Health Of Community-dwelling Older Adults Research Articles

Feasibility, Usability, and Enjoyment of a Home-Based Exercise Program Delivered via an Exercise App for Musculoskeletal Health in Community-Dwelling Older Adults: Short-term Prospective Pilot Study.

BackgroundMany older adults choose and prefer to exercise at home, but to attain the greatest benefits, the correct type and dose of exercise should be prescribed and adherence maintained. Advances in digital health technologies now provide the opportunity for exercise professionals to deliver and monitor personalized, evidence-based exercise programs to anyone at any time.ObjectiveThe aim of this study was to evaluate the feasibility, usability, and enjoyment of a web-based exercise prescription app as a platform for exercise professionals to remotely deliver and monitor an individually tailored, home-based multicomponent exercise program (delivered through tablet computers) to older adults living independently in the community.MethodsThis was an 8-week, prospective single-arm pilot study in 20 adults aged ≥65 years living independently in the community: 10 owned a tablet computer (tablet owners) and 10 did not own tablets (tablet nonowners). All participants were prescribed a home-based, muscle strengthening, weight-bearing impact and challenging balance/mobility program (3 days/week) using a commercial exercise prescription app on a tablet computer. Study endpoints were feasibility (retention, adherence, adverse events), usability (System Usability Scale), physical activity enjoyment (Physical Activity Enjoyment Scale), changes in lower extremity function (Short Physical Performance Battery [SPPB]), and level of physical activity (questionnaire). Process measures related to the participants' experiences and perceptions of the exercise program and web-based app were also included.ResultsA total of 19 participants (mean age, 70 years) completed the study (19/20, 95%), and mean adherence to the exercise program was 84% (95% CI 70%-97%). There were 2 minor adverse events in 2 participants from 401 completed sessions. Mean weekly walking time increased by 78 minutes (95% CI 0-156, P=.049) and moderate-to-vigorous physical activity time by 41 minutes (95% CI –8 to 90, P=.09). For SPPB scores, there was a 0.3 point (95% CI –0.1 to 0.7, P=.17) modest sized (effect size, d=0.42) improvement after 8 weeks. Mean (SD) system usability was high (86 [10] with 100 best imaginable). There was no change in the overall physical activity enjoyment scores after 8 weeks, but participants reported that they enjoyed using the web-based exercise app and the exercise program (median score 4 on a 5-point Likert scale). For all measures, there were no differences between previous tablet owners and nonowners.ConclusionsThis pilot feasibility study indicates that it is safe and feasible for community-dwelling older adults to participate in a home-based, multicomponent exercise program targeting musculoskeletal health and function that was delivered and monitored remotely by exercise professionals using a tablet-based exercise prescription app.

Impact of COVID-19 Measures on Activities and Subjective Health Among Community-Dwelling Older Adults:] 新型コロナウイルス感染症の感染拡大防止策が地域在住高齢者の活動および主観的な健康に与えた影響： 北海道の感染第１波における検討

Objective: This study investigated the impact of the measures implemented for preventing the spread of the first coronavirus disease 2019 outbreak in Hokkaido on the activities and subjective health among community-dwelling older adults. Methods: We compared data from questionnaire surveys conducted in March and August 2019 and April 2020 with a sample of older adults living in an urban area of Hokkaido. Changes in frequency of and reasons behind outings were examined using the responses of the 119 participants of both surveys. We also compared the scores of physical, mental, and social health indicators at three time points—March and August 2019 and April 2020—for 75 participants. Results: In terms of cultural and social activities, the frequency of outings in 2020 decreased in comparison with 2019. Furthermore, scores for social health in August 2019 were significantly lower than those in April 2020. Conclusions: The results suggest that the measures implemented to prevent the spread of the first outbreak in Hokkaido impacted the activities and subjective health of community-dwelling older adults.

Association of Social Frailty with Physical Health, Cognitive Function, Psychological Health, and Life Satisfaction in Community-Dwelling Older Koreans.

