Community-dwelling Adults Research Articles

Cardiac Biomarkers and Malnutrition Incidence in Community-Dwelling Older Adults without Cardiovascular Disease: The Seniors-ENRICA-2 Cohort.

Given the close relationship between cardiovascular disease (CVD) and malnutrition, we examined whether higher concentrations of high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP), which indicate CVD risk in the general population, were prospectively associated with malnutrition incidence in community-dwelling older adults without CVD. We used data from 1490 individuals ≥65 years from the Seniors-ENRICA-2 cohort followed up for 2.2 years. Malnutrition was evaluated by the screening Mini Nutritional Assessment-Short Form (MNA-SF) score, which consists of a short questionnaire, and a complete nutritional assessment according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Associations were summarized with odds ratios (OR) and their 95% confidence interval (CI), obtained from logistic regression and adjusted for the main confounders. NT-proBNP was associated with higher malnutrition incidence assessed by the MNA-SF score and the GLIM criteria, with OR (95% CI) of 1.51 (1.09-2.09) and 1.43 (1.04-1.96) per one logarithmic-unit increment, respectively. Malnutrition incidence according to the GLIM criteria was also higher in participants who had elevated NT-proBNP (heart stress age-specific rule-in cutoffs) vs those who did not, with OR (95% CI) of 1.84 (1.05-3.22). hs-cTnT was not associated with higher malnutrition incidence. In this cohort of older adults without CVD, NT-proBNP was associated with higher malnutrition incidence. Further research is needed to validate our findings, uncover the underlying biological mechanisms, and assess whether preventive interventions can reduce NT-proBNP concentrations and, consequently, reduce the risk of malnutrition.

Translation, cross-cultural adaptation and validation of the composite physical function scale in Chinese community-dwelling older adults

PurposeTo translate, cross-culturally adapt and validate the Composite Physical Function (CPF) scale in Chinese community-dwelling older adults.MethodsThe Chinese version of the CPF (C-CPF) was constructed by following Brislin’s guidelines. A cross-sectional study was conducted to evaluate the measurement properties of the C-CPF in 477 eligible older adults. Factor analysis, hypotheses testing, internal consistency and test-retest were performed to evaluate the validity and reliability of the C-CPF.ResultsThe C-CPF was consistent with the original version, which consisted of a single dimension with 12 items. It had a Cronbach’s alpha coefficient of 0.901, fold-half reliability of 0.831 and test–retest reliability of 0.994. Structural validity was determined through exploratory factor analysis for a single-factor structure explained 75.391% of the total variance. Confirmatory factor analysis for a modified model provided an average fit index (chi-square/free ratio = 3.596, root mean square error of approximation = 0.099, normal fit index = 0.908, incremental fit index = 0.931, comparative fit index = 0.931 and Tucker–Lewis index = 0.909). Construct validity analysis revealed a significant difference in C-CPF scores amongst older adults in groups of different ages, regular exercise and physical activity habits (P < 0.01). Criterion validity was tested for the correlation between the results of C-CPF and the Senior Fitness Test (r = 0.446, P < 0.01).ConclusionsThe C-CPF scale serves as a valid and practical tool for widespread health screening to measure the level of comprehensive physical function and its decline amongst Chinese older adults. Further research is needed to explore the eligibility of the application of the C-CPF in a broad range of populations.

Comparison of Nutrient Intake Across Different Dietary Patterns in Brazilian Community-Dwelling Older Adults

Comparison of Nutrient Intake Across Different Dietary Patterns in Brazilian Community-Dwelling Older Adults

Path model explaining the association between fear of falling and health-related quality of life in (pre-)frail older adults

