Community Healthy Activities Model Program For Seniors Research Articles

Exploring the Relationship between Built Environment Attributes and Physical Activity in Lower-Income Aging Adults: Preliminary Insights from a Multi-Level Trial.

The built environment has been linked to physical activity (PA) behaviors, yet there is limited knowledge of this association among lower-income midlife and older adults who are insufficiently active. The present cross-sectional study utilized baseline data collected between October 2017 and November 2019 from a clustered randomized controlled trial to determine how built environment attributes were associated with PA behaviors among midlife and older adults (n = 255) residing in or near affordable housing sites (n = 10). At each site, perceptions of the built environment were collected and scored at the participant level via the abbreviated Neighborhood Environment Walkability Survey (NEWS-A), while objective built environment attributes were measured and scored by trained research staff using the Physical Activity Resource Assessment (PARA). Multiple PA behaviors-walking, total PA, and moderate-to-vigorous PA (MVPA) (min/wk)-were measured using the validated Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire. Adjusted linear regression models examined associations between NEWS-A measures and PA behaviors, and site-level correlations between PARA measures and PA behaviors were examined using Spearman's rank correlations. At the participant level, adjusted models revealed that a one point increase in the NEWS-A aesthetics score was associated with a 57.37 min/wk increase in walking (β = 57.37 [95% CI: 20.84, 93.91], p = 0.002), with a similar association observed for street connectivity and MVPA (β = 24.31 min/wk [95% CI: 3.22, 45.41], p = 0.02). At the site level, MVPA was positively correlated with the quality of the features of local, PA-supportive environmental resources (ρ = 0.82, p = 0.004). Findings indicate that participant- and site-level measures of the built environment may play a role in promoting PA behavior among this demographic and similar populations. Results also suggest that improvements in aesthetic attributes and street connectivity, along with enhancing the quality of local, PA-supportive environmental resources, may be effective strategies for promoting physical activity among lower-income midlife and older adults.

Relationship between baseline levels of subjective cognitive concern and physical, cognitive and social activity in the U.S. POINTER Study

AbstractBackgroundThere has been little investigation into the relationship between physical, cognitive, and social activity and subjective concern about cognition (SCD) in the absence of objective cognitive decline. This concern about subjective change is an important concept in the field of Alzheimer’s disease as it independently confers risk for developing MCI/AD. However, the exact relationship between SCD and engagement in positive daily activities is poorly understood. This project examines the relationship between SCD and self‐reported engagement in these activities.MethodU.S. POINTER is a phase 3, multicenter, 2‐year randomized controlled trial of two lifestyle interventions varying in intensity and format, conducted in older adults living in the U.S. who do not have objective cognitive impairment at study entry, but have increased risk of cognitive decline and dementia. Participants completed myriad measures at baseline, including the Cognitive Function Inventory (CFI) assessing subjective cognitive decline, and the Community Healthy Activities Model Program for Seniors (CHAMPS) which assesses self‐reported engagement in social, cognitive, and physical activities over the past 4 weeks.ResultsBaseline study characteristics of the current sample (N = 1823) are: Mean age = 68.2y (5.2), 73.5% female, 29.8% with less than 18+ years education, and 29.3% from underrepresented groups (URG). In separate multivariate linear models, CFI was associated with weekly caloric expenditure in exercise (p< .001) and cognitive activity (p <.001), such that CFI scores were higher for participants with lower exercise‐related caloric expenditure and lower cognitive activity levels. Higher CFI scores also tended to predict social activity levels (p = .06). The inverse relationship between CFI and all three variables is significant in women (p = .04; .0001; .05, respectively) but not in men, and the CFI‐cognitive activity relationship is significant for URG (p = .005) but not White participants.ConclusionIn sum, SCD and engagement in physical, cognitive, and social activities are inversely related to varying degrees, such that individuals who report lower levels of engagement in these activities report more subjective cognitive concerns. However, different patterns emerged for some subgroups. Additional modeling is needed to demonstrate the directionality of the relationships between these activities and CFI, and the relationship with demographic variables of interest.

