Physical activity improves strength, balance and endurance in older adults

Question

Can physical activity in adults aged 40–65 years enhance strength and balance and prevent falls?

What was done?

Systematic review with meta-analysis of all published randomised clinical trials of the effects of physical activity on strength, balance and number of falls experienced by adults aged 40-65.

What was found?

Muscle strength, balance, and endurance can be improved by physical activity in people aged 40–65 years. Bigger effects on muscle strength were experienced by programs that used resistance exercises.

How does this effect me?

By including physical activity, e.g. resistance training you can improve your overall physical health.

Article Abstract
Question: Can physical activity in adults aged 40-65 years enhance strength and balance and prevent falls? Design: Systematic review with meta-analysis of randomised clinical trials. Participants: Healthy adults aged 40-65 years. Intervention: Programs that involved the performance of any physical activity in community settings and workplaces. Outcome measures: Strength, balance, endurance, and falls rate. Results: Twenty-three eligible trials were identified and 17 of these were pooled in the meta-analyses. The meta-analysis of strength outcomes found a moderate effect of physical activity on strength (SMD = 0.54, 95% CI 0.38 to 0.70). Larger effects were observed from programs that specifically targeted strength (SMD = 0.68, 95% CI 0.49 to 0.87), when compared to those that did not (SMD = 0.32, 95% CI 0.09 to 0.55). This difference was statistically significant (effect of strength in meta-regression p = 0.045). Physical activity also had a moderate effect on both balance (SMD = 0.52, 95% CI 0.24 to 0.79) and endurance (SMD = 0.73, 95% CI 0.50 to 0.96). No trials reported effects of physical activity on falls soon after receiving the intervention. A statistically non-significant effect on falls 15 years after receiving a physical activity intervention was found in one trial (RR = 0.82, 95% CI 0.53 to 1.26). Conclusions: This review found that muscle strength, balance, and endurance can be improved by physical activity in people aged 40-65 years. There were bigger effects on muscle strength from programs that used resistance exercises, indicating the need to include a resistance training component if strength enhancement is the goal.

Keywords: Exercise, Muscle strength, Postural balance, Accidental falls, Systematic review, Meta-analysis

Article Citation

Ferreira, M.L., Sherrington, C., Smith, K., Carswell, P., Bell, R., Bell, M., Nascimento, D.P., Máximo Pereira, L.S., Vardon, P. Physical activity improves strength, balance and endurance in adults aged 40-65 years: A systematic review (2012) Journal of Physiotherapy, 58 (3), pp. 145-156.

Cognitive functioning improvements associated with video gaming

Background

Studies have suggested that video game training improves cognitive functioning; however, the evidence is unclear.

Why is this important?

Finding new ways to improve cognitive functioning is beneficial.

What was done?

A review of every study looking at the effects of video game training on cognition was conducted.

What was found?

Video game training has beneficial effects on cognitive function.

Article Abstract
It has been suggested that video game training enhances cognitive functions in young and older adults. However, effects across studies are mixed. We conducted a meta-analysis to examine the hypothesis that training healthy older adults with video games enhances their cognitive functioning. The studies included in the meta-analysis were video game training interventions with pre- and posttraining measures. Twenty experimental studies published between 1986 and 2013, involving 474 trained and 439 healthy older controls, met the inclusion criteria. The results indicate that video game training produces positive effects on several cognitive functions, including reaction time (RT), attention, memory, and global cognition. The heterogeneity test did not show a significant heterogeneity (I2 20.69%) but this did not preclude a further examination of moderator variables. The magnitude of this effect was moderated by methodological and personal factors, including the age of the trainees and the duration of the intervention. The findings suggest that cognitive and neural plasticity is maintained to a certain extent in old age. Training older adults with video games enhances several aspects of cognition and might be a valuable intervention for cognitive enhancement.

