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Ishigaki T, Misu S, Miyashita T, Matsumoto D, Kamiya M, Okamae A, Ogawa T, Ihira H, Taniguchi Y, Ohnuma T, Chibana T, Morikawa N, Ikezoe T, Makizako H. Effects of Walking-Only Intervention on Physical Function, Fall-Related Outcomes, and Health-Related Quality of Life in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. J Aging Phys Act 2024:1-13. [PMID: 39179228 DOI: 10.1123/japa.2023-0183] [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: 05/22/2023] [Revised: 05/24/2024] [Accepted: 06/06/2024] [Indexed: 08/26/2024]
Abstract
This study aimed to determine the effects of walking-only intervention (walking was the only exercise in which people participated) on physical function, fall-related outcomes, and health-related quality of life in community-dwelling older adults. We conducted a systematic search across five electronic databases, assessing risk of bias using Minds Manual for Guideline Development. Meta-analyses were performed, and pooled standardized mean differences were calculated. Nine studies (a total of 1,309 participants) were included, showing that walking-only interventions improved walking endurance (standardized mean difference: 1.11, 95% confidence interval: [0.08, 2.15]) and health-related quality of life (standardized mean difference: 0.71, 95% confidence interval: [0.18, 1.25]). However, there were no significant improvements in other outcomes. The certainty of the evidence based on the Grading of Recommendations, Assessment, Development, and Evaluation approach for all outcomes was graded as very low, primarily due to significant inconsistency and imprecision. Our results suggest that walking-only intervention can be effective for enhancing walking endurance and health-related quality of life for community-dwelling older adults. Further studies are required to investigate the effects of walking-only intervention. This need stems from the limited number of randomized controlled trials, heterogeneous intervention settings and results, and the very low certainty of the evidence.
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Affiliation(s)
- Tomoya Ishigaki
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, Nagoya Gakuin University, Nagoya, Japan
| | - Shogo Misu
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan
| | - Toshinori Miyashita
- Inclusive Medical Sciences Research Institute, Morinomiya University of Medical Sciences, Osaka, Japan
| | - Daisuke Matsumoto
- Department of Physical Therapy, Faculty of Health Sciences, Kio University, Kitakatsuragigun, Japan
| | - Midori Kamiya
- The First Nursing Course, Aichi Prefectural School of General Nursing, Nagoya, Japan
| | - Akio Okamae
- Department of Rehabilitation, Hyogo College of Medicine Sasayama Medical Center, Sasayama, Japan
| | - Tatsuya Ogawa
- Department of Rehabilitation, Nishiyamato Rehabilitation Hospital, Kitakatsuragi-gun, Japan
| | - Hikaru Ihira
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Yoshiaki Taniguchi
- Department of Rehabilitation, Faculty of Nursing and Welfare, Kyushu University of Nursing and Social Welfare, Fukuoka, Japan
| | - Takeshi Ohnuma
- Rehabilitation Progress Center Incorporated, Itabashi Rehabili Home-Visit Nursing Station, Itabashi-ku, Japan
| | | | - Natsu Morikawa
- Boys and Girls, Daycare Facility for Persons With Severe Motor and Intellectual Disabilities, CIL Toyonaka, Toyonaka, Japan
| | - Tome Ikezoe
- Faculty of Rehabilitation, Kansai Medical University, Hirakata, Japan
| | - Hyuma Makizako
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
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Walker R, Harada K. Affective Exercise Experience in Childhood and Psychological Determinants of Exercise Among Japanese Older Adults. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024:1-13. [PMID: 39012628 DOI: 10.1080/02701367.2024.2375290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 06/27/2024] [Indexed: 07/17/2024]
Abstract
Japan faces significant challenges associated with its super-aged society. Exercise and physical activity are recommended strategies to promote healthy aging and quality of life in older age. However, what determines exercise behavior among Japanese older adults is relatively unknown. The principle aim of this study was to explore exercise determinants and their relation to exercise behavior among Japanese older adults. Completed self-report questionnaires were received from 1,000 Japanese older adults aged between 65 and 74 years who resided in the Kansai area. A cross-sectional maximum likelihood path analysis was used to test the relationships between variables, where it was hypothesized that affective experiences in childhood had an indirect association with the exercise behavior of Japanese older adults through the seven psychological determinants of exercise. Demographic factors were also included in the model as potential influences of all factors. Knowledge held the largest significant direct association with exercise behavior (β = .539, p = <.001), particularly more intense forms of exercise such as resistance exercise (β = .725, p = <.001) and moderate to strenuous exercise (β = .420, p = <.001), whilst affective exercise experience in childhood (B = 3.749, p = <.001) and gender (B = 5.183, p = .003) held significant indirect associations. This paper emphasizes the importance of exercise-related knowledge among Japanese older adults and future research is warranted to further explore the role of positive affective exercise experiences in childhood and their influence on exercise behavior, especially amongst girls.
