Community-dwelling Older Women Research Articles

Functional brain changes in sarcopenia: evidence for differential central neural mechanisms in dynapenic older women

BackgroundThe European Working Group on Sarcopenia in Older People (EWGSOP2) recently revised its definition and diagnostic criteria for sarcopenia, placing muscle strength at the forefront. The pathogenesis of dynapenia (or low muscle strength) is still not fully understood, but there is emerging evidence that central neural factors constitute critical determinants.MethodsOur cross-sectional study included 59 community-dwelling older women (mean age 73.1 ± 4.9 years). Participants underwent detailed skeletal muscle assessments for muscle strength defined by handgrip strength and chair rise time measurements using the recently published EWGSOP2 cut-off points. Functional magnetic resonance imaging (fMRI) was assessed during the performance of a cognitive dual-task paradigm, consisting of a baseline, two single-tasks (motor and arithmetic) and one dual-task (motor and arithmetic combined).ResultsForty-seven percent (28/59) of participants were classified as dynapenic. fMRI results revealed a differential recruitment of motor circuits in the brain during the dual-task condition in dynapenic as compared with non-dynapenic participants. In particular, while the brain activity during the single-tasks did not differ between the two groups, only during the dual-task non-dynapenic participants showed significant increased activation in dorsolateral prefrontal and premotor cortex, and in supplementary motor area as compared to dynapenic participants.ConclusionOur results point to a dysfunctional involvement of brain networks associated with motor control in dynapenia in a multi-tasking paradigm. A better knowledge of the link between dynapenia and brain functions could provide new impulses in the diagnosis and interventions for sarcopenia.

Method for Activity Sleep Harmonization (MASH): a novel method for harmonizing data from two wearable devices to estimate 24-h sleep–wake cycles

BackgroundDaily 24-h sleep–wake cycles have important implications for health, however researcher preferences in choice and location of wearable devices for behavior measurement can make 24-h cycles difficult to estimate. Further, missing data due to device malfunction, improper initialization, and/or the participant forgetting to wear one or both devices can complicate construction of daily behavioral compositions. The Method for Activity Sleep Harmonization (MASH) is a process that harmonizes data from two different devices using data from women who concurrently wore hip (waking) and wrist (sleep) devices for ≥ 4 days.MethodsMASH was developed using data from 1285 older community-dwelling women (ages: 60–72 years) who concurrently wore a hip-worn ActiGraph GT3X + accelerometer (waking activity) and a wrist-worn Actiwatch 2 device (sleep) for ≥ 4 days (N = 10,123 days) at the same time. MASH is a two-tiered process using (1) scored sleep data (from Actiwatch) or (2) one-dimensional convolutional neural networks (1D CNN) to create predicted wake intervals, reconcile sleep and activity data disagreement, and create day-level night-day-night pairings. MASH chooses between two different 1D CNN models based on data availability (ActiGraph + Actiwatch or ActiGraph-only). MASH was evaluated using Receiver Operating Characteristic (ROC) and Precision-Recall curves and sleep–wake intervals are compared before (pre-harmonization) and after MASH application.ResultsMASH 1D CNNs had excellent performance (ActiGraph + Actiwatch ROC-AUC = 0.991 and ActiGraph-only ROC-AUC = 0.983). After exclusions (partial wear [n = 1285], missing sleep data proceeding activity data [n = 269], and < 60 min sleep [n = 9]), 8560 days were used to show the utility of MASH. Of the 8560 days, 46.0% had ≥ 1-min disagreement between the devices or used the 1D CNN for sleep estimates. The MASH waking intervals were corrected (median minutes [IQR]: − 27.0 [− 115.0, 8.0]) relative to their pre-harmonization estimates. Most correction (− 18.0 [− 93.0, 2.0] minutes) was due to reducing sedentary behavior. The other waking behaviors were reduced a median (IQR) of − 1.0 (− 4.0, 1.0) minutes.ConclusionsImplementing MASH to harmonize concurrently worn hip and wrist devices can minimizes data loss and correct for disagreement between devices, ultimately improving accuracy of 24-h compositions necessary for time-use epidemiology.