BackgroundFear of falling (FoF) is estimated to be prevalent in over 50% of older adults and several studies suggest that it negatively affects health-related quality of life (HrQoL). Unlike previous studies that examined only few mediating variables, this study aimed to develop a more comprehensive path model explaining the association between FoF and HrQoL.MethodsA theoretical path model was developed based on existing evidence and expert feedback and fitted to cross-sectional baseline data on 385 community-dwelling (pre-)frail older adults from the PromeTheus randomized controlled trial using robust weighted least squares estimation. FoF and HrQoL were operationalized by the Short Falls Efficacy Scale International and EQ-5D Index, respectively. The model included potential explanatory pathways through physical activity (German Physical Activity Questionnaire for middle-aged and older adults), physical capacity (Short Physical Performance Battery), physical performance (Late-Life Function and Disability Instrument [LLFDI] function component), disability (LLFDI disability component – short form), and affect (visual analogue scales on ‘happiness’, ‘sadness’, ‘calmness’ and ‘tension’). Age, sex, education, and previous falls were considered as covariates.ResultsThe model demonstrated good fit to the data and the remaining direct effect of FoF on HrQoL was small (β=-0.05). Physical capacity and physical performance were the most important mediators (combined indirect effect of β=-0.17, accounting for > 50% of the total effect). Pathways of minor individual relevance (e.g. through disability or affect) contributed considerably to the total indirect effect when combined. Controlling for sociodemographic data and previous falls only had minor effects on model fit and path coefficients.ConclusionPhysical capacity and physical performance are particularly important levers for reducing the impact of FoF on HrQoL through interventions. However, the other pathways also had a considerable influence when taken together. Hence, research on the association of FoF and HrQol should acknowledge the complexity of causal pathways that may explain this association and not neglect minor pathways. The proposed model should be tested on an alternative sample, using longitudinal data, and extended to include additional explanatory factors (e.g. activity avoidance).Trial registrationGerman Clinical Trials Register, ID: DRKS00024638, https://drks.de/search/en/trial/DRKS00024638, date of registration: March 11th 2021.

Vitamin D Supplementation, COPD and Asthma Exacerbations and Lung Function Decline.

It remains unclear whether supplementation with vitamin D reduces the risk of acute exacerbations of chronic obstructive lung disease (COPD) or asthma, major contributors to the world-wide burden of disease. To compare effects of vitamin D with placebo supplementation for the prespecified primary endpoints (1) acute exacerbations of COPD and (2) decline in pulmonary function measures of airflow obstruction. Prespecified secondary endpoints included asthma exacerbations and control. Lung VITAL (VITamin D and OmegA-3 TriaL) is an ancillary study of VITAL, a U.S. nationwide, randomized, placebo-controlled trial with a two-by-two factorial design, of vitamin D3 (2000 IU per day) and marine n-3 fatty acids (1 g per day) among men 50 years and women 55 years of age or older. Of 25,871 randomized participants, 3632 at risk for respiratory exacerbations, including 1977 with COPD by diagnosis or symptoms and 1654 with self-reported asthma diagnosis, were followed annually for five years by self-administered respiratory questionnaire. Spirometry was performed at baseline and two years post-randomization by 1648 participants from twelve urban centers. Decline in forced expiratory volume in one second [FEV1] and FEV1/FVC (forced vital capacity) was measured between baseline and follow-up. Supplementation with vitamin D was not associated with lower risk of any primary or secondary end point. Over the five-year follow-up, the number of COPD exacerbations was 0.27/year in the vitamin D group and 0.25 /year in the placebo group (rate ratio 1.10; 95% confidence interval, 0.93 to 1.29). Over two-years' follow-up, supplementation was not associated with slower decline (ml/yr) in forced expiratory volume in one second (FEV1). Supplementation with vitamin D, compared to placebo, did not result in a lower rate of COPD exacerbations or improved pulmonary function in community-dwelling adults not selected for vitamin D deficiency. Lung VITAL ClinicalTrials.gov number, NCT01728571. Protocol ID 2010-P-000622 .https://prevention.cancer.gov/clinical-trials/clinical-trials-search/nct01728571.

Age-Related Glucose Intolerance Is Associated with Impaired Insulin Secretion in Community-Dwelling Japanese Adults: The Kumamoto Koshi Study

Age-Related Glucose Intolerance Is Associated with Impaired Insulin Secretion in Community-Dwelling Japanese Adults: The Kumamoto Koshi Study

Social isolation, loneliness, death stress and life satisfaction in older adults: A serial mediation study.