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Mikkilä S, Handegård BH, Johansson J, Hopstock LA, Van den Tillaar R, Emaus N, Morseth B, Welde B. Cross-sectional associations between accelerometer-measured physical activity and hip bone mineral density: the Tromsø Study 2015-2016. JBMR Plus 2024; 8:ziae061. [PMID: 38868594 PMCID: PMC11166893 DOI: 10.1093/jbmrpl/ziae061] [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: 12/06/2023] [Revised: 03/22/2024] [Accepted: 05/03/2024] [Indexed: 06/14/2024] Open
Abstract
Positive associations between physical activity and bone health have been found in population-based studies, however, mostly based on self-reported physical activity. Therefore, we investigated the association between accelerometer-measured physical activity, measured in steps per day and minutes of moderate to vigorous physical activity (MVPA) per day, and total hip areal BMD (aBMD) measured by DXA in a general population, utilizing multiple regression models. The study participants, 1560 women and 1177 men aged 40-84 yr, were part of the seventh survey of the Tromsø Study (2015-2016). In both genders, we found a positive association between the number of daily steps and aBMD adjusted for age, BMI, and smoking status (P < .001). In women, an increase of 1000 steps per day was associated with 0.005 g/cm2 higher aBMD. For men, a polynomial curve indicated a positive association with aBMD up to 5000 steps per day, plateauing between 5000 and 14 000 steps, and then increasing again. Additionally, MVPA duration was positively associated with aBMD in both women (P < .001) and men (P = .004) when adjusted for age, BMI, and smoking status. Specifically, each 60-min increase in daily MVPA was associated with 0.028 and 0.023 g/cm2 higher aBMD in women and men, respectively. Despite positive associations, the clinical impact of physical activity on aBMD in this general population of adults and older adults was relatively small, and a large increase in daily MVPA might not be achievable for most individuals. Therefore, further longitudinal population-based studies incorporating device-based measures of physical activity could add more clarity to these relationships.
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Affiliation(s)
- Saija Mikkilä
- School of Sport Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Bjørn Helge Handegård
- The Regional Centre for Child and Adolescent Mental Health – North, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Jonas Johansson
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Laila A Hopstock
- Department of Health and Care Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | | | - Nina Emaus
- Department of Health and Care Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Boye Welde
- School of Sport Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway
- Division of Mental and Physical Health, Department of Child and Adolescent Health Promotion Services, Norwegian Institute of Public Health, 0404 Oslo, Norway
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Zeng H, Miao C, Wang R, Zhao W, Wang W, Liu Y, Wei S, Liu A, Jia H, Li G, Zhou J, Chen X, Tian Q. Influence of comorbidity of chronic diseases on basic activities of daily living among older adults in China: a propensity score-matched study. Front Public Health 2024; 12:1292289. [PMID: 38638478 PMCID: PMC11024351 DOI: 10.3389/fpubh.2024.1292289] [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: 09/11/2023] [Accepted: 03/14/2024] [Indexed: 04/20/2024] Open
Abstract
Rationale With the accelerating process of population aging, the comorbidity of chronic disease (CCD) has become a major public health problem that threatens the health of older adults. Objective This study aimed to assess whether CCD is associated with basic activities of daily living (BADL) and explore the factors influencing BADL in older adults. Method A cross-sectional community health survey with stratified random sampling among older residents (≥60 years old) was conducted in 2022. A questionnaire was used to collect information on BADL, chronic diseases, and other relevant aspects. Propensity score matching (PSM) was used to match the older adults with and without CCD. Univariate and multivariate logistic regression analyses were used to explore the factors influencing BADL. PSM was used to match participants with single-chronic disease (SCD) and CCD. Results Among the 47,720 participants, those with CCD showed a higher prevalence of BADL disability (13.07%) than those with no CCD (6.33%) and SCD (7.39%). After adjusting for potential confounders with PSM, 6,513 pairs of cases with and without CCD were matched. The univariate analysis found that the older adults with CCD had a significantly higher prevalence of BADL disability (13.07%, 851 of 6,513) than those without CCD (9.83%, 640 of 6,513, P < 0.05). The multivariate logistic regression analysis revealed that CCD was a risk factor for BADL in older adults [OR = 1.496, 95% CI: 1.393-1.750, P < 0.001]. In addition, age, educational level, alcohol intake, social interaction, annual physical examination, retirement benefits, depression, weekly amount of exercise, and years of exercise were related to BADL disability (P < 0.05). PSM matching was performed on participants with CCD and SCD and showed that the older adults with CCD had a significantly higher prevalence of BADL disability (13.07%, 851 of 6,513) than those with SCD (11.39%, 742 of 6,513, P < 0.05). Conclusion The older adults with CCD are at a higher risk of BADL disability than their counterparts with no CCD or SCD. Therefore, we advocate paying attention to and taking measures to improve the health and quality of life of these individuals.