Association between asymmetric dimethylarginine and sarcopenia in community-dwelling older women

Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of endothelium nitric oxide synthesis and causes endothelial dysfunction that may be related to sarcopenia. However, the association between ADMA and sarcopenia has not been studied. We evaluated the correlations between plasma ADMA levels and sarcopenia in community-dwelling older women. In total, 144 community-dwelling older women participated in this study. Plasma ADMA levels were measured using a competitive enzyme-linked immunosorbent assay. Skeletal muscle mass, measured in terms of bioimpedance and grip strength, was used to assess sarcopenia. Plasma ADMA levels were significantly higher in participants with sarcopenia than in those without sarcopenia. Through receiver-operating characteristic curve analysis, the cutoff value of plasma ADMA level for sarcopenia was estimated at 0.57 μM. Sarcopenia was significantly more prevalent in participants with higher plasma ADMA levels than in those with lower plasma ADMA levels. According to logistic regression analysis, the crude odds ratio of higher plasma ADMA levels in participants with sarcopenia was 4.57 (95% confidence interval, 1.82–11.47; p = 0.001). Reductions in the skeletal muscle mass index over 2 years were significantly greater in participants with higher plasma ADMA levels. In conclusion, plasma ADMA levels were significantly associated with sarcopenia in community-dwelling older women.

Challenges, Concerns, and Experiences of Community-Dwelling Older Women with Chronic Low Back Pain—A Qualitative Study in Hong Kong, China

Although chronic low back pain (CLBP) is known to negatively affect multiple aspects of the lives of older people, prior qualitative studies mainly focused on the lived experiences of older people with CLBP in Western countries. Given cultural and contextual differences and poor understanding of CLBP in older women with CLBP, it is important to better understand the concerns and lived experiences of Chinese older women with CLBP. The current study aimed to investigate the experiences, challenges, concerns, and coping strategies of older women with CLBP in Hong Kong. A total of 15 community-dwelling older women with CLBP aged ≥60 years were recruited from a physiotherapy clinic or a community center for semi-structured interviews. The interviews were audio recorded and transcribed 'verbatim'. The transcription was imported to NVivo 12 software. Thematic analysis was conducted using Braun and Clarke's method. Five themes were identified: (1) physical impacts of CLBP on daily life; (2) psychological influences of CLBP; (3) management of CLBP; (4) family support; and (5) social activities and support. Negative physical and psychosocial impacts of CLBP were common among older women, and they adopted diverse pain management strategies, although some of their treatment options were influenced by the Chinese culture. Misbeliefs and responses of family and friends also affected their management strategies. Elderly community centers are a significant source of social support for older women with CLBP, making it an ideal platform for establishing self-help groups to facilitate their self-management of CLBP.

Effectiveness of an Exercise Program for Older Adults Using an Augmented Reality Exercise Platform: A Pilot Study.

With the rapid progression of population aging worldwide, the health management of older adults is emerging as an important topic. To help prevent declines in physical and cognitive function due to aging, older adults must maintain consistent physical activity. The development of digital technology has recently allowed the optimization of exercise programs for older adults using augmented reality (AR) game technology. Fifteen older adult females were enrolled in an AR-based exercise program. The program was conducted for 30 min, three times weekly, for a total of six weeks. To verify the effectiveness of the program and assess physical function before and after exercise, the following tests were performed: timed up-and-go test, five-time sit-to-stand test, one-minute sit-to-stand test, lung capacity test, respiratory muscle strength test, and bioelectrical impedance analysis. The Trail Making Test was used to evaluate cognitive function. For statistical analysis, a paired t-test was used to verify the effects on physical and cognitive function before and after exercise. The study results confirmed improved overall physical and cognitive function. The timed up-and-go test, maximal inspiratory pressure, and Trail Making Test part B scores showed significant increases. This study verified the effectiveness of AR exercise in community-dwelling older adult women. In the future, exercise programs with game elements that increase the interest and motivation of participants to engage in exercise routines should be developed and applied.

