Pilot test of an attribution retraining intervention to raise walking levels in sedentary older adults

OBJECTIVES: To pilot test a new behavioral intervention to increase walking in sedentary older adults. DESIGN: Pre–post community‐based pilot study. SETTING: Three senior centers in greater Los Angeles. PARTICIPANTS: Forty‐six sedentary adults aged 65 and older. INTERVENTION: At four weekly 1‐hour group sessions held at the senior centers, a trained health educator applied a theoretically grounded, standardized “attribution retraining” curriculum developed by a multidisciplinary team of investigators. Participants were taught that becoming sedentary is not inevitable with aging and that older adults should attribute being sedentary to modifiable attributes rather than to old age. A 1‐hour exercise class including strength, endurance, and flexibility training followed each weekly attribution retraining session. MEASUREMENTS: Change from baseline in steps per week recorded using a digital pedometer was measured after 7 weeks. Age expectations (measured using the Expectations Regarding Aging‐38 survey, a previously tested instrument on which higher scores indicate that the participant expects high functioning with aging and lower scores indicate that the participant expects physical and mental decline) and health‐related quality of life were measured using in‐person interviews. RESULTS: Mean steps per week increased from 24,749 to 30,707, a 24% increase—equivalent to 2.5 miles (2‐sided t‐test P=.002). Age expectation scores increased 30% (P<.001), and the changes in age expectations and steps per week correlated (correlation coefficient=0.39, P=.01). Participants experienced improved mental health–related quality of life (P=.049) and reported less difficulty with activities of daily living (P=.04). More than 50% of participants reported improvements in pain, energy level, and sleep quality. CONCLUSION: In this small pre–post community‐based pilot study, a structured attribution retraining curriculum accompanied by a weekly exercise class was associated with increased walking levels and improved quality of life in sedentary older adults. Attribution retraining deserves further investigation as a potential means of increasing physical activity in sedentary older adults.     

Ethnic differences in expectations for aging among older adults

Age-expectations of 611 non-Latino white, African-American, and Latino seniors recruited at 14 community-based senior centers in the greater Los Angeles region were compared. Participants completed the Expectations Regarding Aging (ERA-38) Survey, a self-administered instrument with previously demonstrated reliability and validity for measuring age-expectations. Analysis of variance was used to compare unadjusted differences between scores across ethnic groups. To examine whether observed differences persisted after adjusting for health and sociodemographic characteristics, a series of linear regression models was constructed, with the dependent variable being total ERA-38 score and the primary independent variables being African-American and Latino ethnicity (reference group=white), adjusting for age, sex, physical and mental health-related quality of life (HRQoL), medical comorbidity, activity of daily living (ADL) impairments, depression, and education. Latinos had significantly lower overall age-expectations than non-Latino whites or African Americans after adjusting for age and sex (parameter estimate=-3.4, P=.01); this difference persisted after adjusting for health variables including medical comorbidity, HRQoL, ADL impairments, and depression. After adjusting for education, being Latino was no longer significantly associated with lower age-expectations (parameter estimate=-1.9, P=.18). Being African American was not significantly associated with age-expectations in any of the adjusted models. Younger age and better HRQoL were associated with higher age-expectations in all models. In conclusion, of these 611 older adults recruited at senior centers in the greater Los Angeles region, Latinos had significantly lower age-expectations than non-Latino whites and African Americans, even after adjusting for health characteristics, but differences in educational levels explained this difference.     

Characteristics of physical activity programs for older adults: results of a multisite survey

PURPOSE: Although increased participation in physical activity by older adults is a major public health goal, little is known about the supply and use of physical activity programs in the United States. DESIGN AND METHODS: Seven academic centers in diverse geographic areas surveyed physical activity programs for older adults. Five sites conducted surveys by mail with telephone follow-up, and two administered surveys primarily by telephone. Reported program attendance rates were compared with local census data to assess unmet needs. RESULTS: Of the 2,110 targeted facilities, 77% responded. Aerobic programs were offered by 73%, flexibility by 47%, and strength training by 26%. Commercial gyms or YMCAs, senior centers, park or recreation centers, and senior-housing facilities offered 90% of available programs. The 2000 Census enumerated 1,123,401 total older adults across the seven sites. Facilities reported 69,634 individuals as current weekly program participants, equaling 6% of the sites' total older-adult population. This percentage varied from 3% in Pittsburgh to 28% in Colorado. IMPLICATIONS: Based on conservative estimates of demand, the number of physical activity programs would have to increase substantially (by 78%) to meet the needs of older adults. The data also indicate the need to develop more strength-training programs and to engage a higher percentage of older adults in these programs. There is a clear need to stimulate demand for programs through health promotion.     

