Investigating Relationships between Balance Confidence and Balance Ability in Older Adults

Increasing balance confidence in older individuals is important towards improving their quality of life and reducing activity avoidance. Here, we investigated if balance confidence (perceived ability) and balance performance (ability) in older adults were related to one another and would improve after balance training. The relationship of balance confidence in conjunction with balance performance for varied conditions (such as limiting vision, modifying somatosensory cues, and also base of support) was explored. We sought to determine if balance confidence and ability, as well as their relationship, could change after several weeks of training. Twenty-seven healthy participants were trained for several weeks during standing and walking exercises. In addition, seven participants with a higher risk of imbalance leading to falls (survivors of stroke) were also trained. Prior to and after training, balance ability and confidence were assessed via the Balance Error Scoring System (BESS) and Activities Specific Balance Confidence (ABC) Scale, respectively. Both groups showed improvements in balance abilities (i.e., BESS errors significantly decreased after training). Balance confidence was significantly higher in the healthy group than in the stroke group; however, ABC results reflected that balance confidence did not significantly increase after training for each. The correlations between balance ability and balance confidence were explored. Encouragingly, healthy participants displayed a negative correlation between BESS errors and ABC (i.e., enhancements in balance confidence (increases in ABC Scale results) were related to improvements in balance ability (decreases in BESS errors)). For the stroke participants, despite improvements in balance ability, our results showed that there was no relation to balance confidence (i.e., no correlation between BESS errors and ABC) in this group.

The Survey of Knee Osteoarthritis in the Population over Age 50 Visited in the Health Bus in Kermanshah, Iran

Along with an aging population worldwide, knee osteoarthritis (KOA), which is the main cause of musculoskeletal pain and disability in the elderly and decreases the quality of life, is prevalent, and their impact is widespread. This study aimed to evaluate the knee osteoarthritis status among the population over age 50 in Kermanshah, Iran. The research community consisted of the population who has been visited in the health bus in Kermanshah in 2016-2017, of which 589 were chosen by an available sampling method. A WOMAC questionnaire was used to determine the prevalence of knee osteoarthritis. The prevalence of knee stiffness rate after sitting, lying down, or resting during the day among women and men were 40.7% and 20.5%, respectively. According to the findings, the highest prevalence rate of knee pain was in subjects with a BMI higher than 30 (31.6%) and BMI 25–30 (24.5%). 39.2% of the subjects never experienced knee pain, 16.6% monthly, 13.4% once a week, 20.4% daily, and 10.4% of them had prolonged knee pain experience. The prevalence of gender-based knee pain was 60.5% among women and 38.6% among men. 30.5% of women and 61.4% of men never experienced knee pain.

UVA Exposure Combined with Glycation of the Dermis Are Two Catalysts for Skin Aging and Promotes a Favorable Environment to the Appearance of Elastosis

Skin aging is the result of superimposed intrinsic (individual) and extrinsic (e.g., UV exposure or nutrition) aging. Previous works have reported a relationship between UV irradiation and glycation in the aging process, leading, for example, to modified radical species production and the appearance of AGEs (advanced glycosylation end products) in increasing quantities, particularly glycoxidation products like pentosidine. In addition, the colocalization of AGEs and elastosis has also been observed. We first investigated the combination of the glycation reaction and UVA effects on a reconstructed skin model to explain their cumulative biological effect. We found that UVA exposure combined with glycation had the ability to intensify the response for specific markers: for example, MMP1 or MMP3 mRNA, proteases involved in extracellular matrix degradation, or proinflammatory cytokine, IL1α, protein expression. Moreover, the association of glycation and UVA irradiation is believed to promote an environment that favors the onset of an elastotic-like phenomenon: mRNA coding for elastin, elastase, and tropoelastin expression is increased. Secondly, because the damaging effects of UV radiation in vivo might be more detrimental in aged skin than in young skin due to increased accumulation of pentosidine and the exacerbation of alterations related to chronological aging, we studied the biological effect of soluble pentosidine in fibroblasts grown in monolayers. We found that pentosidine induced upregulation of CXCL2, IL8, and MMP12 mRNA expression (inflammatory and elastotic markers, respectively). Tropoelastin protein expression (elastin precursor) was also increased. In conclusion, fibroblasts in monolayers cultured with soluble pentosidine and tridimensional in vitro skin constructs exposed to the combination of AGEs and UVA promote an inflammatory state and an alteration of the dermal compartment in relation to an elastosis-like environment.

