Physical Activity Scale For The Elderly Research Articles

Interactions of cumulative load with biomarkers of cartilage turnover predict knee cartilage change over 2 years: data from the osteoarthritis initiative.

The purpose was to investigate relationships of cumulative load and cartilage turnover biomarkers with 2-year changes in cartilage in knee osteoarthritis. From participants with Kellgren-Lawrence (KL) grades of 1 to 3, cartilage thickness and transverse relaxation time (T2) were computed from 24-month (baseline) and 48-month magnetic resonance images. Cumulative load was the interaction term of the Physical Activity Scale for the Elderly (PASE) and body mass index (BMI). Serum cartilage oligomeric matrix protein (COMP) and the nitrated form of type II collagen (Coll2-1 NO2) were collected at baseline. Multiple regressions (adjusted for baseline age, KL grade, cartilage measures, pain, comorbidity) evaluated the relationships of cumulative load and biomarkers with 2-year changes. In 406 participants (63.7 (8.7) years), interactions of biomarkers with cumulative load weakly predicted 2-year cartilage changes: (i) COMP × cumulative load explained medial tibia thickness change (R2 increased 0.062 to 0.087, p < 0.001); (ii) Coll2-1 NO2 × cumulative load explained central medial femoral T2 change (R2 increased 0.177 to 0.210, p < 0.001); and (iii) Coll2-1 NO2 × cumulative load explained lateral tibia T2 change (R2 increased 0.166 to 0.188, p < 0.001). Moderate COMP or Coll2-1 NO2 at baseline appeared protective. High COMP or Coll2-1 NO2, particularly with high BMI and low PASE, associated with worsening cartilage. Moderate serum concentrations of cartilage turnover biomarkers, at high and low physical activity, associated with maintained cartilage outcomes over 2 years. In conclusion, high concentrations of cartilage turnover biomarkers, particularly with high BMI and low physical activity, associated with knee cartilage thinning and increasing T2 over 2 years. Key Points • Higher quality cartilage may be better able to tolerate a larger cumulative load than poor quality cartilage. • Among participants enrolled in the Osteoarthritis Initiative Biomarkers Consortium Project, a representation of cumulative load exposure and its interaction with cartilage turnover biomarkers were weakly related with 2-year change in knee cartilage. • These findings suggest that cartilage turnover is a factor that modifies the relationship between loading exposure and cartilage loss in knee OA.

The Relation Between Frailty and Hypertension is Partially Mediated by Physical Activity Among Males and Females in the Canadian Longitudinal Study on Aging.

Frailty reflects the heterogeneity in aging and may lead to the development of hypertension and heart disease, but the frailty-cardiovascular relation and whether physical activity modifies this relation in males and females is unclear. We tested if higher frailty was positively associated with hypertension and heart disease in males and females, and if habitual movement mediated this relation. The relation between baseline frailty with follow-up hypertension and heart disease was investigated using the Canadian Longitudinal Study on Aging at 3-year Follow-Up data (males: n=13095, females: n=13601). Frailty at baseline was determined via a 73-item deficit-based index, activity at follow-up via the Physical Activity Scale for the Elderly, and cardiovascular function was self-reported. Higher baseline frailty level was associated with a greater likelihood of hypertension and heart disease at follow-up, with covariate-adjusted odds ratios of 1.08-1.09 (all, p<0.001) for a 0.01 increase in frailty index score. Among males and females, sitting time and strenuous physical activity were independently associated with hypertension, with these activity behaviours being partial mediators (except males-sitting time) for the frailty-hypertension relation (explained 5-10% of relation). The strength of this relation was stronger among females. Only light-moderate activity partially mediated the relation (~6%) between frailty and heart disease in females, but no activity measure was a mediator for males. Higher frailty levels were associated with a greater incidence of hypertension and heart disease, and strategies that target increases in physical activity and reducing sitting may partially uncouple this relation with hypertension, particularly among females.

Validity of the Short Weekly Calendar Planning Activity in patients with Parkinson disease and nonmanifesting LRRK2 and GBA carriers.

