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Chen L, Huang H, Jiang S, Yao H, Xu L, Huang Q, Xiao M, Zhao Q. Facilitators and barriers to the implementation of dietary nutrition interventions for community-dwelling older adults with physical frailty and sarcopenia: A qualitative meta-synthesis. Int J Nurs Sci 2024; 11:18-30. [PMID: 38352282 PMCID: PMC10859587 DOI: 10.1016/j.ijnss.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 12/02/2023] [Accepted: 12/11/2023] [Indexed: 02/16/2024] Open
Abstract
Objectives With the acceleration of an aging society, the prevalence of age-related chronic diseases such as physical frailty and sarcopenia is gradually increasing with numerous adverse effects. Dietary nutrition is an important modifiable risk factor for the management of physical frailty and sarcopenia, but there are many complex influences on its implementation in community settings. This study aimed to summarize the facilitators and barriers to the implementation of dietary nutrition interventions for community-dwelling older adults with physical frailty and sarcopenia, and to provide a reference for the formulation of relevant health management programs. Methods Searches were conducted in databases including PubMed, Web of Science, Medline (Ovid), Embase (Ovid), and Cochrane Library from inception to January 2023. Searches were completed for a combination of MeSH terms and free terms. The Critical Appraisal Skills Program (CASP) instrument was used to appraise quality. Coding and analysis of the extracted information were performed using the socio-ecological modeling framework. The study protocol for this review was registered on the PROSPERO ( CRD42022381339). Results A total of 10 studies were included. Of these, four were nutrition-only focused interventions, and six were dietary nutrition and exercise interventions. The facilitators and barriers were summarized based on the socio-ecological model that emerged at three levels: individual trait level, external environment level, and intervention-related level, containing ten subthemes. Conclusion Individual internal motivation and external support should be integrated with the implementation of diet- and nutrition-related interventions in community-living aged people with physical frailty and sarcopenia. Develop "tailored" interventions for participants and maximize available human and physical resources.
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Affiliation(s)
- Lijuan Chen
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Huanhuan Huang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Siqi Jiang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Haiyan Yao
- Library, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Xu
- Health Management Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qi Huang
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Mingzhao Xiao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Meigh NJ, Davidson AR, Keogh JWL, Hing W. "If somebody had told me I'd feel like I do now, I wouldn't have believed them…" older adults' experiences of the BELL trial: a qualitative study. BMC Geriatr 2022; 22:481. [PMID: 35658902 PMCID: PMC9164186 DOI: 10.1186/s12877-022-03174-5] [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: 08/30/2021] [Accepted: 05/12/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives This study examined older adults’ experiences of participating in the Ballistic Exercise of the Lower Limb (BELL) trial, involving 12-weeks of group-based hardstyle kettlebell training. Methods In the BELL trial, 28 insufficiently active older adults (15 women, 13 men, 59–79 years) completed six weeks of face-to-face group training, and six weeks of home-based training. In-depth semi-structured interviews were audio recorded, transcribed, and inductively coded, with themes constructed from patterns of shared meaning. Results Four higher-order themes were developed that reflect older adults’ experiences participating in a group-exercise program of hardstyle kettlebell training. These included: (1) “It’s one of the best things we’ve done”—enjoying the physical and psychosocial benefits, (2) “It’s improved it tremendously!”—change in a long-term health condition, (3) “It put me on a better course”—overcoming challenges, and (4) “I wasn’t just a number”—feeling part of a group/community. Discussion Findings highlight the perceived physical and psychological benefits of older adults participating in hardstyle group kettlebell training, and the value attributed to being part of an age-matched community of like-minded people engaged in group exercise. Implications for program design and delivery, and future research, are discussed. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03174-5.
