Activity In Older People Research Articles

High physical activity is associated with greater cortical bone size, better physical function, and with lower risk of incident fractures independently of clinical risk factors in older women from the SUPERB study.

The Physical Activity Scale for the Elderly (PASE) is a validated test to assess physical activity in older people. It has not been investigated if physical activity, according to PASE, is associated with fracture risk independently from the clinical risk factors (CRFs) in FRAX, bone mineral density (BMD), comorbidity, and if such an association is due to differences in physical performance or bone parameters. The purpose of this study was to evaluate if PASE score is associated with bone characteristics, physical function, and independently predicts incident fracture in 3014 75-80-yr-old women from the population-based cross-sectional SUPERB study. At baseline, participants answered questionnaires and underwent physical function tests, detailed bone phenotyping with DXA, and high-resolution peripheral quantitative CT. Incident fractures were X-ray verified. Cox regression models were used to assess the association between PASE score and incident fractures, with adjustments for CRFs, femoral neck (FN) BMD, and Charlson comorbidity index. Women were divided into quartiles according to PASE score. Quartile differences in bone parameters (1.56% for cortical volumetric BMD and 4.08% for cortical area, Q4 vs Q1, p = .007 and p = .022, respectively) were smaller than quartile differences in physical performance (27% shorter timed up and go test, 52% longer one leg standing time, Q4 vs Q1). During 8yr (median, range 0.20-9.9) of follow-up, 1077 women had any fracture, 806 a major osteoporotic fracture (MOF; spine, hip, forearm, humerus), and 236 a hip fracture. Women in Q4 vs. Q1 had 30% lower risk of any fracture, 32% lower risk of MOF, and 54% lower risk of hip fracture. These associations remained in fully adjusted models. In conclusion, high physical activity was associated with substantially better physical function and a lower risk of any fracture, MOF and hip fracture, independently of risk factors used in FRAX, FN BMD, and comorbidity.

Listen, talk, understand. Interpersonal communication in a senior project

Studies carried out around the world on the structure of human populations clearly indicate that modern society is “aging”. Demographic indicators show the dynamism of this process, and thus the trend of population ageing will intensify in the coming years. That is why the activation and activity of older people is so important, this is a condition for functioning in society, playing assigned social roles, meeting bio-psychosocial needs and, above all, communicating. Its absence can cause progressive disability, social isolation, loneliness. That is why activating senior projects aimed at increasing independence and counteracting the risk of social marginalization are so important in the lives of seniors. The aim of the research was to establish the factors that determine proper communication with the elderly people. The study involved 86 seniors, participants of the senior project entitled: "Passion - a recipe for eternal youth". A qualitative strategy was used to collect and analyze the data using partially categorized interviews. In order to supplement the information obtained during the interviews, an analysis of the documents held by the senior project organizer was carried out. The presentation of the results of the study was divided into three areas related to communication: listening, talking, understanding. In order to build effective interpersonal communication with seniors, it is important to understand individual experiences, specific needs, expectations and concerns. For seniors in the process of interpersonal communication important elements are: empathy, patience, commitment, as well as understanding their shortcomings related to the aging process. The openness of expressing desires and needs by seniors is fostered by appreciation and listening. In their family environment, they notice a deficit in the area of active listening, as well as the infantilization of the message addressed to them. They emphasize the very important importance of communication in their lives, and identify its lack with loneliness and isolation. They believe that the activity they undertake in the auditory, motor and cognitive spheres affects the slowing down of the aging process, as well as helps in communication. Taking into account the results of the study, it should be proposed to increase the awareness of people working in senior projects on the specifics of interpersonal communication with seniors through the organization of educational trainings in this area, which should be reflected in legal regulations.

Assessment of the Daily Living Activities of Older People (2004-2023): A Bibliometric and Visual Analysis.

