Effect of Physical Activity Counseling on Disability in Older People: A 2‐Year Randomized Controlled Trial

OBJECTIVES: To study the effect of a physical activity counseling intervention on instrumental activity of daily living (IADL) disability. DESIGN: Primary care–based, single‐blind, randomized controlled trial. SETTING: City of Jyväskylä, central Finland. PARTICIPANTS: Six hundred thirty‐two people aged 75 to 81 who were able to walk 500 meters without assistance, were at most moderately physically active, had a Mini‐Mental State Examination score greater than 21, had no medical contraindications for physical activity, and gave informed consent for participation. INTERVENTION: A single individualized physical activity counseling session with supportive phone calls from a physiotherapist every 4 months for 2 years and annual lectures on physical activity. Control group received no intervention. MEASUREMENTS: The outcome was IADL disability defined as having difficulties in or inability to perform IADL tasks. Analyses were carried out according to baseline IADL disability, mobility limitation, and cognitive status. RESULTS: At the end of the follow‐up, IADL disability had increased in both groups (P<.001) and was lower in the intervention group, but the group‐by‐time interaction effect did not reach statistical significance. Subgroup analyses revealed that the intervention prevented incident disability in subjects without disability at baseline (risk ratio=0.68, 95% confidence interval=0.47–0.97) but had no effect on recovery from disability. CONCLUSION: The physical activity counseling intervention had no effect on older sedentary community‐dwelling persons with a wide range of IADL disability, although it prevented incident IADL disability. The results warrant further investigation to explore the benefits of a primary care–based physical activity counseling program on decreasing and postponing IADL disability.     

Physical Activity and Executive Function in Aging: The MOBILIZE Boston Study

OBJECTIVES: To determine the relationship between physical activity and cognition, specifically executive function, and the possible mediating role of factors such as cardiovascular disease (CVD) and CVD risk factors, chronic pain, and depressive symptoms.
DESIGN: Cross-sectional study.
SETTING: Population-based study of individuals aged 70 and older in the Boston area.
PARTICIPANTS: Older community-dwelling adults (n=544; mean age 78, 62% female).  

MEASUREMENTS:

Presence of heart disease (self-reported physician diagnosed), pain, and depressive symptomatology were assessed using interviewer-administered questions. Blood pressure was measured. Engagement in physical activity was determined using the Physical Activity Scale for the Elderly (PASE). Cognitive function was measured using a battery of neuropsychological tests.
RESULTS: The older adults who engaged in more physical activity had significantly better performance on all cognitive tests, except for Letter Fluency and the memory test of delayed recall, after adjusting for age, sex, education, and total number of medications. With further adjustment for CVD and CVD risk factors (heart disease, diabetes mellitus, stroke, and hypertension), pain, and depressive symptoms, PASE score remained significantly associated with executive function tests.
CONCLUSION: Even after multivariate adjustment, neuropsychological tests that were executive in nature were positively associated with physical activity participation in this cohort of older community-dwelling adults. In contrast, delayed recall of episodic memory was not associated with physical activity, supporting the idea that the relationship with executive function represents a specific biologically determined relationship.     

Higher Pain Intensity,Depression, and Being 75 Years or Older are Associated with Lower Levels of Self-Reported Physical Activity in Older Adults with Pain Attending Primary Care

ABSTRACT

Objective: This study investigated whether pain characteristics (intensity, frequency, duration and number of pain sites), depression, age, sex and comorbidities are associated with lower levels of selfreported physical activity in older adults with pain at the primary healthcare setting.Methods: A total of 504 participants aged 60 years of age and over were assessed for: socio-demographics, comorbidities, pain, depression, and physical activity. Associations between these variables were investigated using ordinal logistic regression.Results: Reporting severe pain or worst imaginable pain, being older (≥ 75 years), and feeling depressed were significantly associated with lower physical activity in the univariate (OR = 2.33, 2.93, 2.31, and 2.23, respectively) and multivariate models (Adj OR = 2.21, 2.47, 2.49, and 1.97, respectively).Conclusions: Interventions aiming to increase physical activity for older adults in primary care should consider the needs of those reporting higher pain intensity, feeling depressed and who are 75 years or older.