A Real-Time Web-Based Intervention with a Multicomponent Group-Based Program for Older Adults: Single-Arm Feasibility Study.

This study aimed to evaluate the association between physical activity level and health-related quality of life in community-dwelling middle aged and older adults in Egypt. Between May and August 2017, a cross-sectional study of 184 middle-aged and older adults between the ages of 55 and 64 years old (129 males and 55 females) with a mean age of 58 ± 4.3 years old participated in this study. Study participants were classified into 3 groups based on their level of physical activity (walking duration); low level of physical activity (<150 minutes/week), moderate level of physical activity (150–300 minutes/week), and high level of physical activity (>300 minutes/week). The health-related quality of life (HRQoL) was calculated using the Euro-Quality of life-5dimensions-3 levels scale questionnaire (EuroQol-5D-3L). Spearman's correlation coefficient was performed to determine the correlation between the physical activity level and HRQoL scores in community-dwelling middle-aged and older adults. The results showed a significant correlation between the physical activity levels and HRQoL dimensions. Significant differences were observed in the HRQoL scores between high, moderate and low-physical activity groups (P < .05). The moderate and high-physical activity groups had significantly higher HRQoL scores in all dimensions than low-physical activity group. The low-physical activity group showed a high predominance of the chronic disease compared to the high and moderate physical activity groups. It was concluded that high and moderate levels of physical activity have a great positive relationship with the HRQoL in community-dwelling middle-aged and older adults in Egypt. Recommendations should be dedicated to supporting the active lifestyle among the different population, particularly middle-aged and older adults.

Older adults are relatively physically active compared to other age group. A lack of physical activity (PA) can cause chronic diseases including osteoarthritis of knee (OA knee) and might eventually reduce quality of life (QOL). This present study was aimed to investigate association between levels of PA and OA knee with levels of QOL in community-dwelling older adults. One thousand and sixty-seven community-dwelling older persons were recruited to this descriptive study. PA activity questionnaire was invented. Standardized Oxford knee score and World Health Organization's Quality of Life scale (WHOQOL-BREF) were used to measure OA knee and QOL levels. Results showed that levels of PA in older adults were significantly associated with levels of OKS (χ2 = 78.565, P-value < .001) and levels of OA knee in older adults were significantly associated with levels of overall QOL (χ2 = 57.738, P-value < .001). Pearson's correlation also showed interrelation among PA, OA knee, and QOL. In conclusion, PA, OA knee, and QOL are interrelated. Therefore, close monitoring and design of proper PA activity should be implemented in community-dwelling older adults with OA knee.

The association between the number of parks near home and levels of physical activity among community-dwelling older adults: A longitudinal study

Increasing life expectancy has implications for the health system. There is strong evidence that health is dependent on peoples’ lifestyle. Sufficient and regular physical activity as well as a good sleep quality are major factors for improved health. Despite health benefits, the majority of older adults do not meet evidence-based physical activity recommendations. Moreover, the prevalence of sleep disorders in this age group is high. PURPOSE: To determine the association between physical activity and sleep quality in community-dwelling older adults (>65 years). METHODS: This cross-sectional study is based on 64 community-dwelling older adults (82.1 ± 6.4 years (MD ± SD); females 42). Barthel-Index was used for physical disability rating. The average amount of physical activity was assessed by means of accelerometer (MyWellnessKey), measured on 4 out of 7 consecutive days. Self-reported sleep quality, duration and bed rest time were obtained using the Pittsburgh Sleep Quality Index (PSQI). Bivariate correlations (Spearman-Rho) were used to explore relationships between physical activity and sleep quality. In order to analyze differences between subgroups (≥7, 6-7, 5-6, <5 hours of sleep; Barthel Index <90 vs. ≥90 pts) univariate ANOVAs were applied; in case of significance followed by Tukey-HSD post-hoc analyses. RESULTS: Physical activity levels among community-dwelling older adults ranged from 561.2 to 5335.7 moves per week. No linear association between physical activity and sleep quality was found (p > .05). In subgroup analyses (n = 41, Barthel Index ≥90 pts, free of pre-existing conditions) physical activity levels (2251.6 ± 1119.1, 2516.4 ± 644.5, 3528.7 ± 1461.9, 2019.2 ± 1105.2 moves per week) differed significantly (p = .037) between groups of different sleep duration. The association between physical activity and sleep quality was confined to older adults reporting ≥7 hours of sleep and older adults reporting 5-6 hours of sleep (p = .049). CONCLUSION: Present data indicate comparable low to very low physical activity levels in community-dwelling older adults. There is no accordance between higher activity levels and better sleep quality in the investigated cohort per se. However, a sleep duration of 5-6 hours seems to be associated with 7.6 hours bed rest time and a higher level of physical activity.

