Activity Intervention For Older Adults Research Articles

\u201cIt makes me feel not so alone\u201d: features of the Choose to Move physical activity intervention that reduce loneliness in older adults

BackgroundDespite the well-known health benefits of physical activity (PA), older adults are the least active citizens. Older adults are also at risk for loneliness. Given that lonely individuals are at risk for accelerated loss of physical functioning and health with age, PA interventions that aim to enhance social connectedness may decrease loneliness and increase long-term PA participation. The objectives of this mixed-method study are to: (1) evaluate whether an evidence-based PA intervention (Choose to Move; CTM) influenced PA and loneliness differently among self-identified ‘lonely’ versus ‘not lonely’ older adults and (2) to describe factors within CTM components most likely to promote social connectedness/reduce loneliness.MethodsCTM is a flexible, scalable, community-based health promoting physical activity intervention for older adults. Two community delivery partner organizations delivered 56 CTM programs in 26 urban locations across British Columbia. We collected survey data from participants (n = 458 at baseline) at 0 (baseline), 3 (mid-intervention) and 6 (post-intervention) months. We conducted in depth interviews with a subset of older adults to understand how CTM facilitated or impeded their PA and social connectedness.ResultsPA increased significantly from baseline to 3 months in lonely and not lonely participants. PA decreased significantly from 3 to 6 months in lonely participants; however, PA at 6 months remained significantly above baseline levels in both groups. Loneliness decreased significantly from baseline to 3 and 6 months in participants identifying as lonely at baseline. Factors within CTM components that promote social connectedness/reduce loneliness include: Activity coach characteristics/personality traits and approaches; opportunity to share information and experiences and learn from others; engagement with others who share similar/familiar experiences; increased opportunity for meaningful interaction; and accountability.ConclusionHealth promoting interventions that focus on PA and social connectedness through group-based activities can effectively reduce social isolation and loneliness of older adults. Given the ‘epidemic of loneliness’ that plagues many countries currently, these kinds of interventions are timely and important. Research that further delineates mechanisms (e.g., sharing experiences vs. lectures), that modify the effect of an intervention on social connectedness outcomes for older adults engaged in community-based PA programs would be a welcome addition to the literature.

Therapeutic Alliance and Its Potential Application to Physical Activity Interventions for Older Adults: A Narrative Review.

Increasing the physical activity (PA) levels of inactive older adults to promote healthy aging and to reduce preventable health conditions is a public health priority. However, there remains uncertainty on what constitutes the most important components and characteristics of effective PA interventions for older adults, and previous research has largely focused on the cognitive and behavioral strategies they adopt to increase uptake and adherence to PA. This narrative review puts forward the novel idea, with supporting evidence, that the strength, quality, and collaborative nature of the professional-client relationship, a concept drawn from the field of psychotherapy and known as therapeutic alliance, may be a vital and foundational element of effective PA interventions. This article will offer a new understanding, and a new direction of research to aid the future conceptualization, design, and development of interventions that aim to increase the PA levels of older adults.

Perspectives of older adults with chronic disease on the use of wearable technology and video games for physical activity.

BackgroundThere is increasing interest in technology to deliver physical rehabilitation and allow clinicians to monitor progress. Examples include wearable activity trackers and active video games (AVGs), where physical activity is required to play the game. However, few studies have explored what may influence the effectiveness of these as technology-based physical activity interventions in older adults with chronic diseases.ObjectiveThis study aimed to explore: 1) perceptions about wearable physical activity trackers; 2) perceptions about using technology to share physical activity information with clinicians; 3) barriers and motivators to playing games, including AVGs for rehabilitation.MethodsQualitative study based on semi-structured interviews with older adults (n = 19) with chronic obstructive pulmonary disease (COPD).ResultsWearable activity trackers were perceived as useful to quantify activity, facilitate goal-setting, visualize long-term improvements and provide reminders. Participants generally wished to share data with their clinicians to gain greater accountability, receive useful feedback and improve the quality of clinical care. Participants were motivated to play games (including AVGs) by seeking fun, social interaction and health benefits. Some felt that AVGs were of no benefit or were too difficult. Competition was both a motivator and a barrier.ConclusionsThe findings of the present study seek to inform the design of technology to encourage physical activity in older adults with chronic diseases.

