Physical Activity In Older People Research Articles

The Importance of Physical Activity in the Process of Successful Ageing - An Overview

Rising life expectancy of the populations living in highly developed countries has been observed over recent decades. The number of people worldwide above the age of 60 is increasing at an unprecedented pace. The purpose of the study was to determine the significance of physical activity of older people in the process of successful ageing. Research methods. This article is a review of Polish and foreign studies considering the relationship between physical activity and successful ageing. The elaboration refers to the results of surveys published in the reviewed scientific journals including empirical studies mainly based on diagnostic survey. Study results. A thorough analysis identified three parts: the concept of successful ageing, the relationship between physical activity and health, and physical activity of older persons in Poland compared to their counterparts abroad. A review of the literature and documents has revealed that one of the main factors affecting successful ageing is physical activity. Conclusions. Physical activity and successful ageing are different in the assessed communities. Thus, it is necessary to monitor physical activity of older people in the context of successful ageing – in order to provide conducive circumstances to activating this social group and thus reducing social security cost.

Exploring the Facilitators and Barriers to Physical Activity in Older People With Sight Loss.

This study aimed to explore facilitators and barriers to physical activity in older people with sight loss. Focus groups were conducted with 13 community-dwelling older adults with sight loss ranging from poor to completely blind. Transcripts were analyzed using an inductive thematic analysis. Facilitators and barriers are experienced in three ways: psychologically; through opportunity and access; and at a societal and policy level. Campaigns are needed to challenge unhelpful age-related stereotypes at both psychological and societal levels. Additionally, interventions grounded in evidence and theory should be trialled and evaluated for increasing physical activity in this population.

Does being physically active prevent future disability in older people? Attenuated effects when taking time-dependent confounders into account

BackgroundCausal experimental evidence that physical activity prevents disability in older people is sparse. Being physically active has nonetheless been shown to be associated with disability-free survival in observational studies. Observational studies are, however, prone to bias introduced by time-dependent confounding. Time-dependent confounding occurs when an exposure (e.g. being physically active at some time-point) potentially affects the future status of a confounder (such as depression sometime later), and both variables have an effect on latter outcome (i.e. disability). “Conventional” analysis with e.g. Cox-regression is the mainstay when analyzing longitudinal observational studies. Unfortunately, it does not provide unbiased estimates in the presence of time-dependent confounding. Marginal structural models (MSM) – a relatively new class of causal models – have the potential to adequately account for time-dependent confounding.Here we analyze the effect of older people being physically active on disability, in a large long-term observational study. We address time-dependent confounding by using marginal structural models and provide a non-technical practical demonstration of how to implement this type of modeling.MethodsData is from 639 elderly individuals ascertained in the European multi-center Leukoaraiosis and Disability study (LADIS), followed-up yearly over a period of three years.We estimated the effect of self-reported physical activity on the probability to transit to instrumental disability in the presence of a large set of potential confounders.We compare the results of “conventional” modeling approaches to those estimated using marginal structural models, highlighting discrepancies.ResultsA “conventional” Cox-regression-like adjustment for salient baseline confounders signals a significant risk reduction under physical activity for later instrumental disability (OR 0.62, 95% CI 0.44–0.90). However, given MSM estimation, the effect is attenuated towards null (OR 1.00, 95% CI 0.57–1.76).ConclusionsContrary to most reports, we did not find that physical activity in older people prevents future instrumental disability, when taking time-dependent confounding into account. This result may be due to the characteristics our particular study population. It is, however, also conceivable that previous evidence neglected the effect of this type of bias.We suggest that analysts of longitudinal observational studies consider marginal structural models as a further modeling approach.

How the built environment affects change in older people's physical activity: A mixed- methods approach using longitudinal health survey data in urban China

Although the general population in China is physically active, only 45% of older adults meet the World Health Organization's recommendation for weekly moderate-to-vigorous exercise, to achieve health benefits. This percentage is even lower (9.8%) in urban China. It is, therefore, important to understand the pathways by which physical activity behaviors are impacted by the built environment. This study utilized a mixed methods approach—interviews (n = 42) and longitudinal (2010–2015) health survey data (n = 3094) for older people residing in three neighborhoods in Huainan, a mid-sized city in Anhui Province, central eastern China. First, a content analysis of interview data was used to identify individual and built environment factors (motivators and barriers) that impacted physical activity within older people's activity spaces. Second, a multilevel path analysis was conducted using the health survey data to demonstrate the pathways by which these motivators and barriers contributed to the initiation, regulation, and maintenance of physical activity. This study found (a) that the liveliness of an apartment building and its proximity to functional spaces (fast-food stores, farmer's markets, supermarkets, pharmacies, schools, hospitals, PA facilities and natural and man-made water bodies) were important factors in attracting sedentary older people to initiate physical activity; (b) the social networks of apartment neighbors helped to initiate, regulate, and maintain physical activity; and housing closeness to functional spaces was important in maintaining physical activity, particularly for those older people with chronic diseases. To increase older people's overall physical activity, future interventions should focus on residential form and access to functional spaces, prior to investing in large-scale urban design interventions.