3 Associations Between Exercise Type, Fluid Intelligence, and Processing Speed in the Oldest-Old

Objective:Exercise elicits a variety of physiological responses in the body. In the brain, exercise can modulate levels of neurotransmitters and other neurochemicals as well as sparking neurogenesis and structural changes. Downstream psychological effects of exercise include changes in mood and cognition. These changes vary depending on the type of exercise conducted (e.g., running versus strength training). While much is known about the effects of exercise in animals and adult humans, literature on the oldest-old (>= 85 years old) is sparse. The present cross-sectional study explores the relationship between exercise and cognition in the oldest-old.Participants and Methods:The final sample includes 194 cognitively healthy participants (106 females, MoCA mean score = 24.75) aged 85 to 99 years old (mean = 88.48). Each participant completed the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire and a cognitive battery comprising of the NIH Toolbox, digit coding, symbol search, verbal fluency, and Stroop task. Three groups (sedentary, cardio, and cardio plus strength training) were derived from responses on CHAMPS.Results:The cardio plus strength training group performed significantly better on the cognitive measures compared to the sedentary group. For two measures, digit coding and symbol search, the cardio plus strength training group also performed significantly better than the cardio group. Cardio group did not significantly differ from the sedentary group on the cognitive measures. All at p < 0.05 and adjusted for multiple comparisons.Conclusions:Our findings suggest exercise in the oldest-old is linked with higher fluid intelligence and better performance on cognitive measures of processing speed and that there may be an additive effect of exercise types on cognition.

Assessing physical activity in heart failure with the CHAMPS physical activity questionnaire

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Office of Research on Women’s Health and the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health Background It is difficult to quantify physical activity among adults with heart failure (HF) in the context of many disease-driven limitations. The Community Healthy Activities Model Program for Seniors (CHAMPS) Physical Activity Questionnaire, designed to measure physical activity among older adults, may be helpful in quantifying physical activity in HF. Purpose To quantify physical activity levels among adults with HF using the CHAMPS Physical Activity Questionnaire and to compare physical activity expenditure and frequency between adults ≥ 65 years vs. < 65 years, women and men, and those physically frail vs. non-physically frail. Methods This was an analysis of data collected from a cohort study of adults with New York Heart Association Functional Class I-IV HF. Using the CHAMPS Questionnaire, we calculated caloric expenditure (kcal) and frequency per week in all activities and moderate intensity activities. Physical frailty was measured with the Frailty Phenotype Criteria. Comparative statistics were used to compare physical activity between groups. Results The average age of the sample (n = 117) was 63.6±15.6 years, 48.7% were female, and most (76.9%) had non-ischemic HF etiology. Median caloric expenditure from all physical activities was 1827 kcal/week [Interquartile Range 735-3943] and moderate intensity activities was 397 kcal/week [Interquartile Range 0-1886]. For caloric expenditure from all physical activities, there was no significant difference between adults ≥ 65 years vs. < 65 years (p = 0.894), but women and those physically frail had significantly lower caloric expenditure (both p < 0.001). For caloric expenditure from moderate intensity physical activities, there was no significant difference between adults ≥ 65 years vs. < 65 years (p = 0.346), but women had significantly lower caloric expenditure (p < 0.001) as well as those physically frail (p < 0.001). Median frequency of all physical activities was 13 times per week [Interquartile Range 8-21] and of all moderate intensity activities was 3 times per week [Interquartile Range 0-8]. Conclusions Many adults with HF, regardless of age, report low physical activity using the CHAMPS Physical Activity Questionnaire; however, women and those physically frail report considerably lower physical activity than men and those non-physically frail, respectively. Capturing physical activity levels across multiple activities is necessary for the design and implementation of physical activity interventions in HF, and the CHAMPS measure may be one tool to do this.

Surgical care and outcomes in older patients with cancer through implementation of a pre-surgical toolkit (OPTI-Surg): Interim results of a phase III cluster randomized trial (Alliance A231601CD).