This study aims to examine the mediating role of loneliness on the relationship between social isolation and life satisfaction among older adults and tests a mechanism through which social isolation exerts its menacing effects through a sequential model of loneliness and death distress. Data came from 548 community-dwelling older adults in rural settings in Turkey. They completed some demographic information including sex, age and measures of social isolation, loneliness, death distress, and life satisfaction. The results showed that loneliness and death distress exacerbated the negative effects of social isolation on life satisfaction. Loneliness and death distress served as a sequential mediating role in the association between social isolation and life satisfaction. Older adults with higher social isolation experience heightened loneliness and death distress, and worsening levels of life satisfaction. Greater experience of loneliness in sequence with greater levels of death distress mediated the relationship between life satisfaction and social isolation.

Enhancing Frailty Status and Health-Related Quality of Life in Community-Dwelling Frail Older Adults

Introduction: Frailty poses a significant concern among older adults residing in the community, impacting their health and quality of life. This study investigated the effectiveness of the FANS in addressing frailty and enhancing health-related quality of life. The study aimed to evaluate the effects of a 6-month FANS on frailty status and health-related quality of life in community-dwelling frail older adults, and to compare the effects on fall efficacy, pain intensity, daily activities, stages of physical activity and nutrition behavior change, and satisfaction following the intervention. Methods: A quasi-experimental design was used to assess the FANS among frail older adults. The intervention, based on the Transtheoretical Model, was conducted in a mixed setting, combining in-person sessions held at a community care center and remote group care delivered through the LINE app. The experimental group (n=43) received the FANS intervention, while the control group (n=38) continued with standard health promotion activities provided at the same community care center. Intention-to-treat analysis evaluated the intervention's impact. Measurements were taken before the intervention and at the 3-month and 6-month marks to assess changes in frailty status, health-related quality of life, fall efficacy, pain intensity, and daily activities. Behavior change stages and satisfaction were monitored using the Fitness and Nutrition for Seniors Behavior Change Stages and Satisfaction Scale. Results: Within the experimental group, significant improvements were observed over time across multiple measures, indicating intra-group effects, including frailty, overall health-related quality of life, fall efficacy, pain intensity, and daily activities. Between-group effects demonstrated statistically significant differences in daily activities. Time and group effects showed statistically significant improvements in frailty at three months and six months post-intervention. Following the intervention, a substantial percentage of participants in the experimental group progressed in behavior change stages related to physical activity and diet, with 83.72% in the action and maintenance stages for physical activity behavior change and 81.40% in those for dietary behavior change. The overall satisfaction rating for the program was 9.25 ± 0.24. Conclusion: The FANS is a feasible and innovative community health promotion initiative tailored specifically for frail older adults residing in the community, particularly during a pandemic. This program has demonstrated significant improvements in frailty status, health-related quality of life, fall efficacy, pain intensity, and daily activities among community-dwelling frail older adults. Moreover, the program has facilitated notable advancements in behavior change stages, supporting community-dwelling frail older adults in adopting and maintaining healthy behaviors effectively.

Internet use and self-rated health among Chinese older adults: the role of social engagement and social support

This study examines how social engagement and social support affect association between internet use and older adults' self-rated health in Kunming. An analysis of 518 community-dwelling older adults reveals that internet use significantly enhances their self-rated health. Social engagement mediates this relationship, while social support strengthens the beneficial impact of social engagement on self-rated health. Additionally, social support amplifies the mediating role of social engagement, suggesting that greater social support enhances the benefits of social engagement on health outcomes. Our findings emphasize the significance of fostering social engagement and providing robust social support to improve older adults' health.

Adverse childhood experiences and elder abuse victimization nexus: A systematic review and meta-analysis.

