Feelings of well being in elderly people: relationship to physical activity and physical function

Quality of Life among LGBTQ Older Adults in the United States: A Systematic Review

BACKGROUND

Sexual and gender minorities constitute a rapidly growing part of the older adult population in the United States and may face quality of life (QOL) challenges in older adulthood. Research on quality of life among lesbian, gay, bisexual, transgender, and queer (LGBTQ) older adults has increased dramatically since 2010. Common findings indicate that LGBTQ older adults face challenges related to personal experiences of discrimination, anticipated discrimination in health care settings, and lack of family support. Research designs were primarily nonprobability surveys, with a small number of qualitative designs and surveys using representative probability samples.

AIM

To identify and summarize research on QOL among LGBTQ older adults conducted in the United States between January 1, 2000 and December 31, 2020.

METHOD

Four scholarly databases were searched to identify studies addressing QOL in LGBTQ older adult populations.

RESULTS

The database search produced a total 568 unique results. Of these, 54 research articles were identified that met all inclusion criteria for the review. Appraisal of evidence was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology.

CONCLUSIONS

Care for mental health of LGBTQ older adults should be sensitive to issues including lifetime history of discrimination, anxiety about anticipated discrimination from health care providers, and potential lack of family support. Focus can also be given to common areas of strength, including strengthening nonfamily social networks.

Relationship of psychotropic medication use with physical function among postmenopausal women

To examine cross-sectional and longitudinal relationships of psychotropic medications with physical function after menopause. Analyses involved 4557 Women's Health Initiative Long Life Study (WHI-LLS) participants (mean age at WHI enrollment (1993-1998): 62.8 years). Antidepressant, anxiolytic, and sedative/hypnotic medications were evaluated at WHI enrollment and 3-year follow-up visits. Performance-based physical function [Short Physical Performance Battery (SPPB)] was assessed at the 2012-2013 WHI-LLS visit. Self-reported physical function [RAND-36] was examined at WHI enrollment and the last available follow-up visit-an average of 22 [±2.8] (range: 12-27) years post-enrollment. Multivariable regression models controlled for socio-demographic, lifestyle, and health characteristics. Anxiolytics were not related to physical function. At WHI enrollment, antidepressant use was cross-sectionally related to worse self-reported physical function defined as a continuous (β = -6.27, 95% confidence interval [CI]: -8.48, -4.07) or as a categorical (< 78 vs. ≥ 78) (odds ratio [OR] = 2.10, 95% CI: 1.48, 2.98) outcome. Antidepressant use at WHI enrollment was also associated with worse performance-based physical function (SPPB) [< 10 vs. ≥ 10] (OR = 1.53, 95% CI: 1.05, 2.21) at the 2012-2013 WHI-LLS visit. Compared to non-users, those using sedative/hypnotics at WHI enrollment but not at the 3-year follow-up visit reported a faster decline in physical function between WHI enrollment and follow-up visits. Among postmenopausal women, antidepressant use was cross-sectionally related to worse self-reported physical function, and with worse performance-based physical function after > 20 years of follow-up. Complex relationships found for hypnotic/sedatives were unexpected and necessitate further investigation.

Social participation, subjective well-being, and cognitive function as serial mediators between tooth loss and functional limitations in older Chinese adults

BACKGROUND

Although tooth loss appears to be related to functional limitations, the mechanisms that underpin this relationship are unknown. We sought to address this knowledge gap by examining a multiple mediation hypothesis whereby tooth loss is predicted to indirectly affect functional limitations through social participation, subjective well-being, and cognitive function.

METHODS

This study included 7,629 Chinese adults from the 2017/2018 Chinese Longitudinal Healthy Longevity Survey wave. The serial mediation effects were examined using Model 6 in the Hayes' PROCESS macro for SPSS.

RESULTS

Tooth loss was significantly related to functional limitations. There was a direct (β = - 0.0308; 95% CI, - 0.0131 to - 0.0036) and indirect (β = - 0.0068; 95% CI, - 0.0096 to - 0.0041) association between tooth loss and instrumental activities of daily living (IADL) limitations, but only an indirect correlation with activities of daily living (ADL) limitations (β = - 0.0188; 95% CI, - 0.0259 to - 0.0121). Social participation, subjective well-being, and cognitive function serially mediated the relationship between tooth loss and ADL/IADL limitations.

CONCLUSION

The association between tooth loss and functional limitations is serially mediated by social participation, subjective well-being, and cognitive function. Our findings underscore the necessity of considering psychological and social factors as integrated healthcare approaches for the functional health of older adults.

Subjective well-being patterns in older men and women without someone to confide in: a latent class analysis approach

Objective

This study aimed to identify the latent subtypes of subjective well-being (SWB) and associated factors in older adults without a confidant in China.

Methods

The data came from the most recent (seventh) wave (2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). This cross-sectional study included 350 older adults who lacked a close confidant. We utilized latent class analysis and multiple logistic regression models to examine the latent SWB subtypes and associated factors.

Results

Three distinct patterns of SWB were identified: the very low SWB class (32%), the medium-low SWB class (46%), and the low evaluative and high affective SWB class (22%). The results indicated that compared to the low evaluative and high affective SWB class, respondents who self-rated their health as not good, currently drank alcohol and rated their financial status as poor/very poor were more likely to be in the very low SWB class, while those who participated in social activities were less likely to be in the very low SWB class. Respondents who had limitations in instrumental activity of daily living (IADL) and rated their financial status as poor/very poor were more likely to be in the medium-low SWB class. However, gender did not affect SWB patterns.

Conclusion

Our findings highlight awareness of the heterogeneity of SWB in older adults without close confidants and provide valuable information for the development of tailored intervention programs to improve their well-being.

Differences in the influence of daily behavior on health among older adults in urban and rural areas: evidence from China

Background

As the population of older adult in China keeps growing, the degree of aging is becoming increasingly serious and the health of older adults is a growing concern. Comparing the personal characteristics and health levels of urban and rural older adults and determining the relationship between these factors are of great significance in maintaining their health. In addition, exploring how these relationships differ between urban and rural areas is important.

Method

This study conducted a literature review to examine the impact of various factors on the physical and mental health of older adults in urban and rural areas in China. Moreover, based on cross-sectional data from the 2017 Chinese General Social Survey (CGSS), urban-rural differences in the factors' degree of influence on the perceived health of older adults were studied using multiple logistic regression.

Results

Regular physical exercise had a powerful protective effect on urban older adults' physical and mental health, whereas regular participation in social activities had a positive impact on rural older adults' health. Low income, low educational level, low social trust, lack of a partner, and having more than one child negatively affected the physical health of rural older people. Low socioeconomic status had a negative impact on rural people's health both in mind and body. Overall, the rural adults' health status was found to be relatively low and deserves more attention.

Conclusion

This study demonstrated that older people's physical and mental health levels can be significantly affected by the frequency of daily activities and individual and family characteristics. Furthermore, urban-rural differences were observed. These findings could provide feasible suggestions for governments, communities, and older adults' family members to help alleviate health inequality.

