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Background: We aimed to evaluate the effectiveness of the combination of protein supplementation and resistance training (RT), compared with RT alone or combined with a placebo, in improving gait speed. Methods: We searched PubMed, Web of Science, Cochrane Library, and SPORTDiscus databases, and 18 randomized controlled trials with 1,147 older participants were included for meta-analysis. Data were pooled as the effect sizes (Hedges' g) with 95% confidence interval (CI) of the gait speed (in meters per second). The random-effect meta-analysis, subgroup analyses, meta-regression, and sensitivity analysis were conducted. Results: The combination of protein supplementation and RT significantly improved gait speed (Hedges' g: 0.52 m/s, 95% confidence interval [0.17, 0.86], p =.005; I2 = 86.5%) compared with the RT alone. The subgroup analyses revealed that the significant improvement in gait speed postprotein intervention plus RT was observed only in participants who consumed protein after RT (Hedges' g: 0.90 m/s, 95% confidence interval [0.46, 1.33], p =.001; I2 = 79.6%). The pooled result did not significantly change after excluding any single study at one time or excluding smaller studies with large effect sizes. Conclusions: Protein supplementation combined with RT could significantly improve the gait speed of older adults compared with RT alone. This positive effect is more pronounced in people who consume protein after RT. [ABSTRACT FROM AUTHOR]

The Performance Index (P-Index) is a measure for evaluating mobility-related dual-task performance in older adults. The identification of specific clinicodemographic factors predictive of P-Index scores, however, remains unclear. This cross-sectional study analyzed data from 120 community-dwelling older adults (average age 71.3 ± 11.23 years) to explore clinicodemographic variables that influence P-Index scores during the instrumented timed up and go test. Unadjusted analyses suggested several factors, including age, gender, body mass index, Mini-Mental Status Examination scores, functional reach test performance, history of falls, ethnicity, Geriatric Depression Scale scores, alcohol consumption, and educational levels, as potential predictors of P-Index. However, adjusted multinomial multiple regression analysis revealed Geriatric Depression Scale and Mini-Mental Status Examination scores as the exclusive independent predictors of P-Index classifications, segmented into high, intermediate, or low (percentiles ≤ 25, 26–74, or ≥ 75, respectively). A significant association was observed between the manifestation of depressive symptoms, lower Mini-Mental Status Examination scores, and reduced cognitive–motor performance. The findings implicate depressive symptoms and low cognitive performance as substantial impediments to optimal dual-task mobility within this cohort. Further studies are warranted to examine the efficacy of cognitive stimulation and antidepressant therapy, in augmenting mobility-related dual-task performance among older adults. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate the effects of multicomponent training on adropin, endothelial function, insulin resistance, and sleep quality in overweight older adults. In this randomized controlled study, 40 overweight older adults were randomly divided into training and control groups. The multicomponent training program including aerobic, resistance, and balance exercise was followed for 8 weeks, 3 days a week. Study variables were measured 48 hr before and after the intervention. After 8 weeks of multicomponent training, adropin (p =.01), nitric oxide (p =.01), and maximal oxygen uptake (VO2max; p =.002) increased, and glucose (p =.001), insulin (p =.001), insulin resistance (p =.01), systolic blood pressure (p =.01), and sleep disorders (p =.01) decreased significantly. Also, Pearson's test results showed a significant inverse relationship between adropin level (p =.01 and r = −.55) and glucose (p =.01 and r = −.51) with sleep disorders. It seems that multicomponent training increases adropin and improves insulin resistance, endothelial function, and sleep quality in older adults. [ABSTRACT FROM AUTHOR]

Background/Objectives: Randomized controlled trials that deliver physical activity interventions have demonstrated benefits for older adults across numerous health outcomes. However, too little attention has been directed to ensuring that such trials are measuring patient-relevant outcomes. To support outcome selection for future trials, the objective of this study was to understand what outcomes related to their physical activity participation older adults find important. Methods: We conducted 12 semistructured interviews with adults aged 65 years and older and analyzed interview transcripts with a reflexive thematic analysis. Results: Older adults desired diverse outcomes from their physical activity participation, ranging from generic (e.g., quality of life) to specific (e.g., leg strength). Relevant outcomes were classified under five themes: physical, clinical, social, psychological, and overarching, each with respective subthemes. Conclusions: The outcomes that older adults found important were plentiful and rooted in a desire to improve their quality of life. Some of the outcome themes have been reported frequently in past trials (e.g., physical), but others have not (e.g., social). Future researchers should be aware of, and responsive to, the priorities of older adults when designing trials and defining outcomes. Significance/Implications: This study will help to improve outcome selection for future trials of physical activity with older adults. In alignment with a patient-oriented research philosophy, this study will also ground future outcome selection in the priorities of older adults. [ABSTRACT FROM AUTHOR]

Background/Objectives: Engagement in sport offers the potential for improved physical and psychological well-being and has been shown to be beneficial for promoting healthy aging. Opportunities for older adults to (re)engage with sport are limited by a paucity of age-appropriate introductory sports intervention programs. As such, the study evaluated the efficacy of a newly designed 8-week badminton training program (Shuttle Time for Seniors) on markers of healthy aging and the lived experiences of participation. Methods: Forty-three older adults assigned to a control (N = 20) or intervention group (N = 23) completed pre–post assessment of physical and cognitive function, self-efficacy for exercise, and well-being. Focus groups were conducted for program evaluation and to understand barriers and enablers to sustained participation. Results: Those in the intervention group increased upper body strength, aerobic fitness, coincidence anticipation time, and self-efficacy for exercise. Objectively improved physical and cognitive functions were corroborated by perceived benefits indicated in thematic analysis. Shuttle Time for Seniors was perceived as appropriate for the population, where the age-appropriate opportunity to participate with likeminded people of similar ability was a primary motivator to engagement. Despite willingness to continue playing, lack of badminton infrastructure was a primary barrier to continued engagement. Conclusion: Shuttle Time for Seniors offered an important opportunity for older adults to (re)engage with badminton, where the physical and psychosocial benefits of group-based badminton improved facets important to healthy aging. Significance/Implications: Age-appropriate introductory intervention programs provide opportunity for older adults to (re)engage with sport. However, important barriers to long-term engagement need to be addressed from a whole systems perspective. [ABSTRACT FROM AUTHOR]