Physical activity and health outcomes in persons with haemophilia B

Regular participation in physical activity helps to prevent damage and maintain joint health in persons with haemophilia. This study describes self‐reported physical activity participation among a sample of people with haemophilia B in the US and measures its association with health‐related quality of life (HRQoL). Data on 135 participants aged 5–64 years were abstracted from Hemophilia Utilization Group Study Part Vb. The International Physical Activity Questionnaire assessed physical activity among participants aged 15–64 years, and the Children's Physical Activity Questionnaire abstracted from the Canadian Community Health Survey was used for participants aged 5–14 years. SF‐12 was used to measure HRQoL and the EuroQol (EQ‐5D‐3L) was used to measure health status for participants older than 18 years of age. PedsQL was used to measure HRQoL in children aged 5–18 years. Sixty‐two percent of participants in the 15–64 year‐old age cohort reported a high level of physical activity, 29% reported moderate activity and 9% reported low activity. For children aged 5–14 years, 79% reported participating in physical activity for at least 4 days over a typical week. Based on the 2008 Physical Activity Guidelines for Americans, 79% of adults achieved the recommended physical activity level. Multivariable regression models indicated that adults who engaged in a high level of physical activity reported EQ‐5D Visual Analogue Scale (VAS) scores that were 11.7 (P = 0.0726) points greater than those who engaged in moderate/low activity, indicating better health outcomes. Among children, no statistically significant differences in health outcomes were found between high and moderate or low activity groups.     

A randomized controlled clinical trial of the Seattle Protocol for Activity in older adults

OBJECTIVES: To compare the efficacy of a physical activity program (Seattle Protocol for Activity (SPA)) for low‐exercising older adults with that of an educational health promotion program (HP), combination treatment (SPA+HP), and routine medical care control conditions (RMC). DESIGN: Single‐blind, randomized controlled trial with two‐by‐two factorial design. SETTING: Community centers in King County, Washington, from November 2001 to September 2004. PARTICIPANTS: Two hundred seventy‐three community‐residing, cognitively intact older adults (mean age 79.2; 62% women). INTERVENTIONS: SPA (in‐class exercises with assistance setting weekly home exercise goals) and HP (information about age‐appropriate topics relevant to enhancing health), with randomization to four conditions: SPA only (n=69), HP only (n=73), SPA+HP (n=67), and RMC control (n=64). Active‐treatment participants attended nine group classes over 3 months followed by five booster sessions over 1 year. MEASUREMENTS: Self‐rated health (Medical Outcomes Study 36‐item Short‐Form Survey) and depression (Geriatric Depression Scale). Secondary ratings of physical performance, treatment adherence, and self‐rated health and affective function were also collected. RESULTS: At 3 months, participants in SPA exercised more and had significantly better self‐reported health, strength, and general well‐being (P<.05) than participants in HP or RMC. Over 18 months, SPA participants maintained health and physical function benefits and had continued to exercise more than non‐SPA participants. SPA+HP was not significantly better than SPA alone. Better adherence was associated with better outcomes. CONCLUSION: Older adults participating in low levels of regular exercise can establish and maintain a home‐based exercise program that yields immediate and long‐term physical and affective benefits.     

Effects of Active Learning Education on Arterial Stiffness of Older Adults with Low Health Literacy: A Randomized Controlled Trial

Aim: We examined the effects of active learning education on arterial stiffness and physical activity of community-dwelling older adults with low health literacy. Methods: This study is a secondary analysis of randomized controlled trial of 60 participants aged 65 and older with low health literacy. The intervention group ( n =30) participated in a weekly 90-minute active learning program session for 24 weeks, which addressed health promotion in older age. The control group ( n =30) attended a 90-minute health education class in a didactic manner. The outcomes were measured at baseline and in week 24. The degree of arterial stiffness was assessed based on the cardio-ankle vascular index (CAVI) using the VS-1500 device (Fukuda Denshi Co., Ltd., Tokyo, Japan). The shortened version of the self-reported International Physical Activity Questionnaire was used to assess the amount of total physical activity determined by the metabolic equivalent hours per week. We used analysis by intention-to-treat, with multiple imputation for missing data. Results: Seven participants (11.7%) dropped out prior to the post-intervention assessment. The multiple imputation analysis revealed that the intervention group showed significant improvement in CAVI [between-groups difference (95% confidence interval)=-0.78 (-1.25 to -0.31), Cohen’s d =0.82] and physical activity [32.5 (0.3 to 64.7), Cohen’s d =0.57] as compared with the control group. The sensitivity analysis for the complete cases showed similar results. Conclusion: Active learning health education may be effective in improving arterial stiffness and physical activity in older adults with low health literacy.     

