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Pomiersky R, Matting L, Haigis D, Eschweiler GW, Frahsa A, Niess A, Thiel A, Sudeck G. Physical Activity, Sedentary Behavior, and Their Predictors Among Nursing Home Residents-Cross-Sectional Results of the BaSAlt Study. J Aging Phys Act 2024; 32:588-597. [PMID: 38589013 DOI: 10.1123/japa.2023-0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 12/04/2023] [Accepted: 02/23/2024] [Indexed: 04/10/2024]
Abstract
Little is known about physical activity (PA) and sedentary behavior (SB) among nursing home residents although PA is known as a health promoter. This study examined PA, SB, and their predictors among nursing home residents (n = 63). Dependent variables were accelerometry-based PA and SB. Predictor variables included in a path analysis were age, sex, body mass index, Barthel Index, cognitive status (Mini-Mental State Examination), physical performance (hand grip strength and habitual walking speed), and well-being (World Health Organization-5 well-being index). PA was very low (M steps per day = 2,433) and SB was high (M percentage of sedentary time = 89.4%). PA was significantly predicted by age (β = -0.27, p = .008), body mass index (β = -0.29, p = .002), Barthel Index (β = 0.24, p = .040), and hand grip strength (β = 0.30, p = .048). SB was significantly predicted by body mass index (β = 0.27, p = .008) and Barthel Index (β = -0.30, p = .012). Results might be helpful for everyday practice to identify individuals at high risk for low PA and high SB.
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Affiliation(s)
- Rebekka Pomiersky
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Leon Matting
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Daniel Haigis
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
| | - Gerhard W Eschweiler
- Center for Geriatric Medicine, University Hospital of Tübingen, Tübingen, Germany
| | - Annika Frahsa
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Andreas Niess
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
| | - Ansgar Thiel
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
| | - Gordon Sudeck
- Institute of Sports Science, University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sports and Physical Activity, University of Tübingen, Tübingen, Germany
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Shao Z, Huang J, Feng H, Hu M. Optimizing the physical activity intervention for older adults with mild cognitive impairment: a factorial randomized trial. Front Sports Act Living 2024; 6:1383325. [PMID: 38774280 PMCID: PMC11106430 DOI: 10.3389/fspor.2024.1383325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 04/15/2024] [Indexed: 05/24/2024] Open
Abstract
Background Physical activity (PA) intervention is one of the most effective interventions to promote cognitive function of older adults with mild cognitive impairment (MCI). However, the level of PA remains low. Based on the two core interventions (X-CircuiT and health education), this study aimed to examine the effect of three implementation strategies (viz., role modeling, goal-setting, and reminding) on the PA level among older adults with MCI using the multiphase optimization strategy (MOST). Methods Participants were randomized into one of eight conditions in a factorial design involving three factors with two levels: (i) role modeling (on vs. off); (ii) goal-setting (on vs. off); and (iii) reminding (on vs. off). The primary outcome was PA level at 12 weeks. The secondary outcomes were cognitive function, self-efficacy, and cost-effectiveness at 12 weeks. The intention-to-treat (ITT) analysis was performed as the main analysis and the per-protocol (PP) analysis as the sensitivity analysis. Results A total of 107 participants were included and randomly assigned into three groups, each receiving different implementation strategies. The results of the multivariate regression analysis showed that the three implementation strategies, namely, reminding (B = 0.31, p < 0.01), role modeling (B = 0.21, p < 0.01), and goal-setting (B = 0.19, p < 0.01), could significantly improve PA level. Specifically, it was found that role modeling (B = 0.68, p = 0.03) could significantly improve cognitive function. There were no significant interactions among the three implementation strategies. Role modeling was the most cost-effective strategy, costing 93.41 RMB for one unit of PA. Conclusions Role modeling was likely to be the best implementation strategy. The value-based and cost-effective PA intervention package could include the core intervention (X-CircuiT and health education) and implementation strategy (role modeling). Clinical Trial Registration https://www.chictr.org.cn, The study was retrospectively registered on 30 June 2022 (ChiCTR2200061693).
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Affiliation(s)
- Zhanfang Shao
- Department of Nursing, Peking Union Medical College Hospital, Beijing, China
| | - Jundan Huang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Hui Feng
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Mingyue Hu
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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Cheong SM, Gaynanova I. Sensing the impact of extreme heat on physical activity and sleep. Digit Health 2024; 10:20552076241241509. [PMID: 38528970 PMCID: PMC10962040 DOI: 10.1177/20552076241241509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 03/27/2024] Open
Abstract
Introduction This study assesses the person-specific impact of extreme heat on low-income households using wearable sensors. The focus is on the intensive and longitudinal assessment of physical activity and sleep with the rising person-specific ambient temperature. Methods This study recruited 30 participants in a low-income and predominantly Black community in Houston, Texas in August and September of 2022. Each participant wore on his/her wrist an accelerometer that recorded person-specific ambient temperature, sedentary behavior, physical activity intensity (low and moderate to vigorous), and sleep efficiency 24 h over 14 days. Mixed effects models were used to analyze associations among physical activity, sleep, and person-specific ambient temperature. Results The main findings include increased sedentary time, sleep impairment with the rise of person-level ambient temperature, and the mitigating role of AC. Conclusions Extreme heat negatively affects physical activity and sleep. The negative consequences are especially critical for those with limited use of AC in lower-income neighborhoods of color. Staying home with a high indoor temperature during hot days can lead to various adverse health outcomes including accelerated cognitive decline, higher cancer risk, and social isolation.
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Affiliation(s)
- So-Min Cheong
- Department of Public Service & Administration, Texas A&M University, College Station, TX, USA
| | - Irina Gaynanova
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
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Tzeng HM, Downer B, Li CY, Raji M, Haas A, Kuo YF. Association Between Cognitive Impairment and Repeat Fractures in Medicare Beneficiaries Recently Hospitalized for Hip Fracture. J Gerontol A Biol Sci Med Sci 2023; 78:1677-1682. [PMID: 36810779 PMCID: PMC10460551 DOI: 10.1093/gerona/glad063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Repeat fractures contribute substantially to fracture incidents in older adults. We examined the association between cognitive impairment and re-fractures during the first 90 days after older adults with hip fractures were discharged home from a skilled nursing facility rehabilitation short stay. METHODS Multilevel binary logistic regression was used to analyze 100% of U.S. national postacute-care fee-for-service Medicare beneficiaries who had a hospital admission for hip fracture from January 1, 2018, to July 31, 2018; were admitted for a skilled nursing facility stay within 30 days of hospital discharge; and were discharged to the community after a short stay. Our primary outcome was rehospitalization for any re-fractures within 90 days of skilled nursing facility discharge. Cognitive status assessed at skilled nursing facility admission or before discharge was classified as either intact or having mild or moderate/severe impairment. RESULTS In 29 558 beneficiaries with hip fracture, odds of any re-fracture were higher in those with minor (odds ratio: 1.48; 95% confidence interval: 1.19-1.85; p < .01) and moderate/major cognitive impairment (odds ratio: 1.42; 95% confidence interval: 1.07-1.89; p = .0149) than in those classified as intact. CONCLUSIONS Beneficiaries with cognitive impairment were more likely than their counterparts with no cognitive impairment to experience re-fractures. Community-dwelling older adults with minor cognitive impairment may experience a higher likelihood of experiencing a repeat fracture leading to rehospitalization.
