Feasibility Trial Evaluation of a Peer Volunteering Active Aging Intervention: ACE (Active, Connected, Engaged).

BACKGROUND: ACE (Active, Connected, Engaged) is a theory-informed, pragmatic intervention using peer volunteering support to promote active ageing in socially disengaged, inactive older adults. This study aimed to establish ACE's feasibility and acceptability. METHODS: Fifty-four older adults were recruited as either peer volunteers (activators; n = 15) or participants (ACEs; n = 39). Participants were randomized to one-to-one support from an activator (ACEs-Intervention [ACEs-I]) or a waiting-list control group (ACEs-Control [ACEs-C]). Activators supported ACEs-I to get out more and engage with local activities. Objectively measured physical activity (PA), lower limb function, and number of out of house activities were assessed at baseline and post-intervention. A mixed-methods process evaluation assessed changes in confidence to get out and about, social support, autonomy, competence, and relatedness. RESULTS: Eighty-two percent of ACEs (mean age = 73.7 years [SD 7.3]) and all activators completed assessments at both baseline and post-intervention (6 months). ACEs-I reported more out of house activities (M [SD] = 6.34 [4.15]). ACEs-I increased physical function post-intervention (M [SD] = 9.8 [2.3]). ACEs-I reported improved well-being and vitality and increased confidence to get out and about, confidence in the face of specific barriers, knowledge of local initiatives, and perceived social support post-intervention. Activators, although sufficiently active at baseline, increased their PA further. ACE was well-accepted and easy to deliver. CONCLUSIONS: ACE is an acceptable and feasible intervention for helping socially disengaged older people to get out and about more, improve their confidence, and engage more with their community.

Higher plain water intake is associated with lower type 2 diabetes risk: a cross-sectional study in humans.

The aim of this study was to investigate the relationship between plain water intake and type 2 diabetes (T2D) risk. It was hypothesized that higher plain water intake would be associated with a lower T2D risk score. One hundred thirty-eight adults from Southwest and Southeast England answered a cross-sectional online survey assessing T2D risk (using the Diabetes UK risk assessment); physical activity (using the short International Physical Activity Questionnaire); and consumption of fruits, vegetables, and beverages (using an adapted version of the Cambridge European Prospective Investigation into Cancer and Nutrition Food Frequency Questionnaire). There was a trend for differences in mean plain water intake between those stratified as having low, increased, moderate, or high risk of T2D; but these did not achieve significance (P = .084). However, plain water intake was significantly negatively correlated with T2D risk score (τ = -0°180, P = .005); and for every 240-mL cup of water consumed per day, T2D risk score was reduced by 0.72 point (range, 0-47) (B = -0.03, 95% confidence interval = -0.06 to -0.01, P = .014). The current study has provided preliminary results that are supported by theory; mechanisms need to be explored further to determine the true effect of plain water intake on disease risk. As increasing plain water intake is a simple and cost-effective dietary modification, its impact on T2D risk is important to investigate further in a randomized controlled trial. Overall, this study found that plain water intake had a significant negative correlation with T2D risk score; and regression analysis suggested that water may have a role in reducing T2D risk.

Objectively assessed physical activity and lower limb function and prospective associations with mortality and newly diagnosed disease in UK older adults: an OPAL four-year follow-up study.

BACKGROUND: Objective measures of physical activity and function with a diverse cohort of UK adults in their 70s and 80s were used to investigate relative risk of all-cause mortality and diagnoses of new diseases over a 4-year period. PARTICIPANTS: Two hundred and forty older adults were randomly recruited from 12 general practices in urban and suburban areas of a city in the United Kingdom. Follow-up included 213 of the baseline sample. METHODS: Socio-demographic variables, height and weight, and self-reported diagnosed diseases were recorded at baseline. Seven-day accelerometry was used to assess total physical activity, moderate-to-vigorous activity and sedentary time. A log recorded trips from home. Lower limb function was assessed using the Short Physical Performance Battery. Medical records were accessed on average 50 months post baseline, when new diseases and deaths were recorded. ANALYSES: ANOVAs were used to assess socio-demographic, physical activity and lower limb function group differences in diseases at baseline and new diseases during follow-up. Regression models were constructed to assess the prospective associations between physical activity and function with mortality and new disease. RESULTS: For every 1,000 steps walked per day, the risk of mortality was 36% lower (hazard ratios 0.64, 95% confidence interval (CI) 0.44-0.91, P=0.013). Low levels of moderate-to-vigorous physical activity (incident rate ratio (IRR) 1.67, 95% CI 1.04-2.68, P=0.030) and low frequency of trips from home (IRR 1.41, 95% CI 0.98-2.05, P=0.045) were associated with diagnoses of more new diseases. CONCLUSION: Physical activity should be supported for adults in their 70s and 80s, as it is associated with reduced risk of mortality and new disease development.

Objectively measured sedentary time and its association with physical function in older adults.

