" (p < 0.001) and activities and participation profile related to mobility (PAPM) (p < 0.001). The IG showed positive results in the self-efficacy for exercise (p = 0.03), PAPM (p = 0.00) and all functional tests, except for timed up and go (p = 0.35). No significant changes were observed in the CG. The results support this intervention program as a good exercise solution to improve functional abilities, social participation, and self-efficacy, reducing the risk of falling.
Collapse
|
40
|
Montana JI, Matamala-Gomez M, Maisto M, Mavrodiev PA, Cavalera CM, Diana B, Mantovani F, Realdon O. The Benefits of emotion Regulation Interventions in Virtual Reality for the Improvement of Wellbeing in Adults and Older Adults: A Systematic Review. J Clin Med 2020; 9:jcm9020500. [PMID: 32059514 PMCID: PMC7073752 DOI: 10.3390/jcm9020500] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 02/04/2020] [Accepted: 02/05/2020] [Indexed: 01/23/2023] Open
Abstract
The impact of emotion regulation interventions on wellbeing has been extensively documented in literature, although only in recent years virtual reality (VR) technologies have been incorporated in the design of such interventions, in both clinical and non-clinical settings. A systematic search, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, was therefore carried out to explore the state of the art in emotion regulation interventions for wellbeing using virtual reality. The literature on this topic was queried, 414 papers were screened, and 11 studies were included, covering adults and older adults. Our findings offer an overview of the current use of VR technologies for the enhancement of emotion regulation (ER) and wellbeing. The results are promising and suggest that VR-based emotion regulation training can facilitate the promotion of wellbeing. An overview of VR-based training interventions is crucial for better understanding how to use these tools in the clinical settings. This review offers a critical debate on the structure of such intervention protocols. It also analyzes and highlights the crucial role played by the selection of the objective and subjective wellbeing assessment measures of said intervention protocols.
Collapse
Affiliation(s)
- Jessica Isbely Montana
- Department of Human Sciences for Education, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milano, Italy; (M.M.-G.); (M.M.); (P.A.M.); (B.D.); (F.M.); (O.R.)
- Correspondence:
| | - Marta Matamala-Gomez
- Department of Human Sciences for Education, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milano, Italy; (M.M.-G.); (M.M.); (P.A.M.); (B.D.); (F.M.); (O.R.)
| | - Marta Maisto
- Department of Human Sciences for Education, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milano, Italy; (M.M.-G.); (M.M.); (P.A.M.); (B.D.); (F.M.); (O.R.)
| | - Petar Aleksandrov Mavrodiev
- Department of Human Sciences for Education, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milano, Italy; (M.M.-G.); (M.M.); (P.A.M.); (B.D.); (F.M.); (O.R.)
| | - Cesare Massimo Cavalera
- Department of Psychology, Catholic University of the Sacred Heart, Largo Gemelli 1, 20100 Milan, Italy;
| | - Barbara Diana
- Department of Human Sciences for Education, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milano, Italy; (M.M.-G.); (M.M.); (P.A.M.); (B.D.); (F.M.); (O.R.)
| | - Fabrizia Mantovani
- Department of Human Sciences for Education, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milano, Italy; (M.M.-G.); (M.M.); (P.A.M.); (B.D.); (F.M.); (O.R.)
| | - Olivia Realdon
- Department of Human Sciences for Education, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milano, Italy; (M.M.-G.); (M.M.); (P.A.M.); (B.D.); (F.M.); (O.R.)