Relationships Among Types of Activity Engagement and Sleep Quality Among Older Adults

There is increasing awareness that lack of activity engagement is associated with poor sleep quality. However, the majority of studies have focused on the effect of a single type of activity engagement on sleep quality. Little is known about the combined effect of multiple types of activity engagement on sleep quality. The aim of this study is to identify relationships among different types of activity engagement and sleep quality among older adults. This study is a secondary data analysis using the Health and Retirement Study data. The participants included 3,357 persons who were age 65 or older and who responded to survey modules on activity engagement and sleep quality in 2016. Before we conducted primary analysis, factor analyses and calculating coefficient omega were conducted to identify factor structure, construct validity and reliability of the activity engagement questionnaire. Then, regression was conducted to examine the relationships among multiple types of activity engagement and sleep quality after adjusting for covariates based on the senescent sleep model. Exploratory and confirmatory factor analysis showed the 14-item questionnaire was comprised of three factors; social, cognitive, and physical activity and the three-factor model showed adequate validity and reliability. In the regression model social (β=0.25, p=0.033) and cognitive (β=0.36, p=0.001) activity engagement were positively related to better sleep quality. Based on these results, future research is needed to identify the mechanisms in which social and cognitive activities influence sleep quality positively and to develop targeted activity interventions for older adults.

Community-based intervention effects on older adults' physical activity and falls: Protocol and rationale for a randomized optimization trial (Ready Steady3.0)

The Ready Steady 3.0 trial is designed to test the main and interactive effects of two behavior change intervention components, within an 8-week physical activity intervention, on older adults' physical activity (PA). Each component is comprised of behavior change strategies that emphasize two different evidence-based ways to motivate older adults to be active: interpersonal and intrapersonal. 308 adults ≥70 years old will be randomized to 1 of 4 conditions in a 2 × 2 full factorial trial in which the two factors represent the receipt (No, Yes) of interpersonal or intrapersonal behavior change strategies. Participants will also receive two core intervention components: the Otago Exercise Program adapted for small groups and a PA monitor. Interventions across conditions will be delivered during 8 weekly, small group, meetings in community settings. The primary outcome of PA, measured objectively, and secondary outcomes of falls and the quality of life will be assessed at baseline and post-intervention: 1 week, 6 months, and 12 months. Findings will enable the identification of behavior change content that contributes to physical activity outcomes within a physical activity intervention for older adults. This study is one of the first to use the MOST framework to guide the development of a community-based physical activity intervention for older adults to reduce the public health problems of low PA and falls. The results will enable the optimization of behavior change content within a PA intervention for older adults and, in turn, other PA interventions for older adults.

Facilitators and challenges in delivering a peer-support physical activity intervention for older adults: a qualitative study with multiple stakeholders

BackgroundInvolving peer volunteers in intervention delivery can provide social support and improve adherence. Whilst such interventions have the potential to reduce physical activity (PA) intervention costs, little is known about the process of delivering them in practice. This qualitative study explored the facilitators and challenges of delivering a peer-support PA intervention for older adults, with a view to making recommendations for the delivery of future interventions.MethodsData were collected via (7) semi-structured interviews and a focus group with stakeholders involved in a peer-support PA intervention for older adults in a large city in the North-West of England. Participants included local authority staff (n = 3), peer volunteers (n = 2) and service users (n = 7). Audio data were transcribed verbatim and thematically coded to identify perceived facilitators and challenges.ResultsFacilitators to delivery included social interaction, community referral pathways, suitable facilities, peer volunteers and high-quality instructors. Challenges surrounded inconsistent practice, staff capacity, safety and accountability, and awareness raising.ConclusionsPeer volunteers can provide an additional support mechanism alongside qualified instructors for increasing social interaction within PA interventions. For optimal intervention delivery, consideration needs to be given to equipment and space, safety and accountability and consistency of practice.

Self-organizing peer coach groups to increase daily physical activity in community dwelling older adults.