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Affiliation(s)
- Hongji Zeng
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Chen Miao
- Henan Medical College, Zhengzhou, China
| | - Rui Wang
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Weijia Zhao
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Wenjuan Wang
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yahui Liu
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Shufan Wei
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Anqi Liu
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Huibing Jia
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Guoxin Li
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Junge Zhou
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xuejiao Chen
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Qingfeng Tian
- School of Public Health, Zhengzhou University, Zhengzhou, China
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Kwok WS, Khalatbari-Soltani S, Dolja-Gore X, Byles J, Tiedemann A, Pinheiro MB, Oliveira JS, Sherrington C. Leisure-Time Physical Activity and Falls With and Without Injuries Among Older Adult Women. JAMA Netw Open 2024; 7:e2354036. [PMID: 38294812 PMCID: PMC10831579 DOI: 10.1001/jamanetworkopen.2023.54036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 12/07/2023] [Indexed: 02/01/2024] Open
Abstract
Importance Falls and fall-related injuries are common among older adults. Older adults are recommended to undertake 150 to 300 minutes of physical activity per week for health benefits; however, the association between meeting the recommended level of physical activity and falls is unclear. Objectives To examine whether associations exist between leisure-time physical activity and noninjurious and injurious falls in older women. Design, Setting, and Participants This population-based cohort study used a retrospective analysis of the Australian Longitudinal Study on Women's Health (ALSWH). ALSWH participants born from 1946 to 1951 who completed follow-up questionnaires in 2016 (aged 65-70 years) and 2019 (aged 68-73 years) were included. Statistical analysis was performed from September 2022 to February 2023. Exposure Self-reported weekly amounts (0, 1 to <150, 150 to <300, ≥300 minutes) and types of leisure-time physical activity, including brisk walking and moderate- and vigorous-intensity physical activity, in the 2016 survey. Main outcome and measures Noninjurious and injurious falls in the previous 12 months reported in the 2019 survey. Associations between leisure-time physical activity and falls were quantified using directed acyclic graph-informed multinomial logistic regression and presented in odds ratios (ORs) and 95% CIs. Results This study included 7139 women (mean [SD] age, 67.7 [1.5] years). Participation in leisure-time physical activity at or above the level recommended by the World Health Organization (150 to <300 min/wk) was associated with reduced odds of noninjurious falls (150 to <300 min/wk: OR, 0.74 [95% CI, 0.59-0.92]; ≥300 min/wk: OR, 0.66 [95% CI, 0.54-0.80]) and injurious falls (150 to <300 min/wk: OR, 0.70 [95% CI, 0.56-0.88]; ≥300 min/wk: OR, 0.77 [95% CI, 0.63-0.93]). Compared with women who reported no leisure-time physical activity, those who reported brisk walking (OR, 0.83 [95% CI, 0.70-0.97]), moderate leisure-time physical activity (OR, 0.81 [95% CI, 0.70-0.93]), or moderate-vigorous leisure-time physical activity (OR, 0.84 [95% CI, 0.70-0.99]) had reduced odds of noninjurious falls. No statistically significant associations were found between the types of leisure-time physical activity and injurious falls. Conclusions and Relevance Participation in leisure-time physical activity at the recommended level or above was associated with lower odds of both noninjurious and injurious falls. Brisk walking and both moderate and moderate-vigorous leisure-time physical activity were associated with lower odds of noninjurious falls.
