Association between physical activity and brain health in older adults

In the present cross-sectional study, we examined physical activity (PA) and its possible association with cognitive skills and brain structure in 331 cognitively healthy elderly. Based on the number of self-reported light and hard activities for at least 30 minutes per week, participants were assigned to 4 groups representing different levels of PA. The cognitive skills were assessed by the Mini Mental State Examination score, a verbal fluency task, and the Trail-making test as a measure of visuospatial orientation ability. Participants also underwent a magnetic resonance imaging of the brain. Multiple regression analysis revealed that greater PA was associated with a shorter time to complete the Trail-making test, and higher levels of verbal fluency. Further, the level of self-reported PA was positively correlated with brain volume, white matter, as well as a parietal lobe gray matter volume, situated bilaterally at the precuneus. These present cross-sectional results indicate that PA is a lifestyle factor that is linked to brain structure and function in late life.     

Comparison of influenza hospitalization outcomes among adults,older adults,and octogenarians: a US national population-based study

ObjectivesThis study sought to more fully elucidate the age-related trends in influenza mortality with a secondary goal of uncovering implications for treatment and prevention.MethodsIn this retrospective cohort analysis of data from the Nationwide Readmission Database, patients with influenza as a primary or secondary discharge diagnosis were separated into three age groups: 55 638 adults aged 20–64 years, 36 862 adults aged 65–79 years and 41 806 octogenarians aged ≥80 years. Propensity score (PS) weighting was performed to isolate age from other baseline differences. Crude and PS-weighted hazard ratios (HR) were calculated from the in-hospital all-cause 30-day mortality rate. Admission threshold bias was minimized by comparison of influenza with bacterial pneumonia mortality.ResultsAdults aged 20–64 years experienced higher in-hospital 30-day mortality compared with older adults aged 65–79 years (HR 0.66; 95% CI 0.55–0.79). Octogenarians had the highest mortality rate, but this was statistically insignificant compared with the adult cohort (HR 1.09; 95% CI 0.94–1.27). This trend was not explained by admission threshold bias: the 30-day mortality rate due to in-hospital bacterial pneumonia increased consistently with age (older adult HR 1.45; 95% CI 1.32–1.59; octogenarian HR 1.99; 95% CI 1.82–2.18).ConclusionsAdults aged 20–64 years and octogenarians were more likely to experience all-cause 30-day mortality during influenza hospitalization compared with older adults aged 65–79 years. These data emphasize the importance of prevention and suggest the need for more tailored treatment interventions based on risk stratification that includes age.     

Self-reported physical and mental health of older adults: the roles of caregiving and resources

Objectives

This study examined factors associated with self-reported physical and mental health, focusing on caregiving status and the availability of social supports and financial resources.

Methods

Two bivariate analyses were performed to examine the sociodemographic characteristics as well as perceived health outcomes among caregiving and non-caregiving participants. Two-equation probit models were used to determine independent predictors of self-reported physical and mental health, using data from 1071 community-based adults (≥60 years). An additional bivariate analysis was conducted to investigate the characteristics of caregivers who reported better physical health.

Results

Approximately 17% (n = 183) of respondents reported being caregivers, and those in caregiving roles tended to be ethnic minorities, married, and have telephone communication with family or friends on a daily basis. Better physical and mental health outcomes were common for caregivers and non-caregivers who reported having more resources (e.g., higher income, better preparedness for future financial need, higher satisfaction with transportation and housing, and no limitation of usual daily activities). However, sociodemographic and social support factors were not significantly associated with physical and mental health among caregivers, unlike their non-caregiver counterparts. In the probit model, caregivers were more likely to be physically healthy compared to non-caregivers (Coefficient = 0.34; p-value = 0.031). Compared with healthy non-caregivers (n = 631), healthy caregivers (n = 141) tended to be ethnic minorities, married, and have telephone communication with family or friends on a daily basis.

Conclusions

Findings suggest that preparing resources and maintaining strong social support systems may foster health status among older family caregivers.     

Suspiciousness, health, and mortality: a follow-up study of 500 older adults

Scores on Factor L of the 16 PF, a measure of suspiciousness that is closely related to the Cook and Medley hostility scale, predicted survival in a sample of 500 older men and women during a follow-up of approximately 15 years. Those individuals with scores indicating higher levels of suspiciousness had greater mortality risk. This association remained significant after controlling for age, sex, physician's ratings of functional health, smoking, cholesterol, and alcohol intake. In addition, Factor L was associated with physician's ratings of health at the initiation of follow-up. These findings add to the weight of evidence that implicates a set of negative interpersonal attitudes in the domain of hostility, anger, cynicism, and mistrust as a prospective marker of individuals at risk for adverse health outcomes.     