Many older adults do not reach the recommended level of physical activity, despite many professional-delivered physical activity interventions. Here we study the implementation of a novel physical activity intervention for older adults that is self-sustainable (no financial support) and self-organizing (participants act as organizers) due to peer coaching. We implemented three groups and evaluated process and effect using participatory observations, questionnaires, six-minute walk tests and body composition measures from October 2016 to September 2018. The intervention was implemented by staff without experience in physical activity interventions. Facilitators were a motivated initiator and a non-professional atmosphere for participants to take ownership. Barriers were the absence of motivated participants to take ownership and insufficient participants to ensure the presence of participants at every exercise session. The groups exercised outside five days a week and were self-organizing after 114, 216 and 263 days. The initial investments were 170€ for sport equipment and 81–187 h. The groups reached 118 members and a retention of 86.4% in two years. The groups continue to exist at the time of writing and are self-sustainable. Quality of life increased 0.4 on a ten-point scale (95%CI 0.1–0.7; p = 0.02) and six-minute walk test results improved with 33 m (95%CI 18–48; p < 0.01) annually. Self-organizing peer coach groups for physical activity are feasible, have positive effects on health and require only a small investment at the start. It is a sustainable and potentially scalable intervention that could be a promising method to help many older adults age healthier.

Evaluation of a Blended Physical Activity Intervention for Older Adults: Mixed Methods Study.

BackgroundPhysical activity can prolong the ability of older adults to live independently. Home-based exercises can help achieve the recommended physical activity levels. A blended intervention was developed to support older adults in performing home-based exercises. A tablet and a personal coach were provided to facilitate the self-regulation of exercise behavior.ObjectiveIn line with the Medical Research Council framework, this study aimed to carry out process evaluation of a blended intervention. The objectives were (1) to assess the long-term usability of the tablet adopted in the blended intervention and (2) to explore how the tablet, in conjunction with a personal coach, supported older adults in performing home-based exercises.MethodsThe process evaluation was conducted with a mixed-methods approach. At baseline, older adults participating in the blended intervention were asked to fill out a questionnaire about their general experience with information and communication technology (ICT) devices and rate their own skill level. After 6 months, participants filled out the Usefulness, Satisfaction, and Ease of use (USE) questionnaire to assess the usefulness, satisfaction, and ease of use of the tablet. With a random selection of participants, in-depth interviews were held to explore how the tablet and coach supported the self-regulation. The interviews were double coded and analyzed with the directed content analysis method.ResultsAt baseline, 29% (65/224) of participants who started the intervention (mean age 72 years) filled out the ICT survey and 36% (37/103) of participants who used the tablet for 6 months (mean age 71 years) filled out the USE questionnaire. Furthermore, with 17% (18/103) of participants (mean age 73 years), follow-up interviews were held. The results of the baseline questionnaire showed that the large majority of participants already had experience with a tablet, used it regularly, and reported being skillful in operating ICT devices. After 6 months of use, the participants rated the usefulness, satisfaction, and ease of use of the tablet on average as 3.8, 4.2, and 4.1, respectively, on a 5-point scale. The analysis of the interviews showed that the participants felt that the tablet supported action planning, behavior execution, and self-monitoring. On the other hand, especially during the first few months, the personal coach added value during the goal setting, behavior execution, and evaluation phases of self-regulation.ConclusionsThe results of the process evaluation showed that older adults who participated in the study were positive about the blended intervention that was designed to support them in performing home-based exercises. Participants reported that the tablet helped them to perform the exercises better, more frequently, and safely. It supported them in various phases of self-regulation. The availability of a personal coach was nevertheless crucial. To support physical activity in older adults, a blended approach is promising.

The Impact of Physical Activities on Cognitive Performance among Healthy Older Individuals.

The population is aging in developed countries. This aging process results in many changes, both physical and mental. Over the years, there has been a gradual decline in the level of cognitive functions closely related to the ageing process, which is most often connected with ageing diseases such as dementia. So far, pharmacological treatment has not yet been able to cure this neurological disorder. Health policies around the world seek to find alternative programs and strategies to help a healthy population prevent cognitive decline and prolong active life. One such strategy appears to be physical activity. The aim of this review is to discuss the impact of physical activity on cognitive performance among healthy older individuals. The methodology of this study is based on a systematic electronic literature search of available studies found in three databases: PubMed, Web of Science and Scopus. The findings suggest that any physical activity in older age seems to have a positive impact on the improvement of cognitive function. Furthermore, it appears that dancing, due to its multiple mechanisms, might have the biggest effect on the enhancement of cognitive performance in healthy older individuals. However, controlled clinical trials of physical activity intervention in older adults are rare. Therefore, further research in this area (particularly on the amount of physical activity, its intensity and type) is needed.