With a rapidly aging global population, comprehending the risks associated with older people's activities of daily living is increasingly important; yet, interdisciplinary analyses remain rare. By providing a bibliometric overview of the capability risks associated with older people's activities of daily living, in order to identify prevailing trends and future directions in the field, the study aims to fill this gap. Using CiteSpace software to analyze data from 928 articles published between 2004 and 2023, the study results demonstrate the growing interest in the capability risks of older people's activities of daily living, with the United States leading in the number of publications, and geriatrics emerging as the dominant discipline. Notably, Institut National de la Sante et de la Recherche Medicale (Inserm) in France emerges as a pivotal contributor in the field. Key research topics encompass risk factors associated with a decline in daily activities and disease-related studies, with emerging trends in cognitive function and instrumental activity research. Future research should prioritize the development of predictive mechanisms for daily living trends, exploration of caregiving solutions, and promotion of interdisciplinary collaboration. This study highlights promising avenues for further research, emphasizing the importance of predictive modeling, innovative caregiving strategies, and interdisciplinary cooperation in addressing capability risks in the activities of daily living of older people.

Social activity in older people with visual impairment

Introduction. A potential factor that significantly reduces the social activity of older people is visual impairment due to various diseases. Visual impairment caused by cataract and diabetic retinopathy changes the social activity of people with the above-mentioned pathology, but it is extremely rarely analyzed by specialists and researchers, which does not allow identifying the limitations of patients in the social sphere and providing targeted medical and social care.
 The purpose of the study is to study social activity in older patients with diabetic retinopathy and cataract. 
 Materials and methods. According to a special questionnaire, one hundred fifteen 60–74 years patients suffered from cataract and diabetic retinopathy and 60–74 years 102 people without ophthalmic diseases were surveyed based on the S.N. Fedorov National medical research center «MNTK Eye Microsurgery», Tambov.
 Results. The average score of social activity in patients with cataract and diabetic retinopathy is statistically was found to be significantly lower, amounting to 3.10 ± 0.08 points versus 5.38 ± 0.09 points in people without ophthalmopathology. The main reasons that reduce social activity in patients with visual impairment are problems with making various purchases and using public or private transport. Factor analysis confirmed the contribution of these causes to the decline in social activity to be the highest and amounts to 0.876 and 0.708, respectively.
 Limitations. The study was carried out just in one territory, which makes it difficult to extrapolate data to other regions.
 Conclusion. It is recommended to increase social assistance to patients with cataract and diabetic retinopathy in solving problems of using transport and buying various goods.
 Limitations of the study. The study was carried out in one territory, which makes it difficult to extrapolate data to other regions.

Capabilities for Physical Activity in Older People: Development and Testing of a Measurement Tool

Based on Sen's capability approach, this study addresses the operationalization of capabilities for leading an active lifestyle. By assessing capabilities, processes of change can be mapped and the development of interventions to promote physical activity in different population groups, e. g., older adults, can be supported. However, no standardized German-language instrument for measuring physical activity-related capabilities is available to date. Building on an exploratory interview study (Sauter et al., 2019) that identified relevant physical activity-related capabilities in older adults, a standardized questionnaire with 41 items was designed. Two different question formulations were designed to query perceived capabilities for physical activity. The "think-aloud" method was conducted to validate the instrument. This involved recording all verbal comments made by participants while completing the questionnaire and conducting supplementary interviews for comprehensibility and applicability. The sample included 16 older adults (w=9, MW=66.3 years). Overall, respondents rated the instrument's usability and comprehensibility as good. For the questioning of perceived capabilities, the formulation "I have the possibility to..." was favored instead of "I perceive my personal opportunities as…". Difficulties in understanding and ambiguities were found in a few items. Thus, further changes were made to specify these questions with regard to unclear terms such as "walking paths". The questionnaire seems to be suitable to asses perceived capabilities for leading an active lifestyle in older adults. The final questionnaire is available in English and in German. Further research is needed to test the applicability of the instrument in other population groups and verify objectivity, reliability and validity.

Program Evaluation and Refinement of the "Safe Functional Home Exercise" Program for Improving Physical Activity in Older People with Dementia Who Receive Home Care.