Introduction: Physical activity and exercise are protective factors for physical and cognitive decline in older adults, but recent studies reveal that a large percentage of this population do not practice exercise at the levels recommended by international guidelines. The frequency, intensity, type, time, volume, and progression (FITT-VP) principles are a widely used method for prescribing physical exercise, allowing the development of a personalized exercise program that meets the needs of each individual. Objectives: This masterclass is intended to serve as a professional application tool for physical therapists who prescribe physical exercise for older adults. We present a section for each FITT-VP principle to facilitate handling these principles individually when prescribing exercise for this population. Methods: Review of the scientific literature and international guidelines on the prescription of physical exercises for older adults. Results: Aerobic, mobility, resistance, balance, and flexibility exercises, as well as functional training, should be included in an exercise program for older adults, which should be progressed using different methods for each of the exercise modalities. Conclusions: An exercise program for older adults should integrate different exercise modalities. Exercise progression should be performed following the FITT-VP principles and some specific progression factors recommended for each exercise modality. Significance: Considering the challenge faced by clinicians in designing a viable exercise program for older adults that responds to international recommendations, with this masterclass we hope to help physical therapists to plan an exercise program that is feasible and at the same time, responds to the expected needs of this population. [ABSTRACT FROM AUTHOR]

We investigated whether dosed failure motivates older adults to perform more repetitions in an exergame that involves hitting targets with stepping movements. The effect of dosed failure was studied in a within-participants design in which all participants performed this exergame in both a Standard condition, in which one never fails, and in a Dosed Failure condition, in which we introduced about 30% failures. The order of conditions (Standard First or Dosed Failure first) was chosen randomly for each participant. Results showed that participants performed more repetitions in the Dosed Failure condition compared with the Standard condition, while play duration and subjective motivation at the moment of quitting did not differ. This shows that dosed failure motivated older adults to put a greater amount of effort to perform the exercise without affecting play duration or subjective motivation. [ABSTRACT FROM AUTHOR]

This randomized pilot trial investigated the feasibility of an active learning physical activity intervention through video conferencing and its preliminary effects. Participants comprised community-dwelling older adults who could use e-mail. The intervention group underwent a 12-week active learning intervention via video conferencing to promote a healthy lifestyle, particularly physical activity. The control group received information via e-mail once per week. The amount of physical activity and sedentary behavior was measured using an accelerometer at baseline, postintervention, and 24-week postintervention (36 weeks). Of the 31 participants, 29 were eligible and randomized into two groups (15 for the intervention and 14 for the control). Adherence to the intervention was 83%–100% (mean, 97%). Compared with the control group, the intervention group showed moderate maintenance effects on total physical activity and sedentary behavior at 36 weeks. Active learning physical activity intervention through video conferencing was found to be feasible and contributed to the prevention of physical activity decline in older adults. [ABSTRACT FROM AUTHOR]

Physical activity levels during skilled nursing facility (SNF) rehabilitation fall far below what is needed for successful community living and to prevent adverse events. This feasibility study's purpose was to evaluate the feasibility, acceptability, and preliminary effectiveness of an intervention designed to improve physical activity in patients admitted to SNFs for short-term rehabilitation. High-Intensity Rehabilitation plus Mobility combined a high-intensity (i.e., high weight, low repetition), progressive (increasing in difficulty over time), and functional resistance rehabilitation intervention with a behavioral economics-based physical activity program. The behavioral economics component included five mobility sessions/week with structured goal setting, gamification, and loss aversion (the idea that people are more likely to change a behavior in response to a potential loss over a potential gain). SNF physical therapists, occupational therapists, and a mobility coach implemented the High-Intensity Rehabilitation plus Mobility protocol with older Veterans (n = 18) from a single SNF. Participants demonstrated high adherence to the mobility protocol and were highly satisfied with their rehabilitation. Treatment fidelity scores for clinicians were ≥95%. We did not observe a hypothesized 40% improvement in step counts or time spent upright. However, High-Intensity Rehabilitation plus Mobility participants made clinically important improvements in short physical performance battery scores and gait speed from admission to discharge that were qualitatively similar to or slightly higher than historical cohorts from the same SNF that had received usual care or high-intensity rehabilitation alone. These results suggest a structured physical activity program can be feasibly combined with high-intensity rehabilitation for SNF residents following a hospital stay. [ABSTRACT FROM AUTHOR]

Older adults are the least physically active group with specific barriers to regular exercise, and online exercise programs could overcome some of those barriers. This scoping review aimed to describe the characteristics of supervised group-based synchronous online exercise programs for older adults living in the community, their feasibility, acceptability, and potential benefits. MEDLINE (Ovid), Embase, SPORTDiscus, and the Cumulative Index to Nursing and Allied Health Literature were searched until November 2022. The included studies met the following criteria: participants aged 50 years and above, a minimum of a 6-week group-based supervised and synchronous intervention, and original articles available in English. Eighteen articles were included, with 1,178 participants (67% female, average age of 71 [57–93] years), most (83%) published in the past 3 years. From the limited reported studies, delivering supervised, synchronous online exercise programs (one to three times/week, between 8 and 32 weeks) for older adults living in the community seems feasible, accepted, and can improve physical function. [ABSTRACT FROM AUTHOR]