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Affiliation(s)
- Neil J Meigh
- Faculty of Health Sciences and Medicine, Bond University, Bond Institute of Health & Sport, Gold Coast, QLD, 4226, Australia.
| | - Alexandra R Davidson
- Faculty of Health Sciences and Medicine, Bond University, Bond Institute of Health & Sport, Gold Coast, QLD, 4226, Australia
| | - Justin W L Keogh
- Faculty of Health Sciences and Medicine, Bond University, Bond Institute of Health & Sport, Gold Coast, QLD, 4226, Australia.,Sports Performance Research Centre New Zealand, AUT University, Auckland, New Zealand.,Kasturba Medical College, Manipal Academy of Higher Education Mangalore, Manipal, Karnataka, India
| | - Wayne Hing
- Faculty of Health Sciences and Medicine, Bond University, Bond Institute of Health & Sport, Gold Coast, QLD, 4226, Australia
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Sergeev K, Runnova A, Zhuravlev M, Kolokolov O, Akimova N, Kiselev A, Titova A, Slepnev A, Semenova N, Penzel T. Wavelet skeletons in sleep EEG-monitoring as biomarkers of early diagnostics of mild cognitive impairment. CHAOS (WOODBURY, N.Y.) 2021; 31:073110. [PMID: 34340349 DOI: 10.1063/5.0055441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/15/2021] [Indexed: 06/13/2023]
Abstract
Many neuro-degenerative diseases are difficult to diagnose in their early stages. For example, early diagnosis of Mild Cognitive Impairment (MCI) requires a wide variety of tests to distinguish MCI symptoms and normal consequences of aging. In this article, we use the wavelet-skeleton approach to find some characteristic patterns in the electroencephalograms (EEGs) of healthy adult patients and patients with cognitive dysfunctions. We analyze the EEG activity recorded during natural sleep of 11 elderly patients aged between 60 and 75, six of whom have mild cognitive impairment, and apply a nonlinear analysis method based on continuous wavelet transformskeletons. Our studies show that a comprehensive analysis of EEG signals of the entire sleep state allows us to identify a significant decrease in the average duration of oscillatory patterns in the frequency band [12; 14] Hz in the presence of mild cognitive impairment. Thus, the changes in this frequency range can be interpreted as related to the activity in the motor cortex, as a candidate for developing the criteria for early objective MCI.
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Affiliation(s)
- Konstantin Sergeev
- Saratov State University, Astrakhanskaya Str., 83, Saratov 410012, Russia
| | - Anastasiya Runnova
- Saratov State University, Astrakhanskaya Str., 83, Saratov 410012, Russia
| | - Maksim Zhuravlev
- Saratov State University, Astrakhanskaya Str., 83, Saratov 410012, Russia
| | - Oleg Kolokolov
- Saratov State Medical University, B. Kazachaya Str., 112, Saratov 410012, Russia
| | - Nataliya Akimova
- Saratov State Medical University, B. Kazachaya Str., 112, Saratov 410012, Russia
| | - Anton Kiselev
- Saratov State Medical University, B. Kazachaya Str., 112, Saratov 410012, Russia
| | - Anastasiya Titova
- Saratov State Medical University, B. Kazachaya Str., 112, Saratov 410012, Russia
| | - Andrei Slepnev
- Saratov State University, Astrakhanskaya Str., 83, Saratov 410012, Russia
| | - Nadezhda Semenova
- Saratov State University, Astrakhanskaya Str., 83, Saratov 410012, Russia
| | - Thomas Penzel
- Saratov State University, Astrakhanskaya Str., 83, Saratov 410012, Russia
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Chastin S, Gardiner PA, Harvey JA, Leask CF, Jerez-Roig J, Rosenberg D, Ashe MC, Helbostad JL, Skelton DA. Interventions for reducing sedentary behaviour in community-dwelling older adults. Cochrane Database Syst Rev 2021; 6:CD012784. [PMID: 34169503 PMCID: PMC8225503 DOI: 10.1002/14651858.cd012784.pub2] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Older adults are the most sedentary segment of society, often spending in excess of 8.5 hours a day sitting. Large amounts of time spent sedentary, defined as time spend sitting or in a reclining posture without spending energy, has been linked to an increased risk of chronic diseases, frailty, loss of function, disablement, social isolation, and premature death. OBJECTIVES To evaluate the effectiveness of interventions aimed at reducing sedentary behaviour amongst older adults living independently in the community compared to control conditions involving either no intervention or interventions that do not target sedentary behaviour. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, PsycINFO, PEDro, EPPI-Centre databases (Trials Register of Promoting Health Interventions (TRoPHI) and the Obesity and Sedentary behaviour Database), WHO ICTRP, and ClinicalTrials.gov up to 18 January 2021. We also screened the reference lists of included articles and contacted authors to identify additional studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) and cluster-RCTs. We included interventions purposefully designed to reduce sedentary time in older adults (aged 60 or over) living independently in the community. We included studies if some of the participants had multiple comorbidities, but excluded interventions that recruited clinical populations specifically (e.g. stroke survivors). DATA COLLECTION AND ANALYSIS Two review authors independently screened titles and abstracts and full-text articles to determine study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted authors for additional data where required. Any disagreements in study screening or data extraction were settled by a third review author. MAIN RESULTS We included seven studies in the review, six RCTs and one cluster-RCT, with a total of 397 participants. The majority of participants were female (n = 284), white, and highly educated. All trials were conducted in high-income countries. All studies evaluated individually based behaviour change interventions using a combination of behaviour change techniques such as goal setting, education, and behaviour monitoring or feedback. Four of the seven studies also measured secondary outcomes. The main sources of bias were related to selection bias (N = 2), performance bias (N = 6), blinding of outcome assessment (N = 2), and incomplete outcome data (N = 2) and selective reporting (N=1). The overall risk of bias was judged as unclear. Primary outcomes The evidence suggests that interventions to change sedentary behaviour in community-dwelling older adults may reduce sedentary time (mean difference (MD) -44.91 min/day, 95% confidence interval (CI) -93.13 to 3.32; 397 participants; 7 studies; I2 = 73%; low-certainty evidence). We could not pool evidence on the effect of interventions on breaks in sedentary behaviour or time spent in specific domains such as TV time, as data from only one study were available for these outcomes. Secondary outcomes We are uncertain whether interventions to reduce sedentary behaviour have any impact on the physical or mental health outcomes of community-dwelling older adults. We were able to pool change data for the following outcomes. • Physical function (MD 0.14 Short Physical Performance Battery (SPPB) score, 95% CI -0.38 to 0.66; higher score is favourable; 98 participants; 2 studies; I2 = 26%; low-certainty evidence). • Waist circumference (MD 1.14 cm, 95% CI -1.64 to 3.93; 100 participants; 2 studies; I2 = 0%; low-certainty evidence). • Fitness (MD -5.16 m in the 6-minute walk test, 95% CI -36.49 to 26.17; higher score is favourable; 80 participants; 2 studies; I2 = 29%; low-certainty evidence). • Blood pressure: systolic (MD -3.91 mmHg, 95% CI -10.95 to 3.13; 138 participants; 3 studies; I2 = 73%; very low-certainty evidence) and diastolic (MD -0.06 mmHg, 95% CI -5.72 to 5.60; 138 participants; 3 studies; I2 = 97%; very low-certainty evidence). • Glucose blood levels (MD 2.20 mg/dL, 95% CI -6.46 to 10.86; 100 participants; 2 studies; I2 = 0%; low-certainty evidence). No data were available on cognitive function, cost-effectiveness or adverse effects. AUTHORS' CONCLUSIONS It is not clear whether interventions to reduce sedentary behaviour are effective at reducing sedentary time in community-dwelling older adults. We are uncertain if these interventions have any impact on the physical or mental health of community-dwelling older adults. There were few studies, and the certainty of the evidence is very low to low, mainly due to inconsistency in findings and imprecision. Future studies should consider interventions aimed at modifying the environment, policy, and social and cultural norms. Future studies should also use device-based measures of sedentary time, recruit larger samples, and gather information about quality of life, cost-effectiveness, and adverse event data.