Developing a predictive equation of muscular age to evaluate muscle health in Chinese community-dwelling older women

Muscle health plays an important role in most common age-related diseases and injuries. To date, a standardized quantitative method to assess muscle health has not yet been developed. Principal component analysis was employed to develop a predictive equation of muscular age based on muscle health variables including skeletal muscle mass of lower limb, grip strength and maximal gait speed. Then validity of muscular age was tested by comparing chronological age to muscular age of the elderly. A predictive equation of muscular age was developed. Muscular age = 0.690 × chronological age − 1.245 × skeletal muscle mass of lower limb + 0.453 × grip strength − 1.291 × maximal walking speed + 40.547. Cross-sectional validity test showed that the predictive equation of muscular age is a valid method to assess muscle health. It is applicable not only to the normal elderly but to the elderly with pre-sarcopenia or sarcopenia.

Association between poor sleep quality and locomotive syndrome in middle-aged and older women: A community-based, cross-sectional study.

Poor sleep quality, such as nocturnal arousal and sleep inefficiency, is associated with frailty and sarcopenia. Herein, we evaluated the relationship between poor sleep quality and locomotive syndrome (LS), a motor organ dysfunction common among community-dwelling middle-aged and older women. Participants comprised 2246 Japanese middle-aged and older women. LS was classified into stages LS-1, LS-2, and LS-3 (from least to most severe) according to the results of the stand-up test, two-step test, and 25-question Geriatric Locomotive Function Scale. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. The Pittsburgh Sleep Quality Index scores were significantly higher in the LS group than that in the non-LS group (P < .001). Multivariate logistic regression analyses adjusted for potential confounders identified poor sleep quality as an independent factor of LS (odds ratio 1.59 [95% confidence interval 1.30-1.93], P < .001). Similar results were observed in the sensitivity analysis in postmenopausal women. LS and trouble sleeping because of pain showed stepwise association in all LS stages. Poor sleep quality was independently associated with LS among community-dwelling middle-aged and older women. As the stage of LS progressed, the proportion of women with poor sleep quality increased significantly.

Fourier transform infrared (FTIR) spectroscopy as a screening tool for osteosarcopenia in community-dwelling older women.

Osteosarcopenia is a complex geriatric syndrome characterized by the presence of both sarcopenia and osteopenia/osteoporosis. This condition increases rates of disability, falls, fractures, mortality and mobility impairments in older adults. The purpose of this study was to analyze the Fourier Transform Infrared (FTIR) spectroscopy diagnostic power for osteosarcopenia in community-dwelling older women (n = 64, 32 osteosarcopenic and 32 non-osteosarcopenia). FTIR is a fast and reproducible technique highly sensitive to biological tissues and a mathematical model was created using multivariate classification techniques that denoted the graphic spectra of the molecular groups. Genetic algorithm and support vector machine regression (GA-SVM) was the most feasible model, achieving 80.0% of accuracy. GA-SVM identified 15 wavenumbers responsible for class differentiation, in which several amino acids (responsible for the proper activation of the mammalian target of rapamycin) and hydroxyapatite (an inorganic bone component) were observed. Imaging tests and a low availability of instruments that allow the observation of osteosarcopenia involves high health costs for patients and restrictive indications. Therefore, FTIR can be used to diagnose osteosarcopenia due to its efficiency, low cost and to enable early detection in the geriatric services, contributing to advances in science and technology that are potential "conventional" methods in the future.