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Affiliation(s)
- Wing S. Kwok
- Sydney Musculoskeletal Health, The University of Sydney, Sydney Local Health District and Northern Sydney Local Health District, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Saman Khalatbari-Soltani
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
- ARC Centre of Excellence in Population Aging Research (CEPAR), The University of Sydney, Sydney, New South Wales, Australia
| | - Xenia Dolja-Gore
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Julie Byles
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Anne Tiedemann
- Sydney Musculoskeletal Health, The University of Sydney, Sydney Local Health District and Northern Sydney Local Health District, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Marina B. Pinheiro
- Sydney Musculoskeletal Health, The University of Sydney, Sydney Local Health District and Northern Sydney Local Health District, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Juliana S. Oliveira
- Sydney Musculoskeletal Health, The University of Sydney, Sydney Local Health District and Northern Sydney Local Health District, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Catherine Sherrington
- Sydney Musculoskeletal Health, The University of Sydney, Sydney Local Health District and Northern Sydney Local Health District, Sydney, New South Wales, Australia
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
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Liang C, Shi L, Li B, He Z. The Mediating Role of Sarcopenia in the Association between Physical Activity and Falls among Chinese Older Adults: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:3146. [PMID: 38132036 PMCID: PMC10743279 DOI: 10.3390/healthcare11243146] [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: 08/23/2023] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 12/23/2023] Open
Abstract
Physical inactivity and sarcopenia are potentially modifiable risk factors for falls in older adults, but the strength of the association between physical activity (PA), sarcopenia, and falls in Chinese older adults is unclear. This study sought to investigate the potential mediation mechanism relationship in the connection between PA, sarcopenia, including its elements (muscle strength, physical performance, and skeletal muscle mass), and falls among Chinese older people. The subjects were 3592 community-dwelling Chinese aged 60 or over, selected from the China Health and Retirement Longitudinal Study (CHARLS). PA was evaluated through the International Physical Activity Questionnaire (IPAQ), and sarcopenia was determined through the Asian Working Group on Sarcopenia (AWGS) 2019 guidelines. We employed logistic regression to explore the link between physical activity, sarcopenia, and falls. Additionally, we applied Karlson, Holm and Breen's (KHB) method to estimate two different mediation models. The results demonstrated that PA lowers the risk of falls [odds ratio (OR) 0.54, 95% confidence interval (CI) 0.48-0.61], whereas sarcopenia increases the risk of falls (OR 1.34, 95% CI 1.16-1.55). Sarcopenia mediated the association between PA and falls, explaining a total of 2.69% of the association (indirect effect = -0.02). PA also had a significant mediating effect on the association between sarcopenia and falls, explaining a total of 20.12% of the association (indirect effect = 0.06). The proportion mediated by sarcopenia was 2.69% for PA and falls (indirect effect = -0.02). Our findings suggest that PA and sarcopenia have a direct effect on falls as well as an indirect effect through each other. Enhancing PA levels and preventing sarcopenia may help prevent falls in older adults.
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Affiliation(s)
| | - Lei Shi
- Sports Centre, Xi’an Jiaotong University, Xi’an 710049, China; (C.L.); (B.L.); (Z.H.)
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Mortazavi S, Delbari A, Vahedi M, Fadayevatan R, Moodi M, Fakhrzadeh H, Khorashadizadeh M, Sobhani A, Payab M, Ebrahimpur M, Ejtahed HS, Sharifi F. Low physical activity and depression are the prominent predictive factors for falling in older adults: the Birjand Longitudinal Aging Study (BLAS). BMC Geriatr 2023; 23:758. [PMID: 37986050 PMCID: PMC10662773 DOI: 10.1186/s12877-023-04469-x] [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: 07/29/2023] [Accepted: 11/08/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Falling in the older adults has many irreparable consequences, including hospitalization to long-term care centers and loss of independence, depression and social isolation, financial burden, and death. The present study was conducted to estimate the incidence of falls and their associated factors among community-dwelling older adults. METHODS This program is a population-based prospective cohort study (≥ 60 years) in Birjand City from 2019 to 2020. A total of 1418 participants were included in the study, and 1344 participants were analyzed according to the inclusion criteria. Thirty-nine risk factors were evaluated. Basic information included demographic information, lifestyle factors, general health and medical history, and mental and functional health. RESULT The incidence of falls among community-dwelling older adults in the previous approximately 24 months in the present study was 9.26% in women and 2.65% in men. In the multiple Cox proportional regression model based on fall risk factors, there was a strong significant relationship between male sex (HR = 0.37, CI = 0.21 to 0.64), being physically active (HR = 0.59, CI = 0.36 to 0.96), moderate-to-severe depression (HR = 2.97, CI = 1.47 to 6.01), severe depression (HR = 3.26, CI = 1.24 to 8.54), and high risk of falls according to the TUG test (HR = 1.73, CI = 1.10 to 2.72). CONCLUSIONS Inactivity and depression were recognized as important factors in falls in older adults. It is recommended for older adults to have an active lifestyle to prevent falls and to prioritize the diagnosis and treatment of depression in older adults. Women as a group at higher risk should be considered in prevention programs. In addition, the use of the TUG test to identify high-risk older adults should be considered.
