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Popelsky BK, Pettee Gabriel K, Dooley EE, Ylitalo KR. Physical Activity Fragmentation and Falls in Older Adults: Findings From the National Health and Aging Trends Study. J Gerontol A Biol Sci Med Sci 2024; 79:glae129. [PMID: 38733095 PMCID: PMC11157969 DOI: 10.1093/gerona/glae129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Physical activity (PA) may be an important fall prevention strategy. Current PA guidelines emphasize total PA dose, but daily patterning of PA is underappreciated. With aging, PA bouts become less frequent and shorter in duration (ie, more fragmented). PA fragmentation may be an indicator of fall risk, but the relationship is not well understood. This study examined daily PA accumulation and patterns with fall risk in older adults. METHODS Participants (n = 685, 54.3% women, 61.5% aged 70-79 years) from the National Health and Aging Trends Study with wrist-worn accelerometry PA data from Round 11 (baseline) and sample person interviews with fall data from Round 12 (follow-up) were included. PA variables were categorized into tertiles and incident falls were defined as ≥1 self-reported fall in the year following the PA assessment between baseline and follow-up. A modified Poisson approach was used to estimate the relative risk of both PA accumulation and fragmentation with falls. RESULTS Overall, 40.0% reported an incident fall. After adjustment for sociodemographic and health characteristics, those in the highest tertile of total PA accumulation had lower fall risk (aRR = 0.74, 95% CI: 0.57, 0.95) and those in the highest tertile of PA fragmentation had increased fall risk (aRR = 1.33, 95% CI: 1.03, 1.73). Models were attenuated after adjustment for physical functioning. CONCLUSIONS PA fragmentation may identify fall risk in older adults. Longitudinal studies are needed to disentangle the temporal sequencing of the complex relationship between PA and physical functioning across the life course.
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Affiliation(s)
- Braden K Popelsky
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, USA
| | - Kelley Pettee Gabriel
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Erin E Dooley
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kelly R Ylitalo
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, USA
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Buitrago-Restrepo CM, Patiño-Villada FA, Arango-Paternina CM. Effects of Aquatic Exercise on Physical Performance in Older Adults: A Systematic Review and Meta-Analysis. J Aging Phys Act 2024:1-17. [PMID: 38710486 DOI: 10.1123/japa.2023-0192] [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: 05/29/2023] [Revised: 01/15/2024] [Accepted: 03/05/2024] [Indexed: 05/08/2024]
Abstract
This systematic review aimed to evaluate the effects of aquatic exercise on physical performance in older adults. Databases were searched up to July 2021. Randomized controlled trials were screened by two reviewers, who extracted data and assessed study quality. Ten randomized controlled trials (603 participants) were included. Compared with nonexercising controls, aquatic exercise probably improved lower limb muscle power (30-s Chair Stand Test; mean difference 4.75 repetitions; 95% confidence interval [0.07, 9.42]; I2 = 99%; 251 participants; very low-quality evidence). When comparing aquatic exercise with land exercise, there is probably no superiority in favor of either intervention on dynamic balance (Timed Up and Go Test; mean difference -0.12 s; 95% confidence interval [-0.37, 0.12]; I2 = 3%; 244 participants; very low-quality evidence).
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Affiliation(s)
- Carlos Mario Buitrago-Restrepo
- Research Group on Physical Activity for Health (AFIS, in Spanish), University Institute of Physical Education and Sports, University of Antioquia, Medellín, Colombia
| | - Fredy Alonso Patiño-Villada
- Research Group on Physical Activity for Health (AFIS, in Spanish), University Institute of Physical Education and Sports, University of Antioquia, Medellín, Colombia
| | - Carlos Mario Arango-Paternina
- Research Group on Physical Activity for Health (AFIS, in Spanish), University Institute of Physical Education and Sports, University of Antioquia, Medellín, Colombia
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Gyasi RM, Aikins E, Dumedah G, Gyasi-Boadu N, Frimpong PB, Boampong MS, Buor D, Mariwah S, Naab F, Phillips DR. Risk of Sleep Problems in Middle-Aged and Older Adults Experiencing Bodily Pains: Serial Multiple Mediation Estimates of Emotional Distress and Activity Limitations. Am J Geriatr Psychiatry 2024:S1064-7481(24)00318-X. [PMID: 38702252 DOI: 10.1016/j.jagp.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVES Pain is increasingly becoming common among middle-aged and older adults. While research on the association between pain characteristics and sleep problems (SP) is limited in low- and middle-income countries, the underlying mechanisms of the association are poorly understood. This study examines the association of bodily pain intensity and pain interference with SP and investigates the mediating role of activity limitation and emotional distress in this association. METHODS We analyzed population-based data, including 1,201 individuals aged ≥50 (mean [SD] age 66.14 [11.85] years) from the 2016-2018 AgeHeaPsyWel-HeaSeeB study in Ghana. Multiple OLS regressions and serial multiple mediation modeling using bootstrapping analyses examined direct and indirect effects from pain to SP through activity limitation and emotional distress. RESULTS Regressions demonstrated that pain intensity and interference were significantly associated with higher levels of activity limitation, emotional distress, and SP (range: β = 0.049-0.658). Bootstrapping analysis showed that activity limitation and emotional distress serially mediated the relationship between pain intensity and SP (total effect: β = 0.264, Bootstrap 95% confidence interval [CI] = 0.165-0.362; direct effect: (β = 0.107, Bootstrap 95% CI = 0.005-0.210; total indirect effect: β = 0.156, Bootstrap 95% CI = 0.005-0.210) accounting for ∼59%. Activity limitation and emotional distress mediated pain interference and SP association (total effect: β = 0.404, Bootstrap 95% CI = 0.318-0.490; direct effect: β = 0.292, Bootstrap 95% CI = 0.201-0.384; and total indirect effect: β = 0.112, Bootstrap 95% CI = 0.069-0.156) yielding ∼28%. CONCLUSION Our data suggest that activity limitation and emotional distress may convey stress-related risks of pain on SP. Future research should evaluate if activity limitation and emotional distress could be effective targets to reduce the effect of pain on sleep in later-life.
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Affiliation(s)
- Razak M Gyasi
- African Population and Health Research Center, Nairobi, Kenya; National Centre for Naturopathic Medicine (NCNM), Southern Cross University, Lismore, Australia.
| | - Emelia Aikins
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Gift Dumedah
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Nelson Gyasi-Boadu
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Prince Boakye Frimpong
- Department of Economics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mary Sefa Boampong
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Daniel Buor
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Simon Mariwah
- Department of Geography and Regional Planning, University of Cape Coast, Cape Coast, Ghana
| | - Francis Naab
- Perivoli Africa Research Centre (PARC), University of Bristol, Bristol, United Kingdom
| | - David R Phillips
- Department of Sociology and Social Policy, Lingnan University, Hong Kong, Hong Kong
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Raj AK, Pedersen SJ, Mainsbridge C, Rao CR, Roy S, Chandrasekaran B. Influence of short bouts of stair climbing on young adults during prolonged sitting on posture, discomfort, and musculoskeletal performance outcomes: a counterbalanced pilot randomised crossover trial. ERGONOMICS 2024:1-12. [PMID: 38571330 DOI: 10.1080/00140139.2024.2335551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 03/22/2024] [Indexed: 04/05/2024]
Abstract
Prolonged sitting is postulated to influence musculoskeletal performance (cervical flexor endurance, balance, and agility), discomfort and alter cervical spine angles during work-based computer use. Stair climbing breaks may be a great addition at typical and home offices however remain unexplored for its impact on musculoskeletal performance. In our counterbalanced pilot crossover trial, 24 adults were randomised to three interventions: (1) prolonged sitting, (2) interrupted by 2 min of self-paced, and (3) externally paced stair climbing for 2 h. Cervical spine angles were measured every 30 min while balance, agility, endurance, and discomfort were assessed before and after 120 min. Stair climbing interruptions have favourable effects on agility (F = 8.12, p = 0.009, ηp2 = 0.26) and musculoskeletal discomfort, but failed to improve other musculoskeletal outcomes associated with prolonged sitting. Brief stair climbing interruptions are effective in improving discomfort and agility while pragmatic trials are warranted for translated effects.
