Exercise In Older Adults Research Articles

Comparing Biological Information and Mood for Video Exercise and Intervention Exercise in Older Adults a Pilot Study

Comparing Biological Information and Mood for Video Exercise and Intervention Exercise in Older Adults a Pilot Study

Home-Based, Low-Intensity, Gamification-Based, Interactive Physical-Cognitive Training for Older Adults Using the ADDIE Model: Design, Development, and Evaluation of User Experience.

Declines in physical and cognitive function are natural biological processes, leading to an increased risk of falls. Promising evidence suggests that combined physical-cognitive exercise has beneficial effects in improving both physical and cognitive health. Although moderate-to-high exercise intensity is commonly recommended, it might be impractical for older adults facing physical limitations or contraindications. Thus, low-intensity exercise is a viable option. The main barriers to engaging in exercise in older adults include transportation, time, motivation, and enjoyment. To overcome these challenges, a home-based, gamification-based training system may provide an effective approach to enhance exercise adherence. This study aimed to develop and evaluate the usability of a low-intensity, gamification-based, interactive physical-cognitive exercise for older adults in a home-based setting. The prototype of a game-based physical-cognitive exercise was created following the ADDIE model (analysis, design, development, implementation, and evaluation) and assessed for user experience in older adults. A total of 15 older adults engaged in the game-based physical-cognitive exercise at home for 60 minutes per day, 3 days per week, for 4 weeks. The usability of the game-based training system was evaluated using the system usability scale (SUS) after completion of a 4-week training program. As for satisfaction, the 8-item Physical Activity Enjoyment Scale (PACES) questionnaire was used to assess participants' enjoyment level after 1 week and 4 weeks of training. Descriptive statistics were used to illustrate the SUS score. A Wilcoxon signed-rank test was used to compare the PACES scores between the first week and the end of the 4-week period, with significance set at P<.05. As for experts' consensus, the game-based training consisted of 3 games: Ocean Diver, Road Runner, and Moving and Memorizing. The games had 3 levels of difficulty: beginner, intermediate, and advanced. A computer vision-based system was selected as the delivery platform for a home setting. The total SUS score for all participants was mean 87.22 (SD 5.76), indicating the user's perception of the usability of a system ranging from good to excellent. At the end of the 4-week training, the total PACES score was significantly greater than the first week, suggesting an improvement in enjoyment (first week: mean 44.93, SD 3.99 vs fourth week: mean 50.53, SD 4.70; P=.001). The prototype of low-intensity, gamification-based, interactive physical-cognitive training was designed and developed using the ADDIE model, which included both experts and end users in the process. The findings showed that the exergame prototype was a usable and practical approach for a home-based setting, enhancing older adults' enjoyment and motivation. Further research is warranted to determine the effectiveness of such gamification-based training in promoting physical and cognitive functions.

A pilot randomized controlled trial of a virtual peer-support exercise intervention for female older adults with cancer