Aging is the primary risk factor for sarcopenia and mobility limitations. Exercise reduces these risks, but older adults have low levels of participation in physical activity and exercise. We investigated the preliminary effectiveness of a live, online exercise program on community-dwelling older adults' physical activity levels. A mixed-method pilot randomized controlled trial was conducted according to CONSORT 2010 statement: extension for pilot and feasibility trials. Sedentary older adults (65-80 years) were randomly assigned to the online exercise intervention (ACTIVE) or a waitlist control (CON) group. Outcomes were measured pre-randomization and following the 8-week intervention for ACTIVE and CON and two months following the end of the intervention for the ACTIVE group. Outcomes included habitual physical activity levels, depression, anxiety, loneliness, life-space mobility, nutrition risk, and feasibility. All participants were invited to participate post-intervention in individual semi-structured qualitative interviews. Reporting of the qualitative research followed the checklist for the Consolidated Criteria for Reporting research. Seventeen older adults (71% women) were allocated to ACTIVE group, while 15 were allocated to CON group (87% women). Following the intervention, participants in the ACTIVE group reported reduced symptoms of depression (ACTIVE: pre = 4.2 ± 2.5; post = 2.2 ± 1.9; CON: pre = 3.5 ± 2.1, post = 3.5 ± 2.1; p <0.001) and improved life-space mobility (ACTIVE: pre = 62.4 ± 14.7; post = 71.8 ± 16.0; CON: pre = 65.1 ± 19.0, post = 63.6 ± 22.0; p = 0.003) compared to waitlist control participants. The ACTIVE group had good adherence (97%) and acceptability (98%). Twenty-two participants participated in qualitative interviews. Five themes were identified, including (1) Feasibility of the online exercise program; (2) Perceived health benefits and improvements; (3) Registered Kinesiologists and Physiotherapists contributed to perceived safety; (4) Social connectivity associated with synchronous/live delivery; and (5) Growing old gracefully and preventing disability. Our online exercise program was acceptable to older adults, had good adherence, reduced depression, and increased life space. Participants reported improved functional and mental health benefits. Further research is warranted to expand on these findings. NCT04627493; 13/11/2020.

Age-related cognitive and psychological impairments are frequently accompanied by bone mineral density decline in older adults. Ultra-high hydrostatic pressurized brown rice (UBR) may support cognitive and bone health; however, the interplay between these domains remains unclear. The present randomized controlled trial aimed to examine the effects of daily UBR consumption for 12 months on cognitive function, mental health and bone status in community-dwelling older adults. In this study, 44 participants aged 65-85 years were randomly assigned to either a white rice (WR) group or a UBR group. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Cognitive Assessment for Dementia, iPad version (CADi). Apathy and depressive symptoms were evaluated using the Starkstein Apathy Scale and the Zung Self-Rating Depression Scale, respectively. The calcaneal bone area ratio was assessed using quantitative ultrasound and expressed as a percentage of the young adult mean (%YAM). At 12 months, the UBR group showed significantly higher MMSE scores compared with the WR group after adjustment for baseline values and age (P=0.046), although change scores were not significantly different. CADi total scores increased and execution time decreased significantly in the UBR group (P<0.05). Apathy scores were also significantly lower in the UBR group (P=0.008). Additionally, %YAM was significantly higher in the UBR group, and partial correlations indicated significant associations between cognitive, apathy and bone health indicators. No adverse events were reported. These findings suggest that daily UBR consumption may help preserve cognitive and motivational functions and support bone health in older adults. Further investigation in larger, prospectively registered trials is warranted. This study was retrospectively registered in February 2024, at UMIN Clinical Trials Registry as UMIN000053587.

Effects of non-pharmacological interventions on loneliness among community-dwelling older adults: A systematic review, network meta-analysis, and meta-regression

