Self-monitored versus supervised walking programs for older adults.

ABSTRACT: Walking is an effective, well accepted, inexpensive, and functional intervention. This study compared the outcomes and changes in walking behavior of self-monitored (SM) and supervised (SU) walking interventions for older adults.Participants were assigned to SM (n = 21) and SU (n = 21) walking groups according to their place of residence. Both groups exercised and wore a pedometer for 3 months.The outcome measures were step count, body mass index (BMI), and physical function. Two-way repeated-measure ANOVA and independent t tests were used to compare the intervention effects. We also plotted the trends and analyzed the walking steps weekly.Only BMI exhibited a group × time interaction. The pre-posttest differences showed knee extension muscle strength (KEMS) and Timed Up and Go test were significantly improved in the SM group, whereas BMI, KEMS, 30-s sit-to-stand, functional reach were significantly improved, but 5-m gait speed significantly slower in the SU group. For participants attending ≥50% of the sessions, those in the SM and SU groups had similar results for all variables, except for 2-min step (2MS) and daily walking step counts.Both self-monitored and supervised walking benefit older adults in most physical functions, especially lower-extremity performance, such as muscle strength, balance, and mobility. The effects of both programs do not differ significantly, except for BMI and 2MS (ie cardiopulmonary endurance). We recommend pedometer-assisted self-monitored walking for older adults because of its ability to cultivate exercise habits over the long term, whereas supervised walking to establish effective exercise intensity.

Correction to: Individualized home-based exercise and nutrition interventions improve frailty in older adults: a randomized controlled trial.

Following publication of the original article [1], the author reported that an abbreviation was incorrect in the original article.

Individualized home-based exercise and nutrition interventions improve frailty in older adults: a randomized controlled trial.

BACKGROUND: Frail older adults are predisposed to multiple comorbidities and adverse events. Recent interventional studies have shown that frailty can be improved and managed. In this study, effective individualized home-based exercise and nutrition interventions were developed for reducing frailty in older adults. METHODS: This study was a four-arm, single-blind, randomized controlled trial conducted between October 2015 and June 2017 at Miaoli General Hospital in Taiwan. Overall, 319 pre-frail or frail older adults were randomly assigned into one of the four study groups (control, exercise, nutrition, and exercise plus nutrition [combination]) and followed up during a 3-month intervention period and 3-month self-maintenance period. Improvement in frailty scores was the primary outcome. Secondary outcomes included improvements in physical performance and mental health. The measurements were performed at baseline, 1 month, 3 months, and 6 months. RESULTS: At the 6-month measurement, the exercise (difference in frailty score change from baseline: - 0.23; 95% confidence interval [CI]: - 0.41, - 0.05; p = 0.012), nutrition (- 0.28; 95% CI: - 0.46, - 0.11; p = 0.002), and combination (- 0.34; 95% CI: - 0.52, - 0.16; p <  0.001) groups exhibited significantly greater improvements in the frailty scores than the control group. Significant improvements were also observed in several physical performance parameters in the exercise, nutrition, and combination groups, as well as in the 12-Item Short Form Health Survey mental component summary score for the nutrition group. CONCLUSIONS: The designated home-based exercise and nutrition interventions can help pre-frail or frail older adults to improve their frailty score and physical performance. TRIAL REGISTRATION: Retrospectively registered at ClinicalTrials.gov (identifier: NCT03477097); registration date: March 26, 2018.

Dietary education with customised dishware and food supplements can reduce frailty and improve mental well-being in elderly people: A single-blind randomized controlled study.

BACKGROUND AND OBJECTIVES: The elderly population is increasing rapidly worldwide, and frailty is a common geriatric syndrome. Comprehensive dietary management strategies may have beneficial effects on frailty prevention and reversal. This 3-month single-blind, paralleled, randomized controlled trial compared the effects of micronutrients and/or protein supplements, and a personalised diet on frailty status in elderly individuals. METHODS AND STUDY DESIGN: Between 2014 and 2015, 40 prefrail or frail subjects aged >=65 years were recruited at Miaoli General Hospital, Taiwan. Of these, 37 completed the study, and 36 were included in the analysis. Participants were randomly assigned to one of four treatment groups: (1) the control (2) multiple micronutrient supplements, (3) multiple micronutrients plus isolated soy protein supplement, and (4) individualised nutrition education with customised dishware and food supplements (mixed nuts and skimmed milk powder). Dietary intake, protein biomarkers, frailty score, and geriatric depression score were assessed. RESULTS: Individualised nutrition education with customised dishware and food supplements significantly increased the participants' intake of vegetables, dairy, and nuts, in addition to increasing the concentration of urinary urea nitrogen. It yielded a significant reduction in frailty score (p<0.05) and a borderline reduction (p=0.063) in geriatric depression score. No significant beneficial changes were observed for the other two intervention groups. CONCLUSIONS: Our study indicated that a dietary approach with easy-to-comprehend dishware and food supplements to optimize the distribution of the consumption of six food groups improved frailty status and, potentially, psychological well-being in elderly people.

Association between Physical Fitness and Successful Aging in Taiwanese Older Adults.

Population aging is escalating in numerous countries worldwide; among them is Taiwan, which will soon become an aged society. Thus, aging successfully is an increasing concern. One of the factors for achieving successful aging (SA) is maintaining high physical function. The purpose of this study was to determine the physical fitness factors associated with SA in Taiwanese older adults (OAs), because these factors are intervenable. Community-dwelling OAs aged more than 65 years and residing in Northern Taiwan were recruited in this study. They received a comprehensive geriatric assessment, which includes sociodemographic data, health conditions and behaviors, activities of daily living (ADL) and instrumental ADL (IADL) function, cognitive and depressive status, and quality of life. Physical fitness tests included the grip strength (GS), 30-second sit-to-stand (30s STS), timed up-and-go (TUG), functional reach (FR), one-leg standing, chair sit-and-reach, and reaction time (drop ruler) tests as well as the 6-minute walk test (6MWT). SA status was defined as follows: complete independence in performing ADL and IADL, satisfactory cognitive status (Mini-Mental State Examination ≥ 24), no depression (Geriatric Depression Scale < 5), and favorable social function (SF subscale ≥ 80 in SF-36). Adjusted multiple logistic regression analyses were performed. Among the total recruited OAs (n = 378), 100 (26.5%) met the aforementioned SA criteria. After adjustment for sociodemographic characteristics and health condition and behaviors, some physical fitness tests, namely GS, 30s STS, 6MWT, TUG, and FR tests, were significantly associated with SA individually, but not in the multivariate model. Among the physical fitness variables tested, cardiopulmonary endurance, mobility, muscle strength, and balance were significantly associated with SA in Taiwanese OAs. Early detection of deterioration in the identified functions and corresponding intervention is essential to ensuring SA.