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Affiliation(s)
- Huey-Ming Tzeng
- School of Nursing, University of Texas Medical Branch, Galveston, USA
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, USA
| | - Brian Downer
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, USA
- School of Health Professions, University of Texas Medical Branch, Galveston, USA
| | - Chih-Ying Li
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, USA
- School of Health Professions, University of Texas Medical Branch, Galveston, USA
| | - Mukaila A Raji
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, USA
- Department of Internal Medicine, John Sealy School of Medicine, University of Texas Medical Branch, Galveston, USA
| | - Allen Haas
- Office of Biostatics, University of Texas Medical Branch, Galveston, USA
| | - Yong-Fang Kuo
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, USA
- Office of Biostatics, University of Texas Medical Branch, Galveston, USA
- Department of Biostatistics & Data Science, School of Public and Population Health, University of Texas Medical Branch, Galveston, USA
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Dillon K, Morava A, Prapavessis H, Grigsby-Duffy L, Novic A, Gardiner PA. Total Sedentary Time and Cognitive Function in Middle-Aged and Older Adults: A Systematic Review and Meta-analysis. SPORTS MEDICINE - OPEN 2022; 8:127. [PMID: 36224459 PMCID: PMC9556686 DOI: 10.1186/s40798-022-00507-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 08/14/2022] [Indexed: 11/06/2022]
Abstract
Background An estimated 47 million people have dementia globally, and around 10 million new cases are diagnosed each year. Many lifestyle factors have been linked to cognitive impairment; one emerging modifiable lifestyle factor is sedentary time. Objective To conduct a systematic review and meta-analysis of peer-reviewed literature examining the association between total sedentary time with cognitive function in middle-aged and older adults under the moderating conditions of (a) type of sedentary time measurement; (b) the cognitive domain being assessed; (c) looking at sedentary time using categorical variables (i.e., high versus low sedentary time); and (d) the pattern of sedentary time accumulation (e.g., longer versus shorter bouts). We also aimed to examine the prevalence of sedentary time in healthy versus cognitively impaired populations and to explore how experimental studies reducing or breaking up sedentary time affect cognitive function. Lastly, we aimed to conduct a quantitative pooled analysis of all individual studies through meta-analysis procedures to derive conclusions about these relationships. Methods Eight electronic databases (EMBASE; Web of Science; PsycINFO; CINAHL; SciELO; SPORTDiscus; PubMed; and Scopus) were searched from inception to February 2021. Our search included terms related to the exposure (i.e., sedentary time), the population (i.e., middle-aged and older adults), and the outcome of interest (i.e., cognitive function). PICOS framework used middle-aged and older adults where there was an intervention or exposure of any sedentary time compared to any or no comparison, where cognitive function and/or cognitive impairment was measured, and all types of quantitative, empirical, observational data published in any year were included that were published in English. Risk of bias was assessed using QualSyst. Results Fifty-three studies including 83,137 participants met the inclusion criteria of which 23 studies had appropriate data for inclusion in the main meta-analysis. The overall meta-analysis suggested that total sedentary time has no association with cognitive function (r = −0.012 [95% CI − 0.035, 0.011], p = 0.296) with marked heterogeneity (I2 = 89%). Subgroup analyses demonstrated a significant negative association for studies using a device to capture sedentary time r = −0.035 [95% CI − 0.063, − 0.008], p = 0.012). Specifically, the domains of global cognitive function (r = −0.061 [95% CI − 0.100, − 0.022], p = 0.002) and processing speed (r = −0.067, [95% CI − 0.103, − 0.030], p < 0.001). A significant positive association was found for studies using self-report (r = 0.037 [95% CI − 0.019, 0.054], p < 0.001). Specifically, the domain of processing speed showed a significant positive association (r = 0.057 [95% CI 0.045, 0.069], p < 0.001). For prevalence, populations diagnosed with cognitive impairment spent significantly more time sedentary compared to populations with no known cognitive impairments (standard difference in mean = −0.219 [95% CI − 0.310, − 0.128], p < 0.001). Conclusions The association of total sedentary time with cognitive function is weak and varies based on measurement of sedentary time and domain being assessed. Future research is needed to better categorize domains of sedentary behaviour with both a validated self-report and device-based measure in order to improve the strength of this relationship. PROSPERO registration number: CRD42018082384. Supplementary Information The online version contains supplementary material available at 10.1186/s40798-022-00507-x.
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Affiliation(s)
- Kirsten Dillon
- grid.39381.300000 0004 1936 8884Faculty of Health Sciences, The University of Western Ontario, Kinesiology, London, ON Canada
| | - Anisa Morava
- grid.39381.300000 0004 1936 8884Faculty of Health Sciences, The University of Western Ontario, Kinesiology, London, ON Canada
| | - Harry Prapavessis
- grid.39381.300000 0004 1936 8884Faculty of Health Sciences, The University of Western Ontario, Kinesiology, London, ON Canada
| | - Lily Grigsby-Duffy
- grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Australia ,grid.1021.20000 0001 0526 7079Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220 Australia
| | - Adam Novic
- grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Australia ,grid.1022.10000 0004 0437 5432School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Paul A. Gardiner
- grid.39381.300000 0004 1936 8884Faculty of Health Sciences, The University of Western Ontario, Kinesiology, London, ON Canada ,grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Australia ,grid.1048.d0000 0004 0473 0844Faculty of Health, Engineering and Sciences, The University of Southern Queensland, Brisbane, Australia
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Physical Activity in People With Dementia Living in Long-Term Care Facilities and the Connection With Environmental Factors and Behavior. J Aging Phys Act 2022; 31:214-222. [PMID: 36041734 DOI: 10.1123/japa.2021-0459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/11/2022] [Accepted: 06/25/2022] [Indexed: 11/18/2022]
Abstract
This study is conducted in order to gain a better understanding of the relationship between physical activity and agitated behavior among older people with dementia, and physical activity and characteristics of long-term care wards. Data were collected among people with dementia living in long-term care facilities (N = 76) by conducting observations at the wards and distributing questionnaires among professional caregivers. The results show that participants are largely inactive (82.8%) and a significant relation was found between the degree of physical activity and characteristics of the ward such as "taking sufficient time," which relates to the time caregivers take when interacting with residents. This study supports the existing knowledge about the degree of physical activity among people with dementia in long-term care and adds information about the potential influence of organizational factors that could be valuable for daily practice.
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Rondão CADM, Mota MP, Oliveira MM, Peixoto F, Esteves D. Multicomponent exercise program effects on fitness and cognitive function of elderlies with mild cognitive impairment: Involvement of oxidative stress and BDNF. Front Aging Neurosci 2022; 14:950937. [PMID: 36092805 PMCID: PMC9453672 DOI: 10.3389/fnagi.2022.950937] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
Regular exercise has been shown to be one of the most important lifestyle influences on improving functional performance, and decreasing morbidity and all-cause mortality among older people. However, although there is some evidence on the effects of aerobic training on oxidative stress, there is little information regarding the effects of multicomponent exercise (dual-task training) and combination of exercise with cognitive stimulation on oxidative stress. In this context, the aim of this study was to verify the effects of a multicomponent exercise program on physical fitness and cognitive function in the elderly with mild cognitive impairment and determine the role of oxidative stress and brain-derived neurotrophic factor (BDNF). At baseline, 37 elderly nursing home residents with mild cognitive impairment were divided into two groups: the control group (CG, n = 12, 81.8 years) and the experimental group (EG, n = 25, 83.2 years). These elderlies followed multicomponent exercise training for 24 weeks, with two sessions per week and 45–50 min per session. The exercises included both aerobic and strength exercises, considering functional movements and light to moderate intensity. Cognitive stimulation comprehended exercises based on word games, puzzles, mathematical calculations, forward and backward counting, computer exercises, exergames, and games on a balanced platform. Physical assessments (weight, height, and body mass index), health and functional parameters (fitness tests: chair stand, arm curls, chair sit-and-reach, eight feet up-and-go, back scratch, 6-min walking, feet together, semi-tandem, and full tandem), lipid profile (total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides), measures of lipid peroxidation damage, thiobarbituric acid reactive substances (TBARS), total antioxidant capacity (TAC), and BDNF were measured in plasma, based on which analyses were performed before and after the 24 weeks of the multicomponent exercise intervention. The results showed an overall improvement in physical and functional performance. Regarding biochemical measures, multicomponent exercises lead to a significant decrease in oxidative damage. The results indicate that multicomponent exercise training induces benefits in functional capacity and reduces damage due to oxidative stress.
