Determinants of participation in a post-hospitalization physical exercise program for older adults

Abstract BACKGROUND: Older patients often experience a decline in physical function and cognitive status after hospitalization. Although interventions involving physical exercise are effective in improving functional performance, participation in physical exercise interventions among older individuals is low. We aimed to identify factors that contribute to exercise refusal among post-hospitalized older patients.METHODS: A cross-sectional study of recruitment data from a randomized controlled trial was conducted involving 495 hospitalized people ≥70 years old. Sociodemographic and clinical data were obtained from the Basque Public Health System database. We determined physical function with the Short Physical Performance Battery (SPPB), nutritional status with the Mini-Nutritional Assessment, frailty according to the Fried phenotype criteria, and cognitive function with the Short Portable Mental Status Questionnaire (SPMSQ). Student’s t, Mann-Whitney U, or chi-squared tests were applied for bivariate analysis. Parameters significantly associated with participation were introduced in a logistic multivariate regression model.RESULTS: Among the analyzed patients, 88.8% declined participation in the physical exercise program. Multivariate regression revealed that older age (OR: 1.13; 95% CI: 1.07 - 1.19), poor nutritional status (OR: 0.81; 95% CI: 0.69 - 0.95), and reduced home accessibility (OR: 0.27; 95% CI: 0.08 - 0.94) were predictors of participation refusal. Moreover, patients who declined participation had worse performance on the SPPB (P < 0.05) and its tests of balance, leg strength, and walking speed (P < 0.05). No differences were found between groups in other variables. CONCLUSIONS: This study confirms low participation of older adults in a post-hospitalization physical exercise program. Non-participation was associated with increased age, poor nutritional status, and reduced home accessibility. Our findings support the need for intervention design that accounts for these factors to increase older patient participation in beneficial exercise programs.TRIAL REGISTRATION: ACTRN12619000093189 (retrospectively registered): Registered January 22, 2019.

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Determinants of participation in a post-hospitalization physical exercise program for older adults

10.21203/rs.3.rs-27243/v3 ◽

2020 ◽

Author(s):

Miriam Urquiza ◽

Iñaki Echeverria ◽

Ariadna Besga ◽

Maria Amasene ◽

Idoia Labayen ◽

...

Keyword(s):

Older Adults ◽

Physical Exercise ◽

Nutritional Status ◽

Physical Function ◽

Multivariate Regression ◽

Older Patients ◽

Exercise Program ◽

Cognitive Status ◽

Exercise Interventions ◽

Poor Nutritional Status

Abstract BACKGROUND: Older patients often experience a decline in physical function and cognitive status after hospitalization. Although interventions involving physical exercise are effective in improving functional performance, participation in physical exercise interventions among older individuals is low. We aimed to identify factors that contribute to exercise refusal among post-hospitalized older patients.METHODS: A cross-sectional study of recruitment data from a randomized controlled trial was conducted involving 495 hospitalized people ≥70 years old. Sociodemographic and clinical data were obtained from the Basque Public Health System database. We determined physical function with the Short Physical Performance Battery (SPPB), nutritional status with the Mini-Nutritional Assessment, frailty according to the Fried phenotype criteria, and cognitive function with the Short Portable Mental Status Questionnaire (SPMSQ). Student’s t, Mann-Whitney U, or chi-squared tests were applied for bivariate analysis. Parameters significantly associated with participation were introduced in a logistic multivariate regression model.RESULTS: Among the analyzed patients, 88.8% declined participation in the physical exercise program. Multivariate regression revealed that older age (OR: 1.13; 95% CI: 1.07 - 1.19), poor nutritional status (OR: 0.81; 95% CI: 0.69 - 0.95), and reduced home accessibility (OR: 0.27; 95% CI: 0.08 - 0.94) were predictors of participation refusal. Moreover, patients who declined participation had worse performance on the SPPB (P < 0.05) and its tests of balance, leg strength, and walking speed (P < 0.05). No differences were found between groups in other variables. CONCLUSIONS: This study confirms low participation of older adults in a post-hospitalization physical exercise program. Non-participation was associated with increased age, poor nutritional status, and reduced home accessibility. Our findings support the need for intervention design that accounts for these factors to increase older patient participation in beneficial exercise programs.TRIAL REGISTRATION: ACTRN12619000093189 (retrospectively registered): Registered January 22, 2019.