People with dementia who receive home care have low levels of physical activity participation. To evaluate and refine a co-designed exercise program for home care clients with dementia, led by trained care support workers. An action research cycle whereby support workers, clients and carers (each n = 26) from the "Safe Functional Home Exercise" feasibility study were invited to complete an evaluation survey. Participants rated statements using Likert-style scales on (1) staff training, (2) staff confidence, (3) program support and (4) satisfaction. The participants could provide comments for situations that affected exercise performance, suggested improvements for staff training, program support and exercises. The co-design panel (original program designers) was reconvened to refine the exercise program. Support workers (n = 19), clients (n = 15) and carers (n = 13) returned their surveys. Support workers (74-90%), carers (77-92%) and clients (100%) rated program support positively and were overall satisfied. Support workers (>80%) agreed that the training course was relevant and were confident in delivering the exercises to clients. Situations included "Covid isolation", the client's "poor medical condition" and "mood fluctuations" that made exercising difficult. Improvements included "making a client video" and "providing tips to motivate clients". The co-design panel modified the exercise program. The "Safe Functional Home Exercise" program is the first exercise program co-designed for people with dementia. It is well accepted by support workers, people with dementia and carers. Utilising support workers to facilitate physical activity participation is potentially low-cost and scalable in home care. Future studies are needed to evaluate the refined program in home care.

O.1.2-9 Sex-related differences in free-living estimates of physical activity energy expenditure between older men and women

Abstract Purpose Physical activity is often quantified as physical activity energy expenditure (PAEE), which may be affected by individual ability to sustain physical activity intensity. We examined if there is a true difference in physical activity between older women and men when their physical capacity is considered. Methods Out of the population-based sample of 1021 (75-85-year-old) adults (62 % women), 410 wore an accelerometer (100 Hz) and a single-channel ECG monitor (250 Hz) for at least 3 days in free-living. A treadmill walk calibration and previously validated equations were used to estimate PAEE from combined acceleration and heart rate sensing using branched equation modelling. Preferred walking speed in a six-minute walking test, fat free mass (FFM) using bioimpedance and isometric maximal leg extension strength scaled to FFM were measured. Independent t-test, Pearson correlation and hierarchical multiple regression were used for statistical analyses. Results PAEE was 41.4 (14.2) kJ/kg/day for men, which was significantly higher (p < 0.001) than the PAEE 34.8 (10.9) for women. Walking speed (1.2 (0.2) vs. 1.1 (0.2) m/s), FFM (56.9 (6.5) vs. 42.1 (4.8) kg) and maximal strength (7.4 (1.8) vs. 6.7 (1.8) N/kg) were higher in men than in women (all p < 0.001). PAEE was significantly associated with walking speed (r = 0.44, p < 0.001), FFM (r = 0.26, p < 0.001), and maximal strength (r = 0.26, p < 0.001). In the regression analysis, 22 % of the variation in PAEE was explained by walking speed, FFM and maximal strength combined (F = 37.8, p < 0.001), whereas adding sex did not improve the model (F = 28.9, p < 0.001). The strongest predictor of PAEE was preferred walking speed (standardized beta=0.35, p < 0.001). Conclusions The results indicate that the observed difference in physical activity volume between sexes was largely explained by physical characteristics, especially the faster preferred walking speed of men compared to women. Free-living physical activity is largely comprised of habitual walking especially in older people which makes walking speed a significant contributor of daily PAEE. Walking speed could be measured more widely in physical activity counselling and health care settings as a potential underlying factor of low physical activity in older people. Support/Funding Sources European Research Council, Academy of Finland and Yrjö Jahnsson Foundation.

A Scalable Program for Improving Physical Activity in Older People with Dementia Including Culturally and Linguistically Diverse (CALD) Groups Who Receive Home Support: A Feasibility Study.

Home care clients with dementia/cognitive impairment are typically functionally dependent and physically inactive. We pilot-tested a co-designed physical exercise program for its feasibility, safety, adherence and potential for benefits on physical activity, physical function, healthcare use and falls. Trained community care support workers delivered a 12-week home exercise program to clients with dementia/cognitive impairment, once weekly for 15 min during care shifts, supplemented by carers' supervision of exercises for 30 min, three times weekly. A physiotherapist provided fortnightly phone support to ensure safety and exercise progression. Baseline and Week 12 assessments using validated scales for physical activity, physical function, daily living independence, falls efficacy, quality of life, self-reported healthcare use, falls and sleep quality were undertaken. Differences were examined with regression analyses. Care support workers (n = 26) and client/carer dyads (n = 26 and 80.8% culturally and linguistically diverse) participated. Participants recorded adverse events/falls and exercises in dairies. Fifteen dyads completed the program. No falls/adverse events occurred with the exercises. The adherence rates against targets for exercise time completed and days in which exercise were undertaken for support workers were 137%/79.6%, and for client/carer dyads were 82%/104.8%, respectively. Physical activity participation, physical function and falls efficacy significantly improved at Week 12 compared to baseline. The feasibility, safety and adherence of the co-designed physical exercise program were demonstrated. Strategies to minimise dropouts in future effectiveness studies are required.

