This systematic review aims to evaluate the efficacy of cognitive and behavioral interventions for improving fall-related psychological concerns. A systematic search yielded eight randomized controlled trials eligible for inclusion. All studies compared a cognitive and behavioral intervention with a control. The meta-analysis showed that cognitive and behavioral treatments had beneficial effects on fear of falling outcomes (lower score better) immediately after treatment (random-effects standardized mean difference [SMD]: −0.3, 95% confidence interval [CI] [−0.50, −0.10]) and at the longer term follow-up (random-effects SMD: −0.29, 95% CI [−0.49, −0.09]). Cognitive and behavioral treatments also showed a positive effect on falls efficacy outcomes (higher score better) immediately after treatment (fixed-effects SMD: 0.19, 95% CI [0.04, 0.34]) and over the longer term (fixed-effects SMD: 0.13, 95% CI [−0.00, 0.25]). However, the clinical significance of these effects on fear of falling and falls efficacy was unclear. Further work is required with best-practice comparators over a longer follow-up period.
Angela Papadimitriou and Mark Perry
Mandy Peacock, Julie Netto, Polly Yeung, Joanne McVeigh and Anne-Marie Hill
Pet ownership is associated with increased levels of physical activity (PA) in older adults. Studies have mainly focused on the association between PA and dog walking; however, broader aspects of pet ownership may influence PA. The purpose of this study was to explore the association between pet ownership and incidental and purposeful PA using a mixed methods approach. Participants’ (N = 15) PA was measured for 7 days using accelerometers and diaries. Semistructured interviews explored participants’ perspectives regarding pet-related activities. Participants’ mean (SD) daily step count was 14,204 (5,061) steps, and mean (SD) sedentary time per day was 8.76 (1.18) hr. Participants strongly concurred that their pets were an integral part of their daily lives. Incidental and purposeful PA resulted from participants undertaking pet care and socially interacting with their pets. Pets may interrupt sedentary behaviors by nudging older adults to engage in PA as part of their daily lived experience.
Élvio R. Gouveia, Andreas Ihle, Bruna R. Gouveia, Matthias Kliegel, Adilson Marques and Duarte L. Freitas
Objective: To investigate the relations of balance to muscle mass (MM) and muscle strength (MS), depending on age and physical activity, which is of particular importance to functional independence in older people. Methods: This cross-sectional study included 802 volunteers (69.82 ± 5.60 years). The Fullerton Advanced Balance scale was used to assess balance and a composite score, including arm curl and chair stand tests for assessing MS. MM was estimated by dual-energy X-ray absorptiometry and physical activity by questionnaire. Results: Greater MM (r = .26, p < .001) and MS (r = .53, p < .001) were positively correlated to balance. The old-old adults and less active individuals attained lower balance. Notably, moderation and subsequent simple slope analyses revealed that the relations of balance, MM, and MS were larger in less active and the old-old adults. Conclusions: The old-old and less active adults were more prone to muscle weakness and balance impairments. Tailored interventions should particularly consider these vulnerable groups.
Matti Hyvärinen, Sarianna Sipilä, Janne Kulmala, Harto Hakonen, Tuija H. Tammelin, Urho M. Kujala, Vuokko Kovanen and Eija K. Laakkonen
Purpose: To investigate the validity and test–retest reliability of a single seven-level scale physical activity assessment question (SR-PA L7) and its three-level categorization (SR-PA C3). Methods: The associations of SR-PA L7 and C3 with accelerometer-measured leisure-time physical activity (ACC-LTPA) and with the results of four different physical performance tests (6-min walk [n = 733], knee extension [n = 695], vertical jump [n = 731], and grip force [n = 780]) were investigated among women aged 47–55 years participating in the Estrogenic Regulation of Muscle Apoptosis study (n = 795). The reliability was studied using Spearman correlations with 4-month test–retest period (n = 152). Results: SR-PA L7 and C3 had low correlations with ACC-LTPA (r s = .105–.337). SR-PA L7, SR-PA C3, and ACC-LTPA explained comparable but small amount of variance of the physical performance test results. The reliability analysis provided moderate agreement (r s = .707 and .622 for SR-PA L7 and C3, respectively). Conclusions: SR-PA L7 and C3 demonstrated limited validity and reasonable repeatability.
Christina E. Miyawaki, Rebecca L. Mauldin and Carolyn R. Carman
Exercise is important for older adults in order to prevent falls and live safer, healthier lives. Visual impairment is a risk factor for falling. Older adults tend to visit optometrists frequently; however, assessing patients’ physical exercise levels is not a routine practice for optometrists. The purpose of this study was to examine the potential for optometrists’ referrals to exercise programs. This study used a mixed-method, cross-sectional design. In focus groups, optometry patients (N = 42) discussed the acceptability of an optometrist’s prescription for exercise programs. The vast majority of optometry patients (90%) indicated that they would follow such a prescription for exercise from their optometrists. Texas optometrists (N = 268) were surveyed about the potential for exercise program prescriptions, and 97% indicated a willingness to prescribe exercise programs to their patients. The results suggest that there is an opportunity for community–clinical partnerships to prevent falls and to improve the health of older patients.