Subtle executive dysfunction is common in people newly diagnosed with Parkinson disease (PD), even when general cognitive abilities are intact. This study examined the Short Weekly Calendar Planning Activity (WCPA-10)'s known-group construct validity, comparing persons with PD to healthy controls (HCs) and nonmanifesting carriers of LRRK2 and GBA gene mutations to HCs. Additionally, convergent and ecological validity was examined. The study included 73 participants: 22 with idiopathic PD (iPD) who do not carry any of the founder GBA mutations or LRRK2-G2019S, 29 nonmanifesting carriers of the G2019S-LRRK2 (n = 14) and GBA (n = 15) mutations, and 22 HCs. Known-group validity was determined using the WCPA-10, convergent validity by also using the Montreal Cognitive Assessment (MoCA) and Color Trails Test (CTT), and ecological validity by using the WCPA-10, Schwab and England Activities of Daily Living Scale (SE ADL), and Physical Activity Scale for the Elderly (PASE). Known-group validity of the WCPA-10 was established for the iPD group only; they followed fewer rules (p = 0.020), were slower (p = 0.003) and less efficient (p = 0.001), used more strategies (p = 0.017) on the WCPA-10, and achieved significantly lower CTT scores (p < 0.001) than the HCs. The nonmanifesting carriers and HCs were similar on all cognitive tests. Convergent and ecological validity of the WCPA-10 were partially established, with few correlations between WCPA-10 outcome measures and the MoCA (r = 0.50, r = 0.41), CTT-2 (r = 0.43), SE ADL (r = 0.41), and PASE (r = 0.54, r = 0.46, r = 0.31). This study affirms the known-group validity for most (four) WCPA-10 scores and partially confirms its convergent and ecological validity for PD.

Global cognition, gender, and level of education predict dual-task gait speed variability metrics in older adults.

To determine if demographic variables and measures of cognitive function, functional mobility, self-reported balance self-efficacy, and self-reported physical activity can predict gait speed variability during single-task walking (STgscv), during cognitive-motor dual-tasking (DTgscv), and dual-task effect on gait speed variability (DTEgscv) in older adults. In 62 older adults, demographics were recorded and cognitive function (including the Montreal Cognitive Assessment, MoCA), functional mobility, balance self-efficacy (Activity-Specific Balance Confidence Scale, ABC), and self-reported physical activity (Physical Activity Scale for the Elderly, PASE) were assessed. Three linear regression models were used to determine whether the functional mobility tests, PASE score, ABC score, and tests of cognitive function predicted gait speed variability outcomes (STgscv, DTgscv, DTEgscv), with demographics included as covariates. MoCA score (p = 0.003), gender (p = 0.040), and years of education (p = 0.010) significantly predicted DTgscv (R^2 = 0.297, p = 0.002). MoCA score (p = 0.008) and years of education (p < 0.001) also significantly predicted DTEgscv. Despite a significant regression model (R^2 = 0.316, p = 0.001), there were no significant individual predictors of STgscv. Older adults with lower cognitive function scores, according to the MoCA, and higher levels of education demonstrate larger gait speed variability during dual-tasking and may be at increased risk of real-world mobility issues or falling.

Effect of weight loss on knee joint synovitis over 48 months and mediation by subcutaneous fat around the knee: data from the Osteoarthritis Initiative

BackgroundObesity influences the development of osteoarthritis via low-grade inflammation. Progression of local inflammation (= synovitis) increased with weight gain in overweight and obese women compared to stable weight. Synovitis could be associated with subcutaneous fat (SCF) around the knee. Purpose of the study was to investigate the effect of weight loss on synovitis progression and to assess whether SCF around the knee mediates the relationship between weight loss and synovitis progression.MethodsWe included 234 overweight and obese participants (body mass index [BMI] ≥ 25 kg/m2) from the Osteoarthritis Initiative (OAI) with > 10% weight loss (n = 117) or stable overweight (< ± 3% change, n = 117) over 48 months matched for age and sex. In magnetic resonance imaging (MRI) at baseline and 48 months, effusion-synovitis and Hoffa-synovitis using the MRI Osteoarthritis Knee Score (MOAKS) and average joint-adjacent SCF (ajSCF) were assessed. Odds-ratios (ORs) for synovitis progression over 48 months (≥ 1 score increase) were calculated in logistic regression models adjusting for age, sex, baseline BMI, Physical Activity Scale for the Elderly (PASE), and baseline SCF measurements. Mediation of the effect of weight loss on synovitis progression by local SCF change was assessed.ResultsOdds for effusion-synovitis progression decreased with weight loss and ajSCF decrease (odds ratio [OR] = 0.61 and 0.56 per standard deviation [SD] change, 95% confidence interval [CI] 0.44, 0.83 and 0.40, 0.79, p = 0.002 and 0.001, respectively), whereas odds for Hoffa-synovitis progression increased with weight loss and ajSCF decrease (OR = 1.47 and 1.48, CI 1.05, 2.04 and 1.02, 2.13, p = 0.024 and 0.038, respectively). AjSCF decrease mediated 39% of the effect of weight loss on effusion-synovitis progression.ConclusionsEffusion-synovitis progression was slowed by weight loss and decrease in local subcutaneous fat. Hoffa-synovitis characterized by fluid in the infrapatellar fat pad increased at the same time, suggesting a decreasing fat pad rather than active synovitis. Decrease in local subcutaneous fat partially mediated the systemic effect of weight loss on synovitis.