Feasibility and behavioral effects of prolonged static and dynamic standing as compared to sitting in older adults with type 2 diabetes mellitus

BackgroundPhysical inactivity is prevalent in older adults with type 2 diabetes mellitus (T2DM) and may exacerbate their clinical symptoms. The aim of this study was to examine the feasibility of 4-h regular versus more dynamic standing sessions while performing routine desktop activities as a non-exercise physical activity intervention in older adults with T2DM to increase non-exercise activity.MethodsTwelve older adult patients with T2DM (3 female; age 71 ± 4 years; Body mass index 34 ± 5 kg/m2) completed three sessions (baseline sitting followed by “static” or “dynamic” desktop standing sessions). Participants stood behind a regular height-adjustable desk in the “static” standing session. An upright dynamic standing desk, which provides cues to make small weight-shifting movements, was used for the “dynamic” standing session. Oxygen consumption, cognitive performance, as well as net standing duration, total movement activity, and musculoskeletal discomfort were assessed during all three sessions.ResultsAll participants were able to complete all sessions. Oxygen consumption and overall movements progressively increased from sitting to static and dynamic standing, respectively (p < 0.001). The duration of breaks during standing (p = 0.024) and rate of total musculoskeletal discomfort development (p = 0.043) were lower in the dynamic standing compared to static standing sessions. There was no evidence of executive cognitive worsening during either standing session compared to sitting.ConclusionsProlonged 4-h standing as a simple non-exercise physical intervention is feasible in older adults with T2DM and may have metabolic (oxygen consumption) benefits. Increasing movement during desktop standing may offer incremental benefits compared to regular standing. Prolonged desktop standing might provide an effective intervention in T2DM older participants to target sedentariness.Trial registrationClinicalTrials.gov (NCT04410055), retrospectively registered May 27, 2020.

The Long-Term Benefits of a Multicomponent Physical Activity Program to Body Composition, Muscle Strength, Cardiorespiratory Capacity, and Bone Mineral Density in a Group of Nonagenarians

Promotion of physical activity among older adults is considered to be one of the main actions that can result in more successful aging. Currently, there are few studies focusing on the effects of long-duration physical activity interventions in older adults. This study examined the effects of an 8-month multicomponent intervention on cardiorespiratory capacity (6-minute walking test), body composition (body-mass index), muscle strength (handgrip and knee extension), and bone mineral density (femoral neck) in a group of nonagenarians. A secondary aim was to determine the impact of the program according to the participant's way of life (institutionalized vs. community dwelling). A total of 14 institutionalized nonagenarians (years: 93.1 ± 1.6; female: 100%) and 16 community-dwelling nonagenarians (years: 93.1 ± 1.6; female: 75%) participated in this study. Our analysis suggested that the multicomponent program significantly improved the levels of strength in handgrip and leg extension in all participants. Intergroup analysis showed that the changes experienced were greater in community-dwelling people. Improvements in the cardiorespiratory capacity of older adults-more distance walked in 6 minutes-who were living in the nursing home (mean distance traveled: 238.5 ± 96.0 vs. 250.7 ± 99.0 m) were observed. Our findings found that an 8-month, multicomponent intervention program results in significant improvements in the levels of strength (handgrip and knee extension) in nonagenarians. This effect is greater in community-dwelling people.

Pilot study of a telehealth perioperative physical activity intervention for older adults with cancer and their caregivers.

Older adults undergoing cancer surgery are at greater risk for poor postoperative outcomes. Caregivers also endure significant burden. Participation in perioperative physical activity may improve physical functioning and enhance overall well-being for both patients and caregivers. In this study, we assessed the feasibility of a personalized telehealth intervention to enhance physical activity for older (≥ 65years) gastrointestinal (GI) and lung cancer surgery patients/caregivers. Participants completed four telehealth sessions with physical therapy/occupational therapy (PT/OT) before surgery and up to 2weeks post-discharge. Outcomes included preop geriatric assessment, functional measures, and validated measures for symptoms and psychological distress. Pre/post-intervention trends/trajectories for outcomes were explored. Thirty-four patient/caregiver dyads (16, GI; 18, lung) were included. Accrual rate was 76% over 8months; retention rate was 88% over 2months. Median for postop of a 6-min walk test, timed up and go, and short physical performance battery test scores improved from baseline to postop. Participant satisfaction scores were high. Our conceptually based, personalized, multimodal, telehealth perioperative physical activity intervention for older patient/caregiver dyads is feasible and acceptable. It offers an opportunity to improve postoperative outcomes by promoting functional recovery through telehealth, behavior change, and self-monitoring approaches. ClinicalTrials.gov Identifier: NCT03267524.

