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Predictors of Usual and Peak Gait Speed in Community-Dwelling Older Adults With Mild-to-Moderate Alzheimer’s Dementia

Dereck L. Salisbury, Molly Maxfield, Rodney P. Joseph, David Coon, Jinjiao Wang, Junxin Li, and Fang Yu

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 (sr 2) 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 (sr 2 = .175; Cohen’s ƒ2 = 0.31; p < .001) and peak gait speed (sr 2 = .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.

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Use of Dual-Task Timed-Up-and-Go Tests for Predicting Falls in Physically Active, Community-Dwelling Older Adults—A Prospective Study

Yujie Tong, Jifeng Rong, Xiaochun Tian, Yejun Wang, Zhengquan Chen, Roger Adams, Jeremy Witchalls, Gordon Waddington, Doa El-Ansary, Sam Wu, Oren Tirosh, Tao Wu, and Jia Han

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.

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What Is Known From the Published Literature About Yoga Interventions Delivered in Community Settings for Older Adults? A Systematic Scoping Review

Janet Lok Chun Lee, Jianli Xing, and Rainbow Tin Hung Ho

In recent years, mind–body exercises have arisen as a popular type of physical exercise among older adults in both Eastern and Western countries. In the last 10 years, yoga has been established as a key physical activity intervention for older adults. Thus, the literature on yoga interventions delivered in community settings for older adults warrants a formal appraisal. This scoping review synthesized information on intervention contents and outcomes and summarized data on attrition, adherence, and adverse events for community health practitioners. In addition, this review used the Template for Intervention Description and Replication and the Population, Intervention, Comparator, Outcome checklist to identify areas of depth and gaps in the literature on yoga interventions.

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The European Portuguese Version of the Composite Physical Function Scale: Cross-Cultural Adaptation and Validation in Community-Dwelling Older Adults

Vera Moniz-Pereira, Thaís Ferreira Silva, Eduardo B. Cruz, and Filomena Carnide

This study aims to perform the cross-cultural adaptation to European Portuguese of the Composite Physical Function Scale and to assess its validity and reliability in a sample of community-dwelling older adults. The scale was translated into European Portuguese, back translated, and piloted in a sample of 16 representative individuals. Its validity and reliability were tested in an independent sample of 114 community-dwelling older adults (52 were tested twice to assess test–retest reliability). The results showed that the scale had good internal consistency (α = .90), construct validity (ρ = .71) and measurement error (78.8% agreement), and excellent test–retest reliability (κ = .98). However, a ceiling effect was found as 28% of the participants achieved the highest possible score. Although the scale has good measurement properties, the presence of ceiling effects is indicative that this tool is not able to distinguish higher levels of intrinsic capacity within community-dwelling older adults.

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Exercise and Protein Supplementation Recommendations for Older Adults With Sarcopenic Obesity: A Meta-Review

Allison T. Contillo, Nancy R. Rodriguez, and Linda S. Pescatello

This systematic meta-review evaluated the effects of exercise with and without protein interventions on muscle strength and function in older adults with sarcopenic obesity. PubMed, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature, Scopus, and SPORTDiscus databases were searched through February 2021 for relevant systematic reviews and meta-analyses with aerobic, resistance, and/or combined training interventions with and without protein supplementation in older adults ≥ 65 years with sarcopenic obesity. This meta-review showed that exercise with and without protein supplementation improved body composition (i.e., decreased percentage body fat) and functional outcomes (i.e., gait speed and grip strength). Because the current literature is limited, determining the effects of exercise and combined protein supplementation in this population requires further investigation. In the meantime, protein recommendations should align with general sarcopenia recommendations. Based upon available findings, tentative exercise recommendations to optimize health outcomes in this population are proposed.

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Protein Supplementation in Addition to Strength Training Programs for Improving Body Composition in Older Adults: What Else Is Left to Know? A Brief Update Review of the Current Evidence

Júlio Benvenutti Bueno de Camargo

Resistance training alongside proper protein intake is an important tool to mitigate the deleterious effects of the aging process on skeletal muscle tissue. However, it is not completely elucidated whether adding protein supplementation provides further improvements on body composition outcomes of older adults during resistance training programs. The present narrative review aimed to describe the most recent evidence regarding the effects of protein supplementation on both lean body mass and fat mass of older adults and to provide insight into how health professionals may use this information to properly design nutritional programs for this population. While individuals with previous training experience, not meeting daily protein requirement, or displaying frailty symptoms may experience some benefits, protein supplementation does not seem to provide further improvements in untrained and healthy subjects. Aspects such as the age of the individuals and the different characteristics of the supplementation protocols must be considered when making evidence-based decisions regarding this topic.