What are relevant predictors of physical activity in older adults with lower limb loss (LLL)? Results of a retrospective analysis.

People with lower limb loss (LLL) have reduced physical activity (PA). There is evidence of physical and psychosocial predictors of PA in older adults with limb loss. However, these 2 areas (physical/psychosocial) have not been evaluated in the same analysis. To describe and identify predictors of PA in individuals with LLL. Cross-sectional study. Secondary analysis of data from a multisite Canadian randomized control trial involving community-dwelling prosthetic ambulators with unilateral transtibial or transfemoral amputation (N = 72). The dependent variable was the Physical Activity Scale for the Elderly. Potential predictors were four step square test, 2-minute walk test, Short Physical Performance Battery, Life Space Assessment, walking while talking test, and Activities-specific Balance Confidence scale. Seventy-two community-dwelling lower limb prosthesis users were enrolled. The sample included 62 male participants (86%), and 58 participants (81%) had transtibial amputation. The average age of participants was 65 (8.9) years, and for 49 participants (70%), the amputation was over 24 months ago. The total mean Standard Deviation (SD) Physical Activity Scale for the Elderly score was 153.2 (88.3), with scores of 148.1 (11.4) and 184.5 (24.7) for male and female participants, respectively. Regression analysis identified Life Space Assessment (β = 1.15, p = 0.007) and Short Physical Performance Battery (β = 3.51, p = 0.043) as statistically significant predictors accounting for 25% of the variance in PA. Community mobility and physical performance are the most meaningful predictors of PA. Future research should examine additional factors (e.g., environment, motivation). Understanding the predictors for PA after LLL would improve clinical practice as clinicians would have increased knowledge to modify and improve training.

Effect of a fluid consumption education intervention on the hydration status of care home residents aged over 65 years

ABSTRACT Dehydration is a typical problem among the elderly people who live in nursing homes. It is a condition that is costly in terms of health care costs and length of treatment due to the illnesses it causes. It is a condition that can be prevented, and elderly people can benefit from initiatives to increase their fluid intake. This study aimed to find out how the hydration status of elderly people is affected by hydration education. It was also an assessment of the participants’ hydration status and water intake from sources. Forty-three elderly people from two nursing homes participated in this quasi-experimental study. There were 25 elderly in the intervention group (IG) and 18 in the control group (CG). For one month, 40-minute sessions per week (20 minutes of education and 20 minutes of activity) were devoted to teaching about fluid consumption. To evaluate the effectiveness of the education, the water balance questionnaire, urine USG and pH measurement, and the Physical Activity Scale for the Elderly were assessed before, at the end of the intervention, and three months after. The results showed that the IG group’s hydration improved, and their short-term water consumption increased. Education needs to be carefully implemented and the results followed up to ensure that elderly people develop a habit of drinking water.

Evaluation of sarcopenia and phase angle in elderly patients with Parkinson’s Disease

Purpose To investigate sarcopenia and related factors and to determine the disease-specific phase angle (PhA) cut-off score in detecting sarcopenia in elderly patients with Parkinson’s Disease (PD). Methods This cross-sectional study was conducted with 89 participants. The Mini-Nutritional Assessment (MNA), the Eating Attitude Test-10 (EAT-10), the Physical Activity Scale for The Elderly (PASE) questionnaire and the Hoehn-Yahr scale have been used. Additionally, anthropometric measurements were performed. The diagnosis of sarcopenia was based on the new consensus published by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). PhA has been performed by Bioelectrical Impedance Analysis (BIA) with Tanita MC 780®. Results The mean age was of the participants 68.9 ± 6.4 years, and 57.3% were male. The prevalence of sarcopenia was 12.3%. PhA, malnutrition, age, disease severity, low calf circumference (CC), low body mass index (BMI), the difference between the pre-diagnosis and current weight loss, dopaminergic treatment, and low PASE score were associated with sarcopenia. The cut-off value of the PhA in terms of the ability to identify sarcopenia was <4.5o with a sensitivity of 53.3% and a specificity of 93.2% (p = 0.001). When we grouped the PhA of the patients according to this cut-off score, it was seen that 14.6% of them were sarcopenic. Age, disease severity, PASE score and hand grip strength were significantly related to both sarcopenia and PhA. Conclusion It is important to be aware of sarcopenia and related factors at an early stage in Parkinson’s patients. Because of disease-related symptoms, it may be more appropriate to use a disease-specific PhA cut-off score in the definition of sarcopenia.