Evaluation of the optimal cutoff number of types of social participation activities in older people

Social participation activities have a close association with health aging. However, the clinical significance of numbers of social participation activities and its cutoff value has not been defined. We recruited 516 people aged ≥55 years. Twelve social participation behaviors modified according to Taiwanese culture were investigated, and the adequacy of cutoff number was determined by the area under the receiver operating characteristic curve (AUC) according to the results of cluster analysis of individual activities and scores of the Brief Symptom Rating Scale-5 (BSRS-5) and the Chinese Happiness Inventory (CHI). Demographic, BSRS-5 and CHI data were then compared according to the candidate cutoff numbers. The distribution of the numbers of social activities suggested that the highest partition of numbers of social activities was 3 in women and 4 in men. The AUC regarding the cluster of activity types was 0.917, with the highest Youden's J value located between 3 and 4. The AUC regarding the cluster of activity types and scores of the BSRS-5 and the CHI was 0.929, with similar cutoffs. If 3 and 4 were used as cutoffs, the between-group differences of both the CHI and the BSRS-5 were significant. More types of social activities had a different engaging frequency with the 3 and 4 cutoffs. Our findings found an adequate cutoff with better differential power in the psychopathology and happiness of older people that provided a basis for application in intervention and policy formation.

Physical fitness according to the level of physical activity in older people: a cross-sectional analysis

Resumo Introdução O envelhecimento é marcado por alterações fisiológicas e diminuição do tempo em atividade física (AF). Tais aspectos podem repercutir no declínio da funcionalidade e propiciar maior probabilidade para eventos adversos. Objetivo Comparar o desempenho em testes de aptidão física de pessoa idosas suficiente e insuficientemente ativas. Métodos Estudo epidemiológico populacional, transversal, realizado com 209 pessoas idosas (58,40% mulheres) de Aiquara/BA. As informações sociodemográficas foram obtidas a partir de entrevistas. A aptidão física foi mensurada por meio dos seguintes testes: força de preensão manual; levantar e sentar da cadeira; flexão do antebraço; levantar, caminhar 2,44 m e sentar; sentar e alcançar o pé; e marcha estacionária. O nível de atividade física foi averiguado pelo International Physical Activity Questionnaire (< 150 min/sem em AF = insuficientemente ativo). As comparações foram feitas por meio dos testes t de Student ou U de Mann-Whitney, conforme a distribuição de normalidade averiguada pelo teste de Kolmogorov-Smirnov (p ≤ 0,05). Resultados A prevalência do nível de AF insuficiente foi de 51,70% (homens: 66,66%; mulheres: 40,98%). Verificou-se, em ambos os sexos, que os insuficientemente ativos demonstraram menor desempenho na força de preensão manual; sentar e levantar da cadeira; flexão do antebraço; levantar, caminhar e sentar; e marcha estacionária (p < 0,05). Além do mais, os homens insuficientemente ativos apresentaram menor desempenho no teste sentar e alcançar o pé em relação aos suficientemente ativos (p < 0,05). Conclusão Identificou-se que os idosos insuficientemente ativos, de ambos os sexos, apresentaram menor força/resistência muscular, equilíbrio dinâmico/agilidade e resistência cardiorrespiratória. Ademais, os homens insuficientemente ativos demonstraram menor flexibilidade do que os suficientemente ativos.

Advising older people on physical activity: challenges and strategies.

Appropriate physical activity has more benefits than risks for older people. Increased physical activity enhances older people's mental and physical well-being and can contribute to reduced morbidity and early mortality. Nurses have an important role in advising older people on the level of physical activity that is right for them. Based on the national requirements for physical activity in older people, nurses can tailor their advice to each individual, address the person's concerns about potential risks and emphasise the likely benefits of them becoming more physically active. This article explains the role of nurses in promoting and encouraging physical activity in older people. It describes the historical background of this area of health promotion, considers the challenges nurses experience and discusses the strategies they can use when advising older people on physical activity.