Social frailty affects various aspects of health in community-dwelling older adults. This study aimed to identify the prevalence of social frailty and the significance of its association with South Korean older adults’ health status and life satisfaction. This study involved a secondary data analysis of the 2017 National Survey of Older Koreans. From the 10,299 respondents of the survey, 10,081 were selected with no exclusion criteria. Multiple regression analyses were conducted to identify the factors related to life satisfaction. Compared with the robust and social prefrailty groups, the social frailty group had higher nutritional risk (χ² = 312.161, p = 0.000), depressive symptoms (χ² = 977.587, p = 0.000), cognitive dysfunction (χ² = 25.051, p = 0.000), and lower life satisfaction (F = 1050.272, p = 0.000). The results of multiple linear regression, adjusted for sociodemographic and health-related characteristics, indicated that social frailty had the strongest negative association with life satisfaction (β = −0.267, p = 0.000). However, cognitive function was significantly positively associated with life satisfaction (β = 0.062, p = 0.000). Social frailty was significantly correlated with physical, psychological, and mental health as well as life satisfaction in community-dwelling older South Koreans. Therefore, accounting for the social aspect of functioning is an essential part of a multidimensional approach to improving health and life satisfaction in communities.

Arts Engagement Programs improves Health in Community-Dwelling Older Adults

We examined how different arts engagement programs compared to control affect health in community-dwelling older adults. 64 adults(71.3 + 4.6years; Dance n=23, Music n=17, Control, n=24) took part in free Dance(Ballroom), Music(Ukulele), or Control(Active social conversation) sessions 2 times/week for 10 weeks. We assessed cognition(Montreal-Cognitive-Assessment-MoCA), physical(Short-Physical-Performance-Battery-SPPB), and Health‐Related Quality-of-Life(HRQoL‐SF‐20) 3 times: (1) before(pre), (2) at the end of 10 weeks(post-1) and (3) 1-month after intervention(post-2). Separate 3(Time)x3(Group) ANOVAs and Bonferroni-pairwise-comparisons examined changes across groups and time(p<.05). Participants’ physical health improved equally across groups(p=.4) and over time(p<.001), specifically from pre(10.5 + 1.4) to post-1(10.7 + 1.3; p=.002), and pre to-post-2(11.3 + 1.0;p<.001). Participants’ cognition improved equally across groups(p=.6) and over time(p<.001) from pre(26.3 + 2.8) to post-1(27.3 + 2.5; p=.002), and pre-to-post-2(27.5 + 2.5;p=.001). Participants’ HRQoL remained similar over time(p=.6) and across groups(p=.7). Overall, participants’ health improved after taking part in arts engagement and social conversation programs. Study findings offer insights about successful implementation of arts-engaged programs in community-dwelling older adults.

Obesity Intervention Improves Outcomes in Socially Isolated Older Adults: Progress Despite a Pandemic

The extended social isolation necessitated by the COVID-19 pandemic will likely have a prolonged negative impact on the health of community-dwelling older adults. We studied the potential to counteract these negative effects, examining the before and after measurements of participants in two obesity intervention studies that were converted from in-person to remote delivery, due to COVID-19. The Veterans Achieving Weight Loss and Optimizing Resilience-Using Protein study (VALOR-UP; n=9) and the Egg-Supplemented Pre-Diabetes Intervention Trial (EGGSPDITE; n=6) enrolled obese (BMI = 34.2±3.8 kg/m2) older adults (age = 71.5±4.5 yrs; 80% male; 47% black) with prediabetes (fasting blood glucose 100-125 mg/dL and/or HbA1c of 5.7-6.4%). Participants followed a hypocaloric diet, attended weekly support groups, and weighed themselves weekly; VALOR-UP participants also attended a weekly exercise class delivered remotely. Outcomes were assessed at baseline (pre-COVID) and the end of a 4-month period coinciding with stay-at-home orders. Between baseline and 4 months, calorie intakes (3-day diet record) decreased by 402.1±529.3 kcal/day (p<0.05) and body weight by 6% (6.1±3.4 kg; p<0.0001). Physical function (Short Physical Performance Battery) improved by 1.1±1.4 units (p<0.01) and Short Form Health Survey (SF-36) physical and mental composite quality of life remained stable (p=0.63 and p=0.48, respectively). Thus, despite COVID-19 circumstances, most participants were able to benefit from an intervention to improve function and reduce obesity. The somewhat surprising findings for this small cohort offer promise not only for future lifestyle interventions during COVID-19 isolation but also for other isolated populations, including home-bound older adults.