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Affiliation(s)
- Sara Mortazavi
- Department of Gerontology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ahmad Delbari
- Iranian Research Center on Ageing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Mohsen Vahedi
- Department of Biostatistics and Epidemiology, Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Reza Fadayevatan
- Iranian Research Center on Ageing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mitra Moodi
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Hossein Fakhrzadeh
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Khorashadizadeh
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Ameneh Sobhani
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moloud Payab
- Non-communicable Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahbube Ebrahimpur
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Bielemann RM, Oliveira R, Bertoldi AD, Tomasi E, Demarco FF, Gonzalez MC, Bohm AW, Brage S, Ekelund U. Objective and Self-Reported Physical Activity and Risk of Falling Among Community-Dwelling Older Adults From Southern Brazil. J Aging Phys Act 2022; 30:972-979. [PMID: 35240575 PMCID: PMC7613917 DOI: 10.1123/japa.2021-0148] [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: 04/26/2021] [Revised: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 12/16/2022]
Abstract
This study evaluated prospective associations between self-reported and objectively measured physical activity (PA) and risk of falls among older adults. A cohort study started in 2014 with 1,451 community-dwelling older adults living in Pelotas, Brazil. Leisure-time PA was obtained by the International Physical Activity Questionnaire and 7-day raw accelerometer data evaluated for total, light PA, and moderate to vigorous PA. In 2016-2017, participants recorded their falls in the previous 12 months. Around 23% of the 1,161 participants followed-up in 2016-2017 experienced a fall in the last 12 months. Participants who did not spend any time in self-reported leisure-time PA at baseline had on average 34% higher risk of falls, and individuals in the lowest tertile for moderate to vigorous PA had on average 51% higher risk of falls compared to those in the highest tertile. Low levels of self-reported and objectively measured moderate to vigorous PA were related to higher risk of falling among Brazilian older adults.
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Affiliation(s)
- Renata M Bielemann
- Post-Graduate Program in Nutrition and Foods, Federal University of Pelotas, Pelotas, RS,Brazil
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Ricardo Oliveira
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN,Brazil
| | - Andréa Dâmaso Bertoldi
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Elaine Tomasi
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Flávio Fernando Demarco
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS,Brazil
- Post-Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Maria Cristina Gonzalez
- Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS,Brazil
| | - Andrea Wendt Bohm
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge,United Kingdom
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo,Norway
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo,Norway
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9
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Kamimura S, Iida T, Watanabe Y, Kitamura K, Kabasawa K, Takahashi A, Saito T, Kobayashi R, Oshiki R, Takachi R, Tsugane S, Iki M, Sasaki A, Yamazaki O, Watanabe K, Nakamura K. Physical activity and recurrent fall risk in community-dwelling Japanese people aged 40-74 years: the Murakami cohort study. Eur Rev Aging Phys Act 2022; 19:20. [PMID: 36056330 PMCID: PMC9438326 DOI: 10.1186/s11556-022-00300-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 08/24/2022] [Indexed: 12/18/2022] Open
Abstract
Background Falls are important causes of injury and mortality in older people, and associated medical costs can be enormous. Physical activity (PA) is a potential preventive factor for falls. However, few studies have examined the effect of different types of PA on fall prevention. This study aimed to evaluate the association between PA levels and the incidence of recurrent falls by type of PA in middle-aged and older people. Methods This cohort study targeted 7,561 community-dwelling individuals aged 40–74 years who did not experience recurrent falls in the year before baseline. Information on PA levels, demographics, body size, lifestyle, and fall/disease history was obtained using a self-administered questionnaire in the baseline survey. Levels of total PA, leisure-time PA, and non-leisure-time PA (occupation, commuting, and housework) were estimated using metabolic equivalent (MET) scores (MET-h/day; hours spent on a given activity per day multiplied by its MET intensity). PA levels were categorized into four groups. Falls were recorded as none, once, or twice or more (recurrent falls). The outcome of the study was the incidence of recurrent falls in the past year before a survey conducted 5 years after the baseline survey. Logistic regression analyses were performed to calculate odds ratios for recurrent falls. Results Higher total PA and non-leisure-time PA levels were associated with a higher risk of recurrent falls (P for trend = 0.0002 and 0.0001, respectively), with the highest total PA and non-leisure-time PA groups having a significantly higher adjusted OR (1.96 [95%CI:1.33–2.88] and 2.15 [95%CI:1.48–3.14], respectively) relative to the lowest group (reference). As for leisure-time PA, the medium group had a significantly lower adjusted OR (0.70 [95%CI:0.49–0.99]) relative to the reference group. By sex, the adjusted OR in the medium leisure-time PA group was significantly lower relative to the reference group in women (0.50 [95%CI: 0.29–0.85]) but not in men. Conclusions Medium level leisure-time PA reduces the risk of recurrent falls in middle-aged and older people, whereas higher level non-leisure-time PA is associated with a higher risk of recurrent falls. Supplementary Information The online version contains supplementary material available at 10.1186/s11556-022-00300-5.