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Affiliation(s)
- Catarina Alexandra de Melo Rondão
- Department of Sports, University of Beira Interior, Covilhã, Portugal
- Camara Municipal do Fundão, Fundão, Portugal
- *Correspondence: Catarina Alexandra de Melo Rondão
| | - Maria Paula Mota
- University of Trás-os Montes e Alto Douro, Vila Real, Portugal
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal
| | - Maria Manuel Oliveira
- University of Trás-os Montes e Alto Douro, Vila Real, Portugal
- Centro de Química, Vila Real, Portugal
| | - Francisco Peixoto
- University of Trás-os Montes e Alto Douro, Vila Real, Portugal
- Centro de Química, Vila Real, Portugal
| | - Dulce Esteves
- Department of Sports, University of Beira Interior, Covilhã, Portugal
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal
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''We usually choose safety over freedom'': results from focus groups with professional caregivers in long-term dementia care. BMC Health Serv Res 2022; 22:677. [PMID: 35596186 PMCID: PMC9121585 DOI: 10.1186/s12913-022-07952-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 04/13/2022] [Indexed: 11/28/2022] Open
Abstract
Background People with dementia living in nursing homes are mostly sedentary, which is a consequence of various personal, environmental and organizational factors. Until now, studies on physical activity and safety in dementia have focused on residents and caregivers from the viewpoint of (individual) care provision and health benefits. There has been little to no focus on the possible influence of group dynamics between care providers with regard to physical activity and safety. The aim of this study is to gain more insight into the viewpoints and intentions of groups of professional caregivers towards safety and physical activity and the potential influence of the group-oriented setting in long-term care on physical activity of individual residents. Methods A qualitative study comprising three focus group discussions including professional caregivers (n = 15) was conducted within two long-term care organizations in the Netherlands. Focus group discussions were structured using an interview guide derived from a preliminary framework, based on existing literature and complemented with clinical expertise. Results Seven themes could be derived from the focus group discussions that influence physical activity and safety: 1) Individual health and abilities; 2) Balancing physical activity and safety; 3) Physical restraints; 4) Group interests versus the individual interests; 5) Organization of care and physical environment; 6) Perceived responsibilities and tasks of professional caregivers and 7) Change is challenging. Conclusions Due to multiple influencing factors, the balance for care providers in long-term care generally tends towards safety over physical activity. Furthermore, in order to stimulate physical activity various limitations are experienced, including the organization of care, the general health of the residents and difficulty to achieve changes in daily care. Most importantly, the group interests of both the professional caregivers and the residents have a substantial influence on the incorporation of physical activity in daily care. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07952-0.
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Galhardas L, Raimundo A, Del Pozo-Cruz J, Marmeleira J. Physical and Motor Fitness Tests for Older Adults Living in Nursing Homes: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5058. [PMID: 35564453 PMCID: PMC9105463 DOI: 10.3390/ijerph19095058] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/09/2022] [Accepted: 04/19/2022] [Indexed: 02/01/2023]
Abstract
This systematic review aimed to identify the physical/motor fitness tests for nursing home residents and to examine their psychometric properties. Electronic databases were searched for articles published between January 2005 and October 2021 using MeSh terms and relevant keywords. Of the total of 4196 studies identified, 3914 were excluded based on title, abstracts, or because they were duplicates. The remaining 282 studies were full-text analyzed, and 41 were excluded, resulting in 241 studies included in the review. The most common physical component assessed was muscle strength; 174 (72.2%) studies assessed this component. Balance (138 studies, 57.3%) and agility (102 studies, 42.3%) were the second and third components, respectively, most widely assessed. In this review, we also describe the most used assessment tests for each physical/motor component. Some potentially relevant components such as manual dexterity and proprioception have been little considered. There are few studies assessing the psychometric properties of the tests for nursing home residents, although the data show that, in general, they are reliable. This review provides valuable information to researchers and health-care professionals regarding the physical/motor tests used in nursing home residences, helping them select the screening tools that could most closely fit their study objectives.
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Affiliation(s)
- Luis Galhardas
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, 7000-727 Évora, Portugal; (A.R.); (J.M.)
- Comprehensive Health Research Centre (CHRC), Palácio do Vimioso, Gabinete 256, Largo Marquês de Marialva, Apart. 94, 7002-554 Évora, Portugal
| | - Armando Raimundo
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, 7000-727 Évora, Portugal; (A.R.); (J.M.)
- Comprehensive Health Research Centre (CHRC), Palácio do Vimioso, Gabinete 256, Largo Marquês de Marialva, Apart. 94, 7002-554 Évora, Portugal
| | - Jesús Del Pozo-Cruz
- Department of Physical Education and Sports, University of Seville, 41013 Sevilla, Spain;
- Epidemiology of Physical Activity and Fitness across Lifespan Research Group (EPAFit), University of Seville, 41013 Sevilla, Spain
| | - José Marmeleira
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais, 7000-727 Évora, Portugal; (A.R.); (J.M.)
- Comprehensive Health Research Centre (CHRC), Palácio do Vimioso, Gabinete 256, Largo Marquês de Marialva, Apart. 94, 7002-554 Évora, Portugal
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Airlie J, Forster A, Birch KM. An investigation into the optimal wear time criteria necessary to reliably estimate physical activity and sedentary behaviour from ActiGraph wGT3X+ accelerometer data in older care home residents. BMC Geriatr 2022; 22:136. [PMID: 35177023 PMCID: PMC8855571 DOI: 10.1186/s12877-021-02725-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/15/2021] [Indexed: 11/27/2022] Open
Abstract
Background Research protocols regarding the use of ActiGraph wGT3X+ accelerometers in care home residents are yet to be established. The purpose of this study was to identify the minimal wear time criteria required to achieve reliable estimates of physical activity (PA) and sedentary behaviour (SB) in older care home residents. Methods Ninety-four older adults from 14 care homes wore an ActiGraph wGT3X+ accelerometer on the right hip for 7 consecutive days. A pragmatic, staged approach was adopted in order to explore the effect of: monitoring day; minimum daily wear time and number of wear days on estimates of four outcomes derived from the accelerometer data: counts.day− 1, counts.minute− 1, PA time and SB time. Results Data from 91 participants (mean age: 84 ± 9 years, 34% male) was included in the analysis. No effect of monitoring day was observed. Lowering the daily wear time to ≥ 8 h (compared to ≥10 h) had no effect on the outcomes of interest. Four days of monitoring was sufficient to provide reliable estimates of all four outcomes. Conclusion In this study, a minimum wear time criterion of ≥ 8 h on any 4 days was required to derive reliable estimates of PA and SB from ActiGraph wGT3X+ accelerometer data in older care home residents.
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Affiliation(s)
- Jennifer Airlie
- Academic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.
| | - Anne Forster
- Academic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.,Academic Unit for Ageing and Stroke Research, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Karen M Birch
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, UK
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Urinary Incontinence and Its Association with Physical and Psycho-Cognitive Factors: A Cross-Sectional Study in Older People Living in Nursing Homes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031500. [PMID: 35162524 PMCID: PMC8835480 DOI: 10.3390/ijerph19031500] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 02/01/2023]
Abstract
Urinary incontinence (UI) is a common geriatric syndrome affecting bladder health and is especially prevalent in nursing homes (NHs). The aim of the study was to determine the prevalence of UI and its associated factors in five Spanish NHs. UI (measured with Minimum Data Set 3.0), sociodemographic, and health-related variables were collected. Chi-square (or Fisher's) or Student's t-test (or Mann Whitney U) for bivariate analysis were used, with Prevalence Ratio (PR) as an association measure. The prevalence of UI was 66.1% (CI:95%, 53.6-77.2) in incontinent (n = 45, mean age 84.04, SD = 7.7) and continent (n = 23, mean age 83.00, SD = 7.7) groups. UI was significantly associated with frailty (PR = 1.84; 95%CI 0.96-3.53), faecal incontinence (PR = 1.65; 95%CI 1.02-2.65), anxiety (PR = 1.64; 95%CI 1.01-2.66), physical performance (PR = 1.77; 95%CI 1.00-3.11), and cognitive state (PR = 1.95; 95%CI 1.05-3.60). Statistically significant differences were found between incontinent and continent NH residents for limitations in activities of daily living (ADL), mobility, quality of life, sedentary behaviour, and handgrip strength. It can be concluded that two out of three of the residents experienced UI, and significant associated factors were mainly physical (sedentary behaviour, frailty, physical performance, ADL limitations, mobility, faecal incontinence, and handgrip strength) followed by psycho-cognitive factors (cognition, anxiety, and quality of life).
