1
|
López-Novis I, Marques-Sule E, Deka P, Dobarrio-Sanz I, Klompstra L, Hernández-Padilla JM. Exploring physical activity experiences of community-dwelling oldest-old adults with chronic multimorbidity: A qualitative study. J Adv Nurs 2025; 81:1953-1965. [PMID: 39152567 DOI: 10.1111/jan.16403] [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: 02/24/2024] [Revised: 07/22/2024] [Accepted: 08/02/2024] [Indexed: 08/19/2024]
Abstract
AIM To explore the physical activity experiences of community-dwelling oldest-old adults with chronic multimorbidity. DESIGN Descriptive qualitative study. METHOD Data collection was conducted through semi-structured interviews with 19 community-dwelling oldest-old adults with chronic multimorbidity. The study was conducted between December 2022 and May 2023. ATLAS.ti software was used for data analysis. RESULTS Three main themes with their respective sub-themes and units of meaning were developed from the data analysis: (1) motivational factors for engaging in physical activity; (2) fear of getting hurt during physical activity and (3) confidence in being physically active. CONCLUSION Motivation, kinesiophobia and confidence are three core elements that influence the experience of physical activity in oldest-old adults with chronic multimorbidity. Interventions tailored to meet the needs of the oldest-old adults are important for promotion and development of active ageing. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Nurses and other healthcare professionals should design, implement and evaluate interventions that aim to increase oldest-old adults' motivation and confidence, while decreasing their fear to engage in physical activity. IMPACT This study provides insights into the way community-dwelling oldest-old adults with chronic multimorbidity experience physical activity in their daily lives. Our findings suggest that motivation, kinesiophobia and confidence are key factors for oldest-old adults to engage in physical activity. These findings could contribute to the design and implementation of interventions that specifically aim at raising the physical activity levels of community-dwelling oldest-old adults with chronic multimorbidity. REPORTING METHOD The study findings are reported according to the COREQ guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
Collapse
Affiliation(s)
| | - Elena Marques-Sule
- Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Pallav Deka
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Iria Dobarrio-Sanz
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
| | - Leonie Klompstra
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - José Manuel Hernández-Padilla
- Faculty of Health Sciences, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
| |
Collapse
|
2
|
Arslan YZ, Hüzmeli İ, Katayıfçı N, Kurtul A. Validity and reliability study of the Turkish version of the multidimensional outcome expectations for exercise scale (MOEES) in patients with cardiovascular diseases. Sci Rep 2025; 15:8464. [PMID: 40069247 DOI: 10.1038/s41598-025-92222-2] [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: 09/13/2024] [Accepted: 02/26/2025] [Indexed: 03/14/2025] Open
Abstract
Outcome expectations are a multidimensional construct encompassing physical, social, and self-evaluative components, significantly influencing adults' exercise behaviors. The study aimed to develop and validate a Turkish version of the 'Multidimensional Outcome Expectations for Exercise Scale' (MOEES) and assess its reliability in adults with cardiovascular disease (CVD). This cross-sectional validation included 150 participants. The MOEES was translated into Turkish, ensuring cultural and linguistic appropriateness, and reviewed by 15 healthcare professionals. Participants' demographic data were collected, and they completed the MOEES, International Physical Activity Questionnaire (IPAQ), and Tampa Scale for Kinesiophobia-Heart (TSK-H) twice, 15 days apart. The internal consistency of the MOEES was excellent, with a Cronbach's Alpha of 0.919. Test-retest reliability showed high intraclass correlation coefficients (ICC) for the physical (0.924), self-evaluative (0.921), and social (0.929) subscales. Confirmatory factor analysis (CFA) indicated an excellent fit (X2/df = 1.782, GFI = 0.908, AGFI = 0.856, CFI = 0.962, RMSEA = 0.072, NFI = 0.918, SRMR = 0.052). Strong correlations were found between MOEES sub-dimensions and IPAQ total and TSK-H scores (p < 0.01), confirming the scale's validity. The Turkish MOEES is a reliable tool for evaluating physical, social, and self-evaluative outcome expectations regarding exercise in CVD patients, making it suitable for clinical and research applications.
Collapse
Affiliation(s)
- Yusuf Ziya Arslan
- Instutue of Health Sciences, Department of Physiotherapy and Rehabilitation, Hatay Mustafa Kemal University, Hatay, Turkey
| | - İrem Hüzmeli
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Hatay Mustafa Kemal University, Hatay, Turkey.
| | - Nihan Katayıfçı
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Hatay Mustafa Kemal University, Hatay, Turkey
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
| | - Alparslan Kurtul
- Tayfur Ata Sökmen Faculty of Medicine, Department of Cardiology, Hatay Mustafa Kemal University, Hatay, Turkey
| |
Collapse
|
3
|
Huang L, Liang Z, Chen H. Association between physical activity and frailty transitions in middle-aged and older adults: a nationwide longitudinal study. Int J Behav Nutr Phys Act 2025; 22:31. [PMID: 40065345 PMCID: PMC11895274 DOI: 10.1186/s12966-025-01725-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2024] [Accepted: 02/20/2025] [Indexed: 03/14/2025] Open
Abstract
BACKGROUND Frailty has become an important health problem in the middle-aged and older people population. Physical activity (PA) is a key intervention for frailty prevention and management. However, studies of the association between COVID-19 pre-pandemic PA and the worsening or improvement of frailty during the pandemic remain unclear. METHODS This longitudinal cohort study used data from the English Longitudinal Study of Ageing (ELSA), including participants aged 50 and over. Three intensities of PA (vigorous, moderate, and mild) were categorized as less than once per week and at least once per week, respectively, based on participant self-report. The frailty index (FI) assessed the frailty status, defining frailty as FI ≥ 25. Logistic regression was applied to examine the association between PA and frailty, estimating odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS Of the 4379 non-frail participants at baseline (median age 67, 54.9% female), 8.1% developed frailty during a mean follow-up of 3.5 years. Among 564 frail participants at baseline (median age 71, 66.5% female), 17.9% regained health. Compared to those engaging in PA less than once per week, participants who engaged in vigorous (OR: 0.47 [95% CI: 0.35-0.62]), moderate (OR: 0.37 [95% CI: 0.29-0.48]), or mild (OR: 0.38 [95% CI: 0.26-0.56]) PA at least once a week had a lower risk of frailty worsening. Additionally, participants who engaged in moderate (OR: 2.04 [95% CI: 1.29-3.21]) or mild (OR: 2.93 [95% CI: 1.54-5.58]) PA at least once a week had a higher likelihood of frailty improvement. Sensitivity analyses based on comprehensive PA levels confirmed these findings. Participants who maintained at least one PA per week had lower frailty worsening (Vigorous, OR: 0.20 [95%CI: 0.12-0.33]; Moderate, OR: 0.13 [95%CI: 0.09-0.19]; Mild, OR: 0.20 [95%CI: 0.11-0.38]) and higher frailty improvement rates (Moderate, OR: 3.43 [95%CI: 1.93-6.11]; Mild, OR: 4.65 [95%CI: 1.90-11.42]). In addition, individuals (Vigorous, OR: 0.35 [95%CI: 0.20-0.60]; Moderate, OR: 0.36 [95%CI: 0.22-0.56]) who transitioned from inactive to active also exhibited a lower risk of frailty. CONCLUSIONS This study emphasized the critical role of PA in preventing and improving frailty in middle-aged and older people, especially during the COVID-19 pandemic. Our study also highlighted the importance of maintaining PA habits to reduce frailty risk and promote its improvement. Also, the study indicated that individuals who transitioned from inactive to active had a lower risk of frailty. These findings enriched the understanding of the association between PA and frailty and provided valuable insights for addressing the health impact of future pandemics on middle-aged and older people.
Collapse
Affiliation(s)
- Li Huang
- Faculty of Medical, Heidelberg University, Heidelberg, Germany
| | - Zhenzhen Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Xinxiang Medical University, Xinxiang, China.
| | - Huajian Chen
- School of Public Health, Wenzhou Medical University, Wenzhou, China.
| |
Collapse
|
4
|
Jiménez-Ten Hoevel C, Queral J, Besora-Moreno M, Tarro L, Sospedra-Senar A, Tomàs-Piqueras J, Sepúlveda C, Valls RM, Pedret A, Solà R, Llauradó E. Health status, lifestyle and quality of life in older adults of rural and urban areas of Tarragona province (Catalonia, Spain): a cross-sectional descriptive study. BMC Public Health 2025; 25:895. [PMID: 40050828 PMCID: PMC11883952 DOI: 10.1186/s12889-025-22045-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2024] [Accepted: 02/20/2025] [Indexed: 03/10/2025] Open
Abstract
BACKGROUND People over 60 years old represent 26.5% of the world's population, and enhancing health emerges as an opportunity. Thus, this study aims to describe and compare the health status (sarcopenia parameters), lifestyles, quality of life, and malnutrition risk of older adults from rural and urban areas of Tarragona province (Catalonia, Spain). METHODS The study was a cross-sectional study comparing rural and urban areas of Tarragona province, including 14 of 61 villages as rural areas (500- ≤ 2,000 inhabitants) and 5 of 8 cities as urban areas (≥ 20,000 inhabitants). The variables assessed were: sarcopenia parameters (muscle mass, muscle strength, and physical performance) and lifestyles (diet, physical activity, sleep quality), quality of life and risk of malnutrition. A total of 291 older adults, n = 189 (rural areas) and n = 102 (urban areas), including 80% women with a mean age of 67.37 (rural areas) and 69.12 (urban areas), were studied. RESULTS The mean of muscle mass (kg) is higher in men from rural areas (57.59 ± 7.01 vs. 53.48 ± 6.82; p = 0.047) than in urban areas. Compared with urban areas, more people from rural areas accomplish the recommendations of consumption of fruits and vegetables (13.8% vs. 4.9%; p = 0.019), and dairy products (95.8% vs. 88.2%; p = 0.015) along with their high-intensity physical activity (76.7% vs. 65%; p = 0.046). Additionally, in rural areas, more people presented better sleep and quality of life, including physical and emotional roles dimensions, than the urban areas individuals (p ≤ 0.05). No difference among groups was shown in nutritional status. CONCLUSION Sarcopenia parameters of urban and rural older adults are similar, except for the highest muscle mass of older adults from rural areas compared to urban ones. In addition, older adults living in rural areas show healthier lifestyles and better quality of life than urban individuals, reinforcing the importance of adapting actions according to the people's environment.
Collapse
Affiliation(s)
- C Jiménez-Ten Hoevel
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Carrer de Sant Llorenç 21, Reus, 43201, Spain
- Institut Investigació Sanitària Pere i Virgili (IISPV), Avda, Josep Laporte 2, Reus, 43204, Spain
| | - J Queral
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Carrer de Sant Llorenç 21, Reus, 43201, Spain
- Institut Investigació Sanitària Pere i Virgili (IISPV), Avda, Josep Laporte 2, Reus, 43204, Spain
| | - M Besora-Moreno
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Carrer de Sant Llorenç 21, Reus, 43201, Spain
| | - L Tarro
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Carrer de Sant Llorenç 21, Reus, 43201, Spain
| | - A Sospedra-Senar
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Carrer de Sant Llorenç 21, Reus, 43201, Spain
| | - J Tomàs-Piqueras
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Carrer de Sant Llorenç 21, Reus, 43201, Spain
| | - C Sepúlveda
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Carrer de Sant Llorenç 21, Reus, 43201, Spain
| | - R M Valls
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Carrer de Sant Llorenç 21, Reus, 43201, Spain
- Institut Investigació Sanitària Pere i Virgili (IISPV), Avda, Josep Laporte 2, Reus, 43204, Spain
| | - A Pedret
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Carrer de Sant Llorenç 21, Reus, 43201, Spain.
- Institut Investigació Sanitària Pere i Virgili (IISPV), Avda, Josep Laporte 2, Reus, 43204, Spain.
| | - R Solà
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Carrer de Sant Llorenç 21, Reus, 43201, Spain.
- Institut Investigació Sanitària Pere i Virgili (IISPV), Avda, Josep Laporte 2, Reus, 43204, Spain.
- Hospital Universitari Sant Joan de Reus, Avda, Josep Laporte 2, Reus, 43204, Spain.
| | - E Llauradó
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, Carrer de Sant Llorenç 21, Reus, 43201, Spain
- Institut Investigació Sanitària Pere i Virgili (IISPV), Avda, Josep Laporte 2, Reus, 43204, Spain
| |
Collapse
|
5
|
Murley B, Chen KM, Gipson CS, Gosselin K, Thornhill J, Ross A, Gladding K, Mastel-Smith B. Effects of the Vitality Acupunch Exercise Program on Older Adults With Probable Sarcopenia: A Mixed Methods Pilot Study. J Holist Nurs 2025; 43:70-83. [PMID: 39491795 PMCID: PMC11869509 DOI: 10.1177/08980101241291756] [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: 05/13/2024] [Revised: 09/04/2024] [Accepted: 09/26/2024] [Indexed: 11/05/2024]
Abstract
Purpose: Age-related loss of muscle mass and strength is a highly prevalent condition in older adults in long-term care (LTC) facilities. This pilot study aimed to test the effects of a vitality acupunch (VA) exercise program on muscle mass, muscle strength, muscle endurance, functional fitness, activities of daily living, quality of life, and sleep quality of older adults in LTC facilities with probable sarcopenia in the United States and understand the experiences of residents who participated in the VA program. Design: A mixed-methods experimental design was used for this study. Methods: The quantitative phase included a sample of 27 participants randomly assigned to the control (n = 13) or VA (n = 14) condition. The VA condition consisted of three weekly 40-minute instructor-led seated exercise sessions over 24 weeks. Measures were obtained at baseline, three, and sixmonth intervals. Semi-structured interviews were conducted to explore participant's experiences of the program. Findings: Statistical comparison revealed significantly higher handgrip strength for the VA group (p = .008). Narrative analysis revealed that the program had a positive impact on participant's daily lives. Conclusions: The VA program offers a holistic, evidence-based exercise program for older adults with probable sarcopenia living in LTC facilities.
Collapse
Affiliation(s)
- Brittany Murley
- Assistant Professor, School of Nursing, The University of Texas at Tyler, TX, USA
| | - Kuei-Min Chen
- Director-General, Department of Long-Term Care, Pingtung Government, Taiwan; Professor, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Christine S. Gipson
- Associate Professor, The University of Texas at Tyler, School of Nursing, TX, USA
| | - Kevin Gosselin
- Professor, The University of Texas at Tyler, School of Nursing, TX, USA
| | - Jenna Thornhill
- CHRISTUS Trinity Mother Frances Health System, Tyler, TX, USA
| | - Allison Ross
- Lecturer, Texas A&M University, School of Nursing, Bryan, TX, USA
| | | | - Beth Mastel-Smith
- Professor, The University of Texas at Tyler, School of Nursing, TX, USA
| |
Collapse
|
6
|
Carr LJ, Marcussen B, Slayman T, Wu Y, Bond DS. Billing for Exercise Is Medicine: An Analysis of Reimbursement Trends for Physical Activity-Related Billing Codes. J Phys Act Health 2025; 22:317-322. [PMID: 39657641 DOI: 10.1123/jpah.2024-0499] [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: 07/24/2024] [Revised: 09/18/2024] [Accepted: 09/26/2024] [Indexed: 12/12/2024]
Abstract
BACKGROUND Physical inactivity is a significant health risk factor linked to chronic diseases and premature death. To address this, initiatives like Exercise is Medicine® aim to promote physical activity in health care systems. However, integrating physical activity counseling into clinical practice faces barriers such as limited reimbursement. Understanding billing practices and reimbursement rates for physical activity counseling is crucial for its integration into health care. METHODS This study used 12 months of billing data from a large midwestern US hospital. Variables included charges, charge amounts, primary payors, reimbursement rates, and denial rates associated with International Classification of Diseases-10 diagnosis codes, and Evaluation and Management billing codes for physical activity counseling. Logistic regression analysis identified factors associated with denial rates. RESULTS Over 12 months, 19,366 lifestyle-related charges were submitted, totaling $7,842,845. Of these, 5.28% were denied, amounting to $414,446. The most common International Classification of Diseases-10 codes were "obesity" (38.8%) and "sedentary lifestyle" (32.6%), while the most common Evaluation and Management codes were for established outpatient office visits. Charges were mainly submitted to employer-paid insurance (43.5%), Medicaid (22.2%), and Medicare (21.9%). Higher odds of denial were associated with newer patients, shorter visit lengths, and the sedentary lifestyle code. CONCLUSION This study provides novel data on the use, reimbursement, and denial rates of physical activity counseling billing codes in a large health care system. Physical activity counseling-related charges are rarely denied by third-party payors. Further research is needed to determine if these findings are generalizable to other US health care systems.