Adverse childhood experiences (ACEs) are important life course events that can influence elder abuse victimisation (EAV) among older adults. This systematic review and meta-analysis aimed to provide synthesised and consolidated evidence on the existing associations between ACEs and EAV. A systematic search was conducted across six databases, including PubMed, PsycINFO, CINAHL Complete, Scopus, Google Scholar, and the Web of Science. All studies that addressed associations between ACEs, in singular or multiple form, and EAV were included in the review. Meta-analysis of the extracted odds ratios (ORs) and confidence intervals (CIs) was conducted using the common-effect inverse-variance model. Nine studies (cross-sectional design = 7; cohort design = 2) met the inclusion criteria. Included studies examined multiple ACEs and multiple EAVs associations (N = 3); at least single ACE and multiple EAVs (N = 3); any single form of ACE and multiple EAVs (N = 3); multiple ACEs-any single form of EAV nexus (N = 2); multiple ACEs-financial elder abuse association (N = 2); and multiple ACEs-physical elder abuse nexus (N = 2). Pooled ORs and CIs showed statistically significant results for all ACEs and EAVs associations whether in singular or multiple form. The results indicate that interventions designed to reduce ACEs, in singular or multiple form, early in life targeting residential and community-dwelling older adults may be relevant in reducing the incidence of EAV. The life course perspective s be integrated into the planning for support services for children, families, and older adults to prevent EAV in singular or multiple forms in later life.

Community perspectives regarding brain-computer interfaces: A cross-sectional study of community-dwelling adults in the UK.

Brain-computer interfaces (BCIs) represent a ground-breaking advancement in neuroscience, facilitating direct communication between the brain and external devices. This technology has the potential to significantly improve the lives of individuals with neurological disorders by providing innovative solutions for rehabilitation, communication and personal autonomy. However, despite the rapid progress in BCI technology and social media discussions around Neuralink, public perceptions and ethical considerations concerning BCIs-particularly within community settings in the UK-have not been thoroughly investigated. The primary aim of this study was to investigate public knowledge, attitudes and perceptions regarding BCIs including ethical considerations. The study also explored whether demographic factors were related to beliefs about BCIs increasing inequalities, support for strict regulations, and perceptions of appropriate fields for BCI design, testing and utilization in healthcare. This cross-sectional study was conducted between 1 December 2023 and 8 March 2024. The survey included 29 structured questions covering demographics, awareness of BCIs, ethical considerations and willingness to use BCIs for various applications. The survey was distributed via the Imperial College Qualtrics platform. Participants were recruited primarily through Prolific Academic's panel and personal networks. Data analysis involved summarizing responses using frequencies and percentages, with chi-squared tests to compare groups. All data were securely stored and pseudo-anonymized to ensure confidentiality. Of the 950 invited respondents, 846 participated and 806 completed the survey. The demographic profile was diverse, with most respondents aged 36-45 years (26%) balanced in gender (52% female), and predominantly identifying as White (86%). Most respondents (98%) had never used BCIs, and 65% were unaware of them prior to the survey. Preferences for BCI types varied by condition. Ethical concerns were prevalent, particularly regarding implantation risks (98%) and costs (92%). Significant associations were observed between demographic variables and perceptions of BCIs regarding inequalities, regulation and their application in healthcare. Conclusion: Despite strong interest in BCIs, particularly for medical applications, ethical concerns, safety and privacy issues remain significant highlighting the need for clear regulatory frameworks and ethical guidelines, as well as educational initiatives to improve public understanding and trust. Promoting public discourse and involving stakeholders including potential users, ethicists and technologists in the design process through co-design principles can help align technological development with public concerns whilst also helping developers to proactively address ethical dilemmas.

Chronic Health Cost Burden in Older Caregivers and non-Caregivers in the United States.

Chronic health conditions affect the physical and financial well-being of millions of older adults, including those who themselves provide care to relatives and friends. As well, certain conditions cost more than others to manage, and older caregivers may be especially at risk of experiencing financial burden from an illness. This study investigated the association between caregiving and longitudinal change in health cost burden by measuring condition-specific expenses in a nationally-representative sample of older caregivers and non-caregivers. Three waves of the Health and Retirement Study (HRS) were used in the analysis. Caregiver socio-demographic and financial status was matched with updated treatment and lost-wage costs for chronic conditions developed by the Milken Institute. Profiles of health cost burden were created for community-dwelling adults 60 years and older who completed the HRS core survey for all three wave years from 2016 through 2020 (N = 10,540). Bivariate and regression analyses were used to examine differences in health cost burden between caregivers and non-caregivers over time. Compared to non-caregivers, caregivers were healthier and less burdened at baseline. Yet, holding other variables constant, caregivers showed steeper increases in chronic condition prevalence and costs over a four-year period after initiating caregiving activities. Findings suggest that whereas older caregivers may appear to select into the caregiving role while healthier, they are more likely to experience increased economic and health burdens over time - both from medical treatment and lost wages - related to chronic conditions.