Exploring Factors Associated with Physical Activity in the Elderly: A Cross-Sectional Study during the COVID-19 Pandemic.

The COVID-19 pandemic negatively influenced individuals' physical activity levels (PALs) and particularly the PAL of the elderly. However, few studies have examined the correlates of PALs in this population during the pandemic. This study aimed to evaluate the residence-specific correlates of PALs in elderly people from Croatia and Bosnia and Herzegovina during the COVID-19 pandemic. The participants were 211 persons older than 65 years (101 females), of whom 111 were community-dwelling residents, and 110 were nursing home residents (71.11 ± 3.11 and 72.22 ± 4.01 years of age, respectively; t-test = 0.91, p < 0.05). The variables included health status, residential status sociodemographic factors, anthropometrics (body mass, height, and body mass index), and PAL. PAL was evaluated using a translated version of the Physical Activity Scale for the Elderly (PASE), and was validated in this study. PASE showed good test-retest reliability (51% of the common variance) and validity (57% of the common variance, with the step count measured using pedometers). Apart from participants' health status and age, PAL was positively correlated with (i) community-dwelling residence (OR = 1.93, 95% CI: 1.60-2.23), and (ii) a lower BMI (OR = 0.85, 95% CI = 0.71-0.98). The pre-pandemic physical activity was positively correlated with the PAL of the nursing home residents (OR = 1.2, 95% CI: 1.02-1.45). A higher education level was positively correlated with the PAL of community-dwelling residents (OR = 1.31, 95% CI: 1.04-1.66). This study evidenced the residence-specific correlates of PALs, and enabled the identification of specific groups that are at risk of having low PALs during the pandemic. Future studies examining this problem during a non-pandemic period are warranted.

Physical activity and health-related quality of life in older adults: depression as a mediator

BackgroundPhysical activity(PA) is associated with health-related quality of life (HRQoL) among older adults, and both are associated with mood, such as depression. However, the indirect effects of PA on HRQoL in older adults have not been clearly established. This study explained how different types and intensities of PA were associated with HRQoL while considering the effects of depression in older adults.MethodsA cross-sectional study was conducted with 7,518 community-dwelling older adults aged 60 years and older. PA (leisure-time, household, and work-related), depression, and HRQoL were measured using the Physical Activity Scale for the Elderly (PASE), the 30-item Geriatric Depression Scale (GDS-30), and the 36-Item Short-Form Health Survey (SF-36), respectively. Information on age, gender, education, monthly income, activities of daily living, smoking, and alcohol drinking was also collected. Regression analysis was used to explore the relationship between PA, depression and HRQoL, and a mediation effect test process was used to verify the mediating mechanism of the depression on this relationship.ResultsThe study showed that after adjusting for a set of covariates, SF-36 Physical Component Summary (PCS) scores were negatively associated with depression (B = -2.046, 95% CI [2.584, -1.509]) and positively with PA (p < 0.001). Similarly, SF-36 Mental Component Summary (MCS) scores were negatively associated with depression (B = -11.657, 95% CI [-12.190, -11.124]). In mediation analyses, we found that depression partially mediated the relationship between different types and intensities PA and PCS (moderate leisure-time PA: B = 0.223, 95%CI [0.153,0.293], P < 0.001; vigorous leisure-time PA: B = 0.323, 95%CI [0.232,0.413], P < 0.001; moderate household PA: B = 0.092, 95%CI [0.045,0.139], P < 0.001; vigorous household PA: B = 0.137, 95%CI [0.085,0.190], P < 0.001; work-related PA: B = 0.193, 95%CI [0.658,0.190], P < 0.001) and MCS (moderate leisure-time PA: B = 1.243, 95%CI [1.008,1.479], P < 0.001; vigorous leisure-time PA: B = 1.800, 95%CI [1.585,2.015], P < 0.001; moderate household PA: B = 0.496, 95%CI [0.274,0.718], P < 0.001; vigorous household PA: B = 0.742, 95%CI [0.521,0.963], P < 0.001; work-related PA: B = 1.026, 95%CI [0.819,1.234], P < 0.001).ConclusionsThis study suggested that leisure-time, household, and work-related PA were negatively associated with depression, while positively affecting HRQoL in Chinese older adults. The relationships between different types and intensities of PA and HRQoL were mediated by depression. Interventions aimed at promoting purposeful exercise and different types of PA may have mental health benefits. It is recommended that geriatric health managers and healthcare planners prioritize interventions to help improve PA intensities, alleviate depressive symptoms to promote beneficial effects on HRQoL in older adults.