Symptom Cluster Profiles in Adults with Chronic Obstructive Pulmonary Disease and Insomnia

BACKGROUND

People with chronic obstructive pulmonary disease (COPD) and insomnia may experience multiple symptoms that can affect physical function, but little research has focused on symptom clusters in this population.

OBJECTIVES

This study aimed to identify subgroups of people with COPD and insomnia based on a pre-specified symptom cluster and determine whether physical function differed in the subgroups.

METHODS

This secondary data analysis included 102 people with insomnia and COPD. Latent profile analysis classified subgroups of individuals sharing similar patterns of five symptoms: insomnia, dyspnea, fatigue, anxiety, and depression. Multinomial logistic regression and multiple regression determined factors associated with the subgroups and whether physical function differed among them.

RESULTS

Three groups of participants were identified based on the severity of all five symptoms: low (Class 1), intermediate (Class 2), and high (Class 3). Compared to Class 1, Class 3 showed lower self-efficacy for sleep and for COPD management and more dysfunctional beliefs and attitudes about sleep. Class 3 showed more dysfunctional beliefs and attitudes about sleep than Class 2. Class 1 showed significantly better physical function than Classes 2 and 3.

CONCLUSIONS

Self-efficacy for sleep and for COPD management and dysfunctional beliefs and attitudes about sleep were associated with class membership. As physical function differed among subgroups, interventions to improve self-efficacy for sleep and for COPD management and minimize dysfunctional beliefs and attitudes about sleep may reduce symptom cluster severity, in turn enhancing physical function.

Relationships among Physical Activity, Physical Function, and Food Intake in Older Japanese Adults Living in Urban Areas: A Cross-Sectional Study

Japan is experiencing a super-ageing society faster than anywhere else in the world. Consequently, extending healthy life expectancy is an urgent social issue. To realize a diet that can support the extension of healthy life expectancy, we studied the quantitative relationships among physical activities (number of steps and activity calculated using an accelerometer), physical functions (muscle strength, movement function, agility, static balance, dynamic balance, and walking function), and dietary intake among 469 older adults living in the Tokyo metropolitan area (65-75 years old; 303 women and 166 men) from 23 February 2017 to 31 March 2018. Physical activities and functions were instrumentally measured, and the dietary survey adopted the photographic record method. There was a significant positive association (p < 0.05) between physical activities (steps, medium-intensity activity, and high-intensity activity) and physical functions (movement function, static balance, and walking function), but no association with muscle strength. These three physical functions were significantly positively correlated with intake of vegetables, seeds, fruits, and milk; with magnesium, potassium, and vitamin B6; and with the dietary fibre/carbohydrate composition ratio (p < 0.05). Future intervention trials must verify if balancing diet and nutrition can improve physical activities in older adults through increased physical functions.

Effects of Physical Activity on Physical Fitness and Functional Ability in Older Adults

A cross-sectional survey was done to investigate the pathways the physical activity acts in improving physical fitness and functional outcomes of older adults (60 years and above) using 880 community-dwelling older adults in Sri Lanka. Structural Equation Modeling (SEM) was used. The final SEM model included five latent factors and 14 co-variances. Goodness of Fit Index (GFI), Comparative fit index (CFI) and Root Mean Square Error of Approximation (RMSEA) values of the model were 0.95, 0.93, 0.91, and 0.05 respectively, indicating a good model fit. Strength enhances balance (β = .52, p < .01) and reduces the time required to complete physical functions (β = -.65, p < .01). Since strength declines with advancing age, muscle-strengthening activity programs should be promoted to enhance balance and functional performances in older adults in advanced ages. Strength test (hand grip and leg strength) can be used as a screening test to predict potential risk of falls and functional disabilities in older adults.

Predictors of Health Satisfaction in Spanish Physically Active Older Adults: A Cross-Sectional Observational Study

Studies that analyze the predictors of satisfaction with the health of the elderly are scarce. That is the reason why the objective of this study is to analyze whether the physical-psychological state, sports practice, and the use of socio-health resources are factors that predict satisfaction with health status in physically active elderly people. The Physical Activity and Quality of Life questionnaires were applied to a sample of 397 elderly people in this cross-sectional observational study. The data have been analyzed using Student's t-test chi-square test, Cohen's d, Phi Coefficient and Cramer's V. The results have shown that the lack of physical illnesses (OR = 3.920; p < 0.001) and psychological problems (OR = 1.940; p = 0.032), practicing a high level of physical activity (OR = 2.049; p = 0.001), having high scores in functional skills (OR = 8.059; p < 0.001) and using little social and health services (OR = 2.595; p < 0.001) are all predictors of being highly satisfied with one's health. In conclusion, predictors associated with high health satisfaction of active older people have been found, such as functional abilities, the existence of physical illness, psychological problems, level of physical activity, frequency of use of health and social services and satisfaction with health and social services; but it is not associated with gender or age of participants.

Beyond physiology: Acute effects of side-alternating whole-body vibration on well-being, flexibility, balance, and cognition using a light and portable platform A randomized controlled trial

A good body-balance helps to prevent slips, trips and falls. New body-balance interventions must be explored, because effective methods to implement daily training are sparse. The purpose of the current study was to investigate acute effects of side-alternating whole-body vibration (SS-WBV) training on musculoskeletal well-being, flexibility, body balance, and cognition. In this randomized controlled trial, participants were randomly allocated into a verum (8.5 Hz, SS-WBV, N = 28) or sham (6 Hz, SS-WBV, N = 27) condition. The training consisted of three SS-WBV series that lasted one-minute each with two one-minute breaks in between. During the SS-WBV series, participants stood in the middle of the platform with slightly bent knees. During the breaks in between, participants could loosen up. Flexibility (modified fingertip-to-floor method), balance (modified Star Excursion Balance Test), and cognitive interference (Stroop Color Word Test) were tested before and after the exercise. Also, musculoskeletal well-being, muscle relaxation, sense of flexibility, sense of balance, and surefootedness were assessed in a questionnaire before and after the exercise. Musculoskeletal well-being was significantly increased only after verum. Also, muscle relaxation was significantly higher only after verum. The Flexibility-Test showed significant improvement after both conditions. Accordingly, sense of flexibility was significantly increased after both conditions. The Balance-Test showed significant improvement after verum, and after sham. Accordingly, increased sense of balance was significant after both conditions. However, surefootedness was significantly higher only after verum. The Stroop-Test showed significant improvement only after verum. The current study shows that one SS-WBV training session increases musculoskeletal well-being, flexibility, body balance and cognition. The abundance of improvements on a light and portable platform has great influence on the practicability of training in daily life, aiming to prevent slip trips and falls at work.

Relationship between university students' physical activity and mobile phone dependence: Mediating effect of subjective well-being and moderating effect of psychological capital

Background

With the ongoing development of the information society, the Internet and smartphones have become an essential way of life, but also fostered the problem of mobile phone dependence. Physical activity and subjective well-being have both been shown to correlate with mobile phone dependence, but the impact of subjective well-being on the relationship between physical activity and mobile phone dependence is not fully understood. This study investigates subjective well-being as a potential mediating variable in the relationship. It also investigates whether psychological capital moderates the association between subjective well-being and mobile phone dependence.