The relationship of objectively measured sedentary time (ST), frequency of breaks in ST, and lower extremity function (LEF) was investigated in a diverse sample aged ≥ 70 years (n = 217). Physical activity (PA) was assessed by accelerometry deriving moderate-vigorous PA (MVPA) minutes per registered hour (MVPA min · hr(-1)), registered ST (ST min · hr(-1)), and breaks in ST min · hr(-1) (breaks · hr(-1)). LEF was assessed by the Short Physical Performance Battery. Univariate associations with overall LEF were MVPA (r = .523), ST (r = -.499), and breaks (r = .389). Adjusted linear regression including MVPA min · hr(-1), ST min · hr(-1), and breaks · hr(-1) explained 41.5% of LEF variance. Each additional break · hr(-1) was associated with 0.58 point increase in LEF. Breaks and MVPA had strongest independent associations with LEF. Promoting regular breaks might be useful in maintaining or increasing LEF and later life independence. This novel finding is important for the design of effective lifestyle interventions targeting older adults.

Getting out and about in older adults: the nature of daily trips and their association with objectively assessed physical activity.

BACKGROUND: A key public health objective is increasing health-enhancing physical activity (PA) for older adults (OAs). Daily trip frequency is independently associated with objectively assessed PA volumes (OAs). Little is known about correlates and these trips' transport mode, and how these elements relate to PA. PURPOSE: to describe the frequency, purpose, and travel mode of daily trips in OAs, and their association with participant characteristics and objectively-assessed PA. METHODS: Participants (n = 214, aged 78.1 SD 5.7 years), completed a seven-day trips log recording daily-trip frequency, purpose and transport mode. Concurrently participants wore an accelerometer which provided mean daily steps (steps·d-1), and minutes of moderate to vigorous PA (MVPA·d-1). Participants' physical function (PF) was estimated and demographic, height and weight data obtained. RESULTS: Trip frequency was associated with gender, age, physical function, walking-aid use, educational attainment, number of amenities within walking distance and cars in the household. Participants reported 9.6 (SD 4.2) trips per week (trips·wk-1). Most trips (61%) were by car (driver 44%, passenger 17%), 30% walking or cycling (active) and 9% public transport/other. Driving trips·wk-1 were more common in participants who were males (5.3 SD 3.6), well-educated (5.0 SD 4.3), high functioning (5.1 SD 4.6), younger (5.6 SD 4.9), affluent area residents (5.1 SD 4.2) and accessing > one car (7.2 SD 4.7). Active trips·wk-1 were more frequent in participants who were males (3.4 SD 3.6), normal weight (3.2 SD 3.4), not requiring walking aids (3.5 SD 3.3), well-educated (3.7 SD 0.7), from less deprived neighbourhoods (3.9 SD 3.9) and with ≥ 8 amenities nearby (4.4 SD 3.8).Public transport, and active trip frequency, were significantly associated with steps·d-1 (p < 0.001), even after adjustment for other trip modes and potential confounders. Public transport, active, or car driving trips were independently associated with minutes MVPA·d-1 (p < 0.01). CONCLUSIONS: Daily trips are associated with objectively-measured PA as indicated by daily MVPA and steps. Public transport and active trips are associated with greater PA than those by car, especially as a car passenger. Strategies encouraging increased trips, particularly active or public transport trips, in OAs can potentially increase their PA and benefit public health.

Objectively measured physical activity in a diverse sample of older urban UK adults.

BACKGROUND: There are many health and social benefits of physical activity (PA) for older adults, but little is known about their activity patterns. PURPOSE: The purpose of this study was to objectively assess the PA patterns of older adults and the lifestyle and demographic factors associated with PA. METHODS: Participants (N = 230, aged 78.1 yr) recruited from medical practices (between 2007 and 2008) completed journey logs and wore accelerometers for 7 d. Mean daily steps, counts per minute (CPM), minutes of sedentary, light, or moderate-to-vigorous PA (MVPA), and frequency of journeys were analyzed (in 2009). RESULTS: Younger participants (age = 70-74.9 yr) were significantly (P < 0.001) more active (5660.8 steps per day) than older participants aged 80+ yr (3409.6 steps per day). Men performed significantly (P = 0.035) more minutes MVPA than women (23.1 vs 13.8 min MVPA per day). Normal weight participants were significantly (P < 0.05) more active (5368.9 steps per day) than overweight (4532.7 steps per day) and obese (3251.4 steps per day) groups. Those performing many journeys (>11.6 journeys per week) were significantly (P < 0.001) more active (5838.2 steps per day) than those performing few (<7 journeys per week) (3094.2 steps per day). PA was significantly (P < 0.001) greater in mornings (259.3 CPM) than afternoons (181.8 CPM) and evenings (102.5 CPM). Sundays were significantly (P < 0.001) less active (3331.7 steps per day) than Saturdays (4193.1 steps per day) and weekdays (4623.5 steps per day). Light activity was significantly (P = 0.005) higher in spring (3.4 h·d(-1)) than that in winter (2.7 h·d(-1)). CONCLUSIONS: Older adults' PA patterns differ by age, gender, and weight status. Daily journeys are associated with more activity for all groups. Variability in volume of activity is high for all age groups. Temporal patterns of PA indicate that journeys out of the house for shopping and personal business are important in their contribution to PA levels.