Physical Activity Levels and Sedentary Behavior of People Living With Mild Cognitive Impairment: A Cross-Sectional Study Using Thigh-Worn Accelerometers.

Community-dwelling people with Mild Cognitive Impairment self-reporting not to be meeting recommended physical activity levels participated in this study to (a)determine compliance of wearing (thigh-worn) accelerometers, (b)describe physical activity levels and sedentary behavior, and (c)determine the validity of the Physical Activity Scale for the Elderly (PASE) compared with activPAL accelerometers. A total of 79 people had valid accelerometer data (median [interquartile range]: age, 71 [54-75]years). Compliance was 86.81%. Participants were sedentary for 10.6hr per day and engaged in a median of 9min per day of moderate-intensity physical activity. Fair correlations were found between the PASE and total stepping time per day (r = .35, p < .01), total number of steps per day (r = .36, p < .01), and number of steps in stepping activities completed for ≤1min (r = .42, p < .01). The PASE and Standing time (r = .04, p = .724) and PASE and Sitting time (r = .04, p = .699) had little to no relationship. The use of thigh-worn accelerometers for this population is achievable. People with Mild Cognitive Impairment have high levels of sedentary behavior and minimal engagement in moderate-intensity physical activity. The PASE has fair, positive criterion validity with activity-based outcomes measured by activPAL accelerometers but not with sedentary behavior, which is high for this population.

Is There an Association Between Self-Reported Dual-Task Performance and Fear of Falling in Older Adults?

Is there an association between self-reported dual-task performance and fear of falling in older adults? Fear of falling tends to increase with age and can negatively impact dual-task abilities, leading to potential declines in overall quality of life. Therefore, it becomes crucial to evaluate dual-task performance in older adults, particularly prior to the onset of fear of falling. This study aims to investigate the potential association between self-reported dual-task performance and fear of falling in older adults. A total of 51 individuals (19 females and 32 males) were recruited. The participants met the inclusion criteria were administered the Dual-Task Questionnaire (DTQ), Falls Efficiency Scale International, and Physical Activity Scale for the Elderly. Multiple linear regression was performed to predict DTQ scores based on age, body mass index, and Physical Activity Scale for the Elderly. A moderate positive correlation was found between Falls Efficiency Scale International scores and self-reported DTQ scores (r: .448, p: .001). Age, body mass index, and Physical Activity Scale for the Elderly were not found to be significant predictors of DTQ scores. Our study reveals a moderate positive association between fear of falling and self-reported dual-task performance in older adults. A direct relationship between physical activity performance, fear of falling, and self-reported dual-task performance was observed among older adults. Significance/Implications: Integrating self-reported measures like the DTQ in clinical evaluations can provide valuable insights into dual-task abilities of older adults.

The role of physical function and physical activity on cognitive function in the elderly

The aim of this study is to clarify the role of physical activity level and physical function on cognitive function of the elderly. A nested case–control investigation from a middle-aged and elderly cognitive health cohort was conducted. 103 mild cognitive impairment (MCI) patients were selected for the purpose of the study and matched 1:1 according to age and sex. Handgrip strength, gait speed and 5-time chair stand test were used to evaluate physical function. The physical activity scale for the elderly (PASE) was used to assess physical activity level. The Montreal cognitive assessment (MoCA) was used to quickly screen the mild cognitive impairment of the subjects. Body composition was estimated by bioelectrical impedance analysis. The total score of MoCA and the scores of different cognitive domains in two groups were different, handgrip strength was lower in the MCI group. Multivariate logistic regression model results showed that handgrip strength decreased could increase the risk of MCI(OR = 3.008, 95%CI: 1.421,6.369), higher PASE score was correlated with lower risk of MCI (OR = 0.402, 95%CI: 0.168,0.966). After combining body composition indices, handgrip strength and PASE score remained significantly associated with the occurrence of MCI, and there is an interaction. Logistic regression models were used for receiver operating characteristic curve analysis, all models demonstrate a good level of predictive performance for MCI. Physical activity level and physical function are associated with mild cognitive impairment. Higher physical activity level, normal handgrip strength are correlated with lower risk of MCI.

