Preserving Mobility in Older Adults with Physical Frailty and Sarcopenia: Opportunities, Challenges, and Recommendations for Physical Activity Interventions

One of the most widely conserved hallmarks of aging is a decline in functional capabilities. Mobility loss is particularly burdensome due to its association with negative health outcomes, loss of independence and disability, and the heavy impact on quality of life. Recently, a new condition, physical frailty and sarcopenia, has been proposed to define a critical stage in the disabling cascade. Physical frailty and sarcopenia are characterized by weakness, slowness, and reduced muscle mass, yet with preserved ability to move independently. One of the strategies that have shown some benefits in combatting mobility loss and its consequences for older adults is physical activity. Here, we describe the opportunities and challenges for the development of physical activity interventions in people with physical frailty and sarcopenia. The aim of this article is to review age-related physio(patho)logical changes that impact mobility in old age and to provide recommendations and procedures in accordance with the available literature.

Predictors of longitudinal changes in older adults' physical activity engagement

The study aimed to investigate factors influencing older adults' physical activity engagement over time. The authors analyzed 3 waves of data from a sample of Israelis age 75-94 (Wave 1 n = 1,369, Wave 2 n = 687, Wave 3 n = 154). Findings indicated that physical activity engagement declined longitudinally. Logistic regressions showed that female gender, older age, and taking more medications were significant risk factors for stopping exercise at Wave 2 in those physically active at Wave 1. In addition, higher functional and cognitive status predicted initiating exercise at Wave 2 in those who did not exercise at Wave 1. By clarifying the influence of personal characteristics on physical activity engagement in the Israeli old-old, this study sets the stage for future investigation and intervention, stressing the importance of targeting at-risk populations, accommodating risk factors, and addressing both the initiation and the maintenance of exercise in the face of barriers.

“Not Ready to Throw in the Towel”: Perceptions of Physical Activity Held by Older Adults in Stockholm and Dublin

The aim of this qualitative study was to explore and describe the perceptions of physical activity held by older urban Swedish and Irish adults. Qualitative interviews were carried out with 30 people age 65 years and older (mean age 74.5), of whom 15 were living in Dublin and 15 were living in Stockholm. The “thematic framework” approach was used to analyze the data. Three central themes were identified regarding people’s perceptions of physical activity: physical activity as self-expression, physical activity as interaction, and physical activity as health promotion. Participants’ perceptions of physical activity tended to relate to their perceived level of physical activity, regardless of their cultural background. Certain culture-specific motivators and barriers to exercise were also identified. Less active Irish men were more likely to underestimate the health-promoting benefits of exercise.

An explanatory mechanism for the different decline in limb strength in older women

The aim of the study was to compare the physical activity level and intensity of the upper and lower limbs in Brazilian women who are usually active, functionally independent, and living in a medium size city. Seventy-two women were assigned into a younger group (YG; n=38; mean age 23.08+/-2.80 years) and older group (OG; 60.68+/-7.16 years; n=34) groups. To discriminate the physical activity level of the upper and lower limbs, a daily activity record questionnaire (DARQ) was developed based on Bouchard's three-day physical activity record (3-day PAR). When compared to the YG, the OG presented: (a) higher levels of daily physical activity for upper limbs compared to the lower limbs and (b) higher levels of perceived exertion for both sets of limbs. In conclusion, these results suggest that women change their inter-limb pattern of daily physical activity with age; that is, they increase upper limb activity and decrease lower limbs activity. Furthermore, they decrease the exertion intensity for both sets of limbs. These findings may help to explain the more accentuated decline in lower limbs muscle strength during the aging process.

Do attitudes toward exercise vary with differences in mobility and disability status? - a study among low-income seniors

PURPOSE

To examine attitudes toward exercise among a vulnerable aged population characterized by low socioeconomic status, poor functional status and lack of available therapeutic exercise resources.

METHOD

This cross-sectional survey among public low-income housing residents (n = 94), aged > 70 years utilizes these assessments: Physician-based Assessment & Counseling for Exercise (PACE) scale, exercise self-efficacy score, Short Physical Performance Battery (SPPB), Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales.

RESULTS

Readiness to exercise differed significantly (p < 0.001) across physical performance levels, and ADL and IADL groups. Exercise self-efficacy also differed significantly (p < 0.001) across performance levels. The highest performance level (score 7 - 12) had a significantly (p < 0.05) higher self-efficacy score (x=7.0+/-2.8) than the medium performance level (score 4 - 6) (x=5.3+/-2.8) and the lowest performance level (0 - 3) (x=4.3+/-2.5) groups. Exercise self-efficacy also differed significantly (p < 0.001) across ADL and IADL groups. However, interest in home-based or class-based exercise participation was high among all groups. More than 70% of subjects reported interest with no significant difference noted among groups.

CONCLUSION

Attitudes toward exercise are significantly associated with observed physical function and self-reported disability among vulnerable older adults living in public low-income housing.