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Comparing Online and In-Person Delivery of a Fall Prevention Exercise Program for Older Adults

Vanessa Pitre, Martin Sénéchal, and Danielle R. Bouchard

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.

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A Descriptive Study Using Rasch Analysis and Hypothesis Testing to Evaluate the Psychometric Properties of the UMOVE Mobility Screen Tested With Hospitalized Older Adults

Barbara Resnick, Marie Boltz, Chris L. Wells, Elizabeth Galik, Ashley Kuzmik, and Rachel McPherson

The purpose of this study was to test the reliability and validity of the UMOVE Mobility Screen in older adults living with dementia using a Rasch analysis and hypothesis testing. The UMOVE Mobility Screen (UMOVE) focuses on nine activities: following commands, muscle strength, and basic functional mobility tasks. Trained evaluators completed assessments on 244 patients, the majority of whom were female (62%), and White (71%). Based on Rasch Analysis, there was evidence of good item and person reliability (indexes > 0.80), good INFIT statistics, and only one item fitting the model based on OUTFIT statistics. Validity was supported based on hypothesis testing. There was no evidence of Differential Item Functioning between races and genders. Item mapping raised concerns about the spread of the items across the full spectrum of mobility assessed in the UMOVE Mobility Screen. Future testing should consider adding some easier and some more difficult items.

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Physical Activity and Psychological Resilience in Older Adults: A Systematic Review of the Literature

Eliza E. Toth, Ferenc Ihász, Roberto Ruíz-Barquín, and Attila Szabo

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.

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Research Protocol Adaptations During the COVID-19 Pandemic: A Process Evaluation

Mariana Wingood, Amy M. Linsky, Rebekah Harris, Patricia Bamonti, Jennifer Moye, and Jonathan F. Bean

In general, COVID-19-related adaptations that transitioned in-person assessments and interventions to a virtual format were not routinely evaluated. We aimed to conduct a process evaluation to examine the impact of COVID-19-related adaptations on a behavior change intervention designed to increase exercise adherence among Veterans with mobility difficulty. We used secondary data from a nonrandomized study to complete a process evaluation examining the intervention’s reach, recruitment, fidelity, dose delivered by physical therapists, and the dose received by the 14 participating Veterans. The physical therapist delivered 95% (133/140) of the study’s 10 sessions. Sessions with the lowest delivery dose included Sessions 1 and 10 (86%; n = 12/14). The elements with the lowest dose received included using an exercise journal and developing a postintervention plan (86%; n = 12/14). Our COVID-19 adaptations allowed us to provide our intervention to the majority (67%) of eligible participants without a negative impact on fidelity, dose delivered, or dose received.

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Self-Reported Vision Loss, Health Status, and Social Participation Among Middle-Aged and Older Adults—Evidence From China

Xiaodong Zhang, Yuqian Lin, and Chengmeng Zhang

Social participation is crucial for enhancing senior’s well-being and promoting their integration into society. Using nationwide data investigated in China, this study explored the association between self-reported visual impairment, health level, and social participation among Chinese middle-aged old adults. It has been found that (a) the probability and frequency of social participation among middle-aged and older adults with self-reported vision loss were significantly lower than those without vision problems; (b) self-reported vision loss was negatively associated with self-rated health and mental health status, and both were positively associated with social participation; and (c) self-rated health and mental health played a mediating role between vision loss and social participation. The findings suggest that under the framework of active aging, universal vision screening programs and rehabilitation plans for the older adults with visual impairment are exceedingly significant to promote their participation in social activities, thereby enhancing their quality of life.

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The Association Between Allostatic Load and Frailty Trajectories Among Adults Aged 50+ Years: Mediating Role of Physical Activity

Kanglin Shi, Lingxiao He, Zeyun Zhang, Jianlin Lin, Xiaodong Chen, Xinyuan Du, Kewei Shi, Jinzhu Yang, Zaixing Shi, and Ya Fang

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.

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Physical and Cognitive Effects of High-Intensity Interval or Circuit-Based Strength Training for Community-Dwelling Older Adults: A Systematic Review

Ashley Morgan, Kenneth S. Noguchi, Ada Tang, Jennifer Heisz, Lehana Thabane, and Julie Richardson

Many older adults do not achieve recommended amounts of aerobic or strengthening exercise and high-intensity interval or circuit-based strengthening may offer a time-efficient solution. This review sought to determine the effects of high-intensity interval/circuit strengthening on physical and cognitive functioning for community-dwelling older adults, and its associated adherence, retention, and adverse events. Six databases were searched to June 2022 and 15 studies (11 for effectiveness) were included. The current certainty of evidence is low to very low; upper body-focused physical functioning measures demonstrated small to large benefits and lower body-focused, self-report, and cardiovascular measures had mixed results. There was insufficient evidence (one study) to determine cognitive effects. The mean adherence rates ranged from 73.5% to 95.8%, overall retention across all studies (n = 812) was 86%, and no serious adverse events were reported, suggesting that this type of exercise is feasible for community-dwelling older adults.

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Physiological Demands of Exergames in Older Adults—A Systematic Literature Review

Claudia Kubica, Benjamin Dütschler, Timo Felder, Dario Querciagrossa, and Claudio R. Nigg

New approaches are needed to address low physical activity levels among older adults and to promote daily physical activity tailored to their interests and abilities. This study aimed to review the current literature analyzing the physiological demands of exergames in older adults. A systematic database search was conducted in October 2020 and March 2022. A total of 3,540 studies were screened, and 16 were incorporated into the data analysis. The studies included 527 participants, 61% female, with a mean age of 72.3 ± 4.7 years. Analyzed physiological parameters included mean heart rate, rate of perceived exertion, and metabolic equivalents or oxygen uptake. Exergames are capable of offering light- to moderate-intensity activity for older adults (mean heart rate: 108 ± 9.1 bpm; mean rate of perceived exertion: 11.5 ± 1.8; metabolic equivalents: 2.7 ± 0.7). Although implications are positive, high diversity was found in the study design according to intervention duration and assessment of physiological parameters.

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Physical Activity During the COVID-19 Stay-at-Home Order in Active Older Adults: A Qualitative Study

Maria E. Damewood, Savannah-Faith Clark, and Ashley L. Artese

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.

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Identifying Ageism Within Australian Local Government Physical Activity Policy: A Critical Discourse Analysis

Michael Butson, Ruth Jeanes, and Justen O’Connor

This research aims to identify ageist content concerning older adults within local government physical activity policy. Policies are not passive texts; they can comprise hidden or disputed connotations. To identify ageism, the study utilizes a critical discourse analysis approach to analyze physical activity policy documents (n = 61) from 16 local government areas in Victoria, Australia, and the perceptions of local government employees trusted with developing these policies, which were gathered during semistructured interviews (n = 11). Results from the critical discourse analysis indicate that local government policies are imbued with ageism, leading to the construction and perpetuation of various stereotypes of older adults. The discourse analysis points to potentially ageist descriptions including older adults being vulnerable, incapable, and a financial burden. Nonetheless, older adults were also revealed to be significant contributors to the community including in paid employment, caregiving roles, and volunteering.