Physical activity and mental well-being in older people participating in the Better Ageing Project.

Increasing evidence suggests that physical activity can prevent some aspects of mental illness in older people such as depression, dementia and Alzheimer's disease. Additionally, limited research has shown that engagement in structured exercise can improve aspects of psychological well-being such as mood and self-perceptions in older adults. However, the relationship between incidental daily activity such as walking or time spent sedentary, with psychological well-being has not been investigated. The Better Ageing Project provided an opportunity to assess well-being and quality of life using standardised questionnaires with 176 adults aged 70 and over. Accelerometry was used to objectively assess daily energy expended in physical activity at different levels of intensity. In addition, an assessment of the impact of the 12-month Better Ageing structured group exercise programme was assessed through questionnaires and interviews. Total daily physical activity energy expenditure (joules/day) and amount of time spent in activity of at least moderate intensity were weakly related (r = 0.20-0.28) to quality of life, subjective well-being and physical self-perceptions. Time spent sedentary (min/day) was weakly and negatively related to several mental health indicators. The quantitative data showed only minor psychological benefits of the exercise intervention. In contrast, interviews with 27 research participants and 4 exercise leaders suggested that important improvements in perceived function and social benefits had been experienced.

Physical activity patterns assessed by accelerometry in older people.

Research into daily physical activity (PA) patterns of older adults (>or=70 years) has primarily relied on self-report. This study used accelerometry, an objective measure of minute-by-minute movement, to assess PA volume and intensity performed by older adults recruited to the Better Ageing project. Results were used to estimate the degree to which current health recommendations for PA were met. Participants [91 older females (OF) aged 76.0 +/- 4.0 years (mean +/- SD), 70 older males (OM) 76.3 +/- 3.9 years, 23 young females (YF) 26.8 +/- 4.1 years and 22 young males (YM) 27.0 +/- 4.2 years] wore an MTI actigraph model 7164 recording activity in 1-min epochs for 7 days. Only those with at least 5 days, and 10 h of actigraph data per day, were included in the analysis, using Caloric.Bas (CSA Inc. 1999) software and a tailored Microsoft Access 2000 macro. Mean counts min(-1) day(-1) were 37% lower for older adults than for young adults [OF 236.1 +/- 84.4 vs. YF 370.0 +/- 81.1 counts min(-1) day(-1) t(114) = -6.86, P < 0.001; OM 255.1 +/- 103.0 vs. YM 404.3 +/- 134.0 ct min(-1) day(-1), t(91) = -5.55, P < 0.001]. Older adults were more restricted in activity intensity range performing significantly fewer minutes of moderate to vigorous (MV) PA day(-1) than young adults [OF 16.7 +/- 12.2 vs. YF 38.4 +/- 18.4 MVPA min day(-1), t(114) = -6.90, P < 0.001; OM 23.8 +/- 20.0 vs. YM 40.4 +/- 19.2 MVPA min day(-1), t(91) = -3.47, P = 0.001]. Nearly half of older adults did not perform any sustained 10-min MVPA bouts (OF 48.4% vs. YF 13.0%, chi2 = 8.10, P = 0.004; OM 44.3% vs. YM 4.5%, chi2 = 9.97, P = 0.002), and none met current PA recommendations for health. This study is the first to provide objective data on a large sample of adults aged 70 years and over and indicates low levels of daily movement that are likely to be inadequate for optimal health benefit.

Reduced plantarflexor specific torque in the elderly is associated with a lower activation capacity.

Previous studies have reported a decrease in muscle torque per cross-sectional area in old age. This investigation aimed at determining the influence of agonists muscle activation and antagonists co-activation on the specific torque of the plantarflexors (PF) in recreationally active elderly males (EM) and, for comparison, in young men (YM). Twenty-one EM, aged 70-82 years, and 14 YM, aged 19-35 years, performed isometric maximum voluntary contractions (MVC). Activation was assessed by comparing the amplitude of interpolated supramaximal twitch doublets at MVC, with post-tetanic doublet peak torque. Co-activation of the tibialis anterior (TA) was evaluated as the ratio of TA-integrated EMG (IEMG) activity during PF MVC compared to TA IEMG during maximal voluntary dorsiflexion. Triceps surae muscle volume (VOL) was assessed using magnetic resonance imaging (MRI), and PF peak torque was normalised to VOL (PT/VOL) since the later approximates physiological cross-sectional area (CSA) more closely than anatomical CSA. Also, physical activity level, assessed by accelerometry, was significantly lower (21%) in the elderly males. In comparison to the YM group, a greater difference in PT (39%) than VOL (19%) was found in the EM group. PT/VOL and activation capacity were respectively lower by 25% and 21% in EM compared to YM, whereas co-activation was not significantly different. In EM PT/VOL correlated with activation (R(2)=0.31, P<0.01). In conclusion, a reduction in activation capacity may contribute significantly to the decline in specific torque in the plantar flexors of elderly males. The hypothesis is put forward that reduced physical activity is partialy responsible for the reduced activation capacity in the elderly.