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Factors Associated With Participation in Physical Leisure Activities in Taiwanese Community-Dwelling Older Adults

Szu-Wei Chen, Tracy Chippendale, and Sharon L. Weinberg

This study was to identify factors at the intrapersonal, interpersonal, and community levels that relate to physical leisure participation in Taiwanese community-dwelling older adults and to examine their relative importance. We used a cross-sectional study with purposive sampling (N = 160). Physical leisure participation was quantified as the variety, frequency, and duration of participation. Data were analyzed using a series of hierarchical multiple linear regressions. The results showed that higher variety, frequency, or duration of physical leisure participation was associated with older males and with those who reported having better health, fewer depressive symptoms, and greater social support. Intrapersonal- and interpersonal-level factors play a relatively more important role in predicting physical leisure participation than factors at the community level. Understanding factors that relate to these three levels of participation has the potential to inform interventions that are tailored to individual profiles.

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Effectiveness and Benefits of Exercise on Older People Living With Mental Illness’ Physical and Psychological Outcomes in Regional Australia: A Mixed-Methods Study

Gabrielle McNamara, Caroline Robertson, Tegan Hartmann, and Rachel Rossiter

Regular exercise is reported to improve depressive symptoms and quality of life for people experiencing mental illness. For older adults, including strength and balance can also decrease falls. Mental health services seldom include funding for Accredited Exercise Physiologist programs. A 9-week Accredited Exercise Physiologist-led program for older adults receiving mental health treatment with a community Older People’s Mental Health Service was trialed in regional Australia. This clinician-conceived small-scale feasibility study utilized a two-phase concurrent triangulation mixed-method design to evaluate physical and psychological program outcomes and identify factors related to engaging in physical activity. This tailored exercise program led to improvements in measures of psychological distress and physical and psychological function. These changes corresponded with participants identifying benefits of exercising as a group of adults living with mental illness. Such findings suggest a supervised, individualized program for older mental health consumers confers physical and psychological benefits; however, further research evaluating exercise interventions with this population is required.

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The Role of Daily Step Count in Determining Risk Factors for Falls

Oshadi Jayakody, Aishwarya Kirubasankar, Taya Collyer, Velandai K. Srikanth, and Michele L. Callisaya

Falls risk is often assessed without considering exposure to risk. We examined the risk factors associated with falls in those with greater and lower levels of daily step count. Falls were recorded over 12 months using bimonthly calendars in community-dwelling older people (mean age 72.0, SD 6.9). Daily step count was measured using a pedometer worn consecutively for 7 days. A cut score of <5,575.5 steps/day was used to identify people with lower step count. Negative binominal models were used to identify cognitive, medical, and sensorimotor factors associated with falls in those with higher versus lower levels of daily step count. In those with lower daily step count, poorer executive function, slower gait speed, and lower steps per day were associated with increased falls risk. In those with higher step count, only mood was associated with increased falls risk. Considering daily step count is important when assessing falls risk in older people.

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Physical Activity Level of Physically Independent Older Adults in a Densely Populated City

Linda Yin-king Lee, Rebecca Cho-kwan Pang, and Mimi Mei-ha Tiu

The aim of this study was to estimate older adults’ physical activity level in all types and categories of physical activities and calculate their total physical activity level. This cross-sectional descriptive study estimated the physical activity level of older adults on a quota sample of 500 physically independent older adults living in a densely populated city (in this case, Hong Kong). It used the Physical Activity Questionnaire (Hong Kong version) to assess participants’ physical activity level. Based on the frequency, duration, and intensity of each type of physical activity being performed by the participants, their physical activity level in terms of energy expenditure (in kilocalories per day) for all types and categories of physical activities and the total physical activity level were calculated. Independent t test or analysis of variance, whatever appropriate, was used to examine the difference in the total physical activity level between participants with different individual characteristics. Linear regression analysis was conducted to determine the contribution of individual characteristics to the total physical activity level (p < .05). Results indicated that the participants mostly engaged in leisurely sitting, watching television, listening to radio, and leisurely walking. They spent the greatest amount of energy on the category of “leisure activity” (710.77 kcal/day). Their total physical activity level was 1,727.09 kcal/day, which was much less than previously reported. Linear regression indicates that age accounted for 3.1% of the variance of the total physical activity level (p = .001) with senior older adults warranting additional support. Future research is suggested to confirm the role of specific neighborhood-level factors on the physical activity performance of older adults.