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Tzeng HM, Downer B, Haas A, Ottenbacher KJ. Association Between Cognitive Status and Falls With and Without Injury During a Skilled Nursing Facility Short Stay. J Am Med Dir Assoc 2022; 23:128-132.e2. [PMID: 34237256 PMCID: PMC8712356 DOI: 10.1016/j.jamda.2021.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/08/2021] [Accepted: 06/10/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To examine the relationship between cognitive status and falls with and without injury among older adults during the first 18 days of a skilled nursing facility (SNF) and determine if this association is mediated by limitations in activities of daily living (ADL) and impaired balance. DESIGN Cohort study of Medicare fee-for-service beneficiaries admitted to an SNF between October 1, 2016, and September 31, 2017. SETTINGS AND PARTICIPANTS 815,927 short-stay nursing home residents admitted to an SNF within 3 days of hospital discharge. METHODS Cognitive status at SNF admission was classified as intact, mild, moderate, or severe impairment. Residents were classified as having no falls, a fall without injury, and a fall with a minor or major injury. We used ordinal logistic regression to model the association between cognitive status and falls adjusting for resident and facility characteristics. A causal mediation analysis was used to test for the mediating effects of ADL limitations and impaired balance on the association between cognitive status and falls with an injury. RESULTS Mild, moderate, and severe cognitive impairment were associated with 1.72 (95% CI: 1.68-1.75), 2.72 (95% CI: 2.66-2.78), and 2.61 (95% CI: 2.48-2.75) higher odds of being in a higher fall severity category, respectively, compared to being cognitively unimpaired. Greater ADL limitations and impaired balance were significantly associated with falls, but each mediated the association between cognitive status and falls by less than 2%. CONCLUSIONS AND IMPLICATIONS Older adults with cognitive impairment are more likely to experience a fall during an SNF stay. ADL limitations and impaired balance are risk factors for falls but may not contribute to the increased fall risk for SNF residents with cognitive impairment. Continued research is needed to better understand the risk factors for falls among SNF residents with cognitive impairment.
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Affiliation(s)
- Huey-Ming Tzeng
- School of Nursing, University of Texas Medical Branch, Galveston, TX, USA; Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
| | - Brian Downer
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA; Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, USA.
| | - Allen Haas
- Office of Biostatistics, University of Texas Medical Branch, Galveston, TX, USA
| | - Kenneth J Ottenbacher
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA; Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, USA
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Forster A, Airlie J, Ellwood A, Godfrey M, Green J, Cundill B, Dawkins B, McMaster N, Hulme C, Cicero R, McLellan V, Graham L, Gallagher B, Ellard DR, Firth J, Farrin A. An intervention to increase physical activity in care home residents: results of a cluster-randomised, controlled feasibility trial (the REACH trial). Age Ageing 2021; 50:2063-2078. [PMID: 34304268 PMCID: PMC8581372 DOI: 10.1093/ageing/afab130] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Care home (CH) residents are mainly inactive, leading to increased dependency and low mood. Strategies to improve activity are required. DESIGN AND SETTING Cluster randomised controlled feasibility trial with embedded process and health economic evaluations. Twelve residential CHs in Yorkshire, United Kingdom, were randomised to the MoveMore intervention plus usual care (UC) (n = 5) or UC only (n = 7). PARTICIPANTS Permanent residents aged ≥65 years. INTERVENTION MoveMore: a whole home intervention involving all CH staff designed to encourage and support increase in movement of residents. OBJECTIVES AND MEASUREMENTS Feasibility objectives relating to recruitment, intervention delivery, data collection and follow-up and safety concerns informed the feasibility of progression to a definitive trial. Data collection at baseline, 3, 6 and 9 months included: participants' physical function and mobility, perceived health, mood, quality of life, cognitive impairment questionnaires; accelerometry; safety data; intervention implementation. RESULTS 300 residents were screened; 153 were registered (62 MoveMore; 91 UC). Average cluster size: MoveMore: 12.4 CHs; UC: 13.0 CHs. There were no CH/resident withdrawals. Forty (26.1%) participants were unavailable for follow-up: 28 died (12 MoveMore; 16 UC); 12 moved from the CH. Staff informant/proxy data collection for participants was >80%; data collection from participants was <75%; at 9 months, 65.6% of residents provided valid accelerometer data; two CHs fully, two partially and one failed to implement the intervention. There were no safety concerns. CONCLUSIONS Recruiting CHs and residents was feasible. Intervention implementation and data collection methods need refinement before a definitive trial. There were no safety concerns.
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Affiliation(s)
- Anne Forster
- Academic Unit for Ageing and Stroke Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
- Leeds Institute of Health Sciences, University of Leeds, Leeds, West Yorkshire, UK
| | - Jennifer Airlie
- Academic Unit for Ageing and Stroke Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Alison Ellwood
- Centre for Dementia Studies, University of Bradford, Bradford, UK
| | - Mary Godfrey
- Academic Unit for Ageing and Stroke Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
- Leeds Institute of Health Sciences, University of Leeds, Leeds, West Yorkshire, UK
| | - John Green
- Academic Unit for Ageing and Stroke Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Bonnie Cundill
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds UK
| | - Bryony Dawkins
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Claire Hulme
- Institute of Health Research, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Robert Cicero
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds UK
| | - Vicki McLellan
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds UK
| | - Liz Graham
- Academic Unit for Ageing and Stroke Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Bev Gallagher
- NHS Bradford District and Craven Clinical Commissioning Group, Bradford, UK
| | - David R Ellard
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Joan Firth
- Patient and Public Involvement Contributor, Ilkley, UK
| | - Amanda Farrin
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds UK
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Forster A, Godfrey M, Green J, McMaster N, Airlie J, Cundill B, Lawton R, Hawkins R, Hulme C, Birch K, Brown L, Cicero R, Crocker TF, Dawkins B, Ellard DR, Ellwood A, Firth J, Gallagher B, Graham L, Johnson L, Lusambili A, Marti J, McCrorie C, McLellan V, Patel I, Prashar A, Siddiqi N, Trépel D, Wheeler I, Wright A, Young J, Farrin A. Strategies to enhance routine physical activity in care home residents: the REACH research programme including a cluster feasibility RCT. PROGRAMME GRANTS FOR APPLIED RESEARCH 2021. [DOI: 10.3310/pgfar09090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background
Care home residents are mainly inactive, leading to increased dependency and low mood. Although exercise classes may increase activity, a more sustainable model is to engage staff and residents in increasing routine activity.
Objectives
The objectives were to develop and preliminarily test strategies to enhance the routine physical activity of care home residents to improve their physical, psychological and social well-being through five overlapping workstreams.
Design
This trial had a mixed-methods research design to develop and test the feasibility of undertaking an evaluative study consisting of gaining an understanding of the opportunities for and barriers to enhancing physical activity in care homes (workstream 1); testing physical activity assessment instruments (workstream 2); developing an intervention through a process of intervention mapping (workstream 3); refining the provisional intervention in the care home setting and clarifying outcome measurement (workstream 4); and undertaking a cluster randomised feasibility trial of the intervention [introduced via three facilitated workshops at baseline (with physiotherapist input), 2 weeks (with artist input) and 2 months], with embedded process and health economic evaluations (workstream 5).
Setting
The trial was set in 12 residential care homes differing in size, location, ownership and provision in Yorkshire, UK.
Participants
The participants were elderly residents, carers, managers and staff of care homes.
Intervention
The intervention was MoveMore, designed for the whole home, to encourage and support the movement of residents in their daily routines.
Main outcome measures
The main outcome measures related to the feasibility and acceptability of implementing a full-scale trial in terms of recruitment and retention of care homes and residents, intervention delivery, completion and reporting of baseline data and outcomes (including hours of accelerometer wear, hours of sedentary behaviour and hours and type of physical activity), and safety and cost data (workstream 5).
Results
Workstream 1 – through a detailed understanding of life in a care home, a needs assessment was produced, and barriers to and facilitators of activity were identified. Key factors included ethos of care; organisation, management and delivery of care; use of space; and the residents’ daily routines. Workstream 2 – 22 (73.3%) out of 30 residents who wore a hip accelerometer had valid data (≥ 8 hours on ≥ 4 days of the week). Workstream 3 – practical mechanisms for increasing physical activity were developed, informed by an advisory group of stakeholders and outputs from workstreams 1 and 2, framed by the process of intervention mapping. Workstream 4 – action groups were convened in four care homes to refine the intervention, leading to further development of implementation strategies. The intervention, MoveMore, is a whole-home intervention involving engagement with a stakeholder group to implement a cyclical process of change to encourage and support the movement of residents in their daily routines. Workstream 5 – 12 care homes and 153 residents were recruited to the cluster randomised feasibility trial. Recruitment in the care homes varied (40–89%). Five care homes were randomised to the intervention and seven were randomised to usual care. Predetermined progression criteria were recruitment of care homes and residents (green); intervention delivery (amber); and data collection and follow-up – 52% of residents provided usable accelerometer data at 9 months (red), > 75% of residents had reported outcomes at 9 months (green, but self-reported resident outcomes were red), 26% loss of residents to follow-up at 9 months [just missing green criterion (no greater than 25%)] and safety concerns (green).
