Health promotion for the oldest of old people. Assessing the Effects of Interpersonal and Intrapersonal Behavior Change Strategies on Physical Activity in Older Adults: a Factorial Experiment Interactive video dance games for healthy older adults Tablet-Based Strength-Balance Training to Motivate and Improve Adherence to Exercise in Independently Living Older People: A Phase II Preclinical Exploratory Trial Social-cognitive and perceived environment influences associated with physical activity in older Australians. Characteristics of physical activity levels among trail users in a U.S. national sample. The Groningen Active Living Model, an example of successful recruitment of sedentary and underactive older adults. Cluster-randomised trial on participatory community-based outdoor physical activity promotion programs in adults aged 65–75 years in Germany: protocol of the OUTDOOR ACTIVE intervention trial Physical activity, sedentary behavior and total wellness changes among sedentary adults: a 4-week randomized controlled trial Promoting community readiness for physical activity among older adults in Germany – protocol of the ready to change intervention trial The effectiveness of healthy physical fitness programs on people with intellectual disabilities living in a disability institution: six-month short-term effect. Community-wide intervention and population-level physical activity: a 5-year cluster randomized trial Why older people do not participate in leisure time physical activity: a survey of activity levels, beliefs and deterrents. Impact and cost-effectiveness of a universal strategy to promote physical activity in primary care: population-based Cohort study and Markov model Promoting physical activity in older adults by education of home visitors Personal, social, and physical environmental correlates of physical activity in African-American women in South Carolina. Effects of square-stepping exercise on cognitive functions of older people. Can practice nurses increase physical activity in the over 65s? Methodological considerations from a pilot study. Quality of life and related factors: a questionnaire survey of older people living alone in Mainland China Tablet-Based Strength-Balance Training to Motivate and Improve Adherence to Exercise in Independently Living Older People: Part 2 of a Phase II Preclinical Exploratory Trial A randomized trial of a multicomponent home intervention to reduce functional difficulties in older adults. Population based study of social and productive activities as predictors of survival among elderly Americans Promoting physical activity in older people in general practice: ProAct65+ cluster randomised controlled trial.
AIM The aim of this study was to explore the factors that contribute to health promotion in the oldest old and the barriers that prevent it . METHOD A non-r and om sample ( n = 52 ) of people aged 80 and older participated in a descriptive correlational study . Respondents completed a series of two Likert-type question naires . The  Health Promoting Lifestyle Profile II  ( Walker et al 1995 ) and  Barriers to Health Promoting Activities  for Disabled Persons Scale ( Becker et al 1991 ) were used to measure health behaviours . RESULTS Differences were noted between the age groups ( 80 - 90 and 91 - 101 ) for health responsibility , physical activity and nutrition . Impairment was the major barrier to health promotion . CONCLUSION To foster optimal living , the health , illness , function and motivation as well as age of older adults must be considered . They should be encouraged to pursue physical , social and intellectual activity , which can enable them to have active and fulfilling lives Abstract Background Little is known about which behavior change strategies motivate older adults to increase their physical activity . Purpose The purpose of this study was to assess the relative effects of two sets of behavior change strategies to motivate increased physical activity among older adults :  interpersonal and intrapersonal . Methods Community-dwelling older adults ( N = 102 , mean age = 79 ) were r and omized in a 2 × 2 factorial experiment to receive interpersonal ( e.g. , social support , friendly social comparison ; no , yes ) and /or intrapersonal ( e.g. , goal setting , barriers management ; no , yes ) behavior change strategies , combined with an evidence -based , physical activity protocol ( Otago exercise program ) and a physical activity monitor ( Fitbit One ™ ) . Results Based on monitor data , participants who received interpersonal strategies , compared to those who did not , increased their average minutes of total physical activity ( light , moderate , vigorous ) per week , immediately ( p = .006 ) and 6 months ( p = .048 ) post-intervention . Similar , increases were observed on measures of functional strength and balance , immediately ( p = .012 ) and 6 months ( p = .003 ) post-intervention . The intrapersonal strategies did not elicit a significant increase in physical activity or functional strength and balance . Conclusions Findings suggest a set of interpersonally oriented behavior change strategies combined with an evidence -based physical activity protocol can elicit modest , but statistically and clinical ly significant , increases in older adults ’ physical activity and functional strength and balance . Future research should replicate these findings and investigate the sustained quantity of physical activity elicited by these strategies and their impact on older adults ’ quality of life and falls . Trial Registration The Clinical Trials.gov registration identifier is NCT02433249 Background Physical activity promotes health in older adults but participation rates are low . Interactive video dance games can increase activity in young persons but have not been design ed for use with older adults . The purpose of this research was to evaluate healthy older adults ’ interest and participation in a dance game adapted for an older user . Methods Healthy older adults were recruited from 3 senior living setting s and offered three months of training and supervision using a video dance game design ed for older people .  