The impact of social support, physical and psychological performance on sleep outcomes in Iranian older adults: a case-control study

BackgroundSleep quality is one of the most important factors to improve the quality of life in older adults and physical and mental health plays an essential role in better sleep quality. This study aimed to determine the impact of social support, and physical and psychological performance on sleep outcomes in Iranian older adults.MethodsIn this case-control study, 400 elder people, who were exposed to sleep problems, and 400 people without sleep problems were randomly selected during 2016–2017 in Amirkola, Iran. Subjects in the case and control groups were matched in terms of gender and age. The demographic characteristics, Duke Social Support Questionnaire (DSSI), Physical Activity Scale for the Elderly (PASE), Activity of Daily Living (ADL), Instrumental Activity of Daily Living (IADL), Mini-Mental State Examination (MMSE), and Pittsburgh Sleep Quality Questionnaire (PSQI) questionnaires were used to collect data. T-test, Chi-square, Pearson Correlation coefficient, and multiple Logistic regression were used for data analysis.ResultsThe mean score of DSSI and its domains including social interaction (DSSI.Int) and social satisfaction (DSSI.Sat) were 28.15 ± 3.55, 9.31 ± 1.23, and 18.84 ± 2.88 in the case group and 28.87 ± 3.20, 9.48 ± 1.10, and 19.83 ± 2.44 in the control group, respectively. In this study, the mean scores of MMSE, PASE, ADL, and IADL were 25.36 ± 3.95, 101.71 ± 56.99, 13/97 ± 0.37, 20.59 ± 2/79; respectively. There was a significant inverse correlation between poor sleep quality with DSSI score (rho = -0.165, P < 0.0001), DSSI.Int (rho = -0.113, P < 0.001), DSSI.Sat (rho = -0.160, P < 0.0001), PASE (rho=-0.160, P < 0.0001), and IADL (rho = -0.112, P < 0.001) score. Therefore, more social support and physical activity improved the quality of sleep. There was a significant negative relationship between DSSI, and its domains with sleep quality in terms of gender. DSSI (rho = 0.25, P < 0.0001), DSSI.Int (P < 0.0001, rho=-0.18), and DSSI.Sat (P < 0.0001, rho=-0.22) was significant in men but not in women. The results of the adjusted logistic regression revealed a significant association between sleep quality problems and DSSI (p < 0.045, OR = 1.40), the use of hypnotic drugs (p < 0.0001, OR = 7.56), and occupation (p <0.03, OR= 12.66).ConclusionsThe results of the present study suggest that low social support and all its domains, PASE, IADL, and using hypnotic drugs may play a role in the development of sleep problems. It can be used as an effective, safe, and low-cost strategy for promoting sleep quality in older adults.

Associations between physical activity and sedentary behaviour patterns and cognition: A cross‐sectional analysis of the Canadian Longitudinal Study on Aging

AbstractBackgroundEngaging in regular physical activity (PA) and limited sedentary behaviour (SB) are critical for healthy cognitive aging. However, it is unclear what combination of PA and SB patterns (e.g., high PA and low SB, high PA and high SB, etc.) is most beneficial for cognition. We thus examined how different combinations of PA and SB were associated with cognitive performance in community‐dwelling middle‐aged and older adults.MethodA cross‐sectional analysis using baseline data from the Comprehensive cohort of the Canadian Longitudinal Study on Aging (CLSA; 2010‐2015) among participants with complete PA and SB data (n = 23,125; age range 45‐86 years). PA and SB were indexed using the Physical Activity Scale for the Elderly (PASE) and cognition using a three‐factor structural equation model (i.e., memory, executive function, and verbal fluency). Participants' PA and SB levels were classified as 1) low PA and high SB; 2) low PA and low SB; 3) high PA and high SB; and 4) high PA and low SB. Linear regressions assessed associations between PA and SB combinations and cognition, adjusted for age, sex, activities of daily living, income level, educational attainment, and depression. Contrasts with Bonferroni correction tested associations of combinations of PA and SB with cognition.ResultHigh PA was associated with better cognition whether combined with low or high SB. A high PA and low SB combination was associated with better executive function (Estimated mean difference = ‐0.24, 95%CI ‐0.39 to ‐0.10, p&lt;0.001) and verbal fluency (Estimated mean difference = ‐0.29, 95%CI ‐0.42 to ‐0.16, p&lt;0.001) vs. low PA and low SB. A combination of high PA and high SB was associated with better executive function (Estimated mean difference = 0.17, 95%CI 0.01 to 0.33, p = 0.034) and verbal fluency (Estimated mean difference = 0.20, 95%CI 0.05 to 0.34, p = 0.002) vs. high PA and low SB. Surprisingly, low PA and high SB was associated with better executive function vs. low PA and low SB (Estimated mean difference = 0.26, 95%CI 0.11 to 0.41, p&lt;0.001) (Table 1 and Figure 1).ConclusionHigh PA, irrespective of SB, is associated with better cognition. Low PA levels may be more detrimental to cognition than high SB levels.