Prevalence of sarcopenia in older women and level of agreement between the diagnostic instruments proposed by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2)

BackgroundThe European Working Group on Sarcopenia in Older People 2 (EWGSOP2) proposed the use of different diagnostic tools to assess sarcopenia. This study aimed to determine prevalence rates of sarcopenia according to the diagnostic instruments proposed by EWGSOP2 and to assess their level of agreement in older Brazilian women.MethodsA cross-sectional study with 161 community-dwelling older Brazilian women. Probable sarcopenia was assessed through Handgrip Strength (HGS) and the 5-times sit-to-stand test (5XSST). In addition to reduced strength, Appendicular Skeletal Muscle Mass (ASM) (obtained by Dual-energy X-ray absorptiometry) and ASM/height² were considered for diagnosis confirmation. Sarcopenia severity was determined by reduced muscle strength and mass and poor functional performance assessed by Gait Speed (GS), Short Physical Performance Battery (SPPB), and Timed Up and Go test (TUG). McNemar’s test and Cochran’s Q-test were used to compare sarcopenia prevalence. Cohen’s Kappa and Fleiss’s Kappa tests were used to assess the level of agreement.ResultsThe prevalence of probable sarcopenia was significantly different (p < 0.05) when using HGS (12.8%) and 5XSST (40.6%). Regarding confirmed sarcopenia, the prevalence was lower when using ASM/height² than with ASM. Regarding severity, the use of SPPB resulted in a higher prevalence in relation to GS and TUG.ConclusionThere were differences in the prevalence rates of sarcopenia and low agreement between the diagnostic instruments proposed by the EWGSOP2. The findings suggest that these issues must be considered in the discussion on the concept and assessment of sarcopenia, which could ultimately help to better identify patients with this disease in different populations.

The association between frailty and incident cardiovascular disease events in community-dwelling healthy older adults

Study objectiveThis study examined the association between frailty and incident cardiovascular disease (CVD) events, major adverse cardiovascular events (MACE), and CVD-related mortality. DesignLongitudinal cohort study. SettingThe ASPirin in Reducing Events in the Elderly (ASPREE) clinical trial in Australia and the United States. Participants19,114 community-dwelling older adults (median age 74.0 years; 56.4 % females). InterventionsPre-frailty and frailty were assessed using a modified Fried phenotype and a deficit accumulation Frailty Index (FI) at baseline. Main outcome measuresCVD was defined as a composite of CVD death, non-fatal myocardial infarction, non-fatal stroke, and hospitalization for heart failure; MACE included all except heart failure. Cox proportional hazards regression was used to analyze the association between frailty and CVD outcomes over a median follow-up of 4.7 years. ResultsBaseline pre-frail and frail groups had a higher risk of incident CVD events (Hazard Ratio (HR): 1.31; 95 % Confidence Interval (CI): 1.14–1.50 for pre-frail and HR: 1.63; 95 % CI: 1.15–2.32 for frail) and MACE (pre-frail HR: 1.26; 95 % CI: 1.08–1.47 and frail HR: 1.51; 95 % CI: 1.00–2.29) than non-frail participants according to Fried phenotype after adjusting for traditional CVD risk factors. Effect sizes were similar or larger when frailty was assessed with FI; similar results for men and women. ConclusionFrailty increases the likelihood of developing CVD, including MACE, in community-dwelling older men and women without prior CVD events. Screening for frailty using Fried or FI method could help identify community-dwelling older adults without prior CVD events who are more likely to develop CVD, including MACE, and may facilitate targeted preventive measures to reduce their risk.

Orthostatic hypotension and neurocognitive disorders in older women: Results from the EPIDOS cohort study.