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Affiliation(s)
- Arjun K Raj
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Scott J Pedersen
- Active Work Laboratory, School of Education, University of Tasmania, Launceston, Australia
| | - Casey Mainsbridge
- Personal Development, Health and Physical Education, Faculty of Humanities, Arts, Social Sciences and Education, School of Education, University of New England, Armidale, Australia
| | - Chythra R Rao
- Department of Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Sohini Roy
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Baskaran Chandrasekaran
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
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5
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Arkkukangas M. Involvement of Older Adults, the Golden Resources, as a Primary Measure for Fall Prevention. Clin Interv Aging 2023; 18:2165-2170. [PMID: 38149083 PMCID: PMC10751217 DOI: 10.2147/cia.s430309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/14/2023] [Indexed: 12/28/2023] Open
Abstract
Falls remain the second leading cause of injury-related deaths worldwide; therefore, longstanding practical fall-prevention efforts are needed. Falls can also lead to a reduction in independence and quality of life among older adults. Fall-prevention research has found that early prevention promotes a prolonged independence. However, it remains unknown which intervention is most beneficial for early prevention and how these interventions should be implemented for long-term effects. In addition, the present and future burden on social and healthcare services contributes to a gap in needs and requires an evidence-based fall prevention. Research suggests that strength, balance, and functional training are effective in reducing falls and fall-related injuries. Such training could greatly impacting independence. Fear of falling and strategies for managing falls are the suggested components to be included when evaluating fall-prevention programs. Thus, the preservation of physical functions is highly relevant for both independence and quality of life. It also contributes to psychological and social well-being, which are important factors for enabling individuals to stay at home for as long as possible. To meet future challenges associated with the expected increase in the older population, older adults should be viewed as a golden resource. With assistance from professionals and researchers, they can learn and gain the ability to institute fall-prevention programs in their own environments. These environments are primarily beyond the responsibilities of the healthcare sector. Therefore, programs comprising current knowledge about fall prevention should be developed, evaluated, and implemented with older adults by using a "train-The-trainer" approach, where a natural collaboration is established between civil society and/or volunteers, healthcare professionals, and researchers. For sustainable and effective fall-prevention programs, a co-design and early collaborative approach should be used in the natural environment, before social and healthcare services are required.
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Affiliation(s)
- Marina Arkkukangas
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
- Department of Medicine, Sport and Fitness Science, Dalarna University, Falun, Sweden
- Department of Physiotherapy, School of Health, Care and Social Welfare, Mälardalen University, Vasteras, Sweden
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6
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Cezón-Serrano N, Arnal-Gómez A, Arjona-Tinaut L, Cebrià I Iranzo MÀ. Functional and emotional impact of COVID-19 lockdown on older adults with sarcopenia living in a nursing home: A 15-month follow-up. Nurs Health Sci 2023; 25:597-608. [PMID: 37705366 DOI: 10.1111/nhs.13050] [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: 01/27/2023] [Revised: 07/26/2023] [Accepted: 08/28/2023] [Indexed: 09/15/2023]
Abstract
This study aimed to detect the functional and emotional impact of COVID-19 lockdown on institutionalized older adults with sarcopenia during a 15-month follow-up. A prospective longitudinal cohort study was conducted in a nursing home. Participants were screened for sarcopenia, and those with a score of ≥4 points according to SARC-F questionnaire were included. Assessments were performed pre-lockdown (T1), 12 months (T2) after, and at a 15-month follow-up (T3). Functional measurements included chair stand test, handgrip, biceps brachii and quadriceps femoris strengths, appendicular skeletal mass, gait speed, Short Physical Performance Battery, and Timed Up-and-Go test. Emotional assessments included Short-Form Health Survey, Geriatric Depression Scale-Short Form, and the Mini-Mental State Examination. The analyzed sample showed a reduction in bicep strength, and other upper and lower limb strength variables showed a decreasing trend with no changes regarding muscle mass. Physical performance showed a change, specifically a deterioration in the subtest related to balance. Cognitive and emotional components were affected and quality of life was decreased. It is of paramount importance to focus on sarcopenic older adults since their characteristics can deteriorate when isolation measures are conducted.
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Affiliation(s)
- Natalia Cezón-Serrano
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
- Physiotherapy in Motion, Multi-specialty Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Anna Arnal-Gómez
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
- Physiotherapy in Motion, Multi-specialty Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Laura Arjona-Tinaut
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Maria Àngels Cebrià I Iranzo
- Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
- Physiotherapy in Motion, Multi-specialty Research Group (PTinMOTION), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
- Physical Medicine and Rehabilitation Service, La Fe Hospital in Valencia, La Fe Health Research Institute (IISLAFE), Valencia, Spain
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7
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Gyasi RM, Odei J, Hambali MG, Gyasi-Boadu N, Obeng B, Asori M, Hajek A, Jacob L, Adjakloe YAD, Opoku-Ware J, Smith L, Koyanagi A. Diabetes mellitus and functional limitations among older adults: Evidence from a large, representative Ghanaian aging study. J Psychosom Res 2023; 174:111481. [PMID: 37677886 DOI: 10.1016/j.jpsychores.2023.111481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 08/04/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVES Literature linking diabetes mellitus (DM) to functional status is limited in low- and middle-income countries. Importantly, factors influencing this association are even less understood. This study aims to examine the association of DM with functional limitations (FL) in older adults and to identify potential factors influencing this association. METHODS In a cross-sectional analysis, we examined the association between DM and basic and instrumental activities of daily living-related FL in 1201 adults aged ≥50 years from the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study. DM was defined as a self-report of physician diagnosis. The associations were assessed using hierarchical regression estimates and bootstrapping technique via the Hayes PROCESS macro program. RESULTS The prevalence of DM and FL was 10.1% and 36.1%, respectively, with OR = 2.50 (95%CI = 1.59-3.92) after accounting for sociodemographic factors, smoking, alcohol use, self-rated health, loneliness, and sleep quality. After full adjustment, polytomous regressions showed that the association of DM with FL increased with the number of FL (i.e., OR = 1.60 for 1-2, OR = 1.88 for 3-5, and OR = 2.0o for >5 FL compared with no FL). However, this association was attenuated after controlling for physical activity (OR = 2.06, 95%CI = 1.28-3.31), hypertension (OR = 1.87, 95%CI = 1.14-2.99), stroke (OR = 1.82, 95%CI = 1.20-2.93), and pain facets (OR = 1.80, 95%CI = 1.04-3.02). PA thus mediated 40.39% of the DM-FL association. CONCLUSIONS In this representative study, older adults with DM showed higher odds for FL, and this association was partially explained by physical activity and health variables. Investing in a holistic management approach might be helpful for public health planning efforts to address DM-induced FL in old age.