1541 Background: Frailty is common in older adults undergoing major cancer surgery. Mounting evidence indicates multimodal interventions to optimize patient functional status by addressing vulnerabilities associated with frailty before surgery result in decreased complications and enhanced functional recovery. This study tested the effectiveness of OPTI-Surg, a surgical prehabilitation toolkit for improving surgical care and outcomes in older patients undergoing major cancer surgery. Here, we report results from the planned futility interim analysis (IA). Methods: Thoracic (T), gastrointestinal (GI), and urologic (GU) oncological surgery practices affiliated with NCI’s Community Oncology Research Program were randomized 1:1:1, stratified by practice type, to usual care (control), OPTI-Surg toolkit, or OPTI-Surg with an implementation coach. The toolkit was implemented at the practice level. It consisted of the 12-item Edmonton Frail Scale and guided recommendations for interventions directed at identified vulnerabilities. Eligible patients were adults ≥70 years old undergoing curative intent surgery for lung, gastrointestinal, or urologic cancers. Primary outcome was 8-week post-operative function (weekly caloric expenditure) derived from the validated Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire. A linear mixed model was used to compare usual care to the 2 OPTI-Surg arms combined, controlling for baseline function. Results: From July 2019 to October 2021, 225 patients, 50% of the total accrual goal, were enrolled from 29 practices, triggering the IA. Study was suspended to new patient accrual March to June 2020 due to the COVID-19 pandemic. There were no differences in demographics by arm (mean age 76.2 years; 46.4% women; 79.6% white; 20.4% lung resection, 69.8% major GI surgery, 9.8% total cystectomy). Of the 225 patients, 140 (47 Usual Care, 93 OPTI-Surg) were evaluable for the IA. There was no significant difference in post-operative function between OPTI-Surg and usual care (mean decrease of 0.59 kCal/week for OPTI-Surg patients and 0.19 kCal/week for usual care patients, p = 0.762, intraclass correlation = 0.033). Based on the futility analysis, the DSMB recommended closure of recruitment on September 16, 2022. Conclusions: Implementation of the OPTI-Surg toolkit did not significantly improve functional outcomes 8 weeks after surgery for patients aged 70 and older undergoing major cancer surgery compared to usual care. Future analysis of implementation and ethnographic data may identify reasons why significant differences between the intervention and usual care arms were not observed, potentially including disruptions due to the COVID-19 pandemic. Clinical trial information: NCT03857620 .

Physical Activity and Symptom Burden in COPD: The Canadian Obstructive Lung Disease Study.

The relationship between symptom burden and physical activity (PA) in chronic obstructive pulmonary disease (COPD) remains poorly understood with limited data on undiagnosed individuals and those with mild to moderate disease. The primary objective was to evaluate the relationship between symptom burden and moderate-to-vigorous intensity PA (MVPA) in individuals from a random population-based sampling mirroring the population at large. Baseline participants of the Canadian Cohort Obstructive Lung Disease (n=1558) were selected for this cross-sectional sub-study. Participants with mild COPD (n=406) and moderate COPD (n=331), healthy individuals (n=347), and those at risk of developing COPD (n=474) were included. The Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire was used to estimate MVPA in terms of energy expenditure. High symptom burden was classified using the COPD Assessment Test ([CAT] ≥10). Significant associations were demonstrated between high symptom burden and lower MVPA levels in the overall COPD sample (β=-717.09; 95% confidence interval [CI]=-1079.78, -354.40; p<0.001) and in the moderate COPD subgroup (β=-694.1; 95% CI=-1206.54, -181.66; p=0.006). A total of 72% of the participants with COPD were previously undiagnosed. The undiagnosed participants had significantly higher MVPA than those with physician diagnosed COPD (β=-592.41 95% CI=-953.11, -231.71; p=0.001). MVPA was found to be inversely related to symptom burden in a large general population sample that included newly diagnosed individuals, most with mild to moderate COPD. Assessment of symptom burden may help identify patients with lower MVPA, especially for moderate COPD and for relatively inactive individuals with mild COPD.

PHYSICAL ACTIVITY MEDIATES LATIN DANCE PARTICIPATION AND FITNESS OUTCOMES IN OLDER LATINOS

Abstract Background The benefits of engaging in physical activity (PA) for older adults (OA) are well documented; however, participation rates remain low, especially among OA Latinos. Latin dance expresses and promotes culture among Latinos, and can be an effective approach to promote PA. However, the physical function and cardiorespiratory fitness (CRF) benefits of OA engaging in Latin dance have not been investigated. The purpose of this study was to test if PA from an 8-month dance trial yielded and explained improvements in physical function and CRF. Methods The study analyzed physical function and CRF outcomes from the BAILA trial. Participants (n= 333) were Latinos (age 55+) who were randomized to a dance or control condition for an 8-month study. PA was assessed using the Community Healthy Activities Model Program for Seniors (CHAMPS), physical function was assessed with the short physical performance battery protocol (SPPB) and estimated CRF was assessed using the Jurca non–exercise test model. Results. ANCOVA models found significant change in SPPB total scores(F1, 331= 4.01, p=0.046) and estimated CRF (F1, 331= 7.66, p= 0.006) over eight months in favor of the dance group. Follow-up mediation models found MVPA to mediate between group and SBBP scores, (β= 0.05, 95% CI [0.0128, 0.1147]). MVPA also mediated between group and CRF, (β= 0.06, 95% CI [0.0164, 0.1197]). Conclusion. The study supports organized Latin dance programs to be effective for improving physical and cardiorespiratory benefits among older adults. The findings also encourage future investigations to promote PA in culturally relevant forms.

