Activity In Sedentary Older Adults Research Articles

Supporting physical activity for mobility in older adults with mobility limitations (SuPA Mobility): study protocol for a randomized controlled trial

BackgroundLimited mobility in older adults consistently predicts both morbidity and mortality. As individuals age, the rates of mobility disability increase from 1.0% in people aged 15–24 to 20.6% in adults over 65 years of age. Physical activity can effectively improve mobility in older adults, yet many older adults do not engage in sufficient physical activity. Evidence shows that increasing physical activity by 50 min of moderate intensity physical activity in sedentary older adults with mobility limitations can improve mobility and reduce the incidence of mobility disability. To maximize the healthy life span of older adults, it is necessary to find effective and efficient interventions that can be delivered widely to prevent mobility limitations, increase physical activity participation, and improve quality of life in older adults. We propose a randomized controlled trial to assess the effect of a physical activity health coaching intervention on mobility in older adults with mobility limitations.MethodsThis randomized controlled trial among 290 (145 per group) community-dwelling older adults with mobility limitations, aged 70–89 years old, will compare the effect of a physical activity health coaching intervention versus a general healthy aging education program on mobility, as assessed with the Short Physical Performance Battery. The physical activity health coaching intervention will be delivered by exercise individuals who are trained in Brief Action Planning. The coaches will use evidence-based behavior change techniques including goal-setting, action planning, self-monitoring, and feedback to improve participation in physical activity by a known dose of 50 min per week. There will be a total of 9 health coaching or education sessions delivered over 26 weeks with a subsequent 26-week follow-up period, wherein both groups will receive the same duration and frequency of study visits and activities.DiscussionThe consequences of limited mobility pose a significant burden on the quality of life of older adults. Our trial is novel in that it investigates implementing a dose of physical activity that is known to improve mobility in older adults utilizing a health coaching intervention.Trial registrationClinicalTrials.gov Protocol Registration System: NCT05978336; registered on 28 July 2023.

Feasibility of combining noninvasive brain stimulation and personalized counseling to increase physical activity

Few older adults meet recommended physical activity guidelines. Behavioral interventions may be more effective when combined with other modalities to promote activity. Transcranial direct current stimulation (tDCS) designed to increase the excitability of the left dorsolateral prefrontal cortex (dlPFC) — a brain region subserving motivation and executive function — has the potential to augment behavioral interventions. We designed a randomized, double-blinded trial to examine the feasibility of combining personalized behavioral counseling and tDCS targeting the left dlPFC to improve physical activity and related outcomes in sedentary older adults living within the supportive housing. Participants wore a Fit-Bit throughout the study period. Baseline step counts were determined for two weeks, then participants completed four bi-weekly personalized counseling sessions over eight weeks. They were also randomized to receive 10 sessions of tDCS or sham stimulation over the two weeks after the baseline. Physical, cognitive, and patient-reported outcomes were assessed at baseline, after ten brain stimulation sessions, and after four behavioral sessions. 33 individuals were screened and 16 enrolled (age=80±7, 13 females). 13 participants completed the study, including 100% of study assessments, 99±5% of brain stimulation sessions, and 98±7% of behavioral sessions. Fit-Bit adherence rate was 93±13%. Daily step counts were 3197±1480 at baseline and 4722±2553 over the last two weeks of the intervention. While the study is ongoing and blinded, these preliminary results indicate that it is feasible to conduct a controlled study of tDCS combined with personalized behavioral counseling to increase physical activity in sedentary older adults living within supportive housing.

The Daily Activity Study of Health (DASH): A pilot randomized controlled trial to enhance physical activity in sedentary older adults

Sedentary behavior increases the risk for multiple chronic diseases, early mortality, and accelerated cognitive decline in older adults. Interventions to reduce sedentary behavior among older adults are needed to improve health outcomes and reduce the burden on healthcare systems. We designed a randomized controlled trial that uses a self-affirmation manipulation and gain-framed health messaging to effectively reduce sedentary behavior in older adults. This message-based intervention lasts 6 weeks, recruiting 80 healthy but sedentary older adults from the community, between the ages of 60 and 95 years. Participants are randomly assigned to one of two groups: 1) an intervention group, which receives self-affirmation followed by gain-framed health messages daily or 2) a control group, which receives daily loss-framed health messages only. Objective physical activity engagement is measured by accelerometers. Accelerometers are deployed a week before, during, and the last week of intervention to examine potential changes in sedentary time and physical activity engagement. Participants undertake structural and functional (resting and task-based) MRI scans, neuropsychological tests, computerized behavioral measures, and neurobehavioral inventories at baseline and after the intervention. A 3-month follow-up assesses the long-term maintenance of any engendered behaviors from the intervention period. This study will assess the effectiveness of a novel behavioral intervention at reducing sedentarism in older adults and examine the neurobehavioral mechanisms underlying any such changes.

A nurse-led intervention to promote physical activity in sedentary older adults with cardiovascular risk factors: a randomized clinical trial (STEP-IT-UP study).