Background/Objectives: Neighborhood walkability is the extent to which built and social environments support walking. Walkability influences older adults' participation in outdoor physical activity. Identifying factors that influence physical therapists' (PTs) decisions about prescribing outdoor walking is needed, especially for those who are aging in place. The purpose of this study is to describe the neighborhood walkability knowledge, perceptions, and assessment practices of PTs who work with community-dwelling older adults. Methods: A cross-sectional survey was sent via email to 5,000 PTs nationwide. The 40-item survey assessed walking prescriptions, walkability perceptions and assessments, and gathered demographic data. Categorical variables were compared using Chi-square analyses. Results: Using a total of 122 PTs who worked in outpatient geriatric physical therapy settings, a significant difference was found between perceptions of whether PTs should assess walkability and whether they actually assess walkability (χ2 = 78.7, p <.001). Decisions to prescribe outdoor walking were influenced by the availability (n = 79, 64.8%) and maintenance (n = 11, 9.0%) of sidewalks, crime (n = 9, 7.4%), terrain (n = 7, 5.7%), and aesthetics (n = 6, 4.9%). Objective walkability measures were not used by the respondents. Conclusion: When considering the assessment of walkability, PTs prioritize the built environment over the social environment. Although most believe it is the responsibility of the PT to assess walkability, most do not. Significance/Implications: Assessment of walkability may allow PTs to identify barriers and make more informed recommendations concerning outdoor walking for older adults. Objective measures are available for PTs when prescribing outdoor walking. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the influence of knee joint range of motion (RoM) on the torque–velocity relationship and fatigue in the knee extensor muscles of 7 young (median = 26 y) and 7 older (68 y) adults. Each leg was assigned a RoM (35° or 75°) over which to perform a torque–velocity protocol (maximal isokinetic contractions, 60–300°·s−1) and a fatigue protocol (120 maximal contractions at 120°·s−1, 0.5 Hz). Six older participants were unable to reach 300°·s−1 over 35°. Therefore, the velocity eliciting 75% of peak torque at 60°·s−1 (V75, °·s−1) was calculated for each RoM from a fit of individual torque–velocity curves (60–240°·s−1), and ΔV75 (35°–75°) was determined. Fatigue (final torque/initial torque) was used to calculate Δfatigue (35°–75°). ΔV75 was not different from 0 in young (−28.3°·s−1 [−158.6 to 55.7], median [range], P =.091) or older (−18.5°·s−1 [−95.0 to 23.9], P =.128), with no difference by age (P =.710). In contrast, fatigue was greater for 75° in young (Δfatigue = 25.9% [17.5–30.3], P =.018) and older (17.2% [11.9–52.9], P =.018), with no effect of age (P =.710). These data indicate that, regardless of age, RoM did not alter the torque–velocity relationship between 60 and 240°·s−1, and fatigue was greater with a larger RoM. [ABSTRACT FROM AUTHOR]

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 10.6 hr per day and engaged in a median of 9 min 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 ≤1 min (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. [ABSTRACT FROM AUTHOR]

There is a critical need for fall-prevention interventions to reach medically underserved, hard-to-reach, rural older adults. The evidence-based Tai Ji Quan: Moving for Better Balance (TJQMBB) program reduces falls in older adults. This pre-COVID-19 pandemic study assessed the feasibility and impact of a 16-week tele-TJQMBB intervention in older adults. Instructors led six tele-TJQMBB classes via Zoom for 52 older adults (mean age ± SD 68.5 ± 7.7 years) at one academic and four community sites. Nearly all (97%) planned sessions were delivered. Average attendance was 61%. There were no adverse events. Fidelity was fair to good (mean 67%). Forty-one percent of sessions experienced technical disruptions. Participants improved their gait speed, balance, lower-extremity strength, and body mass index. Tele-TJQMBB was feasible with a positive impact on outcomes. This study was the first step toward establishing an additional delivery mode that could potentially expand TJQMBB's reach and maintenance. [ABSTRACT FROM AUTHOR]

We aimed to investigate the effects of dual- and single-task training in older adults with age-related hearing loss. Intervention groups included single-, dual-task training, and control groups. The dual- and single-task trainings were held 2 days a week for 40 min for a total of 10 sessions for 5 weeks. We evaluated physical, cognitive, and auditory functions, quality-of-life, balance, concerns about falling, independence in activities of daily living, and dual-task performance. A total of 42 patients fully participated in this study. Statistically significant differences were observed in chair stand, chair sit-and-reach, global cognitive function, and delayed recall between the intervention groups and control group (p <.05). There was no statistically significant difference in quality-of-life, balance, falling concerns, independence in activities of daily living, and dual-task performance between all groups (p >.05). In conclusion, single- and dual-task training had a positive effect on physical and cognitive functioning in older adults with age-related hearing loss. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study investigated adherence to physical activity (PA) guidelines and associated sociodemographic factors among older Koreans from 2011 to 2020. Methods: Utilizing four public data sets from the National Survey of Older Koreans, the study included the data on 40,993 older adults 65 years and older in South Korea, collected between 2011 and 2020. Adherence to PA guidelines and sociodemographic factors were assessed through self-reported questionnaires. The data were analyzed using a two-way analysis of variance and post hoc tests. Results: Overall adherence increased from 39.1% in 2011 to 48.2% in 2017, then decreased to 37.6% in 2020 (p <.001). Men had higher adherence than women (p <.001). Age-related adherence peaked in the young-older group (65–74 years old) and was lowest in the oldest-old group (85+ years old) (p <.001). Marital status, education, and income were also significantly related to PA adherence (p <.001) across the years. Conclusion: Although continuous increase in adherence to PA among Koreans 65 years and older was observed, the decline in PA levels during the COVID era underscored the need for targeted interventions and well-informed health care policies to address demographic challenges. Still, considering that data were collected during the recommended social distancing period, a cautions interpretation of these findings is warranted. Significance/Implications: Health policies aiming to improve adherence to PA guidelines should prioritize Korean older adults who are female, belong to the oldest-old group, are single, and have low education and income levels, with the goal of enhancing health equity. [ABSTRACT FROM AUTHOR]

We identified data-driven multidimensional physical activity (PA) profiles using several novel accelerometer-derived metrics. Participants aged 75, 80, and 85 (n = 441) wore triaxial accelerometers for 3–7 days. PA profiles were formed with k-means cluster analysis based on PA minutes, intensity, fragmentation, sit-to-stand transitions, and gait bouts for men and women. Associations with physical capacity and life-space mobility were examined using age-adjusted general linear models. Three profiles emerged: "Exercisers" and "actives" accumulated relatively high PA minutes, with actives engaging in lighter intensity PA. "Inactives" had the highest activity fragmentation and lowest PA volume, intensity, and gait bouts. Inactives showed lower scores in physical capacity and life-space mobility compared with exercisers and actives. Exercisers and actives had similar physical capacity and life-space mobility, except female exercisers had higher walking speed in the 6-min walk test. Our findings demonstrate the importance of assessing PA as multidimensional behavior rather than focusing on a single metric. [ABSTRACT FROM AUTHOR]