Limitations
Observations of residents’ movements were not conducted in private spaces. Working with care home residents to identify appropriate outcome measures was challenging. Take-up of the intervention was suboptimal in some sites. It was not possible to make a reliably informed decision on the most appropriate physical activity end point(s) for future use in a definitive trial.
Conclusions
A whole-home intervention was developed that was owned and delivered by staff and was informed by residents and staff. The feasibility of conducting a cluster randomised controlled trial was successfully tested: the target numbers of care homes and residents were recruited, demonstrating that it is possible to recruit care home residents to a cluster randomised trial, although this process was time-consuming and resource heavy. A large data set was collected, which provided a comprehensive picture of the environment, residents and staff in care homes. Extensive quantitative and qualitative work comprehensively explored a neglected area of health and social care research. Completion of ethnographic work in a range of settings enabled the production of an in-depth picture of life in care homes that will be helpful for other researchers considering organisational change in this setting.
Future work
The content and delivery of the intervention requires optimisation and the outcome measurement requires further refinement prior to undertaking a full trial evaluation. Consideration could be given to a recommended, simplified, core outcome set, which would facilitate data collection in this population.
Trial registration
Current Controlled Trials ISRCTN16076575.
Funding
This project was funded by the National Institute for Health Research (NIHR) Programme Grant for Applied Research programme and will be published in full in Programme Grant for Applied Research; Vol. 9, No. 9. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Anne Forster
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Mary Godfrey
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - John Green
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | | | - Jennifer Airlie
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Bonnie Cundill
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | | | - Rebecca Hawkins
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Claire Hulme
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Karen Birch
- Faculty of Biological Sciences, University of Leeds, Leeds, UK
| | - Lesley Brown
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Robert Cicero
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Thomas Frederick Crocker
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Bryony Dawkins
- Academic Unit of Health Economics, School of Medicine, University of Leeds, Leeds, UK
| | - David R Ellard
- Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Alison Ellwood
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Joan Firth
- Patient and public involvement contributor, Ilkley, UK
| | - Bev Gallagher
- Bradford District and Craven Clinical Commissioning Group, Bradford, UK
| | - Liz Graham
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | | | - Adelaide Lusambili
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Joachim Marti
- University Institute of Social and Preventive Medicine, Lausanne, Switzerland
| | - Carolyn McCrorie
- Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Vicki McLellan
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Ismail Patel
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Arvin Prashar
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Najma Siddiqi
- Hull York Medical School, Department of Health Sciences, University of York, York, UK
| | - Dominic Trépel
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Ian Wheeler
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Alan Wright
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - John Young
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Amanda Farrin
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
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Karas M, Urbanek JK, Illiano VP, Bogaarts G, Crainiceanu CM, Dorn JF. Estimation of free-living walking cadence from wrist-worn sensor accelerometry data and its association with SF-36 quality of life scores. Physiol Meas 2021; 42. [PMID: 34049292 DOI: 10.1088/1361-6579/ac067b] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/28/2021] [Indexed: 11/12/2022]
Abstract
Objective. We evaluate the stride segmentation performance of the Adaptive Empirical Pattern Transformation (ADEPT) for subsecond-level accelerometry data collected in the free-living environment using a wrist-worn sensor.Approach. We substantially expand the scope of the existing ADEPT pattern-matching algorithm. Methods are applied to subsecond-level accelerometry data collected continuously for 4 weeks in 45 participants, including 30 arthritis and 15 control patients. We estimate the daily walking cadence for each participant and quantify its association with SF-36 quality of life measures.Main results. We provide free, open-source software to segment individual walking strides in subsecond-level accelerometry data. Walking cadence is significantly associated with the role physical score reported via SF-36 after adjusting for age, gender, weight and height.Significance. Methods provide automatic, precise walking stride segmentation, which allows estimation of walking cadence from free-living wrist-worn accelerometry data. Results provide new evidence of associations between free-living walking parameters and health outcomes.
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Affiliation(s)
- Marta Karas
- Department of Biostatistics, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205, United States of America
| | - Jacek K Urbanek
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, 2024 E Monument St, Baltimore, MD 21205, United States of America
| | | | - Guy Bogaarts
- Novartis Pharma AG, Fabrikstrasse 2, 4056 Basel, Switzerland
| | - Ciprian M Crainiceanu
- Department of Biostatistics, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205, United States of America
| | - Jonas F Dorn
- Novartis Pharma AG, Fabrikstrasse 2, 4056 Basel, Switzerland
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16
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Objectively assessed physical activity and sedentary behavior and global cognitive function in older adults: a systematic review. Mech Ageing Dev 2021; 198:111524. [PMID: 34181963 DOI: 10.1016/j.mad.2021.111524] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/11/2021] [Accepted: 06/17/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Both physical activity (PA) and sedentary behavior (SB) are important factors for healthy ageing. This systematic review aimed to determine the association of objectively assessed (instrumented) PA and SB with global cognitive function in older adults. METHODS PubMed, Embase, the Cochrane Library (via Wiley), CINAHL, PsychINFO, and SPORTDiscus (via EBSCO) were searched from inception to June 21, 2020 for articles that described associations of objectively assessed PA/SB with global cognitive function in older adults aged 60 years and older. Results were synthesized using an effect direction heat map and albatross plots portrayed estimated effect sizes (standardized regression coefficients (βs)), which were summarized in boxplots. RESULTS In total, 45 articles were included representing a total of 15,817 older adults (mean/median age ranged from 65 to 88 years; 49.5% female). Longitudinal studies (n = 7) showed that higher moderate-to-vigorous and light PA (MVPA and LPA, respectively) and lower SB were associated with better global cognitive function. Standardized βs of cross-sectional studies (n = 38) showed that lower SB (median [IQR], β = 0.078 [0.004-0.184] and higher LPA (β = 0.096 [0.046-0.188]), activity counts (β = 0.131 [0.049-0.224]), number of steps (β = 0.155 [0.096-0.246]), MVPA (β = 0.163 [0.069-0.285]) and total PA (TPA) (β = 0.174 [0.147-0.255]) were associated with better global cognitive function. CONCLUSIONS Higher PA and lower SB are associated with better global cognitive function in older adults. The greatest estimated effect sizes were found for moderate-to-vigorous and TPA, suggesting that greater duration of any PA, and high intensity PA could be most beneficial for global cognitive function.
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17
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Viviano NA, Galik E, Resnick B. Racial differences in physical activity in nursing home residents with cognitive impairment. Appl Nurs Res 2021; 60:151445. [PMID: 34247786 DOI: 10.1016/j.apnr.2021.151445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/31/2021] [Accepted: 05/16/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Nursing home (NH) residents with moderate-to-severe cognitive impairment experience mostly sedentary lifestyles. AIM Previous research has examined racial differences in physical activity (PA) levels in community-dwelling older adults but not in NH residents with cognitive impairment, and the current study aimed to examine these differences. METHODS This was a secondary data analysis of baseline data from the Function and Behavior Focused Care Intervention (FBFC) study. The sample included 247 cognitively impaired residents from 12 NHs who wore an ActiGraph to measure PA. RESULTS The residents' mean age was 82.6 (SD = 10.1) and had an average MMSE score of 7.8 (SD = 5.0). The sample (N = 247) was 41% African American and 59% White. African American and White residents engaged in only 50.6 and 46.2 min of light- and 1.5 and 1.1 min of moderate-level PA, respectively. Based on a multivariate analysis of covariance (MANCOVA), there was not a statistically significant difference between African American and White residents on combined dependent PA measures [F (8, 237) = 1.067, p = .387, Wilks' Λ = 0.962]. There was a trend that direct care providers subjectively reported that White residents engaged in more PA than their African American counterparts [F(8, 237) = 2.741, p = .09]. CONCLUSIONS These findings are not consistent with prior research. However, these findings indicate severely low levels of PA in NH residents, regardless of racial group. Future research should prioritize PA interventions that make accommodations for all NH residents, and especially consider their underlying physical comorbidities and cognitive function.