Gaming for Health: Systematic Review and Meta-analysis of the Physical and Cognitive Effects of Active Computer Gaming in Older Adults.

Active computer gaming (ACG) is a method of facilitating physical activity in older people to improve health outcomes. The purpose of this study was to update and extend a systematic review of the evidence for ACG to determine its effects on physical and cognitive health in older adults. MEDLINE, EMBASE, CENTRAL in the Cochrane Library, and PsycINFO databases were searched from the date of the previous review (2011) to May 2016. Eligible articles were randomized controlled trials (RCTs) investigating the effect of ACG in adults aged 65 and older. Thirty-five studies were eligible for inclusion. Two review authors independently conducted data extraction, risk-of-bias assessment, and coding of behavior change techniques. Outcomes of interest were analyzed as continuous data and pooled as standardized mean differences (SMD) and 95% confidence intervals (CI). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to determine the quality of the evidence. Behavior change techniques (N = 106) were coded in the included studies (mean = 3.02). Data were pooled for 5 main outcomes of interest. Significant moderate effects in favor of ACG were observed for balance (SMD = 0.52, 95% CI = 0.24 to 0.79; 17 studies; 743 participants), for functional exercise capacity when intervention delivery was >120 minutes per week (SMD = 0.53, 95% CI = 0.15 to 0.90; 5 studies; 116 participants), and for cognitive function (SMD = -0.48, 95% CI = -0.80 to 0.17; 8 studies; 459 participants). There was no significant effect observed for functional mobility or fear of falling. The quality of the evidence for all comparisons was graded low or very low. At present there is very little confidence that ACG improves physical and cognitive outcomes in older adults.

Factors associated with change in objectively measured physical activity in older people \u2013 data from the physical activity cohort Scotland study

BackgroundCross-sectional relationships between physical activity and health have been explored extensively, but less is known about how physical activity changes with time in older people. The aim of this study was to assess baseline predictors of how objectively measured physical activity changes with time in older people.MethodsLongitudinal cohort study using data from the Physical Activity Cohort Scotland. A sample of community-dwelling older people aged 65 and over were recruited in 2009–2011, then followed up 2–3 years later. Physical activity was measured using Stayhealthy RT3 accelerometers over 7 days. Other data collected included baseline comorbidity, health-related quality of life (SF-36), extended Theory of Planned Behaviour Questionnaire and Social Capital Module of the General Household Survey. Associations between follow-up accelerometer counts and baseline predictors were analysed using a series of linear regression models, adjusting for baseline activity levels and follow-up time.ResultsFollow up data were available for 339 of the original 584 participants. The mean age was 77 years, 185 (55%) were female and mean follow up time was 26 months. Mean activity counts fell by between 2% per year (age < =80, deprivation decile 5–10) and 12% per year (age > 80, deprivation decile 5–10) from baseline values. In univariate analysis age, sex, deprivation decile, most SF-36 domains, most measures of social connectedness, most measures from the extended Theory of Planned Behaviour, hypertension, diabetes mellitus, chronic pain and depression score were significantly associated with adjusted activity counts at follow-up. In multivariate regression age, satisfactory friend network, SF-36 physical function score, and the presence of diabetes mellitus were independent predictors of activity counts at follow up after adjustment for baseline count and duration of follow up.ConclusionsHealth status and social connectedness, but not extended Theory of Planned Behaviour measures, independently predicted changes in physical activity in community dwelling older people.

Effects of health risk assessment and counselling on physical activity in older people: A pragmatic randomised trial.