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Affiliation(s)
- Razak M Gyasi
- African Population and Health Research Center, Nairobi, Kenya; National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, Australia.
| | - Julius Odei
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mohammed Gazali Hambali
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Nelson Gyasi-Boadu
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Bernard Obeng
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Moses Asori
- Department of Geography and Earth Sciences, University of North Carolina at Charlotte, Charlotte, NC, United States of America
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, Hamburg 20246, Germany
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | | | - Jones Opoku-Ware
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, United Kingdom
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA), Pg. Lluis Companys 23, Barcelona, Spain
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Navarra GA, Tabacchi G, Scardina A, Agnese M, Thomas E, Bianco A, Palma A, Bellafiore M. Functional fitness, lifestyle and demographic factors as predictors of perceived physical and mental health in older adults: A structural equation model. PLoS One 2023; 18:e0290258. [PMID: 37672501 PMCID: PMC10482288 DOI: 10.1371/journal.pone.0290258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/03/2023] [Indexed: 09/08/2023] Open
Abstract
Over the past 50 years, socioeconomic development has brought a reduction in birth rates, an increase in life expectancy and consequently in the elderly population. For this reason, there has been an increasing focus on physical and mental health of the elderly, promoting the concept of healthy aging. The aim of this study was to explore the associations between perceived physical and mental health of older adults and a variety of determinants, such as demographic factors, physical functional fitness, physical activity level, adherence to the Mediterranean diet and anthropometric indices, through a structural equation modeling (SEM). A cross-sectional observational study involved 208 elderly (24 men and 184 women) over the age of 60, fully independent and autonomous. Perceived physical and mental health were assessed with the Short Form 12 questionnaire. Basic sociodemographic information was collected; anthropometric features were directly measured, functional fitness was assessed with the Senior Fitness Test, and physical activity level was determined through the International Physical Activity Questionnaire; adherence to Mediterranean Diet (MD) was also collected through the MEDAS questionnaire. The SEM analysis revealed that functional fitness, which was a latent variable of the model described by the six administered fitness tests, was a strong predictor both of perceived physical and perceived mental health in the sample of elderly. Physical activity level was as predictor of the perceived physical component, but not of the mental health, while score of metabolic equivalent task did not result a predictor, as well as the sociodemographic factors and adherence to MD. The present findings suggest that it would be strongly recommended for elderly subjects to engage in physical activity specifically targeted to aged populations, in order to enhance their fitness abilities and enable them to improve the perception of their own health status.
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Affiliation(s)
- Giovanni Angelo Navarra
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Garden Tabacchi
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Antonino Scardina
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Massimiliano Agnese
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Ewan Thomas
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Antonio Palma
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Marianna Bellafiore
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
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Gyasi RM, Phillips DR, Boampong MS, Abass K, Kyei-Arthur F, Agunbiade OM, Mohamed SF, Salarvand S, Smith L, Hajek A. Bodily Pain in Physical Function and the Role of Physical Activity Among Community-Dwelling Adults Aged 50-69 Years in Ghana. J Gerontol A Biol Sci Med Sci 2023; 78:1604-1611. [PMID: 37354137 DOI: 10.1093/gerona/glad156] [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: 02/15/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND Older adults who experience pain are likely to report higher functional limitations (FL) and lower physical activity (PA) levels. However, the extent to which PA explains the association of pain with FL is largely unknown, particularly in low- and middle-income countries. This study estimates whether and how much pain in FL is mediated by PA engagement. METHODS We used cross-sectional data from 770 adults aged 50-69 years who participated in the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study in Ghana. FL and pain characteristics were defined using the Medical Outcomes Study Short Form-36. PA was assessed by the International Physical Activity Questionnaire-Short Form. Bootstrapped mediation analyses estimated the direct and indirect hypothesized associations. The control variables included age, sex, residential type, level of education, monthly income, social isolation, emotional distress, multimorbidity, and self-rated health. RESULTS After adjusting for potential confounders, higher pain interference (β = 0.091, p < .05) and higher pain severity (β = 0.075, p < .05) were associated with greater FL. The bootstrapping analyses showed that PA mediated the pain interference-FL association, accounting for approximately 58% (β = 0.124, Boots 95% confidence interval (CI): 0.078-0.175) of the total effect (β = 0.215, Boots 95% CI: 0.095-0.335). Similarly, PA mediated the association between pain severity with FL, accounting for approximately 37% (β = 0.044, Boots 95% CI: 0.001-0.094) of the overall effect (β = 0.119, Boots 95% CI: -0.011 to 0.249). CONCLUSIONS Our data suggest that the higher pain severity and pain interference may lead to higher FL in middle and old age, and the associations are partially explained by PA. Effective and low-cost PA participation could be targeted in efforts to reduce the effect of pain on physical functioning among middle-aged and older adults.
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Affiliation(s)
- Razak M Gyasi
- African Population and Health Research Center, Nairobi, Kenya
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
| | - David R Phillips
- Department of Sociology and Social Policy, Lingnan University, Tuen Mun, Hong Kong
| | - Mary Sefa Boampong
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kabila Abass
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Frank Kyei-Arthur
- Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Ghana
| | - Ojo Melvin Agunbiade
- Department of Nursing Science, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Sukri F Mohamed
- African Population and Health Research Center, Nairobi, Kenya
| | - Shahin Salarvand
- Hepatitis Research Center, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
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10
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Hirakawa K, Nakayama A, Hori K, Uewaki R, Shimokawa T, Isobe M. Utility of Cardiac Rehabilitation for Long-Term Outcomes in Patients with Hospital-Acquired Functional Decline after Cardiac Surgery: A Retrospective Study. J Clin Med 2023; 12:4123. [PMID: 37373816 DOI: 10.3390/jcm12124123] [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: 05/30/2023] [Revised: 06/11/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
Hospital-acquired functional decline is an important outcome that affects the long-term prognosis of patients after cardiac surgery. Phase II cardiac rehabilitation (CR) for outpatients is expected to improve prognosis; however, this is not clear in patients with hospital-acquired functional decline after cardiac surgery. Therefore, this study evaluated whether phase II CR improved the long-term prognosis of patients with hospital-acquired functional decline after cardiac surgery. This single-center, retrospective observational study included 2371 patients who required cardiac surgery. Hospital-acquired functional decline occurred in 377 patients (15.9%) after cardiac surgery. The mean follow-up period was 1219 ± 682 days in all patients, and there were 221 (9.3%) cases with major adverse cardiovascular events (MACE) after discharge during the follow-up period. The Kaplan-Meier survival curves indicated that hospital-acquired functional decline and non-phase II CR was associated with a higher incidence of MACE than other groups (log-rank, p < 0.001), additionally exhibiting prognosticating MACE in multivariate Cox regression analysis (HR, 1.59; 95% CI, 1.01-2.50; p = 0.047). Hospital-acquired functional decline after cardiac surgery and non-phase II CR were risk factors for MACE. The participation in phase II CR in patients with hospital-acquired functional decline after cardiac surgery could reduce the risk of MACE.