Older adults have highly heterogeneous aging rates. To explore the association of biological age (BA) and accelerated aging with frailty in community-dwelling older adults. We assessed 735 community-dwelling older adults from the Coyocan Cohort. BA was measured using AnthropoAge, accelerated aging with AnthropoAgeAccel, and frailty using Fried's phenotype and the frailty index. We explored the association of BA and accelerated aging (AnthropoAgeAccel ≥ 0) with frailty at baseline and characterized the body composition and physical function phenotype of accelerated aging in non-frail/frail participants. We also explored accelerated aging as a risk factor for frailty progression after 3-years of follow-up. Older adults with accelerated aging have higher frailty prevalence and indices, lower handgrip strength and gait speed. AnthropoAgeAccel was associated with higher frailty indices (β = 0.0053, 95%CI 0.0027-0.0079), and increased odds of frailty at baseline (OR 1.16, 95%CI 1.09-1.25). We observed sex-based differences in body composition and physical function linked to accelerated aging in non-frail participants; however, these differences were absent in pre-frail/frail participants. Accelerated aging at baseline was associated with higher risk of frailty progression over time (OR 1.74, 95%CI 1.11-2.75). Despite being intertwined, biological accelerated aging is largely independent of frailty in community-dwelling older adults.

Older adults have heterogeneous aging rates. Here, we explored the impact of biological age (BA) and accelerated aging on frailty in community-dwelling older adults. We assessed 735 community-dwelling older adults from the Coyocan Cohort. BA was measured using AnthropoAge, accelerated aging with AnthropoAgeAccel, and frailty using both Fried's phenotype and the frailty index. We explored the association of BA and accelerated aging (AnthropoAgeAccel ≥0) with frailty at baseline and characterized the impact of both on body composition and physical function. We also explored accelerated aging as a risk factor for frailty progression after 3-years of follow-up. Older adults with accelerated aging have higher frailty prevalence and indices, lower handgrip strength and gait speed. AnthropoAgeAccel was associated with higher frailty indices (β=0.0053, 95%CI 0.0027-0.0079), and increased odds of frailty at baseline (OR 1.16, 95%CI 1.09-1.25). We observed a sexual dimorphism in body composition and physical function linked to accelerated aging in non-frail participants; however, this dimorphism was absent in pre-frail/frail participants. Accelerated aging at baseline was associated with higher risk of frailty progression over time (OR 1.74, 95%CI 1.11-2.75). Despite being intertwined, biological accelerated aging is largely independent of frailty in community-dwelling older adults.

BackgroundPhysical inactivity is an important factor in the development of sarcopenia. This cross-sectional study explores the prevalence of sarcopenia and associations of physical activity (PA) with sarcopenia in two exercise trial populations. These study groups are clinically meaningful community-dwelling populations at increased risk for sarcopenia: older adults not meeting the PA guidelines and those with a recent hip fracture (HF).MethodsData from 313 older adults who did not meet the PA guidelines (60% women; age 74.5 ± 3.8, body mass index 27.9 ± 4.7) and 77 individuals with HF diagnosed on average 70 ± 28 days earlier (75% women; age 79.3 ± 7.1, body mass index 25.3 ± 3.6) were included in this study. Grip strength and muscle mass (Dual-energy X-ray absorptiometry [DXA] in older adults not meeting the PA guidelines and bioimpedance analysis in participants with HF) were used to assess sarcopenia according to the European Working Group in Older People 2019 (EWGSOP2) criteria. The current level of PA was self-reported using a question with seven response options in both study groups and was measured with a hip-worn accelerometer for seven consecutive days in older adults not meeting the PA guidelines.ResultsThe prevalence of sarcopenia and probable sarcopenia was 3% (n = 8) and 13% (n = 41) in the older adults not meeting the PA guidelines and 3% (n = 2) and 40% (n = 31) in the HF group, respectively. In the age- and sex-adjusted logistic regression model, the lowest levels of self-reported PA were associated with increased probable sarcopenia and sarcopenia risk in older adults not meeting the PA guidelines (OR 2.8, 95% CI, 1.3–6.1, p = 0.009) and in the HF group (OR 3.9, 95% CI, 1.4–11.3, p = 0.012). No significant associations between accelerometer-measured PA and probable sarcopenia or sarcopenia were found.ConclusionsProbable sarcopenia is common among community-dwelling older adults not meeting the PA guidelines and very common among individuals recovering from HF who are able to be involved in exercise interventions. In addition, since low PA is associated with higher probable sarcopenia and sarcopenia risk, it is recommended to screen for sarcopenia and promote regular physical activity to prevent sarcopenia in these populations.