BackgroundInterventions to increase physical activity (PA) among older community-dwelling adults may be enhanced by using multidimensional health risk assessment (HRA) as a basis for PA counselling.MethodsThe study was conducted among nondisabled but mostly frail persons 65 years of age and older at an ambulatory geriatric clinic in Bucharest, Romania. From May to July 2014, 200 participants were randomly allocated to intervention and control groups. Intervention group participants completed an initial HRA questionnaire and then had monthly counselling sessions with a geriatrician over a period of six months that were aimed at increasing low or maintaining higher PA. Counselling also addressed the older persons’ concomitant health risks and problems. The primary outcome was PA at six months (November 2014 to February 2015) evaluated with the International Physical Activity Questionnaire.ResultsAt baseline, PA levels were similar in intervention and control groups (median 1089.0, and 1053.0 MET [metabolic equivalent of task] minutes per week, interquartile ranges 606.0–1401.7, and 544.5–1512.7 MET minutes per week, respectively). Persons in the intervention group had an average of 11.2 concomitant health problems and risks (e.g., pain, depressive mood, hypertension). At six months, PA increased in the intervention group by a median of 180.0 MET minutes per week (95% confidence interval (CI) 43.4–316.6, p = 0.01) to 1248.8 MET minutes per week. In the control group, PA decreased by a median of 346.5 MET minutes per week (95% CI 178.4–514.6, p<0.001) to 693.0 MET minutes per week due to a seasonal effect, resulting in a difference of 420.0 MET minutes per week (95% CI 212.7–627.3, p< 0.001) between groups.ConclusionThe use of HRA to inform individualized PA counselling is a promising method for achieving improvements in PA, and ultimately health and longevity among large groups of community-dwelling older persons.Trial registrationInternational Standard Randomized Controlled Trial Number: ISRCTN11166046

Assessment of Physical Activity of Hospitalised Older Adults: A Systematic Review.

The assessment of physical activity levels of hospitalised older people requires accurate and reliable measures. Physical activities that older people in hospital commonly engage in include exercises and walking. Measurement of physical activity levels of older inpatients is essential to evaluate the impact of interventions to improve physical activity levels and to determine associations between physical activity in hospital and other health-related outcome measures. To determine which measures are used to measure physical activity of older people in hospital, and to describe their properties and applications. A systematic review of four databases: Medline, Embase, CINAHL and AMED was conducted for papers published from 1996 to 2016. Inclusion criteria were participants aged ≥ 65 years and studies which included measures of physical activity in the acute medical inpatient setting. Studies which specifically assessed the activity levels of surgical patients or patients with neurological conditions such as stroke or brain injury were excluded. All study designs were included in the review. 18 studies were included from 127 articles selected for full review. 15 studies used objective measures to measure the physical activity of older inpatients: 11 studies used accelerometers and four used direct systematic observations. Seven accelerometers were identified including the StepWatch Activity Monitor, activPAL, GENEActiv, Kenz Lifecorder EX, Actiwatch-L, Tractivity and AugmenTech Inc. Pittsburgh accelerometer. Three studies used a subjective measure (interviews with nurses and patients) to classify patients into low, intermediate and high mobility groups. The StepWatch Activity Monitor was reported to be most accurate at step-counting in patients with slow gait speed or altered gait. The activPAL was reported to be highly accurate at classifying postures. Physical activity levels of older inpatients can be measured using accelerometers. The accuracy of the accelerometers varies between devices and population-specific validation studies are needed to determine their suitability in measuring physical activity levels of hospitalised older people. Subjective measures are less accurate but can be a practical way of measuring physical activity in a larger group of patients.

Relationship between sarcopenia and physical activity in older people: a systematic review and meta-analysis.

Physical activity (PA) has been identified as beneficial for many diseases and health disorders, including sarcopenia. The positive influence of PA interventions on sarcopenia has been described previously on many occasions. Current reviews on the topic include studies with varied PA interventions for sarcopenia; nevertheless, no systematic review exploring the effects of PA in general on sarcopenia has been published. The main aim of this study was to explore the relationship between PA and sarcopenia in older people on the basis of cross-sectional and cohort studies. We searched PubMed, Scopus, EBSCOhost, and ScienceDirect for articles addressing the relationship between PA and sarcopenia. Twenty-five articles were ultimately included in the qualitative and quantitative syntheses. A statistically significant association between PA and sarcopenia was documented in most of the studies, as well as the protective role of PA against sarcopenia development. Furthermore, the meta-analysis indicated that PA reduces the odds of acquiring sarcopenia in later life (odds ratio [OR] =0.45; 95% confidence interval [CI] 0.37–0.55). The results of this systematic review and meta-analysis confirm the beneficial influence of PA in general for the prevention of sarcopenia.