Habitual Physical Activity Is Associated With Prescription Medication Use In Older Adults

Increased prescription medication (Rx) use has been associated with adverse drug events, drug-drug interactions, and rising health-care costs. Few studies have examined the potential relationship between physical activity (PA) level and Rx use. Thus, the purpose of this study was to determine if habitual PA is associated with Rx use in older adults. METHODS: In 171 older adults (116 women, 55 men, 72 ± 8y, BMI: 27 ± 5 kg/m2) physical activity (PA) was measured via 1) self-report (PA-SR) using the Community Healthy Activities Model Program for Seniors (CHAMPS) and 2) objectively (PA-O) using 7-day accelerometry (Actical, Phillips Respironics, Bend, Oregon). PA-SR data were calculated as kcal/wk of moderate-to-vigorous PA (MVPA). Accelerometry data were processed as min/day of MVPA and sedentary behavior, as well as the ratio of Sedentary/MVPA behavior (Sed/Mod). Prescription medication use (Rx) was collected during health history screening. Bivariate and partial correlations (controlling for age and BMI) were utilized to determine if measures of PA were significantly correlated with Rx. Hierarchical linear regression was utilized to determine the predictive power of age, BMI, and PA for estimating Rx use. RESULTS: Average Rx use was 2.5 ± 0.16 meds. Average physical activity was 1,632 ± 1,280 kcal/wk of moderate-to-vigorous PA for PA-SR and 55 ± 35 min/day of MVPA for PA-O. Age (r = 0.21), BMI (r = 0.47), PA-SR (r = -0.31), PA-O (r = -0.45), and Sed/Mod (r = 0.47) were significantly (p < 0.05) correlated with Rx use. Partial correlations (controlling for age and BMI) showed that PA-O and Sed/Mod, but not PA-SR, remained significantly correlated with Rx use. Utilizing hierarchical linear regression, a model containing BMI, Sed/Mod, and age was the most predictive of prescription medication use—explaining 42% of the variance. Of these independent variables, BMI and Sed/Mod ratio explained 21.7% and 21.6% of the variance in Rx use when included in a regression model individually, while age explained 3.8% of the variance in Rx use. CONCLUSION: These data extend previous reports that PA is inversely associated with Rx use. They further suggest that BMI and objective measures of PA are more predictive of Rx use than age in older adults.

Association between physical activity and physical and functional performance in non-institutionalized Mexican older adults: a cohort study

BackgroundAging is an independent risk factor for deterioration in functional capacity. Some studies have reported that physical activity (PA) improves functional capacity and physical performance among older adults (OA). Thus the objective of the present study was to assess the longitudinal association between PA and functional and physical performance in non-institutionalized OA.MethodsA longitudinal analysis using data from the Frailty, Dynapenia and Sarcopenia in Mexican adults (FRADYSMEX, by its Spanish acronym) cohort study was conducted. PA was assessed through the Community Healthy Activities Model Program for Seniors (CHAMPS) instrument. Functionality was measured with the Barthel index and the Lawton and Brody scale, while physical performance was measured with the Short Physical Performance Battery (SPPB). To evaluate the association between the level of PA and physical and functional performance as a continuous variable, a linear regression of mixed effects was performed. To assess PA and dependence in basic activities of the daily life (BADL), instrumental activities of the daily life (IADL), and low physical performance (PP), generalized estimation equation models [to compute odds ratios (OR) and 95% confidence intervals (95%CI)] were computed.ResultsOlder people who performed moderate to vigorous-intensity PA had a lower risk of dependence in IADL (OR = 0.17; 95%CI: 0.10, 0.80) and lower risk of low PP (OR = 0.18; 95%CI: 0.11, 0.58) compared to those in lower categories of PA.ConclusionsOlder adults living in the community who perform PA of moderate to vigorous intensity have a lower risk of dependence in BADL and IADL and have a lower risk of low PP.