BackgroundRegular exercise can mitigate side effects of cancer treatment. However, only a small proportion of adults with cancer meet exercise guidelines, and older adults (> 65 years) are underrepresented in cancer rehabilitation research. Peer support facilitates health-promoting behaviours in general populations, but interventions merging exercise and peer support for older adults with cancer are not examined. The purpose of this study was to determine the feasibility and preliminary effectiveness of a virtual partner-based peer support exercise intervention for older adult female cancer survivors.MethodsOlder adult female cancer survivors with internet access and currently participating in < 150 min of moderate-vigorous physical activity per week were included in this study. Participants were matched with a partner and given a peer support guide, exercise guidelines, and a Fitbit Inspire©. In addition, intervention group dyads (AgeMatchPLUS) had weekly 1-h virtual sessions with a qualified exercise professional for 10 weeks. Dyads randomized to the control group (AgeMatch) independently supported their partner around exercise for 10 weeks. The primary outcome was feasibility, measured using retention and adherence rates. Secondary outcomes included exercise volume, social support, quality of life, physical function, and physical activity enjoyment. Descriptive statistics were used to report feasibility and an ANCOVA was used to explore between group differences on secondary outcomes at post-intervention (10 weeks post baseline) and post-tapering timepoints (14 weeks post baseline).ResultsEighteen participants (9 dyads; mean age 72 years (SD: 5.7 years)) were included in the pilot trial. Retention and adherence rates to the AgeMatchPLUS intervention were 100% and 95% respectively. All but one participant was satisfied with the quality of their peer match. Preliminary effects were seen between group, favouring AgeMatchPLUS for exercise-related social support post-intervention (effect size (d) = 0.27, 95% CI = 0,0.54) and physical activity enjoyment at post-tapering (d = 0.25, 95% CI = 0,0.52) and favouring the AgeMatch group for 30 s sit-to-stand repetitions at post-tapering (d = 0.31, 95% CI = 0.004, 0.57). No other effects were found.ConclusionsA virtual partner-based exercise intervention for older adults with cancer is feasible and shows preliminary effect benefits. Findings inform future trials aimed at increasing exercise in older adults with cancer.Trial registrationClinicaltrials.gov (ID: NCT05549479, date: 22/09/22).

Impact of telephone coaching supporting a physical maintenance exercise programme for older adults at risk of falls: a randomised controlled trial

BackgroundEncouraging compliance with recommended levels of exercise for older adults is a public health challenge. A minimal-resource solution is telephone coaching.ObjectivesPrimary aim: to compare timed up and go (TUG) performance 6 months after beginning a home exercise program between a group of older individuals who received additional telephone coaching, and a control group performing the home exercise program alone. Secondary aims: to compare functional and fall-related outcomes between groups at 6 and 12 months.MethodsMulticentre, assessor-blinded, randomised, controlled, open label, prospective study. Inclusion criteria included age ≥ 65 years, ≥ 1 fall in the past year, and discharged home from hospital rehabilitation or outpatient physiotherapy. All participants received a home exercise booklet and were asked to perform a set of exercises as often as possible (daily). The coaching group additionally received a monthly telephone call (total 5 calls) from their previous physiotherapist. Primary outcome was TUG performance at 6 months. Outcomes were measured at inclusion, and at 6 and 12 months. The primary outcome was analysed using a linear mixed model adjusted for the baseline value.ResultsIn total, 99 individuals were included (coaching group n = 50, control group, n = 49; mean [SD] age 83.1 [5.8] years and 77% women). TUG performance did not differ between groups at 6 months (adjusted difference 1.37, SE 1.32, 95% CI 1.26 to 4.01, p = 0.30). Secondary outcomes did not differ between groups at 6 or 12 months except compliance to the exercise program was higher in the coaching than the control group at 6 months (adjusted difference 1.0, SE 0.5, 95% CI 0.02 to 2.0, p = 0.05).ConclusionsThe lack of difference between the groups in the time taken to complete the TUG at 6 months suggests that the monthly telephone coaching sessions did not improve the effectiveness of a home exercise programme in elderly people who had suffered at least one fall. The trial was registered on ClinicalTrials.gov (NCT02828826; 11th of july 2016, last modification 16th of September 2024).

Post-exercise hypotension after different volumes of combined calisthenic and walking exercises in older adults with hypertension: a randomized controlled trial.

This study aimed to analyze the acute effects of combined calisthenic and walking exercises using different volumes on blood pressure (BP) in aging adults with primary hypertension. A total of 48 participants with primary hypertension aged 50-80 years were randomly assigned into two groups that performed two experimental sessions each: a non-exercising CONTROL session and a LOW (group 1) or HIGH (group 2) volume exercise session. The order of these sessions was randomized. The exercise protocols lasted 30 min (LOW) or 60 min (HIGH) and consisted of calisthenic exercises combined with continuous walking or jogging. Exercise intensity was controlled using a rating of perceived exertion (RPE) scale. BP was measured at baseline and after each session for 60 min. Results showed that systolic BP was lower after the HIGH session at post 30' (p = 0.03), post 40' (p = 0.03), post 50' (p = 0.04), and post 60' (p < 0.02), and after the LOW session at post 30' (p = 0.02), post 40' (p < 0.01), post 50' (p < 0.01), and post 60' (p < 0.01) when compared to the corresponding CONTROL at the same time point. There were no significant differences in systolic and diastolic BP between the HIGH and LOW sessions. In conclusion, a pragmatic combined training session using different volumes acutely reduces BP in older adults with primary hypertension.