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Affiliation(s)
- Kotaro Hirakawa
- Department of Rehabilitation, Sakakibara Heart Institute, Tokyo 183-0003, Japan
| | - Atsuko Nakayama
- Department of Cardiology, Sakakibara Heart Institute, Tokyo 183-0003, Japan
| | - Kentaro Hori
- Department of Rehabilitation, Sakakibara Heart Institute, Tokyo 183-0003, Japan
| | - Reina Uewaki
- Department of Rehabilitation, Sakakibara Heart Institute, Tokyo 183-0003, Japan
| | - Tomoki Shimokawa
- Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo 183-0003, Japan
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11
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Remm SE, Peters K, Halcomb E, Hatcher D, Frost SA. Healthy ageing status and risk of readmission among acutely hospitalised older people. Collegian 2023. [DOI: 10.1016/j.colegn.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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12
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An Active Retirement Programme, a Randomized Controlled Trial of a Sensorimotor Training Programme for Older Adults: A Study Protocol. Healthcare (Basel) 2022; 11:healthcare11010086. [PMID: 36611545 PMCID: PMC9819127 DOI: 10.3390/healthcare11010086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/19/2022] [Accepted: 12/25/2022] [Indexed: 12/29/2022] Open
Abstract
Research shows that exercise training programmes lead to several improvements in older adults' health-related quality of life (HRQoL) and well-being. This study will examine the effects of an active retirement programme on Portuguese older adults, investigating its effects on body composition, physical fitness, HRQoL, and physical activity level (PAL). Therefore, a parallel-group randomised controlled trial will be conducted, including body composition (height and body weight), physical fitness (strength, flexibility, agility, postural control, and gait), HRQoL, and PAL assessments before and after the application of the programme. The programme will be carried out for six months, two days per week (45 min), plus a year of follow-up. The programme will consist of six circuits with eight physical exercises each. The circuits will change at the end of the four weeks (one monthly circuit). The exercises' difficulty will increase throughout the programme, with alternatives for all the participants. If the effectiveness of the programme is demonstrated, implementation in different services and municipalities could be advised, as the actors involved in health and social services should promote the well-being of their citizens through, among others, health-related physical activity and the prevention of diseases associated with inactivity.
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13
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Felser S, Gube M, Gruen J, Coutre PI, Schulze S, Muegge LO, Junghanss C, Ulbricht S. Association Between Cancer-Related Fatigue and Falls in Patients With Myeloproliferative Neoplasms: Results of a Multicenter Cross-Sectional Survey From the East German Study Group for Hematology and Oncology (OSHO #97). Integr Cancer Ther 2022; 21:15347354221143064. [PMID: 36539979 PMCID: PMC9791269 DOI: 10.1177/15347354221143064] [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] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE This study retrospectively examined the association between cancer-related fatigue (CrF) and the number of falls during the last 12 months in patients with myeloproliferative neoplasms (MPNs). METHODS A multicenter, 1-time anonymous survey was conducted using analog and digital questionnaires. Sex-stratified multinomial logistic regression analysis was applied to investigate the association between CrF and number of falls. All analyses were adjusted for age, school education, body mass index, MPN subtype, and quality of life. RESULTS The final sample comprised 688 patients (mean age 57.4 ± 13.8, 62.4% women). The fall rate was 16.2% in women and 12.2% in men (P = .153). There were no differences between women and men in terms of CrF between individuals with more than 1 fall, whereas women with 1 fall had a higher CrF compared to those without a fall (RRR = 1.019; 95% CI [1.002-1.039]), respectively. CONCLUSION CrF increases the risk of falls in women with MPN. Physicians should evaluate and manage CrF symptoms and implement fall prevention strategies for those who are at increased risk. Further research is needed to better understand the effects of CrF on gait performance and associated fall risk.
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Affiliation(s)
- Sabine Felser
- Rostock University Medical Center, Rostock, Germany,Sabine Felser, Department of Internal Medicine, Clinic III—Hematology, Oncology and Palliative Care, Rostock University Medical Center, Ernst-Heydemann-Straße 06, Rostock 18057, Germany.
| | - Martin Gube
- Rostock University Medical Center, Rostock, Germany,University of Rostock, Rostock, Germany
| | - Julia Gruen
- Rostock University Medical Center, Rostock, Germany
| | | | - Susann Schulze
- University Hospital Halle, Halle (Saale), Germany,Carl-von-Basedow-Klinikum, Merseburg, Germany
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Nascimento MDM, Gouveia ÉR, Gouveia BR, Marques A, França C, Freitas DL, Campos P, Ihle A. Exploring Mediation Effects of Gait Speed, Body Balance, and Falls in the Relationship between Physical Activity and Health-Related Quality of Life in Vulnerable Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14135. [PMID: 36361009 PMCID: PMC9655035 DOI: 10.3390/ijerph192114135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/19/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
The present study aimed to examine whether gait speed (GS), body balance (BB), and falls mediated the relationship between physical activity (PA) and health-related quality of life (HRQoL) in community-dwelling older adults. This is a cross-sectional study that included 305 men and 314 women (69.5 ± 5.6 years), residing in the Autonomous Region of Madeira, Portugal. HRQoL and PA were assessed using the SF-36 and Baecke Questionnaires, respectively. While BB was obtained by the Fullerton Advance Balance (FAB) scale, GS by the 50-foot (15 m) walk test, and the frequency of falls was obtained by self-report. According to the analyses, when GS and BB were placed concomitantly as mediators, the direct effect revealed by the model revealed a non-significant relationship between PA and falls. Thus, in the context of falls, GS and BB partially mediated the association between PA and HRQoL in approximately 29.7%, 56%, and 49.2%, respectively. The total HRQoL model explained a variance of 36.4%. The results can help to understand the role that GS, BB, and falls play in the relationship between PA and HRQoL of the vulnerable older adult population.
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Affiliation(s)
- Marcelo de Maio Nascimento
- Department of Physical Education, Federal University of Vale do São Francisco, Petrolina 56304-917, Brazil
| | - Élvio Rúbio Gouveia
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
| | - Bruna R. Gouveia
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
- Regional Directorate of Health, Secretary of Health of the Autonomous Region of Madeira, 9004-515 Funchal, Portugal
- Saint Joseph of Cluny Higher School of Nursing, 9050-535 Funchal, Portugal
| | - Adilson Marques
- CIPER, Faculty of Human Kinetics, University of Lisbon, 1495-751 Lisbon, Portugal
- ISAMB, Faculty of Medicine, University of Lisbon, 1649-020 Lisbon, Portugal
| | - Cíntia França
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal
| | - Duarte L. Freitas
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Pedro Campos
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal
- Department of Informatics Engineering and Interactive Media Design, University of Madeira, 9020-105 Funchal, Portugal
| | - Andreas Ihle
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
- Department of Psychology, University of Geneva, 1205 Geneva, Switzerland
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, 1015 Lausanne, Switzerland
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15
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Testing Leash Walking Training as a Physical Activity Intervention for Older Adult Dog Owners: A Feasibility Study. Geriatrics (Basel) 2022; 7:geriatrics7060120. [PMID: 36412609 PMCID: PMC9680302 DOI: 10.3390/geriatrics7060120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/05/2022] [Accepted: 10/19/2022] [Indexed: 12/14/2022] Open
Abstract
Dog walking is a physical activity (PA) with many health benefits for older adults. Dog behavior issues can be a barrier to dog walking. This study piloted leash manners training as a PA intervention for dog owners ages 60+ years. Fourteen dog owners (mean age = 65 years, female = 71%) enrolled in a leash manners training course. Process evaluation data were collected to determine feasibility and acceptability of the intervention and study procedures. Twelve of fourteen enrolled participants (86%) completed the course, and most were highly engaged with the program, as evidenced by high class attendance (92% of participants who completed the course attended ≥5 of 6 classes) and a majority (64%) reporting frequent skills practice at home. Further, most participants (73%) reported their leash walking skills improved. The PA assessment protocol (7 days of 24 h data collection using activPAL monitors) was well tolerated, with all participants who completed assessments at each time point (pre-program, post-program, 4-week follow-up) providing ≥6 valid days of data. In sum, the intervention approach and study procedures were feasible and acceptable in this sample of older adults. More research is needed to determine the effectiveness of leash manners training for increasing PA in this population.