Manipulating the amount of muscle mass engaged during exercise can noninvasively inform the contribution of central cardiovascular and peripheral vascular-oxidative functions to endurance performance. To better understand the factors contributing to exercise limitation in older and younger individuals, exercise performance was assessed during single-leg and double-leg cycling. 16 older (67 ± 5 years) and 14 younger (35 ± 5 years) individuals performed a maximal exercise using single-leg and double-leg cycling. The ratio of single-leg to double-leg cycling power (RatioPower SL/DL) was compared between age groups. The association between fitness (peak oxygen consumption, peak power output, and physical activity levels) and RatioPower SL/DL was explored. The RatioPower SL/DL was greater in older compared with younger individuals (1.14 ± 0.11 vs. 1.06 ± 0.08, p =.041). The RatioPower SL/DL was correlated with peak oxygen consumption (r =.886, p <.001), peak power output relative to body mass (r =.854, p <.001), and levels of physical activity (r =.728, p =.003) in the younger but not older subgroup. Reducing the amount of muscle mass engaged during exercise improved exercise capacity to a greater extent in older versus younger population and may reflect a greater reduction in central cardiovascular function compared with peripheral vascular-oxidative function with aging. [ABSTRACT FROM AUTHOR]

The aim of this systematic review, meta-analysis, and meta-regression was to examine the effects of virtual reality–based training on global cognition and executive function compared with conventional training or information-based treatment in older adults, regardless of cognitive level. A systematic literature search was conducted using four databases. A total of 31 randomized controlled trials were identified. Pooled effect sizes were calculated, the risk of bias was assessed, and evidence was graded. The primary analyses showed a small but statistically significant effect of virtual reality–based training compared with control on global cognition (Hedges' g 0.42, 95% confidence interval [0.17, 0.68], I2 = 70.1%, n = 876, 20 randomized controlled trials, low evidence) and executive function (Hedges' g 0.35, 95% confidence interval [0.06, 0.65], I2 = 68.4%, n = 810, 16 randomized controlled trials, very low evidence). Meta-regression yielded inconclusive results. Virtual reality–based training may be more effective than control in improving cognition in older adults; however, more high-quality studies are needed. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine factors associated with participation of community-dwelling older Australians (≥65 years) in the Exercise Right for Active Ageing program, consisting of 12 low- to moderate-intensity group exercise classes, delivered weekly, in person or online, by accredited exercise scientists and physiologists across Australia. Out of 6,949 participants recruited, 6,626 (95%) attended one or more classes and were included in the primary analysis, and 49% of participants attended all 12 classes. Factors associated with higher class attendance included participation in yoga/flexibility/mobility classes, attendance at a free trial class (adjusted incidence rate ratio [95% confidence interval]: 1.05 [1.03, 1.08]), and attending online classes (1.19 [1.11, 1.26]). Factors associated with lower class attendance included state of residence, living in inner regional areas (0.95 [0.93, 0.98]), and having two or more comorbidities (0.97 [0.95, 0.99]). High class attendance suggests that the Exercise Right for Active Ageing program was well received by older Australians, particularly in states less impacted by COVID-19 lockdowns. [ABSTRACT FROM AUTHOR]

The aim of this study was to quantify physical activity and sedentary behavior in older adults recovering from hip fracture and to identify groups based on movement patterns. In this cross-sectional cohort study, older adults (≥70 years) were included 3 months after surgery for proximal femoral fracture. Patients received an accelerometer for 7 days. Demographics and outcomes related to physical function, mobility, cognitive functions, quality of life, and hip fracture were assessed. In total, 43 patients with sufficient accelerometer wear time were included. Across all groups, participants engaged in very low levels of physical activity, spending an average of 11 hr/day in prolonged sedentary behavior. Based on the extracted components from a principal component analysis, three groups with substantial differences in levels of physical activity and sedentary behavior could be distinguished. [ABSTRACT FROM AUTHOR]

The objective of this 18-month walking intervention was to evaluate the effect on rest–activity rhythm (RAR) for older adults with mild-to-moderate dementia (65.8% female; aged M = 82.4 [SD = 6.5]). The intervention group (n = 44) was intended to walk 30 min, five times per week for 18 months. The control group (n = 35) received sedentary activities or usual care. RAR was measured at baseline to after 18 months and five times in between actigraphy outcome variables (interdaily stability, intradaily variability, relative amplitude, activity 10 most active hours, and activity 5 least active hours). Hierarchical mixed model analyses revealed no significant intervention effects (with or without baseline confounders as covariate) on RAR. However, participants in the intervention group were able to significantly increase their daily life activity (activity 10 most active hours) from the onset of the preceding measurement, b = 0.10, t(239.32) = 2.36, p =.019. More research is warranted to study the effect of regular walks on older persons with dementia whose RAR is worst at baseline. [ABSTRACT FROM AUTHOR]

Despite the well-known benefits of physical activity, less than half of adults aged 55–75 years participate in sufficient physical activity. Short bouts of vigorous intermittent lifestyle physical activity (VILPA) accumulated throughout the day can contribute toward the recommended volume of physical activity. A rich characterization of the barriers and facilitators to participation in VILPA is needed to develop targeted interventions. This scoping review aimed to identify barriers and facilitators to participation in different components of VILPA in adults aged 55–75 years, and to map barriers and facilitators to the Theoretical Domains Framework. Within the 18 eligible studies, the most prevalent barriers were related to a person's skills, environmental context, and social influences. Most facilitators were related to a person's goals, social influences, and environmental context. Interventions to promote VILPA should test the effectiveness of behavioral change measures related to the unique barriers and facilitators in this age group. [ABSTRACT FROM AUTHOR]