Before and after the program , data was collected on vital signs , physical function and self reported quality of life . Feedback was obtained during and after training . Results Of 36 persons who entered ( mean age 80.1 + 5.4 years , 83 % female ) , 25 completed the study . Completers were healthier than noncompleters . Completers showed gains in narrow walk time , self-reported balance confidence and mental health . While there were no serious adverse events , 4 of 11 noncompleters withdrew due to musculoskeletal complaints . Conclusions Adapted Interactive video dance is feasible for some healthy older adults and may help achieve physical activity goals Background Reaction time , coordination , and cognition performance typically diminish in older adults , which may lead to gait impairments , falls , and injuries . Regular strength – balance exercises are highly recommended to reduce this problem and to improve health , well-being , and independence in old age . However , many older people face a lack of motivation in addition to other strong barriers to exercise . We developed ActiveLifestyle , an information technology (IT)-based system for active and healthy aging aim ing at improving balance and strength . ActiveLifestyle is a training app that runs on a tablet and assists , monitors , and motivates older people to follow personalized training plans autonomously at home . Objective The objectives were to ( 1 ) investigate which IT-mediated motivation strategies increase adherence to physical exercise training plans in older people , ( 2 ) assess the impact of ActiveLifestyle on physical activity behavior change , and ( 3 ) demonstrate the effectiveness of the ActiveLifestyle training to improve gait speed . Methods A total of 44 older adults followed personalized , 12-week strength and balance training plans . All participants performed the exercises autonomously at home . Question naires were used to assess the technological familiarity and stage of behavior change , as well as the effectiveness of the motivation instruments adopted by ActiveLifestyle . Adherence to the exercise plan was evaluated using performance data collected by the app and through information given by the participants during the study . Pretests and posttests were performed to evaluate gait speed of the participants before and after the study . Results Participants were 75 years ( SD 6 ) , predominantly female ( 64 % ) , held a trade or professional diploma ( 54 % ) , and their past profession was in a sitting position ( 43 % ) . Of the 44 participants who enrolled , 33 ( 75 % ) completed the study . The app proved to assist and motivate independently living and healthy older adults to autonomously perform strength – balance exercises ( median 6 on a 7-point Likert scale ) . Social motivation strategies proved more effective than individual strategies to stimulate the participants to comply with the training plan , as well as to change their behavior permanently toward a more physically active lifestyle . The exercises were effective to improve preferred and fast gait speed . Conclusions ActiveLifestyle assisted and motivated independently living and healthy older people to autonomously perform strength – balance exercises over 12 weeks and had low dropout rates . The social motivation strategies were more effective to stimulate the participants to comply with the training plan and remain on the intervention . The adoption of assistive technology devices for physical intervention tends to motivate and retain older people exercising for longer periods of time BACKGROUND Regular physical activity in older adults can facilitate healthy aging , improve functional capacity , and prevent disease . However , factors associated with physical inactivity in older population s are poorly understood . This study attempts to identify social-cognitive and perceived environmental influences associated with physical activity participation in older population s. METHODS In a r and omly selected sample of 449 Australian adults age 60 and older , we assessed self-reported physical activity and a range of social-cognitive and perceived environmental factors . Respondents were classified as sufficiently active and inactive based on energy expenditure estimates ( kcal/week ) derived from self-reported physical activity . Two logistic regression models , with and without self-efficacy included , were conducted to identify modifiable independent predictors of physical activity . RESULTS Significantly more males than females were physically active . Physical activity participation was related to age with a greater proportion of those age 65 - 69 being active than those age 60 - 64 or 70 or older .  