Although it is well-admitted that cardiovascular health affects cognition, the association between orthostatic hypotension (OH) and cognition remains unclear. The objectives of the present study were i) to determine among the EPIDOS cohort (EPIdémiologie de l'OStéoporose) whether OH was cross-sectionally associated with cognitive impairment at baseline, and ii) whether baseline OH could predict incident cognitive decline after 7 years of follow-up. Systolic and Diastolic Blood Pressure (SBP and DBP) changes while standing (ie, ΔSBP and ΔDBP, in %) were measured at baseline among 2,715 community-dwelling older women aged 75 years and older using no antihypertensive drugs from the French EPIDOS cohort. OH was defined as a decrease in SBP ≥20 mmHg and/or a decrease in DBP ≥10 mmHg within 3 min after standing. Cognitive impairment was defined as a Short Portable Mental Status Questionnaire (SPMSQ) score <8 (/10). Among those without cognitive impairment at baseline, a possible incident onset of cognitive decline was then sought after 7 years of follow-up among 257 participants. Baseline ΔSBP was associated with baseline cognitive impairment (adjusted OR = 1.01, p = 0.047), but not with incident onset of cognitive decline after 7 years (adjusted OR = 0.98, p = 0.371). Neither baseline OH nor baseline ΔDBP were associated with cognitive impairment neither at baseline (p = 0.426 and p = 0.325 respectively) nor after 7 years (p = 0.180 and p = 0.345 respectively). SBP drop while standing, but neither OH per se nor DBP drop while standing, was associated with baseline cognitive impairment in older women. The relationship between OH and cognitive impairment appears more complex than previously expected.

Associations of Mutually Exclusive Categories of Physical Activity and Sedentary Behavior with Body Composition and Fall Risk in Older Women: A Cross-Sectional Study.

The individual effects of physical activity (PA) and sedentary behavior (SB) on health are well-recognized. However, little is known about the extent to which different combinations of these behaviors are associated with body composition and fall risk in older adults. This cross-sectional study examined the associations of mutually exclusive categories of PA and SB with body composition and fall risk in older women. Accelerometer-measured PA, body composition and fall risk (static and dynamic balance) parameters were assessed among 94 community-dwelling older women. The participants were categorized into four groups: active-low sedentary, active-high sedentary, inactive-low sedentary and inactive-high sedentary (active: ≥150 min/week moderate-to-vigorous PA (MVPA); low sedentary: lowest tertile of SB and light PA ratio). Compared to the inactive-high sedentary group, more favorable body composition and dynamic balance results were found in the active-low sedentary (body fat mass index (BFMI): β = -4.37, p = 0.002; skeletal muscle mass index (SMI): β = 1.23, p = 0.017; appendicular lean mass index (ALMI): β = 1.89, p = 0.003; appendicular fat mass index (AFMI): β = -2.19, p = 0.003; sit-to-stand: β = 4.52, p = 0.014) and inactive-low sedentary (BFMI: β = -3.14, p = 0.007; SMI: β = 1.05, p = 0.014; AFMI: β = -1.74, p = 0.005, sit-to-stand: β = 3.28, p = 0.034) groups. Our results suggest that PA programs focusing on concurrently achieving sufficient MVPA and reduced SB might promote a healthy body composition and reduced fall risk among older adults.

Velocity walking test: Selective influences on physical functional performance for better tracking of older women

ObjectiveTo examine the selective influences of changes in walking test capability on physical functional performance (COD speed, COD deficit, linear sprint speed, chair stand test, handgrip strength, and unloaded vertical jump) in community dwelling older women. MethodsThe performances of eighty women ((age, 64.7 ± 3.38 y; body mass, 66.3 ± 11.15 kg; height, 153.5 ± 5.71 cm, BMI, 28.08 ± 4.00 kg/m2) were assessed in the 6-m walk test, timed up and go test, chair stand test, handgrip strength, and unloaded vertical jump. The change of direction velocity (CODv) deficit (m.s−1) was calculated as TUG velocity – 6-m walk velocity. Estimation statistics were adopted, which focus on the effect size of the higher/lower, as opposed to significance testing. The bootstrap with 5000 replicates was used to obtain bias-corrected and accelerated 95% compatibility intervals (CI) of the point estimate of each effect ResultsThere were large effects between faster older women compared to slower older women in COD velocity (TUG), chair stand test, and CODv deficit. On the other hand, we observed no influence of 6-m walk test performance on vertical jumps or the handgrip strength test. ConclusionStrength and conditioning coaches and professionals involved with older women should consider the COD deficit (i.e., linear velocity minus change of direction velocity), as a complementary measure to provide an initial idea of the adequate pathway for exercise prescription and to track responses in older women.