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Determinants of Participation in A Post-Hospitalization Physical Exercise Program for Older Adults

10.21203/rs.3.rs-27243/v1 ◽

2020 ◽

Author(s):

Miriam Urquiza ◽

Iñaki Echeverria ◽

Ariadna Besga ◽

Maria Amasene ◽

Idoia Labayen ◽

...

Keyword(s):

Older Adults ◽

Physical Exercise ◽

Nutritional Status ◽

Multivariate Regression ◽

Older Patients ◽

Exercise Program ◽

Mini Nutritional Assessment ◽

Cognitive Status ◽

Exercise Interventions ◽

People Participation

Abstract BACKGROUND: In older patients, functional and cognitive status often decline after hospitalization. Although interventions based on physical exercise can revert these effects, participation in physical exercise interventions is low. This study aimed to identify determinants of refusal to participate in a physical exercise program in post-hospitalized older patients. METHODS: Cross-sectional study of recruitment data from a randomized controlled trial. A total of 509 hospitalized people ≥70 years old participated in this study. Sociodemographic and clinical data were obtained from the Basque Public Health System database. We measured physical function with the Short Physical Performance Battery (SPPB), nutritional status by the Mini-Nutritional Assessment, frailty according to the Fried phenotype criteria, and cognitive function by the Short Portable Mental Status Questionnaire (SPMSQ). Student’s t, Mann-Whitney U or chi-squared tests were applied for bivariate analysis. Parameters significantly associated with participation were introduced in a logistic multivariate regression model. RESULTS: Of evaluated patients, 10.8% declined physical exercise program participation. Multivariate regression revealed that older age (OR: 1.13; 95% CI: 1.06 - 1.18), poor nutritional status (OR: 0.82; 95% CI: 0.69 - 0.96), and worse home accessibility (OR: 0.26; 95% CI: 0.07 - 0.9) were predictors of lower participation. Moreover, patients who declined participation had worse performance in SPPB ( p < 0.05) and its three tests: balance, leg strength and walking speed ( p < 0.05). No differences were found between groups in other variables. CONCLUSIONS: This study confirms low participation of older adults in a post-hospitalization physical exercise program. Non-participation was associated with higher age, poorer nutritional status, and reduced home accessibility. Our findings support the need to design interventions accounting for these determinants to increase older patient participation. TRIAL REGISTRATION: ACTRN12619000093189 (retrospectively registered): Registered January 22, 2019. KEY WORDS Physical exercise, older people, participation, post-hospitalization

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Determinants of participation in a post-hospitalization physical exercise program for older adults

10.21203/rs.3.rs-27243/v4 ◽

2020 ◽

Author(s):

Miriam Urquiza ◽

Iñaki Echeverria ◽

Ariadna Besga ◽

Maria Amasene ◽

Idoia Labayen ◽

...

Keyword(s):