High self-efficacy , regular participation of friends and family , finding footpaths safe for walking , and access to local facilities were significantly associated with being active . CONCLUSION Identifying predictors of physical activity in older population s , particularly social support , facility access , and neighbourhood safety , can inform the development of policy and intervention strategies to promote the health of older people BACKGROUND The Task Force on Community Preventive Services strongly recommends environmental interventions that include enhanced access to opportunities for physical activity , such as walking and cycling trails . Although accumulating evidence indicates that trails can be effective in increasing physical activity , little is known about trail users . METHODS Cross-sectional analysis of a national sample of 3717 adults from the HealthStyles and ConsumerStyles surveys using logistic regression to determine physical activity patterns and sociodemographic correlates related to trail use , and to identify support regarding trail development policies . RESULTS Almost 13 % ( 12.7 % ) of the sample reported using trails at least once a month and 24.3 % at least once a week . People who reported using trails at least once a week were twice as likely than people who reported rarely or never using trails to meet physical activity recommendations ( odds ratio=2.3 , 95 % confidence interval=1.9 - 2.8 ) . Nearly half ( 43.6 % ) of the non-trail users supported exp and ed public spaces for people to exercise , and 36.4 % of the non-trail users reported that they would be willing to pay more taxes to build more parks and trails in their community . CONCLUSIONS Community trails facilitate physical activity , and almost half of frequent trail users report that access to trails and other green space is important in choosing a place to live . These results support the need for prospect i ve research on whether newly built trails promote physical activity in previously inactive people OBJECTIVE Many physical activity interventions do not reach those people who would benefit the most from them . The Groningen Active Living Model ( GALM ) was successful in recruiting sedentary and underactive older adults . METHOD In the fall of 2000 older adults in three municipalities in the Netherl and s received written information , were visited at home and , if eligible according to the GALM recruitment criteria , filled in the Stages of Change question naire and the Voorrips physical activity question naire . RESULTS By using the strategy we succeeded in including 12.3 % of the older adults ( 315 of the 2551 qualifying participants ) , 79.4 % of whom could be indeed regarded as sedentary or underactive . These results can be considered in line with results described in the literature . The cost of successfully recruiting an older adult was estimated at $ 84 . CONCLUSIONS The GALM recruitment strategy is a potentially useful and effective method for reaching community-dwelling sedentary and underactive older adults Background Despite its well-known benefits for health and well-being physical activity levels are insufficient and declining with age in Germany . Physical activity promotion programs for older adults are often not successful , one reason is insufficient relevance of intervention measures for the study population . Community-based participatory research ( CBPR ) is a possible key strategy for tailoring more meaningful intervention programs to a specific community . However , evidence for the effectiveness of CBPR in the general population is scarce . This study aims to formally evaluate the efficacy of a CBPR approach for developing and implementing an outdoor physical activity program for older adults . Methods / design The OUTDOOR ACTIVE intervention trial is a cluster-r and omised intervention study carried out in a r and om sample of eight subdistricts in the city of Bremen , Germany . The eight subdistricts are grouped into four homogenous pairs with regard to socioeconomic level and l and use mix of the subdistrict . Within the pairs , the subdistricts are assigned r and omly to the two study arms : participatory development and implementation of a community-based program to promote outdoor physical activity ( intervention ) versus no intervention ( controls ) . For evaluation , a survey is carried out before ( baseline ) and after ( follow-up ) the intervention period . The measurements include 7-day accelerometer measurement , physical fitness test , blood pressure , basic anthropometry , and self-administered question naire . Discussion The OUTDOOR ACTIVE intervention trial will provide detailed information on PA intervention for older adults in an urban setting . Through the participatory nature of the study it will provide valuable insights into drivers and barriers to PA in this group , and it will inform policy makers and other stakeholders how to benefit from the results .Trial registration German Clinical Trials Register DRKS00015117 ( Date of registration 17 - 07 - 2018 ) Background The construct of total wellness includes a holistic approach to the body , mind and spirit components of life . While the health benefits of reducing sedentary behavior and increasing physical activity are well documented , little is known about the influence on total wellness of an internet-based physical activity monitor design ed to help people to achieve higher physical activity levels . Purpose The purpose of this four-week , personal activity monitor-based intervention program was to reduce sedentary behavior and