Impact of Modifiable Factors Associated with Physical Frailty and Cognitive Impairment Trajectory of Older Adults: Using the Korean Longitudinal Study of Aging 2006–2018

Background/Objectives: To identify joint trajectories of physical frailty and cognitive impairment among community-dwelling older adults and to determine modifiable factors for each trajectory. Methods: Data were utilized from the Korean Longitudinal Study of Aging, which was conducted between 2006 and 2018. Physical frailty was assessed using the Fried phenotype, and cognitive impairment was evaluated using the Korean version of the Mini-Mental State Examination. Group-based trajectory modeling and logistic regression were employed for the analyses. Results: Based on longitudinal data, 415 participants averaging 72.2 years of age were analyzed. Three trajectories of physical frailty were identified: mild physical frailty, moderate physical frailty, and improving frailty. Two trajectories of cognitive impairment were identified: stable cognitive impairment and improving cognitive impairment. Factors influencing physical frailty trajectories included the number of medications taken, being overweight or obese, and depression. Education level was found to be associated with cognitive impairment trajectories. Conclusions: This study provides evidence for the distinct identification of joint trajectories of physical frailty and cognitive impairment, which can inform the target groups for intervention. It offers a basis for including modifiable physical and mental factors in intervention components for physical frailty trajectories.

Exploring predictors of the five-time sit-to-stand test based on cross-sectional findings from the Swedish National Study on Aging and Care (SNAC).

As we age, staying physically active and reducing sedentary behavior becomes crucial. To understand how to achieve this, factors related to daily physical function such as five-time sit-to-stand (STS) time should be explored. This study aimed to investigate the associations between STS time, self-rated physical activity, physical function, health-related quality of life, physical and mental health in community-dwelling older adults aged ≥ 60 years. Cross-sectional design with self-reported and objectively measured data from adults aged ≥ 60 years (n = 819), acquired from the Swedish National Study on Aging and Care. Data was analyzed through multiple linear regression. The model (R2 = 0.268) showed that STS time was predicted by grip strength (β' = -0.204, p < 0.05), age (β' = 0.202, p < 0.05), health-related quality of life (β' = -0.192, p < 0.05), having fallen within the preceding twelve months (β' = -0.127, p < 0.05), physical activities of perceived light to moderate intensity (β' = -0.121, p < 0.05), one-leg stand (β' = -0.099, p < 0.05), and education level (β' = -0.092, p < 0.05). For STS time, health-related quality of life (β = -0.354, confidence interval [CI] (-0.509)-(-0.199)), having fallen within the preceding twelve months (β = -0.222, CI (-0.365)-(-0.078)), and physical activities of perceived light to moderate intensity (β = -0.166, CI (-0.278)-(-0.053)) were the most prominent predictors. The model highlights the importance of grip strength and health-related quality of life in predicting STS time in older adults. Clinicians can use these insights to develop interventions that maintain physical function by regularly assessing and monitoring these factors. Future research should explore the relationship between fall history, faster STS time, and the impact of grip strength and health-related quality of life on sedentary behavior among older adults.

Self-Perceptions of Aging and Loneliness Interact when Predicting Cognition in Older Adults.

There is growing interest in the link between self-perceptions of aging (SPA) and cognition in older adults. This study evaluates the relationship between SPA dimensions and objective cognition and its interaction with loneliness. A sample of 184 community-dwelling Spanish older adults aged 65 and above was recruited. The short form of the Aging Perceptions Questionnaire (APQ-S) was used along with a neuropsychological battery and sociodemographic and health measures. The findings reveal links between negative consequences and processing speed; chronic time and inhibition; cyclical time and selective and alternating attention; and emotional representations and inhibition, selective attention, and working memory. SPA dimensions were found to moderate the relationship of loneliness on processing speed and selective attention. This study offers evidence of the differential link between SPA dimensions and cognition as well as their interaction with loneliness, which is valuable for designing intervention programs that promote cognitive health and active aging.