地域高齢者の精神的健康の縦断変化に及ぼす老年的超越の影響の検討 : 疾患罹患・死別イベントに対する緩衝効果に注目して

地域高齢者の精神的健康の縦断変化に及ぼす老年的超越の影響の検討 : 疾患罹患・死別イベントに対する緩衝効果に注目して

Associations Between Longitudinal Trajectories of Cognitive and Social Activities and Brain Health in Old Age

Prior neuroimaging studies have found that late-life participation in cognitive (eg, reading) and social (eg, visiting friends and family) leisure activities are associated with magnetic resonance imaging (MRI) markers of the aging brain, but little is known about the neural and cognitive correlates of changes in leisure activities during the life span. To examine trajectories of cognitive and social activities from midlife to late life and evaluate whether these trajectories are associated with brain structure, functional connectivity, and cognition. This prospective cohort included participants enrolled in the Whitehall II study and its MRI substudy based in the UK. Participants provided information on their leisure activities at 5 times during calendar years 1997 to 1999, 2002 to 2004, 2006, 2007 to 2009, and 2011 to 2013 and underwent MRI and cognitive battery testing from January 1, 2012, to December 31, 2016. Data analysis was performed from October 7, 2017, to July 15, 2019. Growth curve models and latent class growth analysis were used to identify longitudinal trajectories of cognitive and social activities. Multiple linear regression was used to evaluate associations between activity trajectories and gray matter, white matter microstructure, functional connectivity, and cognition. A total of 574 individuals (468 [81.5%] men; mean [SD] age, 69.9 [4.9] years; median Montreal Cognitive Assessment score, 28 [interquartile range, 26-28]) were included in the present analysis. During a mean (SD) of 15 (4.2) years, cognitive and social activity levels increased during midlife before reaching a plateau in late life. Both baseline (global cognition: unstandardized β [SE], 0.955 [0.285], uncorrected P = .001; executive function: β [SE], 1.831 [0.499], uncorrected P < .001; memory: β [SE], 1.394 [0.550], uncorrected P = .01; processing speed: β [SE], 1.514 [0.528], uncorrected P = .004) and change (global cognition: β [SE], -1.382 [0.492], uncorrected P = .005, executive function: β [SE], -2.219 [0.865], uncorrected P = .01; memory: β [SE], -2.355 [0.948], uncorrected P = .01) in cognitive activities were associated with multiple domains of cognition as well as global gray matter volume (β [SE], -0.910 [0.388], uncorrected P = .02). Baseline (β [SE], 1.695 [0.525], uncorrected P = .001) and change (β [SE], 2.542 [1.026], uncorrected P = .01) in social activities were associated only with executive function, in addition to voxelwise measures of functional connectivity that involved sensorimotor (quadratic change in social activities: number of voxels, 306; P = 0.01) and temporoparietal (linear change in social activities: number of voxels, 16; P = .02) networks. Otherwise, no voxelwise associations were found with gray matter, white matter, or resting-state functional connectivity. False discovery rate corrections for multiple comparisons suggested that the association between cognitive activity levels and executive function was robust (β [SE], 1.831 [0.499], false discovery rate P < .001). The findings suggest that a life course approach may delineate the association between leisure activities and cognitive and brain health and that interventions aimed at improving and maintaining cognitive engagement may be valuable for the cognitive health of community-dwelling older adults.

Emotional approach coping in older adults as predictor of physical and mental health.

Emotional approach coping involves active attempts at emotional expression and processing in response to stressful circumstances. This study tested whether dispositional emotional approach coping processes predict changes in physical and mental health in community-dwelling older adults, particularly within the context of higher perceived stress. To test this, older adults (N = 150) completed assessments of emotional expression and emotional processing at study entry. They also completed measures of perceived stress, depressive symptoms, and ill-health (a composite of subjective and objective physical health indicators, which included blood draw for collection of biomarkers), every 6 months over 4.5 years. Emotional processing and emotional expression were not related significantly to ill-health at study entry. However, emotional processing (but not emotional expression) significantly predicted changes in ill-health. At higher levels of emotional processing, ill-health remained low and stable; at lower levels of emotional processing, ill-health increased over time. However, when perceived stress was high, higher emotional processing and emotional expression were related to lower depressive symptoms at study entry, but higher emotional processing was associated with increasing depressive symptoms over time. Emotional approach coping processes evidence prospective relations with health outcomes, which are partially conditioned by stress perceptions. Emotional processing appears to have a protective impact against declining physical health. Predictive relationships for depressive symptoms are more complex. Older adults with chronically high perceived stress might benefit from interventions that target emotion-regulating coping processes. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Mental Health of Community-Dwelling Older Adults and Related Factors: A Cross-Sectional Study