Association of Social Support with Mild Cognitive Impairment and Dementia Among Older Women: The Women's Health Initiative Memory Study.

Social support may be a modifiable risk factor for cognitive impairment. However, few long-term, large prospective studies have examined associations of various forms of social support with incident mild cognitive impairment (MCI) and dementia. To examine associations of perceived social support with incident MCI and dementia among community-dwelling older women. This prospective cohort study included 6,670 women from the Women's Health Initiative Memory Study who were cognitively unimpaired at enrollment. We used Cox proportional hazards models to assess associations between perceived social support with incident MCI, dementia, or either MCI/dementia during an average 10.7 (SD = 6.1)-year follow-up. Modelling was repeated for emotional/information support, affection support, tangible support, and positive social interaction subscales of social support. Among 6,670 women (average age = 70 years [SD = 3.8]; 97.0% non-Hispanic/Latina; 89.8% White), greater perceived social support was associated with lower risk of MCI/dementia after adjustment for age, ethnicity, race, hormone therapy, education, income, diabetes, hypertension, and body mass index (Tertile [T]3 versus T1: HR = 0.85, 95% CI 0.74-0.99; ptrend = 0.08). Associations were significant for emotional/information support (T3 versus T1: HR = 0.84, 95% CI 0.72-0.97; ptrend = 0.04) and positive social interaction (T3 versus T1: HR = 0.85, 95% CI 0.73-0.99; ptrend = 0.06) subscales. Associations were attenuated and not significant after adjustment for depressive symptom severity. Perceived social support, emotional/information support, and positive social interaction were associated with incident MCI/dementia among older women. Results were not significant after adjustment for depressive symptom severity. Improving social support may reduce risk of MCI and dementia in older women.

The Association of Obesity and Overweight with Executive Functions in Community-Dwelling Older Women.

Among the risk factors reported for cognitive decline, the literature highlights changes in body composition. Thus, the aim of the present study was to examine the relationship between obesity/overweight and executive functions in cognitively normal older adult women. This cross-sectional study included 224 individuals (60-80 years), stratified into normal weight (n = 45), overweight (n = 98), and obesity (n = 81). As outcomes, body mass index (BMI), waist circumference (WC), and Trail Making Test Parts A and B were assessed. We found positive correlations of BMI and WC with completion times of TMT-A and TMT-B, and a negative correlation of BMI and WC with education. ANCOVA showed an association between higher BMI and slower completion time of TMT-A, TMT-B, and ΔTMT (B-A). Impairment of executive functions of cognitively normal older women may be positively associated with obesity and negatively associated with years of education. The findings may contribute to designing strategies that make it possible to prevent cognitive decline in women during aging.

Higher Dietary Vitamin K Intake is Associated with Better Physical Function and Lower Long-Term Injurious Falls Risk in Community-Dwelling Older Women

