BackgroundGiven that limited research has examined the relationships between lifestyle activities of varying intensities, including moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), and sedentary behavior (SB), and dynapenia, which refers to an age-related decline in muscle function, this study aimed to investigate the longitudinal associations between MVPA, LPA, and SB and the risk of dynapenia among older adults in Taiwan.MethodsThis longitudinal study included older adults aged ≥ 65 years with independent mobility, recruited from the National Taiwan University Hospital. Baseline data were collected from September 2020 to December 2021 and follow-up data were collected until December 2022. Participants wore a tri-axial accelerometer (GT3X + ActiGraph) on the hip for seven consecutive days to evaluate baseline time spent of MVPA (≥ 2020 counts/min), LPA (100–2019 counts/min), and SB (< 100 counts/min). To confirm the dynapenia classification at baseline and follow-up, participants underwent standard assessments, including handgrip dynamometry for muscle strength, bioelectrical impedance analysis for muscle mass, and a 6-m walk test for physical performance. Adjusted binary logistic regression analyses were conducted to examine the association between lifestyle activities and dynapenia risks.ResultsAmong 154 participants (mean age 80.3 ± 7.2 years; 53.9% women), 53.9% were classified as having dynapenia at baseline, compared to 55.2% at follow-up. Participants spent an average of 16.9 (± 26.6) min in MVPA, 249.5 (± 85.7) min in LPA, and 604.5 (± 76.4) min in SB daily. The longitudinal analysis results indicated that higher MVPA time was significantly associated with lower odds of dynapenia in both the unadjusted (odds ratio [OR] = 0.625, 95% confidence interval [CI]: 0.466–0.837) and fully adjusted models (OR = 0.578, 95% CI: 0.406–0.823). Each additional 10 min/day of MVPA was associated with 42.2% lower odds of dynapenia in the adjusted model. No significant prospective associations were observed between the LPA or SB time and dynapenia.ConclusionThis study provides longitudinal evidence that higher MVPA levels are significantly associated with a reduced dynapenia risks among community-dwelling older adults in Taiwan. These findings underscore the importance of promoting MVPA as a part of lifestyle interventions aimed at preserving muscle function and preventing dynapenia in older populations.

AimTo investigate the effect of digital exercise interventions on muscle mechanical function in community-dwelling older adults aged 60 and above.MethodsSystematic review of randomised controlled trials (RCTs) retrieved from PubMed, EMBASE (Ovid), the Cochrane Central Register of Controlled Trials, and Web of Science until end of March 2024. The Cochrane RoB2.0 tool and GRADE were employed for quality assessment. We performed meta-analysis using random-effects model and sub-group and meta-regression analyses to investigate the robustness of the findings. GRADE was used to assess the overall certainty of the evidence.ResultsThirty RCTs, comprising 1697 participants with a mean age of 71.27 years, were included in the data analysis. The meta-analysis revealed a significant overall effect of technology-based physical activity intervention on muscle mechanical function (Hedge’s g = 0.27, p = < 0.001). In the sub-analysis, 18 studies focused on interactive interventions on handgrip strength (SMD 0.10, 95% CI -0.17 to 0.38) and leg strength (SMD 0.56, 95% CI 0.19 to 0.93). The overall certainty of the evidence was deemed low.ConclusionDigital interventions focusing on physical activity interventions have generally shown small but significant improvements in older adults. Interactive and semi-interactive interventions were effective, while passive ones were not.Supplementary InformationThe online version contains supplementary material available at 10.1186/s11556-025-00380-z.

BackgroundPhysical activity (PA) may have an impact on cognitive function. Machine learning (ML) techniques are increasingly used in dementia research, e.g., for diagnosis and risk stratification. Less is known about the value of ML for predicting cognitive decline in people with dementia (PwD). The aim of this study was to use an ML approach to identify variables associated with a multimodal PA intervention that may impact cognitive changes in PwD, i.e., by distinguishing between cognitive decliners and non-decliners.MethodsThis is a secondary, exploratory analysis using data from a Randomized Controlled Trial that included a 16-week multimodal PA intervention for the intervention group (IG) and treatment as usual for the control group (CG) in nursing homes. Predictors included in the ML models were related to the intervention (e.g., adherence), physical performance (e.g., mobility, balance), and pertinent health-related variables (e.g., health status, dementia form and severity). Primary outcomes were global and domain-specific cognitive performance (i.e., attention/ executive function, language, visuospatial skills, memory) assessed by standardized tests. A Support Vector Machine model was used to perform the classification of each primary outcome into the two classes of decline and non-decline. GridSearchCV with fivefold cross-validation was used for model training, and area under the ROC curve (AUC) and accuracy were calculated to assess model performance.ResultsThe study sample consisted of 319 PwD (IG, N = 161; CG, N = 158). The proportion of PwD experiencing cognitive decline, in the different domains measured, ranged from 27–48% in CG, and from 23–49% in IG, with no statistically significant differences and no time*group effects. ML models showed accuracy and AUC values ranging from 40.6–75.6. The strongest predictors of cognitive decline or non-decline were performance of activities of daily living in IG and CG, and adherence and mobility in IG.ConclusionsML models showed moderate performance, suggesting that the selected variables only had limited value for classification, with adherence and performance of activities of daily living appearing to be predictors of cognitive decline. While the study provides preliminary evidence of the potential use of ML approaches, larger studies are needed to confirm our observations and to include other variables in the prediction of cognitive decline, such as emotional health or biomarker abnormalities.