Methods

A total of 9,569 students from 38 universities in Jiangsu Province were selected. Participants were surveyed via the online questionnaire distribution platform Questionnaire Star. Common method bias test and Pearson correlation tests were used to analyze the study indicators, and the theoretical model for this study was validated using Process plug-in developed by Hayes and set at p < 0.05 (two- tail) as statistically significant.

Results

The levels of physical activity, subjective well-being, and psychological capital were all significantly higher for male students than female students. However, female students had a significantly higher level of mobile phone dependence. As predicted, there was a direct negative correlation between physical activity and mobile phone dependence, and subjective well-being mediated that relationship. Psychological capital moderated the relationship between subjective well-being and mobile phone dependence. It also positively moderated the indirect effect between physical activity and mobile phone dependence via subjective well-being.

The association between physical performance and subjective wellbeing in Chinese older adults: A cross-sectional study

Purpose

This study aimed to investigate the association between physical performance and subjective wellbeing among Chinese older adults.

Methods

Data on the Chinese population were gathered from the Study on Global Aging and Adult Health Survey (SAGE). This survey used a stratified multistage cluster sample design based on geographical location and economic status. Chinese older adults aged 65 years old or above from eight provinces (Guangdong, Hubei, Jilin, Shaanxi, Shandong, Shanghai, Yunnan, and Zhejiang) were included in this cross-sectional study. Physical performance was measured using relative handgrip strength and normal gait speed. Subjective wellbeing was measured using quality-of-life (QOL), happiness, and mood through interviews with participants. Logistic regressions were used to examine the associations between physical performance and each of the three wellbeing variables (QOL, happiness, and mood).

Results

Data of 5,421 Chinese older adults (mean age: 72.93 ± 5.89 years old, 47.1% men) were analyzed. In this sample, individuals with a higher level of relative handgrip strength (rHGS) had better mood compared to those with a lower level of rHGS (p < 0.05), and persons with lower gait speed had poorer QOL, happiness, and mood compared to those with faster gait speed (p < 0.05).

Conclusion

Our findings suggest that a higher level of relative handgrip strength predicted better mood and lower gait speed predicted poor QOL, happiness, and mood in Chinese older adults.

Association between Neutrophil-to-Lymphocyte Ratio and Physical Function in Older Adults: A Community-Based Cross-Sectional Study in Japan

Inflammatory responses contribute to physical decline in older adults. Clinical studies have shown that the neutrophil-to-lymphocyte ratio (NLR), a marker of inflammation, is associated with physical decline. However, its association with physical function in community-dwelling older people is still unclear. Hence, we used cross-sectional data to investigate the relationship between NLR and physical function in community-dwelling older adults. Specifically, we analyzed data corresponding to 818 individuals (336 men and 482 women) aged ≥ 75 years, all of whom participated in comprehensive health examinations, including face-to-face interviews, biochemical analyses, and physical function tests. Using these data, we performed multivariable logistic regression analysis to assess the relationship between NLR and physical function, adjusting for sex, age, education, alcohol consumption, smoking, instrumental activity of daily living, body mass index, chronic disease, physical activity, serum albumin level, and depressive mood. The results showed that a higher NLR was associated with a lower grip strength, lower knee extension strength, and slower walking speed. Importantly, the relationship between NLR and physical function was maintained after adjusting for the confounding factors. Thus, we showed a significant association between NLR and physical function, supporting the use of NLR as a marker of physical function in community-dwelling older adults.

Associations between physical exercise patterns and pain symptoms in individuals with endometriosis: a cross-sectional mHealth-based investigation

OBJECTIVES

This study investigates the association of daily physical exercise with pain symptoms in endometriosis. We also examined whether an individual's typical weekly (ie, habitual) exercise frequency influences (ie, moderates) the relationship between their pain symptoms on a given day (day t) and previous-day (day t-1) exercise.

PARTICIPANTS

The sample included 90 382 days of data from 1009 participants (~85% non-Hispanic white) living with endometriosis across 38 countries.

STUDY DESIGN

This was an observational, retrospective study conducted using data from a research mobile app (Phendo) designed for collecting self-reported data on symptoms and self-management of endometriosis.

PRIMARY OUTCOME MEASURES

The two primary outcomes were the composite day-level pain score that includes pain intensity and location, and the change in this score from previous day (Δ-score). We applied generalised linear mixed-level models to examine the effect of previous-day exercise and habitual exercise frequency on these outcomes. We included an interaction term between the two predictors to assess the moderation effect, and adjusted for previous-day pain, menstrual status, education level and body mass index.

RESULTS

The association of previous-day (day t-1) exercise with pain symptoms on day t was moderated by habitual exercise frequency, independent of covariates (rate ratio=0.96, 95% CI=0.95 to 0.98, p=0.0007 for day-level pain score, B=-0.14, 95% CI=-0.26 to -0.016, p=0.026 for Δ-score). Those who regularly engaged in exercise at least three times per week were more likely to experience favourable pain outcomes after having a bout of exercise on the previous day.

CONCLUSIONS

Regular exercise might influence the day-level (ie, short-term) association of pain symptoms with exercise. These findings can inform exercise recommendations for endometriosis pain management, especially for those who are at greater risk of lack of regular exercise due to acute exacerbation in their pain after exercise.

A View of the Development of Patient Reported Outcomes Measures, their Clinical Integration, Electronification, and Potential Impact on Rehabilitation Service Delivery

Recognition of the importance of a patient's perception of their status and experience has become central to medical care and its evaluation. This recognition has led to a growing reliance on the use of patient reported outcome measures (PROMs). Nevertheless, while awareness of PROMs and acceptance of their utility has increased markedly, few of us have a good insight into their development; their utility relative to clinician-rated and performance measures such as the FIM and 6-Minute Walk Test or how their "electronification" and incorporation into electronic health records (EHRs) may improve the individualization, value, and quality of medical care. In all, the goal of this commentary is to provide some insight into historical factors and technology developments that we believe have shaped modern clinical PROMs as they relate to medicine in general and to rehabilitation in particular. In addition, we speculate that while the growth of PROM use may have been triggered by an increased emphasis on the centrality of the patient in their care, future uptake will be shaped by their embedding in EHRs and use to improve clinical decision support though their integration with other sources of clinical and sociodemographic data.

Caffeine consumption improves motor and cognitive performances during dual tasking in middle-aged women

The aim of the present study was to explore the effect of caffeine consumption (CC) on cognitive motor interference while walking and maintaining balance in middle-aged women. Twenty middle-aged women (52 ± 2.0 years; height 158 ± 2.0 cm; body mass 77 ± 14.9 kg; body mass index ±3.4 kg/m², mean ± SD) participated in this study. Participants completed measures of a single task (ST) cognitive, a ST motor and a dual task (DT) cognitive-motor tests before and after either caffeine (100 mg) or placebo ingestion. Results showed that before CC, both motor (P < 0.0005) and cognitive (P < 0.05) performances decreased in the DT condition compared to the ST one. After CC, no significant difference in the motor performances between ST and DT conditions was observed. In fact, both standing and walking DT performances were improved as indicated by a significant (P < 0.05) decrease in the dual task cost (DTC) of motor performances. In conclusion, middle-aged women showed difficulties to manage DT situations in which a cognitive and a motor task must be performed concurrently. Caffeine is an effective ergogenic aid to improve both cognitive and motor performances during DT conditions and could be an alternative to nullify the deteriorating effect of DT when maintaining balance and walking in middle-aged women. These enhancements could offer great potential for everyday functioning.