Abstract 036: Influence Of Physical Activity Measurement On The Association Between Life’S Simple 7 And Cardiovascular Disease In Older Women

Introduction: The AHA’s Life’s Simple 7 (LS7) includes physical activity (PA) as one of the metrics for assessing cardiovascular health. Using self-reported PA can misclassify those who meet the PA component of the LS7. Using accelerometer-measured PA may improve the utility of the LS7. Our study compares associations of LS7 and incident cardiovascular disease (CVD) associations using both self-reported and accelerometer-measured PA. Methods: Women’s Health Initiative (WHI) participants in the Objective Physical Activity and Cardiovascular Health Study (n=4075; mean±SD age = 79±7) with no history of CVD completed the WHI PA questionnaire (PAQ) and the Community Healthy Activities Model Program for Seniors (CHAMPS) PAQ prior to wearing a hip-worn accelerometer for up to 7 consecutive days. LS7 components (PA, diet, body mass index, smoking, blood pressure, fasting serum total cholesterol and glucose) were scored on a scale of 0-2 using AHA guidelines, resulting in an LS7 summary score ranging from 0-14 with higher scores reflecting more favorable status. Four LS7 summary scores were created using different PA measures: the WHI PAQ, the CHAMPS PAQ, and two accelerometer measures (MVPA min/week and mean steps/day). LS7 scores were analyzed using quartiles (LS7 scores 1-7, 8, 9, 10-14) and hazard ratios (HR) for incident physician-adjudicated CVD were estimated. Results: There were 500 incident CVD events (see Table) over an average 6 years of follow-up. Multivariable HRs (95% CI) comparing women with high (10-14) vs. low (1-7) LS7 scores were: WHI PAQ= 0.81 (0.60-1.09), CHAMPS PAQ= 0.80 (0.61-1.05), accelerometer (MVPA)= 0.61 (0.47-0.79), accelerometer (steps)= 0.65 (0.45-0.94; see Table). Conclusions: PA is just one component of the LS7, yet the LS7-incident CVD associations vary considerably by PA measurement. Accelerometer-measured PA, such as daily steps, improves the accuracy of the LS7 PA component used to classify cardiovascular health and may be feasible for practitioners to implement.

Assessment of Physical Activities of Older Midwestern Breast Cancer Survivors using Community Healthy Activities Model Program for Seniors (CHAMPS)

Aims: This study applied the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire to describe lifestyle physical activities among older community-dwelling breast cancer survivors (BCSs) living in a medium-sized Midwestern city in the United States. Methods: BCS participants completed the CHAMPS at baseline (n = 146) and 12-month follow-up (n = 67). Generalized linear mixed-effects models, logistic regression, and Wilcoxon signed-rank tests were used to analyze the quantitative data. Qualitative responses were categorized and quantified using frequencies. Results: A total of 247 responses to CHAMPS survey were received from participants (n = 146) who averaged 67 years of age and 10 years post-surgery. About 84% of respondents reported at least some moderate-intensive exercise in the past week for a median of 4 h. For a participant 10 years younger than another, the odds of having at least some moderate and intensive exercise were doubled (odds ratio [OR] = 2.01, P = 0.00) in hours and 89% higher (OR = 1.89, P = 0.00) in caloric expenditure. No statistically significant differences were found between the annual surveys in exercise caloric expenditures. Additional activities, including farm work, woodworking/carpentry, construction activities, and caring for grandchildren, were reported. Item missing rate was only 1.05%. Conclusion: CHAMPS is useful in measuring the lifestyle physical activities among Midwestern older BCS. Further analysis of the constructs of the demographic relevant activities is necessary for optimizing the use of the tool among the aging Midwestern population.

Defining physical activity: A comparison of actigraphy monitoring and self‐report measures