Designing and applying technology for prevention-Lessons learned in AEQUIPA and its implications for future research and practice.

Almost all Western societies are facing the challenge that their population structure is changing very dynamically. Already in 2019, ten countries had a population share of at least 20 percent in the age group of 64 years and older. Today's society aims to improve population health and help older people live active and independent lives by developing, establishing, and promoting safe and effective interventions. Modern technological approaches offer tremendous opportunities but pose challenges when preventing functional decline. As part of the AEQUIPA Prevention Research Network, the use of technology to promote physical activity in older people over 65 years of age was investigated in different settings and from various interdisciplinary perspectives, including technology development and evaluation for older adults. We present our findings in three main areas: (a) design processes for developing technology interventions, (b) older adults as a user group, and (c) implications for the use of technology in interventions. We find that cross-cutting issues such as time and project management, supervision of participants, ethics, and interdisciplinary collaboration are of vital importance to the success of the work. The lessons learned are discussed based on the experiences gained in the overall AEQUIPA network while building, particularly on the experiences from the AEQUIPA sub-projects TECHNOLOGY and PROMOTE. Our experiences can help researchers of all disciplines, industries, and practices design, study and implement novel technology-based interventions for older adults to avoid pitfalls and create compelling and meaningful solutions.

Novel Stacking Classification and Prediction Algorithm Based Ambient Assisted Living for Elderly

Recognition of human activity is a significant area of research with numerous uses. In developed countries, the rising age of citizens requires the improvement of the medical service structure, which raises the price of resources, both financial and human. In that sense, ambient assisted living (AAL) is a relatively novel information and communication technology (ICT) that presents services and recognizes various products that enable older people and the disabled to live autonomously and improve their quality of life. It further assists in reducing the cost of hospital services. In the AAL environment, various sensors and devices are fixed to gather a broad range of data. Moreover, AAL will be the motivating technology for the latest care models by acting as an adjunct. This will become thought-provoking research in a fast-growing world, but exploring different ADL and self-classification will become a major challenge. This paper proposed a Novel Stacking Classification and Prediction (NSCP) algorithm based AAL for the elderly with Multi-strategy Combination based Feature Selection (MCFS) and Novel Clustering Aggregation (NCA) algorithms. This paper’s main aim is to recognize the activity of older people, such as standing, walking, sitting, falling, cramps, and running. The dataset is derived from the Kaggle repository, which refers to data collection from wearable IoT devices. The experimental outcomes demonstrate that the MCFS, NCA, and NSCP algorithms work more efficiently than existing feature selection, clustering, and classification algorithms, respectively, regarding the accuracy, sensitivity, specificity, precision, recall, F-measure, and execution time dataset size and the number of features. Furthermore, the NSCP algorithm provided high accuracy, precision, recall, and F-measure are 98%, 0.96, 0.95, and 0.98, respectively.

Prevalence and incidence of sarcopenia and low physical activity among community-dwelling older Thai people: a preliminary prospective cohort study 2-year follow-up.

BackgroundSarcopenia, defined as a loss of muscle mass, has become a major health problem in older people. Few prospective studies report the incidence and risk of sarcopenia. Therefore, this study aimed to explore the prevalence of sarcopenia at the baseline and follow-up after 2 years in community-dwelling older Thai individuals.MethodsIn 2019, 330 older people were recruited from a community-dwelling population, and these participants were requested to present again in 2021. Sarcopenia was diagnosed using the criteria for the Asia Working Group for Sarcopenia (AWGS). All participants were asked to perform a 6-meter walk test, handgrip strength test, and bioelectric impedance assessment, and complete the Global Physical Activity Questionnaire.ResultsThe study found that the prevalence of sarcopenia was 65 (19.70%) in 330 older people in 2019, and 44 of 205 participants (21.46%) were reported to have sarcopenia after 2 years. The incidence of sarcopenia was noted to be 2.44% in 2021. Analysis with ANOVA and pairwise comparisons showed that the reversibility of sarcopenia was attributed to high level of physical activity in the 2-year follow-up group (p = 0.014, 95% CI [−1753.25–−195.49]). Further, participants with moderate and high physical activity had a reduced incidence of sarcopenia (odds ratio = 9.00 and 14.47, respectively). Therefore, low physical activity in older people led to the development of sarcopenia from the baseline to the 2-year follow-up, indicating that increased physical activity may be useful in reversing sarcopenia, as suggested in the 2-year follow-up study. Low physical activity could be a risk factor for the incidence of sarcopenia. Hence, the prevention of sarcopenia could promote health improvement through moderate to high physical activity.