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Affiliation(s)
| | - Takashi Iida
- Niigata University School of Medicine, Niigata, Japan
| | - Yumi Watanabe
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kaori Kitamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Keiko Kabasawa
- Department of Health Promotion Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Akemi Takahashi
- Department of Rehabilitation, Niigata University of Rehabilitation, Niigata, Japan
| | - Toshiko Saito
- Department of Health and Nutrition, Niigata University of Health and Welfare, Niigata, Japan
| | - Ryosaku Kobayashi
- Department of Rehabilitation, Niigata University of Rehabilitation, Niigata, Japan
| | - Rieko Oshiki
- Department of Rehabilitation, Niigata University of Rehabilitation, Niigata, Japan
| | - Ribeka Takachi
- Department of Food Science and Nutrition, Nara Women's University Graduate School of Humanities and Sciences, Nara, Japan
| | - Shoichiro Tsugane
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Masayuki Iki
- Department of Public Health, Faculty of Medicine, Kindai University, Osaka, Japan
| | | | | | - Kei Watanabe
- Division of Orthopedic Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kazutoshi Nakamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
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10
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An Interpretable Machine Learning Approach to Predict Fall Risk Among Community-Dwelling Older Adults: a Three-Year Longitudinal Study. J Gen Intern Med 2022; 37:2727-2735. [PMID: 35112279 PMCID: PMC9411287 DOI: 10.1007/s11606-022-07394-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 01/03/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Adverse health effects resulting from falls are a major public health concern. Although studies have identified risk factors for falls, none have examined long-term prediction of fall risk. Furthermore, recent evidence suggests that there are additional risk factors, such as psychosocial factors. OBJECTIVE In this 3-year longitudinal study, we evaluated a predictive model for risk of fall among community-dwelling older adults using machine learning methods. DESIGN A 3-year follow-up prospective longitudinal study (from 2010 to 2013). SETTING Twenty-four municipalities in nine of the 47 prefectures (provinces) of Japan. PARTICIPANTS Community-dwelling individuals aged ≥65 years who were functionally independent at baseline (n = 61,883). METHODS The baseline survey was conducted from August 2010 to January 2012, and the follow-up survey was conducted from October to December 2013. Both surveys were conducted involving self-reported questionnaires. The measured outcome at the follow-up survey was self-reported multiple falls during the previous year. The 142 variables included in the baseline survey were regarded as candidate predictors. The random-forest-based Boruta algorithm was used to select predictors, and the eXtreme Gradient Boosting algorithm with 10 repetitions of nested k-fold cross-validation was used for modeling and model evaluation. Furthermore, we used shapley additive explanations to gain insight into the behavior of the prediction model. KEY RESULTS Fourteen out of 142 candidate features were selected as predictors. Among these predictors, experience of falling as of the baseline survey was the most important feature, followed by self-rated health and age. Moreover, sense of coherence was newly identified as a risk factor for falls. CONCLUSIONS This study suggests that machine learning tools can be adapted to explore new associative factors, make accurate predictions, and provide actionable insights for fall prevention strategies.