AbstractBackgroundPhysical activity (PA) helps preserve age‐related brain health. However, PA is a broad construct and its operationalization can vary. Actigraphy monitors are gold‐standard measures of PA, but not always feasible. The Community Healthy Activities Model Program for Seniors (CHAMPS) and Physical Activity Scale for the Elderly (PASE) are widely‐used self‐report questionnaires of PA for older adults, but are limited by scope and subjectivity. We aimed to examine the ecological validity of objective and subjective measures of PA and determine how self‐reported PA relates to distinct actigraphy metrics.Method104 functionally normal older adults completed 30‐day Fitbit monitoring (average daily steps and calories burned), and reported PA levels via PASE (total activity) and CHAMPS‐METs (metabolic expenditure calories burned). Participants also completed measures of vascular (hypertension diagnosis, resting heart rate), neurobehavioral (cognition, Perceived Stress Scale, Everyday Cognition Scale), and brain MRI (medial temporal lobe volume) outcomes. Spearman’s rank correlations and regression models evaluated the associations among PA measures and with outcomes of interest.ResultGreater Fitbit step count associated with higher PASE (r=0.30, p=0.005), but not CHAMPS‐MET scores (r=0.15, p=0.20). On the other hand, Fitbit calories burned related to higher CHAMPS‐METs (r=0.35, p=0.003), but not PASE scores (r=0.16, p=0.15). Only Fitbit measures demonstrated expected positive associations with cognitive outcomes, with slightly stronger associations shown with step count (r range=0.23‐0.26). All 3 PA measures demonstrated expected negative associations with perceived stress and cognitive complaints (r range=‐0.07‐0.26). Greater PA, as measured by Fitbit metrics or CHAMPS‐MET, was associated with less hypertension (Fitbit steps t=0.15; CHAMPS‐METs t=‐2.04) and lower resting heart rate (Fitbit calories burned r=‐0.26). PASE did not significantly associate with vascular health (HTN t=0.93; HR r=‐0.02, ps&gt;0.05). Lastly, greater Fitbit step count (β=0.32, p&lt;0.01) and calories burned (β=0.29, p&lt;0.01), but not PASE or CHAMPS‐MET (β range=0.05‐0.15, ps&gt;0.05), were associated with larger medial temporal lobe volumes.ConclusionObjective indicators of PA demonstrate greater overall ecological validity compared to self‐report. Our findings suggest PA is comprised of several constructs. Metrics capturing PA intensity via calories burned may not be interchangeable with metrics of overall movement. Careful understanding what PA metrics represent will facilitate better‐informed recommendations for healthy aging.

Association of physical activity levels and brain white matter in older Latino adults

ABSTRACT Objective Investigate the associations between self-reported physical activity (PA) engagement and white matter (WM) health (i.e. volume, integrity, and hyperintensities) in older Latinos. Design Cross-sectional study with community-dwelling older adults from predominantly Latino neighborhoods. Participants: Thirty-four cognitively healthy older Latinos from two different cohorts. Measurements: Participants self-reported demographic information, PA engagement [Community Healthy Activities Model Program for Seniors (CHAMPS) Physical Activity Questionnaire for Older Adults] and magnetic resonance imaging (MRI). We used high-resolution three-dimensional T1- and T2-FLAIR weighted images and diffusion tensor imaging acquired via 3 T MRI. We performed a series of hierarchical linear regression models with the addition of relevant covariates to examine the associations between self-reported PA levels and WM volume, integrity, and hyperintensities (separately). We adjusted p-values with the use of the Benjamini-Hochberg's false discovery rate procedure. Results Higher reported levels of leisure-time moderate-to-vigorous PA were significantly associated with higher WM volume of the posterior cingulate (β = 0.220, SE = 0.125, 95% CI 0.009-0.431, p = 0.047) and isthmus cingulate (β = 0.212, SE = 0.110, 95% CI 0.001-0.443, p = 0.044) after controlling for intracranial volume. Higher levels of total PA were significantly associated with higher overall WM volume of these same regions (posterior cingulate: β = 0.220, SE = 0.125, CI 0.024-0.421, p = 0.046; isthmus cingulate: β = 0.220, SE = 0.125, 95% CI 0.003-0.393; p = 0.040). Significant p-values did not withstand Benjamini-Hochberg’s adjustment. PA was not significantly associated with WM integrity or WM hyperintensities. Conclusion Higher levels of PA, particularly higher leisure-time moderate-to-vigorous PA, might be associated with greater WM volume in select white matter regions key to brain network integration for physical and cognitive functioning in older Latinos. More research is needed to further confirm these associations.