Examining Potential Psychosocial Mediators in a Physical Activity Intervention for Older Adults.

The purpose of this study was to examine psychosocial constructs targeted as potential mediators in a prior physical activity (PA) intervention study. This secondary analysis used data from 102 older adults randomized to one of four conditions-within a 2 (Interpersonal Strategies: yes, no) x 2 (Intrapersonal Strategies: yes, no) factorial design. We tested intervention effects on social support, self-efficacy, self-regulation, and goal attainment, and whether these constructs mediated intervention effects on PA. Participants who received interventions with interpersonal strategies, compared to those who did not, increased their readiness (post-intervention), the self-regulation subscale of self-assessment, and goal attainment (post-intervention, 6-months). Participants who received interventions with intrapersonal strategies, compared to those who did not, increased their social support from family (post-intervention). There was no statistically significant mediation. To understand mechanisms through which interventions increase older adults' PA and to improve intervention effectiveness, researchers should continue to examine potential psychosocial mediators.Clinical Trial Registry: NCT02433249.

A Web-Based and Print-Delivered Computer-Tailored Physical Activity Intervention for Older Adults: Pretest-Posttest Intervention Study Comparing Delivery Mode Preference and Attrition.

BackgroundWeb-based interventions can play an important role in promoting physical activity (PA) behavior among older adults. Although the effectiveness of these interventions is promising, they are often characterized by low reach and high attrition, which considerably hampers their potential impact on public health.ObjectiveThe aim of this study was to identify the participant characteristics associated with the preference for a Web-based or a printed delivery mode and to determine whether an association exists between delivery modes or participant characteristics and attrition in an intervention. This knowledge may enhance implementation, sustainability of participation, and effectiveness of future interventions for older adults.MethodsA real-life pretest-posttest intervention study was performed (N=409) among community-living single adults who were older than 65 years, with physical impairments caused by chronic diseases. Measurements were taken at baseline and 3 months after the start of the intervention. Hierarchical logistic regression was used to assess demographic and behavioral characteristics (age, gender, body mass index, educational attainment, degree of loneliness, and PA level), as well as psychosocial characteristics (social support for PA, modeling, self-efficacy, attitude, and intention) related to delivery mode preference at baseline and attrition after 3 months.ResultsThe printed delivery mode achieved higher participation (58.9%, 241/409) than the Web-based delivery mode (41.1%, 168/409). Participation in the Web-based delivery mode was associated with younger age (B=–0.10; SE 0.02; Exp (B)=0.91; P<.001) and higher levels of social support for PA (B=0.38; SE 0.14; Exp (B)=1.46; P=.01); attrition was associated with participation in the Web-based delivery mode (B=1.28; SE 0.28; Exp (B)=3.58; P<.001) and low educational attainment (B=–0.53; SE 0.28; Exp (B)=0.59; P=.049).ConclusionsA total of 41% of the participants chose the Web-based delivery mode, thus demonstrating a potential interest of single older adults with physical impairments in Web-based delivered interventions. However, attrition was demonstrated to be higher in the Web-based delivery mode, and lower educational attainment was found to be a predictor for attrition. Characteristics predicting a preference for the printed delivery mode included being older and receiving less social support. Although Web-based delivery modes are generally less expensive and easier to distribute, it may be advisable to offer a printed delivery mode alongside a Web-based delivery mode to prevent exclusion of a large part of the target population.Trial RegistrationNetherlands Trial Register NTR2297; https://www.trialregister.nl/trial/2173International Registered Report Identifier (IRRID)RR2-DOI: 10.2196/resprot.8093

Aging With Multiple Sclerosis

This review discusses research on physical and cognitive function, physical activity behavior, and physical activity interventions in older adults with multiple sclerosis (MS). Research indicates that older adults with MS demonstrate reduced physical and cognitive function as well as physical activity compared with healthy older adults. Preliminary evidence suggests that levels and patterns of physical activity are associated with physical function and possibly cognition, and physical activity interventions can improve physical function in older adults with MS. Additional research is warranted that further clarifies the value and role of physical activity in managing the functional consequences of aging with MS.

