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Lee Smith, Shahina Pardhan, Trish Gorely, Yvonne Barnett, Louis Jacob, Guillermo F. López-Sánchez, Mark A. Tully, Nicola Veronese, Jae Il Shin, and Ai Koyanagi

The authors investigated the association between vision impairment and physical activity among older adults from low- and middle-income countries. Visual acuity was measured using the tumbling ElogMAR chart, and vision impairment was defined as visual acuity worse than 6/18 (0.48 logMAR) in the better seeing eye. Physical activity was assessed by the Global Physical Activity Questionnaire. Multivariable logistic regression and meta-analysis were conducted to assess associations. The sample included 34,129 individuals aged 50–114 years (mean [SD] age 62.4 [16.0] years; 47.9% male). After adjustment for confounders, near vision impairment was not significantly associated with low physical activity, but far vision impairment showed a significant association (odds ratio = 1.32; 95% confidence interval [1.17, 1.49], I 2 = 0.0%). Far vision impairment was dose-dependently associated with low physical activity (e.g., severe [<6/10] vs. no [≥6/12] far vision impairment; odds ratio = 1.80; 95% confidence interval [1.03, 3.15]). Interventions to address low levels of physical activity in the visually impaired in low- and middle-income countries should target those with far vision impairment.

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Anna Tirkkonen, Jenni Kulmala, Tuomo Hänninen, Timo Törmäkangas, Anna Stigsdotter Neely, and Sarianna Sipilä

Walking is a complex task requiring the interplay of neuromuscular, sensory, and cognitive functions. Owing to the age-related decline in cognitive and physical functions, walking may be compromised in older adults, for cognitive functions, especially poor performance in executive functions, is associated with slow walking speed. Hence, the aim of this study was to investigate the associations between different subdomains of executive functions and physical functions and whether the associations found differ between men and women. Multiple linear regression analysis was performed on data collected from 314 community-dwelling older adults who did not meet physical activity guidelines but had intact cognition. Our results showed that, while executive functions were associated with gait and lower extremity functioning, the associations depended partly on the executive process measured and the nature of the physical task. Moreover, the associations did not differ between the sexes.

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Miguel A. De la Cámara, Ana I. Pardos-Sevilla, Augusto Jiménez-Fuente, Thamara Hubler-Figueiró, Eleonora d’Orsi, and Cassiano Ricardo Rech

The aim of this study was to examine, theoretically, how reallocating time between the intensity of mutually exclusive categories of physical activity and sedentary behavior time is associated with metabolic syndrome. Four hundred and six older adults (61.6% women) from the second wave of the EpiFloripa Aging Cohort Study were included in the study (mean age 71.7 ± 5.9 years). Isotemporal substitution analysis showed a decrease of 35% (odds ratio: 0.65; 95% confidence interval [0.45, 0.96]) in the risk for metabolic syndrome when replacing 30 min/day of sedentary behavior with an equivalent amount of moderate to vigorous physical activity. Furthermore, it has been observed that older adults classified as low sedentary behavior and physically active were 57% less likely to have metabolic syndrome than participants classified as high sedentary and physically inactive (odds ratio: 0.43; 95% confidence interval [0.19, 0.97]). This study highlights the importance of behavioral categories that may emerge concerning the interrelationships of physical activity and health in older adults, having important implications for future health intervention programs.

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Marina Christofoletti, Paula F. Sandreschi, Sofia W. Manta, Susana C. Confortin, Rodrigo S. Delevatti, Eleonora D’Orsi, Tânia R. Bertoldo Benedetti, Cassiano R. Rech, and Thiago S. Matias

This study described the clustering patterns of moderate to vigorous physical activity and sedentary time (ST) according to handgrip strength and investigated the association between identified clusters of fat and lean mass in older adults from southern Brazil. Objective measures were used for moderate to vigorous physical activity, ST, and body composition outcomes. Two-step cluster and linear regression analyses were conducted according to handgrip strength. Three clusters were identified: all-day sitters, sitters, and active sitters. The prevalence of clusters in the low-strength group was 58.2%, 22.8%, and 19.0%, respectively, while the prevalence of clusters in the high-strength group was 42.1%, 34.8%, and 23.1%, respectively. All-day sitters had 2.6% more fat mass than active sitters with low strength. High levels of ST characterized all cluster profiles; low strength, lack of moderate to vigorous physical activity, and high ST levels among older adults may indicate a subpopulation at a greater risk of overweight and obesity-related diseases.