Validation of an Adapted Questionnaire for Outdoor Walking Among Older Adults: The CHAMPS-OUTDOORS

The aim of this study was to examine the construct and known-groups validity of the total score of five items adapted from the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire to measure outdoor walking (CHAMPS-OUTDOORS) in older adults. Data from the baseline assessment of the Getting Older Adult OUTdoors (GO-OUT) trial were used. Construct validity of the CHAMPS-OUTDOORS used objective measures of outdoor walking (accelerometry-GPS), Ambulatory Self-Confidence Questionnaire, RAND-36, 6-min walk test, 10-m walk test, and Mini-Balance Evaluation System Test. For known-groups validity, we compared the CHAMPS-OUTDOORS of those who walked < or ≥1.2m/s. Sixty-five participants had an average age of 76.5 ± 7.8years. The CHAMPS-OUTDOORS was moderately correlated with total outdoor walking time (r = .33) and outdoor steps (r = .33) per week measured by accelerometry-GPS, and weakly correlated with Mini-Balance Evaluation System Test score (r = .27). The CHAMPS-OUTDOORS did not distinguish known groups based on crosswalk speed (p = .33). The CHAMPS-OUTDOORS may be used to assess outdoor walking in the absence of accelerometry GPS. Further research examining reliability is needed.

Lifestyle exercise attenuates immunosenescence; flow cytometry analysis

BackgroundInteraction of physical activity and overall immune profile is very complex and depends on the intensity, duration and frequency of undertaken physical activity, the exposure to cytomegalovirus (CMV) infection and the age-related changes in the immune system. Daily physical activity, which particularly influences immunity, declines dramatically with age. Therefore, the aim of the study was to explain whether physical activity sustained throughout life can attenuate or reverse immunosenescence.MethodsNinety-nine older adults (60–90 years) were recruited for the study. According to the 6-min walk test (6WMT), the Åstrand-Ryhming bike test (VO2max) and Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire, the individuals were classified as physically active (n = 34) and inactive (n = 20) groups. The analysis of T lymphocytes between active vs. inactive participants was performed using eight-parameter flow cytometry.ResultsAnalysis of the baseline peripheral naïve and memory T lymphocytes showed a significant relationship of lifestyle exercise with the CD4/CD8 ratio. Above 50% of physically active participants demonstrated the CD4/CD8 ratio ≥ 1 or ≤ 2.5 contrary to the inactive group who showed the ratio < 1. The older adults with the result of 6WMT > 1.3 m/s and VO2max > 35 mL/kg/min had a significantly higher CD4+CD45RA+ T lymphocyte percentage and also a higher ratio of CD4+CD45RA+/CD4+CD45RO+. Interestingly, in active older adults with IgG CMV+ (n = 30) the count of CD4+CD45RA+ T lymphocytes was higher than in the inactive group with IgG CMV+ (n = 20).ConclusionBased on the flow cytometry analysis, we concluded that lifestyle exercise could lead to rejuvenation of the immune system by increasing the percentage of naïve T lymphocytes or by reducing the tendency of the inverse CD4/CD8 ratio.

Validity of Tools to Measure Physical Activity in Older Adults Following Total Knee Arthroplasty.

Few validated tools exist for measuring physical activity following total knee arthroplasty (TKA) despite the importance of returning to sufficient levels of physical activity post-TKA to achieve health benefits. This study examined the validity of two clinical measures-the Fitbit, a commercially available personal activity monitor, and the Community Healthy Activities Model Program for Seniors (CHAMPS), a self-report questionnaire-compared with a reference standard accelerometer, the SenseWearTM Armband (SWA). At 6-month post-TKA, 47 participants wore the Fitbit and SWA for 4 days and then completed the CHAMPS. Moderate-to-good correlation was observed between the Fitbit and SWA for steps (intraclass correlation coefficient [ICC] = .79), energy expenditure (ICC = .78), and energy expenditure <3 METS (ICC = .79). Poor-to-moderate correlation was observed between the CHAMPS and SWA (ICC = .43) with the questionnaire reporting lower daily energy expenditures than the SWA. Results showed that Fitbit may be a reasonable measurement tool to measure steps and energy expenditures in older adults following TKA.

Acceptability and Feasibility of ActivPAL Activity Tracker for Pre-Frail African American Older Adults