| |
Collapse
|
41
|
Pagnotti GM, Haider A, Yang A, Cottell KE, Tuppo CM, Tong KY, Pryor AD, Rubin CT, Chan ME. Postural Stability in Obese Preoperative Bariatric Patients Using Static and Dynamic Evaluation. Obes Facts 2020; 13:499-513. [PMID: 33080591 PMCID: PMC7670358 DOI: 10.1159/000509163] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/01/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Globally, 300 million adults have clinical obesity. Heightened adiposity and inadequate musculature secondary to obesity alter bipedal stance and gait, diminish musculoskeletal tissue quality, and compromise neuromuscular feedback; these physiological changes alter stability and increase injury risk from falls. Studies in the field focus on obese patients across a broad range of body mass indices (BMI >30 kg/m2) but without isolating the most morbidly obese subset (BMI ≥40 kg/m2). We investigated the impact of obesity in perturbing postural stability in morbidly obese subjects elected for bariatric intervention, harboring a higher-spectrum BMI. SUBJECTS AND METHODS Traditional force plate measurements and stabilograms are gold standards employed when measuring center of pressure (COP) and postural sway. To quantify the extent of postural instability in subjects with obesity before bariatric surgery, we assessed 17 obese subjects with an average BMI of 40 kg/m2 in contrast to 13 nonobese subjects with an average BMI of 30 kg/m2. COP and postural sway were measured from static and dynamic tasks. Involuntary movements were measured when patients performed static stances, with eyes either opened or closed. Two additional voluntary movements were measured when subjects performed dynamic, upper torso tasks with eyes opened. RESULTS Mean body weight was 85% (p < 0.001) greater in obese than nonobese subjects. Following static balance assessments, we observed greater sway displacement in the anteroposterior (AP) direction in obese subjects with eyes open (87%, p < 0.002) and eyes closed (76%, p = 0.04) versus nonobese subjects. Obese subjects also exhibited a higher COP velocity in static tests when subjects' eyes were open (47%, p = 0.04). Dynamic tests demonstrated no differences between groups in sway displacement in either direction; however, COP velocity in the mediolateral (ML) direction was reduced (31%, p < 0.02) in obese subjects while voluntarily swaying in the AP direction, but increased in the same cohort when swaying in the ML direction (40%, p < 0.04). DISCUSSION AND CONCLUSION Importantly, these data highlight obesity's contribution towards increased postural instability. Obese subjects exhibited greater COP displacement at higher AP velocities versus nonobese subjects, suggesting that clinically obese individuals show greater instability than nonobese subjects. Identifying factors contributory to instability could encourage patient-specific physical therapies and presurgical measures to mitigate instability and monitor postsurgical balance improvements.
Collapse
Affiliation(s)
- Gabriel M Pagnotti
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York, USA
| | - Amna Haider
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York, USA
| | - Ariel Yang
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York, USA
| | - Kathryn E Cottell
- Bariatric and Metabolic Weight Loss Center, Stony Brook Medicine, Stony Brook, New York, USA
| | - Catherine M Tuppo
- Bariatric and Metabolic Weight Loss Center, Stony Brook Medicine, Stony Brook, New York, USA
| | - Kai-Yu Tong
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Aurora D Pryor
- Bariatric and Metabolic Weight Loss Center, Stony Brook Medicine, Stony Brook, New York, USA
| | - Clinton T Rubin
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York, USA
| | - M Ete Chan
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York, USA,
| |
Collapse
|
42
|
Veronese N, Soysal P, Stubbs B, Maggi S, Jackson SE, Demurtas J, Celotto S, Koyanagi A, Bolzetta F, Smith L. Dietary Protein Intake and Falls in Older People: Longitudinal Analyses From the Osteoarthritis Initiative. J Am Med Dir Assoc 2019; 20:1623-1627. [DOI: 10.1016/j.jamda.2019.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 03/05/2019] [Accepted: 03/16/2019] [Indexed: 02/05/2023]
|
43
|
de Bruin ED, Patt N, Ringli L, Gennaro F. Playing Exergames Facilitates Central Drive to the Ankle Dorsiflexors During Gait in Older Adults; a Quasi-Experimental Investigation. Front Aging Neurosci 2019; 11:263. [PMID: 31616287 PMCID: PMC6763617 DOI: 10.3389/fnagi.2019.00263] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 09/05/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose Gait training might be of particular importance to reduce fall risk in older adults. In the present study we explore the hypothesis that video game-based training will increase tibialis anterior (TA) muscle EMG-EMG coherence and relates to functional measures of lower limb control. Methods We focus on video game-based training performed in standing position, where the subjects have to lift their toes to place their feet on different target zones in order to successfully play the game. This type of training is hypothesized leading to progressive changes in the central motor drive to TA motor neurons and, consequently, improved control of ankle dorsiflexion during gait. Results Twenty older adults, 79 ± 8 years old, 13 females/7 males, participated. Results showed a significant difference against 0 in the experimental ΔPOST condition in dual-task walking and beta Frequency Of Interest (p = 0.002). Walking under dual task condition showed significant change over time in minimal Toe Clearance for both the left [χ2(2) = 7.46, p = 0.024, n = 20] and right [χ2(2) = 8.87, p = 0.012, n = 20] leg. No change in lower extremity function was detectable. Conclusion Overall we conclude that the initiation of an exergame-based training in upright standing position improves neural drive to the lower extremities in older adults, effects on minimal Toe Clearance and seems an acceptable form of physical exercise for this group.