Testing Interventions for Mobility through Exercise (TIME): Study protocol for a randomized trial comparing a novel, brief home-based exercise program and a standard home-based group exercise for older adults with mobility disability

One in four older adults report difficulty walking, greatly increasing the risk of future disability and death. Though exercise improves mobility, too few older adults do it. While studies show that brief exercise sessions provide most of the benefit of longer sessions and that older adults note that “time” is a critical barrier to being active, what remains unknown is whether briefer RT sessions can improve mobility as well as, or better than, longer traditional sessions, possibly due to greater adherence. We present the design of a 12-month randomized controlled trial of 700 older adults with self-reported walking difficulty. Participants will be randomly assigned, in a 2 × 2 factorial design, to one of two home-based exercise programs: 1) Standard of Care: 45-min, three-times weekly sessions or 2) Experimental: 5-min daily sessions and to one of two doses of behavior change techniques (Standard or Enhanced) as part of their exercise program. The primary outcome measure is self-reported physical function. Secondary outcome measures include objectively measured lower extremity physical performance, walking endurance, balance, walking speed, strength and physical activity as well as self-reported falls, pain, fatigue and balance. This is one of the first studies to examine the clinical outcomes of brief exercise sessions, which may lead to a new generation of exercise programs that are optimized not only for impact, but for adherence as well.

Resistance Exercise Participation in Community-Dwelling Older Adults in Korea: Associated Factors and Sex Differences.

Background/Objectives: Despite the importance of resistance exercise in older adults, factors associated with participation remain unclear, especially regarding sex differences. This study investigated sociodemographic, behavioral, and comorbidity factors associated with insufficient resistance exercise participation among community-dwelling older adults in Korea, with analyses stratified by sex. Methods: Nationally representative cross-sectional data from 8671 participants aged ≥65 years (3758 men and 4913 women; mean age 72.8) were analyzed using the 6th-8th Korea National Health and Nutrition Examination Surveys (2014-2019). Complex-sample multivariable logistic regression identified factors associated with insufficient resistance exercise overall and by sex. Results: Women had a higher prevalence of insufficient resistance exercise than men (91.27% vs. 71.04%, p < 0.001). Older age groups, particularly those aged ≥80 years (OR: 2.39; 95% CI: 1.86-3.07), and those with lower education (OR: 1.56; 95% CI: 1.33-1.82), rural residence (OR: 1.89; 95% CI: 1.49-2.38), low household income, (OR: 1.45; 95% CI: 1.13-1.88), insufficient aerobic exercise (OR: 1.68; 95% CI: 1.46-1.94), current smoking (OR: 1.70; 95% CI: 1.26-2.29), and diabetes (OR: 1.28; 95% CI: 1.09-1.51) were independently associated with a higher likelihood of insufficient resistance exercise. The association of household income, current smoking, hypertension, and diabetes with resistance exercise adherence showed differences in sex-stratified analyses. Conclusions: Multiple sociodemographic, behavioral, and comorbid factors are linked to resistance exercise adherence among older Koreans. Tailored, sex-specific interventions are needed to promote resistance exercise in this population, informing public health strategies and further research on effective approaches for diverse older adults.

Effects of Detraining on Physical Capacity and Its Relationship With Depressive Symptoms, Quality of Life and Sedentary Behavior in Community-Dwelling Older Adults: A Longitudinal Study.