Relationship between decreased activities of daily living, decreased physical strength and future weight loss in community-dwelling older adults.

Weight loss is among the diagnostic criteria for frailty and is associated with increased mortality among older people. This study aimed to identify factors associated with future weight loss among community-dwelling older people. A multidimensional questionnaire-based prospective cohort study was carried out. The questionnaire included the Kihon Checklist, instrumental activities of daily living (IADL) scale, Activity Scale for the Elderly, Fall Risk Index-21 and Dietary Variety Score. The associations among the scores of the scales and the 3-year weight change from study entry were assessed. The participants were categorized into the non-weight loss group, <4.5-kg weight loss group and >4.5-kg weight loss group. In total, 982 participants completed the follow up. Their mean age was 73.4 ± 5.1 years, and 545 (55.5%) participants were women. Among the IADL questionnaire subitems, depositing and withdrawing money from the bank, walking, interacting with people, taking medication, and cooking were associated with 3-year weight loss. Furthermore, cooking was strongly associated with weight loss. However, there was no association between eating frequency and weight loss. Finally, low IADL and physical function scores were associated with a doubled risk of future weight loss. An association was found between 3-year weight loss and physical fitness and IADL, such as walking, among community-dwelling older people. Future weight loss in older people can be caused by a decline in IADL and physical fitness before a decline in dietary intake. Furthermore, maintaining IADL and physical fitness can prevent future weight loss and frailty. Geriatr Gerontol Int 2025; ••: ••-••.

Gender-specific secular trends and related factors of high perceived stress level among Korean older adults: a nation-wide serial cross-sectional study

BackgroundAging is associated with various physical, functional, and social losses, leading to stress, which affects mental health and overall quality of life. Despite its significance, limited research exists on perceived stress and its related factors among community-dwelling older adults. This study aimed to identify temporal trends in the prevalence of high perceived stress according to sex and examine associated factors among older adults.MethodsThis descriptive study analyzed secondary data from the nationally representative Korean Community Health Survey (KCHS) data from 2009 to 2019, including 274,883 older adults aged ≥ 65 years. High-perceived stress was coded as binary data, categorized as ‘yes’ or ‘no’ based on daily stress levels. Gender-stratified analyses examined temporal trends and associated factors affecting high perceived stress.ResultsWomen consistently reported higher levels of perceived stress compared with men across all years, with prevalence ranging from 22 to 30% in women and 14–20% in men. Among men, factors such as insufficient physical activity (OR: 1.32, 95% CI: 1.27–1.37), poor subjective health status (OR: 2.80, 95% CI: 2.69–2.92), and living alone were associated with high perceived stress. Among women, low household income (OR: 1.68, 95% CI: 1.56–1.81), smoking (OR: 1.63, 95% CI: 1.49–1.79), and living with a spouse (OR: 1.51, 95% CI: 1.34–1.70) were significant predictors.ConclusionsThis study highlights significant gender disparities in perceived stress among older adults, with women demonstrating greater vulnerability. Public health policies should prioritize stress reduction strategies tailored to address gender-specific needs and socio-economic disparities in older adults.

Effectiveness of PEER Intervention on Older Adults’ Physical Activity Time Series Using Smoothing Spline ANOVA