Sex- and age-specific normative values for handgrip strength and components of the Senior Fitness Test in community-dwelling older adults aged 65-75 years in Germany: results from the OUTDOOR ACTIVE study

BACKGROUND

Physical fitness is a key component of independent living and healthy ageing. For the measurement of physical fitness in older adults, the Senior Fitness Test is a commonly used tool. The objective of this study is to calculate sex- and age-specific normative values for handgrip strength and components of the Senior Fitness Test for older adults (65-75 years) in Germany.

METHODS

Cross-sectional data of 1657 community-dwelling older adults residing in Bremen, Germany (53% female) were included in this study. Physical fitness was assessed using the following measurements of the Senior Fitness Test battery: 30s-chair stand test, 2 min-step test, sit-and-reach test, and back scratch test. In addition, handgrip strength was measured using a Saehan DHD-3 digital hand dynamometer SH1003. Sex- and age specific normative values were calculated for the 1st, 3rd, 10th, 25th, 50th, 75th, 90th, 97th, and 99th percentile using the GAMLSS method.

RESULTS

The normative values show differences dependent on sex and age. For handgrip strength, the 30s-chair stand test and the 2 min-step test, normative values were higher for men, while women reached higher values in the sit-and-reach test and the back scratch test. For both, men and women, normative values declined with age.

CONCLUSIONS

This study provides sex- and age-specific normative values for handgrip strength and components of the Senior Fitness Test for older adults in Germany. They might be useful for future research and for the application in practice.

Health lifestyles and Chinese oldest-old's subjective well-being-evidence from a latent class analysis

Background

Previous research on the associations between lifestyle behaviors and health has largely focused on morbidity, mortality and disease prevention. More attention should be paid to examining relationships between lifestyle behaviors and positive health outcomes such as well-being. The aim of the study was to classify Chinese oldest-old’s health lifestyles and evaluate the manner in which health lifestyles have impacted Chinese oldest-old’s subjective well-being.

Methods

Analyzing the 2014 Chinese Longitudinal Healthy Longevity Survey (CLHLS), latent class analysis was applied to identify predominant health lifestyles among Chinese oldest-old aged 85 to 105. Ordinary Least Square (OLS) regression models were used to assess the effects of health lifestyles on Chinese oldest-old’s subjective well-being, adjusting for socio-demographic characteristics.

Results

Four distinct classes representing health lifestyles emerged. Health lifestyles were found to be strongly associated with Chinese oldest-old’s subjective well-being, even after controlling for demographic features as well as individual and parental socioeconomic disadvantage. Findings showed that healthy lifestyle behaviors stimulated Chinese oldest-old’s positive feelings and led to better evaluative subjective well-being. In contrast, less healthy lifestyle behaviors can be a predictor of negative feelings.

Conclusions

The regression results highlighted the importance of integrating health lifestyle choices in promoting oldest-old’s psychological well-being. Elders can tackle healthier lifestyle behaviors in their daily lives to reduce the risk of mental health problems. Practicing healthy lifestyles should be integrated in programs for mental health promotion.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02121-0.

Effects of physical activity and sleep quality on well-being: A wrist actigraphy study during the pandemic

Previous studies identified the effects of daytime activity, sleep quality and ambient light exposure on individual well-being. These factors have been greatly changed as people are required to stay home during the COVID-19 pandemic; thus, it is necessary to verify whether these factors effect well-being during the pandemic. We recruited 70 adults (females: 46; age range: 31-60) during a high incidence of COVID-19 in China (17-27 February 2020). Both subjective measurements based on self-report scales and objective measurements collected using wrist actigraphy were employed to investigate the effects of night-time sleep and daytime activity on subjective well-being. The actigraphy data show that participants' total sleep time (>8 hr) is sufficient. Self-reported sleep quality was significantly worse than pre-pandemic, and self-reported daytime activity levels significantly decreased during the pandemic. Physical activity was positively related to well-being, both for self-reported daytime activity (r = .346, p = .003) and for objective measurements (r = .234, p = .051). Our study found that sleep and daytime activity levels were negatively affected by the pandemic. However, increased daytime physical activity could potentially reduce these negative effects.

Muscular Strength and Quality of Life in Older Adults: The Role of ACTN3 R577X Polymorphism

As longevity is increasing, the 65-year-old and older population is projected to increase in the next decades, as are the consequences of age-related muscle deterioration on the quality of life. The purpose of this study was to examine the associations of the ACTN3R577X polymorphism with quality of life and muscular strength in an older Spanish population. In total, 281 older adults participated in this study. Anthropometric measurements, chronic diseases, prescribed medications, quality of life, hand grip strength, and physical activity and nutritional status data were collected. ACTN3 R577X genotyping was determined using Taqman probes. Multivariate regression analysis revealed in adjusted model that, in men, the ACTN3 R577X genotype was significantly associated with hand grip strength (HGS), regression coefficient (β) = 1.23, p = 0.008, dimension 1 of the five-dimension questionnaire EuroQoL (EQ-5D, mobility), (β) = -1.44, p = 0.006, and clinical group risk (CGR) category (β) = -1.38, p = 0.006. In women, a marginal association between the ACTN3 R577X genotype and the CGR category was observed, with a regression coefficient of (β) = -0.97, (p = 0.024). Our findings suggest that the ACTN3 R577X genotype may influence the decline in muscle strength and quality of life in older Spanish adult males.

Accepting the inevitable: A mixed method approach with assessment and perceptions of well-being in very old persons within the northern Sweden Silver-MONICA study

BACKGROUND

As the group of very old persons will form an increasing part of society, the study of how well-being is described and affected by specific factors will be of importance to meet the future needs of these persons. The aim of the study was to increase knowledge of well-being in very old persons by combining assessments and perceptions using the Philadelphia Geriatric Morale Scale (PGCMS).

METHOD

In a mixed method, convergent parallel design, 52 persons 80 years or older were assessed and interviewed using the PGCMS to combine assessment of morale and descriptions of perceptions of well-being using a mixed method approach.

RESULTS

Quantitative and qualitative results converged in four areas: not feeling lonely and being included, rating and perceiving health as good, high physical function/ability and being physically active, living in own house and feeling at home. Areas perceived as important to well-being captured only in qualitative analysis were having freedom and engagement. An example of insights not achievable from the quantitative or qualitative analysis alone was that individuals with high morale expressed anxiety about losing their health due to potential ageing-related threats and that individuals with low morale struggled with acceptance. Acceptance was the key strategy for handling adverse consequences of ageing in all described areas.

CONCLUSION

When using standardized assessment scales in clinical practice, it could be useful to combine quantitative and qualitative data. Acceptance was key for well-being; however, acceptance could be resigned or reorienting in nature.