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Samira Javadpour, Ehsan Sinaei, Reza Salehi, Shahla Zahednejad, and Alireza Motealleh

To compare the effects of single- versus dual-task balance training on the gait smoothness and balance of community-dwelling older adults, 69 volunteers were randomized to single-, dual-task training, and control (no intervention) groups. Exercises were received in 18 sessions through 6 weeks. The gait smoothness was measured by the harmonic ratio of trunk accelerations using a triaxial accelerometer. Balance performance was assessed through the Fullerton Advanced Balance scale, Timed Up and Go test, Activities-specific Balance Confidence, and gait speed. After the trial, all variables improved significantly in the training groups. Moreover, differences in the mean change of all variables, except the Timed Up and Go test, were statistically significant between the interventional groups and the control group, but no significant difference was reported between the two training groups. This study suggests that balance training can improve gait smoothness as well as balance status in healthy older adults.

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Gareth Thompson, Gareth W. Davison, Jacqui Crawford, and Ciara M. Hughes

Sirtuin-1 is a protein that may orchestrate the cardioprotective effect of exercise by controlling cellular processes. This pilot study assessed the feasibility of performing a quasi-experimental study in this area. Patients with postacute myocardial infarction were recruited across four hospital sites in the United Kingdom. The participants were offered one weekly exercise session at Phase-III and Phase-IV cardiac rehabilitation (CR). Measurements were obtained pre-Phase-III CR (Week 1), post-Phase-III CR (Week 8), and post-Phase-IV CR (Week 22). Twenty-eight patients were recruited (79% male, 100% White, 60.2 ± 10.5 years old). The recruitment rate was not fulfilled (<70% eligible patients recruited; 0.9 participants recruited per week over 30 weeks). The success criteria for dropout rate, adherence rate, and collection of sirtuin-1 measures were satisfied. A large increase in sirtuin-1 (0.14 ± 0.03, d ≥ 0.8) was seen after Phase-III and Phase-IV CR. Collectively, a quasi-experimental study is feasible with a revised recruitment strategy.

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Tal Gafni, Kerem Shuval, Galit Weinstein, Carolyn E. Barlow, Kelley Pettee Gabriel, Benjamin L. Willis, David Leonard, William L. Haskell, and Laura F. DeFina

This study cross-sectionally examines the relations of sitting and physical activity (PA) with cognitive impairment in community-dwelling adults aged 55–87 years (n = 3,780). Multivariable logistic regression assessed independent and joint relations of sitting and PA with Montreal Cognitive Assessment scores adjusting for covariates. Sitting ≥75% of the time and not meeting PA guidelines were related to 60% (95% confidence interval [CI] [1.19, 2.17]) and 27% (95% CI [1.06, 1.53]) higher odds for cognitive impairment, respectively. Stratification by age showed that sitting ≥75% of the time was associated with higher cognitive impairment odds in midlife (odds ratio [OR] = 1.86; 95% CI [1.31, 2.65]), but not older adults (OR = 1.06; 95% CI [0.57, 1.95]). Joint association analysis revealed that, overall, the highest odds for cognitive impairment were in those sitting ≥75% of the time while meeting or not meeting PA guidelines (OR = 1.69, 95% CI [1.13, 2.53]; and OR = 1.66, 95% CI [1.19, 2.32], respectively). In conclusion, prolonged sitting and insufficient PA are independent risk markers for cognitive impairment.