Collapse
Affiliation(s)
- Eling D de Bruin
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Nadine Patt
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Lisa Ringli
- SRH Hochschule für Gesundheit, Gera, Germany
| | - Federico Gennaro
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| |
Collapse
|
44
|
Rosenberger ME, Fulton JE, Buman MP, Troiano RP, Grandner MA, Buchner DM, Haskell WL. The 24-Hour Activity Cycle: A New Paradigm for Physical Activity. Med Sci Sports Exerc 2019; 51:454-464. [PMID: 30339658 PMCID: PMC6377291 DOI: 10.1249/mss.0000000000001811] [Citation(s) in RCA: 151] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The physiologic mechanisms by which the four activities of sleep, sedentary behavior, light-intensity physical activity, and moderate-to-vigorous physical activity (MVPA) affect health are related, but these relationships have not been well explored in adults. Research studies have commonly evaluated how time spent in one activity affects health. Because one can only increase time in one activity by decreasing time in another, such studies cannot determine the extent that a health benefit is due to one activity versus due to reallocating time among the other activities. For example, interventions to improve sleep possibly also increase time spent in MVPA. If so, the overall effect of such interventions on risk of premature mortality is due to both more MVPA and better sleep. Further, the potential for interaction between activities to affect health outcomes is largely unexplored. For example, is there a threshold of MVPA minutes per day, above which adverse health effects of sedentary behavior are eliminated? This article considers the 24-h Activity Cycle (24-HAC) model as a paradigm for exploring inter-relatedness of health effects of the four activities. It discusses how to measure time spent in each of the four activities, as well as the analytical and statistical challenges in analyzing data based on the model, including the inevitable challenge of confounding among activities. The potential usefulness of this model is described by reviewing selected research findings that aided in the creation of the model and discussing future applications of the 24-HAC model.
Collapse
Affiliation(s)
| | - Janet E Fulton
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA
| | - Matthew P Buman
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ
| | - Richard P Troiano
- National Cancer Institute, National Institutes of Health, Bethesda, MD
| | | | - David M Buchner
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL
| | - William L Haskell
- Stanford Prevention Research Center, Stanford University, Stanford, CA
| |
Collapse
|
45
|
Oliveira AEPD, Ostolin TLVDP, Vieira WDO, Arantes RL, Gagliardi ARDT, Sperandio EF, Dourado VZ. The association between physical activity, sedentary behavior and the occurrence of falls in asymptomatic adults over 40 years old. FISIOTERAPIA EM MOVIMENTO 2019. [DOI: 10.1590/1980-5918.032.ao15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction: Sedentary behavior (SB) has been described as an independent risk factor for health, regardless of the recommended amount of moderate-to-vigorous physical activity (MVPA). However, SB and MVPA as predictors of falls have been poorly investigated. Objective: To compare the associations between SB and MVPA and the occurrence of falls in middle-aged and older adults. Method: The participants wore a triaxial accelerometer over the dominant hip for seven days to measure SB and MVPA. The occurrence of falls and cardiovascular risk factors were assessed by self-report. Isokinetic peak torque (PT) of knee extension, peak oxygen uptake (V’O2) in a ramp treadmill protocol, and lean (LBM) body mass and body fat (BFM) (bioelectrical impedance) were also assessed. The critical roles of SB and MVPA on the occurrence of falls were compared by multiple logistic regression adjusted for age, sex, cardiovascular risk factors, LBM, peak V’O2, and PT of knee extension. Results: 379 participants were evaluated, aged 40-80 years. Forty-eight participants reported at least one fall in the previous 12 months (14.5%). Fallers presented lower SB and higher MVPA. They were predominantly women and older adults with lower physical fitness. After multivariate analysis, MVPA, but not SB, was selected as an independent predictor of falls, increasing the odds ratio of having a fall (1.184, 95% confidence interval, 1.016 - 1.378). Conclusion: Episodes of falls in predominantly middle-aged and women subjects were associated with a higher amount of MVPA, not the opposite, indicating an adverse effect of MVPA in these subjects.