Activating Seniors to Improve Chronic Disease Care: Results from a Pilot Intervention Study

OBJECTIVES: To evaluate the effect of an activation intervention delivered in community senior centers to improve health outcomes for chronic diseases that disproportionately affect older adults. DESIGN: Two‐group quasi‐experimental study. SETTING: Two Los Angeles community senior centers. PARTICIPANTS: One hundred sixteen senior participants. INTERVENTION: Participants were invited to attend group screenings of video programs intended to inform about and motivate self‐management of chronic conditions common in seniors. Moderated discussions reinforcing active patient participation in chronic disease management followed screenings. Screenings were scheduled over the course of 12 weeks. MEASUREMENTS: One center was assigned by coin toss to an encouragement condition in which participants received a $50 gift card if they attended at least three group screenings. Participants in the nonencouraged center received no incentive for attendance. Validated study measures for patient activation, physical activity, and health‐related quality of life were completed at baseline and 12 weeks and 6 months after enrollment. RESULTS: Participants attending the encouraged senior center were more likely to attend three or more group screenings (77.8% vs 47.2%, P=.001). At 6‐month follow‐up, participants from either center who attended three or more group screenings (n=74, 64%) reported significantly greater activation (P<.001), more minutes walking (P<.001) and engaging in vigorous physical activity (P=.006), and better health‐related quality of life (Medical Outcomes Study 12‐item Short‐Form Survey (SF‐12) mental component summary, P<.001; SF‐12 physical component summary, P=.002). CONCLUSION: Delivering this pilot intervention in community senior centers is a potentially promising approach to activating seniors that warrants further investigation for improving chronic disease outcomes.     

Physical activity level and sedentary time determinants among Moroccan hypertensive patients

IntroductionHypertension is closely associated with an inactive lifestyle. Physical activity and/or exercise have been shown to delay the development of hypertension. This study aimed to assess the level of physical activity and sedentary time, and its determinants among Moroccan Hypertensive patients.Patients and methodsA cross-sectional study was conducted between March and July 2019 including 680 hypertensive patients. We administered international physical activity questionnaire in face-to-face interview to assess the level of physical activity and sedentary time.ResultsThe results showed that only 43.4% of participants met recommended physical activity levels (≥ 600 MET min/week). Adherence to physical activity recommendations was observed more in male participants (p = 0.035), in participants aged less than 40 years (p = 0.040) and those aged between 41 and 50 years (p = 0.047). The average sedentary time was 37.19 ± 18.92 hours per week. This time was significantly longer in people aged 51 and over, in married, divorced, and widowed people, and in those with low levels of physical activity.ConclusionsThe level of physical inactivity and the sedentary time was high. In addition, participants with a high-level sedentary lifestyle had a low level of physical activity. Educational actions should be undertaken among this group of participants to prevent the risks associated with inactivity and sedentary behavior.     

Habitual physical activity differentially affects acute and short-term energy intake regulation in young and older adults

BACKGROUND: Energy intake (EI) regulation is impaired in older adults, but it is not known if habitual physical activity affects accuracy of EI regulation in older compared with young adults. OBJECTIVE: We hypothesized that the ability to compensate for a high-energy yogurt preload beverage at a subsequent ad libitum meal (i.e. acute compensation) and over the course of the testing day (i.e. short-term compensation) would decrease with age, but the magnitude of the decline would be smaller in physically active compared with sedentary older adults. DESIGN: On two occasions, young active (n=15), young sedentary (n=14), older active (n=14) and older sedentary (n=11) subjects consumed either a high-energy yogurt preload beverage (YP: 500 ml, 1988 kJ, men; 375 ml, 1507 kJ, women), or no preload (NP), 30 min before an ad libitum test meal. EI at both ad libitum meals was measured, and total daily EI was determined on both testing days. Percent EI compensation for the YP was calculated for the test meal and testing day to determine acute and short-term compensation. RESULTS: Percent EI compensation at the test meal was significantly lower in the older compared with the young subjects (65+/-4 vs 81+/-4%, P=0.005). There was no effect of habitual physical activity level on acute compensation, and no age by physical activity level interaction (P=0.60). In contrast, short-term compensation was not different with age (87+/-5 vs 93+/-6%, older vs young, P=0.45), but was more accurate in active vs sedentary subjects (100+/-5 vs 79+/-6%, P=0.01). As with acute compensation, there was no age by physical activity interaction (P=0.39). CONCLUSION: Acute EI regulation is impaired in older adults, which is not attenuated by physical activity status. However, EI regulation over the course of a day is more accurate in active vs sedentary adults, which may facilitate long-term energy balance. Future work is needed to determine if higher energy expenditure in older active vs older sedentary adults improves long-term EI regulation.     