Detraining is the partial or complete loss of physical training-induced adaptations as a result of exercise interruption or reduction. The COVID-19 pandemic led to the discontinuation of many older adult exercise programs and led to increased depressive symptoms (DS), increased sedentary behavior (SB), and decreased quality of life (QoL). To evaluate the effects of detraining, in the pandemic, on physical capacity and its relationship with DS, QoL, and SB of community-dwelling older adults. The physical capacity (static balance, dynamic balance, and lower limb and handgrip strength) of 35 participants was assessed prepandemic and after 18 and 24 months of the pandemic. DS, QoL, and SB were evaluated only at 18-month period. The analysis of variance for repeated measures or the Friedman and Pearson or Spearman tests were used for statistical analysis. There was a decline in dynamic balance (p < .001) and strength in the lower limbs (p < .001) in the first 18months, as well as maintenance in the following 6months. The reduction in dynamic balance during the 18months of the pandemic was associated with greater DS (p = .015; r = .414) and worse QoL (p = .024; r = -.381) in this period. More time spent on SB (p = .024; r = .386) in the 18th month was associated with worse dynamic balance in the following 6months. Detraining in the pandemic setting led to long-lasting harmful effects, which can last for 2years, on the physical capacity of community-dwelling older adults. Our findings highlight how periods of detraining can interfere in physical and mental health of older adults.

Balanced: An Evaluation Of A Newly Established Older Adult Exercise Class

Abstract Background Falls are common in older adults and one of the leading causes of morbidity and mortality globally. Evidence based falls exercise programme have been proven to reduce the risk of falling in community dwelling older persons. This study aimed to evaluate the impact of a new falls exercise class for community dwelling older adults. Methods This class was based on the Falls Management Exercise (FaME) programme model, implemented by a trained Physiotherapist and Exercise Instructor. It consisted of a twenty-six-week programme which included a once weekly supervised group exercise class (1hour) supplemented by a twice weekly home exercise programme. Participants were recruited from primary care services based in the local region. Those who met the inclusion criteria were assessed by a physiotherapist who collected basic demographic data. A range of outcome measures were completed pre and post intervention, assessing motor and behavioural domains. Participant feedback was collected. Data was analysed using SPSS. Results Eleven participants completed this programme. The mean age was 78 years old and 73% of participants were female. Participants completed an average of 22 out of 26 classes. The number of falls reported reduced from 0.8 pre intervention to 0.1 post intervention (p 0.03). Timed Up and Go improved from a mean of 11.28 seconds pre intervention to 9.06 seconds post intervention (p 0.02). Mean Health Today Score was 73.2% pre intervention improving to 82.3% post intervention (p 0.05). Participant feedback was positive. Conclusion This study demonstrated the significant positive impact of an evidence-based exercise class on our participants functional ability, quality of life and reducing falls. This is a preliminary evaluation and analysis of further data is essential. These classes may assist in reducing demands on acute healthcare services and should continue to run and be further investigated.

Does high-frequency resistance exercise offer additional benefits to older adults? learnings from a randomized controlled trial

ObjectiveResistance exercise is an effective strategy to improve muscle strength in older adults. A limited-load resistance would be flexible and suitable for community-based training. It was unclear whether high-frequency resistance exercise offer additional benefits to older adults. Here, we aimed to examine the effect of limited-load resistance exercise among different frequency on muscle parameters in older adults.MethodsThe current study was a single-blind, randomized controlled trial comparing the effectiveness of different-frequency resistance exercise in older adults. Change in skeletal muscle was estimated with a multi-frequency bioelectrical impedance analyzer. Demographics, physical examination, nutritional assessment, prealbumin and lymphocytes were also measured. Fisher’s precision probability test and baseline-adjusted generalized linear models were applied accordingly to analyze the influence of dose-different exercise on prevalence of sarcopenia, muscle parameters and body composition. A two-sided p value of < 0.05 was defined statistical significance.ResultsThe participants had a mean age of 71.96 years and close gender ratio. One hundred and twenty-seven participants (control 40; low-dose 46; high-dose 41) completed the 6-month exercise intervention. In contrast to control group, only high-dose exercise groups experienced improvements in muscle mass (0.66 kg, p < 0.001) and max grip strength (+ 2.17 kg, p < 0.001). There were significant dose-response effects of muscle mass (index), fat mass (index), max grip strength, 5-times sit to stand test, 6-minute walking test and visceral fat area (all ptrend <0.01).ConclusionsAs the proved dose-dependent effect, current findings supported high-frequency limited-load resistance exercise applied and extended among older adults in community.Trial RegistrationThis study was registered at Chinese Clinical Trial Registry Network (ChiCTR2200062007, Registered on 19 July 2022).