Background: Improving lifestyle, increasing lifespan and life expectancy have led to the phenomenon of aging in societies. The increasing population of older adults is one of the most important economic, social, and health challenges in the current century. Objectives: This study was conducted to measure the mental health of older adults in Qom City and its relationship with socioeconomic factors. Methods: This is a cross-sectional descriptive-analytical study on 400 older adults over 60 years in the urban areas of Qom in 2018. A multi-stage sampling method was used for this study. The research tools were a demographic questionnaire, the Kessler Psychological Distress scale (K6), and a standard psychological well-being scale. Data were analyzed by Stata 12 software using the t-test. The significance level was considered less than 0.05. Results: Considering the mental health status, based on the K6, 55% of the elderly showed signs of low depression anxiety, 34% moderate, and 11% showed severe anxiety symptoms. Regarding the status of well-being, 49.50% were in good condition (11.3 ± 3.3), 27.75% were in moderate condition (13.8 ± 2.9), and 22.75% were in poor condition (7.3 ± 2.6). Anxiety and depression had significant relationships with gender, having an illness, marital status, having a caregiver, and income. Conclusions: The results showed that about half of the elderly in Qom had moderate anxiety and depression disorders, as well as moderate mental well-being, which indicates the moderate level of anxiety and mental disorders in the elderly in Qom.

CHI study: protocol for an observational cohort study on ageing and mental health in community-dwelling older adults

IntroductionAgeing is associated with a multitude of healthcare issues including dementia, depression, frailty, morbidity associated with chronic disease and high healthcare utilisation. With Singapore’s population projected to age significantly over...

Where do healthy older adults take more time during the Timed Up and Go test?

[Purpose] We need to regularly evaluate motor function to sustain the health of community-dwelling older adults. Our study aimed to identify the kinematic characteristics of healthy older adults in the Timed Up and Go test because the criteria for assessing the motor function of healthy older adults are unclear in the widely used clinical simple methods. [Participants and Methods] In total, 22 healthy younger and 28 healthy older adults participated in this study. Using a 3D motion analysis system, we measured the time ratios, trajectories, trajectory length per unit time, and body inclination angles during the Timed Up and Go test. We compared the kinematic characteristics of the older and younger adults. [Results] The older adults required a longer time ratio to complete the turn and sit subtasks. The trajectory of the older adults’ turn subtask was longer than that of the younger adults. Older adults’ body inclination angles during the turn subtask were smaller than that of the younger adults. [Conclusion] Healthy older adults had a different kinematic index from younger adults during the Timed Up and Go turn subtask. Therefore, we suggest the kinematic index of posture and turning radius be used to measure Timed Up and Go as a clinically useful index for understanding the motor characteristics of older adults.

Cachexia and Cognitive Function in the Community-Dwelling Older Adults: Mediation Effects of Oral Health.

Cognitive impairment and poor oral health are common problems in older adults and are associated with malnutrition. However, it is unclear how they are related to cachexia in community-dwelling older adults. The aim of this study was to examine the relationships among cachexia, cognitive function, and oral health in community-dwelling older adults. This study is a secondary analysis of a data-set. Data were collected in the community setting on older adults who applied for government-funded long-term care services in Hong Kong in 2017. Subjects were community-dwelling and aged ≥60 years. The outcome variable was cachexia. The predictors were cognitive function and oral health. The covariates included demographics and comorbidities associated with cachexia or malnutrition. Path analysis was employed to examine the associations among cachexia, cognitive function, and oral health using the software SAS/STAT and Mplus. This analysis included 12,940 subjects. The prevalence of cachexia was 1.3%. Cognitive function was also found to have a direct effect on the oral health indicators of chewing problems (OR=1.073, p<0.001), brushing teeth problems (OR=1.349, p<0.001), and swallowing problems (coeff.=0.177, p<0.001). Oral health indicators with a direct effect on cachexia included dry mouth (OR=1.250, p<0.001), brushing teeth problems (OR = 1.185, p<0.01), and swallowing problems (OR=1.231, p<0.001). Cognitive function had no significant direct effect, but had a significant indirect effect on cachexia (OR=1.100, p<0.001) which is mediated by brushing teeth problems (OR=1.052, p<0.001) and swallowing problems (OR=1.038, p<0.001). Cognitive impairment causes cachexia indirectly through poor oral health. This study recommends adding cognitive function when screening community-dwelling older adults for cachexia. Health policymakers should stress regular oral health screening and interventions, and encourage increased utilization of oral health services by community-dwelling older adults with cognitive problems.