Wearable device adoption among older adults: A mixed-methods study

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Using a mixed-methods approach, we analyzed the adoption of wearable devices among older adults.

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Perceived complexity of devices (specifically interpreting the outputs) is the most salient deterrent of adoption.

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The effect of cognitive age on adoption is moderated by subjective well-being (SWB).

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Cognitive age negatively (vs. positively) impacts the older adults’ adoption intention when their SWB is high (vs. low).

Recently, the popularity of smart wearable technologies, such as Fitbit, has significantly increased. There are numerous potential benefits in using these devices, especially among seniors. Yet, little is known about seniors’ adoption behavior. Through a mixed-methods approach, this study investigates the factors that impact seniors’ intention to use wearable devices. Results from an online survey and interviews showed that seniors’ perception of the complexity of working with these devices is a barrier to their adoption decisions. Looking more deeply into the role of complexity revealed that seniors’ concern about the complexity of reading and interpreting the output of wearable devices is the main deterring element. Furthermore, we explored the role of two important elements: seniors’ cognitive age, and the influence of their subjective well-being on their adoption behavior. Results demonstrated that cognitive age does not significantly impact use intention by itself; nonetheless, subjective well-being moderates its effect. This result revealed an interesting finding, which is that the influence of cognitive age on seniors’ use intention depends on seniors’ level of subjective well-being. When seniors’ subjective well-being is low, surprisingly, cognitive age increases seniors’ intention to use the device. These findings provide interesting implications for practice and future research.

Physical Activity and Physical Function in Older Adults Living in a Retirement Community: A Cross-Sectional Analysis Focusing on Self-Rated Health

Perceived health is a widely used proxy for measuring individuals' health status across different populations, including older adults. This measure is commonly reported as a subjective indicator, as a strong predictor of longer-term morbidity and mortality, and as a method to identify high-risk groups with health needs. This study examined differences in physical activity (PA) and physical function (PF) among older adults living in a retirement community located in the Midwest region of the United States as a function of perceived health. Results suggest that older adults perceiving their health as excellent reported significantly higher PA and performed significantly better on PF assessments than those reporting it as good or fair. Programs focusing on increasing PA in older adults living in retirement communities should be considered as potential strategies to enhance the health and health perception of this population.

Relationships among Leisure Physical Activity, Sedentary Lifestyle, Physical Fitness, and Happiness in Adults 65 Years or Older in Taiwan

The purpose of this study is to understand the relationship among leisure physical activity, sedentary lifestyle, physical fitness, and happiness in healthy elderly adults aged over 65 years old in Taiwan. Data were recruited from the National Physical Fitness Survey in Taiwan, which was proposed in the Project on the Establishment of Physical Fitness Testing Stations by the Sports Administration of the Ministry of Education. Participants were recruited from fitness testing stations set up in 22 counties and cities from October 2015 to May 2016. A total of 20,111 healthy older adults aged 65-102 years were recruited as research participants. The fitness testing procedure was described to all participants, who were provided with a standardized structured questionnaire. Participants' data included sex, city or county of residence, living status (living together with others or living alone), education level, and income. Physical fitness testing was conducted in accordance with The Fitness Guide for Older Adults published by the Sports Administration of the Ministry of Education. The testing involved cardiorespiratory endurance, muscle strength, muscle endurance, flexibility, balance, and body composition. The t-test was used to evaluate the differences between continuous and grade variables under the two classification variables of sex, city or county of residence, and living status. We used the MARS (multivariate adaptive regression splines) model to analyze the effects of physical fitness variables and leisure physical activity variables on happiness. Among healthy elderly adults, sex, age, living status, body mass index, and leisure physical activity habits proved to be related to happiness. Aerobic endurance (2-min step test), muscular strength and endurance (30-s arm curl and 30-s chair stand tests), flexibility (back stretch and chair sit-and-reach tests), and balance ability (8-foot up-and-go tests and one-leg stance with eyes open tests) were found to be related to happiness. The results of this study indicate that increased physical activity and intensity, as well as physical fitness performance, are associated with improved happiness.

Physical Activity, Mental Health, and Wellbeing among Older Adults in South and Southeast Asia: A Scoping Review

Background

Physical activity is believed to enhance body functions and sense of wellbeing in general population.

Objectives

This study aimed to explore physical activity measures; and the association between those measures, and mental wellbeing among older adults in South and Southeast Asia.

Methods

A systematic search was made in CINHAL, EMBASE, PubMed, and PsycINFO. Articles published between 2008 and 2018 were selected with participants aged 60 years and above, living at home, community, supported housing, or residential care homes, with no diagnosed/limiting illness.

Results

Five observational and four interventional studies on physical activity were analysed. Depression and sleep quality were the commonest outcome variables. Exercise frequency, regularity, and duration were found to positively impact mental wellbeing.

Conclusion

Physical activity was generally found protecting against depression and improved sleep quality of older adults from South and Southeast Asia. Future studies should focus on more objective measures of physical activity.

Polish Adaptation of the Yale Physical Activity Survey: Measurement Properties

The aim of this study was to assess the measurement properties of a Polish adaptation of the Yale Physical Activity Survey (YPAS-PL). The Polish cultural adaptation of the YPAS was administered to a group of 104 people aged 65 to 89 years (mean age 72 ± 5). To assess the reliability of the YPAS-PL, a test-retest procedure was applied. Validity was assessed by comparing the results of the YPAS-PL with accelerometery (ActiGraph wGT3X+). The indicators based on the YPAS-PL activities checklist were characterized by high repeatability and had better reliability values than the YPAS-PL activity dimension indices (energy expenditure interclass correlation coefficient (ICC) = 0.81, total time physical activity ICC = 0.86). We noted a significant positive relationship between energy expenditure measured by an accelerometer and the YPAS-PL (r = 0.23). We can conclude that the YPAS-PL is an adequate tool for assessing energy expenditure related to physical activity in a Polish population of older adults. We also recommend the cautious and well thought-out use of the YPAS-PL activity dimension indices (summary, vigorous, leisurely walking, moving, standing, and sitting indexes).

Relationship of Physicians' Rapport with Patients' Satisfaction and Psychological Well-being During Hospitalization

Objective The purpose of this study was to assess the association between the psychological well-being and satisfaction of patients with physicians during their hospitalization. Methods This cross-sectional study was conducted at a local hospital using the following surveys: Brief Inventory of Thriving (BIT), tool to assess inpatient satisfaction with care from hospitalists (TAISCH) survey, and Erlanger Internal Patient satisfaction survey addressing demographic questions and questions on physicians' quality of care and etiquette. Mixed linear regression models were created to examine the effect of psychological well-being on patient satisfaction. Models were adjusted for age, race, and gender, and all analyses were performed in R 3.1.1 using the 'lme4' package with statistical significance set at p<0.05. Results A total of 360 patients were enrolled in this analysis and the mean age of the cohort was 54.5 years. In the unadjusted analysis, each unit increase in BIT score was associated with a 0.3% (95% CI:0.19-0.4, p<0.001) increase in mean satisfaction score using the five-domain questionnaire and a 0.25% (95%CI:0.16-0.34, p<0.01) increase in mean satisfaction score using the TAISCH questionnaire. Multivariable models, after adjusting confounding variables, also showed the direct and statistically significant relationship between patients' level of psychological well-being and patient satisfaction. Each unit increase in BIT score was associated with a 0.31% (95% CI:0.20-0.43, p<0.001) and 0.26% (95% CI:0.17-0.36, p<0.001) increase in mean satisfaction scores across the five-domain questionnaire and TAISCH questionnaire. Conclusions There is a positive correlation between the level of patients' psychological well-being and satisfaction with his/her physician with a statistical significance. With patient-specific strategies, we can further improve patient rapport with their physicians, resulting in positive patient outcomes.