Collapse
|
46
|
Paz LPDS, Borges LDL, Marães VRFDS, Gomes MMF, Bachion MM, Menezes RLD. Factors associated with falls in older adults with cataracts. CIENCIA & SAUDE COLETIVA 2018; 23:2503-2514. [PMID: 30137120 DOI: 10.1590/1413-81232018238.14622016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 09/02/2016] [Indexed: 12/16/2022] Open
Abstract
The aim of the present study was to evaluate factors associated with falls in community-dwelling older adults diagnosed with cataracts. An analytical, cross-sectional study was conducted with a sample of community-dwelling older adults residing in the Federal District of Brazil. Interviews and assessment tools were administered, such as the Timed Up and Go test, Short Physical Performance Battery (SPPB), Biodex Balance System, Katz Index, Lawton Scale, Minnesota Leisure Time Physical Activity Questionnaire and Mini Mental State Examination. Statistical analysis involved binary logistic regression. One hundred forty-two older adults (85 with cataracts) participated in the study (mean age: 69.39 ± 5.67 years). Falls were associated with the female sex (OR: 4.45) and sub-maximum score on the SPPB (OR: 3.53) among patients with cataracts, whereas multimorbidity (OR: 5.10) was the risk factor risk for older adults without cataracts. The data suggest different risk factors for falls among older adults diagnosed with cataracts.
Collapse
Affiliation(s)
- Leonardo Petrus da Silva Paz
- Faculdade de Ceilândia, Universidade de Brasília (UnB). Universidade de Brasília,. QNN14 AE CEI-Sul, Guariroba. 72220-140 Brasília DF Brasil.
| | | | | | | | | | | |
Collapse
|
47
|
Jang IY, Kim HR, Lee E, Jung HW, Park H, Cheon SH, Lee YS, Park YR. Impact of a Wearable Device-Based Walking Programs in Rural Older Adults on Physical Activity and Health Outcomes: Cohort Study. JMIR Mhealth Uhealth 2018; 6:e11335. [PMID: 30463838 PMCID: PMC6282012 DOI: 10.2196/11335] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/01/2018] [Accepted: 08/01/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Community-dwelling older adults living in rural areas are in a less favorable environment for health care compared with urban older adults. We believe that intermittent coaching through wearable devices can help optimize health care for older adults in medically limited environments. OBJECTIVE We aimed to evaluate whether a wearable device and mobile-based intermittent coaching or self-management could increase physical activity and health outcomes of small groups of older adults in rural areas. METHODS To address the above evaluation goal, we carried out the "Smart Walk" program, a health care model wherein a wearable device is used to promote self-exercise particularly among community-dwelling older adults managed by a community health center. We randomly selected older adults who had enrolled in a population-based, prospective cohort study of aging, the Aging Study of Pyeongchang Rural Area. The "Smart Walk" program was a 13-month program conducted from March 2017 to March 2018 and included 6 months of coaching, 1 month of rest, and 6 months of self-management. We evaluated differences in physical activity and health outcomes according to frailty status and conducted pre- and postanalyses of the Smart Walk program. We also performed intergroup analysis according to adherence of wearable devices. RESULTS We recruited 22 participants (11 robust and 11 prefrail older adults). The two groups were similar in most of the variables, except for age, frailty index, and Short Physical Performance Battery score associated with frailty criteria. After a 6-month coaching program, the prefrail group showed significant improvement in usual gait speed (mean 0.73 [SD 0.11] vs mean 0.96 [SD 0.27], P=.02), International Physical Activity Questionnaire scores in kcal (mean 2790.36 [SD 2224.62] vs mean 7589.72 [SD 4452.52], P=.01), and European Quality of Life-5 Dimensions score (mean 0.84 [SD 0.07] vs mean 0.90 [SD 0.07], P=.02), although no significant improvement was found in the robust group. The average total step count was significantly different and was approximately four times higher in the coaching period than in the self-management period (5,584,295.83 vs 1,289,084.66, P<.001). We found that participants in the "long-self" group who used the wearable device for the longest time showed increased body weight and body mass index by mean 0.65 (SD 1.317) and mean 0.097 (SD 0.513), respectively, compared with the other groups. CONCLUSIONS Our "Smart Walk" program improved physical fitness, anthropometric measurements, and geriatric assessment categories in a small group of older adults in rural areas with limited resources for monitoring. Further validation through various rural public health centers and in a large number of rural older adults is required.
