Telephone versus mail interventions for maintenance of physical activity in older adults.

Although telephone and mail are often used to promote physical activity adoption, their ability to produce long-term maintenance is unclear. In this study, 140 men and women aged 50-65 years received 1 year of telephone counseling to adopt higher (i.e., more vigorous) versus lower intensity (i.e., moderate) exercise. After 1 year, participants were rerandomized to a 2nd year of contact via (a) telephone and mail or (b) predominantly mail. Participants who were prescribed higher intensity exercise and received predominantly mail had better exercise adherence during the maintenance year than those who received telephone and mail. Both strategies were similarly effective in promoting maintenance in the lower intensity condition. Results suggest that after successful adoption of physical activity with the help of telephone counseling, less intensive interventions are successful for physical activity maintenance in older adults.

Sleep problems as a risk factor for falls in a sample of community-dwelling adults aged 64-99 years.

OBJECTIVES: The purpose of this study was to determine if reported nighttime sleep problems and daytime sleepiness were associated with reported falling during the previous 12 months in a representatively sampled older adult population. DESIGN: Random-digit dial telephone survey. SETTING: Representatively sampled older adult population living in northern California. PARTICIPANTS: Participants were 971 women and 555 men, aged 64 to 99 years. MEASUREMENTS: Twenty-minute telephone interview adapted from the National Health Interview Survey. RESULTS: Two hundred and eighty-four participants reported falling during the previous 12 months (19% of the sample). Significantly more women fell than men (20% and 14%, respectively, P < .001). The following variables were significant risk factors for falling in univariate analyses: female gender, being unmarried, living alone, income less than $15,000 per year, difficulty walking, having more than one chronic medical condition, history of cardiovascular disease, hypertension, arthritis, sensory impairment, psychological difficulties, and nighttime sleep problems. All of the nighttime sleep problem variables remained significant risk factors for falling after controlling for other risk factors for falling. CONCLUSIONS: The results provide support for an independent association between reported sleep problems and falls in an older population. One of the implications of these data is that behavioral research focusing on the effectiveness of insomnia treatment in old age should not only examine typical sleep-related outcomes (e.g., total time asleep, number of awakenings) but also the occurrence of falls as well.

Anger expression and natural killer cell activity in family caregivers participating in a physical activity trial.

Associations between psychological functioning and natural killer cell activity (NKA) were examined in 23 older (62.2 ± 7.5 years) family caregivers randomized to a moderate intensity four-month exercise program or to a wait-list control condition. At baseline, although NKA was related to anger-control (r = -.42; trend p < .06) and anger-out (r = .50; p < .03), it was not related to depression, anxiety, perceived stress, or caregiver burden. After controlling for baseline NKA, changes in anger-control explained 14 percent of the variance in NKA four months later. Decreases in anger-control predicted increases in NKA. Group assignment (exercise vs control) was unrelated to changes in NKA over the four-month period; however, the study was not powered to detect this effect. These results are consistent with reported relationships of anger expression with other physiological measures, and extend the importance of anger expression to immune functioning in older family caregivers.

Long-term effects of aerobic exercise on psychological outcomes.

BACKGROUND: Although the literature on increased physical fitness and psychological outcomes has grown large, a number of methodological limitations remain unaddressed. The present study was designed to address a number of these limitations while examining the short- and long-term psychological effects following completion of a 12-week aerobic fitness program using bicycle ergometry (and confirmed increases in fitness). METHOD: Following completion of a 12-week aerobic fitness program (and through 12 months of follow-up), 82 adult participants completed the Beck Depression Inventory, Profile of Mood States, State-Trait Anxiety Inventory, and the Tennessee Self-Concept Scale. Physiological measures used to assess changes in aerobic fitness were maximal work load, submaximal heart rate at a standard work load, predicted maximum oxygen uptake, and resting heart rate. RESULTS: Exercise participants experienced a positive fitness change and psychological improvement over the initial 12-week program compared to a control group. At 1 year follow-up, physiological and psychological benefits remained significantly improved from baseline. CONCLUSIONS: Overall, results indicate that exercise-induced increases in aerobic fitness have beneficial short-term and long-term effects on psychological outcomes. We postulate that participants in the exercise group did not increase the amount of weekly exercise they performed over the 12-month follow-up period and thus the maintenance of the psychological improvements occurred concurrent with equal or lesser amounts of exercise.

Moderate-intensity exercise and self-rated quality of sleep in older adults. A randomized controlled trial.

OBJECTIVE: To determine the effects of moderate-intensity exercise training on self-rated (subjective) sleep quality among healthy, sedentary older adults reporting moderate sleep complaints. DESIGN: Randomized controlled trial of 16 weeks' duration. SETTING: General community. PARTICIPANTS: Volunteer sample of 29 women and 14 men (of 67 eligible subjects) aged 50 to 76 years who were sedentary, free of cardiovascular disease, and reported moderate sleep complaints. No participant was withdrawn for adverse effects. INTERVENTION: Randomized to 16 weeks of community-based, moderate-intensity exercise training or to a wait-listed control condition. Exercise consisted primarily of four 30- to 40-minute endurance training sessions (low-impact aerobics; brisk walking) prescribed per week at 60% to 75% of heart rate reserve based on peak treadmill exercise heart rate. MAIN OUTCOME MEASURE: Pittsburgh Sleep Quality Index (PSQI). RESULTS: Compared with controls (C), subjects in the exercise training condition (E) showed significant improvement in the PSQI global sleep score at 16 weeks (baseline and posttest values in mean [SD] for C=8.93 [3.1] and 8.8 [2.6]; baseline and posttest values for E=8.7 [3.0] and 5.4 [2.8]; mean posttest difference between conditions=3.4; P<.001; 95% confidence interval, 1.9-5.4), as well as in the sleep parameters of rated sleep quality, sleep-onset latency (baseline and posttest values for C=26.1 [20.0] and 23.8 [15.3]; for E=28.4 [20.2] and 14.6 [13.0]; net improvement=11.5 minutes), and sleep duration baseline and posttest scores for C=5.8 [1.1] and 6.0 [1.0]; for E=6.0 [1.1] and 6.8 [1.2]; net improvement=42 minutes) assessed via PSQI and sleep diaries (P=.05). CONCLUSIONS: Older adults with moderate sleep complaints can improve self-rated sleep quality by initiating a regular moderate-intensity exercise program.

Insomnia and styles of parental authority in college students.

This study explored the hypothesis that styles of parental authority are related to insomnia in college students. To do this, I asked a large group of university students (N = 757) to respond to a questionnaire that included the items of Buri's Parental Authority Questionnaire and the Coren Insomnia Scale. Analysis suggested that more strict and uncompromising discipline engaged in by authoritarian parents was associated with higher insomnia in young adults, while the firm though flexible and warm discipline associated with the authoritative parents was associated with less insomnia. Further, as fathers' permissiveness increased, insomnia decreased, while mothers' permissiveness seemed to be unrelated to insomnia.

Frequency of eating problems among Asian and Caucasian college women.

We compared the frequencies of Asian and Caucasian women who were classified by their responses to the EAT-26 scale as having eating problems. We noted that relative to their Asian peers, our sample of Caucasian women was 5.5 times more likely to score above the cut-off score for eating problems on this test. Two earlier studies which had reported opposite results for Asian and Caucasian women were discussed and reevaluated in the context of our data.