LIVING ALONE IS ASSOCIATED WITH POORER PHYSICAL FUNCTION AND BONE MINERAL DENSITY IN ICELANDIC OLD ADULTS

Background: Loneliness and living alone have been significant public health concerns among older adults given their association with a wide range of adverse health outcomes. Aim: The aim of this study was to examine whether living alone is associated with physical function and bone health in community-dwelling older adults. Methods: This was a secondary analysis of existing cross-sectional data of old adults (N=182, 73.7±5.7yrs, 58.2% female) from the Reykjavik capital area in Iceland. Information on socioeconomics, health, dietary intake and physical function was collected. 25-hydroxy-vitamin D (25OHD) and bone mineral density (BM were grouped retrospectively into “living alone” and into “in cohabitation”. Results: Of our subjects, 76.4% were in cohabitation and and 23.6% lived alone. Participants who lived alone were older (74.5±5.6 vs. 72.1±5.0,P=0.008) and more often female (74.4 vs. 53.2%,P=0.014), but there were no differences in education, smoking, number of medications, physical activity (PA) or body mass index (BMI). According to age and gender corrected analyses, participants in cohabitation had higher grip strength (6.2±2.4lb,P=0.011), higher 25OHD (13.1±6.3nmol/L,P=0.037) and higher BMD (z-score lumbal: 1.195±0.417,P=0.005; z-score femur: 0.421±0.219,P=0.054; z-score total: 0.846±0.290,P=0.004). Statistical correction for PA, BMI, education and fish oil intake did not change the results. Conclusion: In comparison to old adults who live in cohabitation, Icelandic old adults who live alone have poorer physical function, lower 25OHD and lower BMD, which increases their risk for wrist or hip fracture. These differences between groups were not explained by physical, dietary or social confounding variables.

Cross-Country Validation of the Association Between Oral Health and General Health in Community-Dwelling Older Adults

ObjectiveOral health is known to be associated with general health, but longitudinal relationships between oral health and general health indicators have not yet been fully explored in international research. Setting and participantsThe sample consisted of 3 longitudinal databases: a sample from Belgium from the Protocol 3 project (n = 8359), a combined sample from 6 European countries (n = 2501) from the IBenC study (Belgium, Finland, Iceland, Germany, Italy, and the Netherlands), and a sample from New Zealand (n = 15,012). All clients were 65 years or older and received long-term home care services. MethodsBayesian models were used to analyze the associations between 3 oral health indicators (chewing difficulty, nonintact teeth, and dry mouth) and 4 aspects of general health (activities of daily living functioning, cognition, depression, and health instability). In addition, the models explored the associations between current oral health and general health status and future oral health and general health status. ResultsClients who had poorer oral health had a higher risk of suffering from poor general health. Especially chewing difficulty was associated with all general health indicators in all data sets (odds ratios > 1). Dry mouth and nonintact teeth showed significant associations with almost all general health indicators. Additionally, having poor oral health (respectively general health) was predictive of poor general health (respectively oral health) at future assessments (significant cross-lagged parameters). Conclusions/ImplicationsThe results point out the need of the inclusion of oral health assessment and advice from dentists or oral health practitioners into the multidisciplinary conversation. In addition, identifying older people with oral health problems is essential in order to provide treatment and monitoring. Raising awareness for oral health is important, and policy makers should foster oral health promotion and care for older adults in order to keep them in good health.