Collapse
Affiliation(s)
- Lucas J Carr
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
| | - Britt Marcussen
- Department of Family Medicine, University of Iowa Healthcare, Iowa City, IA, USA
| | - Tyler Slayman
- Department of Family Medicine, University of Iowa Healthcare, Iowa City, IA, USA
| | - Yin Wu
- Center for Obesity Research, Innovation & Education, Digestive Health Institute, Hartford Healthcare, Hartford, CT, USA
| | - Dale S Bond
- Center for Obesity Research, Innovation & Education, Digestive Health Institute, Hartford Healthcare, Hartford, CT, USA
| |
Collapse
|
7
|
Usui N, Nakata J, Uehata A, Kojima S, Ando S, Saitoh M, Inatsu A, Hisadome H, Nishiyama Y, Suzuki Y. Association of Physiological Reserve Obtained from Cardiopulmonary Exercise Testing and Frailty with All-Cause Mortality in Patients on Hemodialysis. Clin J Am Soc Nephrol 2025; 20:420-431. [PMID: 39693148 DOI: 10.2215/cjn.0000000621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Accepted: 12/13/2024] [Indexed: 12/20/2024]
Abstract
Key Points
This study analyzed the prognostic value of reserves obtained from cardiopulmonary exercise testing in patients on hemodialysis.Each reserve (cardiac, autonomic, and muscular) was associated with mortality, with muscle reserve having the highest prognostic accuracy.Patients with physical frailty also had a fairly good prognosis if their physiological reserve is preserved by exercise testing.
Background
Potential impairment of exercise capacity is prevalent even in patients undergoing hemodialysis without frailty. Cardiopulmonary exercise testing (CPET) can detect physiological reserves, such as cardiopulmonary, muscle, and autonomic function. We hypothesized that these indices could accurately determine the prognosis of patients on hemodialysis and analyzed them on the basis of their relationship to frailty.
Methods
In this two-center prospective cohort study of patients on hemodialysis from Japan, patients underwent CPET and physical assessment to evaluate peak oxygen uptake (peak VO2, indicator of exercise capacity), peak work rate (WR, indicator of muscle function), ventilatory equivalent for carbon dioxide (VE/VCO2) slope (indicator of cardiac reserve), heart rate reserve (indicator of chronotropic incompetence), and frailty phenotype. Survival was followed up for up to 5 years.
Results
Data from 189 patients (median [interquartile range] age: 71 [62–77] years) were analyzed. All CPET indicators showed a consistent nonlinear relationship with all-cause mortality after adjustment: for peak VO2, hazard ratio (HR), 0.79 (95% confidence interval [CI], 0.71 to 0.88), P < 0.001; for peak WR, HR, 0.95 (95% CI, 0.93 to 0.97), P < 0.001; for VE/VCO2 slope, HR, 1.09 (95% CI, 1.05 to 1.13), P < 0.001; and for heart rate reserve, HR, 0.96 (95% CI, 0.93 to 0.99), P = 0.02. Frailty phenotype was associated with mortality after adjustment (HR, 1.73 [95% CI, 1.06 to 2.81], P = 0.03); however, this association was not statistically significant in the model after adding peak VO2 (P = 0.41). Furthermore, in both subgroups with and without frailty, CPET measures were significantly associated with mortality risk (peak VO2, peak WR, and VE/VCO2 slope: P < 0.05). The peak VO2 (Δ area under the curve, 0.09; 95% CI, 0.02 to 0.16) or the peak WR (Δ area under the curve, 0.09; 95% CI, 0.02 to 0.15) most significantly improved the prognostic accuracy.
Conclusions
Results showed the fragile aspect of the frailty phenotype in the hemodialysis population and the superior ability of CPET to indicate death risk complementing that aspect.
Collapse
Affiliation(s)
- Naoto Usui
- Department of Rehabilitation, Kisen Hospital, Tokyo, Japan
- Department of Nephrology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Junichiro Nakata
- Department of Nephrology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Akimi Uehata
- Division of Cardiology, Kisen Hospital, Tokyo, Japan
| | - Sho Kojima
- Department of Rehabilitation, Kisen Hospital, Tokyo, Japan
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Shuji Ando
- Department of Information Sciences, Tokyo University of Science, Chiba, Japan
| | - Masakazu Saitoh
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | | | | | - Yuki Nishiyama
- Department of Rehabilitation, Kisen Hospital, Tokyo, Japan
| | - Yusuke Suzuki
- Department of Nephrology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| |
Collapse
|
8
|
Lemmers GPG, García Juez S, García AC, Le Roch E, Bettocchi M, Papini P, Bellavista P, Gauthier C, Mota de Sousa J, Martín San Gil G, Cruijsberg J, García Batanero S, Atucha Gutiérrez C, Rodriguez Andonaegui I, van der Wees PJ. The InAbled Cities Project: Development of a Physical Activity Enhancement Program for Older Adults and People With Disabilities in Spain and Italy-A Feasibility Study. J Aging Phys Act 2025:1-9. [PMID: 40015288 DOI: 10.1123/japa.2024-0180] [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: 06/12/2024] [Revised: 12/18/2024] [Accepted: 01/17/2025] [Indexed: 03/01/2025]
Abstract
As life expectancies increase, people are tending toward more inactive lifestyles. Older adults and people with disabilities might benefit from accessible physical activities in nearby social networks. The purpose of this European InAbled Cities study is to develop and test the feasibility of a program aimed at enhancing physical activity for older adults and people with disabilities within their social networks. Participatory action research was conducted in two municipalities in urban (Bologna, Italy) and rural (Sevilla La Nueva, Spain) settings with older adults and people with disabilities, healthcare professionals, and communication managers. Data collection comprised a survey, interviews, and focus group interviews for developing a physical activity enhancement program, a mobile device application, and a citizen engagement strategy. Evaluation of the program's usability focused on feasibility, appropriateness, acceptability, and quality of life. The enhancement of physical activity in the two community-based settings revealed similarities and differences in the needs of citizens in the two participating municipalities. Similarities were related to behavioral change for enhancing physical activity. Differences in infrastructure were the main factors driving the need for contextual adaptations. Overall, participants were positive about the appropriateness, feasibility, and acceptability of the program. Participants deemed the physical activity enhancement programs in both communities feasible, thus indicating potential for the further implementation of the program. This research provides new insight into ways of enhancing physical activity in older adults and people with disabilities. Such insight could be used to customize such programs to specific needs.
Collapse
Affiliation(s)
- Gijs P G Lemmers
- IQ Health, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Susana García Juez
- Escuela Universitaria de Fisioterapia de la ONCE, Universidad Autónoma de Madrid, Madrid, Spain
| | | | | | | | | | | | | | - João Mota de Sousa
- Escuela Universitaria de Fisioterapia de la ONCE, Universidad Autónoma de Madrid, Madrid, Spain
| | - Guiomar Martín San Gil
- Escuela Universitaria de Fisioterapia de la ONCE, Universidad Autónoma de Madrid, Madrid, Spain
| | | | | | | | | | | |
Collapse
|
9
|
Liu Y, Luo X, Xu H. Economic autonomy as a determinant of physical activity behavior in Chinese older adults. Front Public Health 2025; 12:1466710. [PMID: 39980618 PMCID: PMC11841652 DOI: 10.3389/fpubh.2024.1466710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Accepted: 12/04/2024] [Indexed: 02/22/2025] Open
Abstract
Background The physical activity of the old people is affected by many factors, and the economic situation is an important factor affecting the physical activity. However, the relationship between economic autonomy and physical activity patterns among older adult Chinese has not been fully studied. Objective To investigate the association between different types of economic autonomy and physical activity patterns among Chinese older adults aged 60 and above. Methods Cross-sectional analysis of 1,961 participants from the 2018 China Health and Retirement Longitudinal Study (CHARLS). Economic autonomy was categorized into autonomous and non-autonomous groups. Physical activity was assessed through type, frequency, duration, and purpose, using validated questionnaires. Results Economic autonomy showed positive associations with low and moderate-intensity physical activities (p < 0.05). However, economically non-autonomous individuals demonstrated higher participation in high-intensity physical activities, primarily due to work-related demands (78.7%). The frequency of physical activity was significantly different among economic autonomy groups (p < 0.01).
Collapse
Affiliation(s)
- Yuanheng Liu
- Hunan Vocational College of Electronic and Technology, Changsha, Hunan, China
| | - Xianglin Luo
- College of Physical Education, Hunan Normal University, Changde, Hunan, China
| | - Hao Xu
- Hunan Applied Technology University Changde, Changde, Hunan, China
| |
Collapse
|
10
|
Wnuk-Scardaccione A, Cima MS. Limb Osseointegration-How Important Is the Role of Nutrition in the Process? Nutrients 2025; 17:606. [PMID: 40004935 PMCID: PMC11858377 DOI: 10.3390/nu17040606] [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: 01/03/2025] [Revised: 02/01/2025] [Accepted: 02/05/2025] [Indexed: 02/27/2025] Open
Abstract
BACKGROUND AND AIMS Osseointegration (OI) surgery of the appendicular skeleton for repair in amputees is a treatment in which a metal implant is directly fixed to the residual bone and subsequently connected to a prosthetic limb via a transcutaneous connector through a small incision in the skin. Current treatment does not consider nutritional advice for patients undergoing the OI procedure. However, since the group of patients is very heterogeneous, the results may not be always satisfactory for patients and clinicians. Furthermore, in some individuals, incorrect nutrition and diet habits may lead to complications and rejection of the implant. METHODS We created an extensive narrative evaluation by conducting a methodical search. A comprehensive search was conducted across three major databases: PubMed, Embase, and Scopus. The search was carried out in October 2024 with no time limit specified. The approach involved using specific, pre-defined search terms, which were first applied in PubMed, followed by Embase and Scopus to ensure a broad and diverse range of articles was captured. The search process was refined by considering studies published in high-impact journals, as identified based on impact factors and subject relevance. To ensure consistency and rigor, the selection criteria were applied uniformly across all databases, and irrelevant or incomplete articles were excluded. RESULTS Based on the specific nature of the OI procedure, it is crucial to adapt patients' diets and nutrition after the process. To translate the findings from the reviewed literature into practical clinical guidance for osseointegration (OI) procedures, we developed dietary recommendations for both patients and clinicians, presented as proposed dietary plans and summarized in tables. These recommendations were informed by evidence from various studies, highlighting findings that were supported by randomized controlled trials (RCTs) as well as areas where the evidence remains inconclusive or unsupported by RCTs. Major vitamins and micro- and macroelements were distinguished and presented as guidelines for clinicians. CONCLUSIONS OI is currently the most promising therapeutic options for amputees. To promote efficient tissue healing and provide energy for rehabilitation, it is recommended to follow a healthy, well-balanced diet that contains all the essential micronutrients, macronutrients, vitamins, and minerals. We also provide suggestions for future studies.
Collapse
Affiliation(s)
- Agnieszka Wnuk-Scardaccione
- Department of Biomechanics and Kinesiology, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 8 Skawińska Street, 31-066 Krakow, Poland
| | - Megan Shawl Cima
- Johns Hopkins Physical Medicine and Rehabilitation, Johns Hopkins Medical Center, Baltimore, MD 21093, USA;
| |
Collapse
|
11
|
Sattler T, Gottschalk S, König HH, Braun T, Büchele G, Denkinger M, Fleiner T, Nerz C, Rapp K, Schäufele M, Werner C, Dams J. Path model explaining the association between fear of falling and health-related quality of life in (pre-)frail older adults. BMC Geriatr 2025; 25:87. [PMID: 39920580 PMCID: PMC11806603 DOI: 10.1186/s12877-025-05718-x] [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: 10/30/2024] [Accepted: 01/20/2025] [Indexed: 02/09/2025] Open
Abstract
BACKGROUND Fear of falling (FoF) is estimated to be prevalent in over 50% of older adults and several studies suggest that it negatively affects health-related quality of life (HrQoL). Unlike previous studies that examined only few mediating variables, this study aimed to develop a more comprehensive path model explaining the association between FoF and HrQoL. METHODS A theoretical path model was developed based on existing evidence and expert feedback and fitted to cross-sectional baseline data on 385 community-dwelling (pre-)frail older adults from the PromeTheus randomized controlled trial using robust weighted least squares estimation. FoF and HrQoL were operationalized by the Short Falls Efficacy Scale International and EQ-5D Index, respectively. The model included potential explanatory pathways through physical activity (German Physical Activity Questionnaire for middle-aged and older adults), physical capacity (Short Physical Performance Battery), physical performance (Late-Life Function and Disability Instrument [LLFDI] function component), disability (LLFDI disability component - short form), and affect (visual analogue scales on 'happiness', 'sadness', 'calmness' and 'tension'). Age, sex, education, and previous falls were considered as covariates. RESULTS The model demonstrated good fit to the data and the remaining direct effect of FoF on HrQoL was small (β=-0.05). Physical capacity and physical performance were the most important mediators (combined indirect effect of β=-0.17, accounting for > 50% of the total effect). Pathways of minor individual relevance (e.g. through disability or affect) contributed considerably to the total indirect effect when combined. Controlling for sociodemographic data and previous falls only had minor effects on model fit and path coefficients. CONCLUSION Physical capacity and physical performance are particularly important levers for reducing the impact of FoF on HrQoL through interventions. However, the other pathways also had a considerable influence when taken together. Hence, research on the association of FoF and HrQol should acknowledge the complexity of causal pathways that may explain this association and not neglect minor pathways. The proposed model should be tested on an alternative sample, using longitudinal data, and extended to include additional explanatory factors (e.g. activity avoidance). TRIAL REGISTRATION German Clinical Trials Register, ID: DRKS00024638, https://drks.de/search/en/trial/DRKS00024638 , date of registration: March 11th 2021.
Collapse
Affiliation(s)
- Tjard Sattler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251, Hamburg, Germany.
- Hamburg Center for Health Economics, Hamburg, Germany.
| | - Sophie Gottschalk
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251, Hamburg, Germany
- Hamburg Center for Health Economics, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251, Hamburg, Germany
- Hamburg Center for Health Economics, Hamburg, Germany
| | - Tobias Braun
- Department of Applied Health Sciences, Hochschule für Gesundheit, Bochum, Germany
- Department of Health, HSD Hochschule Döpfer, Cologne, Germany
| | - Gisela Büchele
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Michael Denkinger
- Institute for Geriatric Research, Ulm University Medical Center, Ulm, Germany
| | - Tim Fleiner
- Institute for Geriatric Research, Ulm University Medical Center, Ulm, Germany
- Institute of Medical Engineering and Mechatronics, Ulm University of Applied Sciences, Ulm, Germany
| | - Corinna Nerz
- Department of Clinical Gerontology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Kilian Rapp
- Department of Clinical Gerontology, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Martina Schäufele
- Department of Social Work, Mannheim University of Applied Sciences, Mannheim, Germany
| | - Christian Werner
- Geriatric Centre, Heidelberg University Hospital, Agaplesion Bethanien Hospital Heidelberg, Heidelberg, Germany
| | - Judith Dams
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251, Hamburg, Germany
- Hamburg Center for Health Economics, Hamburg, Germany
| |
Collapse
|
12
|
Marchant G, Guillet-Descas E, Heutte N. Sense of belonging and its positive association with physical activity levels and negative association with sedentary behaviors in residential aged care facilities in COVID-19 pandemic: a longitudinal study. Front Psychol 2025; 16:1529463. [PMID: 39973961 PMCID: PMC11835940 DOI: 10.3389/fpsyg.2025.1529463] [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: 11/16/2024] [Accepted: 01/15/2025] [Indexed: 02/21/2025] Open
Abstract
Introduction The COVID-19 pandemic reduced physical activity levels and increased sedentary behavior among older adults in residential care facilities. Another effect of this crisis was that facilitating a sense of social belonging through in-person social activities, such as group exercises or communal meals, became difficult. This study examines the relationship between physical activity, sedentary behavior, and sense of social belonging in older adults. Methods This longitudinal study, which lasted 10 months, involved 57 older adults in residential care facilities. Participants completed the Échelle de mesure du Sentiment d'Appartenance Sociale (ESAS) questionnaire three times and wore an accelerometer on their waists for 1 week each time to measure sedentary time and physical activity levels. The ESAS questionnaire, a validated tool for evaluating social belonging in older adults, measures social belonging through a series of questions that assess an individual's feelings of acceptance and intimacy within their social group. Results Participants were predominantly sedentary (7.30 h/day) and engaged in low-intensity physical activities (2.9 h/day). They did not meet the recommended 150 min/week of moderate-to-vigorous physical activity. The sense of social belonging was high, with mean scores of 6.75 (ESAS), 7.08 (Acceptance), and 6.43 (Intimacy). Light physical activity was negatively associated with sedentary time. The sense of social belonging was positively associated with light physical activity and negatively correlated to sedentary time. Conclusion This study underscores the importance of light physical activity and a sense of social belonging in reducing sedentary behavior among older adults in residential care facilities. By promoting social interactions and light physical activity, we can enhance the well-being of this population, especially during pandemic conditions. The study's findings should inspire future interventions to focus on these aspects, thereby improving health outcomes in residential care facilities for older adults.