increase physical activity levels in daily living for sedentary adults and to determine if these changes would also be associated with improvement in total wellness . Methods Twenty-two men and 11 women ( 27 years ± 4.0 ) were r and omly assigned to either an intervention ( n = 18 ) or control group ( n = 15 ) . The intervention group interacted with an online personal activity monitor ( Gruve Solution ™ ) design ed to reduce sedentary time  and increase physical activity during activities of daily living . The control group did not interact with the monitor , as they were asked to follow their normal daily physical activities and sedentary behavior routines . The Wellness Evaluation of Lifestyle ( WEL ) inventory was used to assess total wellness . Sedentary time , light , walking , moderate and vigorous intensity physical activities were assessed for both intervention and control groups at baseline and at week-4 by the 7-day Sedentary and Light Intensity Physical Activity Log ( 7-day SLIPA Log ) and the International Physical Activity Question naire ( IPAQ ) . Results Significant increases in pre-post total wellness scores ( from 64 % ± 5.7 to 75 % ± 8.5 ) ( t ( 17 ) = -6.5 , p < 0.001 ) were observed in the intervention group by the end of week four . Intervention participants decreased their sedentary time ( 21 % , 2.3 hours/day ) and increased their light ( 36.7 % , 2.5 hours/day ) , walking ( 65 % , 1057 MET-min/week ) , moderate ( 67 % , 455 MET-min/week ) and vigorous intensity ( 60 % , 442 MET-min/week ) physical activity ( all p < 0.001 ) . No significant differences for total wellness were observed between the groups at baseline and no pre-post significant differences were observed for any outcome variable in the control group . Conclusion Total wellness is improved when sedentary , but sufficiently physically active adults , reduce sedentary time and increase physical activity levels ( i.e. light , waking , moderate and vigorous ) Background Healthy ageing is an important concern for many societies facing the challenge of an ageing population . Physical activity ( PA ) is a major contributor to healthy ageing ; however insufficient PA levels are prevalent in old age in Germany .  Community capacity building and community involvement are often recommended as key strategies to improve equitable access to prevention and health promotion . However , evidence for the effectiveness of these strategies is scarce . This study aims to assess the community readiness for PA promotion in local environments and to analyse the utility of strategies to increase community readiness for reaching vulnerable groups . Methods / Design We design ed a mixed method intervention trial comprising three study modules . The first module includes an assessment of  community readiness for PA interventions in older adults . The assessment is carried out in a sample of 24 municipalities in the Northwest of Germany using structured key informant interviews . In the second module , eight municipalities with the low community readiness are selected from the sample and r and omly assigned to one of two study groups : active enhancement of community readiness ( intervention ) versus no enhancement ( control ) . After enhancing community readiness in the active enhancement group , older adults in both study groups will be recruited for participation in a PA intervention .  Participation rates are compared between the study groups to evaluate the effects of the intervention . In addition , a cost-effectiveness analysis is carried out calculating recruitment costs per person reached in the two study groups . In the third module , qualitative interviews are conducted with participants and non- participants of the PA intervention exploring reasons for participation or non-participation . Discussion This study offers the potential to contribute to the evidence base of reaching vulnerable older adults for PA interventions and provide ideas on how to reduce participation barriers . Its findings will inform governmental authorities , professionals , academics , and NGOs with an estimate of re sources necessary to achieve equitable access to physical activity programs for vulnerable older adults . Trial registration German Clinical Trials Register DRKS00009564 ( Date of registration 03 - 11 - 2015 Little information is available on the provision of physical fitness and intervention program among people with intellectual disabilities . The aim of this study is to provide information of examining the effectiveness of healthy physical fitness programs on people with intellectual disabilities living in a disability institution . There were 146 participants with intellectual disabilities ( age 19 - 67 years ) were recruited in the study . We collected information on disability condition ( type and level ) , height , weight , BMI , and physical fitness status ( includes V-shape sit and reach test , sit-up 30s , sit-up 60s , and shuttle run ) at the beginning and 6 months later of the program intervention . The results show that there were statistical decreases in individual 's weight , BMI score , BMI category , and positive improvement in V-shape sit and reach test , sit-up in 30s and 60s tests after 6-month interventions . However , the shuttle run test did not improve at the post-test among people with intellectual disabilities . The results also showed that the mild disability level group has the highest effectiveness on the healthy fitness program on