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.

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.

Higher education associated with better ageing trajectories

School participation may have long-term effects on health and wellbeing

Question

What is the relationship between education and long-term health trajectories?

What was done?

1,141 community-dwelling older adults completed questionnaires three times across a four year period regarding their physical, psychological, and social health. Groups of participants that had particularly high levels of overall health were compared with those who had poorer long-term health. Levels of education were compared between groups of high and low levels of overall health.

What was found?

Participants in the highest overall health group had higher levels of education when compared to those in lower health groups.

How does this affect me?

Education may have long-term effects on health.

Article Abstract

As the population ages, interest is increasing in studying aging well. However, more refined means of examining predictors of biopsychosocial conceptualizations of successful aging (SA) are required. Existing evidence of the relationship between early-life education and later-life SA is unclear. The Successful Aging Index (SAI) was mapped onto the Cognitive Function and Aging Study (CFAS), a longitudinal population-based cohort ( n = 1,141). SAI scores were examined using growth mixture modelling (GMM) to identify SA trajectories. Unadjusted and adjusted (age, sex, occupational status) ordinal logistic regressions were conducted to examine the association between trajectory membership and education level. GMM identified a three-class model, capturing high, moderate, and low functioning trajectories. Adjusted ordinal logistic regression models indicated that individuals in higher SAI classes were significantly more likely to have higher educational attainment than individuals in the lower SAI classes. These results provide evidence of a life course link between education and SA.

Link to full article.

Exercise improves depressive symptoms in older adults

Taking exercise is a safe and effective way to reduce depression.

Question

What is the relationship between exercise and symptoms of depression?

What was done?

A review of 16 studies (which included 1487 older adults) that looked at the relationship between exercise and depression, was conducted. Depression symptoms in groups that took exercise were compared with groups that did not.

What was found?

Groups that took exercise experienced reduced depression symptoms.

How does this affect me?

Exercising may improve your physical health as well as reduce symptoms of depression.

Article Abstract

Late-life depression is a growing public health concern. Exercise may be of added value but the literature remains equivocal. We conducted a systematic overview of meta-analyses and an exploratory pooled analysis of previous meta-analyses to determine the effect of exercise on depression in older adults. Two independent researchers searched Pubmed, CINAHL, Cochrane Plus, PsycArticles, and PsycInfo for meta-analyses on exercise in late-life depression. Methodological quality was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) Instrument. We pooled effect sizes from previous meta-analyses of randomized controlled trials to determine the effect of exercise on depression in older adults. The systematic review yielded 3 meta-analyses. In total, 16 unique cohorts of 1487 participants were included. The quality of the three included meta-analyses was considered as “moderate” according to AMSTAR scores. No serious adverse events were reported. Compared to controls (n=583), those exercising (n=541) significantly reduced depressive symptoms. Our umbrella review indicates that exercise is safe and efficacious in reducing depressive symptoms in older people. Since exercise has many other known health benefits, it should be considered as a core intervention in the multidisciplinary treatment of older adults experiencing depression.

Link to full article.

Greater fruit and vegetable intake associated with reduced risk of frailty

Eating more fruits and vegetables may reduce your risk of becoming physically frail.

Question

What is the relationship between fruit and vegetable consumption and frailty?

What was done?

2926 older adults from three studies completed questionnaires on their fruit and vegetable consumption. Participants level of physical frailty was also measured.

What was found?

Consuming more fruits and vegetables was associated with lower rates of of developing symptoms of physical frailty.

How does this affect me?

Adding fruits and vegetables to your diet may have positive effects for physical health.

Article Abstract

Background: Consuming fruit and vegetables (FVs) may protect against frailty, but to our knowledge no study has yet assessed their prospective dose-response relation.

Objective: We sought to examine the dose-response association between FV consumption and the risk of frailty in older adults.

Design: Data were taken from 3 independent cohorts of community-dwelling older adults: the Seniors-ENRICA (Study on Nutrition and Cardiovascular Risk Factors in Spain) cohort (n = 1872), Three-City (3C) Bordeaux cohort (n = 581), and integrated multidisciplinary approach cohort (n = 473). Baseline food consumption was assessed with a validated computerized diet history (Seniors-ENRICA) or with a food-frequency questionnaire (3C Bordeaux and AMI). In all cohorts, incident frailty was assessed with the use of the Fried criteria. Results across cohorts were pooled with the use of a random-effects model.

Results: During a mean 2.5-y follow-up, 300 incident frailty cases occurred. Fully adjusted models showed that the pooled ORs (95% CIs) of incident frailty comparing participants who consumed 1, 2, or ≥3 portions of fruit/d to those with no consumption were, respectively, 0.59 (0.27, 0.90), 0.58 (0.29, 0.86), and 0.48 (0.20, 0.75), with a P-trend of 0.04. The corresponding values for vegetables were 0.69 (0.42, 0.97), 0.56 (0.35, 0.77), and 0.52 (0.13, 0.92), with a P-trend < 0.01. When FVs were analyzed together, the pooled ORs (95% CIs) of incident frailty were 0.41 (0.21, 0.60), 0.47 (0.25, 0.68), 0.36 (0.18, 0.53), and 0.31 (0.13, 0.48), with a P-trend < 0.01 for participants who consumed 2, 3, 4, or ≥5 portions/d, respectively, compared with those who consumed ≤1 portion/d. An inverse dose-response relation was also found between the baseline consumption of fruit and risk of exhaustion, low physical activity, and slow walking speed, whereas the consumption of vegetables was associated with a decreased risk of exhaustion and unintentional weight loss.

Conclusions: Among community-dwelling older adults, FV consumption was associated with a lower short-term risk of frailty in a dose-response manner, and the strongest association was obtained with 3 portions of fruit/d and 2 portions of vegetables/d.

Link to full article.

Listening to music associated with psychological wellbeing

Turning on your favorite songs may improve your wellbeing .

Question

What is the relationship between listening to music and psychological wellbeing?

What was done?

500 community-dwelling older adults completed questionnaires on their uses of music in everyday life. A number of psychological variables were also measured, e.g. wellbeing, life satisfaction.

What was found?

Listening to music was a common activity that was associated with positive emotions.

How does this affect me?

Putting on your favorite music may increase your wellbeing and improve your mood.

Article Abstract

A questionnaire was sent to a random sample of 500 community living older adults in Sweden (aged 65–75 years). The questionnaire assessed uses of music in everyday life: frequency of listening, situations where music is encountered, emotional responses to music, and motives for listening (i.e., listening strategies). Also, different facets of psychological well-being (e.g., affective well-being, life satisfaction, and eudaimonic well-being) and selected background variables (e.g., education level, health status, activity level, and Big-5 personality characteristics) were assessed. Results showed that listening to music is a common leisure activity encountered in many everyday situations, and that listening to music is a frequent source of positive emotions for older adults. Also, the participants reported using a variety of listening strategies related to emotional functions (e.g., pleasure, mood regulation, and relaxation) and issues of identity, belonging, and agency. The associations between listening strategies and well-being were explored through correlation and multiple regression analyses where the influence of background variables was controlled for. Health status and personality were the most important predictors of well-being, but some listening strategies were also significantly associated with psychological well-being. The results give important insights into older adults’ uses of music in everyday life and give clues regarding possible relationships between musical activities and well-being.

Link to full article.