A snapshot of the prevalence of physical activity amongst older, community dwelling people in Victoria, Australia: patterns across the 'young-old' and 'old-old'

Ageing, Leisure Time Physical Activity and Health in Europe

The goal of this article is to analyse leisure time physical activity (LTPA) and health-driven motivations to engage in such activity among elderly people in the European Union. We use as a base the recommendations of the World Health Organisation (WHO) and the theory of the correlation between physical activity according to individual factors (age, gender, socio-economic status) and contextual factors (habitat, community infrastructures, the model of the welfare state of the country of residence). Data are taken from Eurobarometer 88.4. The Generalized Structural Equation Model (GSEM) methodology was used, with the STATA program. The results show that 65.3% of EU citizens over the age of 60 engage in some form of LTPA, that 40.4% do so for health reasons, and that only 32.3% engage in LTPA that meets the minimum guidelines set by the WHO. In addition, there are large differences based on individual and contextual characteristics. The following group was found to be those who practice the most: men, with high socio-economic status, belonging to the middle and upper social classes, living in rural areas where there is infrastructure for physical activity, and above all, in the countries of the Nordic model of social welfare.

Investigating food insecurity, health lifestyles, and self-rated health of older Canadians living alone

BACKGROUND AND OBJECTIVES

There is a large number of older of this demographic fact. Although many studies have investigated the association between living arrangements and health, little is known about potential underlying mechanisms regarding how living alone may predict older Canadians' health. In this study, we address this research gap intending to contribute to offering policy suggestions for older Canadians who live alone.

RESEARCH DESIGN AND METHODS

We applied Cockerham's health lifestyle theory to explore to what degree living alone predicts worse health lifestyles and, further, to what degree these lifestyles can explain the association between living alone and older Canadians' health. We used the 2017-2018 Canadian Community Social Survey (Annual Component) which has a response rate of 58.8%. We focused on respondents aged 60 and above, and the analytical sample size is 39,636.

RESULTS

Older Canadians living alone are more likely to have food insecurity problems and higher possibilities of smoking cigarettes compared to those living with spouses/partners with or without children. Compared to those living with spouses/partners only, the odds of solo-living older Canadians drinking regularly is significantly lower. There also exists a significant difference between older Canadians living alone and their counterparts living with spouses/partners that the former reported lower self-rated health compared to the latter. Moreover, food insecurity and the three health lifestyle variables are significantly associated with respondents' self-rated health; food insecurity, cigarette smoking, and alcohol drinking can partially explain the difference in self-rated health due to living arrangements.

DISCUSSION AND IMPLICATIONS

According to our findings, health officials are recommended to pay more attention to food insecurity and heavy smoking problems facing older Canadians who live by themselves. Local communities and other stakeholders are suggested to provide older adults living alone with more opportunities for social engagement and involvement since regular drinking may have played such a role in enhancing social life quality of the aged.

Prevalence of frailty syndrome and its associated factors among community-dwelling elderly in East Coast of Peninsular Malaysia

OBJECTIVE

Frailty is a clinical syndrome with increased risk of poor health outcomes and particularly prevalent in older adults and community population. The study's aim was therefore to determine the prevalence of frailty and its association with sociodemographic and socioeconomic characteristics, health-related status, and anthropometric measurements among community-dwelling older adults.

METHODS

A total of 279 older adults aged 60 years and above were randomly selected. Respondents were classified as non-frail (<2 criteria) or frail (≥3 criteria) based on the 'phenotype of frailty'. A binary logistic regression was used to determine predictors of frailty.

RESULTS

The prevalence of frailty was 18.3%. The frail older adults were positively associated with advanced age, being unmarried, hospitalisation in the previous year, poor self-rated health, and lower body mass index.

DISCUSSION

These results give an overview on underlying effects and guiding actions for prevention programmes functioning to reverse and minimise the adverse effects of frailty syndrome.