BackgroundPhysical activity (PA) is fundamental to nursing home residents’ health. Likewise, physical capacity (PC) is essential to carry out activities of daily living. Although PC and PA are associated, misalignment has been reported in specific subgroups. Increased PC is oftentimes not linked to high PA (i.e., Can do - don’t do) and vice versa (i.e., Can’t do - do do). Therefore, identifying other contextual factors influencing PA in misaligned groups is important. This study aimed to identify contextual factors in nursing home residents with aligned or misaligned PA and PC.MethodsIn total, 180 nursing home residents (≥ 65 years, 79.4% females) were divided into four quadrants (Q1: Can do - do do; Q2: Can do - don’t do; Q3: Can’t do - do do; Q4: Can’t do - don’t do) based on thresholds for PA (≥ or < 2,500 steps/day) and PC (≤ or > 0.5 m/s gait speed). Kruskal-Wallis H test and effect sizes (ES) were applied to analyze quadrants’ differences regarding PA (steps per day), objective motor capacity, life-space mobility, activities of daily living (ADL), psychosocial well-being, cognition, subjective mobility-related concerns, and spatial orientation.ResultsSpecific contextual factors differed significantly between the groups. Compared to Q1, Q2 presents a significantly lower life-space mobility (ES: 0.35) and objective motor capacity (ES: 0-36-0.49); Q3 has a lower objective motor capacity (ES: 0.55–1.10); Q4 shows lower independence in ADL (ES: 0.57), life-space mobility (ES: 0.48), subjective mobility-related concerns (ES: 0.38) and objective motor capacity (ES: 0.99–1.08). No significant group differences were found for psychosocial well-being, cognition, and spatial orientation.ConclusionsThis study provides new insights into PA behavior of nursing home residents. Key variables linked to PA are objective motor capacity, life-space mobility, ADL, and subjective mobility-related concerns. Surprisingly, some potentially impactful variables such as cognition, orientation, and psychosocial well-being did not differ between the groups. This may suggest that these variables may not represent key targets for interventions aiming to improve PA. This study builds the foundation for further research into the underlying mechanisms behind PA behaviors and supports future efforts to plan specific, targeted interventions for nursing home residents.Trial registrationThe trial was prospectively registered at DRKS.de with registration number DRKS00021423 on April 16, 2020.

BackgroundPhysical activity (PA) behaviours and comorbid diseases are associated with muscle strength. However, the association between dynapenia and detailed PA behaviours, including participation in aerobic and resistance exercises and sedentary behaviour (SB), in relation to comorbid diseases has not yet been investigated. Using nationwide data, this study aimed to evaluate the independent association of dynapenia with detailed PA behaviour (participation in aerobic and resistance exercises and SB), and assess the differential associations of detailed PA behaviour with dynapenia according to comorbid diseases with prevalent sarcopenia.MethodsA total of 7,558 community-dwelling older adults aged ≥ 65 years who were included in the Korea National Health and Nutrition Examination Survey from 2014 to 2019 were included in the present study. Cross-sectional associations between PA behaviours (participation in aerobic exercise, participation in resistance exercise, and SB) and dynapenia were analysed using complex-sample multivariable-adjusted logistic regression models according to the type of comorbid disease (cardiovascular disease [CVD], diabetes mellitus [DM], and chronic lung disease [CLD]).ResultsSufficient aerobic exercise, sufficient resistance exercise, and low sedentary time of < 420 min/day showed independent negative associations with dynapenia (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.60–0.83; OR, 0.54; 95% CI, 0.42–0.69; and OR, 0.84; 95% CI, 0.72–0.97, respectively). Among the participants with CVD or CLD, the associations of sufficient resistance exercise (OR, 0.46; 95% CI, 0.26–0.82 and OR, 0.51; 95% CI, 0.35–0.75 for CVD and CLD, respectively) and low sedentary time (OR, 0.66; 95% CI, 0.45–0.98 and OR, 0.71; 95% CI, 0.55–0.93 for CVD and CLD, respectively) with dynapenia were significant, whereas the association of sufficient aerobic exercise with dynapenia was insignificant. Meanwhile, in participants with DM, sufficient aerobic exercise (OR, 0.70; 95% CI, 0.52–0.94) and sufficient resistance exercise (OR, 0.45; 95% CI, 0.29–0.70) were independently associated with dynapenia, whereas no association between SB and dynapenia was found.ConclusionWe observed an independent inverse association between PA behaviours and dynapenia. Disease-specific associations between each PA behaviour (sufficient aerobic exercise, sufficient resistance exercise, and low sedentary time) and dynapenia differed in the older adults. Therefore, these differences should be acknowledged during interventions for this population.

