Exercise in Aging: Be Balanced

Exploring physical activity experiences of community-dwelling oldest-old adults with chronic multimorbidity: A qualitative study

AIM

To explore the physical activity experiences of community-dwelling oldest-old adults with chronic multimorbidity.

DESIGN

Descriptive qualitative study.

METHOD

Data collection was conducted through semi-structured interviews with 19 community-dwelling oldest-old adults with chronic multimorbidity. The study was conducted between December 2022 and May 2023. ATLAS.ti software was used for data analysis.

RESULTS

Three main themes with their respective sub-themes and units of meaning were developed from the data analysis: (1) motivational factors for engaging in physical activity; (2) fear of getting hurt during physical activity and (3) confidence in being physically active.

CONCLUSION

Motivation, kinesiophobia and confidence are three core elements that influence the experience of physical activity in oldest-old adults with chronic multimorbidity. Interventions tailored to meet the needs of the oldest-old adults are important for promotion and development of active ageing.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Nurses and other healthcare professionals should design, implement and evaluate interventions that aim to increase oldest-old adults' motivation and confidence, while decreasing their fear to engage in physical activity.

IMPACT

This study provides insights into the way community-dwelling oldest-old adults with chronic multimorbidity experience physical activity in their daily lives. Our findings suggest that motivation, kinesiophobia and confidence are key factors for oldest-old adults to engage in physical activity. These findings could contribute to the design and implementation of interventions that specifically aim at raising the physical activity levels of community-dwelling oldest-old adults with chronic multimorbidity.

REPORTING METHOD

The study findings are reported according to the COREQ guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Effects of brisk walking with or without music on body composition, standing balance, cardiovascular parameters, and salivary biomarkers in older women

This study aimed to assess and compare changes in body composition, standing balance, cardiovascular parameters, and salivary biomarkers, particularly salivary antioxidant status, after brisk walking training with or without music in older women. Twenty-four subjects were randomly assigned to brisk walking groups: with music (BWM) (n=12) or without music (BW) (n=12). Eighteen subjects completed the exercise training (9 in each group), and their data were used for analysis. The research protocols were classified into three phases: pretraining phase, training phase, and posttraining phase, while the data collection was divided into four sessions: resting condition, during treadmill exercise testing, immediately posttreadmill exercise testing, and 5-min posttreadmill exercise testing defined as after the cool-down session. The results showed that 8 weeks of home-based brisk walking with or without music did not improve standing balance, blood pressure, salivary biomarkers including total protein concentration, and antioxidant status but maintained or prevented the decline of these parameters. Only the BWM group reduced fat mass relative to increasing fat-free mass (P<0.05) and improved recovery heart rate (P<0.05) by modifying cardiac autonomic control in posttreadmill exercise testing. Therefore, brisk walking with preferred music can be a tool to delay the progression of cardiovascular dysfunction in older women. A longer duration of the exercise program and larger groups of participants are needed for further investigation of brisk walking with or without music on physiological and biochemical changes.

Exergames improve cognitive function in older adults and their possible mechanisms: A systematic review

Objective

The degree of aging in China is deepening, leading to cognitive decline and seriously affecting the health status of the elderly. This article explores the benefits of exergames in improving cognitive function in older adults through a literature review, with aim of contributing to the development of healthy aging.

Methods

Using PubMed, Web of Science, CNKI, dimensional spectrum, search for research papers from 2005 to April 2023 by using keywords such as a somatosensory game, cognitive function, execute function, working memory, aged and suppression control. PEDro Scale was used to check the quality of the literature.

Results

A total of 16 papers were included in the review. Exergames improve the executive function of the elderly and support the relationship between exergames and cognitive performance in older adults. From a mechanistic perspective, somatosensory play promotes signal transduction of brain neurotrophin, thereby protecting the structure and function of neurons in specific brain regions and delays the decline of executive function in older adults as much as possible.

Conclusions

It is recommended to use exergames as an intervention measure for the physical and mental health preservation of older adults. Suggest adopting personalised exergames in the future to explore the impact of cognitive and physical functions in elderly people, as well as measurable changes in brain structure.

The effect of exercise intensity types on the self-rated health status of young-old comorbidities patients: a cross-sectional study in Guangdong, China

Objective

Explore the effect of different types of exercise intensity on the self-rated health status of young-old comorbid patients with cardiovascular disease and metabolic disease, as well as the differences in effect among different genders. Provide more references and suggestions for chronic disease management in older comorbidities patients based on the results of the study.

Methods

A multi-stage stratified cluster random sampling method was used to select older (≥60 years old) comorbidities patients from communities in Guangdong Province as the survey subjects. Using the "Survey Questionnaire on the Current Status and Influencing Factors of older Comorbidities Patients," face-to-face interviews were conducted with 1,300 old patients. Data from 965 young-old patients (aged 60-74) who simultaneously suffered from cardiovascular and metabolic diseases were selected. Unordered multifactor Logistic regression analysis was used to explore the association between the type of exercise intensity and self-rated health. Stratified analysis was performed based on gender.

Results

The results of unordered multivariate logistic regression analysis showed that compared with young-old comorbidities patients with poor self-rated of health status, young-old comorbidities patients who underwent vigorous-intensity exercise were more likely to have better self-rated of health status (OR = 4.368, 95% CI: 2.491-7.661, p < 0.05). Stratified analysis based on gender showed that for young-old comorbidities male patients, those who engaged in vigorous-intensity exercise were more likely to have better self-rated of health status (OR = 2.924, 95% CI = 1.266-6.751, p < 0.05); for young-old comorbidities female patients, those who were encouraged by their family to exercise (OR = 2.460, 95% CI: 1.143-5.291, p < 0.05), participate in social activities (OR = 6.173, 95% CI: 2.285-16.678, p < 0.05), and engage in vigorous-intensity (OR = 4.232, 95% CI: 1.869-9.583, p < 0.05) or moderate-intensity exercise (OR = 4.555, 95% CI: 1.825-11.368, p < 0.05) were more likely to have better self-rated of health status.