Selecting Power-Efficient Signal Features for a Low-Power Fall Detector

Falls are a serious threat to the health of older people. A wearable fall detector can automatically detect the occurrence of a fall and alert a caregiver or an emergency response service so they may deliver immediate assistance, improving the chances of recovering from fall-related injuries. One constraint of such a wearable technology is its limited battery life. Thus, minimization of power consumption is an important design concern, all the while maintaining satisfactory accuracy of the fall detection algorithms implemented on the wearable device. This paper proposes an approach for selecting power-efficient signal features such that the minimum desirable fall detection accuracy is assured. Using data collected in simulated falls, simulated activities of daily living, and real free-living trials, all using young volunteers, the proposed approach selects four features from a set of ten commonly used features, providing a power saving of 75.3%, while limiting the error rate of a binary classification decision tree fall detection algorithm to 7.1%.Falls are a serious threat to the health of older people. A wearable fall detector can automatically detect the occurrence of a fall and alert a caregiver or an emergency response service so they may deliver immediate assistance, improving the chances of recovering from fall-related injuries. One constraint of such a wearable technology is its limited battery life. Thus, minimization of power consumption is an important design concern, all the while maintaining satisfactory accuracy of the fall detection algorithms implemented on the wearable device. This paper proposes an approach for selecting power-efficient signal features such that the minimum desirable fall detection accuracy is assured. Using data collected in simulated falls, simulated activities of daily living, and real free-living trials, all using young volunteers, the proposed approach selects four features from a set of ten commonly used features, providing a power saving of 75.3%, while limiting the error rate of a binary classification decision tree fall detection algorithm to 7.1%.

A Low-Power Fall Detector Balancing Sensitivity and False Alarm Rate

Falls in older people are a major challenge to public health. A wearable fall detector can detect falls automatically based on kinematic information of the human body, allowing help to arrive sooner. To date, most studies have focused on the accuracy of an offline algorithm to distinguish real-world or simulated falls from activities of daily living, while neglecting the false alarm rate and battery life of a real device. To address these two important metrics, which significantly influence user compliance, this paper proposes a low-power fall detector using triaxial accelerometry and barometric pressure sensing. This fall detector minimizes power consumption using both hardware- and firmware-based techniques. Additionally, the fall detection algorithm used in this device is optimized to achieve a balance between sensitivity and false alarm rate, while minimizing the power consumption due to algorithm execution. The fall detector achieved a high sensitivity (91%) with a low false alarm rate (0.1149 alarms per hour), and a commercially-viable battery life (1125 days).

Neighbourhood environment, physical activity, quality of life and depressive symptoms in Hong Kong older adults: a protocol for an observational study

INTRODUCTION

The neighbourhood environment can assist the adoption and maintenance of an active lifestyle and affect the physical and mental well-being of older adults. The psychosocial and behavioural mechanisms through which the environment may affect physical and mental well-being are currently poorly understood.

AIM

This observational study aims to examine associations between the physical and social neighbourhood environments, physical activity, quality of life and depressive symptoms in Chinese Hong Kong older adults.

METHODS AND ANALYSES

An observational study of the associations of measures of the physical and social neighbourhood environment, and psychosocial factors, with physical activity, quality of life and depressive symptoms in 900 Hong Kong older adults aged 65+ years is being conducted in 2012-2016. The study involves two assessments taken 6 months apart. Neighbourhood walkability and access to destinations are objectively measured using Geographic Information Systems and environmental audits. Demographics, socioeconomic status, walking for different purposes, perceived neighbourhood and home environments, psychosocial factors, health status, social networks, depressive symptoms and quality of life are being assessed using validated interviewer-administered self-report measures and medical records. Physical functionality is being assessed using the Short Physical Performance Battery. Physical activity and sedentary behaviours are also being objectively measured in approximately 45% of participants using accelerometers over a week. Physical activity, sedentary behaviours, quality of life and depressive symptoms are being assessed twice (6 months apart) to examine seasonality effects on behaviours and their associations with quality of life and depressive symptoms.

ETHICS AND DISSEMINATION

The study received ethical approval from the University of Hong Kong Human Research Ethics Committee for Non-Clinical Faculties (EA270211) and the Department of Health (Hong Kong SAR). Data are stored in a password-protected secure database for 10 years, accessible only to the named researchers. Findings will be submitted for publication in peer-reviewed journals.

Effectiveness of Advanced Stay Strong, Stay Healthy in Community Settings

The goal of this research was to investigate the effectiveness of the 10-week, University of Missouri (MU) Extension strength training program Advanced Stay Strong, Stay Healthy (ASSSH). It was hypothesized that the program can improve strength, balance, agility, and flexibility-all physical measures of falling among seniors. Matched pair t tests were used to compare differences in five physical measures of health, body composition, and percent body fat (%BF). Two-way ANOVA was conducted to examine the age effects on changes in physical health from the start and finish of the exercise program. Following programming, participants significantly improved strength, flexibility, and balance, and significantly reduced %BF (p < .05). Our data indicate that ASSSH can improve the physical health of senior citizens and can successfully be translated into community practice by MU Extension professionals.