decreasing body weight . Generally speaking , the preliminary study found the healthy exercise program has positive fitness effects on people with intellectual disabilities . To maximize the benefits of regular physical activity on people with ID , there is a need to evaluate the long-term effect of the intervention program and then to initiate the healthy exercise strategies in institution for this group of people Abstract Background Evidence from a limited number of short-term trials indicates the difficulty in achieving population -level improvements in physical activity ( PA ) through community-wide interventions ( CWIs ) . We sought to evaluate the effectiveness of a 5-year CWI for promoting PA in middle-aged and older adults using a cluster r and omized design . Methods We r and omized 12 communities in Unnan , Japan , to either intervention ( 9 ) or control ( 3 ) . Additionally , intervention communities were r and omly allocated to three subgroups by different PA types promoted . R and omly sample d residents aged 40–79 years responded to the baseline survey ( n = 4414 ; 74 % ) and were followed at 1 , 3 and 5 years ( 78–83 % response rate ) . The intervention was a 5-year CWI using social marketing to promote PA . The primary outcome was a change in recommended levels of PA . Results Compared with control communities , adults achieving recommended levels of PA increased in intervention communities [ adjusted change difference = 4.6 percentage points ( 95 % confidence interval : 0.4 , 8.8 ) ] . The intervention was effective for promoting all types of recommended PAs , i.e. aerobic ( walking , 6.4 % ) , flexibility ( 6.1 % ) and muscle-strengthening activities ( 5.7 % ) . However , a bundled approach , which attempted to promote all forms of PAs above simultaneously , was not effective ( 1.3–3.4 % , P ≥ 0.138 ) . Linear dose – response relationships between the CWI awareness and changes in PA were observed ( P ≤ 0.02 ) . Pain intensity decreased in shoulder ( intervention and control ) and lower back ( intervention only ) but there was little change difference in all musculoskeletal pain outcomes between the groups . Conclusions The 5-year CWI using the focused social marketing strategy increased the population -level of PA BACKGROUND Regular physical activity has been shown to have many health benefits . However , many older people are physically inactive . OBJECTIVE To investigate why older people are reluctant to participate in leisure time physical activity and to identify strategies to encourage increased activity . DESIGN Cross-sectional survey . SETTING 16 general practice s in Dundee , Scotl and . METHODS 409 r and omly selected older people ( 65 - 84 years ) who lived independently were interviewed at home . Forty-six percent of those invited to take part were recruited into the study . RESULTS Levels of knowledge about the specific health benefits of physical activity were high . Almost all participants ( 95 % ) believed that physical activity was beneficial and 79 % believed that they did enough to keep healthy . However , 36 % did no leisure time physical activity and a further 17 % did less than 2 hours per week . Regression modelling identified 11 factors that exerted significant independent effects on levels of leisure time physical activity .  The most powerful deterrent was lack of interest ( OR = 7.8 ) . Other factors included lack of daily access to a car , shortness of breath , joint pain , dislike of going out alone or in the evening , perceived lack of fitness , lack of energy , doubting that exercise can lengthen life , not belonging to a group and doubting that meeting new people is beneficial . CONCLUSIONS Increasing leisure time physical activities poses major challenges . Beliefs about desirable levels of activity in older people would need to be changed . Action would be needed to relieve physical symptoms and address fears about perceived ability to undertake physical activity . Finally , easily accessible facilities would be needed to encourage participation in physical activity Background This study aim ed to estimate the cost-effectiveness of a universal strategy to promote physical activity in primary care . Methods Data were analysed for a cohort of participants from the general practice research data base . Empirical estimates informed a Markov model that included five long-term conditions ( diabetes , coronary heart disease , stroke , colorectal cancer and depression ) . Simulations compared an intervention promoting physical activity in healthy adults with st and ard care . The intervention effect on physical activity was from a meta- analysis of r and omised trials . The annual cost of intervention , in the base case , was one family practice consultation per participant year . The primary outcome was net health benefit in quality adjusted life years ( QALYs ) . Results A cohort of 262,704 healthy participants entered the model . Intervention was associated with an increase in life years lived free from physical disease . With 5 years intervention the increase was 52 ( 95 % interval −11 to 115 ) per 1,000 participants entering the model ( probability increased 91.9 % ) ; with 10 years intervention the increase was 102 ( 42–164 ) per 1,000 ( probability 99.7 % ) . Net health benefits at a threshold of £ 30,000 per QALY were 3.2 ( −11.1 to 16.9 ) QALYs per 1,000 participants with 5 years intervention ( probability cost-effective 64.7 % ) and 5.0 ( −9.5 to 19.3 ) with 10 years intervention ( probability cost-effective 72.4 % ) . Conclusions A universal strategy to promote physical activity in primary care has the potential to increase life years lived free from physical disease . There is only weak evidence that a universal intervention strategy might prove cost-effective The objectives were to investigate in older adults ( 1 ) whether regular preventive home visits are associated with change or stability in physical activity and ( 2 ) whether education of home visitors influences stability and change in physical activity . The design was a prospect i ve controlled r and omised follow-up study with r and omization at municipality level ( 17 intervention and 17 control municipalities ) and outcomes measured at individual level . Visitors in the intervention-municipalities received regular education during 3 years . The effect of the intervention was measured by a question naire survey among 1,913 old persons living in the 34 municipalities at baseline and 4½-year follow-up  . Changes in physical activity were measured through self-reported frequencies of vigorous physical activity . All logistic regression analyses were stratified by sex and age group ( 75 and 80 years old ) . There was no effect of receiving preventive home visits on change in physical activity among the men and among the 75-year-old women . Among the physically active 80-year-old women those who accepted and received more than four preventive home visits were more likely to go on being physically active compared to women who did not receive preventive home visits . Among the sedentary 80-year-old women those living in the intervention municipalities tended to increase their physical activity compared to the control women . These results were not seen in the old men . Preventive home visits as part of daily routine in primary care and education of home visitors and general practitioners may promote physical activity in older women BACKGROUND Little is known about the correlates of physical activity among African-American women living in the southeastern United States . The purpose of this study was to assess the relationship of personal , social , cultural , environmental , and policy variables with physical activity among women in ethnic minority groups . METHODS The Women and Physical Activity Survey was used in a telephone interview of 917 African-American women living in two counties in South Carolina . The sample of women was selected by r and om-digit dialing . RESULTS Approximately one third ( 34.1 % ) of the women met current recommendations for moderate or vigorous physical activity , 49.4 % were insufficiently active , and 16.5 % were inactive . Meeting the recommendations or engaging in insufficient activity ( versus inactive ) was related to attaining higher educational levels , being married or with a partner ; being in excellent or very good health , having greater self-efficacy , seeing people exercise in the neighborhood , having more favorable ratings of women who exercise ( social issues score ) , having lower social role strain , and reporting the presence of sidewalks or lighter traffic in the neighborhood . CONCLUSION Multiple factors influence physical activity . Interventions to increase physical activity should use multilevel approaches that incorporate the personal , social environmental , and physical environmental factors related to participation in physical activity AIM Cognitive functions can decline with age , and interventions focusing on stimulating them may have positive results . Previous studies have shown that square-stepping exercise ( SSE ) has a good influence on balance , but this exercise also seems to promote cognitive stimulation . Therefore , the purpose of the present study was to analyse the effect of 16 weeks of SSE on cognitive functions in non-demented community-dwelling older people . METHODS This was a longitudinal , non-r and omized study . Forty-one older adults ( 60 years and older ) were recruited , and 21 participated in the SSE group ( practised only SSE sequences ) and 20 were in the control group ( continued with their activities of daily living ) . Both groups were evaluated using the Mini-Mental State Examination , the Digit Span test , the Toulouse-Pierón Attention Test and the Modified Card Sorting Test . RESULTS The SSE group showed a significant improvement in global cognitive status , concentrated attention and mental flexibility after 16 weeks of the SSE intervention . CONCLUSION Evidence shows that SSE is a physical activity that positively influences cognitive functions in non-demented older people There is ample evidence of the benefits of exercise for older people . Less is known about the most effective strategies for promoting the participation of older people in exercise regimes . An approach whereby practice nurses  used motivational interviewing , based on Prochaska and Di Clemente 's model of behaviour change , was piloted in two general practice s. The strategy appeared feasible and will be tested further in a large controlled trial Purpose There is a growing population of older people living alone within the context of dramatic population ageing and changing living arrangements . However , little is known about the quality of life ( QoL ) of older people living alone in Mainl and China . This study aim ed to investigate QoL and its related factors among Chinese older people who live alone . Methods A stratified r and om cluster sample of 521 community-dwelling older people living alone in Shanghai completed a structured question naire through face-to-face interviews .  