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16
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Nascimento MDM, Gouveia ÉR, Gouveia BR, Marques A, Campos P, García-Mayor J, Przednowek K, Ihle A. The Mediating Role of Physical Activity and Physical Function in the Association between Body Mass Index and Health-Related Quality of Life: A Population-Based Study with Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192113718. [PMID: 36360598 PMCID: PMC9656348 DOI: 10.3390/ijerph192113718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/17/2022] [Accepted: 10/20/2022] [Indexed: 06/07/2023]
Abstract
This study aimed (1) to investigate the association between body mass index (BMI), physical activity (PA), and physical function (PF) with health-related quality of life (HRQoL), and (2) to examine in-depth whether PA and PF mediate the relationship between BMI and HRQoL in older adults. We investigated 802 individuals (mean age 69.8 ± 5.6 years), residents of the Autonomous Region of Madeira, Portugal. Harmol and PA were assessed using the SF-36 and Baecke questionnaires, respectively, and PF by the Senior Fitness Test. The prevalence of overweight was 71.3%, 26.5% for normal weight, and 2.1% for underweight. We verified a small correlation between age and sex with BMI, PA, PF, and medium borderline with HRQoL. After adjusting for covariates (i.e., sex, age, comorbidities), the multivariate regression analysis indicated a 93.1% chance of improvement in HRQoL for low BMI, while PA and PF revealed a chance of increasing HRQoL by 91.8% and 60.0%, respectively. According to the serial mediation pathway, PA and PF partially mediated the association between BMI and HRQoL by 32.3% and 81.5%, respectively. The total variance of the model was 90%. It was concluded that BMI can negatively affect HRQoL. On the other hand, PA and PF are able to increase HRQoL levels during the aging process.
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Affiliation(s)
- Marcelo de Maio Nascimento
- Department of Physical Education, Federal University of Vale do São Francisco, Petrolina 56304-917, PE, Brazil
| | - Élvio Rúbio Gouveia
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal
- LARSYS—Laboratory for Robotics and Engineering System, Interactive Technologies Institute, 9020-105 Funchal, Portugal
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
| | - Bruna R. Gouveia
- LARSYS—Laboratory for Robotics and Engineering System, Interactive Technologies Institute, 9020-105 Funchal, Portugal
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
- Regional Directorate of Health, Secretary of Health of the Autonomous Region of Madeira, 9004-515 Funchal, Portugal
- Saint Joseph of Cluny Higher School of Nursing, 9050-535 Funchal, Portugal
| | - Adilson Marques
- CIPER, Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, 1499-002 Cruz Quebrada, Portugal
- Environmental Health Institute (ISAMB), University of Lisbon, 1649-020 Lisbon, Portugal
| | - Pedro Campos
- Department of Informatics Engineering and Interactive Media Design, University of Madeira, 9000-072 Funchal, Portugal
| | - Jesús García-Mayor
- Public Health and Epidemiology Research Group, San Javier Campus, University of Murcia, 30720 San Javier, Spain
| | - Krzysztof Przednowek
- Institute of Physical Culture Sciences, Medical College, University of Rzeszów, 35-959 Rzeszów, Poland
| | - Andreas Ihle
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
- Department of Psychology, University of Geneva, 1205 Geneva, Switzerland
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, 1015 Lausanne, Switzerland
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Nascimento MDM, Gouveia ÉR, Marques A, Gouveia BR, Marconcin P, França C, Ihle A. The Role of Physical Function in the Association between Physical Activity and Gait Speed in Older Adults: A Mediation Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12581. [PMID: 36231881 PMCID: PMC9564593 DOI: 10.3390/ijerph191912581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 06/16/2023]
Abstract
Adequate levels of physical function (PF) are essential for vulnerable older adults to perform their daily tasks safely and remain autonomous. Our objective was to explore the mediating role of PF in the relationship between physical activity (PA) and gait speed (GS) in a large sample of older adults from the north of Brazil. This is a cross-sectional study that analyzed 697 older adults (mean age 70.35 ± 6.86 years) who participated in the project "Health, Lifestyle, and Physical Fitness in Older Adults in Amazonas" (SEVAAI). PA was assessed using the Baecke Questionnaire, PF using the Senior Fitness Test, and GS using the 50-foot Walk Test. Mediation pathways were analyzed to test the possible mediating role of PF between specific PA domains (PA-total score, PA-housework, PA-sport, PA-leisure) and GS. Regarding PA-total, the analysis showed that high-performance GS was partially mediated in approximately 19% by better PF performance. Moreover, the PF could partially mediate the association between PA-sport and PA-leisure with GS, at levels of approximately 9% and 46%, respectively. An inverse relationship was observed between PA-housework (sedentary lifestyle) and GS. This association was partially mediated to an extent of approximately 9% by better PF performance. We conclude that PF plays a crucial role in mediating the association between PA and GS among vulnerable older adults.