Despite recent advances, there is little research on factors associated with emotional abuse among Korean older adults. The present study investigated the relationships between depression and emotional abuse among community-dwelling Korean older adults. We analyzed the dataset from the Survey of Living Conditions and Welfare Needs of Korean Older Persons conducted by the Korea Institute for Health and Social Affairs in 2011. Older adults (aged >65 years, n=10674) were randomly selected. Multivariate logistic regression was used to investigate factors associated with emotional abuse in terms of sociodemographic, health-related, and psychological variables, including depression using the short version of the Geriatric Depression Scale. In our study, 9.4% of the older adults reported experiencing emotional abuse in the previous year. In addition, 44.0% of those experiencing emotional abuse suffered from depression. Multiple logistic regression modeling showed that depression in older adults was independently associated with emotional abuse [odds ratio (OR)=1.788, p<0.001]. Along with depression, poor social support (OR for no social support=1.712, p<0.001) and having chronic illnesses (OR for more than 3=1.481, p<0.005) were associated an increased risk of emotional abuse. Our results showed that emotional abuse among older adults in Korea is prevalent. Our findings suggest that depression, poor social support, and having chronic illnesses are significant factors associated with emotional abuse among the Korean older adult population. Addressing these factors with preventive interventions could have significant public health implications. Further studies are warranted to gain a better understanding of emotional abuse in older Korean adults.

BackgroundWith the growing prevalence of aging populations, improving the health and quality of life of older adults has become a critical concern globally. In this context, sports technology presents promising applications. The exergame-based training mat—an electronic exercise technology—integrates gamification with diverse training designs, offering a safe and engaging approach to promoting health and well-being in older adults.ObjectiveThis study aims to examine the impact of a novel exergame-based mat training program on community-dwelling older adults, particularly evaluating its effectiveness in enhancing physical activity levels, quality of life, and functional fitness. The primary end point was exploratory, focusing on the feasibility and effectiveness of the exergame-based training program on physical fitness, physical activity, and quality of life.MethodsThis randomized parallel-designed study enrolled 32 older adults aged 60-80 years from Taipei City. Participants were randomly assigned to either the experimental or control group. The experimental group underwent a 10-week exergame-based mat training program, consisting of 2 sessions per week (70 minutes per session), using gamified group-based exercise training. The control group maintained their usual daily activities. Pre- and postintervention assessments were conducted using the International Physical Activity Questionnaire (IPAQ), the World Health Organization Quality of Life Brief Version (WHOQOL-BREF), the Senior Fitness Test, and the AFAscan fitness assessment.ResultsThe experimental group demonstrated significantly increased overall and high-intensity physical activity levels (P=.04; mean difference [MD] 439, 95% CI 28-914; d=0.72). Quality of life significantly enhanced across the physical (P=.01; r=0.53), psychological (P=.02; r=0.52), and social (P=.02; r=0.50) domains of the WHOQOL-BREF. Furthermore, functional fitness parameters, including upper limb muscular strength (P=.007; MD 5.33, 95% CI 1.59-9.07; d=1.06), lower limb muscular strength (P=.01; MD 4.73, 95% CI 1.15-8.32; d=0.98), core strength (P<.001; MD 13.1, 95% CI 7.90-18.2; d=1.89), lower limb flexibility (P=.008; MD 6.47, 95% CI 1.82-11.1; d=1.04), dynamic balance (P=.03; MD –0.72, 95% CI −1.36 to −0.07; d=0.84), static balance (P=.005; MD 15.1, 95% CI 5.01-25.3; d=1.12), agility (P=.001; MD 32.6, 95% CI 15.6-49.6; d=1.44), and cardiorespiratory endurance (P=.04; MD 9.73, 95% CI 0.37-19.1; d=0.78), showed significant enhancements with the exergame-based mat training program. There were no adverse events observed during the study.ConclusionsIn this exploratory trial, the exergame-based mat training program produced medium-to-large improvements (Cohen d ranging from 0.72 to 1.89) across physical activity, quality of life, and functional fitness domains. Although the precision of the CIs varied, the consistent direction of effects supports a meaningful impact of the intervention. These findings suggest that exergame-based mat training programs may serve as a practical community health promotion strategy, potentially preventing age-related frailty and enhancing independence and well-being among older adults.