Current Trends of Exercise Programs for Improving Cognitive Function in Older Adults

PURPOSE: Limited studies have analyzed exercise protocols for cognitive improvement in older adults. Therefore, we closely examined the composition, content, and operation methods of these exercise programs to identify current trends.METHODS: We searched the Web of Science, PubMed, and Google Scholar databases for studies published between 2019 and 2024. The search terms used included “older adults”, “cognitive function”, “mild cognitive impairment”, “dementia”, “exercise”, “physical activity”, and other related terms, in both Korean and English.RESULTS: Aerobic exercises primarily comprised step-based exercises (walking and stepping) and dance routines, typically lasting 15-60 minutes per session, 1-3 times per week for 6-24 weeks, regardless of the individual’s cognitive level. Assistant instructors often participated, and in cases of severe cognitive impairment, patients’ caregivers also participated. Resistance exercises were most often performed using body weight and elastic bands, along with other tools and equipment, such as balls, water bottles, or specialized equipment. The exercises commonly involved 8-12 repetitions, 2-3 sets, with 1-minute rest between sets. Several programs included functional exercises to improve daily living performance. Other activities that were incorporated into the exercise programs included exergames and balance, mind-body, peripheral, and eye exercises.CONCLUSIONS: Recent cognitive exercise programs for older adults typically last three months and use a variety of tools or digital technologies within the scope of older adult exercise guidelines. Exercises for people with severe cognitive impairment tend to be more individualized, gradual, and flexible in their approach.

Artificial neural network inference analysis identified novel genes and gene interactions associated with skeletal muscle aging.

Sarcopenia is an age-related muscle disease that increases the risk of falls, disabilities, and death. It is associated with increased muscle protein degradation driven by molecular signalling pathways including Akt and FOXO1. This study aims to identify genes, gene interactions, and molecular pathways and processes associated with muscle aging and exercise in older adults that remained undiscovered until now leveraging on an artificial intelligence approach called artificial neural network inference (ANNi). Four datasets reporting the profile of muscle transcriptome obtained by RNA-seq of young (21-43years) and older adults (63-79years) were selected and retrieved from the Gene Expression Omnibus (GEO) data repository. Two datasets contained the transcriptome profiles associated to muscle aging and two the transcriptome linked to resistant exercise in older adults, the latter before and after 6months of exercise training. Each dataset was individually analysed by ANNi based on a swarm neural network approach integrated into a deep learning model (Intelligent Omics). This allowed us to identify top 200 genes influencing (drivers) or being influenced (targets) by aging or exercise and the strongest interactions between such genes. Downstream gene ontology (GO) analysis of these 200 genes was performed using Metacore (Clarivate™) and the open-source software, Metascape. To confirm the differential expression of the genes showing the strongest interactions, real-time quantitative PCR (RT-qPCR) was employed on human muscle biopsies obtained from eight young (25±4years) and eight older men (78±7.6years), partaking in a 6-month resistance exercise training programme. CHAD, ZDBF2, USP54, and JAK2 were identified as the genes with the strongest interactions predicting aging, while SCFD1, KDM5D, EIF4A2, and NIPAL3 were the main interacting genes associated with long-term exercise in older adults. RT-qPCR confirmed significant upregulation of USP54 (P=0.005), CHAD (P=0.03), and ZDBF2 (P=0.008) in the aging muscle, while exercise-related genes were not differentially expressed (EIF4A2 P=0.99, NIPAL3 P=0.94, SCFD1 P=0.94, and KDM5D P=0.64). GO analysis related to skeletal muscle aging suggests enrichment of pathways linked to bone development (adj P-value 0.006), immune response (adj P-value <0.001), and apoptosis (adj P-value 0.01). In older exercising adults, these were ECM remodelling (adj P-value <0.001), protein folding (adj P-value <0.001), and proteolysis (adj P-value <0.001). Using ANNi and RT-qPCR, we identified three strongly interacting genes predicting muscle aging, ZDBF2, USP54, and CHAD. These findings can help to inform the design of nonpharmacological and pharmacological interventions that prevent or mitigate sarcopenia.