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Affiliation(s)
- Nicole A Viviano
- University of Maryland School of Medicine, Department of Epidemiology and Public Health, Division of Gerontology, 660 W. Redwood Street, Howard Hall 222, Baltimore, MD 21201, United States of America.
| | - Elizabeth Galik
- University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD 21210, United States of America
| | - Barbara Resnick
- University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD 21210, United States of America
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18
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Quantifying physical activity in aged residential care facilities: A structured review. Ageing Res Rev 2021; 67:101298. [PMID: 33592308 DOI: 10.1016/j.arr.2021.101298] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/29/2021] [Accepted: 02/09/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND Engaging aged residential care (ARC) residents with physical activity (PA) may be a useful strategy to decelerate dependence and disability. It is unclear what volume, intensity and patterns of PA ARC residents participate in. This review aims to synthesize the literature to quantify the volume, intensity and pattern of PA that ARC residents participate in across differing care levels (e.g. low, intermediate, high, mixed), and make recommendations for future research. METHODS 30 studies of 48,760 yielded were reviewed using systematic review strategies. RESULTS Questionnaires and technological tools were used to assess PA, with accelerometers employed in 70% of studies. Overall, studies reported low volumes and intensities of PA across all care levels, and suggested limited variation in patterns of PA (e.g. little day-to-day variation in total PA). There was limited inclusion of people with cognitive impairment, potentially causing representativeness bias. Findings were limited by lack of consistency in methodological approaches and PA outcomes. DISCUSSION Based on findings and limitations of current research, we recommend that total volume or low-light intensity PA are more useful interventional outcomes than higher-intensity PA. Researchers also need to consider which methodology and PA outcomes are most useful to quantify PA in ARC residents.
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Farrés-Godayol P, Jerez-Roig J, Minobes-Molina E, Yildirim M, Goutan-Roura E, Coll-Planas L, Escribà-Salvans A, Molas-Tuneu M, Moreno-Martin P, Rierola-Fochs S, Rierola-Colomer S, Romero-Mas M, Torres-Moreno M, Naudó-Molist J, Bezerra de Souza DL, Booth J, Skelton DA, Giné-Garriga M. Urinary incontinence and sedentary behaviour in nursing home residents in Osona, Catalonia: protocol for the OsoNaH project, a multicentre observational study. BMJ Open 2021; 11:e041152. [PMID: 33879481 PMCID: PMC8061864 DOI: 10.1136/bmjopen-2020-041152] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 01/14/2021] [Accepted: 03/24/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Several studies have shown that physical activity (PA) levels and sedentary behaviour (SB) are independent risk factors for many health-related issues. However, there is scarce evidence supporting the relationship between SB and urinary incontinence (UI) in community-dwelling older adults, and no information on any possible association in institutionalised older adults. Stage I of this project has the main objective of determining the prevalence of UI and its associated factors in nursing home (NH) residents, as well as analysing the association between UI (and its types) and SB. Stage II aims to investigate the incidence and predictive factors of functional and continence decline, falls, hospitalisations, mortality and the impact of the COVID-19 pandemic among NH residents. METHODS AND ANALYSIS Stage I is an observational, multicentre, cross-sectional study with mixed methodology that aims to explore the current status of several health-related outcomes in NH residents of Osona (Barcelona, Spain). The prevalence ratio will be used as an association measure and multivariate analysis will be undertaken using Poisson regression with robust variance. Stage II is a 2-year longitudinal study that aims to analyse functional and continence decline, incidence of falls, hospitalisations, mortality and the impact of the COVID-19 pandemic on these outcomes. A survival analysis using the actuarial method for functional decline and continence, evaluated every 6 months, and the Kaplan-Meier method for falls, hospitalisations and deaths, and Cox regression for multivariate analysis will be undertaken. ETHICS AND DISSEMINATION The study received the following approvals: University of Vic - Central University of Catalonia Ethics and Research Committee (92/2019 and 109/2020), Clinical Research Ethics Committee of the Osona Foundation for Health Research and Education (FORES) (code 2020118/PR249). Study results will be disseminated at conferences, meetings and through peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT04297904.
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Affiliation(s)
- Pau Farrés-Godayol
- 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 (UVic-UCC), Vic, Barcelona, Spain
| | - Javier Jerez-Roig
- 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 (UVic-UCC), Vic, Barcelona, Spain
| | - Eduard Minobes-Molina
- 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 (UVic-UCC), Vic, Barcelona, Spain
| | - Meltem Yildirim
- 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 (UVic-UCC), Vic, Barcelona, Spain
| | - Ester Goutan-Roura
- Research group on Tissue Repair and Regeneration Laboratory (TR2Lab), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Barcelona, Spain
| | - Laura Coll-Planas
- 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 (UVic-UCC), Vic, Barcelona, Spain
- Fundació Salut i Envelliment (Foundation on Health and Ageing), Autonomous University of Barcelona, Barcelona, Spain
| | - Anna Escribà-Salvans
- 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 (UVic-UCC), Vic, Barcelona, Spain
| | - Miriam Molas-Tuneu
- 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 (UVic-UCC), Vic, Barcelona, Spain
| | - Pau Moreno-Martin
- 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 (UVic-UCC), Vic, Barcelona, Spain
| | - Sandra Rierola-Fochs
- 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 (UVic-UCC), Vic, Barcelona, Spain
| | - Sergi Rierola-Colomer
- 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 (UVic-UCC), Vic, Barcelona, Spain
| | - Montse Romero-Mas
- 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 (UVic-UCC), Vic, Barcelona, Spain
| | - Miriam Torres-Moreno
- 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 (UVic-UCC), Vic, Barcelona, Spain
| | - Jordi Naudó-Molist
- Research group on Mental Health and Social Innovation (SAMIS), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Barcelona, Spain
| | - Dyego Leandro Bezerra de Souza
- 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 (UVic-UCC), Vic, Barcelona, Spain
- Department of Collective Health, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Joanne Booth
- Research Centre for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Dawn A Skelton
- Research Centre for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Maria Giné-Garriga
- Faculty of Psychology, Education and Sport Sciences Blanquerna, Ramon Llull University, Barcelona, Spain
- Faculty of Health Sciences Blanquerna, Ramon Llull University, Barcelona, Spain
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20
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Ferreira S, Raimundo A, Del Pozo-Cruz J, Marmeleira J. Psychometric properties of a computerized and hand-reaction time tests in older adults using long-term facilities with and without mild cognitive impairment. Exp Gerontol 2021; 147:111271. [PMID: 33549821 DOI: 10.1016/j.exger.2021.111271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/25/2021] [Accepted: 02/02/2021] [Indexed: 10/22/2022]
Abstract
The aim of this study was to determine the absolute and relative reliability and validity of two reaction time (RT) tests in older adults using long-term facility: the ruler drop test (RDT, a simple RT) and the Deary-Liewald RT task (DLRT, simple and four-choice RT). Participants (≥65 years old) using long-term facilities were distributed into a group without cognitive impairment (GWCI, n = 41), and a group with mild cognitive impairment (GCI, n = 32). The tests were administered one week apart, by the same evaluator. Relative reliability was measured by the Intraclass Correlation Coefficient (ICC3.1), absolute reliability by the standard error of measurement (SEM) and minimal detectable change (MDC95) and convergent validity by the Pearson correlation. The results showed that the relative reliability was good for the RDT (GWCI, ICC = 0.84; GCI, ICC = 0.80) and moderate for the Deary Liewald RT simple (DLRT-S) (GWCI, ICC = 0.61; GCI, ICC = 0.65). The relative reliability of the Deary Liewald RT choice (DLRT-C) was good (ICC = 0.89) for the GWCI and excellent (ICC = 0.93) for the GCI. However, the DLRT-C had low feasibility in the GCI, as most participants were unable to complete the test. Measurement precision was acceptable for the RDT and DLRT-C (GWCI) and for the DLRT-C (GCI). There were no significant associations between the RDT and DLRT scores. We conclude that the RDT could be more suitable than the DLRT-S for assessing simple RT in older adults. Future studies should explore if fewer than the four stimulus-response alternatives used in the DLRT-C could be more appropriate for assessing choice RT in older adults with cognitive impairment.