The Connections between Attitudes towards Nursing Home Placement, Intergenerational Solidarity, and the Conflict between Tradition and Modernity among Three Generations of Arab Muslim Families in Israel

The goal of this study was to examine three generations of Arab Muslims in Israel, to investigate the relationships between their attitudes regarding the placement of an older relative in a nursing home, intergenerational solidarity, and to ultimately proceed with the nursing home placement. The backdrop to this examination was the increasing sociocultural tension between modernization tendencies and the long-established traditions and norms in the Arab Muslim society in Israel. The sample included a total of 126 university students, as well as one parent and one grandparent of each student. All participants completed identical questionnaires examining the attitudes towards the nursing home placement of an elder relative. The findings of the study indicate a strong objection among the youngest generation, whose attitudes were more similar to those of their grandparents than to those of their parents. Psychosocial mechanisms in the Arab Muslim population, such as intergenerational solidarity, has been the subject of increased scrutiny and debate over recent years, given the intensive pace of modern developments, which has called into question the familiar norms, thus constituting a threat to the tradition that has guided the population throughout numerous centuries and generations.

Urban-Rural Dimension of Falls and Associated Risk Factors among Community-Dwelling Older Adults in West Java, Indonesia

Falls are one of the common problems among older adults; it is estimated that 684,000 fatal cases of falls occur every year. Furthermore, falls constitute one of the leading causes of mortality due to accidental injury. This study aims to identify the risk factors for falls in the older adults who live in the community, according to the dimensions of the living area: in urban and rural. The proportional sampling method was used to identify the rural and urban areas in West Java Prefecture; meanwhile, the incidence of fall in the last 12 months was selected as the outcome variable. Furthermore, sociodemographic background, chronic medical condition, fear of falling, visual and hearing impairments, Activity of Daily Living (ADL), Barthel index, physical performance (Short Performance Physical Battery (SPPB)), and living environment were analyzed to identify the risk factors that contribute to the incidence of falls. A total of 611 older adults participated in this study: 62% of them are living in rural area and 38% of them are living urban areas. More than 70% of study participants were aged 60–69 years, while 73% were females. There is no significant difference in fall prevalence in rural (16.5%) and urban (10.7%) areas ( p value = 0.228). Furthermore, the multiple logistic regression analysis showed that the male gender (OR = 0.29, 95%CI [0.09–0.88]), chronic illness (OR = 3.25, 95%CI [1.24–8.53]), and visual impairment (OR = 3.6, 95%CI [1.52–8.54]) were associated with fall among older adults in urban areas. Meanwhile, visual impairment (OR = 1.81, 95%CI [1.03–3.18]) and living environment (OR = 3.36, 95% CI [1.14–9.93]) were significantly associated with falls in rural areas. Based on the associated risk factors identified in this study, a different approach is needed to reduce the falling risk among older adults in urban and rural areas in Indonesia.

Depression in the Iranian Elderly: A Systematic Review and Meta-Analysis

Depression can lead to increased medical costs, impaired individual and social functioning, nonadherence to therapeutic proceeding, and even suicide and ultimately affect quality of life. It is important to know the extent of its prevalence for successful planning in this regard. This study was conducted to determine the prevalence of depression in the Iranian elderly. This systematic review and meta-analysis study was done through Medline via PubMed, SCOPUS, Web of Science, ProQuest, SID, Embase, and Magiran with determined keywords. Screening was done on the basis of relevance to the purpose of the study, titles, abstracts, full text, and inclusion and exclusion criteria. The quality of the articles was assessed using the Newcastle-Ottawa standard scale. After primary and secondary screening, 30 articles were finally included in the study. According to the 30 articles reviewed, the prevalence of depression in the Iranian elderly was 52 percent based on the random-effects model (CI 95%: 46–58). According to the results of the present study, depression in the Iranian elderly was moderate to high. Therefore, more exact assessment in terms of depression screening in elderly people seems necessary. Coherent and systematic programs, including psychosocial empowerment counselling for the elderly and workshops for their families, are also needed. Researchers can also use the results of this study for future research.

Test-Retest Reliability of Low-Cost Posturography for Assessing Postural Stability Control Performance during Standing

Postural stability control performance assessment is necessary in providing important information for individuals who are at risk of falling or who have balance impairment. Instrumented assessment is suggested as a valid and reliable test, but the cost and the difficulty of setup are significant limitations. The aim of this cross-sectional (test-retest reliability) study was to develop and determine the reliability of a low-cost posturography for assessing postural stability control performance during standing. The low-cost posturography was developed with four load cells and an acrylic platform. The center of pressure (COP) displacement and velocity were analyzed using written software. Test-retest reliability was performed with six different standing postural stability tests in twenty healthy volunteers on two different days. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), coefficient of variation (CV), and Bland–Altman plot and limits of agreements (LOA) were used for analyses. The low-cost posturography was accurate (ICC = 0.99, p < 0.001 ; SEM = 0.003 cm) when compared to the true with calculated X and Y coordinates, with a moderate to excellent test-retest reliability for both COP displacement (ICCs ranged 0.62–0.91, p < 0.05 ; SEMs ranged 17.92–25.77%) and COP velocity (ICCs ranged 0.62–0.91, p < 0.05 ; SEMs ranged 18.09–27.69%) in all standing postural stability tests. Bland–Altman plots and LOAs suggested good agreement of tested parameters from the developed low-cost posturography between different days. In conclusion, the developed low-cost posturography had adequate reliability for assessing COP displacement and velocity during standing postural control stability performance tests.