Motivating and assisting physical exercise in independently living older adults: A pilot study

BackgroundWith age reaction time, coordination and cognition tend to deteriorate, which may lead to gait impairments, falls and injuries. To reduce this problem in elderly and to improve health, well-being and independence, regular balance and strength exercises are recommended. However, elderly face strong barriers to exercise.ObjectiveWe developed Active Lifestyle, an IT-based system for active and healthy aging aiming at improving elderly's balance and strength. Active Lifestyle is a proactive training application, running on a tablet, which assists, monitors and motivates elderly to follow personalized training plans autonomously at home, while integrating them socially. The objective is to run a pilot study to investigate: (i) the feasibility of assisting the autonomous, physical training of independently living elderly with the Active Lifestyle system, (ii) the adherence of the participants to the training plans, and (iii) the effectiveness of the motivation instruments built into the system.MethodsAfter three introductory meetings, 13 elderly adults followed personalized two-weeks strength and balance training plans using the Active Lifestyle app autonomously at home. Questionnaires were used to assess the technological familiarity of the participants, the feasibility aspects of the physical intervention, and the effectiveness of the motivation instruments. Adherence to the exercise plan was evaluated using the performance data collected by the app during the study.ResultsA total of 13 participants were enrolled, of whom 11 (85%) completed the study (mean age 77 ± 7 years); predominantly females (55%), vocational educated (64%), and their past profession requiring moderate physical activity (64%). The Active Lifestyle app facilitated autonomous physical training at home (median = 7 on a 7-point Likert scale), and participants expressed a high intention to use the app also after the end of the study (median = 7). Adherence with the training plans was 73% (89% on the balance exercises and 60% on the strength exercises). The outcome from our questionnaires showed that without the app the participants did not feel motivated to perform exercises; with the support of the app they felt more motivated (median = 6). Participants were especially motivated by being part of a virtual exercise group and by the capability to automatically monitor their performance (median = 6 for both).ConclusionsThis study shows that the Active Lifestyle app prototype has valuable potential to support physical exercise practice at home and it is worthwhile to further develop it into a more mature system. Furthermore, the results add to the knowledge base into mobile-based applications for elderly, in that it shows that elderly users can learn to work with mobile-based systems. The Active Lifestyle app proved viable to support and motivate independently living elderly to autonomously perform balance and strength exercises.     

Atopy in Norwegian and Russian adults: a population-based study from the common border area

Background: Several studies have concluded that atopy is more common in Western than in Eastern Europe. We aimed to study whether a similar difference exists between Norwegian and Russian adults living in geographically adjacent areas. Methods: A cross‐sectional population‐based study was performed in Sør‐ Varanger municipality (Norway) and in the cities of Nikel and Zapolyarny (Russia). The Russian cities are heavily polluted by sulfur dioxide from local nickel industry. In addition to questionnaire information, results on IgE sensitization (S‐Phadiatop, Pharmacia & Upjohn, Uppsala, Sweden) were obtained from 3134 Norwegian and 709 Russian participants. Results: A positive Phadiatop was found in 20.7% of the Norwegians (men 21.9%, women 19.7%) and in 27.5% of the Russians (men 35.7%, women 23.0%); the sex‐ and age‐adjusted relative risk of testing positive in Russia being 1.49 (95% CI 1.23–1.81). The Norwegian participants reported more atopic dermatitis and hay fever, although this difference was statistically significant only for atopic dermatitis in women. Conclusion: IgE sensitization was more common in Russia than in Norway, unlike findings from other east–west European studies. The Russians did not, however, report more atopic diseases. This discrepancy might reflect different awareness of allergies in the two countries and demonstrates the need for objective markers of atopy when comparing prevalence in different populations.     

Changes in depression and physical decline in older adults: a longitudinal perspective

BACKGROUND: The impact of chronicity and changes in depression on physical decline over time in older persons has not been elucidated. METHODS: This prospective cohort study of 2121 community-dwelling persons aged 55-85 years uses two measurement occasions of depression (CES-D scale) over 3 years to distinguish persons with chronic, remitted, or emerging depression and persons who were never depressed. Physical function is assessed by self-reported physical ability as well as by observed performance on a short battery of tests. RESULTS: After adjustment for baseline physical function, health status and sociodemographic factors, chronic depression was associated with significantly greater decline in self-reported physical ability over 3 years when compared to never depressed persons (odds ratio (OR)=2.83, 95% confidence interval (CI)=1.86-4. 30). In the oldest old, but not in the youngest old, chronic depression was also significantly predictive of greater decline in observed physical performance over 3 years (OR=2.22, 95% CI=1.43-3. 79). Comparable effects were found for older persons with emerging depression. Persons with remitted depression did not have greater decline in reported physical ability or observed performance than persons who were never depressed. CONCLUSIONS: Our findings among community-dwelling older persons show that chronicity of depression has a large impact on physical decline over time. Since persons with remitted depression did not have greater physical decline than never depressed persons, these findings suggest that early recognition and treatment of depression in older persons could be protective for subsequent physical decline.     

The influence of primary health care professionals in encouraging exercise and physical activity uptake among White and South Asian older adults: Experiences of young older adults

Objective

To explore the influence of primary health care professionals in increasing exercise and physical activity among 60–70-year-old White and South Asian community dwellers.