Conclusion

If the physical condition allows, vigorous-intensity exercise has a significant positive effect on the self-rated of health status of young-old comorbidities patients with cardiovascular disease and metabolic disease. Specifically, for young-old comorbidities male patients, those who engage in vigorous-intensity exercise are more likely to self-evaluate their health as good; for young-old comorbidities female patients, both vigorous-intensity and moderate-intensity exercise can improve their self-rated of health status.

Is Dance Closer to Physical Activity or Spirituality? A Philosophical Exploration

Dancing is inevitably associated with kinesthetics of the body, including movements, gestures, poses, jumps, turnings, transferring body weight, etcetera. Thus, dance is a manifestation of an amateur or the skilled behavior of a fully trained athletic performance. At the same time, dance is accompanied by emotions as an effect of expression, narration of choreography. Dance is also pre-planned and designed to produce numerous styles and techniques. It is a unique type of improvisation. However, in certain situations, styles and techniques that will be discussed below, the dancing body can bring the dancer closer to his/her emotionality and even spirituality. Thus, the aim of this philosophical exploration is to analyze the impact of spirituality on dance performance.

Relationship between functional limitations due to subjective cognitive decline and falling focusing exercise intensity: Results from the Korean Community Health Survey

Background

To explore the association between functional limitation due to subjective cognitive decline (SCD) and falling by focusing on exercise intensity in the Korean population aged 45 years and older.

Study Design

The 2019 Korean Community Health Survey (KCHS) was used to analyze 35,387 people by applying individual weights imposed from the raw data.

Methods

To analyze the association between functional limitation due to SCD and falling in the Korean population aged 45 years and older, weighted logistic regression analysis and weighted zero-inflated Poisson regression analysis were used.

Results

In both the middle-aged group and the older adult group, the functional limitation due to SCD had a higher fall experience rate and more falls than the non-functional limitation due to SCD group. Additionally, the middle-aged group and the moderate or vigorous physical exercise (MVPE) group had a higher fall experience rate and number of falls than the non-MVPE group; however, the older adult group walking regularly and performing MVPE had a lower fall experience rate and number of falls than the non-exercise group.

Conclusions

Active participation in exercise is encouraged and should lead to fewer falls in older adults. Furthermore, a group with functional limitations due to SCD should be provided with exercise guidelines and a community program and facilities that enable regular participation should be developed.

Leg Fidgeting Improves Executive Function following Prolonged Sitting with a Typical Western Meal: A Randomized, Controlled Cross-Over Trial

Prolonged uninterrupted sitting and a typical Western meal, high in fat and refined sugar, can additively impair cognitive and cerebrovascular functions. However, it is unknown whether interrupting these behaviours, with a simple desk-based activity, can attenuate the impairment. The aim of this study was to determine whether regular leg fidgeting can off-set the detrimental effects of prolonged sitting following the consumption of a typical Western meal, on executive and cerebrovascular function. Using a randomized cross-over design, 13 healthy males consumed a Western meal and completed 180-min of prolonged sitting with leg fidgeting of 1 min on/4 min off (intervention [INT]) and without (control [CON]). Cognitive function was assessed pre and post sitting using the Trail Maker Test (TMT) parts A and B. Common carotid artery (CCA) blood flow, as an index of brain flow, was measured pre and post, and cerebral (FP1) perfusion was measured continuously. For TMT B the CON trial significantly increased (worsened) completion time (mean difference [MD] = 5.2 s, d = 0.38), the number of errors (MD = 3.33, d = 0.68) and cognitive fatigue (MD = 0.73, d = 0.92). Compared to CON, the INT trial significantly improved completion time (MD = 2.3 s, d = 0.97), and prevented declines in cognitive fatigue and a reduction in the number of errors. No significant changes in cerebral perfusion or CCA blood flow were found. Leg fidgeting for 1-min on/4-min off following a meal high in fats and refined sugars attenuated the impairment in executive function. This attenuation in executive function may not be caused by alterations in CCA blood flow or cerebral perfusion.

The Effects of Physical Running on Dendritic Spines and Amyloid-beta Pathology in 3xTg-AD Male Mice

Memory loss is the key symptom of Alzheimer's disease (AD). As successful drug treatments have not yet been identified, non-pharmaceutical interventions such as physical exercise and training have been employed to improve the memory function of people with dementia. We investigated the effect of prolonged physical running on hippocampal-dependent spatial memory and its underlying mechanisms using a well-established rodent model of AD. 3xTg-AD transgenic mice and non-transgenic mice were subjected to voluntary wheel running for 5 months (1 hour per day, 5 days per week), followed by spatial memory testing. After the behavioral testing, dendritic spines, synapses, and synaptic proteins as well as amyloid-beta (Aβ) pathology were analyzed in the dorsal hippocampi. Running improved hippocampal-dependent spatial memory in 3xTg-AD mice. This running strategy prevented both thin and mushroom-type spines on CA1 pyramidal cells in 3xTg-AD mice, whereas the effects of running in non-transgenic mice were limited to thin spines. The enormous effects of running on spines were accompanied by an increased number of synapses and upregulated expression of synaptic proteins. Notably, running downregulated the processing of amyloid precursor protein, decreasing intracellular APP expression and extracellular Aβ accumulation, and spatial memory performance correlated with levels of Aβ peptides Aβ_1-40 and Aβ_1-42. These data suggest that prolonged running may improve memory in preclinical AD via slowing down the amyloid pathology and preventing the loss of synaptic contacts.