151Factors Associated With Change In Objectively Measured Physical Activity In Older People - Data From The Physical Activity Cohort Scotland Study

151Factors Associated With Change In Objectively Measured Physical Activity In Older People - Data From The Physical Activity Cohort Scotland Study

Physical activity in older people – Case studies of how to make change happen

Enhancing physical activity (PA) is recognized as a powerful intervention for the prevention and treatment of chronic diseases and disability in older people. Furthermore, there is an agreement that increased PA in daily life is a key determinant of active and healthy ageing and should be recommended for frail and sedentary older people. Unfortunately, relatively few older people engage in regular PA or stay active in the long term. This article summarizes and discusses PA recommendations for older adults without focussing on specific diseases, presents the main barriers and facilitators for increasing PA levels, and considers the implementation of these recommendations on the basis of the existing evidence. Finally, we provide case studies of PA programmes for older people that were successfully implemented and highlight the current lessons learned.

New Ways to Promote Physical Activity in Residential Care

Most researchers in the area of physical activity in older people know how hard it is to actual changing behavior of people in the desired direction. My own experience after 30 years of research is that the we have an enough knowledge about the benefits of physical activity in older people, but that knowledge about changing behaviour is still far from complete. It is known that the older population (65 years and more) and especially older people in nursing homes, are extremely physically inactive.

Physical Activity in Community Dwelling Older People: A Systematic Review of Reviews of Interventions and Context.

BackgroundThe promotion and maintenance of higher physical activity (PA) levels in the older population is an imperative for cognitive and healthy ageing but it is unclear what approaches are best suited to achieve this for the increasing number of older people living in the community. Effective policies should be informed by robust, multi-disciplinary and multi-dimensional evidence, which not only seeks what works, but in ‘what context? In addition to evidence on the efficacy and effectiveness of PA for maintaining cognitive health, social contexts such as ‘how do we actually get older people to partake in PA?’ and ‘how do we sustain that activity long-term?’ also need highlighting. This review is part of a comprehensive evidence synthesis of preventive interventions in older age, with a focus on healthy behaviours to identify evidence gaps and inform policy relating to ageing well and cognitive health. An overview of systematic reviews of PA was conducted to explore three topics: (1) PA efficacy or effectiveness for primary prevention of cognitive decline in 55+; (2) Interventions efficacious or effective for increasing PA uptake and maintenance in 55+; (3) barriers and facilitators to PA in 55+.MethodsMultiple databases were searched for studies in English from OECD countries between 2000 and 2016. Quality of included reviews in questions (1) and (2) were assessed using AMSTAR. Review protocols were registered on PROSPERO (CRD42014015554, 42014015584, CRD42014015557) and reviews follow PRISMA guideline.FindingsOverall, 40 systematic reviews were included. Question 1 (n = 14). 8,360 participants. Evidence suggests that PA confer mild positive effects on cognition in older adults with and without previous cognitive impairment. However, there is insufficient evidence of a dose-response relationship. Evidence on the effects of PA on delay of dementia onset is inconclusive. Question 2 (n = 17). 79,650 participants. Evidence supports the effectiveness of a variety of interventions, including group delivered, centre-based and cognitive approaches on short-term uptake of PA behaviour. Question 3 (n = 9). 22,413 participants. Barriers include health status, previous PA habits and experiences, and cultural sensitivity, while facilitators include enjoyable activities and convenient scheduling.ConclusionPA can offer small benefits to brain health, but evidence on how much activity is required to produce this effect is lacking. Evidence on the effectiveness of PA for preventing dementia and cognitive decline is lacking. Behavioural (walking, exercise) and cognitive (counselling and motivational interviews) interventions are effective for short-term uptake of physical activity in older people. In order to maintain long-term participation in PA, individualised interventions modelled using behavioural theories may be required. Public health messages should be aimed at promoting acceptable levels of PA above normal daily activities in older people. Policy and strategies aimed at increasing PA in older people should be encouraged while considering barriers and facilitators to behaviour change.

Physical activity in community-dwelling older people: a review of systematic reviews of interventions and context