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Affiliation(s)
- Marcelo de Maio Nascimento
- Department of Physical Education, Federal University of Vale do São Francisco, Petrolina 56304-917, Brazil
| | - Élvio Rúbio Gouveia
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal
- Laboratory for Robotics and Engineering System (LARSYS), Interactive Technologies Institute, 9020-105 Funchal, Portugal
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
| | - Adilson Marques
- Interdisciplinary Centre for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, 1495-751 Lisbon, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculty of Medicine, University of Lisbon, 1649-020 Lisbon, Portugal
| | - Bruna R. Gouveia
- Laboratory for Robotics and Engineering System (LARSYS), Interactive Technologies Institute, 9020-105 Funchal, Portugal
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
- Regional Directorate of Health, Secretary of Health of the Autonomous Region of Madeira, 9004-515 Funchal, Portugal
- Saint Joseph of Cluny Higher School of Nursing, 9050-535 Funchal, Portugal
| | - Priscila Marconcin
- Interdisciplinary Centre for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, 1495-751 Lisbon, Portugal
- KinesioLab, Research Unit in Human Movement Analysis, Piaget Institute, 2805-059 Almada, Portugal
| | - Cíntia França
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal
- Laboratory for Robotics and Engineering System (LARSYS), Interactive Technologies Institute, 9020-105 Funchal, Portugal
| | - Andreas Ihle
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
- Department of Psychology, University of Geneva, 1205 Geneva, Switzerland
- Swiss National Centre of Competence in Research LIVES–Overcoming Vulnerability: Life Course Perspectives, 1015 Lausanne, Switzerland
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Zhao Y, Duan Y, Feng H, Nan J, Li X, Zhang H, Xiao LD. Trajectories of physical functioning and its predictors in older adults: A 12-year longitudinal study in China. Front Public Health 2022; 10:923767. [PMID: 36111197 PMCID: PMC9469466 DOI: 10.3389/fpubh.2022.923767] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/01/2022] [Indexed: 01/24/2023] Open
Abstract
Objective Maintaining and delaying a decline in physical function in older adults is critical for healthy aging. This study aimed to explore trajectories, critical points of the trajectory changes, and predictors among older people in the Chinese community. Design This study was one with a longitudinal design performed in China. Setting and participants The target population was community-dwelling older adults aged over 65 years. A total of 2,503 older adults from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were included in this study. Methods Physical functioning was measured by instrumental activities of daily living (IADL). Population-based trajectory models were used to identify potential heterogeneity in longitudinal changes over 12 years and to investigate associations between baseline predictors and different trajectories for different cohort members using LASSO regression and logistic regression. Results Four trajectories of physical function were identified: slow decline (33.0%), poor function and moderate decline (8.1%), rapid decline (23.5%), and stable function (35.4%). Older age, male sex, worse self-reported health status, worse vision status, more chronic diseases, worse cognitive function, and a decreased frequency of leisure activity influenced changes in the trajectory of physical function. Having fewer teeth, stronger depressive symptoms, a lack of exercise, and reduced hearing may increase the rate of decline. Conclusion and implications Four trajectories of physical function were identified in the Chinese elderly population. Early prevention or intervention of the determinants of these trajectories can maintain or delay the rate of decline in physical function and improve healthy aging.
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Affiliation(s)
- Yinan Zhao
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yunzhu Duan
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Hui Feng
- Xiangya School of Nursing, Central South University, Changsha, China,Xiangya-Oceanwide Health Management Research Institute, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China,*Correspondence: Hui Feng
| | - Jiahui Nan
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Xiaoyang Li
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Hongyu Zhang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia,Lily Dongxia Xiao
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Muscle Strength and Balance as Mediators in the Association between Physical Activity and Health-Related Quality of Life in Community-Dwelling Older Adults. J Clin Med 2022; 11:jcm11164857. [PMID: 36013095 PMCID: PMC9409764 DOI: 10.3390/jcm11164857] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/06/2022] [Accepted: 08/16/2022] [Indexed: 12/02/2022] Open
Abstract
Lower extremity muscle strength (LEMS) and body balance (BB) are essential for older adults to maintain an upright posture and autonomously perform their basic activities of daily living. This study aimed to examine whether LEMS and BB mediate the relationship between physical activity (PA) and health-related quality of life (HRQoL) in a large sample of community-dwelling older adults. This is a cross-sectional study carried out with 802 individuals, 401 males and 401 females (69.8 ± 5.6 years), residents of the Autonomous Region of Madeira, Portugal. PA and HRQoL were assessed by the Baecke Questionnaire and e SF-36, respectively. LEMS was assessed by the Senior Fitness Test and BB by the Fullerton Advance Balance (FAB). The serial mediation pathway model pointed out that LEMS and BB partially mediated the association between PA and HRQoL in approximately 39.6% and 47%, respectively. The total variance in HRQoL explained by the entire model was 98%. Our findings may indicate the role that LEMS and BB play in the relationship between PA and HRQoL in the older population.
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Physical activity and gender buffer the association of retirement with functional impairment in Ghana. Sci Rep 2022; 12:12832. [PMID: 35896681 PMCID: PMC9329384 DOI: 10.1038/s41598-022-17178-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 07/21/2022] [Indexed: 11/30/2022] Open
Abstract
Females on average live longer but with higher rates of functional impairment and lower physical and economic activities than men. However, research linking retirement to functional impairment and the modifying role of gender and physical activity (PA) is limited especially in low- and middle-income countries. This paper examines the association between retirement and functional impairment in Ghana and evaluates the effect modification of the association by gender and PA. The sample included 1201 adults aged ≥ 50 years from a population-based study. Functional impairment was assessed with the activities of daily living scale. Ordinary least squares regression models adjusted for confounding variables and estimated gender-wise and PA heterogeneity effect of retirement on functional impairment. Regressions showed that retirement predicted an increase in functional impairment score in the full sample (β = .76, p < .001) and in men (β = 1.96, p < .001), but not in women. Interestingly, retirement significantly increased functional impairment in ≥ 65 age cohort (full sample: β = .71, p < .005; men: β = 1.86, p < .001) although not in women. However, the effect was significantly moderated by PA such that retirement × PA predicted a decrease in functional impairment in the full sample (β = −.81, p < .005) and the ≥ 65 age group (β = −.43, p < .005). Functional impairment risk of retirement is gender-specific, but PA buffers the relationship. Retirement is generally commonplace, but these findings imply that promoting PA may hold promise for addressing functional impairment in old age. Attending to the physical health needs of men during retirement should be a social policy priority.
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Martínez-Hernández BM, Rosas-Carrasco O, López-Teros M, González-Rocha A, Muñoz-Aguirre P, Palazuelos-González R, Ortíz-Rodríguez A, Luna-López A, Denova-Gutiérrez E. Association between physical activity and physical and functional performance in non-institutionalized Mexican older adults: a cohort study. BMC Geriatr 2022; 22:388. [PMID: 35505279 PMCID: PMC9066903 DOI: 10.1186/s12877-022-03083-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/22/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Aging is an independent risk factor for deterioration in functional capacity. Some studies have reported that physical activity (PA) improves functional capacity and physical performance among older adults (OA). Thus the objective of the present study was to assess the longitudinal association between PA and functional and physical performance in non-institutionalized OA. METHODS A longitudinal analysis using data from the Frailty, Dynapenia and Sarcopenia in Mexican adults (FRADYSMEX, by its Spanish acronym) cohort study was conducted. PA was assessed through the Community Healthy Activities Model Program for Seniors (CHAMPS) instrument. Functionality was measured with the Barthel index and the Lawton and Brody scale, while physical performance was measured with the Short Physical Performance Battery (SPPB). To evaluate the association between the level of PA and physical and functional performance as a continuous variable, a linear regression of mixed effects was performed. To assess PA and dependence in basic activities of the daily life (BADL), instrumental activities of the daily life (IADL), and low physical performance (PP), generalized estimation equation models [to compute odds ratios (OR) and 95% confidence intervals (95%CI)] were computed. RESULTS Older people who performed moderate to vigorous-intensity PA had a lower risk of dependence in IADL (OR = 0.17; 95%CI: 0.10, 0.80) and lower risk of low PP (OR = 0.18; 95%CI: 0.11, 0.58) compared to those in lower categories of PA. CONCLUSIONS Older adults living in the community who perform PA of moderate to vigorous intensity have a lower risk of dependence in BADL and IADL and have a lower risk of low PP.