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Testing the Effects of a Multicomponent Frailty Management Program for Community-Dwelling Older Adults in Singapore: A Feasibility Study

Tianma Xu, Ting-Ting Yeh, Kidman Yi Jer Ng, Nicole Wen Ru Wong, and Verna Sock Juen Koh

Frailty in later life is often associated with functional declines and reduced quality of life. A multicomponent frailty management program (mFMP) is lacking in Singapore. This study aimed to determine the feasibility and effects of an mFMP in reducing frailty and increasing participation among frail community-living older adults. Pre- and postassessments at three time points were conducted to compare the differences in body functions between the mFMP (experimental group [EG]) and a fitness program (control group [CG]). Recruitment, dropouts, and fall data were collected. Weekly field notes and semistructured interviews postintervention were thematically analyzed. Sixteen out of 23 participants (EG: eight; CG: eight) completed the 12-week interventions with reduced frailty immediately postintervention. At 3-month postintervention, 10 participants (EG: five; CG: five) being followed up had a sustained level of frailty (p < .05). The EG and CG reported zero and two falls, respectively. The mFMP demonstrated its feasibility and exhibited a trend to facilitate personal behavioral changes postintervention.

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The Application of Artificial Intelligence in Digital Physical Activity and Falls Prevention Interventions for Older Adults

David C. Wong, Siobhan O’Connor, and Emma Stanmore

This article discusses the practical applications of artificial intelligence in digital physical activity and falls prevention interventions for older adults. It notes the range of technologies that can be used to collect digital datasets on older adult health and how machine learning algorithms can be applied to these to improve our understanding of physical activity and falls. In particular, these advanced computational techniques could help personalize exercises, feedback, and notifications to older people, improve adherence to and reduce attrition from digital health interventions, and enhance monitoring by providing predictive analytics on the physiological and environmental conditions that contribute to physical activity and falls in aging populations.

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Different Levels of Leisure Walking and Mental Health Among Older Adults With Mild Cognitive Impairment

Jungjoo Lee, Seok Min Oh, Jaehyun Kim, and Junhyoung Kim

Leisure walking has been found to be positively associated with increased mental health. However, the benefits of leisure walking of varying intensities on the mental health of older adults (>50 years old) with mild cognitive impairment are not clear. This study employed 2020 Health and Retirement Study data to investigate the benefits of leisure walking for three groups based on levels of participation (low, mid, and high). We conducted a multivariate analysis of covariance (n = 834) to examine the group mean differences (MDs). The respondents in the high and mid groups presented higher life satisfaction and happiness than those in the low group. The high group had lower loneliness and stress scores than those in the low and mid groups. These findings indicate that older adults with mild cognitive impairment gained more mental health benefits and life satisfaction through moderate and vigorous leisure walking than through light leisure walking.

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Ability of the Seventh Cervical Vertebra Wall Distance to Determine Mobility Deficits of Older Adults

Sugalya Amatachaya, Patcharawan Suwannarat, Apassanan Wiyanad, Pakwipa Chokphukia, Thanat Sooknuan, and Pipatana Amatachaya

Thoracic hyperkyphosis could affect mobility and independence of older adults. However, there was no clear evidence on the use of the seventh cervical vertebra wall distance (C7WD), a practical measure for thoracic hyperkyphosis, to indicate mobility deficits relating to independence of these individuals. This study explored the ability of C7WD to determine mobility impairments in 104 older adults. Participants (average age of 74.1 ± 7.4 years) with various degree of thoracic kyphosis were cross-sectionally measured for their C7WD, mobility, and Cobb angle. The findings indicate that participants with thoracic hyperkyphosis (Cobb angle = 46.1 ± 5.2°) had significantly poorer mobility than those without thoracic hyperkyphosis (Cobb angle = 32.8 ± 5.9°, p < .05). A C7WD of ≥7.8 cm could indicate mobility deficits of the participants (sensitivity = 71%–92%, specificity = 75%–94%, and area under the curve >0.80). The findings confirm the ability of C7WD that could be clinically measured using rulers to indicate mobility deficits of older adults.