Depression and its association with functional status and physical activity in the elderly in Karachi, Pakistan

OBJECTIVE

The aim of the study was to determine the functional status and level of physical activity and their association with depression in the elderly population (age 60 and above) in Karachi, Pakistan.

METHODS

This was a cross-sectional study. Subjects were recruited through multi-stage cluster sampling technique. Questionnaire-based interviews were conducted from July to September 2008. Functional status and physical activity were assessed using activities of daily living (ADL) and physical activity questionnaires, respectively. Depression was evaluated using the 15-item geriatric depression scale (GDS).

RESULTS

Both mean ADL score (9.9±0.2 vs. 9.6±0.2) as well as time spent in physical activity/week (377.3±26.9min vs. 251.7±15.4min) was higher in men than women, respectively. Subjects spending more than 310min (>5.2h) per week in physical activity were 60% less likely to be depressed compared to those who spent less than 120min (<2h) per week (Adjusted OR=0.4, 95% CI=0.2-0.7). A one unit increase in ADL score showed a 10% decrease in depression after adjusting for other variables (Adjusted OR=0.9, 95% CI=0.8-0.9).

CONCLUSIONS

We found a strong association between depression and time spent in physical activities as well as activities of daily living. Our results indicate the potentially important positive role of higher functional status and physical activity in prevention of depression in the elderly in Karachi.

Ageing in an ultra-dense metropolis: perceived neighbourhood characteristics and utilitarian walking in Hong Kong elders

OBJECTIVE

The neighbourhood built environment may affect walking behaviour of elders. However, such effects remain underexplored, especially in an Asian context. We examined associations of perceived environmental attributes with overall and neighbourhood-specific walking for transport in a sample of Chinese elders residing in Hong Kong, an ultra-dense Chinese metropolis.

DESIGN

Cross-sectional observational study using a two-stage stratified sampling strategy.

SETTING

Hong Kong, China.

SUBJECTS

Chinese-speaking elders (n 484), with no cognitive impairment and able to walk without assistance, residing in thirty-two selected communities stratified by socio-economic status and walkability, were interviewer-administered validated measures of perceived neighbourhood environment and walking for transport.

RESULTS

Much higher levels of transport-related walking (mean 569 (sd 452) min/week) than found in Western samples were reported. The degree of perceived access to shops, crowdedness, presence of sitting facilities and easy access of residential entrance were independently positively related to both frequency of overall and within-neighbourhood walking for transportation. Infrastructure for walking and access to public transport were predictive of higher frequency of transport-related walking irrespective of location, while the perceived degree of land-use mix was predictive of higher levels of within-neighbourhood walking.

CONCLUSIONS

The provision of easy access to shops, residential entrances and sitting facilities in the neighbourhood may promote overall transport-related walking, while a good public transport network and pedestrian infrastructure linking destination-poor with destination-rich locations may compensate for the detrimental effects of living in less walkable neighbourhoods. Governmental investment in these micro- and macro-environmental features would help the promotion of an active lifestyle in elders.

Physical activity in older people: a systematic review

BACKGROUND

Physical activity (PA) in older people is critically important in the prevention of disease, maintenance of independence and improvement of quality of life. Little is known about the physical activity of the older adults or their compliance with current physical activity guidelines.

METHODS

A systematic literature search of the published literature was conducted. Included were published reports of original research that independently reported: the PA level of non-institutional older adults (aged 60 years and over); and the proportion of older adults in the different samples who met PA recommendations or guidelines. The review was restricted to studies published since 2000 to provide a current picture of older adults' PA levels.

RESULTS

Fifty three papers were included in the review. The percentage of older adults meeting recommended physical activity ranged from 2.4 - 83.0% across the studies. Definitions of "recommended" physical activity in older adults varied across the studies as did approaches to measurement which posed methodological challenges to data analysis. Older age groups were less likely than the reference group to be regularly active, and women were less likely than men to achieve regular physical activity, especially leisure time physical activity, when measured by both subjective and objective criteria.

CONCLUSION

The review highlights the need for studies which recruit representative random samples of community based older people and employ validated measurement methods consistently to enable comparison of PA levels over time and between countries.