The Effect of Exercise and Learning Therapy on Cognitive Functions and Physical Activity of Older People with Dementia in Indonesia

Background. This study aims to analyze the effect of exercise and learning therapy on the cognitive functions and daily physical activities of older people with dementia in Indonesia. Methods. This was an experimental study with a pretest-posttest design and a control group. Samples were selected using nonrandom sampling methods and were then randomly assigned to intervention and control groups. The study population was older people with mild-to-moderate dementia, and the sample number was 90 people. The intervention group received an Indonesian physical exercise program for older people and reading therapy through 12 sessions over four weeks. The intervention was led by a community health volunteer who has been trained and certified. Results. The mean score for cognitive function in the intervention group showed significant increase between pre- and postintervention, with p value < 0. 001 , and there was no significant difference in the control group before and after intervention, with a p value of 0. 198 . Further, the Mann–Whitney test showed that there were significant differences in the mean scores for cognitive function between the intervention and control groups with p value < 0. 001 and a 95% confidence level. Conclusion. Based on the results, the Indonesian older people exercise program and reading aloud activity had a positive effect on the cognitive function of older people with dementia.

Acute Effects of Low- and High-Speed Resistance Exercise on Cognitive Function in Frail Older Nursing-Home Residents: A Randomized Crossover Study

Aim. The present study investigated the acute effects of low- and high-speed resistance exercise on the cognitive function of frail older women living in nursing home. Materials and Methods. Ten institutionalized frail older women were recruited. Rey Auditory Verbal Learning Test and Stroop test were performed before, immediately after, 1 h after, and 24 h after the end of the experimental session. Participants randomly performed low- and high-speed resistance exercise and a control session. Exercise sessions were composed of 4 resistance exercises with 4–8 sets of 4–10 repetitions at moderate intensity. Results. Results indicated that the performance of Rey Auditory Verbal Learning Test was similarly increased immediately after both low- and high-speed resistance exercises. However, only improvements elicited by low-speed resistance exercise remained significant 1 h after the end of the exercise session. No acute effects of resistance exercise were observed on Stroop performance. Conclusion. Our findings indicated that both low- and high-speed resistance exercises acutely increased episodic memory in frail older women, whereas no changes on Stroop were observed.

Evaluation of Nutrients Intake for a Group of Jordanian Older Adults with Sarcopenia Syndrome in Amman: An Explorative and Pilot Study

Aim. Sarcopenia is an age-related syndrome that is characterized by a progressive loss of muscle mass, strength, and function. This study was performed in order to evaluate nutrients intake and physical activity level and to investigate the effect of sarcopenia syndrome on food intake for a group of Jordanian older adults with sarcopenia syndrome in Amman. Methodology. The study sample consisted of 25 nonsarcopenic people and 25 sarcopenic patients aged over 60 years old with a male to female ratio of 1 : 1. A special questionnaire was used to collect demographic data, health data, data about syndrome characteristics, nutritional assessment, and physical activity level. A 24-hour recall was also used to collect food intake data. Body weight, height, and skinfold thicknesses were measured. Results. The mean of the sarcopenic patients’ age was 77.5 ± 6.9 years, and the mean of the weight was significantly lower in sarcopenic patients than the nonsarcopenic people. In this study, all macronutrients and micronutrients from dietary intake information were analyzed. Vitamin intake (water- and fat-soluble), as well as minerals (major and trace), amino acids, and essential fatty acids, was assessed. The mean intake of energy and carbohydrates, fat, and dietary fiber was lower than their recommendations, while the mean intake of protein was within the range of its recommendations in the sarcopenia group. The mean of the intake of omega 3 and omega 6 was below their recommendations. Conclusion. It could be concluded that sarcopenic older patients in Jordan have similar characteristics with patients studied worldwide with regard to age of patients, female to male ratio, and main symptoms. Sarcopenic older patients in Jordan generally have lower weight and BF% than nonsarcopenic adults and have inadequate dietary intake compared to their recommendations and compared to nonsarcopenic older adults. Therefore, the diet of sarcopenic patients needs modification and follow-up. The level of physical activity and daily living activities for sarcopenic older patients is lower than that of nonsarcopenic older adults.