QoL was measured using the  Older People ’s Quality of Life Question naire . Other data collected included self-rated health , physical health , cognitive function , depression , functional ability , loneliness , social support , physical activity , health services satisfaction , satisfaction with overall dwelling conditions and socio-demographic variables . Results Older people living alone in Mainl and China rated social relationships and financial circumstances as sources of low satisfaction within their QoL. Multiway analysis of variance showed that satisfaction with overall dwelling conditions , self-rated health , functional ability , depression , economic level , social support , loneliness , previous occupation and health services satisfaction were independently related to QoL , accounting for 68.8 % of the variance . Depression and previous occupation had an interaction effect upon QoL. Conclusions This study identified nine factors influencing the QoL of older people living alone in Mainl and China . Interventions to increase satisfaction with dwelling conditions , improve economic level , social support and functional ability , decrease loneliness and depression and improve health services satisfaction appear to be important for enhancing their Background Home-based exercise programs can improve physical functioning and health status of elderly people . Successful implementation of exercise interventions for older people presents major challenges and supporting elderly people properly while doing their home-based exercises is essential for training success . We developed a tablet-based system — ActiveLifestyle — that offers older adults a home-based strength-balance training program with incorporated motivation strategies and support features . Objective The goal was to compare 3 different home-based training programs with respect to their effect on measures of gait quality and physical performance through planned comparisons between ( 1 ) tablet-based and brochure-based interventions , ( 2 ) individual and social motivation strategies , and ( 3 ) active and inactive participants . Methods A total of 44 autonomous-living elderly people ( mean 75 , SD 6 years ) were assigned to 3 training groups : social ( tablet guided , n=14 ) , individual ( tablet guided , n=13 ) , and brochure ( brochure guided , n=17 ) . All groups joined a 12-week progressive home-based strength-balance training program . Outcome measures were gait performance under single and dual task conditions , dual task costs of walking , falls efficacy , and physical performance as measured by the Short Physical Performance Battery ( SPPB ) . Furthermore , active ( ≥75 % program compliance ) and inactive ( < 75 % program compliance ) individuals were compared based on their characteristics and outcome measures . Results The tablet groups showed significant improvements in single and dual task walking , whereas there were no significant changes observable in the brochure group . Between-groups comparisons revealed significant differences for gait velocity ( U=138.5 ; P=.03 , r=.33 ) and cadence ( U=138.5 , P=.03 r=.34 ) during dual task walking at preferred speed in favor of the tablet groups . The brochure group had more inactive participants , but this did not reach statistical significance ( U=167 , P=.06 , r=.29 ) . The active participants outperformed the inactive participants in single and dual task walking , dual task costs of walking , and SPPB scores . Significant between-groups differences were seen between the tablet groups and the brochure group , in favor of the tablet groups . Conclusions A tablet-based strength-balance training program that allows monitoring and assisting autonomous-living older adults while training at home was more effective in improving gait and physical performance when compared to a brochure-based program . Social or individual motivation strategies were equally effective . The most prominent differences were observed between active and inactive participants . These findings suggest that in older adults a tablet-based intervention enhances training compliance ; hence , it is an effective way to improve gait OBJECTIVES To test the efficacy of a multicomponent intervention to reduce functional difficulties , fear of falling , and home hazards and enhance self-efficacy and adaptive coping in older adults with chronic conditions . DESIGN A prospect i ve , two-group , r and omized trial . Participants were r and omized to a treatment group or no-treatment group . SETTING Urban community-living older people . PARTICIPANTS Three hundred nineteen community-living adults aged 70 and older who reported difficulty with one or more activities of daily living . INTERVENTION Occupational and physical therapy sessions involving home modifications and training in their use ; instruction in strategies of problem-solving , energy conservation , safe performance , and fall recovery techniques ; and balance and muscle strength training . MEASUREMENTS Outcome measures included self-rated functional difficulties with ambulation , instrumental activities of daily living , activities of daily living , fear of falling , confidence performing daily tasks , and use of adaptive strategies . Observations of home hazards were also conducted . RESULTS At 6 months , intervention participants had less difficulty than controls with instrumental