As rates of obesity continue to rise, so does the impact of obesity on cognitive function. Engaging in physical activity is one pathway through which individuals can help maintain cognitive function. This study examined whether any link between exercise and cognitive function was associated with weight characteristics. Data from 6,012 participants in the Health and Retirement Study were used. The association between participation in light or moderate physical activity and better cognitive function was particularly strong for overweight or obese adults and less so for those who were normal weight. Overall, the findings suggested that while being physically active is associated with better cognitive function regardless of weight, the associations were stronger for individuals who were overweight/obese compared with those who were normal weight. Given the results were particularly pronounced for waist circumference (relative to body mass index), further research should be conducted to examine if individuals with greater abdominal adiposity may benefit most from staying active in terms of their cognitive function. [ABSTRACT FROM AUTHOR]

We tested if a dance trial yielded improvements in physical function and cardiorespiratory fitness (CRF) in middle-aged/older Latino adults. Physical activity was assessed using the Community Healthy Activities Model Program for Seniors, physical function with the Short Physical Performance Battery (SPPB) protocol, and estimated CRF with the Jurca nonexercise test model. Multivariate analysis of covariance models found significant change in SPPB protocol total scores, F(1, 329) = 4.23, p =.041, and CRF, F(1, 329) = 5.16, p =.024, between the two study arms in favor of the dance group. Mediation models found moderate- to vigorous-intensity physical activity to mediate to mediate between group and SPPB scores (β = 0.054, 95% confidence interval [0.0142, 0.1247]). Moderate- to vigorous-intensity physical activity and total physical activity were found to partially mediate between group and CRF (β = 0.02, 95% confidence interval [−0.0261, 0.0751]), with the direct pathway no longer being significant (p >.05). This provides support for Latin dance programs to have an effect on SPPB protocol and CRF. [ABSTRACT FROM AUTHOR]

Physical activity is an effective, proactive intervention to reduce or reverse frailty and functional decline. However, uncertainty exists about the feasibility and impact of resistance training on multidimensional health in prefrail older adults in residential care. This mixed methods feasibility study assessed practicability with limited efficacy testing on health and functional outcomes. Eleven prefrail older adults participated in a 6-week progressive resistance training protocol three times per week. The intervention and measures were found to be appropriate and acceptable by those who completed the trial, with participants self-reporting improved well-being, mood, and function. Analysis identified several barriers to recruitment, including prior commitments, seasonal impact, and session timing, and offered potential solutions with further recommendations for program refinement prior to a definitive randomized controlled trial. These findings add to our understanding of prefrail older adults' preferences regarding participation in physical activity research and the perceived benefits of resistance training. This trial was registered with ClinicalTrials.gov: NCT03141879. [ABSTRACT FROM AUTHOR]

Evidence is sparse on how community-based health-promoting programs can be culturally adapted for racially minoritized, immigrant older adult populations. Choose to Move (CTM) is an evidence-based health-promoting program that enhances physical activity and mobility and diminished social isolation and loneliness in older adults in British Columbia, Canada. However, racially minoritized older adults were not reached in initial offerings. We purposively sampled CTM delivery staff (n = 8) from three not-for-profit organizations, in Metro Vancouver, British Columbia, that serve Chinese older adults. We used semistructured interviews, ethnographic observations, and meeting minutes to understand delivery staff's perspectives on factors that influence CTM adaptations for Chinese older adults. Deductive framework analysis guided by an adaptation framework, Framework for Reporting Adaptations and Modifications-Enhanced, found three dominant cultural- and immigration-related factors influenced CTM adaptations for Chinese older adults: (a) prioritizations, (b) familiarity, and (c) literacy. Findings may influence future program development and delivery to meet the needs of racially minoritized older adult populations. [ABSTRACT FROM AUTHOR]

Older adults face numerous unfavorable functional changes caused by aging, but many exhibit resilience, which helps them cope with challenges. Physical activity is positively associated with resilience. Therefore, this systematic literature review aimed to uncover the relationships between physical activity and resilience in older adults. We have analyzed three freely and openly available databases: (a) PubMed/Medline, (b) ScienceDirect, and (c) Google Scholar, which yielded 20 eligible articles based on the inclusion and exclusion criteria. Most studies (14) were cross-sectional, three were longitudinal, and three others used mindfulness-based or endurance-enhancing physical activity interventions. Their results revealed increased resilience even after short-duration and low-frequency interventions. Cross-sectional research results also support the positive relationship between physical activity and resilience in older adults, suggesting that the relationship might depend on exercise volume. Still, further research is needed to design interventions, understand the mechanism(s) involved in altering resilience, and maximize physical activity's benefits in aging people. [ABSTRACT FROM AUTHOR]

This study investigated the impact of multimorbidity patterns on physical activity and capacity outcomes over the course of a year-long exercise intervention, and on physical activity 1 year later. Participants were 314 physically inactive community-dwelling men and women aged 70–85 years, with no contraindications for exercise at baseline. Physical activity was self-reported. Physical capacity measurements included five-time chair-stand time, 6-minute walking distance, and maximal isometric knee-extension strength. The intervention included supervised and home-based strength, balance, and walking exercises. Multimorbidity patterns comprised physician-diagnosed chronic disease conditions as a predictor cluster and body mass index as a measure of obesity. Multimorbidity patterns explained 0%–12% of baseline variance and 0%–3% of the change in outcomes. The magnitude and direction of the impact of unique conditions varied by outcome, time point, and sex. Multimorbid older adults with no contraindications for exercise may benefit from multimodal physical training. [ABSTRACT FROM AUTHOR]

Physical activity (PA) and physical function (PF) are modifiable risk factors for falls in older adults, but their ability to predict future fall incidence is unclear. The purpose of this study was to determine the predictive ability of baseline measures of PA, PF, and lower limb strength on future falls. A total of 104 participants underwent baseline assessments of PA, PF, and lower limb strength. Falls were monitored prospectively for 12 months. Eighteen participants fell at least once during the 12-month follow-up. Participants recorded almost exclusively sedentary levels of activity. PA, PF, and lower limb strength did not differ between fallers and nonfallers. Twelve participants, who reported a minor musculoskeletal injury in the past 6 months, experienced a fall. The results of this study suggest that in a cohort of highly functioning, sedentary older adults, PA does not distinguish fallers from nonfallers and that the presence of a recent musculoskeletal injury appears to be a possible risk factor for falling. [ABSTRACT FROM AUTHOR]