Effects of yoga on well-being and healthy ageing: study protocol for a randomised controlled trial (FitForAge)

INTRODUCTION

Due to ageing populations worldwide, the burden of disability is increasing. It is therefore important to develop interventions that improve healthy ageing, reduce disability onset and enhance life quality. Physical activity can promote healthy ageing and help maintain independence, yet many older adults are inactive. Yoga is a form of physical activity that aims to improve health and may be particularly suitable for older adults. Research indicates positive effects of yoga on several health-related outcomes; however, empirical studies examining the benefits of yoga on well-being among the elderly remain scarce. This study protocol reports the methodology for a 12-week yoga programme aimed to improve health and well-being among physically inactive older adults.

METHODS AND ANALYSIS

Three group parallel, single-blind randomised controlled trial. Two comparison groups are included: aerobic exercise and a non-active wait-list control. In total, 180 participants aged 65-85 years will be recruited. Assessments will be performed at baseline and postintervention (12-week follow-up). The primary outcome is subjective well-being. Secondary outcomes include physical activity/sedentary behaviour, mobility/fall risk, cognition, depression, anxiety, mood, stress, pain, sleep quality, social support and cardiometabolic risk factors. Data will be analysed using intention-to-treat analyses, with mixed linear modelling.

ETHICS AND DISSEMINATION

This study is approved by the Ethical Review Board in Stockholm (2017/1862-31/2). All participants must voluntarily agree to participate and are free to withdraw from the study at any point. Written informed consent will be obtained from each participant prior to inclusion. Results will be available through research articles and conferences. A summary of key results will be publicly available through newspaper articles.

TRIAL REGISTRATION NUMBER

DRKS00015093, U1111-1217-4248.

Relevance of Activity Tracking With Mobile Devices in the Relationship Between Physical Activity Levels and Satisfaction With Physical Fitness in Older Adults: Representative Survey

Background

Physical activity has been shown to positively affect many aspects of life, and the positive relationship between physical activity levels and health is well established. Recently, research on the interrelationship between physical activity levels and subjective experiences has gained attention. However, the underlying mechanisms that link physical activity levels with subjective experiences of physical fitness have not been sufficiently explained.

Objective

This study aimed to explore the role of physical activity tracking (PAT) in the relationship between physical activity levels and satisfaction with physical fitness in older adults. It is hypothesized that higher levels of physical activity are associated with a higher satisfaction with physical fitness in older adults and that this positive association is stronger for older people who use mobile devices for PAT.

Methods

As part of this study, 1013 participants aged 50 years or older and living in Switzerland were interviewed via computer-assisted telephone interviews. Bivariate and multivariate analyses were applied. The interaction effects between physical activity levels and PAT were evaluated using multiple linear regression analysis.

Results

Descriptive analyses showed that 719 participants used at least 1 mobile device and that 136 out of 719 mobile device users (18.9%) used mobile devices for PAT. In the multivariate regression analysis, frequent physical activity was found to have a positive effect on satisfaction with physical fitness (beta=.24, P<.001). A significant interaction effect between physical activity levels and PAT (beta=.30, P=.03) provides some first evidence that the positive effects of physical activity on satisfaction with physical fitness can be enhanced by PAT.

Conclusions

The results indicate the potential of PAT to enhance the physical fitness of older adults. However, the results also raise new issues in this context. Recommendations for further research and practice include the acquisition of longitudinal data, a more detailed observation of durations of use, and the development of devices for PAT considering health psychology and gerontology theories.

Perspectives of Older Adults on Aging Well: A Focus Group Study

BACKGROUND

With increasing number of older adults worldwide, promoting health and well-being becomes a priority for aging well. Well-being and physical and mental health are closely related, and this relation may become more vital at older ages as it may contribute to aging well. The state of well-being is a multifaceted phenomenon that refers to an individual's subjective feelings, and exploring perspectives of older adults on aging well is developing to be an important area of research. Therefore, the aim of this study was to explore perceptions on aging well among older adult Palestinians ≥60 years.

METHODS

A qualitative research design in the context of focus group discussions was used; seven focus groups were conducted including fifty-six participants (aged 63-81 years). Data were analyzed using a qualitative interpretative thematic approach described by Braun and Clarke.

RESULTS

Three major themes were identified, "sense of well-being," "having good physical health," and "preserving good mental health." The participants perceived that aging well is influenced by positive feelings such as being joyous, staying independent, having a life purpose, self-possessed contentment, and financially secured, in addition to be socially engaged and enjoying good physical and mental health.

CONCLUSION

This study contributes to get a better insight concerning older adults' perspectives on aging well. Enhancing physically active lifestyle, participation in social and leisure activities, healthy eating habits, having a purpose in life, and being intellectually engaged are all contributing factors to aging well. Vital factors are to be considered in developing strategic health and rehabilitative plans for promoting aging well among older adults.

The effects of a structured group exercise programme on functional fitness of older persons living in old-age homes

Despite the benefits of exercise, a large percentage of the older population in South Africa continue to lead sedentary lifestyles. This study aimed to determine the effects of a structured group exercise programme on functional fitness of older persons living in old-age homes. A quasi-experimental design was used to compare the effects of a 12-week group exercise programme. Twenty participants each were selected from five old-age homes. Participants were randomly allocated into either an experimental group or a comparison group at each site. The experimental group participated in the exercise intervention three times weekly, while the comparison group received the same intervention twice weekly for 12 weeks. The intervention programme included warm-up, balance, endurance, resistance and cool-down components. Assessments of upper and lower body strength and flexibility, aerobic endurance, agility and balance were conducted before and after the intervention programme using the Senior Functional Test. Comparisons of baseline and post-intervention measures showed greater improvements in upper and lower body strength and flexibility, as well as aerobic endurance capacity (p < 0.05). Training frequency revealed no significant difference in functional fitness measures between both groups following the 12-week intervention programme. Twelve weeks of multifaceted group exercise training, at least twice a week, can be used as an effective strategy to promote functional fitness in this population.

Contributory Factors to critically wrong road-crossing judgements among older people: an integrated research study

Introduction

Older people are having higher risk of vehicle-pedestrian collisions. This study examines the relative importance of different environmental, physical and cognitive factors in contributing to critically wrong road-crossing judgements.