Moderate-Vigorous Physical Activity in Older People in Northern Ireland: Levels, Demographic Patterns and Types of Moderate-Vigorous Physical Activity Undertaken

Work on the health benefits of physical activity currently recommends participation in 2.5 h of moderate-vigorous physical activity/week, and advocates consideration of the physical activity gained from activities of daily living in this total. Using the inclusion of activities of daily living, this analysis aimed to investigate the physical activity undertaken by a representative sample of older people living in Northern Ireland (NI). Using a telephone questionnaire, 426 individuals (representative of the NI older population) reported participating in a mean 4.1?±?6.3 h of moderate–vigorous physical activity/week, but 225 (53 %) of these individuals reported participation in less than 2.5 h of moderate-vigorous activity/week, and 126 of these individuals reported none. Regression analyses revealed greater participation by males, younger individuals and those living in less deprived areas (smallest B?=??0.11, p?=?0.03). Males were also found to participate in more Do-It-Yourself, cycling, heavy gardening and exercise/sport in summer and less heavy housework, than females (smallest B?=??0.03, p?=?0.05), but no differences were found dependent on age or deprivation of residential area. These findings suggest a need to increase participation in moderate-vigorous physical activity in this population, with specific emphasis on females, older individuals and those living in more deprived areas. Analysis of the types of moderate-vigorous physical activity undertaken suggests that females may benefit particularly from increased opportunity or promotion of exercise/sport as a leisure activity.     

Depressive symptoms and physical performance in the lifestyle interventions and independence for elders pilot study

OBJECTIVES: To determine whether the presence of high depressive symptoms (Center for Epidemiologic Studies Depression Scale (CES‐D) score ≥14) diminished physical performance benefits after a comprehensive physical activity intervention in older adults. DESIGN: A post hoc analysis of data from the Lifestyle Interventions and Independence for Elders Pilot (LIFE‐P) study, a single‐blind randomized controlled trial comparing a moderate‐intensity physical activity intervention (PA) with a successful aging control (SA). SETTING: Multicenter U.S. institutions participating in the LIFE‐P trial. PARTICIPANTS: Four hundred twenty‐four sedentary, noninstitutionalized adults aged 70 to 89. MEASUREMENTS: Depressive symptoms were assessed using the CES‐D. Physical performance tests included the Short Physical Performance Battery (SPPB) and 400‐m walk time (400 mw) at baseline and 6 and 12 months. RESULTS: Of the participants, 15.8% had high depressive symptom scores (CES‐D ≥14). For participants with low depressive symptoms, SPPB scores improved more in the PA than the SA group over 12 months (adjusted score difference +0.70; P<.001 at 6 months and +0.58; P=.004 at 12 months), and 400 mw times improved in the PA group at 6 months (adjusted score difference ?0.41 minutes; P=.02). For participants with high depressive symptoms, the difference in improvement fell short of statistical significance on the SPPB between the PA and SA groups (adjusted score difference +0.76 (P=.18) at 6 months and +0.94 (P=.12) at 12 months). CONCLUSION: The presence of high depressive symptoms did not substantially diminish physical performance benefits realized after a PA intervention in sedentary older adults.     

Health contract with sedentary older adults

PURPOSE: Health educators used health contracts with sedentary older adults for the purpose of increasing exercise or physical activity. DESIGN AND METHODS: Two health educators helped 25 sedentary older adults complete health contracts, and then they conducted follow-up evaluations. The percentage of scheduled exercise sessions successfully completed by older adults was calculated. Participants were asked if each of five components of the health contract-motivation, goal setting, social support, memory techniques, and problem solving-was helpful in achieving their exercise goals. RESULTS: Of the 25 participants, 20 achieved at least 75% of their exercise goals and 15 had a 100% success rate. Most of the older adults reported that several behavioral, social, and cognitive strategies were helpful to them. IMPLICATIONS: This technique may be applied by health educators or clinicians in a variety of settings and can be focused on one of several potential risk factors.     