Older Adults ◽

Physical Exercise ◽

Nutritional Status ◽

Physical Function ◽

Multivariate Regression ◽

Older Patients ◽

Exercise Program ◽

Cognitive Status ◽

Exercise Interventions ◽

Poor Nutritional Status

Abstract BACKGROUND: Older patients often experience a decline in physical function and cognitive status after hospitalization. Although interventions involving physical exercise are effective in improving functional performance, participation in physical exercise interventions among older individuals is low. We aimed to identify factors that contribute to exercise refusal among post-hospitalized older patients.METHODS: A cross-sectional study of recruitment data from a randomized controlled trial was conducted involving 495 hospitalized people ≥70 years old. Sociodemographic and clinical data were obtained from the Basque Public Health System database. We determined physical function with the Short Physical Performance Battery (SPPB), nutritional status with the Mini-Nutritional Assessment, frailty according to the Fried phenotype criteria, and cognitive function with the Short Portable Mental Status Questionnaire (SPMSQ). Student’s t, Mann-Whitney U, or chi-squared tests were applied for bivariate analysis. Parameters significantly associated with participation were introduced in a logistic multivariate regression model.RESULTS: Among the analyzed patients, 88.8% declined participation in the physical exercise program. Multivariate regression revealed that older age (OR: 1.13; 95% CI: 1.07 - 1.19), poor nutritional status (OR: 0.81; 95% CI: 0.69 - 0.95), and reduced home accessibility (OR: 0.27; 95% CI: 0.08 - 0.94) were predictors of participation refusal. Moreover, patients who declined participation had worse performance on the SPPB (P < 0.05) and its tests of balance, leg strength, and walking speed (P < 0.05). No differences were found between groups in other variables. CONCLUSIONS: This study confirms low participation of older adults in a post-hospitalization physical exercise program. Non-participation was associated with increased age, poor nutritional status, and reduced home accessibility. Our findings support the need for intervention design that accounts for these factors to increase older patient participation in beneficial exercise programs.

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Determinants of participation in a post-hospitalization physical exercise program for older adults

BMC Geriatrics ◽

10.1186/s12877-020-01821-3 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Miriam Urquiza ◽

Iñaki Echeverria ◽

Ariadna Besga ◽

María Amasene ◽

Idoia Labayen ◽

...

Keyword(s):

Older Adults ◽

Physical Exercise ◽

Nutritional Status ◽

Physical Function ◽

Multivariate Regression ◽

Older Patients ◽

Exercise Program ◽

Trial Registration ◽

Exercise Interventions ◽

Poor Nutritional Status

Abstract Background Older patients often experience a decline in physical function and cognitive status after hospitalization. Although interventions involving physical exercise are effective in improving functional performance, participation in physical exercise interventions among older individuals is low. We aimed to identify factors that contribute to exercise refusal among post-hospitalized older patients. Methods A cross-sectional study of recruitment data from a randomized controlled trial was conducted involving 495 hospitalized people ≥70 years old. Sociodemographic and clinical data were obtained from the Basque Public Health System database. We determined physical function with the Short Physical Performance Battery (SPPB), nutritional status with the Mini-Nutritional Assessment, frailty according to the Fried phenotype criteria, and cognitive function with the Short Portable Mental Status Questionnaire (SPMSQ). Student’s t, Mann-Whitney U, or chi-squared tests were applied for bivariate analysis. Parameters significantly associated with participation were introduced in a logistic multivariate regression model. Results Among the analyzed patients, 88.8% declined participation in the physical exercise program. Multivariate regression revealed that older age (OR: 1.13; 95% CI: 1.07–1.19), poor nutritional status (OR: 0.81; 95% CI: 0.69–0.95), and reduced home accessibility (OR: 0.27; 95% CI: 0.08–0.94) were predictors of participation refusal. Moreover, patients who declined participation had worse performance on the SPPB (P < 0.05) and its tests of balance, leg strength, and walking speed (P < 0.05). No differences were found between groups in other variables. Conclusions This study confirms low participation of older adults in a post-hospitalization physical exercise program. Non-participation was associated with increased age, poor nutritional status, and reduced home accessibility. Our findings support the need for intervention design that accounts for these factors to increase older patient participation in beneficial exercise programs. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12619000093189, (date: January 22, 2019, retrospectively registered).

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EFFECT OF PHYSICAL EXERCISE ON COGNITION IN ADULT DAY PARTICIPANTS

Innovation in Aging ◽

10.1093/geroni/igz038.2421 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S652-S653

Author(s):

Bradford Stucki ◽

Ben Katz ◽

Jonathan Briganti ◽

Ila Schepisi ◽

Shannon Jarrott

Keyword(s):