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Affiliation(s)
- Soraia Ferreira
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Portugal; Comprehensive Health Research Centre (CHRC), Universidade de Évora, Portugal.
| | - Armando Raimundo
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Portugal; Comprehensive Health Research Centre (CHRC), Universidade de Évora, Portugal
| | - Jesus Del Pozo-Cruz
- Departamento de Educación Física y Deporte, Universidad de Sevilla, Spain; Epidemiology of Physical Activity and Fitness Across Lifespan Research Group (EPAFit), Universidad de Sevilla, Spain
| | - José Marmeleira
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Portugal; Comprehensive Health Research Centre (CHRC), Universidade de Évora, Portugal
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21
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Quijoux F, Bertin-Hugault F, Zawieja P, Lefèvre M, Vidal PP, Ricard D. Postadychute-AG, Detection, and Prevention of the Risk of Falling Among Elderly People in Nursing Homes: Protocol of a Multicentre and Prospective Intervention Study. Front Digit Health 2021; 2:604552. [PMID: 34713067 PMCID: PMC8521935 DOI: 10.3389/fdgth.2020.604552] [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: 09/09/2020] [Accepted: 12/15/2020] [Indexed: 12/02/2022] Open
Abstract
Introduction: While falls among the elderly is a public health issue, because of the social, medical, and economic burden they represent, the tools to predict falls are limited. Posturography has been developed to distinguish fallers from non-fallers, however, there is too little data to show how predictions change as older adults' physical abilities improve. The Postadychute-AG clinical trial aims to evaluate the evolution of posturographic parameters in relation to the improvement of balance through adapted physical activity (APA) programs. Methods: In this prospective, multicentre clinical trial, institutionalized seniors over 65 years of age will be followed for a period of 6 months through computer-assisted posturography and automatic gait analysis. During the entire duration of the follow-up, they will benefit from a monthly measurement of their postural and locomotion capacities through a recording of their static balance and gait thanks to a software developed for this purpose. The data gathered will be correlated with the daily record of falls in the institution. Static and dynamic balance measurements aim to extract biomechanical markers and compare them with functional assessments of motor skills (Berg Balance Scale and Mini Motor Test), expecting their superiority in predicting the number of falls. Participants will be followed for 3 months without APA and 3 months with APA in homogeneous group exercises. An analysis of variance will evaluate the variability of monthly measures of balance in order to record the minimum clinically detectable change (MDC) as participants improve their physical condition through APA. Discussion: Previous studies have stated the MDC through repeated measurements of balance but, to our knowledge, none appear to have implemented monthly measurements of balance and gait. Combined with a reliable measure of the number of falls per person, motor capacities and other precipitating factors, this study aims to provide biomechanical markers predictive of fall risk with their sensitivity to improvement in clinical status over the medium term. This trial could provide the basis for posturographic and gait variable values for these elderly people and provide a solution to distinguish those most at risk to be implemented in current practice in nursing homes. Trial Registration: ID-RCB 2017-A02545-48. Protocol Version: Version 4.2 dated January 8, 2020.
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Affiliation(s)
- Flavien Quijoux
- Centre Borelli UMR 9010/Université Paris-Saclay, ENS Paris-Saclay, CNRS, SSA, Université de Paris, Inserm, Paris, France
- ORPEA Group, Puteaux, France
| | | | | | | | - Pierre-Paul Vidal
- Centre Borelli UMR 9010/Université Paris-Saclay, ENS Paris-Saclay, CNRS, SSA, Université de Paris, Inserm, Paris, France
- Institute of Information and Control, Hangzhou Dianzi University, Hangzhou, China
| | - Damien Ricard
- Centre Borelli UMR 9010/Université Paris-Saclay, ENS Paris-Saclay, CNRS, SSA, Université de Paris, Inserm, Paris, France
- Service de Neurologie de l'Hôpital d'Instruction des Armées de Percy, Service de Santé des Armées, Clamart, France
- Ecole du Val-de-Grâce, Ecole de Santé des Armées, Paris, France
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22
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Ferreira S, Raimundo A, Marmeleira J. Test-retest reliability of the functional reach test and the hand grip strength test in older adults using nursing home services. Ir J Med Sci 2021; 190:1625-1632. [PMID: 33475966 DOI: 10.1007/s11845-020-02492-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/17/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE This study aimed to determine the absolute and relative test-retest reliability of the functional reach test (FRT) and the handgrip strength test (HGST) in older adults using nursing homes. METHODS Participants (≥ 65 years old), living in nursing homes or using their day care services, were distributed into a group without cognitive impairment (GWCI, n = 43) and a group with mild cognitive impairment (GCI; n = 22). A 1-week test-retest was performed for the FRT and the HGST. Relative reliability was measured by the intraclass correlation coefficient (ICC3.1), and absolute reliability by the standard error of measurement (SEM), minimal detectable change (MDC95), and Bland-Altman plots. RESULTS The ICC showed high reliability for the FRT (GWCI, ICC = 0.83; GCI, ICC = 0.87) and the HGST (ICC ≥ 0.95 in both hands and participant groups). The absolute reliability was good: FRT, SEM = 2.96/2.29, MDC95 = 8.20/6.35 for the GWCI and the GCI, respectively; HGST dominant hand SEM = 1.26/0.82, MDC95 = 3.50/2.29, and HGST non-dominant hand SEM = 1.05/0.80, MDC95 = 2.90/2.21, for the GWCI and the GCI, respectively. Bland-Altman showed that there was not a systematic bias for the tests in both groups. DISCUSSION Findings show that the FRT and the HGST are reliable, have acceptable measurement error, and may be used for research and clinical purposes to assess functional balance and strength of the hands in older adults using nursing homes.
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Affiliation(s)
- Soraia Ferreira
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Rua de Reguengos de Monsaraz, n° 14, 7005-399, Évora, Portugal. .,Comprehensive Health Research Centre (CHRC), Lisboa, Portugal.
| | - Armando Raimundo
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Rua de Reguengos de Monsaraz, n° 14, 7005-399, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), Lisboa, Portugal
| | - José Marmeleira
- Departamento de Desporto e Saúde, Escola de Ciências e Tecnologia, Universidade de Évora, Rua de Reguengos de Monsaraz, n° 14, 7005-399, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), Lisboa, Portugal
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23
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Born Lopes P, Rodacki ALF, Wolf R, Fisher K, Bento PCB, Pereira G. Can Age Influence Functional Tests Differently to Predict Falls in Nursing Home and Community-Dwelling Older Adults? Exp Aging Res 2021; 47:192-202. [PMID: 33423605 DOI: 10.1080/0361073x.2020.1871277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Aim: The aim of this cross-sectional study was to determine which functional tests are able to predict falls in nursing home residents (NHR) and community-dwelling (CDW) older adults grouped by age. Methods: Two hundred and fifty-two older adults were assessed in the following tests, Mini-Mental State Examination, anthropometric characteristics, fall history and functional tests. The participants were assigned to one of the following groups: Young Older Adults (YOA; 60-69 years, n = 102; 27.5% NHR), Old Older Adults (OOA; 70-79 years; n = 100; 23.5% NHR) and Very Older Adults (VOA, ≥80 years; n = 50; 52% NHR). Results: The five times sit-to-stand showed 1.41 odds to experience a fall in the NHR of the VOA. In the CDW, the handgrip strength score decreased the odds to fall occurrence (0.92 odds) in the YOA, while the low score in timed up and go test of the OOA showed 1.21 odds to experience a fall. Conclusions: Therefore, the five times sit-to-stand test can predict falls in NHR of VOA groups, while handgrip strength and timed up and go tests can predict falls in CDW of YOA and OOA groups, respectively.