activities of daily living ( P=.04 , 95 % confidence interval (CI)=-0.28 - 0.00 ) and activities of daily living ( P=.03 , 95 % CI=-0.24 to -0.01 ) , with largest reductions in bathing ( P=.02 , 95 % CI=-0.52 to -0.06 ) and toileting ( P=.049 , 95 % CI=-0.35 - 0.00 ) . They also had greater self-efficacy ( P=.03 , 95 % CI=0.02 - 0.27 ) , less fear of falling ( P=.001 , 95 % CI=0.26 - 0.96 ) , fewer home hazards ( P=.05 , 95 % CI=-3.06 - 0.00 ) , and greater use of adaptive strategies ( P=.009 , 95 % CI=0.03 - 0.22 ) . Benefits were sustained at 12 months for most outcomes . CONCLUSION A multicomponent intervention targeting modifiable environmental and behavioral factors results in life quality improvements in community-dwelling older people who had functional difficulties , with most benefits retained over a year Abstract Objectives : To examine any association between social , productive , and physical activity and 13 year survival in older people . Design : Prospect i ve cohort study with annual mortality follow up . Activity and other measures were assessed by structured interviews at baseline in the participants ' homes Proportional hazards models were used to model survival from time of initial interview . Setting : City of New Haven , Connecticut , United States . Participants : 2761 men and women from a r and om population sample of 2812 people aged 65 and older . Main outcome measure : Mortality from all causes during 13 years of follow up . Results : All three types of activity were independently associated with survival after age , sex , race/ethnicity , marital status , income , body mass index , smoking , functional disability , and history of cancer , diabetes , stroke , and myocardial infa rct ion were controlled for . Conclusions : Social and productive activities that involve little or no enhancement of fitness lower the risk of all cause mortality as much as fitness activities do . This suggests that in addition to increased cardiopulmonary fitness , activity may confer survival benefits through psychosocial pathways . Social and productive activities that require less physical exertion may complement exercise programmes and may constitute alternative interventions for frail elderly people . Key messages Little is known about predictors of survival among elderly people Physical activity is clearly good for health , but the potential benefits of social activities have not been studied Social and productive activities are as effective as fitness activities in lowering the risk of death Enhanced social activities may help to increase the quality and length of BACKGROUND Regular physical activity reduces falls , hip fractures , and all-cause mortality , but physical activity levels are low in older age groups . AIM To evaluate two exercise programmes promoting physical activity among older people . DESIGN AND SETTING Pragmatic three-arm , parallel- design cluster r and omised controlled trial involving 1256 people aged ≥65 years ( of 20 507 invited ) recruited from 43 general practice s in London , Nottingham , and Derby . METHOD Practice s were r and omised to the class-based Falls Management Exercise programme ( FaME ) , the home-based Otago Exercise Program ( OEP ) , or usual care . The primary outcome was the proportion reaching the recommended physical activity target 12 months post-intervention . Secondary outcomes included falls , quality of life , balance confidence , and costs . RESULTS In total , 49 % of FaME participants reached the physical activity target compared with 38 % for usual care ( adjusted odds ratio 1.78 , 95 % confidence interval [ CI ] = 1.11 to 2.87 , P = 0.02 ) . Differences between FaME and usual care persisted 24 months after intervention . There was no significant difference comparing those in the OEP ( 43 % reaching target at 12 months ) and usual-care arms . Participants in the FaME arm added around 15 minutes of moderate-to-vigorous physical activity per day to their baseline level ; this group also had a significantly lower rate of falls ( incident rate ratio 0.74 , 95 % CI = 0.55 to 0.99 , P = 0.042 ) . Balance confidence was significantly improved in both intervention arms . The mean cost per extra person achieving the physical activity target was £ 1740 . Attrition and rates of adverse reactions were similar . CONCLUSION The FaME programme increases self-reported physical activity for at least 12 months post-intervention and reduces falls in people aged ≥65 years , but uptake is low . There was no statistically significant difference in reaching the target , or in falls , between the OEP and usual-care arms
The heterogeneity in reported effects was reduced in higher quality studies , when physical activity was self-directed with some professional guidance and when there was on-going professional support .
Our review suggests that physical activity interventions have a moderate effect on self reported physical activity and cardio-respiratory fitness , but not on achieving a predetermined level of physical activity .
Due to the clinical and statistical heterogeneity of the studies , only limited conclusions can be drawn about the effectiveness of individual components of the interventions .
BACKGROUND Little is known about the effectiveness of strategies to enable people to achieve an increase in their physical activity .
OBJECTIVES To assess the effects of interventions for promoting physical activity in adults aged 16 years and older , not living in an institution .