Keywords: aging, cognitive functions, meta-analysis, moderating factors, video game training

Article Citation

Toril, P., Reales, J. M., & Ballesteros, S. (2014). Video game training enhances cognition of older adults: A meta-analytic study. Psychology And Aging, 29(3), 706-716. doi:10.1037/a0037507

Link to Full Article

Social support and physical activity associated with greater resilience

Background

Many older adults experience reduced physical strength and mobility, particularly those in lower socioeconomic positions. However, some individuals have high wellbeing despite these challenges, i.e. they are “resilient”.

Why is this important?

If we can identify resources, such as physical activity and social support, that are associated with greater resilience, older adults may have higher quality of life despite facing age-related challenges.

What was done?

A survey of over 1756 older adults was administered, asking participants about their levels of wellbeing. Trained nurses then measured participants’ level of physical functioning.

What was found?

Increased physical activity and social support was associated with greater resilience.

How does this affect me?

By taking more exercise and being more socially involved, you may experience greater wellbeing.

Article Abstract
Background:
Aging is associated with declines in physical capability; however, some individuals demonstrate high well-being despite this decline, i.e. they are “resilient.” We examined socioeconomic position (SEP) and resilience and the influence of potentially modifiable behavioral resources, i.e. social support and leisure time physical activity (LTPA), on these relationships.

Methods:
Data came from the Medical Research Council National Survey of Health and Development, a nationally-representative birth cohort study. Resilience–vulnerability at age 60–64 years (n = 1,756) was operationalized as the difference between observed and expected levels of well-being, captured by the Warwick–Edinburgh Mental Well-being Scale (WEMWBS), given the level of performance-based physical capability. SEP was assessed by father’s and own social class, parental education, and intergenerational social mobility. PA and structural/functional social support were reported at ages 53 years and 60–64 years. Path analysis was used to examine mediation of SEP and resilience–vulnerability through LTPA and social support.

Results:
Participants in the highest social class had scores on the resilience to vulnerability continuum that were an average of 2.3 units (β = 0.46, 95% CI 0.17, 0.75) higher than those in the lowest social class. Greater LTPA (β = 0.58, 95% CI 0.31, 0.85) and social support (β = 3.27, 95% CI 2.90, 3.63) were associated with greater resilience; LTPA partly mediated participant social class and resilience (23.4% of variance).

Conclusions:
Adult socioeconomic advantage was associated with greater resilience. Initiatives to increase LTPA may contribute to reducing socioeconomic inequalities in this form of resilience in later life.

Keywords: resilience, healthy aging, physical functioning, wellbeing

Article Citation

Cosco, T., Cooper, R., Kuh, D., & Stafford, M. (2017). Socioeconomic inequalities in resilience and vulnerability among older adults: A population-based birth cohort analysis. International Psychogeriatrics, 1-9. doi:10.1017/S1041610217002198

Benefits of replacing sitting time with activities

Background

Researchers wanted to uncover what, if any, the benefits of replacing sitting time with exercise and activities were.

Why is this important?

The effects of replacing time spent with other activities has not been explored.

What was done?

A survey of over 300,000 older adults was administered, identifying how much time individuals spent sitting and in exercise and other activities.

What was found?

Increased time spent sitting was associated with increased risk of death. Replacing sitting time with activities, especially purposeful exercise, decreased the risk of death.

How does this effect me?

Increase your chances of living longer by avoiding sitting and replacing this time with activities. For example, instead of watching an extra episode on TV, go for a walk.

Article Abstract
Purpose
Prolonged sitting has emerged as a risk factor for early mortality, but the extent of benefit realized by replacing sitting time with exercise, or activities of everyday living (i.e. non-exercise activities), is not known.

Methods
We prospectively followed 154,614 older adults (59–82 years) in the NIH-AARP Diet and Health Study who reported no major chronic diseases at baseline and reported detailed information about sitting time, exercise, non-exercise activities. Proportional hazards models were used to estimate adjusted hazard ratios and 95% confidence intervals (HR [95%CI]) for mortality. An isotemporal modeling approach was used to estimate associations for replacing sitting time with specific types of physical activity, with separate models fit for less active and more active participants to account for non-linear associations.