Collapse
Affiliation(s)
- Il-Young Jang
- Division of Geriatric Medicine, Department of Internal Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Hae Reong Kim
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eunju Lee
- Division of Geriatric Medicine, Department of Internal Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Hee-Won Jung
- Graduate School of Medical Science And Engineering, Korea Advanced Institute Of Science And Technology, Daejeon, Republic of Korea
| | - Hyelim Park
- Division of Geriatric Medicine, Department of Internal Medicine, Asan Medical Center, Seoul, Republic of Korea.,Pyeongchang Health Center & Country Hospital, Gangwon-do, Republic of Korea
| | - Seon-Hee Cheon
- Pyeongchang Health Center & Country Hospital, Gangwon-do, Republic of Korea
| | - Young Soo Lee
- Division of Geriatric Medicine, Department of Internal Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Yu Rang Park
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
48
|
Khow KSF, Dollard J, Bray K, Smyth C, Chehade M, Theou O, Visvanathan R. A randomized controlled feasibility study to evaluate the effects of a goal-setting coaching intervention using feedback from an accelerometer on sedentary time in older people at risk of falls (SMART-MOVE): a study protocol. Pilot Feasibility Stud 2018; 4:173. [PMID: 30473871 PMCID: PMC6240173 DOI: 10.1186/s40814-018-0366-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 11/04/2018] [Indexed: 12/24/2022] Open
Abstract
Background Sedentary behaviour and falls are important interrelated health issues in older people. One in three people aged 65 years and above fall at least once a year and sedentary behaviour has been identified as one of the risk factors for falls. Studies have shown that the duration of sedentary time increases with age. These dual problems need to be addressed effectively as the ageing population grows. Accelerometers enable accurate measurement of sedentary time. This study aims to establish the feasibility and effect of an individualized goal-setting health coaching intervention using feedback initially from an accelerometer and then pedometer over a period of 12 weeks (intervention) compared with providing a one-off advice through a brochure (control), on sedentary time in older people with a recent fall or at risk of one. Methods A single-blinded randomized controlled feasibility trial involving 80 community-dwelling people aged 65 years and above will be conducted with 40 randomized to the intervention and another 40 to control. Primary outcomes will be the feasibility of the intervention and change in total sedentary time at 12 and 24 weeks. Secondary outcomes include a change in fear of falling based on the falls efficacy scale, gait speed, self-reported sedentary time, the proportion of fallers and number of falls. Four focus groups (two from each arm) will be conducted at the end of the study to evaluate the feasibility and effectiveness of this intervention. Feasibility findings will be primarily descriptive. Mean group differences will be examined using independent samples t test for normally distributed data and nonparametric tests (Kruskal-Wallis and Mann-Whitney U) for non-normally distributed data. Differences in frequency of variables will be compared using chi-square test. Analysis of variance (ANOVA) will be used to test the post-intervention difference between the two groups at 12 and 24 weeks. Discussion The trial will address a key gap in evidence about sedentary behaviour and falls amongst older people and will evaluate the feasibility of an intervention that could be implemented within the primary health care settings. Trial registration Australian New Zealand Clinical Trials Registry 12617001186347, Registered 11 August 2017.
Collapse
Affiliation(s)
- Kareeann Sok-Fun Khow
- National Health and Medical Research Council Centre for Research Excellence in Frailty and Healthy Ageing, Adelaide, South Australia Australia.,2Adelaide Geriatrics Training and Research with Aged Care (G-TRAC Centre), Discipline of Medicine, Adelaide Medical School, University of Adelaide, 61 Silkes Road Paradise, Adelaide, South Australia SA 5075 Australia.,Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, SA Health, Adelaide, South Australia Australia
| | - Joanne Dollard
- National Health and Medical Research Council Centre for Research Excellence in Frailty and Healthy Ageing, Adelaide, South Australia Australia.,2Adelaide Geriatrics Training and Research with Aged Care (G-TRAC Centre), Discipline of Medicine, Adelaide Medical School, University of Adelaide, 61 Silkes Road Paradise, Adelaide, South Australia SA 5075 Australia
| | - Kathy Bray
- Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, SA Health, Adelaide, South Australia Australia
| | - Carla Smyth
- Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, SA Health, Adelaide, South Australia Australia
| | - Mellick Chehade
- 4Centre for Orthopaedic Trauma and Research, Royal Adelaide Hospital, The University of Adelaide, Adelaide, South Australia Australia
| | - Olga Theou
- National Health and Medical Research Council Centre for Research Excellence in Frailty and Healthy Ageing, Adelaide, South Australia Australia.,5Geriatric Medicine, Dalhousie University, Halifax, Canada
| | - Renuka Visvanathan
- National Health and Medical Research Council Centre for Research Excellence in Frailty and Healthy Ageing, Adelaide, South Australia Australia
| |
Collapse
|
49
|
Soares WJS, Lopes AD, Nogueira E, Candido V, de Moraes SA, Perracini MR. Physical Activity Level and Risk of Falling in Community-Dwelling Older Adults: Systematic Review and Meta-Analysis. J Aging Phys Act 2018; 27:1-10. [PMID: 29543113 DOI: 10.1123/japa.2017-0413] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This systematic review examines the association between physical activity (PA) level and risk of falling in community-dwelling older adults. A search of PubMed, Embase, CINAHL, SPORTDiscus, and Web of Science was performed in January 2017. Four prospective cohort studies investigating the incidence of falls in a period of at least 12 months and its association with the level of PA in people aged 60 years and older were reviewed and pooled for meta-analysis. The pooled risk ratio (RR) for being a recurrent faller (2,420 participants) was 39% higher among those who were in the lowest PA level (RR = 1.39; 95% confidence interval [1.17, 1.65]; I2 = 0%, p = .43; p < .0001). The association between being a faller (7,927 participants) and PA level was inconclusive. This review identified that the benefit of general PA for preventing falls is associated with the adopted PA level.