Limited Evidence for the Benefits of Exercise in Older Adults with Hematological Malignancies: A Systematic Review and Meta-Analysis.

Older patients receiving antineoplastic treatment face challenges such as frailty and reduced physical capacity and function. This systematic review and meta-analysis aimed to evaluate the effects of exercise interventions on physical function outcomes, health-related quality of life (QoL), and symptom burden in older patients above 65 years with hematological malignancies undergoing antineoplastic treatment. This review adheres to Cochrane guidelines, with the literature searches last updated on 27 March 2024, including studies with patients above 18 years. Screening of identified studies, data extraction, risk of bias, and GRADE assessments were performed independently by two authors. Meta-analyses evaluated the impact of exercise, considering advancing age. Forty-nine studies contributed data to the meta-analyses. Five studies included patients with a mean age above 60 years, and none included only patients above 60. Exercise interventions had moderate to small positive effects on QoL global (SMD 0.34, 95% CI [0.04-0.64]) and physical function (SMD 0.29, 95% CI [0.12-0.45]). Age did not explain the variability in exercise effects, except for physical function (slope 0.0401, 95% CI [0.0118-0.0683]) and pain (slope 0.0472, 95% CI [0.01-0.09]), which favored younger patients. Exercise interventions improve physical function and QoL and reduce symptoms in adults with hematological malignancies undergoing antineoplastic treatment; however, the influence of age remains inconclusive.

It Is Not Just a Matter of Motivation: The Role of Self-Control in Promoting Physical Activity in Older Adults—A Bayesian Mediation Model

This study aimed to understand how psychological factors affect regular exercise in older adults, hypothesising that trait self-control mediates the relationship between motivation types (intrinsic, extrinsic, and amotivation) and exercise time. In this cross-sectional study, 430 older adults (mean age = 68.8 ± 6.72) completed questionnaires regarding their perceived trait self-control, motivation towards leisure activities, and level of physical activity. A Bayesian mediation analysis was performed, controlling for demographics. We documented positive direct (c′ = 0.021, 95%CI [0.001, 0.043]) and indirect (ab = 0.028, 95%CI [0.014, 0.043]) effects of intrinsic motivation on exercise, a fully mediated indirect effect of extrinsic motivation on exercise (ab = 0.027, 95%CI [0.011, 0.046]), and negative direct (c′ = −0.281, 95%CI [−0.368, −0.194]) and indirect (ab = −0.161, 95%CI [−0.221, −0.105]) effects of amotivation on exercise. There was no direct association between extrinsic motivation and exercise (c′ = 0.013, 95% CI [−0.013, 0.037]). In conclusion, trait self-control mediates motivation to influence exercise behaviour in older adults. Intrinsically motivated individuals resist sedentary living and show higher self-control, while extrinsically motivated ones rely on self-control and are more susceptible to non-adherence during mental fatigue. High amotivation is linked to less exercise and reduced self-control, suggesting potential non-compliance with structured exercise interventions.

Factors influencing older adult community fall prevention exercise implementation: a scoping review.

