Correlation analysis of physical fitness and its impact on falls in 2130 community- dwelling older adults: a retrospective cross-sectional study

The association between physical activity and fear of falling among community-dwelling older women in China: the mediating role of physical fitness

Background

This study aimed to explore the association between physical activity (PA) and fear of falling (FOF) and to determine whether this relationship was mediated by physical fitness (PF) in community-dwelling older women.

Methods

For this cross-sectional study, a total of 1,108 older women were recruited. Moderate-to-vigorous physical activity (MVPA) and light physical activity (LPA) were objectively measured by accelerometers. Physical fitness indicators including body mass index (BMI), forced vital capacity, choice reaction time, grip strength, sit and reach, and five times sit-to-stand were measured. FOF was evaluated by the Chinese version of the activities-specific balance confidence scale. A stepwise linear regression model analysis was used for mediation analysis, and bootstrap analysis was used to verify the mediation effects.

Result

The Pearson correlation coefficient results suggested that MVPA was significantly and negatively correlated with FOF while LPA was not correlated with FOF. Logistic regression analysis suggested a significant association between MVPA, BMI, forced vital capacity, choice reaction time, sit and reach, grip strength, five times sit-to-stand, and FOF. The mediation analysis showed a negative relationship between MVPA and FOF. BMI completely mediated the relationship between MVPA and FOF while sit and reach, five times sit-to-stand, and forced vital capacity partially mediated the relationship between MVPA and FOF.

Conclusion

Accumulation of more daily MVPA was associated with reducing the odds of FOF in community-dwelling older women. PF indicators fully or partially mediate the relationship between MVPA and FOF. Therefore, more intervention efforts should focus on the promotion of MVPA to improve PF and thus reduce FOF among older women.

Effects of Taiwan's COVID-19 alert levels on the physical activity behaviors and psychological distress of community-dwelling older adults

BACKGROUND

The Taiwanese government implemented stringent preventative health measures to curb the spread of COVID-19. However, these measures negatively affected the physical activity behaviors and psychological distress of individuals. In this study, we investigated the effects of Taiwan's COVID-19 alert-based restrictions on the physical activity behaviors and psychological distress of community-dwelling older adults.

METHODS

In this longitudinal study, 500 community-dwelling older adults were randomly sampled from a health promotion center in Taiwan. Telephone interviews were conducted between May 11, 2021, and August 17, 2021, which coincided with the Level 3 alert period when group physical activities were prohibited. Telephone interviews were again conducted between June 20, 2022, and July 4, 2022, after the alert level was reduced to Level 2 but group physical activities were prohibited period. Through the telephone interviews, data regarding the participants' physical activity behaviors (type and amount) and 5-item Brief Symptom Rating Scale (BSRS-5) scores were collected. Moreover, data regarding physical activity behaviors were collected from the records of our previous health promotion programs, which were conducted before the national alert period. The obtained data were analyzed.

RESULTS

The alert levels influenced physical activity behaviors. Because of strict regulations, physical activity amount decreased during the Level 3 alert period and did not recover rapidly during the Level 2 alert period. Instead of engaging in group exercises (e.g., calisthenics and qigong), the older adults chose to exercise alone (e.g., strolling, brisk walking, and biking). Our findings indicate that the COVID-19 alert level has a significant influence on the amount of physical activity for participants (p < 0.05, partial η2 = 0.256), with pairwise comparisons showing that the physical activity amount decreased significantly across the three time periods (p < 0.05). The psychological distress of the participants did not appear to change during the regulation period. Although the participants' overall BSRS-5 score was slightly lower during the Level 2 alert period compared to the Level 3 alert period, the difference was not statistically significant (p = 0.264, Cohen's d = 0.08) based on a paired t-test. However, the levels of anxiety (p = 0.003, Cohen's d = 0.23) and inferiority (p = 0.034, Cohen's d = 0.159) were considerably higher during the Level 2 alert period than during the Level 3 alert period.

CONCLUSIONS

Our findings indicate that Taiwan's COVID-19 alert levels influenced the physical activity behaviors and psychological distress of community-dwelling older adults. Time is required for older adults to regain their prior status after their physical activity behaviors and psychological distress were affected by national regulations.