Barriers and facilitators of adherence to a perioperative physical activity intervention for older adults with cancer and their family caregivers

PurposePerioperative physical activity behavior change in older adults with cancer is complex. Identifying the barriers and facilitators to physical activity before and after surgery can help predict adherence and optimize outcomes. We aimed to determine the barriers and facilitators of adherence to a perioperative physical activity intervention in older adults with lung and gastrointestinal (GI) cancers and their family caregivers (FCGs). MethodsA qualitative analysis of physical therapy/occupational therapy (PT/OT) baseline geriatric/functional assessment and intervention sessions notes were undertaken (N = 34 dyads). Written text documents (N = 6 independent PT/OT notes per dyad) were transcribed into a spreadsheet for coding and thematic analysis. Content analysis qualitative approach was used to identify themes and guide data interpretation. ResultsTen themes for barriers and five themes for facilitators emerged, reflecting barriers to and facilitators of perioperative physical activity adherence. Primary barriers to adherence included comorbid health conditions, physical symptoms, functional limitations, anxiety, other roles and responsibilities, unexpected life events, lack of time and motivation, not accustomed to physical activity, and environment/weather. Facilitators that enabled intervention adherence included physical activity as part of routine, coping strategies, setting goals for motivation, social/family support, and experiencing benefits from walking. ConclusionsBarriers and facilitators to a perioperative physical activity is multidimensional, and focused on social-ecological determinants of health behaviors, including intrapersonal, interpersonal, and environmental factors. Perioperative physical activity interventions for older adults with cancer and their FCGs should integrate strategies to promote self-efficacy, support realistic activity goals, enhance motivation, and optimize social support.

Effectiveness of Web-based physical activity interventions for older adults: A systematic review of randomized controlled trials

Physical activity (PA) plays an important role in healthy aging among older adults. Web-based interventions may present a novel and accessible way to promote PA in older adults. This study systematically explored the effectiveness of web-based interventions designed to promote PA in older adults. A systematic search of published and unpublished literature using PubMed, ProQuest, and ProQuest Dissertations and Theses identified 10 qualifying studies. From these, we identified three methods of web-based delivery for PA intervention in older adult populations: (a) online assessment; (b) PA online materials; and (c) tailored messages. Seven of the10 studies also reported significant changes in PA levels between the intervention and control groups over their respective study periods. Results also indicated that individually tailoring web-based interventions may increase the effectiveness of the intervention. Results of this systematic review will help practitioners develop more effective web-based interventions targeting PA among older adults.

Peer-Based Strategies to Support Physical Activity Interventions for Older Adults: A Typology, Conceptual Framework, and Practice Guidelines.

Despite the documented and well-publicized health and well-being benefits of regular physical activity (PA), low rates of participation have persisted among American older adults. Peer-based intervention strategies may be an important component of PA interventions, yet there is inconsistent and overlapping terminology and a lack of clear frameworks to provide a general understanding of what peer-based programs are exactly and what they aim to accomplish in the current gerontological, health promotion literature. Therefore, a group of researchers from the Boston Roybal Center for Active Lifestyle Interventions (RALI) collaborated on this paper with the goals to: (a) propose a typology of peer-based intervention strategies for use in the PA promotion literature and a variety of modifiable design characteristics, (b) situate peer-based strategies within a broader conceptual framework, and (c) provide practice guidelines for designing, implementing, and reporting peer-based PA programs with older adults. We advance clarity and a common terminology and highlight key decision points that offer guidance for researchers and practitioners in using peers in their health promotions efforts, and anticipate that it will facilitate appropriate selection, application, and reporting of relevant approaches in future research and implementation work.

Changes In Cortical Gray Matter Following A 12-month Physical Activity Intervention In Older Adults

Changes In Cortical Gray Matter Following A 12-month Physical Activity Intervention In Older Adults

Effects of a Group-based Physical Activity Intervention in Older Adults

Effects of a Group-based Physical Activity Intervention in Older Adults