BackgroundAccidental falls are one of the greatest threats to older adults’ health and well-being. The risk of falling can be significantly reduced with strength and balance interventions. However, there needs to be further knowledge into how older adults can be supported to achieve a maintained exercise behaviour. Therefore, the aim of this study was to explore factors that enabled older adults to maintain their exercise during a 1-year self-managed digital fall prevention exercise intervention.MethodsThis study used a grounded theory methodology. Semi-structured individual interviews were conducted by phone or conference call. Eighteen community-dwelling older adults aged 70 years or more participated. The participants had a self-reported exercise dose of 60 min or more per week during the last three months of participation in a 12-months intervention of self-managed digital fall prevention exercise, the Safe Step randomized controlled trial. Open, axial, and selective coding, along with constant comparative analysis, was used to analyze the data.ResultsThe analysis resulted in a theoretical model. We found that the fall prevention exercise habits of adults were developed through three stages: Acting against threats to one’s own identity, Coordinating strategies to establish a routine, and Forming habits through cues and evaluation. The main category of Maintaining balance in life encases the participants transition through the three stages and reflects balance in both physical aspects and in between activities in daily life. The process of maintaining balance in life and desire to do so were mediated both by intrinsic person-dependent factors and the Safe Step application acting as an external mediator.ConclusionThis study identified three stages of how older adults developed self-managed fall prevention exercise habits, supported by a digital application. The generated theoretical model can inform future interventions aiming to support long-term engagement in digitally supported and self-managed fall prevention interventions.

BackgroundDeployment of geriatric care would be more sustainable if we could limit geriatric co-management to older hip fracture patients who benefit most from it. We assumed that riding a bicycle is a proxy of good health and hypothesized that older patients with a hip fracture due to a bicycle accident have a more favorable prognosis than patients whose hip fracture was caused by another type of accident.MethodsRetrospective cohort study of hip fracture patients ≥ 70 years admitted to hospital. Nursing home residents were excluded. Primary outcome was length of hospital stay (LOS). Secondary outcomes were delirium, infection, blood transfusion, intensive care unit stay and death during hospitalization. The group with a bicycle accident (BA) was compared to the non-bicycle accident (NBA) group using linear and logistic regression models, with correction for age and sex.ResultsOf the 875 patients included, 102 (11.7%) had a bicycle accident. BA patients were younger (79.8 versus 83.9 years, p < 0.001), less often female (54.9 versus 71.2%, p = 0.001) and lived independently more often (100 versus 85.1%, p < 0.001). Median LOS in the BA group was 0.91 times the median LOS in the NBA group (p = 0.125). For none of the secondary outcomes the odds ratio favored the BA group, except for infection during hospital stay (OR = 0.53, 95%CI 0.28–0.99; p = 0.048).ConclusionsAlthough older hip fracture patients who had a bicycle accident appeared more healthy than other older hip fracture patients, their clinical course was not more favorable. Based on this study, a bicycle accident is not an indicator that geriatric co-management can be omitted.