Collapse
Affiliation(s)
- Gonzalo Marchant
- Center for the Study and the Transformation of Physical Activities (CETAPS) UR 3832, University of Rouen Normandy, Mont-Saint-Aignan, Normandy, France
| | - Emma Guillet-Descas
- Laboratory L-ViS, F-69622, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Natacha Heutte
- Center for the Study and the Transformation of Physical Activities (CETAPS) UR 3832, University of Rouen Normandy, Mont-Saint-Aignan, Normandy, France
| |
Collapse
|
13
|
Baky I, Bourke A, Byrne C, MacDonagh J, Clifford A, Niranjan V, O'Regan A. How do doctors manage physical activity advocacy for patients and their own self-care? A qualitative interview study of general practitioners in Ireland. BMJ Open 2025; 15:e084301. [PMID: 39900412 PMCID: PMC11795391 DOI: 10.1136/bmjopen-2024-084301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 10/23/2024] [Indexed: 02/05/2025] Open
Abstract
OBJECTIVES This study explored general practitioners' (GPs) understanding of physical activity advocacy to patients and their own self-care, how GPs perceive their own physical activity behaviours, how their personal experience of physical activity affects how they promote it in practice and how they define the limitations of their role in this. DESIGN A qualitative design, involving online semi-structured interviews, was employed. Data was analysed by an interdisciplinary team of researchers using an inductive thematic approach. SETTING AND PARTICIPANTS Participants were GPs (n=21) and were recruited from an education and research network. FINDINGS A single meta-theme was identified-moving towards more physically active lifestyles through the art of medicine-with three related subthemes. Subthemes relate to how GPs determine the extent of their role and responsibilities, how physical activity promotion is adapted to the context and how 'what I' say is not necessarily 'what I do'. After many consultations, mutual trust can develop when the GP's role is clarified, and the GP can educate and support the initiation and maintenance of physical activity behavioural change by sharing personal experiences of physical activity behaviour. CONCLUSION Based on personal experience and enduring relationships with their patients, GPs are in a unique position to discuss appropriate physical activity with their patients and perform an important role in explaining and gaining access to physical activity for their patients. Support in the form of community-based resources and programmes as well as brief intervention skills could enhance GP ability to further promote physical activity.
Collapse
Affiliation(s)
- Ibak Baky
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Alison Bourke
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Conor Byrne
- School of Medicine, University of Limerick, Limerick, Ireland
| | | | - Amanda Clifford
- School of Allied Health, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Vikram Niranjan
- Department of Public Health, Health Service Executive, Dublin, Ireland
- Assistant professor of Public Health, University of Limerick, Limerick, Ireland
| | - Andrew O'Regan
- School of Medicine, Health Research Institute, University of Limerick, Limerick, Ireland
| |
Collapse
|
14
|
Reis NA, Waldhauser KJ, Hives BA, Hulteen RM, Ruissen GR, Wierts CM, Puterman E, Liu Y, Rhodes RE, Beauchamp MR. Effects of older adults' social identification on psychological flourishing and exercise program adherence. Psychol Health 2025; 40:272-284. [PMID: 37231641 DOI: 10.1080/08870446.2023.2215804] [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: 03/01/2023] [Revised: 04/22/2023] [Accepted: 05/15/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND With the onset of the COVID-19 pandemic, many exercise programs moved online. The purpose of this study was to examine the extent to which older adults' social identification with other exercise program members contributed to their psychological flourishing and exercise program adherence. METHODS The study represented a secondary analysis of data derived from the Seniors COVID-19 Pandemic and Exercise (SCOPE) Trial, in which older adults were randomized to a waitlist control condition or one of two online (personal v group) exercise programs. Only data from participants in the trial intervention conditions (N = 162; Mage = 73.52 years; SD = 5.61) were utilized in this secondary analysis. We assessed psychological flourishing and social identification at baseline and every two weeks, as well as program adherence over each 2-week block, for 12 weeks. RESULTS Based on stepwise multilevel modeling the results revealed that older adults' social identification with others in their respective exercise program had a direct effect on psychological flourishing (ΔR2Unique Marginal = 0.063, p < .001) and program adherence (ΔR2Unique Marginal = 0.014, p = .03). CONCLUSIONS The results highlight the value of bolstering older adults' social identification with others in an online exercise program to support adherence and well-being.
Collapse
Affiliation(s)
- Nathan A Reis
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Benjamin A Hives
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | - Colin M Wierts
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Eli Puterman
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Yan Liu
- Carleton University, Ottawa, Ontario, Canada
| | - Ryan E Rhodes
- University of Victoria, Victoria, British Columbia, Canada
| | - Mark R Beauchamp
- University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
15
|
Buckinx F, Libin V, Peyrusqué E, Aubertin-Leheudre M, Bruyère O. Mitigating Deconditioning in Nursing Homes: A Feasibility and Acceptability Study of the PUSH Tool (Promoting the Autonomy through Exercise in Nursing Home). J Am Med Dir Assoc 2025; 26:105381. [PMID: 39642917 DOI: 10.1016/j.jamda.2024.105381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 10/23/2024] [Accepted: 10/23/2024] [Indexed: 12/09/2024]
Affiliation(s)
- Fanny Buckinx
- Research Unit in Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium; Research Center of the University Institute of Geriatrics of Montreal, Montreal, QC, Canada.
| | - Valentine Libin
- Department of Sport and Rehabilitation Sciences, University of Liège, Liège, Belgium
| | - Eva Peyrusqué
- Research Center of the University Institute of Geriatrics of Montreal, Montreal, QC, Canada; Faculty of Sciences, Département des Siences de l'activité physique, UQAM, Montreal, QC, Canada
| | - Mylène Aubertin-Leheudre
- Research Center of the University Institute of Geriatrics of Montreal, Montreal, QC, Canada; Faculty of Sciences, Département des Siences de l'activité physique, UQAM, Montreal, QC, Canada
| | - Olivier Bruyère
- Research Unit in Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium; Department of Sport and Rehabilitation Sciences, University of Liège, Liège, Belgium
| |
Collapse
|
16
|
Meier C, Wieczorek M, Aschwanden D, Ihle A, Kliegel M, Maurer J. Physical activity partially mediates the association between health literacy and mild cognitive impairment in older adults: cross-sectional evidence from Switzerland. Eur J Public Health 2025; 35:134-140. [PMID: 39749887 PMCID: PMC11832147 DOI: 10.1093/eurpub/ckae209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2025] Open
Abstract
Individuals' health literacy (HL) is positively associated with healthy behaviors and global cognitive functioning. Current evidence also suggests that physical activity may prevent or delay cognitive decline and dementia. This study examines the potential mediating role of physical activity in the association between HL and cognition in a population-based sample of adults aged 58+ in Switzerland. We used data from 1645 respondents to Wave 8 (2019/2020) of the Survey on Health, Ageing, and Retirement in Europe in Switzerland. HL was assessed using the HLS-EU-Q16 questionnaire. Mild cognitive impairment (MCI) was defined as a 1.5 SD below the mean of age- and education-specific global cognition score. The frequency of moderate and vigorous physical activity was self-reported. The associations were assessed using probit regression models, controlling for social, health, and regional characteristics. Structural equation modeling was used to test the mediation hypothesis. Higher HL was associated with a higher likelihood of being engaged in moderate (P < .001) and vigorous (P < .01) physical activity and with a lower likelihood of having MCI (P < .05). In addition, both moderate (P < .05) and vigorous (P < .01) physical activity were associated with a lower probability of having MCI. Mediation analysis indicated that the association between HL and MCI was partially mediated by both moderate (12.9%) and vigorous (6.7%) physical activity. Given that physical activity may partially mediate the association between HL and MCI, improving HL in older adults could potentially foster engagement in physical activity, which could, in turn, act as a protective factor against MCI.
Collapse
Affiliation(s)
- Clément Meier
- Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland
- Swiss Centre of Expertise in the Social Sciences (FORS), University of Lausanne, Lausanne, Switzerland
- Swiss Center of Expertise in Life Course Research LIVES, Lausanne and Geneva, Switzerland
| | - Maud Wieczorek
- Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland
- Swiss Center of Expertise in Life Course Research LIVES, Lausanne and Geneva, Switzerland
| | - Damaris Aschwanden
- Swiss Center of Expertise in Life Course Research LIVES, Lausanne and Geneva, Switzerland
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Andreas Ihle
- Swiss Center of Expertise in Life Course Research LIVES, Lausanne and Geneva, Switzerland
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
- Department of Psychology, University of Geneva, Geneva, Switzerland
| | - Matthias Kliegel
- Swiss Center of Expertise in Life Course Research LIVES, Lausanne and Geneva, Switzerland
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Jürgen Maurer
- Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland
- Swiss Center of Expertise in Life Course Research LIVES, Lausanne and Geneva, Switzerland
| |
Collapse
|
17
|
Domingues WJR, Germano-Soares AH, Cucato GG, de Souza LC, Brandão EKSDS, Souza ELDCD, da Silva E Silva TR, Arêas GPT, Costa C, Campelo PRDS, Dos Santos NJN, Silva GOD, Simões CF. Physical activity levels in patients with chronic venous insufficiency. Phlebology 2025; 40:47-54. [PMID: 39126137 DOI: 10.1177/02683555241273153] [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] [Indexed: 08/12/2024]
Abstract
BACKGROUND Increasing the levels of physical activity (PA) is widely recommended for people with chronic venous insufficiency (CVI). However, studies investigating the patterns of PA and adherence to PA guidelines using objective measures are lacking. OBJECTIVE The primary aim was to examine the patterns of PA and adherence to PA guidelines among patients with CVI. A secondary aim was to identify whether adherence to PA recommendations differed according to patients' sociodemographic and clinical characteristics. METHODS This cross-sectional study included 96 patients with CVI with Clinical-Etiology-Anatomy-Pathology (CEAP) C3 to C6 (69.1% women 59 ± 11 years; 51.5% C5-C6 on CEAP classification). Objective time spent in PA was measured by a triaxial accelerometer. To examine adherence to PA guidelines, patients were grouped as meeting (or) the recommendations if they had at least 150 min/week of moderate to vigorous PA. Sociodemographic and clinic characteristics were obtained by self-report. Binary logistic regression was employed to examine whether sociodemographic and clinical characteristics were associated with adherence to PA guidelines. T-tests were employed to compare PA levels at different intensities according to patients' age. RESULTS Patients spent an average of 311.4 ± 91.5 min/week, 42.1 ± 28.0 min/week, and 19.8 ± 17.8 min/week in low-light PA, high-light PA, and moderate-to-vigorous PA, respectively. The proportion of patients meeting PA recommendations was 36.2%, and older patients had lower odds (OR = 0.94; 95%CI: 0.89 to 0.99). Additional analysis reinforced that by showing lower time in high-light PA (51.2 ± 30.0 min/day vs. 31.9 ± 21.8 min/day; p = .001) and moderate-to-vigorous PA (24.3 ± 15.8 min/day vs. 14.8 ± 18.8 min/day; p = .012) among older patients than their peers younger. CONCLUSION Our findings showed that 36,2% of CVI patients met PA recommendations, with lower odds found among older patients. Public health interventions to enhance PA engagement among CVI patients should prioritize those who are older.
Collapse
Affiliation(s)
| | | | - Gabriel Grizzo Cucato
- Department of Sport Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, UK
| | - Lenon Corrêa de Souza
- Graduation Program in Human Movement Sciences, Universidade Federal do Amazonas, Manaus, Brazil
| | | | | | | | | | - Cleinaldo Costa
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil
| | | | | | | | | |
Collapse
|
18
|
Hudgins BL, Seo Y, Bittel KM, Williams K, Hevel DJ, Labban JD, Maher JP. Does Attraction Toward Physical Activity Predict Physical Activity Behavior in Older Adults? J Aging Phys Act 2025; 33:63-70. [PMID: 39159928 DOI: 10.1123/japa.2024-0013] [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: 01/16/2024] [Revised: 04/18/2024] [Accepted: 06/06/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND/OBJECTIVES Few studies have investigated associations between the motivational outcome based on physical activity (PA) affective experiences (i.e., attraction vs. antipathy toward PA) and behavior. This study investigated cross-sectional and longitudinal associations between attraction (vs. antipathy) toward PA and device-based PA in older adults. METHODS Older adults (n = 139; 71% female, Mage = 70.5) completed assessments of attraction (vs. antipathy) toward PA and 14 days of device-based accelerometry at Times 1 and 2. RESULTS Greater attraction toward PA at Time 1 was associated with greater steps (β = 5.31, p < .01) and moderate to vigorous intensity PA (β = 3.08, p < .05) at Time 1. Greater attraction toward PA at Time 1 was not significantly associated with steps or moderate to vigorous intensity PA at Time 2. CONCLUSION Greater emphasis on resultant motivation from PA affective experiences may be useful in promoting PA in older adults. Significance/Implications: In spite of mixed findings in the present study, there is strong evidence that positive affective responses during a single bout of PA play an important role in predicting future engagement. Yet, affective experiences during PA can be individualistic and often influenced by contextual factors. Interventions designed to increase PA should focus on factors that may create positive affective experiences for participants.
Collapse
Affiliation(s)
- Brynn L Hudgins
- Department of Kinesiology, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Yeongjun Seo
- Department of Kinesiology, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Kelsey M Bittel
- Department of Kinesiology, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Kemiah Williams
- Department of Kinesiology, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Derek J Hevel
- Department of Kinesiology, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Jeffrey D Labban
- School of Health and Human Sciences, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Jackie P Maher
- Department of Kinesiology, University of North Carolina Greensboro, Greensboro, NC, USA
| |
Collapse
|
19
|
Bauer C, Smith C, Vogrin S, Palmer AS, Woessner M, Landen S, Jacques M, Byrnes E, Eynon N, Sim M, Lewis JR, Levinger I. Circulating lipocalin-2 across the adult lifespan. JBMR Plus 2025; 9:ziae162. [PMID: 39830147 PMCID: PMC11739805 DOI: 10.1093/jbmrpl/ziae162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Revised: 11/27/2024] [Accepted: 12/13/2024] [Indexed: 01/22/2025] Open
Abstract
Lipocalin-2 (LCN2), a hormone produced by adipocytes, osteoblasts, and renal tubular cells, is implicated in age-related diseases, including cardio-metabolic disease. To understand the role LCN2 may play in pathological states, we first need to elucidate the relationship between circulating LCN2 with indices of cardio-metabolic health during "normal" aging. This study examined the relationship between serum levels of LCN2, age, and cardio-metabolic measures across the adult lifespan in males and females. We conducted a pooled cohort analysis including 124 community-dwelling males (n = 52) and females (n = 72) (age 20-87 yr, median BMI 25.92 [23.04, 29.81] kg/m2). Serum LCN2 was analyzed using a two-step chemiluminescent microparticle monoclonal immunoassay. The relationship between LCN2 and age was evaluated by linear regression and cubic spline. Simple linear regressions were performed to investigate the relationship between LCN2 and the following variables: BMI, VO2peak, serum glucose, and body composition (DXA). For every 1 yr increase in age, LCN2 levels were 0.26 mg/L higher (P = .007, 95% CI [0.07, 0.45]). Each 1 unit increase in BMI (kg/m2) was associated with 0.88 mg/L higher LCN2 levels (P = .027, [0.10, 1.66]) and each 1 unit increase in VO2peak (mL/kg/min) was associated with 0.38 mg/L lower LCN2 (p = .003, [-0.63, -0.13]).There was no significant relationship between LCN2 and sex, glucose levels or body composition (all p > .05). LCN2 increased linearly across the adult lifespan while it decreased as fitness level increased. Future research should build on these findings to determine whether LCN2 can be used as a biomarker for chronic disease and if exercise can mitigate age-related disease associated with LCN2 changes.
Collapse
Affiliation(s)
- Carlie Bauer
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3011, Australia
- Australian Institute for Musculoskeletal Science, Victoria University, University of Melbourne, St Albans, VIC 3021, Australia
| | - Cassandra Smith
- Nutrition & Health Innovation Research Institute, Edith Cowan University, Joondalup, WA 6027, Australia
- Medical School, The University of Western Australia, Perth, WA 6009, Australia
| | - Sara Vogrin
- Australian Institute for Musculoskeletal Science, Victoria University, University of Melbourne, St Albans, VIC 3021, Australia
- Department of Medicine, Western Health, The University of Melbourne, St Albans, VIC 3021, Australia
- Department of Medicine, St Vincent’s Hospital Melbourne, The University of Melbourne, Fitzroy, VIC 3065, Australia
| | - Andrew S Palmer
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3011, Australia
| | - Mary Woessner
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3011, Australia
| | - Shanie Landen
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Melbourne, VIC 3168, Australia
| | - Macsue Jacques
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3011, Australia
- Australian Regenerative Medicine Institute, Monash University, Clayton, VIC 3168, Australia
| | | | - Nir Eynon
- Australian Regenerative Medicine Institute, Monash University, Clayton, VIC 3168, Australia
| | - Marc Sim
- Nutrition & Health Innovation Research Institute, Edith Cowan University, Joondalup, WA 6027, Australia
- Medical School, The University of Western Australia, Perth, WA 6009, Australia
| | - Joshua R Lewis
- Nutrition & Health Innovation Research Institute, Edith Cowan University, Joondalup, WA 6027, Australia
- Medical School, The University of Western Australia, Perth, WA 6009, Australia
- Centre for Kidney Research, Children’s Hospital at Westmead School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia
| | - Itamar Levinger
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3011, Australia
- Australian Institute for Musculoskeletal Science, Victoria University, University of Melbourne, St Albans, VIC 3021, Australia
| |
Collapse
|
20
|
Olivares-Tirado P, Zanga R. Associations of Physical Activity and Sedentary Behavior With Self-Rated Health Status in Brazilian Older Adults. J Aging Phys Act 2025; 33:51-62. [PMID: 39179213 DOI: 10.1123/japa.2023-0318] [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: 10/01/2023] [Revised: 05/16/2024] [Accepted: 06/06/2024] [Indexed: 08/26/2024]
Abstract
In a longevity society, as we live longer, adopting healthy lifestyles is essential to develop and maintain functional ability, which enables well-being in older adults. We aim to examine the associations of physical activity (PA) and sedentary behaviors (SBs) with self-rated health (SRH) status in older Brazilian adults. We analyzed 21,701 persons aged 60 or older from the Brazilian National Health Survey. A partial proportional odds model for SRH adjusted by sociodemographic confounders was estimated. The marginal effects of PA and SB on SRH status were expressed in terms of the average-adjusted probabilities. In addition, average-adjusted probabilities for the better and worse SRH status among representative cases of Brazilian socioeconomic inequalities were calculated. The main findings of the study indicate: (a) a significant positive association exists between PA and SRH status and, conversely, a negative association exists between SB and SRH; (b) the PA effect across daily sitting time watching TV attenuated and improved the probability of declaring a worse and better SRH status, respectively; and (c) the SRH status differences associated with PA and SB represent the socioeconomic inequalities in the older Brazilian population. Beyond some methodological limitations, we conclude that increasing PA and SB in older persons is significantly associated with better and worse SRH status, respectively. In addition, the results suggest that SRH status is a consistent health inequality measurement. In societies moving on longevity transition, substantial efforts are required in individuals' behavior across the life courses and public policies to promote healthy aging.