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Translation and Linguistic Validation of the Assessment of Physical Activity in Frail Older People into Simplified Chinese Using Cognitive Interviewing Methodology

YueLin Li, LinYu Lyu, Xing Fan, LiJuan Xu, RuoRan Zhao, YuBo Jiang, Jisu Seo, CaiFu Li, and Rhayun Song

The Assessment of Physical Activity in Frail Older People (APAFOP) is a patient-reported outcome measure assessing physical activity among community-dwelling older adults. However, this instrument has not been verified in the Chinese context. Thus, we translated the APAFOP into Chinese and then linguistically validated the Chinese version of APAFOP (APAFOP-C) by following the guidelines developed by Beaton and Willis. The translation process took 6 months. We identified nine translation issues in the translation process, of which experiential equivalence issues were the most frequent. It took three rounds of cognitive interviews to achieve linguistic validity, and the most significant issues were related to the layout of the questionnaire identified during the cognitive interview. In conclusion, the items of the APAFOP-C were considered comprehensive and relevant to assessing the physical activities of frail older adults in China. This study has laid the foundation for future evaluation of its measurement properties.

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Wrist-Worn Accelerometry, Aging, and Gait Speed in the Baltimore Longitudinal Study of Aging

Amal A. Wanigatunga, Fangyu Liu, Jacek K. Urbanek, Hang Wang, Junrui Di, Vadim Zipunnikov, Yurun Cai, Ryan J. Dougherty, Eleanor M. Simonsick, Luigi Ferrucci, and Jennifer A. Schrack

Wrist-worn accelerometry metrics are not well defined in older adults. Accelerometry data from 720 participants (mean age 70 years, 55% women) were summarized into (a) total activity counts per day, (b) active minutes per day, (c) active bouts per day, and (d) activity fragmentation (the reciprocal of the mean active bout length). Linear regression and mixed-effects models were utilized to estimate associations between age and gait speed with wrist accelerometry. Activity counts per day, daily active minutes per day, and active bouts per day were negatively associated with age among all participants, while positive associations with activity fragmentation were only observed among those ≥65 years. More activity counts, more daily active minutes, and lower activity fragmentation were associated with faster gait speed. There were baseline age interactions with annual changes in total activity counts per day, active minutes per day, and activity fragmentation (Baseline age × Time, p < .01 for all). These results help define and characterize changes in wrist-based physical activity patterns among older adults.

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The 180° Turn Phase of the Timed Up and Go Test Better Predicts History of Falls in the Oldest-Old When Compared With the Full Test: A Case-Control Study

Fabiane de Oliveira Brauner, Anelise Ineu Figueiredo, Matheus de Souza Urbanetto, Rafael Reimann Baptista, Aniuska Schiavo, and Régis Gemerasca Mestriner

The 180° turn phase of the test may better differentiate the oldest-old regarding their history of falls. This is a case-control study designed to detect the ability of the 180° turn timed up and go (TUG) phase to detect a history of falls in the oldest-old. Sixty people aged 85 years and older were assessed in their homes. The single-task and dual-task TUG tests were performed using an inertial sensor (G-Walk). Sociodemographic data, physical activity levels, mental status, depressive symptoms, concern for falls occurrence, number of medicines in use, self-perception of balance, and the functional reach test were also assessed. The logistic regressions revealed the 180° turn phase of both the single-task and dual-task TUG was almost three times better than the full TUG test to detect a history of falls, thus providing insights that can be used to better assess functional mobility in the oldest-old.

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Volume 30 (2022): Issue 5 (Oct 2022)

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The Effect of Age and Fall History on Lower Extremity Neuromuscular Function During Descent of a Single Transition Step

Emily E. Gerstle, Kristian O’Connor, Kevin G. Keenan, Brooke A. Slavens, and Stephen C. Cobb

Despite the higher injury rate of falls on steps versus level ground, few studies have examined the influence of age and fall history on step descent. The purpose of this study was to determine the lead and trail limb neuromuscular function (peak joint moments and powers, electromyographic activity) differences between young females (n = 15) and older females with (n = 15) and without (n = 15) a fall history while descending a single step. Trail limb moments and powers did not differ between groups. Lead limb sagittal plane powers at the hip and knee were greater in the young adults. Electromyographic co-activation levels (knee and ankle) were not significantly different between groups. However, peroneal activation was greater in the older groups, which may have assisted in stabilizing the ankle joint in lieu of increased co-activation at the ankle. These results demonstrate consideration of step descent is important in working with older women at risk of falls.

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Erratum. The Effect of Age and Fall History on Lower Extremity Neuromuscular Function During Descent of a Single Transition Step