Collapse
|
50
|
Martins AC, Moreira J, Silva C, Silva J, Tonelo C, Baltazar D, Rocha C, Pereira T, Sousa I. Multifactorial Screening Tool for Determining Fall Risk in Community-Dwelling Adults Aged 50 Years or Over (FallSensing): Protocol for a Prospective Study. JMIR Res Protoc 2018; 7:e10304. [PMID: 30072360 PMCID: PMC6096167 DOI: 10.2196/10304] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 05/02/2018] [Accepted: 05/05/2018] [Indexed: 12/16/2022] Open
Abstract
Background Falls are a major health problem among older adults. The risk of falling can be increased by polypharmacy, vision impairment, high blood pressure, environmental home hazards, fear of falling, and changes in the function of musculoskeletal and sensory systems that are associated with aging. Moreover, individuals who experienced previous falls are at higher risk. Nevertheless, falls can be prevented by screening for known risk factors. Objective The objective of our study was to develop a multifactorial, instrumented, screening tool for fall risk, according to the key risk factors for falls, among Portuguese community-dwelling adults aged 50 years or over and to prospectively validate a risk prediction model for the risk of falling. Methods This prospective study, following a convenience sample method, will recruit community-dwelling adults aged 50 years or over, who stand and walk independently with or without walking aids in parish councils, physical therapy clinics, senior’s universities, and other facilities in different regions of continental Portugal. The FallSensing screening tool is a technological solution for fall risk screening that includes software, a pressure platform, and 2 inertial sensors. The screening includes questions about demographic and anthropometric data, health and lifestyle behaviors, a detailed explanation about procedures to accomplish 6 functional tests (grip strength, Timed Up and Go, 30 seconds sit to stand, step test, 4-Stage Balance test “modified,” and 10-meter walking speed), 3 questionnaires concerning environmental home hazards, and an activity and participation profile related to mobility and self-efficacy for exercise. Results The enrollment began in June 2016 and we anticipate study completion by the end of 2018. Conclusions The FallSensing screening tool is a multifactorial and evidence-based assessment which identifies factors that contribute to fall risk. Establishing a risk prediction model will allow preventive strategies to be implemented, potentially decreasing fall rate. Registered Report Identifier RR1-10.2196/10304
Collapse
Affiliation(s)
- Anabela Correia Martins
- Physiotherapy Department, Coimbra Health School, Polytechnic Institute of Coimbra, Coimbra, Portugal
| | - Juliana Moreira
- Physiotherapy Department, Coimbra Health School, Polytechnic Institute of Coimbra, Coimbra, Portugal
| | - Catarina Silva
- Physiotherapy Department, Coimbra Health School, Polytechnic Institute of Coimbra, Coimbra, Portugal
| | | | | | - Daniela Baltazar
- Physiotherapy Department, Coimbra Health School, Polytechnic Institute of Coimbra, Coimbra, Portugal
| | - Clara Rocha
- Complementary Sciences Department, Coimbra Health School, Polytechnic Institute of Coimbra, Coimbra, Portugal.,Institute for Systems Engineering and Computers at Coimbra, Coimbra, Portugal
| | - Telmo Pereira
- Clinical Physiology Department, Coimbra Health School, Polytechnic Institute of Coimbra, Coimbra, Portugal
| | - Inês Sousa
- Fraunhofer Portugal AICOS, Porto, Portugal
| |
Collapse
|