The effects of social isolation due to COVID-19 on the fear of movement, falling, and physical activity in older people.

ObjectiveThis study investigates the interaction between fear of movement, fall risk, and physical activity levels in ageing individuals who experienced social isolation during the COVID‐19 pandemic.MethodsIn this descriptive and cross‐sectional study, 254 eligible participants used an online background survey. Individuals’ fear of movement was evaluated by the kinesiophobia causes scale, fall risk by the falls efficacy scale, and physical activity levels by the physical activity scale for the ageing.ResultsThe fear of movement had a significant positive interaction on fall risk (β = 0.471, R 2 = 0.495, p < 0.001). The fall risk had a negative effect on physical activity (β = −1.686, R 2 = 0.161, p < 0.001). The fear of movement and fall risk explained 15.6% of the change in physical activity levels of ageing individuals (p < 0.001).ConclusionsThese results showed a significant interaction between physical activity levels and fear of movement, with a high fall risk in ageing individuals during the pandemic period.

The Relationship Between Concerns About Falling and Daily Life Activity in Older Men and Women.

Concerns about falling (CAF) affect daily life activities in older people; however, it is unclear whether gender moderates this relationship. The authors investigated the cross-sectional relationship between CAF and objectively measured physical activity (PA) and gait quality in 503 community-dwelling older men and women. About 448 people (age = 76.2 [SD 7.9] years, 296 females) contributed sufficient data on movement intensity, activity duration (bouts of walking, sitting, and standing), number of transitions between activities (sit-to-stand and sit-to-walk), number of steps and gait quality, quantified as walking speed, and sample entropy. Associations with the Iconographical Falls Efficacy Scale were tested. The authors found no significant moderation by gender. However, women participated in less PA than men and showed a more irregular walking pattern. Higher levels of CAF led to lower PA and poorer gait quality. Our findings suggest that prevention of CAF-related PA avoidance may be particularly important for women, who are less active and at higher risk of falls.

Promoting exercise in older people to support healthy ageing.

As people in the UK continue to live longer, the concept of healthy ageing has become increasingly important. Regular exercise that is appropriate for the ability of each individual can have several benefits for older people, such as slowing the loss of muscle mass, increasing aerobic capacity, maintaining cognitive function and improving health-related quality of life. This article explores the benefits of various forms of exercise and physical activity in older people, and offers practical advice that can assist nurses in supporting a person-centred approach to this aspect of care.

DNA methylation is associated with muscle loss in community-dwelling older men -the Yakumo study- : a preliminary experimental study.

ABSTRACTFrailty is a state of reduced muscle strength and activity in older people. DNA methylation is associated with osteoporosis and muscle loss in murine and other animal studies, but there are no epidemiological studies in humans. This study aimed to assess the association of osteoporosis and muscle loss with DNA methylation in community-dwelling older people. This cross-sectional study was performed in a rural part of Japan. We analyzed 204 subjects (98 men and 106 women). In univariate analysis, the two groups were compared according to the presence or absence of osteoporosis and of muscle loss. Logistic regression analysis was performed to determine predictors of frailty in the muscle loss group. We used age, sex, body mass index, smoking history, drinking history, serum albumin and C-reactive protein levels, diabetes, hypertension, hyperlipidemia, heart disease history, and LINE-1 DNA methylation as the factors. Probability values < 0.05 were considered to be statistically significant. The levels of LINE-1 DNA methylation in leukocytes were associated with muscle loss in men over the age of 60. LINE-1 DNA methylation levels were not associated with bone mineral density in either the men or women over the age of 60. LINE-1 DNA methylation levels in leukocytes correlated significantly with the risk of frailty in men over the age of 60. Promoting an understanding of DNA methylation may lead to a better understanding of the pathophysiology of muscle loss.