A single-center survey on physical activity barriers, behaviors and preferences in adults with epilepsy

BackgroundImproved understanding of physical activity barriersand preferences in people with epilepsyis needed to successfully design and perform larger, more robust effectivenesstrials. MethodsAdult patients at a single tertiary epilepsy center between January and April 2020 were surveyed. The survey included a validated physical activity questionnaire (Physical Activity Scale for the Elderly) plus 15 items aimed to address 1) perceptions and beliefs regarding physical activity, 2) barriers to routine physical activity, and 3) willingness and ability to participate in a physical activity intervention and 4) current physical abilities, activities, and preferences. Results95 participants with epilepsy (age 42 ± 16.2, 59 % female) completed the survey. Sixty-five participants (68.4 %) reported that they believe that physical activity could improve their seizure frequency. However, 40 % of those surveyed said their neurologist had never talked to them about physical activity. The most commonly reported barriers to physical activity were lack of time (24.7 %) and fear of having a seizure (19.7 %), while barriers to intervention participation included being unable to come to in-person sessions (53 % of those willing to participate),living far away (39.3 %), time constraints (28.6 %), and lack of transportation (21.4 %). ConclusionFuture physical activity studies in people with epilepsy should focus on using tailored interventions that accommodate their unique beliefs and barriers.

Hyponatremia, hypernatremia and impairment of functional, psychological and sexual domains

ObjectiveTo determine the influence of serum sodium on physical, psychologic and sexual function.MethodsThis is a cross-sectional survey on 3340 community-dwelling men aged 40–79 years from a prospective cohort study in eight European countries, the European Male Ageing Study (EMAS). Participants filled-out the Short Form-36 (SF-36), the Physical Activity Scale for the Elderly (PASE), and the EMAS sexual function questionnaire. For all the analyses, serum sodium corrected for glycaemia ([Na+]G) was used.ResultsThe relationship between [Na+]G and SF-36 physical function score (F = 3.99; p = 0.01), SF-36 mental health score (F = 7.69; p < 0.001), and PASE score (F = 14.95; p < 0.001) were best described by a quadratic equation, with worse scores for [Na+]G in either the lowest or the highest ends of the range. After dividing the sample into [Na+]G < 136 mmol/L (n = 81), 136–147 mmol/L (n = 3223) and > 147 mmol/L (n = 36), linear regression analyses with linear spline functions adjusted for confounders did not confirm these relationships. Similarly, erectile dysfunction and [Na+]G, were in a quadratic relationship (F = 9.00; p < 0.001). After adjusting for confounders, the linear regression with spline functions denoted a significantly worsened erectile function for increases in serum [Na+]G > 147 mmol/L (B = 0.15 [0.04;0.26], p < 0.01) but no relationship with [Na+]G < 136 mmol/L. Likewise, the relationship of [Na+]G with concerns about sexual dysfunction was confirmed only for men with serum [Na+]G > 147 mmol/L.ConclusionsThis is the first study supporting an association between [Na+]G and sexual function. A worsening of erection and concerns about sexual function were observed for the highest values of [Na+]G, independently of other relevant factors.

Sleep Quality and Associated Factors Among Older Adults in Tabriz, Iran: Tabriz Older People Health Survey (TOPS-2019)