BackgroundIn recent years, a potential beneficial role of Vitamin K in neuromuscular function has been recognised. However, the optimal dietary intake of Vitamin K to support muscle function in the context of falls prevention remains unknown.ObjectiveTo examine the relationship of dietary Vitamin K1 and K2 with muscle function and long-term injurious fall-related hospitalisations in older women.DesignCohort study.Participants1347 community-dwelling older Australian women ≥70 years.MeasurementsA new Australian Vitamin K nutrient database, supplemented with published data, was used to calculate Vitamin K1 and K2 intake from a validated food frequency questionnaire at baseline (1998). Muscle function (grip strength and timed-up-and-go; TUG) as well plasma Vitamin D status (25OHD) were also assessed at baseline. Fall-related hospitalisations over 14.5 years were obtained from linked health records. Multivariable-adjusted logistic regression and Cox-proportional hazard models were used to analyse the data.ResultsOver 14.5 years of follow-up (14,774 person-years), 535 (39.7%) women experienced a fall-related hospitalisation. Compared to women with the lowest Vitamin K1 intake (Quartile 1, median 49 µg/d), those with the highest intake (Quartile 4, median 120 µg/d) had 29% lower odds (OR 0.71 95%CI 0.52–0.97) for slow TUG performance (>10.2 s), and 26% lower relative hazards of a fall-related hospitalisation (HR 0.74 95%CI 0.59–0.93) after multivariable adjustment. These associations were non-linear and plateaued at moderate intakes of ∼70–100 µg/d. There was no relation to grip strength. Vitamin K2 intakes were not associated with muscle function or falls.ConclusionA higher habitual Vitamin K1 intake was associated with better physical function and lower long-term injurious falls risk in community-dwelling older women. In the context of musculoskeletal health, Vitamin K1 found abundantly in green leafy vegetables should be promoted.

CONSTRUCT VALIDITY OF EXERCISE ADHERENCE RATING SCALE IN COMMUNITY DWELLING OLDER WOMEN: PROOF OF CONCEPT

Abstract Exercise is an effective health promotion strategy that has a positive effects on frailty and sarcopenia, particularly in older women, yet they do not adhere to exercise guidelines. Accurate assessment is critical for clinical management and research with this population. Interviews and exercise logs are most commonly used to assess adherence to exercise. However, they are burdensome and not highly reliable. A brief validated measure of exercise adherence for assessment is greatly needed. The six-item Exercise Adherence Rating Scale (EARS) was originally validated among a clinical orthopedic population but not been used in community-dwelling adults. Our aim was to determine the feasibility of using the EARS to assess exercise adherence among community-dwelling older women. Twelve women (age=72±7 years) completed one-time assessment for this proof-of-concept study. For the EARS, overall Cronbach’s alpha was 0.78 with inter-item correlations of 0.72–0.89 for all but item three that pertains to healthcare professionals (correlation of 0.27). When item three was removed, overall Cronbach’s alpha increased to 0.80. Correlation analysis with the reduced five-item scale demonstrated good construct validity. There were significant relationships with global quality of life (r=0.76, p &amp;lt; .01) and physical function (r=0.61, p &amp;lt; .05). There were also moderate to strong relationships with variables expected to be linked to exercise adherence including mobility (r=0.57), BMI (r=0.51), vigorous (r=0.40) and moderate (r=0.36) exercise, upper body strength (r=0.41) and lower body strength (r=0.30). Based on these findings use of a five-item version of the EARS is feasible and appears to be a valid measure of exercise adherence.

OLDER INDONESIAN WOMEN’S EXPERIENCE TO MAINTAIN INDEPENDENCE IN FOOD-RELATED ACTIVITIES

Abstract The ability to conduct food-related activities such as cooking, eating, and cleaning are central to older adults’ health. Such ability is especially critical for older women who are more likely to live alone or become caregivers for their spouses and other family members. We investigated the experience of older Indonesian women, an understudied population in aging research, when engaging in food-related activities. Using the grounded theory approach, we examined the challenges and adaptive behavior of twelve community-dwelling older women in Indonesia (60+) when conducting food-related activities at home. We employed two data collection strategies: photo and video elicitation, followed by an interview. Through photo and video elicitation, participants took photos and videos of the space where they conducted food-related activities to provide physical environmental data. In the interview, participants explained their routine, activity challenges, and adaptation strategies in food-related activities. We discovered that participants’ view of their role in cooking food for the family is central to their sense of identity. When faced with age-related challenges, participants accepted assistance from others for activities less connected to food production, such as sweeping, mopping, or cleaning the kitchen. However, they are less likely to accept assistance for cooking activities. Instead, they adapted by modifying the physical environment, simplifying the tasks, and adjusting the method to remain engaged in cooking. Older Indonesian women’s cultural identity influenced their strategy to face age-related challenges and maintain independence. This finding highlights the importance of a culturally sensitive approach when planning support for older adults.