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Affiliation(s)
- Sebastien Chastin
- School of Health & Life Sciences, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, UK
- Department of Movement and Sports Sciences, Ghent University, Gent, Belgium
| | - Paul A Gardiner
- School of Health & Wellbeing, University of Southern Queensland, Ipswich, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Juliet A Harvey
- School of Health & Life Sciences, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, UK
| | - Calum F Leask
- Aberdeen City Health & Social Care Partnership, Aberdeen, UK
| | - Javier Jerez-Roig
- Department of Social Sciences and Community Health, Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia, Vic, Spain
| | - Dori Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Maureen C Ashe
- Centre for Hip Health and Mobility, Department of Family Practice, The University of British Columbia, Vancouver, Canada
| | - Jorunn L Helbostad
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Dawn A Skelton
- School of Health & Life Sciences, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, UK
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von Berens Å, Fielding RA, Gustafsson T, Kirn D, Laussen J, Nydahl M, Reid K, Travison TG, Zhu H, Cederholm T, Koochek A. Effect of exercise and nutritional supplementation on health-related quality of life and mood in older adults: the VIVE2 randomized controlled trial. BMC Geriatr 2018; 18:286. [PMID: 30463527 PMCID: PMC6249766 DOI: 10.1186/s12877-018-0976-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 11/06/2018] [Indexed: 11/12/2022] Open
Abstract
Background Health-related quality of life (HRQoL) and absence of depressive symptoms are of great importance for older people, which may be achieved through lifestyle interventions, e.g., exercise and nutrition interventions. The aim of this investigation was to analyze the effects of a physical activity program in combination with protein supplementation on HRQoL and depressive symptoms in community-dwelling, mobility-limited older adults. Methods In the Vitality, Independence, and Vigor 2 Study (VIVE2), community-dwelling men and women with an average age of 77.5 ± 5.4 years, some mobility limitations and low serum vitamin D levels (25(OH)Vit D 22.5–60 nmol/l) from two study sites (Stockholm, Sweden and Boston, USA) were randomized to receive a nutritional supplement or a placebo for 6 months. All took part in a physical activity program 2–3 times/ week. The primary outcome examined in VIVE2 was 400 M walk capacity. HRQoL was measured using the Medical Outcomes Study 36-item Short Form Health Survey (SF36), consisting of the Physical Component Summary (PCS) and Mental Component Summary (MCS), and depressive symptoms were measured using The Centre for Epidemiologic Studies Depression Scale (CES-D). In the sensitivity analyses, the sample was divided into sub-groups based on body measures and function (body mass index (BMI), appendicular lean mass index (ALMI), handgrip strength and gait speed). Results For the whole sample, there was a significant improvement in both MCS, mean (95% CI) 2.68 (0.5, 4.9) (p 0.02), and CES-D -2.7 (− 4.5, − 0.9) (p 0.003) during the intervention, but no difference was detected between those who received the nutritional supplement and those who received the placebo. The results revealed no significant change in PCS or variation in effects across the sub-categories. Conclusions This study demonstrates that a six-month intervention using a physical activity program had positive effects on mental status. No additional effects from nutritional supplementation were detected. Trial registration Registered at ClinicalTrials.gov, March 2 2012, NCT01542892.
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Affiliation(s)
- Åsa von Berens
- Department of Public Health and Caring Sciences/Clinical Nutrition and Metabolism, Uppsala University, Uppsala Science Park, 751 85, Uppsala, Sweden.
| | - Roger A Fielding
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Thomas Gustafsson
- Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Dylan Kirn
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Jonathan Laussen
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Margaretha Nydahl
- Department of Food studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Kieran Reid
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Thomas G Travison
- Harvard Medical School, Boston, MA, USA.,Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
| | - Hao Zhu
- Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences/Clinical Nutrition and Metabolism, Uppsala University, Uppsala Science Park, 751 85, Uppsala, Sweden
| | - Afsaneh Koochek
- Department of Public Health and Caring Sciences/Clinical Nutrition and Metabolism, Uppsala University, Uppsala Science Park, 751 85, Uppsala, Sweden.,Department of Food studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
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