Method

Fifteen focus groups and 40 in-depth interviews with community dwelling White and South Asian 60–70-year olds. The sample was selected to include people with very different experiences of participation and non-participation in exercise and physical activity. Data were analysed using framework analysis.

Results

Primary health care professionals’ advice and support was found to be a motivator to the initiation of exercise and physical activity. However, this was usually in relation to advice on weight reduction, cardiac conditions and mobility issues, but not generally to improve or increase activity levels. An underlying attitude of genuine interest and empathy was valued and shaped decisions about initiating and/or increasing activity levels.

Conclusion

Primary health care professionals should be encouraged to show interest and empathy with older people about the positive benefits of exercise and physical activity to them individually. This advice needs to be tailored to the older adult's symptoms.

Practice implications

Primary health care professionals need to be able to provide specific advice as to the quantity (frequency, duration, intensity and type) of exercise or physical activity to undertake. Practitioners need to listen to their patients’ needs, show empathy and avoid ageism during consultations.     

Sexual assault disclosure in relation to adolescent mental health: results from the National Survey of Adolescents.

Child sexual assault is a risk factor for a wide range of emotional and behavioral problems. Little is known about mental health functioning in relation to victims' decisions to tell someone (or not) about their assault. This study used data from a nationally representative sample of 4,023 adolescents to examine the relation between sexual assault disclosure characteristics and mental health outcomes. Results indicated that youth who disclosed the assault to someone within 1 month were at reduced risk for current major depressive episode (MDE) and delinquency. No relation was found between disclosure latency and risk for posttraumatic stress disorder (PTSD) or substance use problems. Notably, disclosure to mothers was associated with significantly reduced risk for current PTSD and delinquency.     

Eczema, atopy and allergen exposure in adults: a population-based study

BACKGROUND: There are few published studies on geographical variation in prevalence of eczema in adults or its association with recognised risk factors for allergic disease. OBJECTIVE: To describe the geographical variation in prevalence of eczema in adults, assess the associations with sociodemographic risk factors, serum-specific IgE and IgG, and exposure to allergen. METHODS: A community-based sample of 8206 adults aged 27-56 years, in 25 European centres and Portland, USA, provided questionnaire information on symptoms of eczema. Serum-specific IgE to house dust mite (HDM), cat, grass and Cladosporium, and IgG and IgG4 to HDM and cat were measured. Mattress levels of mite and cat allergen were assessed. RESULTS: Overall prevalence of eczema was 7.1% (range between countries of 2.2-17.6%). Eczema was associated with female gender [odds ratio (OR) 1.25; 95% confidence interval (CI) (1.01-1.55)], family history of atopic disease (OR 1.43; 95% CI 1.18-1.74), IgE sensitization to at least one allergen (OR 1.50; 95% CI 1.19-1.90), particularly Cladosporium (OR 3.65; 95% CI 1.81-7.37), and total IgE. Eczema was negatively associated with age and no clear associations were observed with sibship size, mattress mite and cat allergen levels or with cat and HDM-specific IgG or IgG4. CONCLUSIONS: There is geographical variation in the prevalence of eczema in adults both within and between countries. Although the disease is associated with IgE sensitization, in this study it was not related to mattress mite or cat allergen levels.     

Determinants of initiation and maintenance of physical activity among older adults: a literature review

Abstract

Understanding the determinants of changing physical activity among older adults is crucial for effective intervention development. The aim of this study was to review and update the evidence relating to the determinants of physical activity initiation and maintenance among older adults, and to explore the main similarities and dissimilarities in determinants between the two phases. Only longitudinal and experimental studies were used to assess the level of evidence. Fifty-nine longitudinal observational and experimental studies were identified. Recent studies were identified that focused on some recently developed concepts, especially in the field of the post-motivational concepts and several environmental determinants in predicting physical activity initiation and maintenance. Furthermore, dissimilarities were found in determinants between physical activity initiation and maintenance. It can be concluded that determinants are to a large degree phase-specific, which should be taken into account during further investigation, theory development and intervention development. Further investigation is needed to study the importance of promising concepts, such as post-motivational and environmental determinants. Recommendations for further empirical research, theory development and intervention development are outlined in this review.     

Improved physical function and physical activity in older adults following a community-based intervention: Relationships with a history of depression

The purpose of this study was to explore the relationship of a history of depression with moderate physical activity and physical function before and after a physical activity intervention of congregate meal participants in senior centers from all 12 Georgia Area Agencies on Aging (AAA). Participants were a convenience sample of older adults (n=376, mean age=76 years, 82% female, 64% Caucasian, 36% African American, 22% a history of depression). The physical activity intervention included educator-led chair exercises that incorporated balls and bands. Pre- and post-tests assessed moderate physical activity and physical function. At the pre-test, a history of depression was not related to moderate physical activity or physical function. Following the intervention there were significant increases in both moderate physical activity and physical function, but a history of depression was a negative predictor of improvements in physical activity when controlled for site, demographics, and health-related conditions. These results provide an evidence base for the effectiveness of this intervention in improving moderate physical activity and physical function in a community setting, but additional efforts may be needed to improve the impact of this type of intervention among older adults with a history of depression.