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Affiliation(s)
- Paula Born Lopes
- Núcleo de Ciências Biologicas da Saúde, Positivo University , Curitiba, Brazil.,Physical Education Department, Federal University of Parana , Curitiba, Brazil
| | | | - Renata Wolf
- Physical Education Department, Federal University of Parana , Curitiba, Brazil
| | - Koren Fisher
- Department of Kinesiology, California State University, Fullerton , Fullerton, California, USA
| | | | - Gleber Pereira
- Physical Education Department, Federal University of Parana , Curitiba, Brazil
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24
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Galhardas L, Raimundo A, Marmeleira J. Test-retest reliability of upper-limb proprioception and balance tests in older nursing home residents. Arch Gerontol Geriatr 2020; 89:104079. [DOI: 10.1016/j.archger.2020.104079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 12/26/2022]
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25
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Bouillon-Minois JB, Lahaye C, Dutheil F. Coronavirus and quarantine: will we sacrifice our elderly to protect them? Arch Gerontol Geriatr 2020; 90:104118. [PMID: 32470862 PMCID: PMC7240263 DOI: 10.1016/j.archger.2020.104118] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/17/2020] [Accepted: 05/18/2020] [Indexed: 12/25/2022]
Affiliation(s)
- Jean-Baptiste Bouillon-Minois
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Emergency Medicine, F-63000 Clermont-Ferrand, France.
| | - Clément Lahaye
- Université Clermont Auvergne, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Department of Geriatric, F-63000 Clermont-Ferrand, France
| | - Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Occupational and Environmental Medicine, WittyFit, F-63000 Clermont-Ferrand, France
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26
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Kang GE, Najafi B. Sensor-Based Daily Physical Activity: Towards Prediction of the Level of Concern about Falling in Peripheral Neuropathy. SENSORS 2020; 20:s20020505. [PMID: 31963201 PMCID: PMC7014201 DOI: 10.3390/s20020505] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 01/10/2020] [Accepted: 01/15/2020] [Indexed: 12/16/2022]
Abstract
Concern about falling is prevalent and increases the risk of falling in people with peripheral neuropathy (PN). However, the assessment of concern about falling relies on self-report surveys, and thus continuous monitoring has not been possible. We investigated the influence of concern about falling on sensor-based daily physical activity among people with PN. Forty-nine people with PN and various levels of concern about falling participated in this study. Physical activity outcomes were measured over a period of 48 hours using a validated chest-worn sensor. The level of concern about falling was assessed using the falls efficacy scale-international (FES-I). The low concern group spent approximately 80 min more in walking and approximately 100 min less in sitting/lying compared to the high concern group. In addition, the low concern group had approximately 50% more walking bouts and step counts compared to the high concern group. Across all participants, the duration of walking bouts and total step counts was significantly correlated with FES-I scores. The duration of walking bouts and total step counts may serve as eHealth targets and strategies for fall risk assessment among people with PN.
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27
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Lu Z, Harris TB, Shiroma EJ, Leung J, Kwok T. Patterns of Physical Activity and Sedentary Behavior for Older Adults with Alzheimer's Disease, Mild Cognitive Impairment, and Cognitively Normal in Hong Kong. J Alzheimers Dis 2019; 66:1453-1462. [PMID: 30412502 DOI: 10.3233/jad-180805] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is the most common form of dementia, and mild cognitive impairment (MCI) is a transitional phase between healthy cognition and dementia. Physical activity (PA) has protective effects on cognitive decline. However, few studies have examined how PA and sedentary behavior is structured throughout the day in older adults across varied cognitive status in Hong Kong. OBJECTIVE This study aimed to compare patterns of PA and sedentary behavior among individuals with AD, MCI, or normal cognition living in Hong Kong. METHODS Participants in the MrOs and MsOs Hong Kong cohort study and the Hong Kong AD biomarker study (n = 810) wore a wrist-worn accelerometer for 7 days in free-living environment. Patterns of PA in wake time and in-bed time, and detailed analysis of sedentary bouts were compared between groups using analysis of covariance adjusting for covariates. RESULTS Participants with MCI and low MoCA only did not differ from their cognitively normal peers in PA and sedentary behavior. Nevertheless, when comparing to the others, participants with AD exhibited significantly lower average daily counts per minute during the day (p < 0.05), and tended to start their activity later in the morning. AD participants spent a larger proportion of time in sedentary behavior (p < 0.05) and had more sedentary bouts≥30 minutes (p < 0.05). CONCLUSIONS The pattern of PA and sedentary behavior was different between individuals with AD and the others. Cognitive status may alter the purpose and type of PA intervention for AD individuals.
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Affiliation(s)
- Zhihui Lu
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Tamara B Harris
- Lab of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
| | - Eric J Shiroma
- Lab of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
| | - Jason Leung
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, China
| | - Timothy Kwok
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.,Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, China
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28
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Mc Ardle R, Del Din S, Donaghy P, Galna B, Thomas A, Rochester L. Factors That Influence Habitual Activity in Mild Cognitive Impairment and Dementia. Gerontology 2019; 66:197-208. [DOI: 10.1159/000502288] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/23/2019] [Indexed: 11/19/2022] Open
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29
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Zadworna-Cieślak M. Spirituality, satisfaction with life and health-related behavior of older residents of long-term care institutions-a pilot study. Explore (NY) 2019; 16:123-129. [PMID: 31519423 DOI: 10.1016/j.explore.2019.07.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 07/18/2019] [Accepted: 07/25/2019] [Indexed: 01/06/2023]
Abstract
Spirituality and satisfaction with life are psychological factors related to health behavior. The aim of the study was to determine whether satisfaction with life acts as a mediator in the relationship between the spirituality of residents of long-term care institutions and their health-related behavior. A total of 102 people aged 60-99 were examined. It was found that satisfaction with life played a mediating role in the relationship between spirituality and health behavior. The study addresses the gap in knowledge regarding institutionalized older adults, exploring the role of spirituality and satisfaction with life on lifestyle in nursing home settings.
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Affiliation(s)
- Magdalena Zadworna-Cieślak
- University of Lodz, Faculty of Educational Sciences, Institute of Psychology, Department of Health Psychology, Smugowa Street 10/12, 91-433 Łódź, Poland.
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30
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Kehler DS, Theou O. The impact of physical activity and sedentary behaviors on frailty levels. Mech Ageing Dev 2019; 180:29-41. [PMID: 30926562 DOI: 10.1016/j.mad.2019.03.004] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 03/12/2019] [Accepted: 03/25/2019] [Indexed: 12/17/2022]
Abstract
Heterogeneity in aging can be explained by frailty. Lifestyle behaviors such as physical activity can help manage frailty levels. Conversely, sedentary behaviours are associated with frailty independently of physical activity. Here, we summarize epidemiological and clinical trial evidence concerning the impact of physical activity and sedentary behaviors on frailty levels. We also analysed the National Health and Nutrition Examination Survey (NHANES) data to describe physical activity and sedentary behavior accumulation patterns across frailty levels and their impact on mortality risk. The few prospective and intervention studies demonstrate that higher physical activity levels are associated with a lower incidence of frailty. There are no interventions published which limit sedentary behaviors to manage frailty. Using the NHANES data we demonstrate that individuals are less likely to meet physical activity guidelines and are more likely to accumulate sedentary time in prolonged bouts. Prolonged sedentary bouts and total sedentary time were associated with a higher mortality risk in frail individuals but not in the fit group. Non-bouted sedentary time was not associated with mortality risk. Our review and novel data suggest that there is a need for more intervention studies which focus on increasing physical activity or minimizing sedentary time to manage frailty levels.
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Affiliation(s)
| | - Olga Theou
- Department of Medicine, Dalhousie University, Halifax, NS, Canada
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31
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Cho MS, Kim JY. Effects of exercise and nutrition education programs on motor function and eating habit in mild dementia patients. J Exerc Rehabil 2019; 15:88-94. [PMID: 30899742 PMCID: PMC6416496 DOI: 10.12965/jer.1836632.316] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 01/22/2019] [Indexed: 12/17/2022] Open
Abstract
The purpose of this study was to investigate the effects of physical ac-tivity and nutrition education programs on mild dementia patients with changes in exercise function and eating habits. We examined the effects of pre and post program on 23 old patients with dementia who were diagnosed with menarche or mild dementia with the permission of the dementia center in Incheon city and visited from April to July 2017. The Mini-Mental State Examination score of the subjects in this study was 19.68±3.25, consisting of mild dementia patients. After performing the program for 16 weeks, the senior fitness test showed a significant change in the arm curl test, chair sit-and-reach test, and 2-min step test, and a total score of mini nutrition assessment increased from 19.16 to 21.0. In particular, in a level 2 evaluation, which contains more details such as the condition of taking drugs, number of daily meals, protein food intake condition, intake of vegetables, fruit, and water, whether one can eat alone, and evaluation of nutritive condition, a significant increase from 9.78 to 11.28 was verified. There is a significant increase in nutrition condition recovery as a result of nutrition education. In comparing pre and post program, a significant result was confirmed, and there was significance to provide the basic empirical data for the exercise and dietary life nutritional education of mild dementia patients.
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Affiliation(s)
- Min-Soo Cho
- Liberal Arts College, Chungwoon University, Incheon, Korea
| | - Ji-Youn Kim
- Exercise Rehabilitation Convergence Institute, Gachon University, Incheon, Korea
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