Results
During 6.8 (SD=1.0) years of follow-up 12,201 deaths occurred. Greater sitting time (≥ 12 vs. < 5 hrs/d) was associated with increased risk for all-cause and cardiovascular mortality. In less active adults (< 2 hrs/d total activity), replacing one hour of sitting per day with an equal amount of activity was associated with lower all-cause mortality for both exercise (HR=0.58 [0.54,0.63]) and non-exercise activities (HR=0.70 [0.66,0.74]), including household chores, lawn and garden work, and daily walking. Among more active participants (2+ hrs/d total activity) replacement of sitting time with purposeful exercise was associated with lower mortality (HR=0.91 [0.88–0.94]), but not with non-exercise activity (HR=1.00 [0.98–1.02]). Similar results were noted for cardiovascular mortality.

Conclusions
Physical activity intervention strategies for older adults often focus on aerobic exercise, but our findings suggest that reducing sitting time and engaging in a variety of activities is also important, particularly for inactive adults.

Keywords: sedentary behavior, prevention, lifestyle activities, cancer

Article Citation

Matthews, C.E., Moore, S., Sampson, J., Blair, A., Xiao, Q., Keadle, S., Hollenbeck., Park, Y. (2014). Mortality benefits for replacing sitting time with different activities. Medicine & Science in Sports & Exercise.

Dog ownership associated with greater physical activity

  Having a companion dog may encourage greater exercise.

Question

What is the relationship between dog ownership and physical activity?

What was done?

Older adults in the European Prospective Investigation into Cancer and Nutrition Norfolk cohort used accelerometers to monitor their physical activity for a week. The amount of exercise taken by participants was compared in dog owners and non-owners.

What was found?

Dog ownership was associated with greater physical activity.

How does this affect me?

Having a dog to take for walks may encourage greater exercise.

Article Abstract

Background Dog ownership has been suggested to encourage physical activity in older adults and may enhance resilience to poor environmental conditions. This study investigates the role of dog ownership and walking as a means of supporting the maintenance of physical activity in older adults during periods of inclement weather.

Methods The analysis used data from the European Prospective Investigation into Cancer and Nutrition Norfolk cohort. Daily physical activity (counts per minute) and minutes of sedentary behaviour were measured using accelerometers over 7 days. Three types of environmental conditions, day length, precipitation and maximum temperature, were date matched with daily physical activity. A multilevel first-order autoregressive time-series model quantified the moderating effect of self-reported dog ownership and walking on the association between physical activity and weather factors.

Results Among the 3123 participants, 18% reported having a dog in their households and two-thirds of dog owners walked their dogs at least once a day. Regular dog walkers were more active and less sedentary on days with the poorest conditions than non-dog owners were on the days with the best conditions. In days with the worst conditions, those who walked their dogs had 20% higher activity levels than non-dog owners and spent 30 min/day less sedentary.

Conclusion Those who walked dogs were consistently more physically active than those who did not regardless of environmental conditions. These large differences suggest that dog walking, where appropriate, can be a component of interventions to support physical activity in older adults.

Link to full article.

The world’s longest studied birth cohort turns 70 – here’s what they’ve told us

This article was originally published on The Conversation. Read the original article.

The world’s oldest continually running birth cohort study – the MRC National Survey of Health and Developmentturns 70 this month.

A birth cohort study is one where a representative sample of newborns is followed over many years – with the consent of their parents – to track their health, development, education and other life circumstances. In the case of this cohort, what began as a study of maternity has now evolved into a valuable resource for studying ageing.

Early years

James Douglas was appointed to run the initial maternity survey and, within a year of the end of World War II, health visitors had interviewed 13,687 mothers, from across Britain, who gave birth in March 1946. They asked about the care of the mother and her baby, and the costs she incurred during pregnancy and childbirth.

In this first phase, the study revealed important differences in the mothers’ and babies’ health and survival by geographical area and income group. The study showed that many more babies from poor families died compared with those from well-off families.

Soon after the maternity study was completed, Douglas decided to follow a group of 5,362 infants to discover the factors that led to poor growth and ill health during preschool years. This data contributed to the design of NHS care for the preschool child.