Both navigation abilities and gait can be affected by the atrophy in the medial temporal cortex. This study aimed to determine whether navigation abilities could differentiate seniors with and without medial temporal lobe atrophy who complained about their cognitive status. The participants, classified to either the medial temporal atrophy group (n = 23) or the control group (n = 22) underwent neuropsychological assessment and performed a spatial navigation task while their gait parameters were recorded. The study showed no significant differences between the two groups in memory, fluency, and semantic knowledge or typical measures of navigating abilities. However, gait parameters, particularly the propulsion index during certain phases of the navigation task, distinguished between seniors with and without medial temporal lobe lesions. These findings suggest that the gait parameters in the navigation task may be a valuable tool for identifying seniors with cognitive complaints and subtle medial temporal atrophy. [ABSTRACT FROM AUTHOR]

This study aimed to compare community-dwelling older adults' physical activity (PA) during the COVID-19 restrictions in 2020 to their PA levels 2 years before and investigate associations between earlier physical performance and PA levels over the follow-up. Participants' (n = 809, initial age 75–85 years) self-reported PA was assessed at baseline in 2017–2018 and May/June 2020 as total weekly minutes of walking and vigorous PA. Physical performance was assessed at baseline using the maximal handgrip strength and Short Physical Performance Battery tests. During the first wave of the COVID-19 pandemic, a median change in total weekly minutes of walking and vigorous PA among all participants was + 20.0 (interquartile range: −60.0 to 120.0, p <.001) min per week compared with 2 years earlier. Higher baseline Short Physical Performance Battery total scores were associated with higher total weekly minutes of walking and vigorous PA over the follow-up in men and women, and better handgrip strength in women. [ABSTRACT FROM AUTHOR]

Many studies have shown that personalized exergames have a positive effect on promoting regular and proper exercise. However, there is no consensus on the design characteristics and evaluation of exergames. This systematic review of published research literature aimed to explore the general characteristics, personalization characteristics, and evaluation of personalized exergames for middle-aged and older people. We screened published studies in the Web of Science, Scopus, PubMed, ACM, and IEEE Xplore databases, extracted data, and performed a thematic analysis according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist. Three main themes and nine subthemes were generated from 24 included papers. Moreover, a personalization model (FACTS) and evaluation system (PMSS) of exergames were developed. Personalized exergames had potential positive effects on motivating middle-aged and older people to exercise and improve their health, particularly physical, mental, and social health. However, more fine-grained studies on personalized exergames are necessary in the future. [ABSTRACT FROM AUTHOR]

This study aimed to describe the level of physical activity and its relation to fatigue and frailty during the COVID-19 pandemic in community-dwelling older adults aged 80 years and over. Three hundred and ninety-one older adults (aged 86.5 ± 3.00) completed a survey including physical activity, the Mobility Tiredness scale, and the FRAIL scale. Linear regression analysis was conducted to assess whether the variables age, sex, and physical activity (independent factors) were significantly related to fatigue and frailty. Respectively, 30.5% and 24.7% of the participants reported a decrease in walking and in energy-intensive activities; 25.4% reported increased sedentary behavior. A lower level of physical activity was associated with higher levels of fatigue and increased frailty risk (p <.05), independently from psychological symptoms. These results are important because participants with lower levels of physical activity and more sedentary behavior are more likely to feel fatigued and have higher risk to be frail. [ABSTRACT FROM AUTHOR]

Resistance exercise training (RET) can be applied effectively to increase muscle mass and function in older adults (65–75 years). However, it has been speculated that older adults above 85 years are less responsive to the benefits of RET. This study compares the impact of RET on muscle mass and function in healthy older adults 65–75 years versus older adults above 85 years. We subjected 17 healthy older adults 65–75 years (OLDER 65–75, n = 13/4 [female/male]; 68 ± 2 years; 26.9 ± 2.3 kg/m2) and 12 healthy older adults above 85 years (OLDER 85+, n = 7/5 [female/male]; 87 ± 3 years; 26.0 ± 3.6 kg/m2) to 12 weeks of whole-body RET (three times per week). Prior to, and after 6 and 12 weeks of training, quadriceps and lumbar spine vertebra 3 muscle cross-sectional area (computed tomography scan), whole-body lean mass (dual-energy X-ray absorptiometry scan), strength (one-repetition maximum test), and physical performance (timed up and go and short physical performance battery) were assessed. Twelve weeks of RET resulted in a 10% ± 4% and 11% ± 5% increase in quadriceps cross-sectional area (from 46.5 ± 10.7 to 51.1 ± 12.1 cm2, and from 38.9 ± 6.1 to 43.1 ± 8.0 cm2, respectively; p <.001; η2 =.67); a 2% ± 3% and 2% ± 3% increase in whole-body lean mass (p =.001; η2 =.22); and a 38% ± 20% and 46% ± 14% increase in one-repetition maximum leg extension strength (p <.001; η2 =.77) in the OLDER 65–75 and OLDER 85+ groups, respectively. No differences in the responses to RET were observed between groups (Time × Group, all p >.60; all η2 ≤.012). Physical performance on the short physical performance battery and timed up and go improved (both p <.01; η2 ≥.22), with no differences between groups (Time × Group, p >.015; η2 ≤.07). Prolonged RET increases muscle mass, strength, and physical performance in the aging population, with no differences between 65–75 years and 85+ years older adults. [ABSTRACT FROM AUTHOR]

Exercise is the single most effective strategy to reduce the risk of falls. Online classes have grown in popularity, but the benefits of online classes remain unknown. Zoomers on the Go is a peer-led 12-week exercise program offered twice weekly to adults 50+ years old. The main outcome was lower body strength measured by the 30-s chair stand test. Other outcomes included dropout, attendance, balance, cardiorespiratory fitness, and perceived health. A total of 74 participants (age 66.3 ± 7.1 years) in the online group and 84 participants in the in-person group (age 67.3 ± 7.2 years) completed the program, with attendance for the online group. Both groups significantly improved their 30-s chair stand, cardiorespiratory fitness, and balance (p <.001) with no difference in functional benefits between groups. The in-person group improved their perceived health and significantly reduced levels of stress and depression, while no such changes were observed in the online group. [ABSTRACT FROM AUTHOR]