The spread of the coronavirus in spring 2020 led to a lockdown of physical activity (PA) offers. The aim of this study was to investigate how PA, as well as general and mental health, in community-dwelling older adults were affected by the COVID-19 restrictions in Norway. Invitation to participate in the study was sent via Facebook and the Norwegian Pensioners' Association. Inclusion criteria were being ≥ 65years old and living at home. Participants completed a questionnaire either digitally or on paper in June-August 2020. The questionnaire included questions on PA, general health, and mental health both before (13th of March) and during lockdown. We included 565 participants (mean age 74 ± 5.3years, 60.4% female); almost 60% had a university degree, 84% reported performing PA more than once per week, and 20% reported a fall in the previous 12months. The Wilcoxon signed-rank test indicated that the corona lockdown significantly reduced activity level (Z = -4.918,p < 0.001), general health (Z = -6,910, p < 0.001) and mental health (Z = -12.114, p < 0.001). Those who were less active during lockdown had higher odds of experiencing worse health than those who maintained their activity level, odds ratio: 9.36 (95% CI = 4.71-18.58, p < 0.001) for general health and 2.41 (95% CI = 1.52-3.83, p < 0.001) for mental health. Those who attended organized exercise offers before lockdown had higher odds of being less active during lockdown compared to those who did not exercise in an organized setting, odds ratio: 3.21 (95% CI = 2.17-5.76, p < 0.001). In a relatively highly educated and active group of older participants, COVID-19 restrictions still negatively affected level of activity as well as general and mental health. These short-term decreases in activity level and health suggest that preventive actions and increased focus on measures to support older adults in maintaining an active lifestyle are needed.

BackgroundStudies examining associations of socio-eco-demographic characteristics with physical activity (PA) participation of older adults have produced inconsistent results. Perceived PA barriers may be a possible explanation for the mixed findings. Therefore, the purpose of this study was to examine the correlation of socio-eco-demographic (SED) characteristics with PA of older adults and the moderation effects of perceived barriers of PA.MethodsThree hundred eighty-four older adults (≥ 60 years old) were recruited from public places in six different cities. Questions regarding socio-eco-demographic characteristics, PA, and perceived PA barriers were asked, in-person, by two examiners. Ordinal logistic regression models examined the association of socio-eco-demographic characteristics with subjectively measured PA, and the interactive effects of subscales of perceived PA barriers and socio-eco-demographic variables for PA outcomes.ResultsSignificant main effects for PA outcomes were found for education and living status (P < 0.01) and college-educated individuals and those were living in their private houses reported higher PA. Also, 24 significant interactive effects of perceived PA barriers by socio-eco-demographic factors were found (P < 0.05). Significant moderation effects by all subscales of perceived PA barriers were observed for education and living status. The effect of age for the PA outcomes was moderated by “lack of time”, “fear of injury”, and “lack of skill”. Only “fear of injury” and “lack of time” moderated the effect of gender and marriage for outcome variable, respectively. The effect of employment was moderated by “lack of willpower”, “fear of injury”, “lack of skill” and “lack of resources”.ConclusionsNovel evidence revealed that there are moderations by perceived PA barriers for the effect of almost all socio-eco-demographic characteristics. These findings highlight a need to consider older adults’ perspectives and perceptions, when it comes to establish policies for PA participation.

ObjectiveWe conducted a meta-analysis to analyze the effects of resistance training on measures of body composition, muscle strength, and muscle performance in older people with sarcopenia.MethodsAll randomized controlled trials on the effects of resistance training on outcome variables in older people with sarcopenia were searched on Pubmed, Embase, Cochrane Library, the China National Knowledge Infrastructure (CNKI), and Wanfang. Data from January 2010 to October 2020 were reviewed. Two researchers extracted data and evaluated the quality of the studies that met the inclusion criteria independently. Meta-analysis for pre-post changes were calculated as standardized mean difference (SMD) with 95% confidence intervals (CI).ResultsFourteen studies meeting inclusion criteria included 561 healthy older adults (age 65.8 to 82.8) with sarcopenia. Compared with the control group, resistance training had positive effects on body fat mass (SMD = -0.53, 95% CI − 0.81 to − 0.25, p = 0.0002, I2 = 0%), handgrip strength (SMD = 0.81, 95%CI 0.35 to 1.27, p = 0.0005, I2 = 81%), knee extension strength (SMD = 1.26, 95% CI 0.72 to 1.80, p < 0.0001, I2 = 67%), gait speed (SMD = 1.28, 95%CI 0.36 to 2.19, p = 0.006, I2 = 89%), and the timed up and go test (SMD = -0.93, 95% CI − 1.30 to − 0.56, p < 0.0001, I2 = 23%). Resistance training had no effects on appendicular skeletal muscle mass (SMD = 0.25, 95% CI − 0.27 to 0.78, p = 0.35, I2 = 68%), skeletal muscle mass (SMD = 0.27, 95% CI − 0.02 to 0.56, p = 0.07, I2 = 0%) and leg lean mass (SMD = 0.12, 95% CI − 0.25 to 0.50, p = 0.52, I2 = 0%). Old people with sarcopenia of different ages, genders or diagnostic criteria and weights have different gains in muscle mass, handgrip strength, knee extension strength and muscle performance after different intervention duration, frequencies, mode and intensity resistance training.ConclusionResistance training is an effective treatment to improve body fat mass, muscle strength, and muscle performance in healthy older people with sarcopenia.