Collapse
Affiliation(s)
- Pedro Olivares-Tirado
- Departamento de Economia, Centro de Ciências Sociais Aplicadas, Universidade Federal de Pernambuco, Recife, Brazil
| | - Rosendo Zanga
- System Policy and Management Program, School of Public Health, University of Chile, Santiago, Chile
| |
Collapse
|
21
|
Chao LL, Barnes DE, Chesney MA, Mehling WE, Lee JA, Benjamin C, Lavretsky H, Ercoli L, Siddarth P, Narr KL. Multi-domain Online Therapeutic Investigation Of Neurocognition (MOTION) - A randomized comparative-effectiveness study of two remotely delivered mind-body interventions for older adults with cognitive decline. Contemp Clin Trials 2025; 149:107811. [PMID: 39809343 PMCID: PMC11887397 DOI: 10.1016/j.cct.2025.107811] [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: 06/29/2024] [Revised: 11/15/2024] [Accepted: 01/10/2025] [Indexed: 01/16/2025]
Abstract
BACKGROUND Research suggest that mind-body movement programs have beneficial effects on cognitive outcomes for older adults with cognitive decline. However, few studies have directly compared specific approaches to mind-body movement or studied the impact of remote program delivery. METHODS In a 3-arm randomized controlled trial (RCT) for older adults with cognitive impairment, we are comparing a multidomain mind-body program that emphasizes movement, body awareness, personal meaningfulness, and social connection, and a traditional Chinese mind-body exercise (Tai Chi) to a health and wellness education control condition. All 3 interventions are delivered remotely two times per week (onehour per session) for 12 weeks. The two active interventions are live-streamed. Outcomes are assessed prior to, after, and 6-months after the interventions. The co-primary outcomes are changes on the Alzheimer's Disease Assessment Scale - Cognitive Subscale (ADAS-cog) and brain functional connectivity in the Default Mode Network (DMN). Secondary outcomes include measures of specific cognitive domains (e.g., executive function, attention), mobility, and self-report measures of general well-being, quality of life, social engagement, self- and attention-regulation. CONCLUSION This RCT will directly compare the effects of two mind-body movement programs versus an education control delivered remotely over 12 weeks on cognitive, neuroimaging, and participant-reported outcomes. If successful, these programs may provide scalable strategies for slowing cognitive decline, which could potentially delay dementia onset in some individuals. TRIAL REGISTRATION ID NCT05217849.
Collapse
Affiliation(s)
- Linda L Chao
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, United States of America; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, United States of America; San Francisco Veterans Affairs Health Care System, San Francisco, CA, United States of America.
| | - Deborah E Barnes
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, United States of America; Department of Epidemiology and Biostatistics, University of California, San Francisco, United States of America
| | - Margaret A Chesney
- Osher Center for Integrative Medicine, University of California, San Francisco, United States of America; Department of Medicine, University of California, San Francisco, United States of America
| | - Wolf E Mehling
- Osher Center for Integrative Medicine, University of California, San Francisco, United States of America; Department of Family and Community Medicine, University of California, San Francisco, United States of America
| | - Jennifer A Lee
- Together Senior Health, San Francisco, CA, United States of America
| | - Cynthia Benjamin
- Together Senior Health, San Francisco, CA, United States of America
| | - Helen Lavretsky
- Department of Psychiatry, Semel Institute for Neuroscience and Behavior, University of California, Los Angeles, United States of America
| | - Linda Ercoli
- Department of Psychiatry, Semel Institute for Neuroscience and Behavior, University of California, Los Angeles, United States of America
| | - Prabha Siddarth
- Department of Psychiatry, Semel Institute for Neuroscience and Behavior, University of California, Los Angeles, United States of America
| | - Katherine L Narr
- Department of Neurology, University of California, Los Angeles, United States of America
| |
Collapse
|
22
|
Dino MJS, Dion KW, Abadir PM, Budhathoki C, Balbin PT, Malacas MKG, Hernandez RP, Nicolas JJG, Barcial-Espinosa J, Himmelfarb CRD, Davidson PM, Thiamwong L. Community-Dwelling Filipino Older Adults' Experiences with Virtual Coach for Health-Enhancing Physical Activity (HEPA): A Phenomenology. NURSING REPORTS 2025; 15:49. [PMID: 39997785 PMCID: PMC11858177 DOI: 10.3390/nursrep15020049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Revised: 01/21/2025] [Accepted: 01/29/2025] [Indexed: 02/26/2025] Open
Abstract
Background: Physical inactivity among older adults persists as one of the global burdens. Older adults' physical activity (PA) levels decline simultaneously with age, causing health problems and poor outcomes. Immersive interventions, such as mixed reality virtual coaches, are gaining the potential to provide innovative solutions to prevent physical inactivity among older adults. However, an in-depth understanding of older adults' experience in using virtual-coach-driven physical exercise programs remains unexplored. Purpose: This study explored the experiences of community-dwelling older adults in using a virtual-coach-driven physical exercise program. Design: This study applied a phenomenological design using the qualitative approach to determine the lived experiences of community-dwelling older adults about the mother project, the "Move and Groove for Older Adults Program" (Hataw at Sigla para kay Lolo at Lola), a virtual-coach-driven physical exercise program using MR. A semi-structured interview guide was crafted consisting of three domains (acceptability, barriers, and facilitators), each with two open-ended questions. MAXQDA was used to thematically analyze the qualitative data. Results: Nine key informants shared their experiences with the virtual coach-driven physical exercise program using mixed reality. Four themes were identified describing their experiences with the program: (1) "Looking around": Exploring MR technology, (2) "Looking after": Engaging with MR exercise peers, (3) "Looking at": Examining issues with MR technology devices, and (4) "Looking Ahead": Envisioning the future of MR exercises. Conclusions: The findings of this study introduced new concepts and challenged old notions regarding older adults' technological engagement. The virtual-coach-driven physical exercise program enabled the participants to explore the novel methodology, enhance peer relationships, examine potential issues, and envision a future of possibilities using the technology. These outcomes are pertinent for progressing studies, scholars, and technology developers in incorporating MR into gerontechnology for wellness and fullness of life in the aging population. The mother project of this study was retrospectively registered [ID NCT06136468].
Collapse
Affiliation(s)
- Michael Joseph S. Dino
- School of Nursing, Johns Hopkins University, Baltimore, MD 21218, USA; (K.W.D.); (C.B.); (C.R.D.H.); (P.M.D.)
- Research Development and Innovation Center, Our Lady of Fatima University, Valenzuela City 1440, Philippines; (P.T.B.); (M.K.G.M.); (R.P.H.); (J.J.G.N.); (J.B.-E.)
- College of Nursing, University of Central Florida, Orlando, FL 32816, USA;
- Sigma Theta Tau, International Honor Society in Nursing, Indianapolis, IN 46220, USA
| | - Kenneth W. Dion
- School of Nursing, Johns Hopkins University, Baltimore, MD 21218, USA; (K.W.D.); (C.B.); (C.R.D.H.); (P.M.D.)
- Sigma Theta Tau, International Honor Society in Nursing, Indianapolis, IN 46220, USA
| | - Peter M. Abadir
- School of Medicine, Johns Hopkins University, Baltimore, MD 21218, USA;
| | - Chakra Budhathoki
- School of Nursing, Johns Hopkins University, Baltimore, MD 21218, USA; (K.W.D.); (C.B.); (C.R.D.H.); (P.M.D.)
| | - Patrick Tracy Balbin
- Research Development and Innovation Center, Our Lady of Fatima University, Valenzuela City 1440, Philippines; (P.T.B.); (M.K.G.M.); (R.P.H.); (J.J.G.N.); (J.B.-E.)
| | - Ma. Kristina G. Malacas
- Research Development and Innovation Center, Our Lady of Fatima University, Valenzuela City 1440, Philippines; (P.T.B.); (M.K.G.M.); (R.P.H.); (J.J.G.N.); (J.B.-E.)
- The Graduate School, University of Santo Tomas, España Blvd., Sampaloc, Manila 1008, Philippines
| | - Rommel P. Hernandez
- Research Development and Innovation Center, Our Lady of Fatima University, Valenzuela City 1440, Philippines; (P.T.B.); (M.K.G.M.); (R.P.H.); (J.J.G.N.); (J.B.-E.)
- The Graduate School, University of Santo Tomas, España Blvd., Sampaloc, Manila 1008, Philippines
| | - Jacquelyn Joyce G. Nicolas
- Research Development and Innovation Center, Our Lady of Fatima University, Valenzuela City 1440, Philippines; (P.T.B.); (M.K.G.M.); (R.P.H.); (J.J.G.N.); (J.B.-E.)
| | - Jhal Barcial-Espinosa
- Research Development and Innovation Center, Our Lady of Fatima University, Valenzuela City 1440, Philippines; (P.T.B.); (M.K.G.M.); (R.P.H.); (J.J.G.N.); (J.B.-E.)
| | - Cheryl R. Dennison Himmelfarb
- School of Nursing, Johns Hopkins University, Baltimore, MD 21218, USA; (K.W.D.); (C.B.); (C.R.D.H.); (P.M.D.)
- Sigma Theta Tau, International Honor Society in Nursing, Indianapolis, IN 46220, USA
| | - Patricia M. Davidson
- School of Nursing, Johns Hopkins University, Baltimore, MD 21218, USA; (K.W.D.); (C.B.); (C.R.D.H.); (P.M.D.)
- Sigma Theta Tau, International Honor Society in Nursing, Indianapolis, IN 46220, USA
- Division of the Vice-Chancellor and President, University of New South Wales, Sydney, NSW 2052, Australia
| | - Ladda Thiamwong
- College of Nursing, University of Central Florida, Orlando, FL 32816, USA;
- Sigma Theta Tau, International Honor Society in Nursing, Indianapolis, IN 46220, USA
| |
Collapse
|
23
|
Rauzi MR, Abbate LM, Lum HD, Cook PF, Stevens-Lapsley JE. Multicomponent telerehabilitation programme for older veterans with multimorbidity: a programme evaluation. BMJ Mil Health 2025; 171:33-39. [PMID: 37709508 PMCID: PMC10937321 DOI: 10.1136/military-2023-002535] [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: 07/20/2023] [Accepted: 08/29/2023] [Indexed: 09/16/2023]
Abstract
INTRODUCTION Older veterans with multimorbidity experience physical, mental and social factors which may negatively impact health and healthcare access. Physical function, behaviour change skills and loneliness may not be addressed during traditional physical rehabilitation. Thus, a multicomponent telerehabilitation programme could address these unmet needs. This programme evaluation assessed the safety, feasibility and change in patient outcomes for a multicomponent telerehabilitation programme. METHODS Individuals were eligible if they were a veteran/spouse, age ≥50 years and had ≥3 comorbidities. The telerehabilitation programme included four core components: (1) High-intensity rehabilitation, (2) Coaching interventions, (3) Social support and (4) Technology. Physical therapists delivered the 12-week programme and collected patient outcomes at baseline, 4 weeks, 8 weeks and 12 weeks. Programme evaluation measures included safety events (occurrence and type), feasibility (adherence) and patient outcomes (physical function). Safety and feasibility outcomes were analysed using descriptive statistics. The mean pre-post programme difference and 95% CI for patient outcomes were generated using paired t-tests. RESULTS Twenty-one participants enrolled in the telerehabilitation programme; most were male (81%), white (72%) and non-Hispanic (76%), with an average of 5.7 (3.0) comorbidities. Prevalence of insession safety events was 3.2% (0.03 events/session). Fifteen (71.4%) participants adhered to the programme (attended ≥80% of sessions). Mean (95% CI) improvements for physical function are as follows: 4.7 (2.4 to 7.0) repetitions for 30 s sit to stand, 6.0 (4.0 to 9.0) and 5.0 (2.0 to 9.0) repetitions for right arm curl and left arm curl, respectively, and 31.8 (15.9 to 47.7) repetitions for the 2 min step test. CONCLUSION The telerehabilitation programme was safe, feasible and demonstrated preprogramme to postprogramme improvements in physical function measures while addressing unmet needs in a vulnerable population. These results support a randomised clinical trial while informing programme and process adaptations.
Collapse
Affiliation(s)
- Michelle R Rauzi
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - L M Abbate
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), VA Eastern Colorado Health Care System, Aurora, Colorado, USA
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, USA
| | - H D Lum
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - P F Cook
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - J E Stevens-Lapsley
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), VA Eastern Colorado Health Care System, Aurora, Colorado, USA
| |
Collapse
|
24
|
Sun Y, Peng Z, Liang H. Role of physical activity in cardiovascular disease prevention: impact of epigenetic modifications. Front Cardiovasc Med 2025; 12:1511222. [PMID: 39901899 PMCID: PMC11788406 DOI: 10.3389/fcvm.2025.1511222] [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: 10/14/2024] [Accepted: 01/07/2025] [Indexed: 02/05/2025] Open
Abstract
Cardiovascular disease (CVD) remains the leading cause of death worldwide, imposing a major burden on morbidity, quality of life, and societal costs, making prevention of CVD a top public health priority. Extensive research has pointed out that lack of adequate physical activity in life is one of the key risk factors for heart disease. Indeed, moderate exercise is not only beneficial to the heart in healthy populations, but also exerts a protective effect in pathological states. However, the molecular mechanisms underlying the cardioprotective effects of exercise are still not fully understood. An increasing body of research indicates that variations in the epigenetic system-such as DNA methylation, histone modifications, and production of non-coding RNA-are essential for maintaining heart health and preventing heart disease. Exercise is a potent epigenetic modulator that induces direct and long-lasting genetic changes and activates biological signals associated with cardiovascular health. These changes can be influenced by external stimuli such as physical activity and may even be passed on to offspring, thus providing a mechanism for generating genetic effects through behavioral interventions. Therefore, understanding this relationship can help identify potential biomarkers and therapeutic targets associated with CVD. This study aims to provide an overview of the beneficial effects of exercise on heart health. This information may help guide future research efforts and improve our understanding of epigenetics as a therapeutic, prognostic, and diagnostic biomarker for CVD.
Collapse
Affiliation(s)
- Yi Sun
- Heilongjiang Academy of Traditional Chinese Medicine, Harbin, China
| | - Zuoying Peng
- Heilongjiang Academy of Traditional Chinese Medicine, Harbin, China
| | - Hua Liang
- School of Basic Medicine, Heilongjiang University of Chinese Medicine, Harbin, China
| |
Collapse
|
25
|
Bilsborough H, Davies A, Todd C, Stathi A, Hawley-Hague H. Motives of Peer Volunteers Aged Over 50 in Physical Activity Programs: A Scoping Review. J Aging Phys Act 2025:1-11. [PMID: 39832499 DOI: 10.1123/japa.2023-0229] [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: 07/03/2023] [Revised: 06/14/2024] [Accepted: 10/15/2024] [Indexed: 01/22/2025]
Abstract
Peer-volunteering schemes can facilitate health improvement via increasing physical activity levels. Understanding what motivates peer volunteers is valuable for the feasibility of volunteering schemes. This scoping review aims to explore the motivations of peer volunteers aged over 50 who participate in programs that promote physical activity. Four databases were searched in March 2023 with no date restrictions. The inclusion criteria were adults over 50 years of age, experience in physical activity peer-volunteering schemes, assessed volunteer motivation, and uses English language. Nine studies were included (252 participants, aged 54-85) Peer-volunteer and volunteering characteristics were extracted from the papers. An inductive thematic analysis approach was taken to analyze the motivation data. The themes were then mapped onto theoretical constructs of motivation. Three themes of motivation emerged that could enable us to better design peer-volunteer recruitment strategies: altruistic (giving back), personal improvement (meeting goals), and past experience (helping others overcome experienced barriers). The review suggested that peer-volunteer motivations fall in line with the mechanisms of motivation suggested by psychological theories such as social cognitive and self-determination theories. To improve peer-volunteer uptake and retention, appropriate theoretical frameworks should be employed to inform the content of future interventions to ensure that volunteers will have their motivations met.