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Lisa Sheehy, Heidi Sveistrup, Frank Knoefel, Anne Taillon-Hobson, Tara Martin, Mary Egan, Martin Bilodeau, Vivian Welch, Christine Yang, and Hillel Finestone

Individuals with mild cognitive impairment are at risk of cognitive and physical decline. Virtual reality (VR) exercise may provide beneficial physical and cognitive exercise. The objectives of this study were to assess the feasibility and safety of home-based VR exercise and to provide pilot data for physical and cognitive efficacy. Eleven individuals with mild cognitive impairment (seven males/four females, average 78 years old, and average 3 years since diagnosis) performed a 30-min home-based VR exercise program 5 days a week for 6 weeks. The VR platform was successfully installed in participants’ homes, and all participants were able to learn the VR program and progress. Participants completed 99% of the prescribed exercise. There were no major adverse events. Most participants enjoyed the VR program and reported physical benefits; fewer reported cognitive benefits. No physical or cognitive outcome measures showed change after 6 weeks. Home-based VR exercise is safe and feasible in individuals with mild cognitive impairment.

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Pierre Jéhannin, Alexis Le Faucheur, Ségolène Chaudru, Aline Taoum, Guillaume Mahé, and Pierre-Yves de Müllenheim

The authors investigated the agreement between StepWatch3™ (SW3) and ActiGraph™ wGT3X+ monitors for measuring step-based metrics in patients with peripheral artery disease and older adults. In 23 patients with peripheral artery disease and 38 older participants, the authors compared the metrics obtained during an outdoor (400-m track) walking session (step count) and a 7-day free-living period (step count and 60/30/5/1-min maximal or peak step accumulation) using the SW3 (ankle) and the wGT3X+ (hip) with the low-frequency extension filter enabled (wGT3X+/LFE) or not (wGT3X+/N). During outdoor walking session, agreement was high, particularly for wGT3X+/LFE: correlations ≥.98, median absolute percentage errors <1%, and significant equivalence using a ± 15% equivalence zone or narrower. In free living, no wGT3X+ method was equivalent to SW3 for step count. The wGT3X+/LFE was equivalent to SW3 regarding all step accumulation metrics using a ± 20% equivalence zone or narrower, with median absolute percentage errors <11%. The wGT3X+/LFE method is the best option for comparisons with SW3 in peripheral artery disease and older adults.

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Bong Kil Song, Angelique G. Brellenthin, Joey M. Saavedra, and Duck-chul Lee

Background: The association between muscular strength (MS) and prevalent gastroesophageal reflux disease (GERD) in the older adults is not well established. Methods: This study included 542 older adults with no history of myocardial infarction, stroke, or cancer. MS was measured by handgrip dynamometry. Participants were categorized into sex-specific quartiles of MS, while cases of GERD were identified by self-reported physician diagnosis. Logistic regression was used to calculate the odds ratios and 95% confidence intervals of GERD by quartiles of MS. Results: There were 112 GERD cases. Compared with the first quartile of MS, the odds ratios (95% confidence intervals) of GERD were 0.50 (0.27–0.95), 0.39 (0.20–0.75), and 0.55 (0.29–1.04) in the second, third, and fourth quartiles of MS, respectively, after adjusting for possible confounders including body mass index. In a joint analysis of MS and body mass index, participants were dichotomized into weak (first MS quartile) or strong (upper 3 MS quartiles) and normal weight, overweight, or obese. Compared with the weak–obese group, odds ratios (95% confidence intervals) were 0.34 (0.14–0.80), 0.43 (0.16–1.13), 0.29 (0.12–0.68), 0.18 (0.06–0.55), and 0.07 (0.03–0.21) for the strong–obese, weak–overweight, strong–overweight, weak–normal weight, and strong–normal weight. Conclusions: MS was independently and inversely associated with GERD in older adults.