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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.

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Association Between Moderate Physical Activity Level and Subsequent Frailty Incidence Among Community-Dwelling Older Adults: A Population-Based Cohort Study

Wenjing Zhao, Shigekazu Ukawa, Sachiko Sasaki, Emiko Okada, Tomoko Kishi, Kastunori Kondo, and Akiko Tamakoshi

Our study aimed to demonstrate the association between physical activity (PA) and frailty incidence among Japanese community-dwelling older adults with a narrow age range of 70–74 years. This study included 485 participants from the Japan Gerontological Evaluation Study. Frailty was assessed at baseline and 3 years later by using the Kaigo-Yobo Checklist. PA was assessed using the short-term International PA Questionnaire at baseline. Logistic regression was performed to calculate the odds ratio with 95% confidence intervals after adjusting for potential confounders. The associations of frailty scores with both PA volume and daily walking time presented a U-shaped curve, albeit only the latter was statistically significant. After adjusting for potential confounders, walking for 0.5–1 hr/day displayed a greater association with decreased frailty risk than higher levels of daily walking time. Further study is needed to cumulate the evidence that moderate PA levels may delay frailty incidence and improve the aging process.

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Dual-Task Interference of Gait Parameters During Different Conditions of the Timed Up-and-Go Test Performed by Community-Dwelling Older Adults

Anna Cristina Åberg, Liss Elin Larsson, Vilmantas Giedraitis, Lars Berglund, and Kjartan Halvorsen

The Timed Up-and-Go (TUG) test has been combined with different verbal/cognitive tasks (i.e., TUG dual task [TUGdt]) as a form of motor-cognitive testing. However, it is still unclear how different TUGdt conditions affect gait among older adults. Thirty community-dwelling older adults, with mean age of 73 years, participated in the study. Data were collected using marker-free video recordings. Gait parameters were extracted using a semiautomatic deep learning system. Comparisons of execution time and gait parameter outcomes were made under TUG and three types of TUGdt test conditions: TUGdt-naming animals, TUGdt-months backwards, and TUGdt-serial 7s. Statistical analyses were based on mean values of the gait parameters for each participant and TUG condition, including TUGdt gait cost, that is, the relative difference between TUGdt and TUG. All the investigated TUGdt conditions resulted in varying degrees of gait parameter changes. Under TUGdt conditions, participants took shorter and slower steps, with TUGdt-serial 7s causing the largest interference.

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Volume 31 (2023): Issue 2 (Apr 2023)

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Dimensions of Physical Activity Are Important in Managing Anxiety in Older Adults: A Systematic Review and Meta-Analysis

Esther Frema Ofosu, Len de Nys, Jenni Connelly, Gemma Cathrine Ryde, and Anna C. Whittaker

Physical activity (PA) is a known approach for managing anxiety symptoms in older adults. This systematic review and meta-analysis address the benefits of PA and its dimensions (frequency, session time, type, and intervention period) on anxiety symptoms in older adults aged 65 years and above. Searches covered eight databases reporting eight randomized controlled trials (RCTs) and five non-RCTs. Meta-analysis of RCTs (standardized mean difference = −0.41; 95% confidence interval [−0.58, −0.24]; p < .00001) and Fisher’s method of combining p values for non-RCTs supported the effectiveness of PA for managing anxiety symptoms in older adults. Subgroup analysis revealed significant effects for all PA types, session times, frequency, and intervention periods compared with control groups, albeit with different magnitudes of effect. In conclusion, although some dimensions of PA contribute to its effectiveness for anxiety, PA intensity and mode required to maximize PA effects remain unclear.

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Instructor Social Support in the Group Physical Activity Context: Older Participants’ Perspectives

Lindsay Morrison, Meghan H. McDonough, Chantelle Zimmer, Cari Din, Jennifer Hewson, Ann Toohey, Peter R.E. Crocker, and Erica V. Bennett

Instructors in organized physical activity classes can be a source of social support through their relationships with participants, influence on participants’ interactions with each other, and design of activities. Grounded in interpretive description, the objective of this study was to examine older adults’ experiences of and their perspectives on group physical activity instructors’ supportive behaviors. Observations of 16 group physical activity classes (N = 295) and focus groups or interviews with N = 38 class participants aged ≥ 55 (n = 29 women) were conducted at four municipal recreation facilities in a Canadian city. Five themes shed light on how instructors provided social support: (a) supporting autonomous engagement, (b) developing caring connections, (c) fostering trust through expert instruction, (d) managing conflict directly and effectively, and (e) creating a climate where people want to go. Instructor training should consider older adults’ social support needs and help instructors embody behaviors that support continued physical activity participation, thereby contributing to healthy aging.