Objectives: To identify frailty trajectories and examine its association with allostatic load (AL) and mediating effect of physical activity (PA). Methods: This study included 8,082 adults from the English Longitudinal Study of Aging over Waves 4–9. AL was calculated by 14 biological indicators, and a 53-item frailty index was used to evaluate frailty. Frailty trajectories were classified by group-based trajectory modeling, and the mediated effect of PA was tested by causal mediation analysis. Results: Four frailty trajectories were identified: "Robustness" (n = 4,437, 54.9%), "Incident prefrailty" (n = 2,061, 25.5%), "Prefrailty to frailty" (n = 1,136, 14.1%), and "Frailty to severe frailty" (n = 448, 5.5%). High baseline AL was associated with increased odds of "Incident prefrailty," "Prefrailty to frailty," and "Frailty to severe frailty" trajectories. PA demonstrated significant mediated effects in aforementioned associations. Conclusions: AL is significantly associated with the onset and progression of frailty, and such associations are partially mediated by PA. [ABSTRACT FROM AUTHOR]

The objective of this study was to estimate the extent to which motivational regulations influence physical activity behavior through role identity among people 55 years or older. Participants (N = 409; Mage = 66.29 years [SD = 7.06]) completed online questionnaires to measure motivational regulations, role identity, and the frequency of physical activity in a typical week and in the past month. Mediation analysis using ordinary least squares path analysis revealed that autonomous forms of motivational regulation (positively) and controlled forms of motivational regulation (negatively) influenced role identity, which then positively influenced physical activity behavior. Bootstrap confidence intervals (95%) for the indirect effects (a × b) based on 5,000 bootstrap samples were entirely above or below zero. These findings point to future experimental evaluations of interventions aiming at both increasing and decreasing autonomous and controlled motivational regulations, respectively, to promote physical activity behavior through role identity. [ABSTRACT FROM AUTHOR]

To reduce the spread of COVID-19, in March of 2020, the state of Virginia issued a stay-at-home order requiring fitness center closures for 2.4 months. The purpose of this study was to explore how the fitness center closures influenced physical activity (PA) in older adults who previously participated in the centers' exercise classes. Eleven older adults (69.0 ± 6.6 years) completed semistructured interviews, which were transcribed and analyzed to identify emergent themes. Ten participants reported engaging in PA during the stay-at-home order; four participants maintained/increased PA compared to prepandemic levels. Four themes emerged regarding PA are as follows: recognition of the value of PA, high self-efficacy in regard to PA, adaptation to circumstances, and functional limitations. Findings suggest that prior exercise class participation positively influenced PA. While most participants did not maintain prepandemic PA levels, they remained active because they recognized the benefits of PA, had high self-efficacy for exercise, and adapted to their circumstances. [ABSTRACT FROM AUTHOR]

Adequate body composition is essential for health, function, and independence in older adults. However, standard body composition assessments require complex and costly modalities, limiting their use for early detection of body composition changes and periodic follow-up. This study explored the ability of three practical measures—handgrip strength, five times sit-to-stand test, and upper limb loading during seated push-up test (ULL-SPUT)—to determine body composition in 109 older adults with and without sarcopenia. Participants (average age 76 years) were cross-sectionally measured for outcomes of the study. The ULL-SPUT and handgrip strength, but not the five times sit-to-stand test, significantly correlated with body composition (rs, r =.297–.827, p <.01). The ULL-SPUT, in combination with demographic data, could determine body composition up to 82%. Therefore, the ULL-SPUT may be a practical preliminary measure to identify older adults for whom standard body composition assessments and follow-up would prove timely and beneficial. [ABSTRACT FROM AUTHOR]

Pickleball offers sociopsychological and physical activity benefits for older adults but lacks racial diversity. The purpose of this study was to identify constraints to pickleball participation with Black older adults (65+ years) as well as examine differences based on physical activity and sex. A Qualtrics panel included Black older adults (N = 292) who have heard of pickleball and are physically able to play but have not played. Results found Knowledge, Accessibility, Interpersonal, and Interest were the most salient constraints overall. Multivariate analysis of variance found that those who report low physical activity had significantly higher Interpersonal, Psychological, Costs, and Perceived Racism constraints. Additionally, females report significantly higher Knowledge, Psychological, and Cost constraints compared to males. The results further the theoretical application of constraints to physical activity research and provide insights into practitioner implications to grow the sport of pickleball for Black older adults. [ABSTRACT FROM AUTHOR]

The onset of retirement and children leaving the family home may offer a "window of opportunity" for individuals to influence regular moderate- to vigorous-intensity physical activity; therefore, this study examines the feasibility of a moderate- to vigorous-intensity physical activity intervention among recently retired participants (RET) and parents (P) with children who recently left the family home. A total of 46 inactive RET and nine inactive P were randomized to a 10-week web intervention (n = RET = 25/P = 4) or waitlist control (n = RET = 21/P = 5). Intervention techniques followed the multiprocess action control framework. Enrollment (37.5% for P; 40% for RET), retention (89% for P; 83% for RET), and satisfaction were high. One hundred percent of intervention-sectioned participation increased moderate- to vigorous-intensity physical activity compared with 52% of controls; large effect size differences were observed for key multiprocess action control constructs. Participants were highly satisfied with the intervention; however, recruitment challenges of P support moving to a randomized controlled trial for only the RET group. [ABSTRACT FROM AUTHOR]

Time spent in physical activity, sedentary behavior, and sleep collectively impact health of older adults. There is a need for valid self-reported methods for the assessment of movement behaviors across the entire 24-hr day. The aim of this study was to explore the validity of the German version of Daily Activity Behaviours Questionnaire (DABQ), the "Schlaf- und Aktivitätsfragebogen (SAF)," among older adults. Participants were asked to wear activity monitor (activPAL) for a period of 8 days and to complete the German version of DABQ. Seventy-seven participants (45 females; 68 ± 5 years of age) completed the protocol. Spearman's correlation coefficients between DABQ and activPAL estimates for time spent in sleep, sedentary behavior, light physical activity, and moderate to vigorous physical activity were.69,.35,.24, and.52, respectively. The German version of the DABQ showed satisfactory validity to be used in epidemiological research and population surveillance among older adults. [ABSTRACT FROM AUTHOR]