Longitudinal associations between dietary inflammatory index and musculoskeletal health in community-dwelling older adults

Aging is characterized by progressive decline in physiologic reserves and functions as well as prolonged inflammation, increasing susceptibility to disease. Diet plays an important role in maintaining health, and reducing morbidity and mortality, especially in older populations. This study was designed to determine prospective associations between dietary inflammatory index (DII®) scores and bone health, sarcopenia-related outcomes, falls risk and incident fractures in community-dwelling Australian older adults. A total of 1098 [51% male; age (mean±SD) 63.0±7.5 years] non-institutionalized older adults who participated in the Tasmanian Older Adult Cohort Study (TASOAC) at baseline, 768 at 5 years, and 566 at 10 years follow-up were included in this analysis. Baseline energy-adjusted DII (E-DII) scores were calculated using a validated Food Frequency Questionnaire. Changes in bone mineral density (BMD) and appendicular lean mass (ALM) were measured over ten years using dual-energy x-ray absorptiometry. Ten-year changes in hand grip, knee extensor and whole lower-limb muscle strength and quality were assessed by dynamometers and change in falls risk score using the Physical Profile Assessment (PPA). Incident fractures at any site and non-vertebral fractures over 10 years were self-reported. The E-DII range was-3.48 to+3.23 in men and-3.80 to+2.74 in women. Higher E-DII score (indicating a more pro-inflammatory diet) was associated with lower total hip (B:-0.009; 95% CI:-0.017, 0.000) and lumbar spine BMD (B:-0.013; 95% CI:-0.024,-0.002), and higher falls risk score (B: 0.040; 95% CI: 0.002, 0.078) over 10 years in men. Women with higher E-DII scores had higher whole lower-limb muscle quality over 10 years (B: 0.109; 95% CI: 0.002, 0.215). For every unit increase in E-DII score, incident fracture rates increased by 9.0% in men (IRR: 1.090; 95% CI: 1.011, 1.175) and decreased by 12.2% in women (IRR: 0.878; 95% CI: 0.800, 0.964) in a fully adjusted model. Higher E-DII scores were associated with lower bone density, higher falls risk, and increased incidence of fractures in community-dwelling older men, but decreased fracture incidence in women, over 10 years. This suggests pro-inflammatory diets may be more detrimental to musculoskeletal health in older men than in women. Additional studies are warranted to elucidate these sex differences.

Mid-calf skeletal muscle density and its associations with physical activity, bone health and incident 12-month falls in older adults: The Healthy Ageing Initiative.

Lower skeletal muscle density, indicating greater infiltration of adipose tissue into muscles, is associated with higher fracture risk in older adults. We aimed to determine whether mid-calf muscle density is associated with falls risk and bone health in community-dwelling older adults. 2214 community-dwelling men and women who participated in the Healthy Ageing Initiative (Sweden) study at age 70 were included in this analysis. Mid-calf muscle density (mg/cm3) at the proximal tibia, and volumetric bone mineral density (vBMD) and architecture at the distal and proximal tibia and radius, were assessed by peripheral quantitative computed tomography. Whole-body lean and fat mass, lumbar spine and total hip areal bone mineral density (aBMD) were assessed by dual-energy X-ray absorptiometry. Participants completed seven-day accelerometer measurements of physical activity intensity, and self-reported falls data were collected 6 and 12 months later. 302 (13.5%) participants reported a fall at the 6- or 12-month interview, and 29 (1.3%) reported a fall at both interviews. After adjustment for confounders, each standard deviation decrease in mid-calf muscle density was associated with a trend towards greater likelihood of experiencing a fall (OR 1.13; 95% CI 1.00, 1.29 per SD lower) and significantly greater likelihood of multiple falls (1.61; 1.16, 2.23). Higher muscle density was not associated with total hip aBMD, and was associated with lower lumbar spine aBMD (B = -0.003; 95% CI -0.005, -0.001 per mg/cm3) and higher proximal cortical vBMD (0.74; 0.20, 1.28) at the radius. At the tibia, muscle density was positively associated with distal total and trabecular vBMD, and proximal total and cortical vBMD, cortical thickness, cortical area and stress-strain index (all P < 0.05). Only moderate/vigorous (%) intensity physical activity, not sedentary time or light activity, was associated with higher mid-calf muscle density (0.086; 0.034, 0.138). Lower mid-calf muscle density is independently associated with higher likelihood for multiple incident falls and appears to have localised negative effects on bone structure in older adults.

Perceived victimization risk, avoidance behavior, and health of community-dwelling older adults in urban China

Objectives: This study examined the associations between perceived crime-specific victimization risk, avoidance behavior, and their relationships with health of older adults.Method: A representative sample of 453 Chinese aged 60 and older from Kunming provided information on their socio-demographic characteristics, perceived crime victimization risk, avoidance behavior, physical and mental health.Results: Avoidance behavior was common among participants, with 61.4% avoiding unsafe areas and 42.2% avoiding social activities. Path analyses showed that perceived risk of vandalism was associated with avoiding participating in social activities, while perceived risk of attack was related to avoiding unsafe areas during the day. Meanwhile, avoiding social activities and perceived risk of vandalism were significant predictors of poor mental health, and avoiding unsafe areas was a salient predictor of poor physical health. Perceived risk of attack had an indirect effect on physical health through avoiding unsafe areas during the day.Conclusion: Study findings highlight the importance of addressing perceived victimization risk in encouraging social participation and mobility among older adults.