Collapse
Affiliation(s)
- Helena Bilsborough
- School of Health Sciences, The University of Manchester, Manchester, United Kingdom
- National Institute for Health and Care Research Applied Research Collaboration Greater Manchester (NIHR ARC-GM), Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
- Manchester Institute for Collaborative Research on Ageing, Manchester, United Kingdom
| | - Amy Davies
- School of Health Sciences, The University of Manchester, Manchester, United Kingdom
- National Institute for Health and Care Research Applied Research Collaboration Greater Manchester (NIHR ARC-GM), Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
- Manchester Institute for Collaborative Research on Ageing, Manchester, United Kingdom
| | - Chris Todd
- School of Health Sciences, The University of Manchester, Manchester, United Kingdom
- National Institute for Health and Care Research Applied Research Collaboration Greater Manchester (NIHR ARC-GM), Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
- Manchester Institute for Collaborative Research on Ageing, Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Afroditi Stathi
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Helen Hawley-Hague
- School of Health Sciences, The University of Manchester, Manchester, United Kingdom
- National Institute for Health and Care Research Applied Research Collaboration Greater Manchester (NIHR ARC-GM), Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
- Manchester Institute for Collaborative Research on Ageing, Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| |
Collapse
|
26
|
Mikkonen U, Tusa N, Sinikallio S, Lehto SM, Ruusunen A, Kautiainen H, Mäntyselkä P. The relationship between self-care preparedness and quality of life in a 3-year-follow-up: a study in primary health care. Fam Pract 2025; 42:cmae069. [PMID: 39673498 PMCID: PMC11770812 DOI: 10.1093/fampra/cmae069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2024] Open
Abstract
BACKGROUND Measuring self-care preparedness may enable better support for patients in general practice. OBJECTIVE This study assessed the relationship between the self-care preparedness index (SCPI) and health-related quality of life (HRQoL) in a longitudinal analysis over 36 months. METHODS This was a secondary analysis of an intervention group of a randomized controlled trial. Participants were adults (n = 256) with hypertension, diabetes, or coronary artery disease in primary health care. The intervention group was included in the present study since they had answered SCPI as a part of the intervention. The relationship between SCPI and HRQoL (15D) and other outcomes were studied at baseline. The mean changes in SCPI and 15D were calculated from baseline up to 36 months. Regression-based analysis was used to study to what extent the baseline SCPI was associated with the change in SCPI and 15D and to what extent the change in SCPI was associated with the change in 15D. RESULTS At baseline, 15D, physical activity, self-rated health, life satisfaction, and patient activation measures had a positive linear relationship with SCPI. Body mass index and depressive symptoms had a negative linear relationship with SCPI. The longitudinal association between changes in SCPI and 15D was statistically significant and positive. The adjusted β was + 0.19 (95% confidence interval: 0.07 to 0.30, P = .002). CONCLUSION Those patients who managed to increase their SCPI over the study period experienced an improvement in HRQoL.
Collapse
Affiliation(s)
- Ulla Mikkonen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
- Wellbeing Services County of North Savo, Health Services, P.O. Box 1711, FI-70211 Kuopio, Finland
| | - Nina Tusa
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
- Wellbeing Services County of North Savo, Educational services, P.O. Box 1711,FI- 70211 Kuopio, Finland
| | | | - Soili Marianne Lehto
- Institute of Clinical Medicine, University of Oslo, P.O. Box 1171, Blindern, 0318 Oslo, Norway
- R&D Department, Division of Mental Health Services, Akershus University Hospital, 1478 Lørenskog, Norway
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22, FI-00014 Helsinki, Finland
| | - Anu Ruusunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
- Wellbeing Services County of North Savo, Mental Health and Wellbeing, Kuopio University Hospital, P.O. Box 1711, FI-70211 Kuopio, Finland
- School of Medicine, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, Deakin University, P.O. Box 281, Geelong, Victoria 3220, Australia
| | - Hannu Kautiainen
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland
| | - Pekka Mäntyselkä
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
- Wellbeing Services County of North Savo, Clinical Research and Trials Centre, Kuopio University Hospital, P.O. Box 1711, FI-70211 Kuopio, Finland
| |
Collapse
|
27
|
Brinkley AJ, Cusimano KM, Freeman P, Southall-Edwards R, Gladwell VF. 'It's about collaboration': a whole-systems approach to understanding and promoting movement in Suffolk. Int J Behav Nutr Phys Act 2025; 22:7. [PMID: 39819450 PMCID: PMC11740498 DOI: 10.1186/s12966-024-01688-2] [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: 05/10/2024] [Accepted: 11/28/2024] [Indexed: 01/19/2025] Open
Abstract
BACKGROUND Population-levels of physical activity have remained stagnant for years. Previous approaches to modify behaviour have broadly neglected the importance of whole-systems approaches. Our research aimed to (i) understand, (ii) map, (iii) identify the leverage points, and (iv) develop solutions surrounding participation in physical activity across an English rural county. METHODS A systems-consortium of partners from regional and local government, charities, providers, deliverers, advocacy groups, and health and social care, and public health engaged in our research, which consisted of two-phases. Within Phase 1, we used secondary data, insight-work, a narrative review, participatory workshops, and interviews in a pluralistic style to map the system-representing physical activity. Phase 2 began with an initial analysis using markers from social network analysis and the Action Scales Model. This analysis informed a participatory workshop, to identify leverage points, and develop solutions for change within the county. RESULTS The systems-map is constructed from biological, financial, and psychological individual factors, interpersonal factors, systems partners, built, natural and social environmental factors, and policy and structural factors. Our initial analysis found 13 leverage points to review within our participatory workshop. When appraised by the group, (i) local governing policies, (ii) shared policies, strategies, vision, and working relationships, (iii) shared facilities (school, sport, community, recreation), and (iv) funding were deemed most important to change. Within group discussions, participants stressed the importance and challenges associated with shared working relationships, a collective vision, and strategy, the role of funding, and management of resources. Actions to leverage change included raising awareness with partners beyond the system, sharing policies, resources, insight, evidence, and capacity, and collaborating to co-produce a collective vision and strategy. CONCLUSIONS Our findings highlight the importance and provide insight into the early phase of a whole-systems approach to promoting physical activity. Our whole-systems approach within Suffolk needs to consider methods to (i) grow and maintain the systems-consortium, (ii) create a sustainable means to map the system and identify leverage points within it, and (iii) monitor and evaluate change.
Collapse
Affiliation(s)
- A J Brinkley
- Sport, Rehabilitation and Exercise Sciences, University of Essex, Essex, CO4 3SQ, UK.
| | - K M Cusimano
- Sport, Rehabilitation and Exercise Sciences, University of Essex, Essex, CO4 3SQ, UK
| | - P Freeman
- Sport, Rehabilitation and Exercise Sciences, University of Essex, Essex, CO4 3SQ, UK
| | - R Southall-Edwards
- Sport, Rehabilitation and Exercise Sciences, University of Essex, Essex, CO4 3SQ, UK
- Institute of Health and Wellbeing, University of Suffolk, Suffolk, IP4 1QJ, UK
| | - V F Gladwell
- Sport, Rehabilitation and Exercise Sciences, University of Essex, Essex, CO4 3SQ, UK
- Institute of Health and Wellbeing, University of Suffolk, Suffolk, IP4 1QJ, UK
| |
Collapse
|
28
|
Sullens DG, Gilley K, Moraglia LE, Dison S, Hoffman JT, Wiffler MB, Barnes RC, Ginty AT, Sekeres MJ. Sex in aging matters: exercise and chronic stress differentially impact females and males across the lifespan. Front Aging Neurosci 2025; 16:1508801. [PMID: 39881679 PMCID: PMC11774976 DOI: 10.3389/fnagi.2024.1508801] [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: 10/09/2024] [Accepted: 12/30/2024] [Indexed: 01/31/2025] Open
Abstract
Assessing sex as a biological variable is critical to determining the influence of environmental and lifestyle risks and protective factors mediating behavior and neuroplasticity across the lifespan. We investigated sex differences in affective behavior, memory, and hippocampal neurogenesis following short- or long-term exposure to exercise or chronic mild stress in young and aged mice. Male and female mice were assigned control, running, or chronic stress rearing conditions for 1 month (young) or for 15 months (aged), then underwent a behavioral test battery to assess activity, affective behavior, and memory. Stress exposure into late-adulthood increased hyperactivity in both sexes, and enhanced anxiety-like and depressive-like behavior in aged female, but not male, mice. One month of stress or running had no differential effects on behavior in young males and females. Running increased survival of BrdU-labelled hippocampal cells in both young and aged mice, and enhanced spatial memory in aged mice. These findings highlight the importance of considering sex when determining how aging is differently impacted by modifiable lifestyle factors across the lifespan.
Collapse
Affiliation(s)
- D. Gregory Sullens
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, United States
| | - Kayla Gilley
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, United States
- Department of Biology and Chemistry, Liberty University, Lynchburg, VA, United States
| | - Luke E. Moraglia
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, United States
- Department of Psychology, The University of Texas at Dallas, Richardson, TX, United States
| | - Sarah Dison
- Department of Biology, Baylor University, Waco, TX, United States
| | - Jessica T. Hoffman
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, United States
| | - Madison B. Wiffler
- Department of Biology, Baylor University, Waco, TX, United States
- Department of Neurobiology, University of Utah, Salt Lake City, UT, United States
| | - Robert C. Barnes
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, United States
- Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX, United States
| | - Annie T. Ginty
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, United States
| | - Melanie J. Sekeres
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, United States
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| |
Collapse
|
29
|
Tóth EE, Vujić A, Ihász F, Ruíz-Barquín R, Szabo A. Functional fitness and psychological well-being in older adults. BMC Geriatr 2025; 25:9. [PMID: 39755626 DOI: 10.1186/s12877-024-05654-2] [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: 06/29/2023] [Accepted: 12/23/2024] [Indexed: 01/06/2025] Open
Abstract
BACKGROUND Physical fitness and functioning are related to better mental health in older age. However, which fitness components (body composition, strength, flexibility, coordination, and endurance) are more closely related to psychological well-being (PWB) is unclear. METHODS This research examined how body mass index (BMI) and six indices of functional fitness (i.e., lower and upper body strength, lower and upper body flexibility, coordination [based on agility and balance], and aerobic endurance) relate to five psychological measures that could mirror PWB (i.e., resilience, mental well-being, optimism, life satisfaction, and happiness). Thirty-nine older adults (60-94 years; two-thirds female) were examined with the Fullerton Functional Fitness Test (FFFT) after completing five psychometric instruments. RESULTS Data were analyzed with correlations, ordinary least squares regressions, and regularized (elastic net) regressions, calculating the Lindeman, Merenda, and Gold (LMG) indices of the relative importance of the six FFFT components separately for the five psychological measures. Results revealed that BMI, upper body strength, and upper body flexibility were the least significant predictors of PWB. In contrast, endurance, complex movement coordination, and lower body flexibility emerged as the most significant predictors. Still, lower body strength correlated moderately positively with all PWB indices, and similarly, upper body flexibility with resilience, mental well-being, and happiness. CONCLUSIONS These findings should stimulate research on the mechanism connecting functional fitness with PWB in older adults. Further, apart from their novelty, the findings could be valuable in providing directions for physical fitness intervention programs targeting mental and physical health for older people.
Collapse
Affiliation(s)
- Eliza E Tóth
- Doctoral School of Psychology, ELTE Eötvös Loránd University Budapest, Budapest, Hungary
| | - Aleksandar Vujić
- Doctoral School of Psychology, ELTE Eötvös Loránd University Budapest, Budapest, Hungary
| | - Ferenc Ihász
- Institute of Sport Science, Faculty of Education and Psychology, ELTE Eötvös Loránd University, Szombathely, Hungary
| | - Roberto Ruíz-Barquín
- Facultad de Formación de Profesorado y Educación, Universidad Autónoma de Madrid, Madrid, Spain
| | - Attila Szabo
- Institute of Health Promotion and Sport Sciences, Faculty of Education and Psychology, ELTE Eötvös Loránd University, Bogdánfy St. 12, Budapest, H-1117, Hungary.
| |
Collapse
|
30
|
Goodwin AM, Gordon S, Sahni R, Vicari F, Accardi K, Crusco S, Duer-Hefele J, Friel C, Suls J, Cheung YK, Vrany EA, Davidson KW. Influencing basic behavioral mechanisms of action while targeting daily walking in sedentary adults at risk for cardiovascular disease: randomised factorial design protocol. BMJ Open 2025; 15:e080307. [PMID: 39755564 PMCID: PMC11749394 DOI: 10.1136/bmjopen-2023-080307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/10/2024] [Indexed: 01/06/2025] Open
Abstract
INTRODUCTION Cardiovascular disease (CVD) is the leading cause of mortality worldwide, though it may be prevented by increasing physical activity (PA). When behaviour change techniques (BCTs) are bundled together, they increase PA, though which individual BCTs increase PA (and the behavioural mechanism of action (MoA) responsible for said increase) have not been studied. The aim of this study is to conduct a randomised factorial experiment to determine which of four BCTs significantly engage the proposed MoA-self-efficacy for PA-in adults at risk for CVD. METHODS AND ANALYSIS Eight hundred and twenty sedentary adults (18-74 years old) at risk for CVD will be recruited between September 2022 and June 2025 to a fully remote, 24-week randomised BCT intervention. To identify those who might benefit from this intervention, we define self-reported walking <7500 steps per day as 'sedentary'. Following a 4-week run-in period to confirm sedentary behaviour and adherence to the study protocol, 624 eligible participants will be randomised to an 8-week intervention period. A full factorial randomised experiment will be conducted with 16 possible conditions: one will receive no BCTs (no-BCT condition), another will receive all four, and 14 will receive a unique combination of BCTs. During the intervention, participants will receive their randomised daily BCT(s) via text message. Daily steps will be continuously measured using an activity tracker. Self-efficacy for PA will be assessed bi-weekly via the Self-Efficacy for Walking Scale-Duration. Participants will complete a 12-week post-intervention follow-up period where steps will be monitored despite no BCTs being delivered. BCT(s) associated with increased daily step counts and increased self-efficacy for PA between run-in and study completion (week 12 of follow-up) will be determined alongside whether or not self-efficacy for PA mediates the association between each BCT and increased walking. ETHICS AND DISSEMINATION This trial was approved by the Northwell Health Institutional Review Board. The full factorial experimental trial results will be published in a peer-reviewed journal. Data from this clinical trial will be made available on reasonable request. TRIAL REGISTRATION NUMBER clinicaltrials.gov; Identifier: NCT05425641, 06/21/2022.
Collapse
Affiliation(s)
- Ashley M Goodwin
- Northwell Health, New Hyde Park, New York, USA
- Feinstein Institutes for Medical Research, New Hyde Park, New York, USA
| | - Samantha Gordon
- Northwell Health, New Hyde Park, New York, USA
- Feinstein Institutes for Medical Research, New Hyde Park, New York, USA
| | - Ravneet Sahni
- Northwell Health, New Hyde Park, New York, USA
- Feinstein Institutes for Medical Research, New Hyde Park, New York, USA
| | - Frank Vicari
- Northwell Health, New Hyde Park, New York, USA
- Feinstein Institutes for Medical Research, New Hyde Park, New York, USA
| | - Kaitlyn Accardi
- Northwell Health, New Hyde Park, New York, USA
- Feinstein Institutes for Medical Research, New Hyde Park, New York, USA
| | | | - Joan Duer-Hefele
- Northwell Health, New Hyde Park, New York, USA
- Feinstein Institutes for Medical Research, New Hyde Park, New York, USA
| | - Ciaran Friel
- Northwell Health, New Hyde Park, New York, USA
- Feinstein Institutes for Medical Research, New Hyde Park, New York, USA
| | - Jerry Suls
- Northwell Health, New Hyde Park, New York, USA
- Feinstein Institutes for Medical Research, New Hyde Park, New York, USA
| | - Ying Kuen Cheung
- Columbia University Mailman School of Public Health, New York, New York, USA
| | - Elizabeth A Vrany
- Northwell Health, New Hyde Park, New York, USA
- Feinstein Institutes for Medical Research, New Hyde Park, New York, USA
| | - Karina W Davidson
- Northwell Health, New Hyde Park, New York, USA
- Feinstein Institutes for Medical Research, New Hyde Park, New York, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| |
Collapse
|
31
|
Chapman CG, Schroeder MC, Marcussen B, Carr LJ. Identifying Patients at Risk for Cardiometabolic and Chronic Diseases by Using the Exercise Vital Sign to Screen for Physical Inactivity. Prev Chronic Dis 2025; 22:E02. [PMID: 39745943 PMCID: PMC11721010 DOI: 10.5888/pcd22.240149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2025] Open
Abstract
Introduction Physical inactivity is a major health risk factor for multiple chronic diseases and early death. Despite evidence supporting diet and physical activity behavioral counseling interventions, physical inactivity is rarely measured or managed in primary care. A need exists to fully explore and demonstrate the value of screening patients for physical inactivity. This study aimed to 1) compare health profiles of patients screened for inactivity versus patients not screened for inactivity, and 2) compare health profiles of inactive, insufficiently active, and active patients as measured by the Exercise Vital Sign screener. Methods The study sample comprised adult patients attending a well visit from November 1, 2017, through December 1, 2022, at a large midwestern university hospital. We extracted data from electronic medical records on exercise behavior reported by patients using the Exercise Vital Sign (EVS) questionnaire. We extracted data on demographics characteristics, resting pulse, encounters, and disease diagnoses from PCORnet Common Data Model (version 6.1). We used the Elixhauser Comorbidity Index to determine disease burden. We compared patients with complete and valid EVS values (n =7,261) with patients not screened for inactivity (n = 33,445). We conducted further comparisons between screened patients reporting 0 minutes (inactive), 1 to 149 minutes (insufficiently active), or ≥150 minutes (active) minutes per week of moderate-vigorous physical activity. Results Patients screened for inactivity had significantly lower rates of several comorbid conditions, including obesity (P < .001), diabetes (P < .001), and hypertension (P < .001) when compared with unscreened patients. Compared with insufficiently active and inactive patients, active patients had a lower risk of 19 inactivity-related comorbid conditions including obesity (P < .001), depression (P < .001), hypertension (P < .001), diabetes (P < .001), and valvular disease (P < .001). Conclusion These findings suggest inactive and insufficiently active patients are at increased risk for multiple inactivity-related chronic conditions. These findings further support existing recommendations that inactive patients receive or be referred to evidence-based lifestyle behavioral counseling programs.