We aimed to examine exercise intensity among older adults participating from home in remotely delivered EnhanceFitness (Tele-EF). Exercise intensity was assessed through Fitbit-measured heart rate and the Borg 10-point rating of perceived exertion over 1 week of a 16-week exercise program. Outcomes included mean minutes spent at or above the heart rate reserve calculated threshold for moderate intensity and mean rating of perceived exertion. Pearson and Spearman rank correlations were used to examine associations between baseline characteristics with exercise intensity. During the 60-min classes, the 55 participants achieved moderate intensity for a mean of 21.0 min (SD = 13.5) and had a mean rating of perceived exertion of 4.9 (SD = 1.2). There were no significant associations between baseline characteristics and exercise intensity. Older adults can achieve sustained moderate-intensity exercise during Tele-EF supervised classes. Baseline physical function, physical activity, and other health characteristics did not limit ability to exercise at a moderate intensity, though further investigation is warranted. [ABSTRACT FROM AUTHOR]

The purpose of this study was to test the feasibility and acceptability of a staff-delivered physical exercise program embedded into the daily lives of older adults living in nursing homes. A randomized controlled pilot feasibility study was carried out, which included quantitative, qualitative, and economic assessments at baseline, 12 weeks, and 12 months. Two nursing homes (one intervention and one control) took part. The exercise program was carried out on 3 days per week for 12 weeks and consisted of a program of Morning Movement (walking and sit-to-stand exercises) and Activity Bursts. The results confirm that the intervention and study processes are largely acceptable and feasible to implement in the nursing home setting. Potential short-term improvements in physical mobility and quality of life were noticed as positive mean changes and supported by qualitative assessment. Future randomized controlled trials should consider using the 6-meter walk test and refining nursing home and participant eligibility criteria. [ABSTRACT FROM AUTHOR]

This study evaluated the relationship between the muscle mass of the gluteus medius (GM) and skeletal muscle mass index (SMI) measured in patients with hip fractures. In this study, 141 patients with hip fractures were divided into those with high or low SMI. The GM index (GMI) was calculated by dividing the GM by the square of the height in meters. The correlation between GMI and SMI was subsequently analyzed, and cutoff values for determining the loss of skeletal muscle mass were calculated using the receiver operating characteristic curve. GMI and SMI showed a positive correlation for both sexes (male: r =.890, female: r =.626, p <.001). The GMI cutoff values were 19.460 cm2/m2 for males and 17.850 cm2/m2 for females. Skeletal muscle mass evaluation of the GM could contribute to hip fracture recovery by improving mobility and facilitating the early diagnosis of loss of SMM. [ABSTRACT FROM AUTHOR]

This prospective study aimed to determine which specific mobility tests were the most accurate for predicting falls in physically active older adults living in the community. Seventy-nine physically active older adults who met the American College of Sports Medicine physical activity guidelines volunteered. Participants were assessed and followed up for 12 months. Mobility assessments included the 30-s sit-to-stand test, five times sit-to-stand test, single-task timed-up-and-go test (TUG), motor dual-task TUG (Mot-TUG), and cognitive dual-task TUG (Cog-TUG). Mot-TUG and Cog-TUG performances were moderately correlated with number of falls (r =.359, p <.01 and r =.372, p <.01, respectively). When Mot-TUG, Cog-TUG, or Age were included as fall predictors, discrimination scores represented by the area under the receiver operating characteristic curve (AUC) were AUC (Mot-TUG) = 0.843 (p <.01), AUC (Cog-TUG) = 0.856 (p <.01), and AUC (Age) = 0.734 (p <.05). The cutoff point for Cog-TUG was 10.98 s, with test sensitivity of 1.00 and specificity of 0.66. Fall predictors for different populations may be based on different test methods. Here, the dual-task TUG test more accurately predicted falls in older adults who met American College of Sports Medicine's physical activity guidelines. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the interlimb coordination, asymmetry, and variability between older adults who participated in sports (n = 25; age = 72.6 ± 6.46 years) and sedentary older adults (n = 20; age = 70.85 ± 3.82 years). The sport participants were selected from tennis and badminton clubs, whereas the sedentary participants were recruited from local community centers. The participants walked at their preferred speed in a 10-m walkway for 2 min. The interlimb coordination was measured by the phase coordination index. Other walking metrics were speed, cadence, swing time, stance time, double-support time, stride time, and swing time asymmetry. The results showed that the sport participants relative to the sedentary group had better interlimb coordination, higher walking speed and cadence, and less swing time variability. Young older adults also had a better interlimb coordination. In conclusion, the findings of this study showed that long-term participation in sports has some antiaging benefits on gait coordination and symmetry in older adults. [ABSTRACT FROM AUTHOR]

Gait speed significantly affects functional status and health outcomes in older adults. This cross-sectional study evaluated cognitive and physical fitness contributors to usual and peak gait speed in persons with Alzheimer's dementia. Multiple hierarchal linear regression was used to obtain squared semipartial correlation coefficients (sr2) and effect sizes (Cohen's ƒ2). Participants (n = 90; 56% male) averaged 77.1 ± 6.6 years of age and 21.8 ± 3.4 on Mini-Mental State Examination. Demographic/clinical, physical fitness, and cognition variables explained 45% and 39% of variance in usual and peak gait speed, respectively. Muscle strength was the only significant contributor to both usual (sr2 =.175; Cohen's ƒ2 = 0.31; p <.001) and peak gait speed (sr2 =.11; Cohen's ƒ2 = 0.18; p <.001). Women who were "slow" walkers (usual gait speed <1.0 m/s) had significantly lower cardiorespiratory fitness and executive functioning compared with "fast" walkers. In conclusion, improving muscle strength may modify gait and downstream health outcomes in Alzheimer's dementia. [ABSTRACT FROM AUTHOR]