Physical inactivity and related barriers: a study in a community dwelling of older brazilians

This study sought to investigate the prevalence of physical inactivity and related barriers in older Brazilian adults. A cross-sectional, population-based study was conducted, and a stratified random sampling procedure was used. A total of 359 older adults were interviewed. The long version of the International Physical Activity Questionnaire (IPAQ) and the Questionnaire of Barriers to Physical Activity Practice were used to assess physical activity level and barriers, respectively. No statistically significant difference was observed on the prevalence of physical inactivity in either gender or age groups. Regarding barriers, the proportion of 9 out of 22 barriers was statistically significant between men and women. Self-reported physical inactivity/activity in older Brazilian adults continues to be a concern. Uncommonly, older males reported a higher prevalence of physical inactivity compared to their counterparts. Additionally, physical inactivity prevalence continued to increase with the aging process. Yet, personal barriers such as lack of time and poor health were strongly associated with physical inactivity. The results of this study may help health professionals and public policy makers to better address the issues related to a healthy lifestyle among older adults and promote physical activity among Brazilian older adults and in other countries with similar characteristics.

Prevalence of health conditions and predictors of mortality in oldest old Mexican Americans and non-Hispanic whites

BACKGROUND

The oldest old represent a unique group of older adults. This group is rapidly growing worldwide and yet there are gaps in the knowledge related to their health condition. Ethnic differences in disease prevalence and mortality must be understood to better care for the oldest old.

OBJECTIVE

To compare prevalence of common health conditions and predictors of mortality in oldest old Mexican Americans and non-Hispanic whites.

METHODS

This study included 568 community-dwelling Mexican Americans (MA) aged 85 years and older from the Hispanic Established Population for the Epidemiological Study of the Elderly 2004-2005 and 933 non-Hispanic whites (NHW) of the same age from the Health and Retirement Study 2004. Measures included sociodemographic variables, self-reported medical conditions, activities of daily living (ADLs), and instrumental activities of daily living. Logistic regression analysis was used to examine 2-year mortality in both populations.

RESULTS

Heart attack was significantly more prevalent in oldest old NHW compared with MA, regardless of gender. Conversely, diabetes was significantly more prevalent among MA men and women compared with their NHW counterparts. Compared with NHW men, MA men had significantly higher prevalence of cognitive impairment and hypertension. Additionally, prevalence of hip fracture was significantly higher for MA women compared with NHW women. Significant differences in ADL disability were observed only between both groups of women, whereas significant differences in instrumental activities of daily living disability were observed only between men. MA men and women had higher prevalence of obesity compared with NHW. Predictors of 2-year mortality for both ethnic groups included older age, male gender, and ADL disability. Cognitive impairment was a mortality predictor only for NHW. Similarly, lung disease was a predictor only for MA.

CONCLUSION

Health-related conditions that affect the oldest old vary by gender and ethnicity and entail careful evaluation and monitoring in the clinical setting. Better care requires inclusion of such differences as part of the comprehensive evaluation of the oldest old adults.

Are Active Australia physical activity questions valid for older adults?

OBJECTIVE

The Active Australia Survey (AAS) is used for physical activity (PA) surveillance in the general Australian adult population, but its validity in older adults has not been evaluated. Our aim was to examine the convergent validity of the AAS questions in older adults.

DESIGN

The AAS was validated against pedometer step counts as an objective measure of PA, self-reported physical function, and a step-test to assess cardiorespiratory fitness.

METHOD

Participants were community-dwelling adults, aged 65-89 y, with the ability to walk 100 m. They completed a self-administered AAS and the step-test in one interview. One week earlier, they completed the Short Form-36 physical function subscale. Between these two interviews, they each wore a YAMAX Digiwalker SW200 pedometer and recorded daily steps. Using the AAS data, daily walking minutes and total PA minutes (walking, moderate-intensity PA and vigorous-intensity PA) were compared with the validity measures using Spearman rank-order correlations. Fifty-three adults completed the study.

RESULTS

Median daily walking minutes were 34.2 (interquartile range [IQR] 17.1, 60.0), and median daily total PA minutes were 68.6 (IQR 31.4, 113.6). Walking and total PA minutes were both moderately correlated with pedometer steps (Spearman correlation r=0.42, p=0.003, for each) but not with step-test seconds to completion (r=-0.11, p=0.44; r=-0.25, p=0.08, respectively). Total PA minutes were significantly correlated with physical function scores (r=0.39, p=0.004), but walking minutes were not (r=0.15, p=0.29).