BackgroundResearch evidence on the importance of physical activity for prevention and delay of long-term conditions is strong. However, activity rates decline substantially over the life course, particularly around later life. This review is part of a comprehensive evidence synthesis of preventive interventions in older age, with a focus on healthy behaviours to identify evidence gaps and inform policy relating to ageing well and cognitive health. An overview of systematic reviews of physical activity was conducted to explore in adults aged 55 years and older: (review 1) the effectiveness of physical activity for primary prevention of cognitive decline and dementia; (review 2) interventions effective for increasing physical activity uptake and maintenance; and (review 3) barriers and facilitators to physical activity. MethodsMultiple databases were searched for studies in English from Organisation for Economic Co-operation and Development countries between 2000 and 2014 (Medline, Embase, PsycINFO, CINAHL, Social Science Index, the Cochrane Collaboration and Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Health Technology Assessment, and York CRD Database). Search strategy covered the following domains and concepts: ageing and older people; health behaviours and risk reduction relating to diet, physical activity, inactivity, alcohol, smoking; and risk reduction relating to loneliness and isolation, sun exposure, hearing, and vision. The quality of reviews 1 and 2 were assessed with AMSTAR. Findings35 systematic reviews were included. In review 1 (12 systematic reviews, 7751 participants), physical activity conferred mild, positive effects on cognition in older adults with and without previous cognitive impairment. However, evidence of a dose–response association was insufficient, and evidence on the effects of physical activity on delay of cognitive decline and dementia onset was inconclusive. The evidence in review 2 (16, 75 194) supported the effectiveness of various interventions, including group-delivered, centre-based, and cognitive approaches on short-term uptake of physical activity behaviour. In review 3 (7, 15 921), barriers included health status, previous physical activity habits and experiences, and cultural sensitivity, whereas facilitators included enjoyable activities and convenient scheduling. InterpretationPhysical activity can offer small benefits to brain health, but evidence on how much activity is required to produce this effect is lacking. Interventions aimed at increasing physical activity in older people should be encouraged while considering barriers and facilitators to behaviour change. In the absence of evidence on the minimum physical activity effective for maintaining brain health and increasing participation, public health messages should be aimed at promoting acceptable levels of physical activity above normal daily activities in older people. To maintain long-term participation in physical activity, individualised interventions modelled using behavioural theories may be required. FundingNational Institute for Health Research (NIHR) School for Public Health Research Ageing Well Programme and the NIHR Collaborations for Leadership in Applied Health Research and Care East of England.

The association of the neighbourhood built environment with objectively measured physical activity in older adults with and without lower limb osteoarthritis.

BackgroundThis study examined the associations of objectively measured neighbourhood built environment characteristics with objectively measured physical activity (PA) in older people with and without lower limb osteoarthritis (LLOA), and assessed whether these relationships differ between both groups.MethodsData from the Dutch component of the European Project on OSteoArthritis were used. American College of Rheumatology classification criteria were used to diagnose LLOA (knee and/or hip osteoarthritis). Daily average time spent on total PA and separate PA intensity categories, including light PA, low-light PA, high-light PA, and moderate to vigorous PA, were measured using Actigraph GT3X accelerometers. Geographic Information Systems were used to measure street connectivity (number of street connections per km2) and distances (in km) to resources (health care resources, retail resources, meeting places, and public transport) within neighbourhoods. Multiple Linear Regression Analyses were used to examine the associations between measures of the neighbourhood built environment and PA, adjusted for several confounders.ResultsOf all 247 participants (66–85 years), 41 (16.6 %) had LLOA. The time spent on any PA did not differ significantly between participants with and without LLOA (LLOA: Mean = 268.3, SD = 83.3 versus non-LLOA: Mean = 275.8, SD = 81.2; p = 0.59). In the full sample, no measures of the neighbourhood built environment were statistically significantly associated with total PA. Larger distances to specific health care resources (general practice and physiotherapist) and retail resources (supermarket) were associated with more time spent on PA in older people with LLOA than in those without LLOA. In particular, the associations of light and high-light PA with distances to these specific resources were stronger in participants with LLOA compared to their counterparts without LLOA.ConclusionsSpecific attributes of the neighbourhood built environment are more strongly associated with PA in older people with LLOA than in those without LLOA. Knowledge on the relationship between objectively measured neighbourhood characteristics and PA in older people with and without LLOA could be used to inform policymakers and city planners about adaptation of neighbourhoods and their infrastructures to appropriately facilitate PA in healthy and functionally impaired older adults.

051 Increasing Physical Activity in Older People with Pain: Development of a Brief and Simple Intervention to Promote Walking

051 Increasing Physical Activity in Older People with Pain: Development of a Brief and Simple Intervention to Promote Walking

Sleep Quality and Recommended Levels of Physical Activity in Older People.