To see, meet and adapt \u2013 an interview study about physiotherapists\u2019 pedagogical approach to dementia

BackgroundPhysiotherapists need to use pedagogical approaches and strategies in their work. However, there is no previous definition of what a pedagogical approach in physiotherapy means neither in general nor specifically to dementia. The purpose of this study was therefore to gain greater insight into physiotherapists’ pedagogical approach to dementia by investigating physiotherapists’ views and working methods in contact with older people with dementia, relatives, and nursing staff in elderly care.MethodsThis was a qualitative study with an inductive approach. Semi-structured individual interviews were conducted with 15 physiotherapists with experience of working with older people with dementia in elderly care. The interviews were analyzed with qualitative content analysis.ResultsThe term “pedagogical approach” could sometimes be experienced as “vague” or “hard to grasp”. Our research nonetheless identified one overarching theme To see, meet and adapt which is based on insights from the interviews grouped in to five categories. This theme can be seen as an expression of the physiotherapists’ pedagogical approach in contact with older people with dementia, relatives, and nursing staff. It captures the participants’ desire to always see the person in front of them, meet them where they are and adapt their own way of working accordingly. Creating a trusting relationship was described as important and made it easier for the participants to adapt their working methods. The participants’ adaptations could apply to the way they communicated with people with dementia, and how they organized tutoring/education of relatives and nursing staff to maximize learning. Learning through experience and reflection was described as a key to advancing the pedagogical approach and the participants experienced their own learning as constantly ongoing.ConclusionsThis study provides increased understanding into physiotherapists’ pedagogical approach in contact with older people with dementia, relatives, and nursing staff in elderly care and shows that learning through experience and reflection can contribute to the development of the pedagogical approach. Thus, opportunity for reflection should be accommodated in the physiotherapists’ work. The importance of more pedagogical education for physiotherapists both in bachelor and master level were also highlighted. Increasing mobility and physical activity in older people with dementia is important since physical inactivity and sedentary behavior is common. Future research may be directed at further exploring physiotherapists’ pedagogical approach in tutoring/education of nursing staff, with the aim of increasing physical activity among older people with dementia.

Meta-Analysis: Effectiveness of Web-Based Intervention to Increase Physical Activity in Older People

Background: The increasing global population of older people and the trend of life expectancy make the discussion of physical activity an urgent urgency, given its role in preventing various non-communicable diseases and increasing life expectancy. Web-based intervention is believed to be an intervention that can change habits related to physical activity in older people. This study aimed to find out whether web-based intervention is effective in increasing physical activity for older people. Subjects and Method: This research is a meta-analysis based on the PRISMA flow diagram. The article search process is carried out through journal databases, in the form of: Google Scholar, PubMed, and ResearchGate. Keywords to search for articles are: "Aged" OR "older adult" OR "elderly" AND "Exercise" OR "exercise" OR "physical activity" OR "physical activities" OR "physical exercise" OR " physical exercises" OR "physical fitness" AND "Internet-Based Intervention" OR "internet-based interventions" OR "web-based interventions" OR "web-based interventions" OR "online interventions" OR “internet intervention” OR “mobile health” OR “mhealth” OR “tele­health” OR “ehealth” AND “randomized control trials” OR “randomized control trials” OR “RCT”. The articles included are study design randomized control trial (RCT), articles with research subjects older people aged 50 years and over, and the intervention used is web-based intervention. Articles that meet the criteria are then analyzed using the Revman 5.3 application. Results: A total of 9 articles were found from the Netherlands, Spain, England, Belgium, and Sweden. The data collected showed that web-based intervention increase physical activity in older people, and it was statistically significant (SMD= 0.78; 95% CI=0.15 to 1.41; p= 0.020). Conclusion: Web-based intervention is effective for increasing physical activity for older people who are more than 50 years old. Keywords: web-based intervention, physical activity, older people, meta analysis. Correspondence: Gina Fazrina. Study Program of Physiotherapy, School of Health Sciences Cirebon. Jl. Brigjen Dharsono No. 12B ByPass Cirebon 45153, West Java, Indonesia. Email: ginafazrina@gmail.com. Mobile: +681212533833. Journal of Health Promotion and Behavior, (2022), 07(01): 55-66 DOI: https://doi.org/10.26911/thejhpb.2021.07.01.06