Older Adults ◽

Physical Exercise ◽

Effective Means ◽

Cognitive Status ◽

Data Set ◽

Moderation Effect ◽

Exercise Interventions ◽

Mini Mental Status Exam ◽

Exercise Regimen ◽

Exercise Activity

Abstract Aerobic exercise has been demonstrated to be one of the most effective means of improving cognition in older adults. However, less is known about how exercise programs may improve cognition in older adults participating in Adult Day Service (ADS) programs. We analyzed a ten-year longitudinal data set from the Virginia Tech ADS center. We limited our analyses to individuals for whom we had two time points of the Mini-Mental Status Exam (MMSE) (n=142; average age = 78.48; 63 female, average days at center = 347; SD=432.71). Participants in the center completed approximately 30 minutes of physical exercise each day of attendance. The exercise regimen was largely composed of aerobic chair exercise, stretching, and lifting. Facilitator ratings of engagement with the exercise activity between the two test administrations were used to create an average engagement score for each participant. Multiple regression analyses were conducted using engagement as a predictor and change in MMSE as an outcome; no significant relationship was identified between exercise engagement and change in cognitive status. However, a moderation analysis conducted with diagnosis of Alzheimer’s disease (AD) or dementia as a predictor, change in MMSE as an outcome, and exercise engagement as a moderator revealed a significant moderation effect (p = .001). Greater exercise engagement was associated with improvements on the MMSE, but only for individuals without a diagnosis of AD or dementia. Given that many ADS programs serve individuals both with and without AD or dementia, these findings may inform more personalized exercise interventions at ADS centers.

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Multicomponent Physical Exercise in Older Adults after Hospitalization: A Randomized Controlled Trial Comparing Short- vs. Long-Term Group-Based Interventions

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17020666 ◽

2020 ◽

Vol 17 (2) ◽

pp. 666 ◽

Cited By ~ 2

Author(s):

Iñaki Echeverria ◽

Maria Amasene ◽

Miriam Urquiza ◽

Idoia Labayen ◽

Pilar Anaut ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Physical Exercise ◽

Nutritional Status ◽

Physical Function ◽

Mixed Model ◽

Exercise Intervention ◽

Exercise Interventions ◽

Positive Effects

Multicomponent physical exercise is effective in curbing the effect of hospitalization in older adults. However, it is not well established which characteristics of the exercise interventions would optimize intervention sustainability and efficacy. This study compared the effects of two group-based multicomponent exercise interventions of different lengths in older adults after hospitalization. Fifty-five participants were randomly assigned to a short-term group-based branch (SGB, n = 27) or to a long-term group-based branch (LGB, n = 28). The SGB participated in a six-week multicomponent group-based exercise-training program followed by 18 weeks of home-based exercise. The LGB completed 12 weeks of each phase. Physical function, physical activity, quality of life, anthropometrics, and nutritional status were assessed at baseline, after 12 weeks, and after 24 weeks of intervention. Both groups improved physical function and nutritional status and increased physical activity after 12 weeks of intervention (paired student’s t-test, p < 0.01), and maintained the positive effects during the following 12 weeks. No group-by-time interaction was observed in any of the studied variables using mixed-model ANOVA. Based on these findings, we determined that 6 weeks of a group-based exercise intervention caused similar functional and nutritional benefits to a longer group-based intervention of 12 weeks when both are continued at home until 24 weeks.

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Optimization of the Effects of Physical Activity on Plantar Sensation and Postural Control With Barefoot Exercises in Institutionalized Older Adults: A Pilot Study

Journal of Aging and Physical Activity ◽

10.1123/japa.2018-0016 ◽

2019 ◽

Vol 27 (4) ◽

pp. 452-465

Author(s):

Karim Korchi ◽

Frédéric Noé ◽

Noëlle Bru ◽

Thierry Paillard

Keyword(s):

Older Adults ◽

Pilot Study ◽

Physical Exercise ◽

Exercise Intervention ◽

Exercise Program ◽

Falls Prevention ◽

Control Group ◽

Noticeable Effect ◽

Exercise Interventions ◽

Somatosensory Information

Increasing somatosensory information from the foot by exercising barefoot can potentially optimize the effectiveness of physical exercise interventions on falls prevention in the older adults. This pilot study was then undertaken to explore the effects of increased somatosensory information from the foot by exercising barefoot on balance, gait, and plantar cutaneous sensitivity in institutionalized older adults involved in multimodal exercise intervention. Participants were assigned to three groups: a control group which did not perform any physical exercise and two groups in which they were involved in a multimodal exercise program performed barefoot or shod. Postural, gait, and plantar cutaneous sensitivity parameters were collected. The results showed that the exercise program produced larger effects on balance and plantar cutaneous sensitivity when exercises were performed barefoot, without any noticeable effect on gait. Hence, barefoot exercising could be a relevant means to optimize the fall-prevention exercise programs in institutionalized older adults.