A minimum level of activity likely to improve sleep outcomes among older people has not previously been explored. In a representative UK sample aged 65+ (n = 926), cross-sectional regressions controlling for appropriate confounders showed that walking at or above the internationally recommended threshold of ≥ 150 min per week was significantly associated with a lower likelihood of reporting insomnia symptoms (OR = 0.67, 95% CI = 0.45-0.91, p < .05). At a 4-year follow-up (n = 577), higher walking levels at baseline significantly predicted a lower likelihood of reporting sleep onset (OR = 0.64, 95% CI = 0.42-0.97, p < .05) or sleep maintenance (OR = 0.63, 95% CI = 0.41-0.95, p < .05) problems. These results are consistent with the conclusion that current physical activity guidelines can support sleep quality in older adults.

How the local built environment affects physical activity behaviour in older adults in the UK: a cross-sectional analysis linked to two national cohorts

BackgroundPolicy makers are increasingly interested in how changes in local neighbourhood environments can affect health behaviours, especially physical activity, but individual studies rarely consider multiple environmental dimensions. Although older people can be particularly at risk of physical challenges in their local environment, few studies have focused on this age group. MethodsWe developed a local environment audit instrument to capture multiple dimensions of the built environment that could affect the physical activity of older people; we linked the environmental data to physical activity behaviour collected in two nationally representative cohorts: the British Regional Heart Study and British Women's Heart and Health Study. Comprehensive foot-based audits were conducted by trained field staff in 20 towns across England and Scotland covering 590 lower super output areas and data zones; interobserver reliability of the instrument was high. The primary outcome was time spent in moderate-to-vigorous physical activity measured in participants for 1 week during 2010–12 with GT3X accelerometers (Actigraph, Pensacola, FL, USA). Using multilevel regression analysis, we assessed the association between aspects of the built environment and physical activity adjusted for individual-level confounders and area-level population density. Findings686 men and 638 women aged 69–92 years participated in the accelerometer study and were included in the analysis. Geometric mean time in moderate-to-vigorous physical activity was 26·3 min/day (geometric SD 2·7) in men and 23·8 min/day (SD 2·5) in women. There was no evidence of associations between any of the domains studied (quality of the built environment defined by latent class analysis; number of bus stops; area aesthetics; density of shops and services; amount of green space) and moderate-to-vigorous physical activity. Relative to areas with the worst quality walking environment, people living in areas with the best walking environments spent 2% more time in moderate-to-vigorous physical activity (95% CI −11 to 17, p=0·78 for overall trend). InterpretationAlthough small effect sizes cannot be discounted, this study suggests that older individuals might be less affected by their local neighbourhood environment than is often presumed in the scientific literature, reflecting both the heterogeneous functionality of this age group and the varying nature of their activity spaces. FundingThis study was funded by a grant from the Medical Research Council (MR/J007145/1). The collection and extraction of data on physical activity in these cohorts was supported by grants from the British Heart Foundation (PG/09/024 and PG/13/66/304422) and National Institute for Health Research (PDF 2010-03-23).

Promoting physical activity in older people in general practice: ProAct65+ cluster randomised controlled trial.

Regular physical activity reduces falls, hip fractures, and all-cause mortality, but physical activity levels are low in older age groups. To evaluate two exercise programmes promoting physical activity among older people. Pragmatic three-arm, parallel-design cluster randomised controlled trial involving 1256 people aged ≥65 years (of 20 507 invited) recruited from 43 general practices in London, Nottingham, and Derby. Practices were randomised to the class-based Falls Management Exercise programme (FaME), the home-based Otago Exercise Program (OEP), or usual care. The primary outcome was the proportion reaching the recommended physical activity target 12 months post-intervention. Secondary outcomes included falls, quality of life, balance confidence, and costs. In total, 49% of FaME participants reached the physical activity target compared with 38% for usual care (adjusted odds ratio 1.78, 95% confidence interval [CI] =1.11 to 2.87, P = 0.02). Differences between FaME and usual care persisted 24 months after intervention. There was no significant difference comparing those in the OEP (43% reaching target at 12 months) and usual-care arms. Participants in the FaME arm added around 15 minutes of moderate-to-vigorous physical activity per day to their baseline level; this group also had a significantly lower rate of falls (incident rate ratio 0.74, 95% CI = 0.55 to 0.99, P = 0.042). Balance confidence was significantly improved in both intervention arms. The mean cost per extra person achieving the physical activity target was £1740. Attrition and rates of adverse reactions were similar. The FaME programme increases self-reported physical activity for at least 12 months post-intervention and reduces falls in people aged ≥65 years, but uptake is low. There was no statistically significant difference in reaching the target, or in falls, between the OEP and usual-care arms.

Regular physical activity of older people in Kosovo: a population-based survey

Regular physical activity of older people in Kosovo: a population-based survey