Methods

An integrated research design is adopted. Older pedestrians were recruited through Elderly Community Centres in Hong Kong. Data about their physical and cognitive ability were collected through setting up outreach laboratories within the participants' neighbourhood communities. In addition to obtaining two walking speeds, three clinical tests (the visual acuity test, Timed Up and Go test and Mini Mental State Examination [MMSE] test) were conducted. A questionnaire survey collected personal information and activity data. Eighteen different road-crossing scenarios showing the same dual-lane one-way local road with different traffic conditions (a vehicle approaching at different distances, at different speeds, and on different lanes) were captured in videos and presented to the participants. Their decision time and judgement for each scenario were recorded in a computer. Apart from descriptive statistics, a binary logistic generalised estimating equation model was estimated. The dependent variable is whether a road-crossing judgement was critically wrong or not.

Results and Conclusions

A total of 7,182 road-crossing judgements of 399 older people were collected. The most statistically significant factors contributing to critically wrong road-crossing judgements are the road environment variables of the speed and distance of the oncoming vehicle. On physical variables, walking speed is the most important factor. Lastly, the cognitive variable of MMSE score is significant. For the mild and moderate impairment groups, the chances of making a critically wrong judgement are 1.83 and 2.01 times that of the normal group respectively.

Physical and mental health status and their correlations among older wheelchair users with dementia in long-term care facilities

PURPOSE

To investigate the physical health (daily functioning and functional fitness) and mental health (depression and behavioral dysfunction) of older wheelchair users with dementia in long-term care facilities, examine the correlations between physical and mental health, and identify the independent variables of their daily functioning.

METHODS

A descriptive correlational method was adopted, which was conducted in six long-term care facilities in three cities, south Taiwan. Participants comprised 98 older wheelchair users with dementia. Data were collected using structured questionnaires (Mini-Mental State Examination, Barthel Index, Cornell Scale for Depression in Dementia, and Clifton Assessment Procedures for the Elderly Behavior Rating Scale) and from functional fitness testing (cardiopulmonary functioning, body flexibility, joint mobility, and muscle strength and endurance).

RESULTS

Older adults with dementia who had high depression scores were likely to have more behavioral dysfunctions, poorer performance in shoulder flexion and abduction, and lower upper limb muscle strength and endurance. More behavioral dysfunctions were associated with poorer daily functioning, lung capacity, body flexibility, shoulder flexion, and upper limb muscle strength and endurance. Those with better lung capacity, body flexibility, upper limb muscle strength, and endurance were likely to have high daily functioning scores (all p < .05). The key independent variables associated with daily functioning were behavioral dysfunction, lower body flexibility, and lung capacity, which together explained 59.3% of the total variance.

CONCLUSIONS

Further research should develop appropriate activity-based intervention programs for older wheelchair users with dementia to delay their deterioration and promote their physical and mental health.

Efficacy of rhythmic exercise and walking exercise in older adults' exercise participation rates and physical function outcomes

AIM

The purpose of the present study was to evaluate the efficacy of two different exercise types, rhythmic exercise designed from local music and dance (RE) and walking exercise (WE), in terms of exercise participation and physical function changes in older adults over a period of 12 weeks.

METHODS

Exercise participation was assessed through the attendance rate and retention rate, and physical function was evaluated through the Short Physical Performance Battery, static balance test and gait test.

RESULTS

The RE group showed significantly higher attendance and retention rates; greater improvement in Short Physical Performance Battery scores; and greater improvement in static balance, as compared with the WE. No differences were found between the RE and WE groups in gait parameters.

CONCLUSIONS

The results suggest that RE was more effective than WE in retaining exercise participation and improving physical function in older adults. Geriatr Gerontol Int 2017; 17: 2311-2318.

Role of Marital Quality in Explaining Depressive Symptoms After Marital Termination Among Older Adults

This study assesses whether prior marital quality moderates the impact of divorce or widowhood on subsequent depression. Poor marital quality may buffer depression associated with divorce/widowhood; conversely, the effect of divorce/widowhood on depression could be exacerbated by previous marital quality. Three waves from the National Survey of Families and Households based on respondents, ages 50 and older, (N = 2,570) included eight marital quality measures. We find limited evidence suggesting higher marital quality elevates, while lower marital quality decreases, depression after divorce. No moderating effects were found for widowhood. Additionally, health condition is more important than current marital status for elders' well-being after divorce or widowhood. Heterogeneity in the context of the marriage before divorce should be considered when examining marital termination effects on elders' depression.

Experiences of Habitual Physical Activity in Maintaining Roles and Functioning among Older Adults: A Qualitative Study

Physically active older adults have reduced risk of functional restrictions and role limitations. Several aspects may interrelate and influence habitual physical activity (PA). However, older adults' own perspectives towards their PA need to be addressed. The aim of this study was to explore the experiences of habitual physical activity in maintaining roles and functioning among older adult Palestinians ≥60 years. Data were collected through in-depth interviews based on a narrative approach. Seventeen participants were recruited (aged 64-84 years). Data were analyzed using a narrative interpretative method. Findings. Three central narratives were identified, "keep moving, stay healthy," "social connectedness, a motive to stay active," and "adapting strategies to age-related changes." Conclusion. Habitual physical activity was perceived as an important factor to maintain functioning and to preserve active roles in older adults. Walking was the most prominent pattern of physical activity and it was viewed as a vital tool to maintain functioning among the older adults. Social connectedness was considered as a contributing factor to the status of staying active. To adapt the process of age-related changes in a context to stay active, the participants have used different adapting strategies, including protective strategy, awareness of own capabilities, and modifying or adopting new roles.

The level of physical activity affects the health of older adults despite being active

Health care in the ageing population is becoming a crucial issue, due to the quality of life. Physical activity, is of primary importance for older adults. This report compared the physical activity in two active older adults population with functionality, quality of life, and depression symptoms. A cross-sectional study was developed with 64 older adults. Physical activity was assessed through the Yale Physical Activity Survey for classification into a less activity (LA) group and a more activity (MA) group. Afterwards, the other health variables were measured through specific questionnaires: the quality of life with the EuroQol (EuroQol five dimensions questionnaire, EQ-5D), functionality with the Berg balance scale (BBS) and depression symptoms with the geriatric depression scale (GDS). There is a statistical significant difference between groups for the BBS (t=2.21; P=0.03, d=0.27). The Pearson correlation analysis shows in LA group a moderate correlation between the BBS and age (r=−0.539; P<0.01) and EQ-5D (r=0.480; P<0.01). Moreover, both groups had a moderate negative correlation between GDS and the the EQ-5D time trade-off (r=−0.543; P=0.02). Active older adults with different amounts of physical activity differ in the BBS. This functional score was higher in the MA group. When observing to quality of life, only the LA group was negatively associated with age while in both groups were associated with depression index.