Regular physical activity should constitute the essence of treatment in patients with cardiovascular risk factors. We sought to determine the benefits of nurse-led intervention to promote physical activity in sedentary older adults in a primary care setting. A group of 199 sedentary older adults (mean age 62.7±6.9, 34.2% male) with at least one more cardiovascular risk factor were randomized 1:1 to receive a nurse-led tutorial on lifestyle modification, including pedometer hand-out - with a daily goal of at least 7000 steps - and supporting phone calls (study group), or without a goal or calls (control group). Body weight (BW), resting heart rate, systolic and diastolic blood pressure (SBP/DBP), total cholesterol (TC) and glucose were assessed at baseline and after 3 months. Subjects in the study group (n = 86) achieved higher daily step count in comparison to the control group (n = 78), 10,648±3098 vs. 3589±2000, p < 0.0001. The study group presented an improvement in all analysed parameters but glucose, including BW (-2.5±1.9 kg), SBP and DBP (-7.9±7.6 mmHg and -6.2±6.5 mmHg) and TC (-14.7±30.4 mg%), all p < 0.0001. In the control group, all parameters increased or remained unchanged. An inverse correlation between the daily step count and delta of the analysed parameters (r = -0.26 to -0.72, p < 0.001) was found. Nurse-led intervention with pedometer, goal setting and supporting phone calls is an effective way to promote physical activity in sedentary older adults and leads to improvement of cardiovascular risk factors within 3 months.

"I Just Roll Over, Pick Myself Up, and Carry On!" Exploring the Fall-Risk Experience of Canadian Masters Athletes.

The risk of falling increases in adults aged 65 years and older. A common barrier to take up physical activity in sedentary older adults is the fear of falls and injury. Experiences of master athletes can provide insights into management of the risk of falling. The purpose of this phenomenological study was to explore the fall-risk experience of masters athletes actively competing in sport. Masters athletes aged 55 years and older (N = 22) described their experiences in semistructured interviews. Data were analyzed through an interpretive-constructivist paradigm using inductive content analysis. Five dominant themes emerged: acceptance, learning, awareness, resilience, and self-fulfillment. Participants of this study reported an acceptance of the risk they take in sport for falls and injuries in their pursuits for self-fulfillment. Findings indicate that master athletes accept the risk for falls and injuries in sport, find ways to adapt, and continue to compete because it is self-fulfilling. Sharing their experiences might inspire other older adults to get active as a rewarding means of remaining independent.

P 083 - The effect of a bespoke home based physical activity intervention on markers of oxidative stress and markers of general health in older adults

Home-based unsupervised exercise training has been shown to improve health in older adults. Assessing adherence, especially using a self-report format, in unsupervised exercise interventions is problematic. The aim of this pilot study was to objectively assess the effect of an unsupervised home-based exercise intervention in community dwelling older adults. Markers of oxidative stress and measures of health were assessed, including cerebral hemodynamics and cognitive function. Physical activity was measured continuously using a wrist watch type accelerometer with optical heart rate monitoring. A secondary aim of the study was to test the feasibility of a wrist activity monitor as a tool to assess physical activity in this population. The intervention failed to increase the level of physical activity in all the participants, although changes were observed. No significant changes were observed in markers of oxidative stress or other measures of health in response to the exercise intervention. Progressive goals, based on adherence measurement, are potentially important for the success of an unsupervised exercise intervention. Wrist-based accelerometers may be useful tools for the assessment of physical activity in sedentary older adults, but further development of specialist software may be necessary.

Descriptive and narrative reports of barriers and motivators to physical activity in sedentary older adults

Objectives We sought a richer understanding of the determinants and complexities of physical activity (PA) behavior by examining how early life experiences and beliefs were manifested over time to determine PA behavior in late life. Method We interviewed 23 inactive older adults regarding past and current attitudes and beliefs regarding PA in a two-study format. Study 1 participants responded to a semi-structured interview and data were analyzed inductively for emergent themes. Study 2 participants responded to an unstructured, narrative set of three interviews and data were analyzed using narrative analytical techniques. Results Study 1 descriptively confirmed previously reported barriers and motivators and shed light on how experiences across the lifespan may affect current perceptions. Study 2 extended these findings by demonstrating how beliefs and experiences formed at a young age were manifested over time to determine current behaviors and attitudes. Conclusion Implications include how the findings presented and the narrative method itself can be used to inform contemporary theoretical perspectives and promote PA behavior in older adults.