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Affiliation(s)
| | | | - Miriam López-Teros
- Departamento de Salud, Universidad Iberoamericana, Ciudad de Mexico, México
| | - Alejandra González-Rocha
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Paloma Muñoz-Aguirre
- CONACYT-Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Rosa Palazuelos-González
- Center for Evaluation and Survey Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | | | - Edgar Denova-Gutiérrez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, México.
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Salinas-Rodríguez A, Manrique-Espinoza B, Palazuelos-González R, Rivera-Almaraz A, Jáuregui A. Physical activity and sedentary behavior trajectories and their associations with quality of life, disability, and all-cause mortality. Eur Rev Aging Phys Act 2022; 19:13. [PMID: 35488197 PMCID: PMC9052456 DOI: 10.1186/s11556-022-00291-3] [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: 08/02/2021] [Accepted: 04/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity (PA) and sedentary behavior (SB) are not stable conditions but change over time and among individuals, and both could have deleterious effects on health-related outcomes among older adults. This study aimed to identify the longitudinal trajectories of PA and SB and estimate their association with quality of life, disability, and all-cause mortality in a national sample of older Mexican adults. METHODS Data comes from three waves of the WHO Study on global AGEing and adult health (SAGE) in Mexico (2009, 2014, 2017). In total, 3209 older adults ages 50 and above were included. PA and SB were determined by using the Global Physical Activity Questionnaire (GPAQ). Disability was measured using the WHO Disability Assessment Schedule (WHODAS 2.0), quality of life using the WHOQOL (WHO Quality of Life) instrument, and all-cause mortality using a verbal autopsy. We used growth mixture modeling (GMM) to investigate the longitudinal trajectories of PA and SB. Three-level linear mixed effect models were used to estimate the associations of PA and SB with quality of life and disability and the Cox model for the association with all-cause mortality. RESULTS Three longitudinal trajectories of PA and SB were found: low-PA-decreasers, moderate-PA-decreasers, and high-PA-decreasers for PA; and low-maintainers, steep-decreasers, and steep-increasers for SB. Decreased quality of life, increased disability, and all-cause mortality were all consistently associated with worse PA and SB trajectories. CONCLUSIONS Our results highlight the need for health policies and prevention strategies that promote PA and limit SB in middle-aged adults. Further studies should consider these activities/behaviors as exposures that vary throughout life and work to identify vulnerable groups of older adults for whom physical activation interventions and programs would be most impactful.
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Affiliation(s)
- Aarón Salinas-Rodríguez
- Center for Evaluation and Surveys Research, National Institute of Public Health, Av. Universidad #655. Colonia Santa María Ahuacatitlan ZC, 62100, Cuernavaca, Mor, Mexico
| | - Betty Manrique-Espinoza
- Center for Evaluation and Surveys Research, National Institute of Public Health, Av. Universidad #655. Colonia Santa María Ahuacatitlan ZC, 62100, Cuernavaca, Mor, Mexico
| | - Rosa Palazuelos-González
- Center for Evaluation and Surveys Research, National Institute of Public Health, Av. Universidad #655. Colonia Santa María Ahuacatitlan ZC, 62100, Cuernavaca, Mor, Mexico.
| | - Ana Rivera-Almaraz
- Center for Evaluation and Surveys Research, National Institute of Public Health, Av. Universidad #655. Colonia Santa María Ahuacatitlan ZC, 62100, Cuernavaca, Mor, Mexico
| | - Alejandra Jáuregui
- Center for Research in Nutrition and Health, National Institute of Public Health, Av. Universidad #655. Colonia Santa María Ahuacatitlan ZC, 62100, Cuernavaca, Mor, Mexico
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The effect-modification of physical activity on the association of pain with impaired physical function in aging adults. Exp Gerontol 2022; 163:111791. [PMID: 35367593 DOI: 10.1016/j.exger.2022.111791] [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: 01/13/2022] [Revised: 03/22/2022] [Accepted: 03/28/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Pain is prevalent among older adults and may result in impairment in physical function. However, little is known about the effect-modification of this relationship by physical activity (PA) participation. This large and representative study sought to estimate the effect of pain on physical function among older adults in Ghana and evaluate whether PA modifies this association. METHODS Data came from 1201 adults aged ≥50 years participating in the AgeHeaPsyWel-HeaSeeB Study in Ghana. Pain constructs were defined using the Medical Outcomes Study Short Form-36 (MOS SF-36). PA was assessed using the International Physical Activity Questionnaire short form (IPAQ-SF) and physical function impairment was measured by seven-item domains based on the activities of daily living (ADL) and instrumental ADL (IADL). Adjusted hierarchical OLS regressions were fitted to estimate the direct and moderating relationships between pain facets, PA, and impaired physical function. RESULTS The relationships of pain severity (β = 0.348, p < .001), and pain interference (β = 0.424, p < .001) with impaired physical function were robust after full adjustment for confounding variables. Persons with pain experiences had significantly increased impaired physical function risks. PA significantly modified the association between pain severity (β = -0.232, p < .001) and pain interference (β = -0.143, p < .001) with impaired physical function. CONCLUSIONS Our data indicate that the relationships of pain with physical function impairment are modified by PA intensity. Future studies are warranted to understand the indirect effect of pain on functional limitations and how PA promotion could manage pain and improve functional ability in aging adults.
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Chen LY, Wang JX, Chen YY, Yang YJ, Yao JJ, Shen X. Activities-specific performance frequency can accurately detect fallers in elderly populations: an alternative method for quantifying activity restrictions. BMC Geriatr 2022; 22:205. [PMID: 35287578 PMCID: PMC8922773 DOI: 10.1186/s12877-022-02912-z] [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: 11/02/2021] [Accepted: 03/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background The high prevalence of falling among older adults constitutes a major public and clinical health concern. Many elderly persons may develop activities-specific restriction due to the risk of falling. This highlights the need for relevant evaluative tools. Methods This cross-sectional study used activities-specific performance frequency indicators to quantify activity restrictions in elderly participants, with all measures based on items from the Activities-Specific Balance Confidence (ABC) scale. Specifically, we tested for correlations between activities-specific performance frequency and balance confidence, functional balance/mobility, and fall history. There were 88 elderly participants, including 28 with stroke, 30 with Parkinson’s disease, and 30 with no neurological diseases. In addition to their activities-specific performance frequency measures, we collected a series of demographic and health-related characteristics from each participant. We analyzed between-group differences in activities-specific performance frequency and other demographic and health-related characteristics via the one-way analysis of variance and Kruskal-Wallis test. Next, we used the Spearman’s rank correlation test and binary logistic regression to investigate the correlations between activities-specific performance frequency and demographic/other health-related characteristics. Results There were significant group differences in performance frequency for all ABC activity items except for walking around the house, average ABC scores, and functional balance/mobility among normal older adults, participants with strokes and those with Parkinson's disease. Activities-specific performance frequency showed stronger correlations with activities-relevant functional mobility (r=0.250-0.713 for 15 items with significant correlations, 13 activity items with r≧0.4) than with balance confidence (r=0.279-0.668 for 13 items with significant correlations, 10 activity items with r≧0.4). The performance frequency of walking in crowds/bumped was the most sensitive measure for predicting fallers (odd ratio=3.310, p<0.05). Conclusions This study proposed and validated the usage of activities-specific performance frequency as an alternative method for quantifying activity restrictions among older adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02912-z.