Collapse
Affiliation(s)
- Cole G Chapman
- Department of Pharmacy Practice and Science, University of Iowa, Iowa City
| | - Mary C Schroeder
- Department of Pharmacy Practice and Science, University of Iowa, Iowa City
| | - Britt Marcussen
- Department of Family Medicine, University of Iowa Health Care, Iowa City
| | - Lucas J Carr
- Department of Health and Human Physiology, University of Iowa, Iowa City
- Iowa Bioscience Innovation Facility, 115 South Grand Ave, Iowa City, IA 52245
| |
Collapse
|
32
|
Sletten R, Slaaen M, Oldervoll LM, Kjesbu Skjellegrind H, Šaltytė Benth J, Åstrøm L, Kirkevold Ø, Bergh S, Grønberg BH, Rostoft S, Bye A, Mork PJ, Berger Christiansen O. Physical Performance and Activity in Older Prostate Cancer Survivors in Comparison with Population-based Matched Controls. EUR UROL SUPPL 2025; 71:87-95. [PMID: 39758854 PMCID: PMC11697607 DOI: 10.1016/j.euros.2024.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2024] [Indexed: 01/07/2025] Open
Abstract
Background and objective Whether radical prostate cancer treatment affects long-term physical performance and physical activity in older men is not known. We aimed to compare physical performance and self-reported physical activity between relapse-free older prostate cancer survivors and population-based controls. Methods A single-centre, cross-sectional study including 109 men aged ≥70 yr receiving robotic-assisted radical prostatectomy (61.5%) or external beam radiotherapy (38.5%) between 2014 and 2018 was conducted. Population-based matched (age, gender, and education) controls (n = 327) were drawn from the Trøndelag Health Study. The primary (the Short Physical Performance Battery [SPPB] summary score) and secondary (gait speed, grip strength, one-legged balance, and the self-reported Physical Activity Index) outcomes were compared between survivors and controls by adjusted linear mixed models. Key findings and limitations The SPPB score, gait speed, and Physical Activity Index did not differ between survivors (mean age 78.3 yr, mean time since treatment 52.9 mo) and controls (mean age 78.2 yr). Survivors had slightly poorer grip strength (regression coefficient [RC] -5.81, p < 0.001, 95% confidence interval [CI] -7.46; -4.17) and one-legged balance (RC -4.36, p < 0.001, 95% CI -6.72; -2.00; adjusted models), but the clinical significance is uncertain. Small sample size and potential selection of the fittest survivors are limitations that may reduce the generalisability of our findings. Conclusions and clinical implications 3 to 8 yr after radical prostate cancer treatment, older men's overall physical performance and physical activity level were comparable with those of matched controls. This suggests that the treatment had little impact on functional status. Patient summary In this study, we investigated physical function in older men several years after they had undergone curatively intended treatment for prostate cancer in comparison with men in a general population of the same age and education. We found that physical function was similar, except slightly poorer grip strength and balance on one leg in men treated for prostate cancer. We conclude that the overall physical function was comparable with that of the general population and believe that this indicates that prostate cancer treatment was well tolerated despite older age.
Collapse
Affiliation(s)
- Reidun Sletten
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- The Research Center for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
- Department of Oncology and Palliative Care, Innlandet Hospital Trust, Gjøvik/Lillehammer, Norway
| | - Marit Slaaen
- The Research Center for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Line Merethe Oldervoll
- Centre for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
- The National Institute on Intellectual Disability and Community, Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
| | - Håvard Kjesbu Skjellegrind
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Jūratė Šaltytė Benth
- The Research Center for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Lennart Åstrøm
- Section of Clinical and Experimental Oncology, Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Øyvind Kirkevold
- The Research Center for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
- Faculty of Health, Care and Nursing, NTNU Gjøvik, Gjøvik, Norway
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Sverre Bergh
- The Research Center for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Bjørn Henning Grønberg
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
- Department of Oncology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Siri Rostoft
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Asta Bye
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Ola Berger Christiansen
- The Research Center for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
- Department of Urology, Innlandet Hospital Trust, Hamar, Norway
| |
Collapse
|
33
|
Stoutenberg M, Rogers M, Denison P, Schlicht J, Weitzel K, Ory M, Kellar G, Summers L, Wingood M. Assessing older adult physical activity levels in clinical settings: The modified PAVS for older adults. J Am Geriatr Soc 2025; 73:266-276. [PMID: 39363528 DOI: 10.1111/jgs.19202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2024] [Revised: 08/29/2024] [Accepted: 09/07/2024] [Indexed: 10/05/2024]
Abstract
BACKGROUND Participating in recommended levels of physical activity (PA) is critical for preventing functional decline, falls, and frailty, making it essential to identify older adults not meeting national PA guidelines. However, guidance on assessing older adult PA levels, particularly in clinical settings, is lacking. This article presents an overview of clinically feasible PA assessment tools for older adults, identifies gaps in current tools, and provides recommendations on addressing these gaps. METHODS We conducted a literature review on clinically feasible PA assessment tools, suggested modifications to an existing PA assessment for older adult patients, and highlighted opportunities for integrating the modified PA assessment tool in clinical settings. RESULTS We identified 16 PA assessment tools used in clinical settings. The most widely used tool is the Physical Activity Vital Sign (PAVS), which has been successfully integrated into several electronic health records (EHR) and clinical practices. Most tools, including the PAVS, primarily focus on aerobic activities, with limited consideration for strength and balance. We recommend the use of a Modified PAVS for Older Adults that includes items on muscle-strengthening and balance activities to better align with national PA guidelines. We then identified several existing opportunities for broad implementation of the Modified PAVS for Older Adults within clinical settings. CONCLUSIONS Widespread integration of the Modified PAVS for Older Adults will better support healthcare providers in identifying individuals not meeting national PA recommendations, assisting them in prescribing tailored PA prescriptions and better connecting their patients to appropriate resources and professionals for further support.
Collapse
Affiliation(s)
- Mark Stoutenberg
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
- College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
| | - Michael Rogers
- Department of Human Performance Studies, Wichita State University, Wichita, Kansas, USA
| | | | - Jeff Schlicht
- Department of Health Promotion & Exercise, Western Connecticut State University, Danbury, Connecticut, USA
| | - Kelsey Weitzel
- Department of Physical Therapy, University of Missouri, Columbia, Missouri, USA
| | - Marcia Ory
- Department of Environmental and Occupational Health, Texas A&M University, College Station, Texas, USA
| | - Garrett Kellar
- Department of Health Professions, Youngstown State University, Youngstown, Ohio, USA
| | - Louisa Summers
- College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Mariana Wingood
- Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| |
Collapse
|
34
|
Pradhan S, Esterov D, Driver S, Whyte J, Bell KR, Barber J, Temkin N, Bombardier CH. Predictors of Physical Activity One Year After Moderate to Severe Traumatic Brain Injury. J Head Trauma Rehabil 2025; 40:E54-E65. [PMID: 38916401 DOI: 10.1097/htr.0000000000000966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
OBJECTIVES To identify predictors of moderate to vigorous physical activity (MVPA) at 12-months post-moderate-severe traumatic brain injury (TBI). SETTING Four inpatient rehabilitation centers. PARTICIPANTS Individuals enrolled in the TBI Model Systems with moderate to severe TBI, admitted to inpatient rehabilitation, and able to ambulate without physical assistance from another person. DESIGN Prospective longitudinal cohort study. MVPA was measured by having participants wear an ActiGraph GT3X on their wrist for 7 consecutive days. MAIN ANALYSES We used multivariate regression to predict minutes per week of MVPA at 12 months after TBI. Three classes of predictors were entered hierarchically-demographic and clinical variables (age, sex, body mass index, education, TBI severity, neighborhood walkability score, and self-reported preinjury physical activity [PA] level), baseline TBI-related comorbid conditions (eg, measures of sleep, pain, mood, fatigue, and cognition), and intention to exercise and exercise self-efficacy assessed approximately 1 week after discharge from inpatient rehabilitation. RESULTS 180 participants (ages 17.7-90.3 years) were enrolled, and 102 provided at least 5 days of valid accelerometer data at 12 months. At 12 months, participants recorded an average of 703 (587) minutes per week of MVPA. In univariate and multivariate analyses, age was the only significant predictor of 12-month MVPA ( r = -0.52). A sharp decline in MVPA was observed in the tertile of participants who were over the age of 61. CONCLUSIONS Older adults with TBI are at elevated risk of being physically inactive. Assuming PA may enhance health after TBI, older adults are a logical target for prevention or early intervention studies. Studies with longer outcomes are needed to understand the trajectory of PA levels after TBI.
Collapse
Affiliation(s)
- Sujata Pradhan
- Author Affiliations: Department of Rehabilitation Medicine (Dr Pradhan and Dr Bombardier), Department of Neurological surgery (Dr Barber and Dr Temkin), University of Washington, Seattle, Washington; Department of Physical Medicine and Rehabilitation (Dr Esterov), Mayo Clinic, Rochester, Minnesota; Department of Physical Medicine and Rehabilitation (Dr Driver), Baylor Scott and White Research Institute, Dallas, Texas; Department of Physical Medicine and Rehabilitation (Dr Whyte), Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania; and Department of Physical Medicine and Rehabilitation (Dr. Bell), University of Texas Southwestern Medical Center, Dallas, Texas
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Guerrini B, Clarke JJ, Smith BJ, McVeigh JA, Holmes K, Wild J, Talbot R, Ashley J, McEvoy PM. The Impacts of Engagement in Men's Sheds on Incidental Physical Activity and Wellbeing Outcomes. Health Promot J Austr 2025; 36:e958. [PMID: 39775895 PMCID: PMC11706697 DOI: 10.1002/hpja.958] [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: 09/18/2024] [Revised: 12/19/2024] [Accepted: 12/20/2024] [Indexed: 01/11/2025] Open
Abstract
BACKGROUND As a large proportion of older adults are insufficiently active, it is imperative to identify ways to increase incidental physical activity. Men's Sheds, a mutual-aid, community-based organisation appear to be a promising approach for optimising wellbeing outcomes. OBJECTIVES To investigate whether Men's Sheds attendance is associated with higher levels of physical activity, and the relationships between physical activity, health-related quality of life (HRQOL), and wellbeing in Men's Shed members. METHODS Participants (N = 45) wore a hip accelerometer (Actigraph GTX-9) for 11 days. The majority (n = 30, Mage = 72.3 ± 9.4) also consented to complete an online questionnaire investigating HRQOL and wellbeing. RESULTS Linear mixed models revealed members, on average, spent an additional 34 min in light physical activity, had an extra six breaks in sedentary behaviour, and took an extra 1193 steps on days they attended Men's Sheds, though, these effects were small. Physical activity was not significantly associated with HRQOL and wellbeing. CONCLUSION Men's Sheds appear to be a valuable approach for increasing light intensity physical activity, breaks in sedentary behaviours, and step count in older adults. However, additional Men's Shed activities specifically targeting increased movement may be required to realise greater impacts on health-related quality of life and wellbeing. SO WHAT?: Men's Sheds may provide a valuable opportunity to increase some indices of physical activity, which may contribute to better overall health. While these effects may be small for active Men's Shed members, these effects may be more appreciable for more sedentary individuals.
Collapse
Affiliation(s)
- Briana Guerrini
- School of Population HealthCurtin UniversityPerthWestern AustraliaAustralia
| | - James J. Clarke
- School of Population HealthCurtin UniversityPerthWestern AustraliaAustralia
- enAble InstituteCurtin UniversityPerthWestern AustraliaAustralia
| | - Brendan J. Smith
- School of Population HealthCurtin UniversityPerthWestern AustraliaAustralia
- enAble InstituteCurtin UniversityPerthWestern AustraliaAustralia
| | - Joanne A. McVeigh
- School of Allied HealthCurtin UniversityPerthWestern AustraliaAustralia
- School of PhysiologyUniversity of WitwatersrandJohannesburgGautengSouth Africa
| | - Kirsten Holmes
- School of Management and MarketingCurtin UniversityPerthWestern AustraliaAustralia
| | - James Wild
- Men's Sheds of Western AustraliaPerthWestern AustraliaAustralia
| | - Rebecca Talbot
- Men's Sheds of Western AustraliaPerthWestern AustraliaAustralia
| | - Jaxon Ashley
- Men's Sheds of Western AustraliaPerthWestern AustraliaAustralia
| | - Peter M. McEvoy
- School of Population HealthCurtin UniversityPerthWestern AustraliaAustralia
- enAble InstituteCurtin UniversityPerthWestern AustraliaAustralia
- Centre for Clinical InterventionsNorth Metropolitan Health ServicePerthWestern AustraliaAustralia
| |
Collapse
|
36
|
Bauman A. Commentary on Izquierdo (2024): Where next for exercise recommendations for healthy longevity in older adults? J Nutr Health Aging 2025; 29:100421. [PMID: 39743382 DOI: 10.1016/j.jnha.2024.100421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2024] [Accepted: 11/14/2024] [Indexed: 01/04/2025]
Affiliation(s)
- Adrian Bauman
- School of Public Health, Faculty of Medicine and Health, Sydney University, Australia.
| |
Collapse
|
37
|
Skjødt M, Brønd JC, Tully MA, Tsai L, Koster A, Visser M, Caserotti P. Moderate and Vigorous Physical Activity Intensity Cut-Points for Hip-, Wrist-, Thigh-, and Lower Back Worn Accelerometer in Very Old Adults. Scand J Med Sci Sports 2025; 35:e70009. [PMID: 39753998 PMCID: PMC11698702 DOI: 10.1111/sms.70009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Revised: 11/15/2024] [Accepted: 12/20/2024] [Indexed: 01/06/2025]
Abstract
Physical activity (PA) reduces the risk of negative mental and physical health outcomes in older adults. Traditionally, PA intensity is classified using METs, with 1 MET equal to 3.5 mL O2·min-1·kg-1. However, this may underestimate moderate and vigorous intensity due to age-related changes in resting metabolic rate (RMR) and VO2max. VO2reserve accounts for these changes. While receiver operating characteristics (ROC) analysis is commonly used to develop PA, intensity cut-points, machine learning (ML) offers a potential alternative. This study aimed to develop ROC cut-points and ML models to classify PA intensity in older adults. Sixty-seven older adults performed activities of daily living (ADL) and two six-minute walking tests (6-MWT) while wearing six accelerometers on their hips, wrists, thigh, and lower back. Oxygen uptake was measured. ROC and ML models were developed for ENMO and Actigraph counts (AGVMC) using VO2reserve as the criterion in two-third of the sample and validated in the remaining third. ROC-developed cut-points showed good-excellent AUC (0.84-0.93) for the hips, lower back, and thigh, but wrist cut-points failed to distinguish between moderate and vigorous intensity. The accuracy of ML models was high and consistent across all six anatomical sites (0.83-0.89). Validation of the ML models showed better results compared to ROC cut-points, with the thigh showing the highest accuracy. This study provides ML models that optimize the classification of PA intensity in very old adults for six anatomical placements hips (left/right), wrist (dominant/non-dominant), thigh and lower back increasing comparability between studies using different wear-position. Clinical Trial Registration: clinicaltrials.gov identifier: NCT04821713.