Cardiovascular disease, muscle function, and long-term falls risk: The Perth Longitudinal Study of Ageing Women

BackgroundA few cross-sectional studies have highlighted inconsistent associations between cardiovascular disease (CVD) and musculoskeletal conditions. We sought to investigate the relationship between clinical CVD including subtypes, compromised muscle function, as well as incident self-reported and injurious falls in older women. Materials and methods1431 community-dwelling older women (mean age ± SD; 75.2 ± 2.7 years) were included in over 14.5 years of a prospective study, the Perth Longitudinal Study of Ageing in Women. CVD (up to 18-years prior to the baseline visit) and injurious fall hospitalizations over 14.5 years were obtained from linked health records. Self-reported falls for five years were obtained via a written adverse event diary posted every four months. Timed-Up-and-Go (TUG) test and hand grip strength were used to assess mobility and muscle strength, respectively. Mobility impairment was defined as TUG performance >10.2 sec and muscle weakness characterized as grip strength <22 kg. ResultsOver 5-years, 411 (28.7%) women reported a falls, while 567 (39.6%) were hospitalized due to an injurious fall over 14.5 years. Prior CVD events were associated with 32% (HR 1.32 95%CI, 1.06–1.64) and 29% (HR 1.29 95%CI, 1.07–1.56) increased risk of self-reported and injurious falls, respectively, in multivariable-adjusted models. When considering subtypes of CVD, only cerebrovascular disease was related to self-reported (HR 1.77; 95%CI, 1.15–2.72) and injurious falls requiring hospitalization (HR 1.51; 95%CI, 1.00–2.27). CVD was also associated with cross-sectional and prospective mobility impairments. However, no evidence for such relationships was observed for muscle weakness. ConclusionsPrevalent CVD events, particularly cerebrovascular disease, are related to an increased risk of long-term falls. These findings highlight the need to recognize increased falls risk in patients with CVD. Further, there is a need to understand whether incorporating prevalent CVD into falls screening tools improves risk stratification or affects model calibration.

Lay Definitions of Successful Ageing and Contributing Factors among Croatian Older Adults

Lay concepts of successful ageing have attracted the attention of researchers over the past 15 years. However, little is known about how older people in Southeastern European countries understand successful ageing and the factors associated with it. Therefore, the aim of this qualitative study conducted in Croatia, a Southeastern European country, was to explore Croatian older people’s definitions of successful ageing and the contributing factors. Interviews were conducted with 95 community-dwelling older men (49.5% of the sample) and women (50.5%) aged 65 to 90 years. Participants answered questions about definitions and contributing factors/determinants of successful ageing. Responses were subjected to thematic analysis. Results showed that participants gave similar responses to questions about the components and determinants of successful ageing. The most frequently mentioned components of successful ageing were the physical/physiological (with subthemes of general health, healthy habits, and physical mobility), the psychological component (with subthemes of good life, subjective well-being, and psychological resources, etc.), and the engagement and activity component. Among factors that contribute to successful ageing, social and physical were mentioned most frequently, followed by psychological, financial factors, and engagement/activity. Longevity and good genes were rarely cited as factors associated with successful ageing. Besides, Croatian older people have not mentioned spirituality or religiosity as important components or determinants of successful ageing. The results of our study are mostly consistent with the findings of previous research on successful ageing in predominantly Western cultures. They show the great heterogeneity of lay conceptions, which are much broader and more complex compared to researchers’ models of successful ageing.