CONCLUSIONS

This initial examination of the psychometric properties of the AAS for older adults suggests that this surveillance tool has acceptable convergent validity for ambulatory, community-dwelling older adults.

Ambulance transport of the oldest old in Tokyo: a population-based study

Background

Few studies have investigated ambulance utilization in people aged 85 years or older, ie, the oldest old.

Methods

We conducted a 1-year population-based observational study of patients transported by ambulance to emergency departments in Tokyo, Japan, which has a population of about 12 million. Demographic data, symptoms/events associated with ambulance transport, and the proportion of hospital admissions were recorded. Transport rates by age and sex were calculated using data for the background population and ambulance transports, and the 10 most frequent symptoms/events requiring transport were compared between the oldest old and those aged 65 to 84 years.

Results

Of the 642 764 patients who were transported to hospitals by ambulances, 59 570 (9%) were aged ≥85 years; 64% were women. The annual ambulance transport rate for this population was 250 per 1000/year and was significantly greater than the rate (90 per 1000/year) for those aged 65 to 84 years. The highest rate was for men aged 85 to 99 years (292 per 1000/year). Among the oldest old, the most frequent reason for ambulance transport was fall (38.5 per 1000/year), and the symptom most likely to result in hospital admission was dyspnea.

Conclusions

The ambulance transport rate for the oldest old was high, particularly among men aged ≥95 years. To reduce the need for ambulance transport among the oldest old, preventive care is needed to reduce falls and acute exacerbations of cardiac and respiratory disorders.

Effects of Resistance- and Flexibility-Exercise Interventions on Balance and Related Measures in Older Adults

This research explored the balance benefits to untrained older adults of participating in community-based resistance and flexibility programs. In a blinded randomized crossover trial, 32 older adults (M = 66.9 yr) participated in a resistance-exercise program and a flexibility-exercise program for 16 weeks each. Sway velocity and mediolateral sway range were recorded. Timed up-and-go, 10 times sit-to-stand, and step test were also assessed, and lower limb strength was measured. Significant improvements in sway velocity, as well as timed up-and-go, 10 times sit-to-stand, and step test, were seen with both interventions, with no significant differences between the 2 groups. Resistance training resulted in significant increases in strength that were not evident in the flexibility intervention. Balance performance was significantly improved after both resistance training and standing flexibility training; however, further investigation is required to determine the mechanisms responsible for the improvement.

Total hip replacement in patients eighty years of age and older

BACKGROUND

The number of people eighty years of age and older in developed countries is increasing, with a concomitant increased demand for total hip replacement. We analyzed the outcomes of total hip arthroplasty for patients in this age group using data from the Finnish National Arthroplasty Registry.

METHODS

Data from the Finnish Arthroplasty Registry on 6540 patients (6989 hips) who were eighty years of age or older at the time of a total hip arthroplasty, performed between 1980 and 2004, were evaluated with use of survival analyses. Factors affecting survivorship rates were sought, and the reasons for revision were identified.

RESULTS

The mean age of the patients undergoing a primary total hip arthroplasty was 82.7 years. The mean longevity of 3065 patients who died following total hip arthroplasty was 5.1 years. With revision total hip arthroplasty for any reason as the end point, Kaplan Meier survivorship was 97% (95% confidence interval, 96% to 97%) at five years (2617 hips) and 94% (95% confidence interval, 93% to 95%) at ten years (532 hips). Of the 195 hip replacements that required revision, 183 had information on the reason for revision. Eighty-four (46%) were revised for aseptic loosening; thirty-six (20%), for recurrent dislocation; twenty-four (13%), for a periprosthetic fracture; and twenty-three (13%), for infection. Seven hundred and twenty-nine patients had undergone hybrid fixation (a cemented stem and a cementless cup). The survivorship of these replacements was significantly better than that for replacements with cementless fixation in 399 patients (p < 0.05).

CONCLUSIONS

In patients who had a total hip arthroplasty when they were more than eighty years old, the prevalence of aseptic loosening was less than that encountered in younger patients, but recurrent dislocation, periprosthetic fracture, and infection were more common in this age group. Cementation of the femoral stem demonstrated better long-term results than cementless fixation, indicating that it may provide better initial fixation and, therefore, longer life-in-service.