Effectiveness of physical activity and sedentary behaviour interventions in altering sedentary behaviour among older adults: a systematic review

Background

Long and frequent bouts of sedentary behaviour pose a major risk to health and increase the incidence of hypokinetic diseases and mortality, independent of the risks caused by physical inactivity alone. The aim of this systematic review was to determine the effectiveness of interventions used by researchers in altering sedentary behaviour among adults aged 60 years or older.

Intergenerational relations: pre-med students at senior centers

Misconceptions about aging and a negative bias against caring for older adults entail unfortunate consequences for society. This study explored the potential of frequent personal contact in reducing misconceptions and improving personal attitude towards older adults. Thirty students, predominantly Asian, with English as their second language, attended senior centers three times per week for 11 months, on the average. They assisted in teaching health promotion classes for the prevention of falls, conducted health assessments by interview, and collected physiological data. At the senior centers, a sample of 70 older adult Americans participated in the health promotion classes and in this evaluation of intergenerational relations. Students completed anonymously two questionnaires; one was objective, testing misconceptions about aging; the other was subjective, rating their reactions to elders at senior centers. Older adults completed, also anonymously, a subjective questionnaire on their reactions to students at their centers. Results on students' misconceptions about aging were similar to those among students at Duke University who did not experience frequent personal contact with well elderly. According to the Facts on Aging Quiz, the overall attitude among students at senior centers was more biased in the negative direction than among Duke students, especially among students who had just joined the project. However, in the subjective questionnaires, students at senior centers expressed feeling at ease at the centers and they disagreed with statements of impatience and frustration. Older adults at the centers had a positive attitude toward the students and most thought that students were sympathetic.     

The level of willingness to evacuate among older adults

The issues of rising numbers of disasters, overwhelming increases in number of older adults, and historically flawed evacuations present real challenges. During the next two decades, the number of American baby boomers, who turn 65, will increase by 40%. As evidenced by recent disasters, the imperfections and vulnerabilities of flawed evacuations for older adults are still present. This study examined the level of willingness to evacuate among older adults in the event of a disaster. Despite the extensive literature on disasters and evacuation, a significant question regarding evacuation and older adults has not been addressed. The study addressed the following concern: What is the level of willingness among older adults to evacuate when asked to do so by emergency management officials? The sample population consisted of 765 voluntary participants aged 60 years and older from 30 senior/community centers within seven counties within a midwestern state. A group administered survey (The Disaster Evacuation Survey) included a total of 15 questions. The findings revealed that older adults are more likely to comply with a mandatory evacuation order. Important practical implications for emergency officials responding to vulnerable older adults in disaster situations are also provided.     

Low-intensity exercise and reduction of the risk for falls among at-risk elders

BACKGROUND: Among elderly persons, falls account for 87% of all fractures and are contributing factors in many nursing home admissions. This study evaluated the effect of an easily implemented, low-intensity exercise program on the incidence of falls and the time to first fall among a clinically defined population of elderly men and women. METHODS: This community-based, randomized trial compared the exercise intervention with a no-intervention control. The participants were 294 men and women, aged 60 years or older, who had either a hospital admission or bed rest for 2 days or more within the previous month. Exercise participants were scheduled to attend exercise sessions lasting 45 minutes, including warm-up and cool-down, 3 times a week for 8 weeks (24 sessions). Assessments included gait and balance measures, self-reported physical function, the number of medications being taking at baseline, participant age, sex, and history of falling. Falls were tracked for 1 year after each participant's baseline assessment. RESULTS: 29% of the study participants reported a fall during the study period. The effect of exercise in preventing falls varied significantly by baseline physical function level (p < or =.002). The risk for falls decreased for exercise participants with low baseline physical functioning (hazard ratio,.51) but increased for exercise participants with high baseline physical functioning (hazard ratio, 3.51). CONCLUSIONS: This easily implemented, low-intensity exercise program appears to reduce the risk for falls among elderly men and women recovering from recent hospitalizations, bed rest, or both who have low levels of physical functioning.     