Falls are a major cause of injury among older adults. The Physio-fEedback Exercise pRogram (PEER) combines physio-feedback, cognitive reframing, and guided exercises to reduce fall risk. However, its impact on physical activity (PA) over time is underexplored. Functional time-series analysis offers insight into behavior patterns and sustainability. This preliminary study assessed PEER’s effectiveness in improving PA levels immediately and over time. A total of 64 community-dwelling older adults were cluster-randomized into PEER (N=33) or control groups (N=31). Participants wore Fitbit trackers, generating time-series data on activity. The PEER group completed an 8-week program, while the control group received CDC fall prevention pamphlets. PA data were analyzed using smoothing spline analysis of variance (SSANOVA), chosen for its flexibility in modeling complex, non-linear relationships in time-series data and its ability to handle skewed distributions and repeated measures. Unlike traditional parametric models, SSANOVA decomposes temporal trends into interpretable components, capturing both smooth trends and abrupt changes, such as those occurring on group workout days. This capability ensures robust and nuanced analysis of intervention effects. Results showed PEER participants significantly increased evenly and had very active minutes and reduced sedentary behavior during the intervention. No significant effect was found for light active minutes. Specifically, during the intervention period, PEER participants engaged in an average of 6.7% fewer sedentary minutes per day, 13.8% additional fairly active minutes per day, and 2.8% additional very active minutes per day compared to the control group. While the reduction in sedentary minutes and increase in fairly active minutes were not statistically significant, the increase in very active minutes was significant. However, our functional time-series analysis revealed these improvements diminished over the 15-week follow-up, indicating challenges in maintaining PA. In conclusion, PEER boosts PA and reduces sedentary behavior short-term, but strategies are needed to sustain these benefits. In conclusion, PEER boosts PA and reduces sedentary behavior short-term, but strategies are needed to sustain these benefits. Public health policies should emphasize technology-driven fall risk assessments, community-based prevention programs, and initiatives that promote physical activity, home safety, and chronic condition management.

Factors Related to Self-Rated Health Among Community-Dwelling Older Adults

Abstract: Background/Objectives: This study explored factors influencing self-rated health (SRH) among community-dwelling older adults to better support its use in health screening and provide an alternative for older adults who may have difficulty working with lengthy assessment scales. Methods: The participants were 8379 individuals aged 65 years or older from the 2020 Elderly Survey. Data were collected in South Korea between September and November 2020. Descriptive statistics were calculated, and independent samples t-tests, a Kruskal–Wallis test, and weighted multiple regression analysis were conducted using IBM SPSS for Windows ver. 23.0. SRH factors, such as illness, daily living performance, nutritional status, depression, and cognitive impairment, were analyzed. Results: The greater the number of chronic conditions (β = −0.21, p &lt; 0.001), the higher the dependence on activities of daily living and instrumental activities of daily living (β = −0.05, p = 0.002; β = −0.13, p &lt; 0.001), the higher the depression score (β = −0.22, p &lt; 0.001), the more severe the cognitive impairment (β = −0.04, p &lt; 0.001), and the worse the SRH. Conclusions: Participants with high-risk medical conditions, such as cancer, stroke, and depression, thought their health was poor. However, they did not consider hypertension, malnutrition, and abnormal BMI as significantly affecting their health status. Therefore, these factors should be considered when measuring SRH in older adults.

Does a real-life cognitively enriched walking program "Take a walk with your brain" benefit cognitive functioning and physical activity in community-dwelling older adults? A randomized controlled trial.

Most studies examining combined cognitive and physical activity are conducted in laboratory settings. This randomized controlled trial (RCT) examines the effects of a real-life cognitively enriched walking program on cognitive functioning and moderate-to-vigorous physical activity (MVPA) in adults aged ≥65 years. A three-arm RCT was conducted, comparing the cognitively enriched walking program (WALK+, doing cognitive tasks while walking) with a walking program without enrichment (WALK-only) and a passive control condition (CONT). Both WALK+ and WALK-only had a duration of six months, with two outdoors, supervised group-based sessions/week (60-90 minutes/session). Cognitive functioning (short- and long-term memory, executive functioning and processing speed) and MVPA were measured at baseline, three, six and 12 months using the Cambridge Neuropsychological Test Automated Battery (CANTAB) and ActiGraph GT3X+ accelerometers respectively. A total of 148 community-dwelling adults (median age: 69 years, range: 65-85; 72% (n=107) female) were included. Comparing WALK+ to WALK-only and CONT, and WALK-only to CONT, there were no significant intervention effects on cognitive functioning at three, six or 12 months. MVPA decreased with 13 minutes/day in WALK+ between baseline and 12 months, whilst it increased between baseline and six months with 12 minutes/day in WALK-only and between three and six months with 16 minutes/day in CONT. The WALK+ program did not lead to statistically significant benefits for cognitive functioning or MVPA compared to WALK-only or CONT. Future studies should explore for whom combined interventions may work and determine the optimal dosage.