Collapse
Affiliation(s)
- Mathias Skjødt
- Department of Sports Science and Clinical BiomechanicsUniversity of Southern DenmarkOdenseDenmark
- Department of Sports Science and Clinical Biomechanics, Center for Active and Healthy Ageing (CAHA)University of Southern DenmarkOdenseDenmark
| | - Jan Christian Brønd
- Department of Sports Science and Clinical BiomechanicsUniversity of Southern DenmarkOdenseDenmark
| | | | - Li‐Tang Tsai
- Research Unit for ORL—Head and Neck Surgery and AudiologyOdense University Hospital and University of Southern DenmarkOdenseDenmark
| | - Annemarie Koster
- Department of Social Medicine, CAPHRI Care and Public Health Research InstituteMaastricht UniversityMaastrichtthe Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research InstituteVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Paolo Caserotti
- Department of Sports Science and Clinical BiomechanicsUniversity of Southern DenmarkOdenseDenmark
- Department of Sports Science and Clinical Biomechanics, Center for Active and Healthy Ageing (CAHA)University of Southern DenmarkOdenseDenmark
| |
Collapse
|
38
|
O’Reilly S, Ní Bhriain O, Dillon S, Clifford AM. A comprehensive scoping review of intergenerational dance programmes for cohorts with a generational gap. PLoS One 2024; 19:e0311564. [PMID: 39700190 PMCID: PMC11658520 DOI: 10.1371/journal.pone.0311564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 09/21/2024] [Indexed: 12/21/2024] Open
Abstract
INTRODUCTION Loneliness and physical inactivity are issues that affect both young people and older adults. This can have negative health outcomes and well as high costs on health services. Physical activity can positively influence both physical and psychosocial health outcomes, however enjoyment is necessary for adherence. Combining exercise with arts-based activities can improve enjoyment for older adults and young people. Dance has been found to be a safe and enjoyable form of physical activity that can be equally or more effective than conventional exercise options. Intergenerational interventions can improve relationships between generations. The aim of this scoping review was to collate and map the available evidence for intergenerational dance. METHODS This scoping review followed the guidance outlined by the Joanna Briggs Institute. A systematic search of nine multidisciplinary databases and four repositories was conducted. Inclusion criteria were intergenerational dance or movement to music programmes. Exclusion criteria included dance movement therapy or groups with less than one generational gap. Data were extracted and summarised using narrative synthesis and research papers were appraised using the Mixed Methods Appraisal Tool. RESULTS The search identified eleven research studies, seven expert opinion/practice expertise and 13 sources from the grey literature. Dance classes were typically 11-12 weeks long. Genres varied with some programmes including co-creation through choreography. Experiences and social outcomes were the most assessed outcomes, with a lack of studies examining physical outcomes. Participants reported enjoying the programmes stating they felt proud for taking part and looked forward to sessions. The term intergenerational was not defined in any paper. CONCLUSIONS Intergenerational dance is an emerging area of research. Many programmes run in communities but are not researched, therefore several gaps remain. More large-scale trials are needed around intergenerational dance. Definitions and descriptions of dance and intergenerational activity should be considered in future studies to ensure consistency.
Collapse
Affiliation(s)
- Siobhán O’Reilly
- School of Allied Health, University of Limerick, Castletroy, Limerick, Ireland
- Health Research Institute, University of Limerick, Castletroy, Limerick, Ireland
| | - Orfhlaith Ní Bhriain
- Health Research Institute, University of Limerick, Castletroy, Limerick, Ireland
- Ageing Research Centre, University of Limerick, Castletroy, Limerick, Ireland
- Irish World Academy of Music and Dance, University of Limerick, Castletroy, Limerick, Ireland
| | - Sarah Dillon
- School of Allied Health, University of Limerick, Castletroy, Limerick, Ireland
- Health Research Institute, University of Limerick, Castletroy, Limerick, Ireland
| | - Amanda M. Clifford
- School of Allied Health, University of Limerick, Castletroy, Limerick, Ireland
- Health Research Institute, University of Limerick, Castletroy, Limerick, Ireland
- Ageing Research Centre, University of Limerick, Castletroy, Limerick, Ireland
| |
Collapse
|
39
|
Zhao Y, Soh KG, Saad HBA, Rong W, Liu C, Wang X. Effects of active video games on mental health among college students: a systematic review. BMC Public Health 2024; 24:3482. [PMID: 39695572 DOI: 10.1186/s12889-024-21011-9] [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: 06/09/2024] [Accepted: 12/06/2024] [Indexed: 12/20/2024] Open
Abstract
BACKGROUND Mental health significantly impacts college students' academic performance and overall happiness. Active video games (AVGs) have gained popularity among college students due to their ample entertainment, and there is growing interest in utilizing them to address mental health issues. However, there has not been a comprehensive summary and systematic review of research on the effects of AVGs on college students' mental health. METHODS As of October 18th, 2024, searches were conducted in six internationally renowned databases (PubMed, SCOPUS, Web of Science, CINAHL Plus, EBSCOhost, Cochrane Library). Inclusion and exclusion criteria were developed based on the PICOS principles. A systematic review was conducted following the PRISMA guidelines, and compliant studies using randomised controlled trial design (RCT) were included. The methodological quality of the included studies was evaluated using the PEDro scale. RESULTS A total of 3471 articles were retrieved, of which 17 met the criteria inclusion. The PEDro scores of the 17 studies ranged from four to nine. The results indicate that AVGs can effectively improve college students' poor mental health, such as stress, anxiety, and depression, as well as increase their happiness and psychological satisfaction. Moreover, AVGs have been shown to increase motivation for exercise, improve college students' attitudes toward other forms of exercise, and promote sustained physical activity. Additionally, AVGs have demonstrated efficacy in improving sleep quality. CONCLUSION Overall, AVGs can serve as an effective intervention to reduce dysphoria and promote positive psychological states among college students, thus improving mental health. Using the theory-based design of AVGs will further increase the effect. However, the effects of AVGs vary depending on their type and initial design purpose. Therefore, when using AVGs to improve college students' mental health, it is necessary to carefully consider the students' original state, select AVGs with rich game content that can provide at least moderate-intensity physical activity, and adopt the correct intervention strategy to achieve good results. AVG can potentially become a valuable tool for improving college students' mental health. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero , identifier: CRD42024510488.
Collapse
Affiliation(s)
- Yue Zhao
- Faculty of Educational Studies, Department of Sports Studies, Universiti Putra Malaysia, Selangor, Malaysia
| | - Kim Geok Soh
- Faculty of Educational Studies, Department of Sports Studies, Universiti Putra Malaysia, Selangor, Malaysia.
| | - Hazizi Bin Abu Saad
- Faculty of Medicine and Health Sciences, Department of Nutrition, Universiti Putra Malaysia, Selangor, Malaysia
| | - Wenchao Rong
- Faculty of Educational Studies, Department of Sports Studies, Universiti Putra Malaysia, Selangor, Malaysia
| | - Cong Liu
- Faculty of Educational Studies, Department of Sports Studies, Universiti Putra Malaysia, Selangor, Malaysia
| | - Xinzhi Wang
- Faculty of Educational Studies, Department of Sports Studies, Universiti Putra Malaysia, Selangor, Malaysia
| |
Collapse
|
40
|
Esterley M, Krach LE, Pederson K, Wandersee NG, Tierney SC, Boyer ER. Physical and Psychosocial Consequences of Falls in Ambulatory Individuals With Cerebral Palsy by Age and Gross Motor Function. Arch Phys Med Rehabil 2024:S0003-9993(24)01407-2. [PMID: 39701203 DOI: 10.1016/j.apmr.2024.12.010] [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: 10/11/2023] [Revised: 11/08/2024] [Accepted: 12/08/2024] [Indexed: 12/21/2024]
Abstract
OBJECTIVE To quantify physical and psychosocial impacts of falls by age and Gross Motor Classification System (GMFCS) level in ambulatory individuals with cerebral palsy (CP). DESIGN Cross-sectional survey. SETTING Tertiary specialty hospital and online CP communities. PARTICIPANTS Ambulatory individuals with CP (N=201 adults; 18-76 years old) or the caregivers of minors (N=180; 5-17 years old). MAIN OUTCOME MEASURE(S) Participants completed online surveys to report fall frequency, fall characteristics, injuries, concern about falling (Short Falls Efficacy Scale-International), activity avoidance due to concern about falling (Short Falls Efficacy Scale-International Avoidance Behavior), and psychosocial constructs related to perceived consequences of falling (Consequences of Falling-Damage to Identity subscale). RESULTS Most participants fell in the past 12 months (86%). Fall frequency in the past 12 months differed by age (P<.001) and GMFCS level (P=.021). Individuals aged 5-12 years or GMFCS level II reported the most falls. The percentage of participants who experienced a past serious fall-related injury (eg, head/face stitches, concussion, fractures) increased with age (P<.001), affecting 80% of ≥50-year olds. Falls often occurred in the forward direction, when wearing shoes, and during ambulation. Uneven surfaces and fatigue were notable causes. Concern about falling and associated activity avoidance scores differed by age and GMFCS level (all P<.01), both of which were highest for ≥50-year olds and GMFCS level III. Although psychosocial consequences of falls (eg, embarrassment, lost confidence) were elevated across all groups, they did not differ by age or GMFCS level (P=.130, P=.083). Nearly everyone (88%) wished they fell less. CONCLUSIONS Falls are common for ambulatory children and adults with CP. Physical and psychosocial consequences of falls were frequent and impacted behavior. Differences observed by age and GMFCS level should be considered in care delivery. Clinically tracking and discussing falls and their repercussions across the lifespan will aid in addressing this under-researched and under-resourced concern of people with CP.
Collapse
Affiliation(s)
| | - Linda E Krach
- Gillette Children's - Department of Adult Physical Medicine and Rehabilitation, Saint Paul, MN; Department of Rehabilitation Medicine, University of Minnesota - Twin Cities, Minneapolis, MN
| | - Kari Pederson
- Gillette Children's - Department of Adult Physical Medicine and Rehabilitation, Saint Paul, MN
| | | | | | - Elizabeth R Boyer
- Gillette Children's - Department of Research, Saint Paul, MN; Department of Orthopedic Surgery, University of Minnesota - Twin Cities, Minneapolis, MN.
| |
Collapse
|
41
|
Huang Z, Xu T, Huang Y, Zhao Q, Dong W, Xu J, Liu X, Fu Y, Wang Y, Chen C. Types of Home and Community-Based Physical Activity and Their Effects on the Older Adults' Quality of Life: A Systematic Review and Meta-Analysis. J Appl Gerontol 2024; 43:1950-1967. [PMID: 39023884 DOI: 10.1177/07334648241257799] [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] [Indexed: 07/20/2024] Open
Abstract
Home and community-based physical activity (HCBPA) has been extensively utilized among older adults. Nevertheless, the varying types of HCBPA, including different duration, intensity, and frequency, have sparked controversy regarding their impact on the quality of life in older adults. This study aims to explore the effects of HCBPA on QoL in older adults. We conducted a systematic review and retrieved studies published from January 2000 to April 2023 from multiple databases (PubMed, Embase, Cochrane, and the Web of Science Library). Seventeen articles met the inclusion criteria for this study. Long-term HCBPA interventions may have a more pronounced positive impact on older adults' quality of life than short-term ones, with the intervention's intensity and frequency playing a key role in its effectiveness. The results of the meta-analyses showed significant differences in PCS but not in MCS, both with low certainty of evidence. Policymakers should prioritize the importance of promoting HCBPA interventions with appropriate duration, intensity, and frequency to create a more age-inclusive society.
Collapse
Affiliation(s)
- Zishuo Huang
- School of Medical Humanities and Management, Wenzhou Medical University, Wenzhou, China
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Tingke Xu
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yunyun Huang
- School of Medical Humanities and Management, Wenzhou Medical University, Wenzhou, China
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Qianru Zhao
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Weizhen Dong
- Department of Sociology and Legal Studies, University of Waterloo, Waterloo, ON, Canada
| | - Jixiang Xu
- School of Public Health, Fudan University, Shanghai, China
| | - Xinyu Liu
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Yating Fu
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Ying Wang
- School of Public Health, Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Chun Chen
- School of Medical Humanities and Management, Wenzhou Medical University, Wenzhou, China
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| |
Collapse
|
42
|
Chicoine AX, Chertkow H, Tardif JC, Busseuil D, D'Antono B. Childhood maltreatment, cognitive performance, and cognitive decline in middle-aged and older adults with chronic disease: A prospective study. J Psychosom Res 2024; 187:111965. [PMID: 39461232 DOI: 10.1016/j.jpsychores.2024.111965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 10/17/2024] [Accepted: 10/19/2024] [Indexed: 10/29/2024]
Abstract
OBJECTIVES Childhood maltreatment (CM) may increase the risk for cognitive deficits and dementia later in life. However, most research has been cross-sectional in nature, has typically focused on specific types of CM, and rarely examined individual differences. The objectives are to evaluate 1) if CM predicts poorer cognitive performance and greater cognitive decline over a 5-year follow-up in older men and women with coronary artery disease (CAD) or other non-cardiovascular (non-CVD) chronic disease, and whether 2) sex and CAD status influence these relations. METHODS Men and women (N = 1254; 39.6 % women; 65.6 ± 7.0 years old) with CAD or other non-CVD chronic diseases completed the Childhood Trauma Questionnaire Short Form (CTQ-SF). The Montreal Cognitive Assessment (MoCA) was administered twice at 5-year intervals. Main analyses included bivariate correlations, hierarchical analyses and moderation analyses controlling for sociodemographic and health parameters. RESULTS CM was experienced by 32 % of the sample, while scores suggestive of cognitive deficits were obtained by 32.7 % and 40.2 % at study onset and follow-up, respectively. CM was associated with significantly lower MoCA scores at study onset (b = -0.013, p = 0.020), but not with change in MoCA over time (b = -0.002, p = 0.796). While MoCA scores did differ as a function of sex and CAD status, the latter did not influence the relations between maltreatment and MoCA. CONCLUSIONS CM predicted poorer cognitive functioning among older individuals with chronic diseases but did not play a role in any further cognitive decline over the follow-up period. Further research is needed to help understand the mechanisms implicated.
Collapse
Affiliation(s)
- Ann Xiuli Chicoine
- Research Centre, Montreal Heart Institute, Montreal, Canada; Psychology Department, Université de Montréal, Montreal, Canada
| | - Howard Chertkow
- Baycrest Academy for Research and Education, Toronto, Ontario, Canada
| | - Jean-Claude Tardif
- Research Centre, Montreal Heart Institute, Montreal, Canada; Department of Medicine, Université de Montréal, Montreal, Canada
| | - David Busseuil
- Research Centre, Montreal Heart Institute, Montreal, Canada
| | - Bianca D'Antono
- Research Centre, Montreal Heart Institute, Montreal, Canada; Psychology Department, Université de Montréal, Montreal, Canada.
| |
Collapse
|
43
|
Kyrönlahti S, Lehtisalo J, Ngandu T, Kivipelto M, Strandberg T, Antikainen R, Laatikainen T, Soininen H, Tuomilehto J, Havulinna S, Kulmala J. Cognition, Depression, Pain, and Exercise Motives as Predictors of Longitudinal Profiles of Physical Activity During a Seven-Year Follow-Up Among Older Adults. Scand J Med Sci Sports 2024; 34:e14777. [PMID: 39670449 PMCID: PMC11638919 DOI: 10.1111/sms.14777] [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: 04/18/2024] [Revised: 11/22/2024] [Accepted: 11/28/2024] [Indexed: 12/14/2024]
Abstract
This study investigated longitudinal physical activity (PA) profiles over 7 years in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). Cognition, depression, pain, and PA motives were included as determinants of the PA profiles. The 1259 participants, aged 60-77 years at baseline, were randomized into either a control group receiving general health advice, or an intervention group offered a comprehensive 2-year multidomain intervention including physical exercise, diet advice, cognitive training, and vascular risk factor management. The participants reported weekly moderate-intensity PA at baseline and 1, 2, 5, and 7 years after the baseline. Those providing PA data at two or more time points were included (n = 1188). Longitudinal PA profiles were determined using latent class growth analysis, and their associations with baseline determinants via multinomial logistic regression analysis. Interaction terms were added to investigate whether the intervention modified these associations. Six PA profiles were identified: Very high-stable (6%), High-stable (22%), Moderate-declining (47%), Moderate-steeply declining (5%), Low-increasing (9%), and Constantly low (12%). Participants in the intervention group and those motivated by distal and proximal benefits of exercise were likelier to maintain high PA level. Conversely, depressive symptoms and pain were predictors of Constantly low profile. Results show that high baseline PA was generally maintained, while greater variability in PA changes was observed among initially less active participants.