Effects of a 12-Week Pilates Program on Functional Physical Fitness and Basal Metabolic Rate in Community-Dwelling Middle-Aged Women: A Quasi-Experimental Study

Background: The aging society worldwide carries public and inevitable issues. Aging is accompanied by multiple diseases, and the health impacts challenge healthcare and social systems. In addition to medical treatment, exercise has been recognized as an effective strategy not only for disease prevention and alleviation, but also for multiple health benefits on health promotion. The purpose of this study was to investigate the effects of a suitable Pilates exercise intervention program on health maintenance and benefits in community-dwelling middle-aged women with a quasi-experimental design. Methods: We recruited healthy middle-aged community-dwelling women who had not regularly exercised in the previous three months. The participants were assigned to the experimental (n = 22) and control (n = 23) groups based on a quasi-experimental design. The experimental group participated in a mat-based Pilates exercise class twice a week (1 h/session) throughout the 12-week intervention, whereas there was no intervention for the control group. Body composition, basal metabolic rate, and functional physical fitness—comprising cardiovascular capacity, flexibility, muscular strength of upper limbs, muscular strength of lower limbs, core strength, agility, static balance, and dynamic balance—were assessed as primary outcomes in both groups before and after the intervention. Results: There were no significant differences in any of the dependent variables between the two groups before the exercise intervention. After the 12-week intervention, body composition, including body mass index, body fat (−1.5 to 3%), and basal metabolic rate (+10.6%), and functional fitness, including flexibility (+3.5%), core strength (+31.5%), lower-limb strength (+13.5%), agility (+7.3%), and balance (+4.2%), improved significantly in the experimental group relative to the control group (p < 0.05). Moreover, the improvement in physical fitness in lower-limb strength, agility, and balance for fall prevention also demonstrated higher clinical significance than the control. Conclusions: This 12-week mat-based Pilates exercise program significantly improved body composition, basal metabolic rate, and functional physical fitness in community-dwelling middle-aged women. The beneficial effects of Pilates exercise programs may thus promote improved health in the middle-aged female population, with practical implications for communities.

Associations between Muscle-Tendon Morphology and Functional Movements Capacity, Flexibility, and Balance in Older Women

Loss of functional movement capacity in older adults is related to adverse changes in musculotendinous morphology, but this relationship is poorly understood. This study examined the associations between musculotendinous morphology and functional movements, flexibility, and balance ability. Ninety-nine older women (66.6 ± 4.6 years, body mass index 23.5 ± 3.3 kg∙m−2) were recruited from Chonburi Province, Thailand. During one 90-min visit, muscle ultrasound imaging of vastus lateralis, biceps femoris, and medial gastrocnemius muscles, and tendon ultrasonography of the Achilles tendon and patellar tendon were performed. Measures were also obtained for the straight leg raise, passive dorsiflexion, balance, and functional tests (Five Times Sit to Stand (5TSTS), Timed Up and Go (TUG), 10-Meter Fast Walk Test (10-MFWT), and 6-Minute Walk Test (6-MWT)). The results specify that functional movement performance correlates most strongly with medial gastrocnemius muscle thickness (5TSTS (r = −0.26), TUG (r = −0.44), 10-MFWT (r = 0.41), and 6-MWT (r = 0.48) all p < 0.05) and that vastus lateralis muscle thickness and medial gastrocnemius muscle thickness correlate positively with balance ability (r = 0.24, 0.34; p < 0.05) and negatively with fear of falling. It appears that muscle mass, rather than other morphological parameters, such as muscle quality or fascicle length, is the main factor affecting the susceptibility of older women to frailty.

Physical fitness and its correlation with handgrip strength in active community-dwelling older adults

In this cross-sectional study, we assessed the physical fitness levels of active community-dwelling older adults. Moreover, we investigated the correlation of their (stratified by age and sex) fitness levels with handgrip strength (HGS). Comprehensive physical fitness tests, including sarcopenia screening, were conducted with a total of 2,130 older adults residing in a rural area of Taiwan. The 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles of age- and sex-specific physical fitness levels were determined. Furthermore, we identified the key parameters for assessing the physical fitness of older adults and performed stepwise multiple linear regression analysis. Both men and women exhibited age-related decreases in all aspects of functional fitness, a trend indicating that older adults in Taiwan may lose their independence in the future. Furthermore, the regression analysis revealed that HGS was positively correlated with sex, body mass index, and the results of 30-s arm curl and back scratch tests but negatively correlated with age and the result of 8-foot up-and-go test. Our reference values for physical fitness may help assess the fitness levels of active community-dwelling older adults and design community-based health programs to prevent the early loss of independence in community-dwelling older adults in Taiwan.