Older Community Residents Who Participate in Group Activities Have Higher Daily Physical Activity Levels and Lower Medical Costs.

Participation in a group activity improves levels of activities of daily living and self-rated health in community-dwelling older adults. However, whether the group activity is associated with daily physical activity (PA) levels and medical costs has not yet been explored. The author administered a questionnaire to participants of group activities for community-dwelling older adults. Levels of daily PA were greater in those who participated once a month (n = 1147), twice a month (n = 1432), and 4 times a month (n = 635) compared with nonparticipating counterparts (n = 570). In the stepwise regression, group activity participation rate was identified as an independent predictor of daily PA levels. Before group activities began, there were no differences in medical costs between participants (n = 721) and nonparticipants (n = 1124). However, after group activities were established, medical costs were lower in participants than in nonparticipants. These results suggest that older community residents who participate in group activities have higher daily PA levels and lower medical costs.

The relationship between objectively assessed physical activity and bone health in older adults differs by sex and is mediated by lean mass.

To investigate associations of objectively assessed PA and bone health in community-dwelling older adults. This secondary analysis of a subset of the Tasmanian Older Adult Cohort study included participants with PA assessed utilising ActiGraph GT1M accelerometers over 7days (N = 209 participants, 53% female; mean ± SD age 64.5 ± 7.2years). Steps/day and PA intensity were estimated via established thresholds. Bone mineral content (BMC) was acquired at the total hip, lumbar spine, legs and whole body by DXA at baseline and approximately 2.2years later. Relationships between PA and BMC were assessed by multivariable linear regression analyses adjusted for age, smoking status, height and total lean mass. Men with above-median total hip BMC completed significantly less steps per day, but there was no significant difference in PA intensity compared with those with below-median BMC. There were no significant differences in PA in women stratified by median BMC. In women, steps/day were positively associated with leg BMC (B = 0.178; P = 0.017), and sedentary behaviour was negatively associated with leg BMC (- 0.165; 0.016) at baseline. After adjustment for confounders including lean mass and height, higher sedentary behaviour at baseline was associated with declines in femoral neck BMC (- 0.286; 0.011) but also with increases in pelvic BMC (0.246; 0.030) in men and increases in total hip BMC (0.215; 0.032) in women, over 2.2years. No other significant longitudinal associations were observed after adjustment for body composition. Associations of accelerometer-determined sedentary behaviour and PA with bone health in older adults differ by sex and anatomical site and are mediated by body composition.

Is there a role for vitamin D in supporting cognitive function as we age?

Globally, an estimated 46 million people are currently living with dementia and this figure is projected to increase 3-fold by 2050, highlighting this major public health concern and its substantial associated healthcare costs. With pharmacological treatment yet to reach fruition, the emphasis on evidence-based preventative lifestyle strategies is becoming increasingly important and several modifiable lifestyle factors have been identified that may preserve cognitive health. These include good cardiovascular health, physical activity, low alcohol intake, smoking and a healthy diet, with growing interest in vitamin D. The aim of the present paper is to review the evidence supporting the potential roles of vitamin D in ageing and cognitive health in community-dwelling older adults. Furthermore, to describe the utility and challenges of cognitive assessments and outcomes when investigating vitamin D in this context. Evidence indicates that serum 25-hydroxyvitamin D (25(OH)D) may impact brain health. There is a biological plausibility from animal models that vitamin D may influence neurodegenerative disorders, through several mechanisms. Epidemiological evidence supports associations between low serum 25(OH)D concentrations and poorer cognitive performance in community-dwelling older populations, although an optimal 25(OH)D level for cognitive health could not be determined. The effect of raising 25(OH)D concentrations on cognitive function remains unclear, as there is a paucity of interventional evidence. At a minimum, it seems prudent to aim to prevent vitamin D deficiency in older adults, with other known common protective lifestyle factors, as a viable component of brain health strategies.