Exercise that challenges balance is the most effective fall prevention intervention in community-dwelling older adults. Identifying factors influencing implementation of community fall prevention exercise programs is a critical step in developing strategies to support program delivery. To identify implementation facilitators, barriers, and details reported in peer-reviewed publications on community fall prevention exercise for older adults. Scoping review. We searched multiple databases up to July 2023 for English-language publications that reported facilitators and/or barriers to implementing an evidence-based fall prevention exercise program in adults aged 50+ years living independently. At least two reviewers independently identified publications and extracted article, implementation, and exercise program characteristics and coded barriers and facilitators using the Consolidated Framework for Implementation Research (CFIR). We included 22 publications between 2001 and July 2023 that reported factors influencing implementation of 10 exercise programs. 293 factors were reported: 183 facilitators, 91 barriers, 6 described as both a facilitator and barrier, and 13 unspecified factors. Factors represented 33 CFIR constructs across all five CFIR domains: implementation inner setting (n = 95 factors); innovation (exercise program) characteristics (n = 84); individuals involved (n = 54); implementation process (n = 40) and outer setting (n = 20). Eight publications reported implementation strategies used; 6 reported using a conceptual framework; and 13 reported implementation outcomes. The high number of factors reflects the complexity of fall prevention exercise implementation. The low reporting of implementation strategies, frameworks and outcomes highlight the ongoing need for work to implement and sustain community fall prevention exercise programs.

The Efficacy of Joyful Learning on Exercise in Older Adults: The GAME Strategy

Exercise can effectively slow aging and prevent the onset and reduce the complications of chronic diseases in the elderly. However, roughly one-third of older adults are inactive. Joyful learning is an effective method for promoting physical activity, while using games is a feasible strategy for achieving joyful learning that enables individuals to fully immerse themselves in and enjoy an activity. Therefore, exploring gaming strategies to enhance physical activity among the elderly is worthwhile. In this paper, a set of gaming strategies based on the literature and practical experience is proposed. The name of this strategy, GAME, is an acronym of the following: goal setting and educational content development (G), activity design and game content creation (A), mechanics and dynamics implementation (M), and evaluation of qualitative and quantitative health outcomes (E). This systematic descriptive approach helps clearly demonstrate how gamification strategies can promote physical activity and health in older adults. The aim of this paper is to provide a reference and guide for education, research, and clinical practice in health promotion programs targeting older adults.

Tai Chi Expertise Classification in Older Adults Using Wrist Wearables and Machine Learning.

Tai Chi is a Chinese martial art that provides an adaptive and accessible exercise for older adults with varying functional capacity. While Tai Chi is widely recommended for its physical benefits, wider adoption in at-home practice presents challenges for practitioners, as limited feedback may hamper learning. This study examined the feasibility of using a wearable sensor, combined with machine learning (ML) approaches, to automatically and objectively classify Tai Chi expertise. We hypothesized that the combination of wrist acceleration profiles with ML approaches would be able to accurately classify practitioners' Tai Chi expertise levels. Twelve older active Tai Chi practitioners were recruited for this study. The self-reported lifetime practice hours were used to identify subjects in low, medium, or highly experienced groups. Using 15 acceleration-derived features from a wearable sensor during a self-guided Tai Chi movement and 8 ML architectures, we found multiclass classification performance to range from 0.73 to 0.97 in accuracy and F1-score. Based on feature importance analysis, the top three features were found to each result in a 16-19% performance drop in accuracy. These findings suggest that wrist-wearable-based ML models may accurately classify practice-related changes in movement patterns, which may be helpful in quantifying progress in at-home exercises.

Prefrontal Cortex Oxygenation During Exercise in Older Adults with Motoric Cognitive Risk Syndrome.