Collapse
Affiliation(s)
- Saila Kyrönlahti
- Department of Public Health, Lifestyles and Living Environments UnitFinnish Institute for Health and Welfare (THL)HelsinkiFinland
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC)Tampere UniversityTampereFinland
| | - Jenni Lehtisalo
- Department of Public Health, Lifestyles and Living Environments UnitFinnish Institute for Health and Welfare (THL)HelsinkiFinland
| | - Tiia Ngandu
- Department of Public Health, Lifestyles and Living Environments UnitFinnish Institute for Health and Welfare (THL)HelsinkiFinland
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer ResearchKarolinska InstituteStockholmSweden
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer ResearchKarolinska InstituteStockholmSweden
- Faculty of Health Sciences, Institute of Public Health and Clinical NutritionUniversity of Eastern FinlandKuopioFinland
- Ageing Epidemiology Research UnitSchool of Public Health Imperial College LondonLondonUK
| | - Timo Strandberg
- Center for Life Course Health Research/GeriatricsUniversity of OuluOuluFinland
- University of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Riitta Antikainen
- Center for Life Course Health Research/GeriatricsUniversity of OuluOuluFinland
- Medical Research Center OuluOulu University HospitalOuluFinland
| | - Tiina Laatikainen
- Department of Public Health, Lifestyles and Living Environments UnitFinnish Institute for Health and Welfare (THL)HelsinkiFinland
- Faculty of Health Sciences, Institute of Public Health and Clinical NutritionUniversity of Eastern FinlandKuopioFinland
| | - Hilkka Soininen
- Institute of Clinical Medicine – NeurologyUniversity of Eastern FinlandKuopioFinland
| | - Jaakko Tuomilehto
- Department of Public Health, Lifestyles and Living Environments UnitFinnish Institute for Health and Welfare (THL)HelsinkiFinland
- Department of Public HealthUniversity of HelsinkiHelsinkiFinland
- South Ostrobothnia Central HospitalSeinäjokiFinland
| | - Satu Havulinna
- Department of Healthcare and Social Welfare, Services UnitFinnish Institute for Health and WelfareHelsinkiFinland
| | - Jenni Kulmala
- Department of Public Health, Lifestyles and Living Environments UnitFinnish Institute for Health and Welfare (THL)HelsinkiFinland
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC)Tampere UniversityTampereFinland
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer ResearchKarolinska InstituteStockholmSweden
| |
Collapse
|
44
|
Lynch L, McCarron M, McCallion P, Burke E. An exploration into self-reported inactivity behaviours of adults with an intellectual disability using physical activity questionnaires. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:1396-1407. [PMID: 39229682 DOI: 10.1111/jir.13184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 07/12/2024] [Accepted: 08/11/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND Inactivity is a correlate of adverse health. Adults with an intellectual disability (ID) are more inactive than the general population and often present with more complex health issues. Self-reported activity questionnaires such as the International Physical Activity Questionnaire - Short Form (IPAQ-SF) and Rapid Assessment of Physical Activity (RAPA) questionnaire are the predominant source of activity information because of their low cost, non-invasive nature, ease of administration and interpretation of results. METHODS Correlates of inactivity among the general and ID populations were identified through a literature scoping review. Inactivity was measured using the RAPA and the IPAQ-SF. A multiple-imputation chained equation was used to impute missing data. Using Pearson chi-squared analyses, relationships between these correlates as well as covariates of age, sex, level of ID, body mass index (BMI) and aetiology, and RAPA and IPAQ-SF categories were explored. Logistic regression provided more detailed analyses. Results were summarised using the Systems of Sedentary Behaviour framework. Spearman correlations examined the IPAQ-SF and RAPA relationships. RESULTS Three correlates for inactivity emerged from the IPAQ-SF and RAPA questionnaire. Up after 07:00 h was a correlate for both. Difficulty walking 100 yards and epilepsy were additional correlates of inactivity. Weak but significant correlations were seen between IPAQ-SF and RAPA scores. CONCLUSIONS High inactivity levels are present in adults with an ID. The IPAQ-SF and RAPA questionnaires are weakly correlated.
Collapse
Affiliation(s)
- L Lynch
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - M McCarron
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - P McCallion
- College of Public Health, Temple University, Philadelphia, PA, USA
| | - E Burke
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
45
|
Wanigatunga AA, Liu F, Dougherty RJ, Roche KB, Urbanek JK, Zampino M, Simonsick EM, Tian Q, Schrack JA, Ferrucci L. Relationship between skeletal mitochondrial function and digital markers of free-living physical activity in older adults. GeroScience 2024; 46:6173-6182. [PMID: 38809390 PMCID: PMC11493922 DOI: 10.1007/s11357-024-01212-1] [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: 04/23/2024] [Accepted: 05/16/2024] [Indexed: 05/30/2024] Open
Abstract
This study examined the association between in vivo skeletal mitochondrial function and digital free-living physical activity patterns-a measure that summarizes biological, phenotypic, functional, and environmental effects on mobility. Among 459 participants (mean age 68 years; 55% women) in the Baltimore Longitudinal Study of Aging, mitochondrial function was quantified as skeletal muscle oxidative capacity via post-exercise phosphocreatine recovery rate (τPCr) in the vastus lateralis muscle of the left thigh, using 31P magnetic resonance spectroscopy. Accelerometry was collected using a 7-day, 24-h wrist-worn protocol and summarized into activity amount, intensity, endurance, and accumulation patterning metrics. Linear regression, two-part linear and logistic (bout analyses), and linear mixed effects models (time-of-day analyses) were used to estimate associations between τPCr and each physical activity metric. Interactions by age, sex, and gait speed were tested. After covariate adjustment, higher τPCr (or poorer mitochondrial function) was associated with lower activity counts/day (β = - 6593.7, SE = 2406.0; p = 0.006) and activity intensity (- 81.5 counts, SE = 12.9; p < 0.001). For activity intensity, the magnitude of association was greater for men and those with slower gait speed (interaction p < 0.02 for both). Conversely, τPCr was not associated with daily active minutes/day (p = 0.15), activity fragmentation (p = 0.13), or endurance at any bout length (p > 0.05 for all). Time-of-day analyses show participants with high τPCr were less active from 6:00 a.m. to 12:00 a.m. than those with low τPCr. Results indicate that poorer skeletal mitochondrial function is primarily associated with lower engagement in high intensity activities. Our findings help define the connection between laboratory-measured mitochondrial function and real-world physical activity behavior.
Collapse
Affiliation(s)
- Amal A Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- Center On Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, MD, USA.
- , Baltimore, MD, 21025, USA.
| | - Fangyu Liu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ryan J Dougherty
- Center On Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Karen Bandeen Roche
- Center On Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, MD, USA
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jacek K Urbanek
- Center On Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, MD, USA
- Biostatistics and Data Management, Regeneron Pharmaceuticals, Tarrytown, NY, USA
| | - Marta Zampino
- Department of Internal Medicine, University of Maryland, Baltimore, MD, USA
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute On Aging, National Institutes of Health, Baltimore, MD, USA
| | - Qu Tian
- Intramural Research Program, National Institute On Aging, National Institutes of Health, Baltimore, MD, USA
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Center On Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, MD, USA
| | - Luigi Ferrucci
- Intramural Research Program, National Institute On Aging, National Institutes of Health, Baltimore, MD, USA
| |
Collapse
|
46
|
Fuentes Diaz MF, Leadbetter B, Pitre V, Nowell S, Sénéchal M, Bouchard DR. Synchronous Group-Based Online Exercise Programs for Older Adults Living in the Community: A Scoping Review. J Aging Phys Act 2024; 32:703-717. [PMID: 38823794 DOI: 10.1123/japa.2023-0214] [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: 06/21/2023] [Revised: 03/22/2024] [Accepted: 04/08/2024] [Indexed: 06/03/2024]
Abstract
Older adults are the least physically active group with specific barriers to regular exercise, and online exercise programs could overcome some of those barriers. This scoping review aimed to describe the characteristics of supervised group-based synchronous online exercise programs for older adults living in the community, their feasibility, acceptability, and potential benefits. MEDLINE (Ovid), Embase, SPORTDiscus, and the Cumulative Index to Nursing and Allied Health Literature were searched until November 2022. The included studies met the following criteria: participants aged 50 years and above, a minimum of a 6-week group-based supervised and synchronous intervention, and original articles available in English. Eighteen articles were included, with 1,178 participants (67% female, average age of 71 [57-93] years), most (83%) published in the past 3 years. From the limited reported studies, delivering supervised, synchronous online exercise programs (one to three times/week, between 8 and 32 weeks) for older adults living in the community seems feasible, accepted, and can improve physical function.
Collapse
Affiliation(s)
- Maria Fernanda Fuentes Diaz
- Cardiometabolic Exercise & Lifestyle Laboratory, Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
| | - Brianna Leadbetter
- Cardiometabolic Exercise & Lifestyle Laboratory, Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
| | - Vanessa Pitre
- Cardiometabolic Exercise & Lifestyle Laboratory, Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
| | - Sarah Nowell
- Cardiometabolic Exercise & Lifestyle Laboratory, Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
| | - Martin Sénéchal
- Cardiometabolic Exercise & Lifestyle Laboratory, Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
| | - Danielle R Bouchard
- Cardiometabolic Exercise & Lifestyle Laboratory, Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
| |
Collapse
|
47
|
Pereira-Payo D, Pastor-Cisneros R, Mendoza-Muñoz M, Carrasco-Marcelo L. Associations Among Reduced Income, Unhealthy Habits, the Prevalence of Non-Communicable Diseases, and Multimorbidity in Middle-Aged and Older US Adults: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:2398. [PMID: 39685021 DOI: 10.3390/healthcare12232398] [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: 10/11/2024] [Revised: 11/22/2024] [Accepted: 11/28/2024] [Indexed: 12/18/2024] Open
Abstract
INTRODUCTION Evidence supports the relationships between socioeconomic status and access to health care, incidence of pathologies, and lifestyle. OBJECTIVE The aim of this research was to investigate whether there are associations between having a household income below the poverty line, and participation in unhealthy lifestyle habits, the prevalence of non-communicable diseases, and the number of comorbidities in US middle-aged and older adults. METHODS This cross-sectional study is based on the NHANES 2011-2020. A total of 10,788 US middle-aged and older adults (5653 males and 5135 females) participated in this research. Associations were studied through the Chi-squared test, and odds ratios were calculated using a binary logistic regression model. RESULTS There were associations between a household income below the poverty line and physical inactivity, unhealthy diet, and being or having been an alcoholic. Associations were found between this adverse economic situation and having hypertension, diabetes, liver disease, kidney problems, arthritis, congestive heart failure, angina pectoris, heart attack, stroke, and also with having two or more, three or more, four or more, and five or more comorbidities. Increased odds of being involved in these unhealthy habits and of suffering these diseases and multimorbidity were found for those with a family income below the poverty threshold. CONCLUSIONS The existence of associations between having a family income under the poverty threshold and having unhealthy habits, suffering non-communicable diseases, and having multimorbidity is confirmed in US middle-aged and older adults. Increased odds for various non-communicable diseases, multimorbidity, and for being involved in these unhealthy habits were found for this low-income group. These findings should serve to draw the attention of policy makers to the increased health vulnerability of the adult population below the poverty line in the US.
Collapse
Affiliation(s)
- Damián Pereira-Payo
- Health, Economy, Motricity and Education (HEME) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Raquel Pastor-Cisneros
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - María Mendoza-Muñoz
- Physical and Health Literacy and Health-Related Quality of Life (PHYQoL), Faculty of Sport Science, University of Extremadura, 10003 Caceres, Spain
| | - Lucía Carrasco-Marcelo
- Department of Financial Economics and Accounting, Faculty of Business, Finance and Tourism, University of Extremadura, Avda. de la Universidad, s/n, 10071 Cáceres, Spain
| |
Collapse
|
48
|
Masuko S, Matsuyama Y, Kino S, Kondo K, Aida J. Changes in leisure activity, all-cause mortality, and functional disability in older Japanese adults: The JAGES cohort study. J Am Geriatr Soc 2024. [PMID: 39578386 DOI: 10.1111/jgs.19264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 10/22/2024] [Accepted: 10/26/2024] [Indexed: 11/24/2024]
Abstract
BACKGROUND/OBJECTIVES Leisure activities provide various health benefits for older adults. However, few studies have examined changes in leisure activities and health. This study aimed to determine the association among changes in leisure activities, subsequent all-cause mortality, and functional disability. METHODS Using a longitudinal, prospective cohort design, we analyzed data from the Japan Gerontological Evaluation Study (JAGES) in 2010 and 2013 merged with government data on death and long-term care needs by 2020. Changes in leisure activity were defined as four-category exposure based on a question about leisure activities: those with leisure activities in both 2010 and 2013, those who started leisure activities in 2013, those without leisure activities in both 2010 and 2013 (reference group), and those who stopped leisure activities in 2013. All-cause mortality and functional disability were defined as onset during the 6-year follow-up from the 2013 survey. We applied the inverse probability of censoring and treatment-weighted methods for analyses using Cox proportional hazards models, where missingness was addressed using multiple imputation. RESULTS The study included 38,125 participants with a mean age of 72.8 ± 5.5 years at baseline, and 46.9% were male. Among those without leisure activities between 2010 and 2013 and those who started leisure activities in 2013, mortality rates by 2020 were 28.6% and 21.1%, and functional disability rates were 24.6% and 18.1%, respectively; and in analyses with the inverse probability of censoring and treatment-weighted methods, the hazard ratio for mortality was 0.82 (95% confidence interval (CI), 0.75-0.90) and 0.89 (95% CI, 0.79-1.01) for functional disability, respectively. CONCLUSION Initiation of leisure activities among the older adults was associated with a lower risk of mortality and functional disability over the subsequent 6 years compared to older adults who did not report initiating any leisure activities.
Collapse
Affiliation(s)
- Sayo Masuko
- Department of Dental Public Health, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan
| | - Yusuke Matsuyama
- Department of Dental Public Health, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan
| | - Shiho Kino
- Department of Preventive Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan
| | - Katsunori Kondo
- Department of Community Building for Well-being, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Research Department, Institute for Health Economics and Policy, Tokyo, Japan
| | - Jun Aida
- Department of Dental Public Health, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan
| |
Collapse
|
49
|
Zhao D, Wang Y, Zhang A, He J, Gao Y, Chen X, Jiang L, Zhang Y. The effect of cultural capital on the physical fitness level of a Chinese older adult population: chain mediation of household income and stockpiling of physical fitness goods. Front Public Health 2024; 12:1473775. [PMID: 39624417 PMCID: PMC11609571 DOI: 10.3389/fpubh.2024.1473775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Accepted: 10/28/2024] [Indexed: 12/29/2024] Open
Abstract
Background Health behaviors of older people are influenced by many factors, and physical activity are important lifestyle behaviors that promote healthy aging. Purpose This study is to analyze the intrinsic mechanism of the influence of cultural capital on the physical fitness level of older people, and to provide a theoretical basis for the improvement of the differences in physical fitness level caused by the differences in physical fitness concepts of the classes brought about by cultural capital, and the unequal distribution of resources. Methods The subjects of this study were derived from people over 60 years old in the 2020 China National Fitness Activity Status Survey, and a total of 20,896 samples were obtained using the principle of multi-stage stratified random sampling. The dependent variable was assessed by the Physical Activity Rating Scale (PARS-3) to calculate the physical activity level score of the older adult population. Pearson correlation analysis and stratified regression methods were used to analyze and explore the factors influencing the physical fitness level of sport older adult people, followed by quantile regression to explore the distribution of the influence of institutional cultural capital in different physical fitness levels. The use of quantile regression not only provided a robust test of the results of stratified linear regression, but also analyzed the differential effects of institutional cultural capital among individuals with different fitness levels. Finally, Bootstrap methods were used to test the mediating effects of household income and physical cultural capital. Results Institutional cultural capital (p < 0.01), household income (p < 0.01), physical cultural capital (p < 0.01), and health status (p < 0.01) are all conducive to improving fitness levels among older people. Family income (95%CI = [0.467, 0.235]) and material cultural capital (95%CI = [0.199, 0.291]) play a chain mediating role. Conclusion Cultural capital has a positive impact on the health of older people, mediated by household income and stocks of sporting goods. An increase in the level of cultural capital of older persons is beneficial to the improvement of health perception. Therefore, it is possible to promote the improvement of physical fitness among older people through the enhancement of their cultural capital and to realize healthy aging.
Collapse
|
50
|
Sun J, Zhang H, Mo X, Liu Y, Pan L, Luo H. Association between functional disability and mental health among Chinese older adults: Examining the moderating effects of social participation and physical exercise. Arch Public Health 2024; 82:212. [PMID: 39538336 PMCID: PMC11562310 DOI: 10.1186/s13690-024-01431-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 10/22/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND Functional disability significantly burdens healthcare services, negatively affecting older adults' social interaction and quality of life. This study aims to identify the association between functional disability and mental health, and examine the moderating effects of social participation and physical exercise on the association. METHODS The data were drawn from 2018 wave of Chinese Longitudinal Healthy Longevity Survey, and ordinary least squares regression model was exploited to explore the association between functional disability and mental health. RESULTS Activity of daily living (ADL) disability negatively predicted mini-mental state examination (MMSE) score. Furthermore, social participation and physical exercise moderated the association between ADL disability and MMSE score. CONCLUSION The results highlight the importance of social participation and physical exercise for the older adults with ADL disability.
Collapse
Affiliation(s)
- Jian Sun
- College of Public Administration, Nanjing Agricultural University, Nanjing, China
- China Resources & Environment and Development Academy, Nanjing Agricultural University, Nanjing, China
- Jin Shanbao Institute for Agriculture & Rural Development, Nanjing Agricultural University, Nanjing, China
| | - Haiyong Zhang
- School of Mathematics and Finance, Chuzhou University, Chuzhou, China
| | - Xinxin Mo
- Center for Translational Regenerative Medicine, Guangxi Medical University, Nanning, China
| | - Yujiang Liu
- College of Public Administration, Nanjing Agricultural University, Nanjing, China
| | - Lin Pan
- Department of Social and Ecological Civilization, Party School of Anhui Provincial Committee (Anhui Academy of Governance), Hefei, China
| | - Hongye Luo
- School of Information and Management, Guangxi Medical University, Nanning, China.
| |
Collapse
|