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11
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Multidomain Integrated Exercises Decreased the Risk of Falls of Community-Dwelling Older Adults. TOPICS IN GERIATRIC REHABILITATION 2022. [DOI: 10.1097/tgr.0000000000000353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Goethals L, Barth N, Hupin D, Chapoton B, Guyot J, Celarier T, Roche F, Gallopel-Morvan K, Bongue B. Social Marketing Intervention to Engage Older Adults in Balance Workshops for Fall Prevention: A Multicenter Quasi-Experimental Protocol Study. Front Public Health 2021; 9:614119. [PMID: 34336750 PMCID: PMC8316617 DOI: 10.3389/fpubh.2021.614119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 06/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Falls affects one of three people after 65 years old, and it can lead to serious consequences. Scientific evidence point out that physical exercise is the most efficient way to prevent falls among older adults. Objective: The main objective of this study is to determine if a social marketing program can increase the attendance rate of people aged 60 and over at group balance workshops. Methods: This quasi-experimental multicenter study is being conducted in three French Regions (Loire, Haute-Loire and Rhône) over a period of 18 months. The Social Marketing Campaign will be done in three ways. Firstly, a Communication Campaign will take place in the two Test Areas but not in the Control Area. Secondly, flyers have been designed to be distributed by local partners. Finally, conferences for older people will be organized in the areas of intervention in order to reach the target audience for the program. The study will include people aged 60 and older who want to participate in the Balance Program. Results: The Crédit Agricole Loire/Haute-Loire Foundation funded the study and the Jean Monnet University of Saint-Etienne reviewed it. The Ethics Committee of the University Teaching Hospital of Saint-Etienne approved and peer-reviewed it on September 6, 2019, under Reference Number IRBN622019/CHUSTE. Conclusion: The results of this first study will demonstrate whether or not social marketing for promoting group balance workshops in the elderly will increase their attendanceship in adapted physical activity sessions, especially those that prevent falls. Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT04136938, identifier NCT04136938.
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Affiliation(s)
- Luc Goethals
- Laboratoire SAINBIOSE, U1059 INSERM-Université Jean Monnet, Saint-Etienne, France.,Chaire Santé des Ainés-Université Jean Monnet, Saint-Etienne, France
| | - Nathalie Barth
- Laboratoire SAINBIOSE, U1059 INSERM-Université Jean Monnet, Saint-Etienne, France.,Chaire Santé des Ainés-Université Jean Monnet, Saint-Etienne, France.,Gérontopole AURA, Saint-Etienne, France
| | - David Hupin
- Laboratoire SAINBIOSE, U1059 INSERM-Université Jean Monnet, Saint-Etienne, France.,Chaire Santé des Ainés-Université Jean Monnet, Saint-Etienne, France.,Service de Physiologie, Clinique et de l'Exercice, CHU de Saint-Etienne, Saint-Etienne, France.,Department of Medicine, K2, Solna Karolinska Institutet, Stockholm, Sweden
| | - Boris Chapoton
- Université Lyon, Université Saint-Étienne, HESPER EA 7425, Saint-Etienne, France
| | - Jessica Guyot
- Laboratoire SAINBIOSE, U1059 INSERM-Université Jean Monnet, Saint-Etienne, France.,Chaire Santé des Ainés-Université Jean Monnet, Saint-Etienne, France
| | - Thomas Celarier
- Chaire Santé des Ainés-Université Jean Monnet, Saint-Etienne, France.,Gérontopole AURA, Saint-Etienne, France.,Service de Gérontologie Clinique, CHU de Saint-Etienne, Saint-Etienne, France
| | - Frederic Roche
- Laboratoire SAINBIOSE, U1059 INSERM-Université Jean Monnet, Saint-Etienne, France.,Chaire Santé des Ainés-Université Jean Monnet, Saint-Etienne, France
| | | | - Bienvenu Bongue
- Laboratoire SAINBIOSE, U1059 INSERM-Université Jean Monnet, Saint-Etienne, France.,Chaire Santé des Ainés-Université Jean Monnet, Saint-Etienne, France.,Centre Technique d'Appui et de Formation, Saint-Etienne, France
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13
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14
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Goethals L, Barth N, Hupin D, Mulvey MS, Roche F, Gallopel-Morvan K, Bongue B. Social marketing interventions to promote physical activity among 60 years and older: a systematic review of the literature. BMC Public Health 2020; 20:1312. [PMID: 32859180 PMCID: PMC7456007 DOI: 10.1186/s12889-020-09386-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 08/13/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Falls are a significant source of morbidity in people aged 65 and over, affecting one in three people in this age group. The scientific evidence indicates that physical activity is the most effective method for preventing falls among seniors. Although public health professionals often use social marketing to design and plan successful interventions, its use to promote physical activity and prevent falls among older people remains low. This article aims to provide a new systematic literature review of social marketing interventions promoting physical activity and targeting people aged 60 and over. METHODS Following CRD's guidance and PRISMA guidelines, we searched between January 2008 and July 2019 for relevant articles in five primary databases using predefined search and inclusion criteria. Two independent reviewers analysed the selected articles to identify evidence of the seven social marketing benchmark criteria, defined by experts in the field as the common elements that contribute to social marketing success. RESULTS The final review included nine studies. Of the studies selected, three specifically targeted over 60-year-olds, whereas the others segmented the population into several age-based subcategories, including over 60-year-olds. Eight studies highlighted positive results for the participants with an increase in participation or an increase in physical activity level. None of the nine studies selected for this systematic review implemented the entire social marketing approach. CONCLUSION Few published interventions use the seven social marketing criteria. Further research is required to encourage uptake and inclusion in successful social marketing interventions to increase program effectiveness in this target population.