Direct and indirect influences of socio-economic position on the wellbeing of older adults: a Structural Equation Model using data from the first wave of the Irish Longitudinal Study on Ageing

The authors use Structural Equation Modelling techniques to analyse the determinants of wellbeing amongst older adults using data from the first wave of the Irish Longitudinal Study on Ageing (TILDA), a rich source of data on people aged over 50 and living in private households. The analysis uses a two-group linear statistical model to explore the influence of socio-economic position on the wellbeing of men and women, with Full Information Maximum Likelihood estimation to handle missing data. The fit indices for the final model are highly satisfactory and the measurement structure is invariant by gender and age. The results indicate that socio-economic position has a significant direct influence on wellbeing and a strong indirect influence which is mediated by health status and lifestyle. The total standardised effect of Socio-economic Position on Socio-emotional Wellbeing is statistically significant (p⩽ 0.05) and equal to 0.32 (men) and 0.43 (women), a very strong influence which risks being underestimated in standard multivariate models. The authors conclude that health, cognitive functioning and wellbeing reflect not just the ageing process, but also the impact of social inequalities across the lifecourse and how they are transmitted across different life spheres. These results can help to orient future research on factors which mediate between socio-economic position and wellbeing, an important policy-related issue.

Physical Activity Patterns in the Elderly Kashan Population

Background

Physical activity is an important component of health in old age that provides personal independence, physical ability, and quality of life.

Objectives

The current study aimed to evaluate physical activity and associated factors among the elderly population in Kashan, Iran.

Patients and Methods

This is a descriptive cross-sectional study. The sample was 400 elderly people (aged more than 60 years) living in Kashan, Iran in 2014. The subjects randomly selected via multi-stage cluster sampling from healthcare centers in three regions of Kashan. The sample size differed by gender and residence type. Each participant’s demographic characteristics and level of physical activity were recorded in a questionnaire, and the data were analyzed by SPSS version 16. Descriptive statistics, chi-square tests, Pearson correlations, and ordinal regression were used in the data analysis. The significance level for all the tests was P < 0.05.

Results

237 (59.2%) of the subjects were female. The average age of the study population was 67.6 ± 6.8 years. Their average physical activity energy consumption was 326.21 ± 364.84 according to the metabolic equivalent of hours per week. 20 subjects (5%) reported no physical activity. 320 (80%) and 59 (14.8%) subjects had low and moderate physical activity levels, respectively. Only 1 subject (0.2%) had extreme levels of physical activity. Men (n = 43, 26.4%) were more likely to be moderately or extremely physically active than women were (n = 17, 7.2%). There was a significant relationship between physical activity and sex (P < 0.0001), marital status (P < 0.0001), educational status (P < 0.002), current occupation (P < 0.0001), and personal independence (P < 0.00001). Of course, effective predictive variations included age (P = 0.034), gender (P = 0.001), marital status (P = 0.033), independent status (P = 0), and local environment (P =0.001).

Conclusions

The study revealed low physical activity in the elderly population in Kashan. The pattern of physical activity in the elderly depends on their lifestyle. A promotion of active lifestyles should be a part of health care planning for the elderly.

Espiritualidad, esperanza y dependencia como predictores de la satisfacción vital y la percepción de salud: efecto moderador de ser muy mayor

Objetivo: analizar algunos predictores de la calidad de vida en personas mayores, diferenciando entre mayores jóvenes o muy mayores. Esto es, se estudia un potencial efecto moderador debido a ser muy mayor, dado que este sector de la población está en rápido crecimiento en todo el mundo. Materiales y métodos: estudio transversal analítico de encuesta a 224 personas mayores, en dos grupos diferenciales, menores de 75 años y 75 años o más, que viven en la ciudad de Valencia (España). Resultados: se ajustó un modelo estructural multimuestra donde las dimensiones de espiritualidad y la esperanza predicen dos indicadores de calidad de vida en personas mayores: satisfacción vital y percepción de salud. Se han encontrado relaciones estadísticamente significativas (p < 0,05) entre la espiritualidad y la esperanza, y los dos indicadores; especialmente potente es la predicción de la satisfacción vital. Asimismo, los resultados multimuestra indican que la fe juega un papel diferencial relevante en los muy mayores. Discusión: se ponen en relación los hallazgos con la literatura. Conclusiones: existe un importante impacto, en algunos casos diferencial para los muy mayores, de la espiritualidad sobre indicadores de envejecimiento con éxito tales como la satisfacción vital y la salud, y la capacidad para realizar actividades, ya sea instrumentales de la vida diaria, o en general todo tipo de actividades productivas.

Relationship between socioeconomic status and quality of life in older adults: a path analysis

PURPOSE

The main objective of this study was to determine the relationship between quality of life, social functioning, depressive symptoms, self-efficacy, physical function, and socioeconomic status (SES) in community-dwelling older adults.

METHODS

A cross-sectional design was used to examine the relationships. A sample of 193 community-dwelling older adults completed the measurements. Structural equation modeling with full information maximum likelihood in LISREL was used to evaluate the relationships between the latent variables (SES, social functioning, depressive symptoms, self-efficacy, physical function, and quality of life).

RESULTS

The path analysis exhibited significant effects of SES on physical function, social functioning, depressive symptoms, and self-efficacy (γ = 0.42-0.73), and significant effects in regard to social functioning, depressive symptoms, and self-efficacy on quality of life (γ = 0.27-0.61). There was no direct effect of SES on the quality of life. The model fit indices demonstrated a reasonable fit (χ (2) = 98.3, df = 48, p < 0.001), matching the relative Chi-square criterion and the RMSEA criterion. The model explained 55.5 % of the variance of quality of life.

CONCLUSIONS

The path analysis indicated an indirect effect of SES on the quality of life by social functioning, depressive symptoms, and self-efficacy in community-dwelling older adults. Physical function did not have a direct effect on the quality of life. To improve the quality of life in older adults, additional focus is required on the socioeconomic psychosocial differences in the community-dwelling older population.

Subjective well-being in Swedish active seniors and its relationship with physical activity and commonly available biomarkers

BACKGROUND

Physical activity is claimed to be related to well-being and to a lower risk of cardiovascular disease. Therefore, the possible associations of well-being with physical activity and biomarkers of somatic health were studied in a sample of Swedish active seniors to determine the strength of these associations.

METHODS

Three hundred and eighty-nine community-dwelling senior citizens (127 men and 262 women) of mean age 74 ± 5 years were recruited for this cross-sectional population study. Serum samples were analyzed for lipoproteins and markers of inflammation. The Psychological General Well-Being (PGWB) index was used to measure subjective well-being. Physical activity was assessed by the International Physical Activity Questionnaire modified for the elderly.

RESULTS

More than 50% of men and women rated their physical activity as high; in the women, there was a significant difference between the age groups (younger and older than the median age [median =74.1 years], respectively). The mean PGWB index indicates a high degree of subjective well-being in this group of Swedish seniors. Of the PGWB subdimensions, general health had the strongest positive relationship with physical activity (r (2)=5.4%). For the subdimensions of depressed mood, positive well-being, vitality, and PGWB index, physical activity had an r (2) ≤ 4%, while the contributions of sex, age, and biomarkers were minor.

CONCLUSION

We have estimated the contribution of physical activity to the variance of subjective well-being in active seniors. Physical activity appears to play a greater role as a determinant of subjective well-being than do biomarkers of somatic health, especially in females, but most of the variance remained unaccounted for by the studied variables.