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Nutritional Status and Its Contributing Factors among Older Adults with Cancer Receiving Chemotherapy

Clinical Nursing Research ◽

10.1177/1054773820947953 ◽

2020 ◽

Vol 29 (8) ◽

pp. 650-658

Author(s):

Eman Shokry Abd Allah ◽

Hanan Mohammed Mohammed Gad ◽

Hassanat Ramadan Abdel-Aziz

Keyword(s):

Older Adults ◽

Nutritional Status ◽

Older Patients ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

University Hospitals ◽

Contributing Factors ◽

Patients With Cancer ◽

Study Results ◽

Relationship Of

The study aimed to assess nutritional status and its contributing factors among older adults with cancer receiving chemotherapy so, a descriptive study design was used. The study was conducted at Zagazig University Hospitals, Egypt. The study’s sample was selected purposively which composed of 194 older adults. Nutritional status was measured by the Arabic version of the Mini-Nutritional Assessment (MNA). Contributing factors were identified by examining the relationship of nutritional status with demographic and clinical variables. Study results revealed that 33% of the older patients were malnourished and 51.5% were at risk for malnutrition. Statistically significant relations were found between nutritional status and advanced age, illiteracy, insufficient monthly income, comorbidities, cancer stage four at diagnosis, and receiving ≥4 chemotherapy cycles. High prevalence of malnutrition and many contributing factors were identified among older patients with cancer receiving chemotherapy. So, continuous malnutrition screening along chemotherapy courses with special concern for contributing factors assessed in this study is recommended.

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A High Masticatory Muscle Tone Predicts the Risk of Malnutrition and Frailty in Inpatient Older Adults: A Cross-Sectional Study

Gerontology ◽

10.1159/000516627 ◽

2021 ◽

pp. 1-7

Author(s):

Yin-Hwa Shih ◽

Zhen-Rong Hong ◽

Shih-Min Hsia ◽

Shang-Yu Yang ◽

Tzong-Ming Shieh

Keyword(s):

Older Adults ◽

At Risk ◽

Nutritional Status ◽

Masseter Muscle ◽

Muscle Tone ◽

Handgrip Strength ◽

Muscle Performance ◽

Masticatory Muscle ◽

Masticatory Performance ◽

Poor Nutritional Status

Introduction: The prevalence of malnutrition among inpatient older adults is as high as 20∼50%. Masticatory performance is known to affect the nutritional status of individuals. However, an objective measurement to reflect the real status of masticatory muscle performance is lacking at the bedside. Methods: This pilot study analyzed the masticatory performance using surface electromyography (sEMG) of masticatory muscles that measures both muscle strength and muscle tone at the bedside. The nutritional status was measured using the Mini Nutritional Assessment tool. The handgrip strength was measured using a hand dynamometer. The statistical data were analyzed using SPSS 25 software. Results: The data revealed that female inpatient older adults more frequently had substandard handgrip strength (p = 0.028), an at-risk and poor nutritional status (p = 0.005), and a higher masseter muscle tone (p = 0.024). Inpatient older adults with an at-risk and poor nutritional status had an older age (p = 0.016), lower handgrip strength (p = 0.001), and higher average masseter muscle tone (p = 0.01). A high masseter muscle tone predicted the risk of having an at-risk and poor nutritional status. The at-risk or poor nutritional status predicted having a substandard handgrip strength by 5-fold. Conclusions: A high masticatory muscle tone predicts malnutrition and frailty. Medical professionals should combat masticatory dysfunction-induced malnutrition by detecting masticatory muscle performance using sEMG and referring patients to dental professionals. Additionally, encouraging inpatient older adults to perform oral motor exercise is recommended.

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