By the end of the school years two sets of data had been collected. One on health and growth and the other on cognitive and emotional development and educational attainment. The data revealed an increased risk of underachievement – known as the “waste of talent” – among children with high intelligence in poorer families.

Adapting to the times

After Douglas retired, Michael Wadsworth took over the leadership of the project. He expanded the data collection in the second phase of the study to investigate mental health in early adulthood. Under his directorship, the study also expanded the number of physical traits that were measured. In these years the study began to address emerging areas of research concerning the influence of early-life factors, such as growth and environment, on early adulthood.

After Wadsworth came Diana Kuh and by now the study participants were in their sixties. Kuh changed the focus of the study to ageing.

Over the past decade researchers on the project have tried to understand how social and biological factors across life influence ageing. By examining survival, physical and cognitive ability, as well as psychological and social well-being they have gained a better understanding of ageing at the individual, body system and cellular level.

As a result of the lifelong commitment of the study participants, researchers have been able to gain insight into what factors, from early- and midlife, contribute to the risk of decreases in physical and cognitive ability and of common diseases, such as type 2 diabetes, heart disease, stroke, cancer and dementia.

Brain imaging provides insights into ageing.
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New tools

The study continues to collect data on study participants, using new methods and medical technologies. For example, medical imaging technology was first used to scan the hearts and bones of study participants and is now being used to scan their brains. And DNA is now collected from study participants, which is now giving us insights into ageing at the genetic and epigenetic levels.

Through the contributions of the study founders, directors and researchers as well as the lifetime of commitment from its thousands of participants, the cohort study has provided – and continues to provide – a wealth of information on ageing, as questions surrounding ageing become increasingly important and complex.

The Conversation

Theodore D Cosco, Postdoctoral Research Associate, UCL

This article was originally published on The Conversation. Read the original article.

Increased muscle strength gains from resistance training with creatine supplementation

Supplementing with creatine in addition to resistance exercise may further improve muscle strength.

Question

Increased muscle strength gains from resistance training with creatine supplementation

What was done?

A group of healthy older adults were given either i)creatine before and placebo after resistance training, ii) placebo before and creatine after resistance training, iii) or placebo before and after resistance training for 12 weeks. Muscle strength and muscle mass was measured before and after training.

What was found?

Creatine supplementation both before and after training increased muscle strength more than placebo.

How does this affect me?

Including creatine supplementation in addition to resistance exercise may further improve muscle strength.

Article Abstract
Creatine supplementation in close proximity to resistance training may be an important strategy for increasing muscle mass and strength; however, it is unknown whether creatine supplementation before or after resistance training is more effective for aging adults. Using a double-blind, repeated measures design, older adults (50–71 years) were randomized to 1 of 3 groups: creatine before (CR-B: n = 15; creatine (0.1 g/kg) immediately before resistance training and placebo (0.1 g/kg cornstarch maltodextrin) immediately after resistance training), creatine after (CR-A: n = 12; placebo immediately before resistance training and creatine immediately after resistance training), or placebo (PLA: n = 12; placebo immediately before and immediately after resistance training) for 32 weeks. Prior to and following the study, body composition (lean tissue, fat mass; dual-energy X-ray absorptiometry) and muscle strength (1-repetition maximum leg press and chest press) were assessed. There was an increase over time for lean tissue mass and muscle strength and a decrease in fat mass (p < 0.05). CR-A resulted in greater improvements in lean tissue mass (Δ 3.0 ± 1.9 kg) compared with PLA (Δ 0.5 ± 2.1 kg; p < 0.025). Creatine supplementation, independent of the timing of ingestion, increased muscle strength more than placebo (leg press: CR-B, Δ 36.6 ± 26.6 kg; CR-A, Δ 40.8 ± 38.4 kg; PLA, Δ 5.6 ± 35.1 kg; chest press: CR-B, Δ 15.2 ± 13.0 kg; CR-A, Δ 15.7 ± 12.5 kg; PLA, Δ 1.9 ± 14.7 kg; p < 0.025). Compared with resistance training alone, creatine supplementation improves muscle strength, with greater gains in lean tissue mass resulting from post-exercise creatine supplementation.