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Affiliation(s)
- Lin Y Chen
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, 201619, China
| | - Jing X Wang
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, 201619, China
| | - Ying Y Chen
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, 201619, China
| | - Ya J Yang
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, 201619, China
| | - Jia J Yao
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, 201619, China
| | - Xia Shen
- Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, 201619, China. .,Department of Rehabilitation Sciences, Tongji University School of Medicine, Shanghai, 200092, China.
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Awuviry-Newton K, Amoah D, Tavener M, Afram AA, Dintrans PV, Byles J, Kowal P. Food Insecurity and Functional Disability Among Older Adults in Ghana: The Role of Sex and Physical Activity. J Am Med Dir Assoc 2022; 23:1432.e1-1432.e7. [PMID: 35218730 DOI: 10.1016/j.jamda.2022.01.065] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/15/2022] [Accepted: 01/19/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVES We examined the associations between food insecurity and functional disability among older adults in Ghana and, the roles of sex and physical activity on the relationship. DESIGN A cross-sectional study design was employed. SETTING AND PARTICIPANTS A total of 4446 older adults (50+ years of age) from the Study on Global Aging and Adult Health Ghana Wave 2, a countrywide study, was completed in 2015. METHODS Logistic regression models were used to examine the associations between measures of food insecurity and functional disability using data from Study on Global Aging and Adult Health Ghana Wave 2. Functional disability was assessed using World Health Organization Disability Assessment Schedule 2.0 composed of 12 items in 6 domains of cognition, mobility, self-care, getting along, life activities, and participation in society. Food insecurity was assessed from 12-month food sufficiency and experience of hunger over the last 12 months. RESULTS Approximately 11% were identified as having functional disability. The prevalence of food insecurity was 23.8% for insufficient food intake and 18.3% for hunger. Adjusting for all variables, older adults who reported consuming insufficient food (OR 2.27; 95% CI 1.57, 3.28), and those who experienced hunger (OR 2.35; 95% CI 1.59, 3.46) had higher odds of functional disability, compared with those not reporting these issues. Sex differences modified the association between hunger and functional disability. Physical activity served as a protective factor (OR 0.60; 95% CI 0.38, 0.95) on the association implying that older adults who engaged in physical activity were 40% less likely to experience food insecurity-induced functional disability. CONCLUSIONS AND IMPLICATIONS Food insecurity is associated with functional disability among older adults. Results highlight the usefulness of tackling the social determinants of health and promoting financial/social security in older age in a changing Ghanaian society.
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Affiliation(s)
| | - Dinah Amoah
- African Health and Aging Research Center (AHaARC), Winneba, Ghana; School of Health Sciences, University of Tasmania, Hobart, Australia
| | - Meredith Tavener
- African Health and Aging Research Center (AHaARC), Winneba, Ghana; Center for Women's Health Research, Hunter Medical Research Institutes, The University of Newcastle, Callaghan, Australia
| | - Adjeiwa Akosua Afram
- African Health and Aging Research Center (AHaARC), Winneba, Ghana; Department of Health Policy, Planning and Management, School of Public Health, University of Ghana, Accra, Ghana
| | - Pablo Villalobos Dintrans
- African Health and Aging Research Center (AHaARC), Winneba, Ghana; Programa Centro Salud Pública, Facultad de Ciencias Médicas, Universidad de Santiago, Santago, Chile; Millennium Institute for Caregiving Research (MICARE), Santiago, Chile
| | - Julie Byles
- African Health and Aging Research Center (AHaARC), Winneba, Ghana; Center for Women's Health Research, Hunter Medical Research Institutes, The University of Newcastle, Callaghan, Australia
| | - Paul Kowal
- Center for Women's Health Research, Hunter Medical Research Institutes, The University of Newcastle, Callaghan, Australia
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Food insecurity and geriatric functional limitations: Observational analysis from the AgeHeaPsyWel–HeaSeeB Survey. Exp Gerontol 2022; 160:111707. [DOI: 10.1016/j.exger.2022.111707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/13/2022] [Indexed: 11/18/2022]
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The effect of physical and social isolation due to the COVID-19 pandemic on the incidence of hip fractures among senior citizens. Geriatr Nurs 2021; 43:21-25. [PMID: 34798310 PMCID: PMC8531412 DOI: 10.1016/j.gerinurse.2021.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 12/04/2022]
Abstract
This study aimed to explore the effects of the lockdown due to the coronavirus disease 2019 pandemic on the incidence and characteristics of hip fracture in older adults. Data from the three-month lockdown period and the corresponding period in the previous year were obtained from the computerized medical records of a large acute-care hospital. No significant differences were observed in the absolute and relative numbers of hip fractures. There were no significant differences in terms of socio-demographic and clinical characteristics, which are considered risk factors for falls. Similarly, there was no difference in the length of time between admission and surgery and the mean length of hospital stay. Compared to the previous year, there was a significantly higher incidence of hip fractures in older adults living alone during the lockdown. Health policy should provide social support and monitoring of healthcare, particularly to older adults living alone.
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Zhang H, Zhu M, Li Y, Zhang C, Bie Y, Liu H. Physical activity analysis for the elderly person in free-living conditions. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2021. [DOI: 10.3233/jifs-219159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A growing amount of people are beginning to monitor themselves with the rapid emergence of a wide variety of cost-effective personal sensing instruments. To measure different facets of personal life, innovation helps people better understand their lifestyles, enhance their work quality, or maximize various health factors, allowing free-living. Although vast amounts of raw information on the provisioning and physiological parameters have been obtained much more straightforward, making use of all the information remains a significant task. The article introduces the Physical Activity Analysis Framework (PAAF) for the Elderly Person in Free-Living Conditions. In the framework, the acceleration signals split into overlapped windows and derive information in each frame’s frequency domain. The framework’s sensors sense the activity and evaluate a profound learning structure dependent on each window’s progressive networks. The proposed IoT model has multiple layers separately connected with each sensor, and the critical element integrates the outputs of all sensors for the classification of physical activity. In longer cycles, the model combines the window decision with a substantial increase in its efficiency. The model in the research has been evaluated using labelled free-living pilot data. Eventually, discover the use of the proposed models from a broader lifestyle intervention analysis in unlabeled, free-living data. The results show that the proposed model performs well for both labelled and unlabeled data. The experimental analyses of an older person in living conditions with their daily activities to be monitored via IoT system as Meditation effect analysis ratio is 86.6%, Physical activity ratio is 87.12%, Physical disability ratio is 87.1%, Exercise satisfaction ratio is 85.05%, and Self-efficacy ratio is 93.5%.
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Affiliation(s)
- Hui Zhang
- Shenzhen University, Shenzhen, Guangdong, China
| | - Mingjiang Zhu
- North China University of Water Resources and Electric Power, Zhengzhou, Henan, China
| | - Yuanjing Li
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Chengyun Zhang
- Guangdong Engineering Polytechnic, Guangzhou, Guangdong, China
| | - Yejun Bie
- Guangdong Engineering Polytechnic, Guangzhou, Guangdong, China
| | - Haishan Liu
- Guangdong Engineering Polytechnic, Guangzhou, Guangdong, China
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