Frailty is more prevalent among African American (AA) older adults compared to their White counterparts. Physical activity (PA) interventions are effective to attenuate frailty progression. The Activpal is adhered to the thigh and allows unobtrusive PA measurement for up to 14 days. However, few studies have tested the acceptability and feasibility of activity trackers among older pre-frail AA. In this study, pre-frail AA older adults were asked to wear the ActivPAL tracker on their thigh for 7 consecutive days. Acceptability was measured by compliance. Feasibility was evaluated by the valid number of days and programing errors. Intraclass correlation coefficients were used to assess the agreement of light to vigorous PA level between ActivPAL and the Community Healthy Activities Model Program for Seniors (CHAMPS). In a sample of 28 pre-frail AA older adults (mean age= 73.21,SD= 9.37, 100% female), 24 completed the 7-day data tracking. Reasons for non-compliance included skin irritation (n=1), and fear of causing other health issues (n=3). The number of valid days was= 6.9 0.33 with 1 incident of programming error. The agreement between ActivPAL and CHAMPS was fair (ICC =0.57, [95%CI]= -.08 -.85) with most participants (61.6%) over-reporting PA on CHAMPS. The ActivPAL accelerometer was acceptable and feasible to use among pre-frail AA older adults. Communication prior to applying the accelerometer is crucial to prevent non-compliance. The results confirm prior studies, which suggest that older adults may over-report PA levels. ActivPAL offers a feasible and accurate approach to assess PA among older AA.

Physical Activity and Neighborhood Socioeconomic Disadvantage Among Low-Income African Americans

Research shows regular physical activity (PA) is associated with better health and longevity; however, few studies consider contextual factors related to PA among African American (AA) older adults living in socioeconomically disadvantaged neighborhoods. The Physical and Cognitive Health Pilot Study (n=50) was used to examine associations between PA and level of neighborhood socioeconomic disadvantage among sedentary, AA older adults from four public housing communities in Durham, NC and Annapolis, MD (mean age=64.5; SD=10.42; 72% women). Participants were administered the Community Healthy Activities Model Program for Seniors (CHAMPS), a self-report questionnaire measuring weekly frequency and duration of PAs. Neighborhood socioeconomic disadvantage was defined by the Neighborhood Atlas Area Deprivation Index (ADI), which ranks neighborhoods according to Census block group/neighborhoods within each state and nationally. For the present sample, two of the Durham housing facilities were located in communities in the most disadvantaged block groups. Meanwhile, one Durham location and the Annapolis community were located in the least disadvantaged block groups. Bivariate correlations showed greater neighborhood socioeconomic disadvantage was associated with less participation in various PAs (p<.05). Next, ANOVA revealed the Annapolis group participated in statistically significantly more PAs, including visiting the senior center, church attendance, and light gardening (p<.05) compared to the most disadvantaged groups. The present findings suggest there are benefits to living in advantaged contexts despite lower-income status. These findings also suggest barriers within disadvantaged neighborhoods that limit access to recreational activities favorable to health status. Future research should address ways to overcome such barriers.

An Optimal Self-Report Physical Activity Measure for Older Adults: Does Physical Function Matter?

The authors compared two self-report measures of physical activity, the Physical Activity Scale for the Elderly (PASE) and the Community Healthy Activities Model Program for Seniors (CHAMPS), against the device-derived SenseWear Armband (SWA), to identify a recommended self-report tool to measure physical activity in older adults across physical function levels. A total of 65 community-dwelling older adults completed the PASE, CHAMPS, and seven full days of SWA wear. The authors measured physical function using the modified short physical performance battery (SPPB) and a usual-paced 6-m walk. Age- and sex-adjusted Spearman correlations showed that CHAMPS and SWA were correlated in higher functioning participants (SPPB: ρ = .33, p = .03; gait speed: ρ = .40, p = .006) and also correlated in lower functioning participants for SPPB (ρ = .70, p = .003) only. PASE and SWA were not significantly correlated across physical function. When an objective measure of physical activity is not practical, the CHAMPS questionnaire appears to capture physical activity for older adults across physical function levels.

Cross-Cultural Adaptation and Psychometric Evaluation of the Community Healthy Activities Model Program for Seniors Physical Activity Questionnaire in Chinese Older Adults.

The study's aims were to translate the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire to Chinese and examine its psychometric properties. Adapting it for use in China involved forward translation, synthesis, back translation, expert review, and pretesting. A convenience sample of 201 Chinese older adults completed the Chinese version (CHAMPS-C) to evaluate its construct validity index and associations with physiological, psychosocial, and energy expenditure measures. The construct validity index of the CHAMPS-C was 0.95, and it had fair to moderate associations with physiological and psychosocial measures, other scales of physical activity, and accelerometer measurements. Our structured, stepwise process of cross-cultural adaptation produced a scale (i.e.,CHAMPS-C), with items equivalent in meaning to the English version, for use with Chinese older adults. The findings of this study indicate that the CHAMPS-C has acceptable reliability and validity to assess the physical activity of older Chinese adults.