Exploring Differences in Older Adult Accelerometer-Measured Sedentary Behavior and Resting Blood Pressure Before and During the COVID-19 Pandemic.

Older adults have higher sedentary behavior (SB), lower physical activity, and are particularly susceptible to negative impacts from the COVID-19 pandemic and associated public health restrictions. Pandemic impacts to SB and health, particularly via objective assessment, are not well documented in the literature. Here we described differences in SB, physical activity, and blood pressure (BP) for older adults before and during the pandemic. Baseline thigh-worn activPAL accelerometer and BP measurements from 95 participants enrolled in a SB intervention trial pre-pandemic were compared to 60 enrolled post-pandemic. We used linear regression models adjusted for demographic and health factors to estimate differences in sample means of SB measures and BP. The post-COVID sample was older (age 67 vs. 70), more female (60% vs. 72%), and included more individuals of color (21% vs. 32%). In fully adjusted models, systolic BP was statistically significantly higher in the post-COVID group (6.8, 95% CI: [0.3,13.3]). After adjustment, activPAL-measured and self-reported activity were non-significant but trended towards greater total sitting (0.4 hours [-0.3, 1.1]), fewer daily steps (-270 [-1078, 538]), and greater self-reported TV time (0.4 hours, [-0.3, 1.1]) post-COVID. Future analyses are warranted to better quantify these impacts and guide clinical care and future interventions.

Protocol for a randomized controlled trial of sitting reduction to improve cardiometabolic health in older adults.

Older adults with obesity spend the majority of their waking hours sedentary. Given substantial barriers to regular physical activity in this population, approaches to reduce sedentary time could be an effective health promotion strategy. We present the protocol of a randomized controlled trial to reduce sitting time in older adults with a body mass index of 30 kg/m2 or above. Participants (N = 284) will be randomized to receive a sitting reduction intervention (termed I-STAND) or a healthy living focused attention control condition. I-STAND includes 10 contacts with a health coach (10 sessions total) and participants receive a wrist-worn prompting device and portable standing desk. The healthy living condition includes 10 sessions with a health coach to set goals around various topics relating to healthy aging. Participants receive their assigned intervention for 6 months. After 6 months, those receiving the I-STAND condition are re-randomized to receive five booster health coaching sessions by 'phone or no further contact; healthy living participants receive no further contact and those in both conditions are followed for an additional 6 months. Measurements initially included wearing an activPAL device and completing several biometric tests (e.g., blood pressure, HbA1c), at baseline, 3 months, 6 months, and 12 months; however, during the COVID-19 pandemic we shifted to remote assessments and were unable to collect all of these measures. The primary outcomes remained activPAL-assessed sitting time and blood pressure. Recruitment is anticipated to be completed in 2022.

"They're Going to Zoom It": A Qualitative Investigation of Impacts and Coping Strategies During the COVID-19 Pandemic Among Older Adults.

Introduction: Older adults, who already have higher levels of social isolation, loneliness, and sedentary behavior, are particularly susceptible to negative impacts from social distancing mandates meant to control the spread of COVID-19. We sought to explore the physical, mental, and social health impacts of the pandemic on older adults and their coping techniques. Materials and Methods: We conducted 25 semi-structured interviews with a sub-sample of participants in an ongoing sedentary behavior reduction intervention. Interviews were recorded and transcribed, and iterative coding was used to extract key themes. Results: Most participants reported an increase in sedentary behavior due to limitations on leaving their home and increased free time to pursue seated hobbies (e.g., reading, knitting, tv). However, many participants also reported increased levels of intentional physical activity and exercise, particularly outdoors or online. Participants also reported high levels of stress and a large decrease in in-person social connection. Virtual connection with others through phone and video was commonly used to stay connected with friends and family, engage in community groups and activities, and cope with stress and social isolation. Maintenance of a positive attitude and perspective gained from past hardships was also an important coping strategy for many participants. Discussion: The COVID-19 pandemic and associated social distancing measures have impacted older adults' perceived levels of activity, stress, and social isolation, but many leveraged technology and prior life experiences to cope. These themes could inform future interventions for older adults dealing with chronic stress and isolation.