We read with great interest the study by Kubo et al. on physical activity associations with physical function and body composition among community-dwelling older adults in Japan: The Kyotango Longevity Cohort Study [1]. This research confirmed that the community-dwelling older adults can maintain good physical function and favorable body composition by engaging in physical activity. This study features innovative design, reliable data, and conclusions providing guiding value for clinical diagnosis and treatment practice. Here, we would like to focus on the following aspects. First, we should fully recognize the benefits that physical activity brings to the elderly in the community. The China Health and Retirement Longitudinal Study (CHARLS) confirmed that physical activity not only directly improves mental health but also indirectly reduces the risk of falls among urban elderly people by reducing stress. Meanwhile, physical activity has an improving effect on depression among the people [2]. Kim et al. found that for the elderly, it was beneficial to engage in physical activities, especially leisure-time sports and resistance exercises. At the same time, physical activity may reduce the prevalence of diabetes in the elderly [3]. Appetite loss among community-dwelling older adults is common and may lead to malnutrition, reduced function, and frailty. A study from Europe showed that regular physical activity among the elderly may help increase their appetite and maintain good health [4]. A systematic review indicated that for the elderly, physical exercise is effective in improving physical and mental health. Tai Chi, aerobic training, resistance training, and combination training may change the health outcomes of elderly people with gait disorders. Among them, Tai Chi has become the most commonly used and beneficial exercise method [5]. Second, we need to ascertain the factors that hinder older adults from engaging in physical activity and develop long-term plans and intervention measures to overcome these obstacles. The risks of chronic diseases increase among the elderly, which may lead to a reduction in their physical activity levels. A study from China showed that gamification and mobile health (mHealth) technologies may enhance the potential, sustainability, and effectiveness of physical activity among the elderly [6]. Chen et al. pointed out that in the community, the main personal factors that hinder elderly people from engaging in physical activity include fear of injury, pain, low motivation, and lack of free time. Interpersonal factors were lack of social support and family obligations. Adverse weather, poor building environment, and high costs of using sports facilities are environmental factors that hinder physical exercise for the community-dwelling older adults [7]. A study from the UK using the Capability, Opportunity, Motivation, and Behavior (COM-B) model analysis found that lower socioeconomic status had adverse effects on physical activity and overall health status among older adults. Evaluation and intervention measures aimed at improving physical activity should be carried out for elderly people with low socioeconomic status [8]. Research from Israel pointed out that the elderly often encounter obstacles to regular exercise, including restricted access, lack of motivation, and financial constraints. Designated outdoor locations and sports activity parks specifically designed for the elderly may eliminate these obstacles [9]. Engaging in physical activity is beneficial for community-dwelling older adults. For the elderly, healthcare decision-makers should provide specific and personalized suggestions for physical activity, develop long-term plans and security measures to overcome various obstacles that restrict the elderly from engaging in physical activity. This study was funded by the special funding for high-level talents in the medical and health industry in Jinan (202412) and Shandong Province Medical and Health Science and Technology Development Plan (202003030878). The authors have nothing to report. The authors have nothing to report. The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Sarcopenia is the age-related reduction of skeletal muscle mass in older individuals. Respiratory muscle strength may be related to skeletal muscle mass and, thus, the present study attempted to estimate the risk of sarcopenia relative to decreased pulmonary function. The present findings demonstrated that low pulmonary function was associated with low muscle mass in community-dwelling older adults. Lean body mass is related to pulmonary function in patients with chronic obstructive pulmonary disease (COPD). However, the relationship between muscle mass and pulmonary function in healthy older adults has yet to be clarified. Thus, the present study investigated the association of pulmonary function with muscle mass in an older community-dwelling Korean population. This study included 463 disease-free subjects over 65 years of age who underwent anthropometric measurements, laboratory tests, spirometry, and the estimation of appendicular skeletal muscle (ASM) mass in the 2008-2011 Korea National Health and Nutrition Examination Survey (KNHANES). Low muscle mass was defined as the value of ASM divided by height squared (ASM/height(2)) that was less than two standard deviations (SD) below the sex-specific mean of the young reference group. Forced expiratory volume in 1 s (FEV1[L]) and forced vital capacity (FVC[L]) were positively correlated with ASM/height(2) in males (p < 0.001 and p = 0.001, respectively) but not in females (p = 0.360 and p = 0.779, respectively). A univariate logistic regression analysis revealed that males with low FEV1 or FVC were more likely to have low muscle mass (odds ratio [OR] = 3.11, 95% confidence interval [CI] 1.62-5.99 for FEV1; OR = 1.99, 95% CI 1.13-3.53 for FVC); similar results were found for females, but the significance was lower (OR = 11.37, 95% CI 0.97-132.91 for FEV1; OR = 7.31, 95% CI 1.25-42.74 for FVC). After adjusting for age, smoking, and moderate physical activity, a low FEV1 value was associated with low muscle mass in both males (OR = 2.90, 95% CI 1.50-5.63) and females (OR = 9.15, 95% CI 1.53-54.77). Using nationally representative data from the 2008-2011 KNHANES, low pulmonary function was found to be associated with low muscle mass in community-dwelling older Korean adults.

Relationship of Serum 25-Hydroxyvitamin D Levels with Sarcopenia and Body Composition in Community-Dwelling Older Adults: APaired Case-Control Study.