Motoric cognitive risk syndrome (MCR) is a pre-dementia syndrome characterized by subjective memory complaints and gait impairments that may be related to lower prefrontal cortex (PFC) function. Acute bouts of aerobic exercise are shown to improve PFC function, however, the acute effects of exercise on PFC oxygenation have not yet been examined in MCR. This study aims to characterize the PFC oxygenation responses during acute exercise in older adults with MCR. Nineteen older adults with MCR performed a submaximal cycling exercise protocol. Functional near-infrared spectroscopy (fNIRS) is used to measure concentrations of oxygenated (OxyHb) and deoxygenated (DeoxyHb) hemoglobin from the PFC. There is a trend for increased OxyHb concentrations and decreased DeooxyHb concentrations during exercise. Exercise also induced significant increases in ratings of perceived exertion (RPEs) and heart rate. A significant, positive correlation between PFC OxyHb and RPEs during the cycling exercise are also observed. The findings reveal that PFC oxygenation increases during exercise in an intensity-dependent manner and the subjective perception of exertion is associated with the magnitude of PFC oxygenation. These results suggest that moderate-intensity cycling exercise may have beneficial effects on increasing cerebral blood flow in the PFC of older adults with MCR.

Acute Exercise Improves Large-Scale Brain Network Segregation in Healthy Older Adults.

Introduction: Age-related cognitive decline and mental health problems are accompanied by changes in resting-state functional connectivity (rsFC) indices, such as reduced brain network segregation. Meanwhile, exercise can improve cognition, mood, and neural network function in older adults. Studies on effects of exercise on rsFC outcomes in older adults have chiefly focused on changes after exercise training and suggest improved network segregation through enhanced within-network connectivity. However, effects of acute exercise on rsFC measures of neural network integrity in older adults, which presumably underlie changes observed after exercise training, have received less attention. In this study, we hypothesized that acute exercise in older adults would improve functional segregation of major cognition and affect-related brain networks. Methods: To test this, we analyzed rsFC data from 37 healthy and physically active older adults after they completed 30 min of moderate-to-vigorous intensity cycling and after they completed a seated rest control condition. Conditions were performed in a counterbalanced order across separate days in a within-subject crossover design. We considered large-scale brain networks associated with cognition and affect, including the frontoparietal network (FPN), salience network (SAL), default mode network (DMN), and affect-reward network (ARN). Results: We observed that after acute exercise, there was greater segregation between SAL and DMN, as well as greater segregation between SAL and ARN. Conclusion: These findings indicate that acute exercise in active older adults alters rsFC measures in key cognition and affect-related networks in a manner that opposes age-related dedifferentiation of neural networks that may be detrimental to cognition and mental health.

Sex Differences in Energy Metabolism: A Female-Oriented Discussion.

The purpose of this review is to delineate aspects of energy metabolism at rest and during exercise that may be subject to sex differences and the potential underlying mechanisms involved. It focuses on distinct aspects of female physiology with an oriented discussion following the reproductive life stages of healthy, eumenorrheic females, including premenopausal time frames, pregnancy, perimenopause, and menopause. Finally, this review aims to address methodological challenges surrounding sexual dimorphism in energy metabolism investigations and confounding factors in this field. During resting conditions, females tend to have higher rates of non-oxidative free fatty acid clearance, which could contribute to lower respiratory exchange ratio measures. At the same time, carbohydrate energy metabolism findings are mixed. In general, females favor lipid energy metabolism during moderate-intensity exercise, while men favor carbohydrate energy metabolism. Factors such as age, dietary intake, genetics, and methodological decisions confound study findings, including properly identifying and reporting the menstrual cycle phase when female subjects are eumenorrheic. Pregnancy presents a unique shift in physiological systems, including energy metabolism, which can be observed at rest and during exercise. Changes in body composition and hormonal levels during the post-menopausal period directly impact energy metabolism, specifically lipid metabolism. This change in physiological state factors into the evidence showing a reduction in our understanding of sex differences in lipid metabolism during exercise in older adults. This review reveals a need for a focused understanding of female energy metabolism that could help exercise and nutrition professionals optimize female health and performance across the lifespan.