Pilot Test of an Attribution Retraining Intervention to Raise Walking Levels in Sedentary Older Adults

To pilot test a new behavioral intervention to increase walking in sedentary older adults. Pre-post community-based pilot study. Three senior centers in greater Los Angeles. Forty-six sedentary adults aged 65 and older. At four weekly 1-hour group sessions held at the senior centers, a trained health educator applied a theoretically grounded, standardized "attribution retraining" curriculum developed by a multidisciplinary team of investigators. Participants were taught that becoming sedentary is not inevitable with aging and that older adults should attribute being sedentary to modifiable attributes rather than to old age. A 1-hour exercise class including strength, endurance, and flexibility training followed each weekly attribution retraining session. Change from baseline in steps per week recorded using a digital pedometer was measured after 7 weeks. Age expectations (measured using the Expectations Regarding Aging-38 survey, a previously tested instrument on which higher scores indicate that the participant expects high functioning with aging and lower scores indicate that the participant expects physical and mental decline) and health-related quality of life were measured using in-person interviews. Mean steps per week increased from 24,749 to 30,707, a 24% increase-equivalent to 2.5 miles (2-sided t-test P=.002). Age expectation scores increased 30% (P<.001), and the changes in age expectations and steps per week correlated (correlation coefficient=0.39, P=.01). Participants experienced improved mental health-related quality of life (P=.049) and reported less difficulty with activities of daily living (P=.04). More than 50% of participants reported improvements in pain, energy level, and sleep quality. In this small pre-post community-based pilot study, a structured attribution retraining curriculum accompanied by a weekly exercise class was associated with increased walking levels and improved quality of life in sedentary older adults. Attribution retraining deserves further investigation as a potential means of increasing physical activity in sedentary older adults.

Effectiveness of Telephone Counseling on Physical Activity in Sedentary Older Adults

Effectiveness of Telephone Counseling on Physical Activity in Sedentary Older Adults

Groningen Active Living Model (GALM): stimulating physical activity in sedentary older adults; validation of the behavioral change model

Background A significant proportion of older adults in The Netherlands do not participate regularly in leisure-time physical activity. The Groningen Active Living Model (GALM) was developed to change this situation for the better. Longitudinal results of the validation of the GALM behavioral change model are presented. Methods We obtained data on potentially mediating variables of physical activity behavior change (self-efficacy, social support, perceived fitness, and enjoyment) from 96 participants in a prospective study during the 18 months the GALM strategy lasted. Results Prospective analyses revealed significant differences in several potentially mediating variables, although some of these differences were contrary to our hypothesis. Discriminant analysis resulted in canonical correlations of 0.50 after 6 months and 0.66 after 18 months of program participation between adherers and nonadherers, respectively; 73.8 and 80.0% of the subjects were classified correctly. Conclusions Based on the results, it can be concluded that we partially succeeded in manipulating the potentially mediating variables by means of our GALM strategy. Several mediating variables were identified that reliably discriminated long-term adherers from nonadherers, expanding the generalizability of social cognitive theory-driven variables to a Dutch population.

Groningen Active Living Model (GALM): Stimulating Physical Activity in Sedentary Older Adults; First Results

Background. A significant proportion of older adults in The Netherlands does not regularly participate in leisure-time physical activity. The Groningen Active Living Model (GALM) was developed to change this situation for the better. In this article the first results with respect to the validation of the model are presented.Methods. We obtained cross-sectional data from a sample of 392 potential participants. Scores on the potentially causal variables (self-efficacy, social support, perceived fitness, and enjoyment) and the stages of change give a first indication of the potential validity of the GALM behavioral change model.Results. Seventeen percent of the subjects could be categorized as in the precontemplation stage, 42% in the contemplation/eparation stage, and 39% in the action/maintenance stage. Data with respect to stages of change were missing for 2% of the subjects. Scores on all potentially causal variables rose significantly from the precontemplation to the action/maintenance stage. Discriminant analysis resulted in a canonical correlation of 0.58 between the precontemplation and the contemplation/paration stages and 0.59 between the contemplation/preparation and action/maintenance stages; respectively, 82.6 and 78.3% of the subjects had been classified correctly.Conclusions. The results found in this study support our hypothesis, as described in the conceptual theory of the GALM behavioral change model. For a more comprehensive validation of the model's action theory and conceptual theory, follow-up measurements are required.

Groningen Active Living Model (GALM): Stimulating Physical Activity in Sedentary Older Adults

Background. A significant number of Dutch older adults can be considered sedentary when it comes to regular participation in leisure-time physical activity. Sedentariness is considered a potential public health burden—all the more reason to develop a strategy for stimulating older adults toward becoming more involved in leisure-time physical activity. The Groningen Active Living Model (GALM) is a behavioral change strategy for stimulating participation in leisure-time physical activity.Methods. The GALM strategy is based on a process model of behavioral change in which behavioral change is seen as a multidimensional and dynamic process. The strategy has three phases: recruitment, introduction, and follow-up, and lasts 18 months.Results. Preliminary results indicate that, up until the summer of 1998, about 4000 older adults were participating in 76 local GALM projects. Further research will be done to assess the validity of the model and its effects on the leisure-time physical activity pattern, ADL performance, and health in newly active older adults.Conclusions. The GALM strategy is a feasible strategy for stimulating leisure-time physical activity participation on a large-scale basis. The strategy is being implemented in The Netherlands on a nationwide basis.