Happiness and Humor Group Promotes Life Satisfaction for Senior Center Participants

ABSTRACT

The impact of positive psychological attitudes on physical health and healthy aging has been well documented through research. This study assessed whether a therapeutic recreation program specifically addressing happiness and humor could promote life satisfaction among older adults. The Happiness and Humor Group was a 10-week program conducted once a week at an urban senior center. The Life Satisfaction Scale (LSS) was administered as a pretest and posttest to 15 people who participated in the entire program. Scores from this self-rated assessment showed significant improvement in life satisfaction for the program participants. Anecdotal evidence also shows participants' outlook changed significantly as a result of program participation. An overview of the Happiness and Humor Group program is provided as a model that can be replicated in senior centers.     

Bright light treatment decreases depression in institutionalized older adults: a placebo-controlled crossover study

BACKGROUND: An important parallel exists between patients with seasonal affective disorder and institutionalized older adults. Many older patients, as a result of global physical decline and immobility, are confined to their rooms, experiencing little natural sunlight. Thus, institutionalized older adults are at risk for chronic light deprivation. Testing the hypothesis that chronic light deprivation might be responsible, at least in part, for some depression among institutionalized older adults, the aim of this study was to investigate the efficacy of morning bright light treatment on depression among older adults residing in a long-term care facility. METHODS: In a placebo controlled, crossover design, participants (N = 10, six women and four men; M age = 83.8) received each of the following: (i) 1 week (5 days) of 10,000 lux (therapeutic dose); (ii) 1 week (5 days) of 300 lux (placebo); or 1 week of no treatment (control). Each week of light treatment was 5 consecutive days, 30 minutes daily, with a wash-out period consisting of 1 week between conditions. RESULTS: Geriatric Depression Scale (GDS) scores at baseline during all treatment conditions were positively correlated (r = .81, p < .01) with months of institutionalization, where participants with higher GDS scores experienced more time institutionalized. Scores on the GDS remained unchanged during the placebo and control conditions, but depression scores decreased significantly during the 10,000 lux treatment (pretest GDS M = 15 vs posttest GDS M = 11, p < .01). After the 10,000 lux treatment, 50% of the participants no longer scored in the depressed range. Improvement during the 10,000 lux condition was positively correlated (r = .62, p < .05) to baseline GDS scores, where participants with higher GDS scores experienced greater improvement following the 10,000 lux treatment. CONCLUSIONS: The results of the present study suggest that bright light treatment may be effective among institutionalized older adults, providing nonpharmacological intervention in the treatment of depression. Furthermore, the length of institutionalization may play an important role in determining the efficacy of bright light treatment for older adults in the nursing-home setting.     

Older Australians and physical activity levels: Do we know how many are meeting guidelines?

Aim: Current recommendations suggest that older Australians (defined here as ≥65 years of age) should, for health benefits, accumulate 30 minutes of at least moderate intensity physical activity on most days each week. The aim of this study was to determine the proportion who meets this recommendation. Method: Systematic review of scholarly journals published between 1 January 2000 and 5 October 2010. Results: Of 357 potentially relevant papers, 22 met the study criteria. Estimates from the 15 studies with samples >500 suggest that between 25% and 55% of Australians ≥65 years were meeting guidelines, but in these studies definitions, measures and age ranges of participants varied widely. Discussion: Because of the heterogeneity of samples, measures and definitions, it is not possible to estimate with confidence the proportion of older adults in Australia who meet current physical activity recommendations.     

Oral health problems and significant weight loss among community-dwelling older adults

BACKGROUND: Studies of hospitalized and institutionalized older adults suggest a relationship between poor oral health and subsequent weight loss. Given the association between weight loss and subsequent mortality and morbidity, we evaluated how oral health problems contributed to significant weight loss over a 1-year period among a representative sample of community-dwelling older adults. METHODS: The study population consisted of 563 adults aged 70 years and older living at home in rural and urban areas in six New England states. Baseline data included information regarding health status, functional status, physical activity, disease diagnoses, lifestyle behaviors, and cognitive and affective status. Dentists performed oral health assessments. One year later, participants were called and asked questions regarding their health and dietary practices and their current weight. RESULTS: Over the 1-year period of follow-up, approximately one third of the sample had lost 4% or more of their previous total body weight; 6% of men and 11% of women lost 10% or more of their previous body weight. Of the subjects, 37% were edentulous; most of these individuals wore full dentures. With gender, income, advanced age, and baseline weight controlled for, edentulousness remained an independent risk factor for significant weight loss (odds ratio 1.63 for 4% weight loss and 2.03 for 10% weight loss). Individuals with increasing numbers of posterior teeth and functional units were at slightly lower risk for weight loss; however, these associations did not reach statistical significance. CONCLUSIONS: Dentate status is an important risk factor for clinically significant weight loss among community-dwelling older adults.