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Affiliation(s)
- Luc Goethals
- Laboratoire SNA EPIS EA 4607, Université Jean Monnet, Saint-Étienne, France.
| | - Nathalie Barth
- Laboratoire SNA EPIS EA 4607, Université Jean Monnet, Saint-Étienne, France.,Gerontopole AURA, Saint-Etienne, France
| | - David Hupin
- Laboratoire SNA EPIS EA 4607, Université Jean Monnet, Saint-Étienne, France.,Service de physiologie, Clinique et de l'exercice, CHU de Saint-Etienne, Saint-Etienne, France
| | - Michael S Mulvey
- Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
| | - Frederic Roche
- Laboratoire SNA EPIS EA 4607, Université Jean Monnet, Saint-Étienne, France
| | | | - Bienvenu Bongue
- Laboratoire SNA EPIS EA 4607, Université Jean Monnet, Saint-Étienne, France.,Centre Technique d'Appui et de Formation (CETAF), Saint-Étienne, France
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15
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Jehu DA, Davis JC, Liu-Ambrose T. Risk factors for recurrent falls in older adults: a study protocol for a systematic review with meta-analysis. BMJ Open 2020; 10:e033602. [PMID: 32376749 PMCID: PMC7223009 DOI: 10.1136/bmjopen-2019-033602] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Older adults who fall recurrently (i.e., >1 fall/year) are at risk for functional decline and mortality. Key risk factors for recurrent falls in community-dwelling older adults are not well established due to methodological limitations, such as recall bias. A better understanding of the risk factors for recurrent falls will aid in refining clinical practice guidelines for secondary fall prevention strategies. The primary objective of this systematic review with meta-analysis is to examine the risk factors for recurrent falls in prospective studies among community-dwelling older adults. METHODS AND ANALYSIS A comprehensive search for articles indexed in MEDLINE, EMBASE, PsycINFO and CINAHL databases as well as grey literature was conducted on April 25, 2019. We will use MeSH and keyword search terms around the following topics: falls, recurrence, fall-risk, ageing and prospective studies. Prospective studies with monthly falls monitoring for 12 months, investigating risk factors for recurrent falls in older adults will be included. One author will complete the search. Two authors will remove duplicates and screen the titles and abstracts for their potential inclusion against the eligibility criteria. Two authors will screen the full texts and extract the data using a piloted extraction sheet. Included studies will be evaluated for the risk of bias with the Joanna Briggs Institute Prevalence Critical Appraisal tools. The quality of reporting will be determined with the Strengthening the Reporting of OBservational studies in Epidemiology. The data extraction will include study characteristics as well as sociodemographic, balance and mobility, sensory and neuromuscular, psychological, medical, medication and environmental factors. The results will be presented via figures, summary tables, meta-analysis (when possible) and narrative summaries. ETHICS AND DISSEMINATION No ethics approval will be required. Findings will be disseminated through publication and media. PROSPERO REGISTRATION NUMBER CRD42019118888; Pre-results.
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Affiliation(s)
- Deborah A Jehu
- Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
- Aging, Mobility and Cognitive Neuroscience Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer C Davis
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
- Social & Economic Change Laboratory, Faculty of Management, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
| | - Teresa Liu-Ambrose
- Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
- Aging, Mobility and Cognitive Neuroscience Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
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16
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Cunningham C, O' Sullivan R, Caserotti P, Tully MA. Consequences of physical inactivity in older adults: A systematic review of reviews and meta‐analyses. Scand J Med Sci Sports 2020; 30:816-827. [DOI: 10.1111/sms.13616] [Citation(s) in RCA: 220] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 11/26/2019] [Accepted: 12/12/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | - Roger O' Sullivan
- Institute of Public Health in Ireland Belfast UK
- Ulster University Belfast UK
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