Objectives: The study aimed to investigate the sleep quality of aged people in Tabriz and identify its associated factors. Design: Cross-sectional study. Setting(s): Tabriz, the capital of the East Azerbaijan province in northwest Iran. Participants: A total of 1362 participants were selected from a representative sample of community-dwelling older people aged≥60 years who were living in Tabriz, using the probability proportional to size (PPS) sampling method. Outcome measures: Blood pressure (BP), sleep quality, depression, anxiety, loneliness, physical activity, daily activities, living independently, and social support were assessed using a standard mercury sphygmomanometer, Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), the 6-item De Jong Gierveld Loneliness Scale, Physical Activity Scale for the Elderly (PASE), Activity of Daily Living (ADL), Instrumental Activity of Daily Living (IADL), respectively. Results: The mean score of total PSQI was 5.39±2.91. The multivariable logistic regression model showed that being female (Odds ratio [OR]=1.68, 95% confidence interval [CI]=1.29 to 2.18), hypertensive (OR=2.12, 95% CI=1.52 to 2.95), diabetes mellitus (DM) (OR=1.29, 95% CI=0.96 to 1.72), abnormal anxiety level (OR=2.38, 95% CI=1.67 to 3.38), and low PASE score (OR=0.99, 95% CI=0.99 to 1) were significantly associated with a higher risk of poor sleep quality. Conclusions: Low physical activity is a modifiable risk factor for low sleep quality in older adults. Hence, the development of physical activity programs can be effective in improving sleep quality. Furthermore, women are the priority in designing interventions.

The Fear of Falling, Physical Activity, and Quality of Life in Elderly After COVID-19

The COVID-19 negatively affected the physical and mental health of elderly due to pandemic-related restrictions. This study aimed to investigate the influences on fear of falling, physical activity level, and quality of life in older people living in the community after the COVID-19. Falls Efficacy Scale-International (FES-I), Physical Activity Scale for the Elderly (PASE), and Nottingham Health Profile (NHP) were used to study. One hundred fifty individuals older than 65 years. Results indicated that 69.3% of the individuals had fallen in the past 6 months. FES-I showed that the elderly had moderate FES-I (31.95 ± 10.55), and PASE showed that this cohort had severe activity limitation (85.42 ± 56.45) and low NHP (213.62 ± 143.45). There was negative association between FES-I and PASE levels (ρ = .000, r = −0.291) and a moderate negative association between. FES-I and NHP (ρ = .000, r = 0.577). The variables for the number of falls and FES-I were included in the multiple linear regression analysis and model formed with FES-I that predicted PASE level was statistically significant. As a result, it is important to raise awareness about older individuals’ concerns regarding falling to implement essential measures that can effectively alleviate such fears.. In this context, it is advisable to explore innovative clinical and policy strategies that can facilitate the seamless integration of interdisciplinary preventive care for vulnerable elderly individuals, with the overarching aim of enhancing their overall quality of life.

Physical Activity Intervention for Leisure-Time Activity Levels Among Older Adults

Current randomized trial evidence of the effects of physical activity interventions in older adults is mainly from developed countries, with little reliable evidence from low- and middle-income countries, such as China, where race, culture, and lifestyles differ substantially from those in Western populations. To evaluate the effects of a multilevel intervention for increasing leisure-time activity levels in Chinese older adults. This cluster randomized trial was conducted from May 2021 to May 2023, including an 8-week intervention period and a follow-up period of 24 months. Eight villages in China were randomly assigned to the intervention (4 villages) or the control (4 villages) group. Potentially eligible participants were 60 years or older. A total of 511 older adults from the selected 8 villages were enrolled. The intervention group received an 8-week socioecological model-based intervention, comprising individual, interpersonal, and community-level components, whereas the control group did not. The primary outcome was the change in leisure-time activity at 8 weeks, measured by the Physical Activity Scale for the Elderly (PASE). Possible PASE scores for leisure-time activity range from 0 to 502, with higher scores indicating higher activity levels. A total of 511 older adults from 8 villages were recruited and randomly allocated to the intervention (240 participants, 4 villages) or control (271 participants, 4 villages) groups. The mean (SD) age was 70.95 (5.72) years, and 284 (55.6%) were female participants. Seven serious adverse events (unrelated deaths) were reported. Participants in the intervention group increased leisure-time activity more than those in the control group, with a mean difference in PASE scores of 13.74 points (95% CI, 8.58-18.91 points) between the groups at 8 weeks (P < .001). Significant differences in leisure-time activity were also found over 24 months (mean difference in scores at 4 weeks, 11.66 points; 95% CI, 6.41-16.90 points; P < .001; at 6 months, 12.35 points; 95% CI, 7.19-17.50 points; P < .001; at 12 months, 11.55 points; 95% CI, 6.32-16.78 points; P < .001; and at 24 months, 14.51 points; 95% CI, 9.28-19.75 points; P < .001). In this cluster randomized trial, the multilevel intervention was effective in promoting leisure-time activity over 24 months of follow-up in older adults from China. This finding suggests that implementation of such interventions could be an important step in addressing physical inactivity in older adults in low- and middle-income countries. Chinese Clinical Trial Registry Identifier: ChiCTR2100045653.