Developing a Multiprofessional Mobile App to Enhance Health Habits in Older Adults: User-Centered Approach.

BACKGROUND: Although comprehensive lifestyle habits are crucial for healthy aging, their adherence tends to decline as individuals grow older. Sustaining a healthy life over time poses a motivational challenge. Some digital tools, such as smartphone apps aimed at promoting healthy habits, have been used to counteract this decline. However, a more profound investigation is necessary into the diverse experiences of users, particularly when it concerns older adults or those who are unfamiliar with information and communications technologies. OBJECTIVE: We aimed to develop a mobile app focused on promoting the health of older adults based on the principles of software engineering and a user-centered design. The project respected all ethical guidelines and involved the participation of older adults at various stages of the development of the app. METHODS: This study used a mixed methods approach, combining both quantitative and qualitative methodologies for data collection. The study was conducted in Ribeirão Prêto, São Paulo, Brazil, and involved 20 older adults of both genders who were aged ≥60 years and enrolled in the Physical Education Program for the Elderly at the University of São Paulo. The research unfolded in multiple phases, encompassing the development and refinement of the app with active engagement from the participants. RESULTS: A total of 20 participants used a mobile health app with an average age of 64.8 (SD 2.7) years. Most participants had a high school education, middle-class status, and varying health literacy (mean score 73.55, SD 26.70). Overall, 90% (18/20) of the participants owned smartphones. However, 20% (4/20) of the participants faced installation challenges and 30% (6/20) struggled with web-based searches. The focus groups assessed app usability and satisfaction. Adjustments increased satisfaction scores significantly (Suitability Assessment of Materials: 34.89% to 70.65%; System Usability Scale: 71.23 to 87.14). Participant feedback emphasized font size, navigation, visual feedback, and personalization, and suggestions included health device integration, social interaction, and in-app communication support. CONCLUSIONS: This study contributes to the development of health care technologies tailored to the older adult population, considering their specific needs. It is anticipated that the resulting app will serve as a valuable tool for promoting healthy habits and enhancing the quality of life for older adults.

Older postmenopausal women with lower lean mass have hypermethylated sites in the PI3K-Akt pathway.

Introduction: The decrease in lean mass is directly related to the loss of independence, muscle strength, and worse quality of life over the years. Although the genetic determinants of muscle mass were well recognized, recent literature has been uncovering new epigenetic factors affecting the state of muscular tissue. This study aimed to verify differences in the DNA methylation profile among Brazilian postmenopausal women aged 50-70 years according to the lean mass evaluation. Methods: A cross-sectional study comprised 40 women aged 50-70 years. After K-means cluster analysis the 40 participants were divided into two groups, the Lower Lean Mass group with 20 participants (61.1 ± 4.6 years) and the Higher Lean Mass group with 20 participants (60.7 ± 3.2 years). Lean mass was measured by dual-energy X-ray emission densitometry (DEXA). The participants' DNA was extracted using the Salting Out technique and subsequently, the Illumina 850k EPIC Infinium Methylation BeadChip was performed to obtain methylation data. Results: We obtained 1,913 differentially methylated sites (p ≤ 0.005 of ß > 5% and ß < -5%) in a total of 979 genes between groups (p ≤ 0.005; -5% > ß > 5%). In addition, the PI3K-Akt pathway had the greatest power of significance with an FDR of 4.6 × 10-3. Conclusion: Our results demonstrate a differentiation between specific sites of different genes, which have essential functions in body composition and energy metabolism, supporting future studies that aim to relate lean mass with epigenetics.

Comparing Fourteen Weeks of Multicomponent Training Versus Combined Training in Physically Inactive Older Women: A Randomized Trial.

BACKGROUND: Combined (CT) and multicomponent training (MT) presents several benefits for aging individuals. However, the literature does not provide evidence on which of the two physical training models can better enhance improvements in physical capacity and health parameters in middle-aged and older women. OBJECTIVE: The aim of this study was to compare the effects of MT and CT on physical capacity, cognitive, behavioral, and psychosocial assessment, and biochemical profile of physically inactive women aged between 50 and 70 years. METHODS: Participants were randomized into two groups: MT (32 women, 64.2 ± 6.4 years) and CT (39 women, 61.4 ± 4.3 years). Both training sessions had a weekly volume of 180 min, for 14 weeks, with assessments at baseline and after the training period. RESULTS: CT showed better results when compared to MT. In the four evaluation blocks, we noticed differences in the effect size (L = large, M = moderate, S = small, and T = trivial) between the groups in 26 variables in total, highlighting the CT group (L = 11, M = 5, S = 2, and T = 8) compared to the MT group (L = 8, M = 7, S = 7, and T = 4). Our findings showed group-time differences for strength variables using the maximum dynamic repetition test in upper and lower limbs and for agility. The multicomponent training showed improvement in the functional strength of the upper limbs evaluated through the elbow flexion and extension test (p = 0.037), and HDL (p = 0.022). CONCLUSIONS: Fourteen weeks of CT showed better benefits when compared to MT.

Nitrate Derived From Beetroot Juice Lowers Blood Pressure in Patients With Arterial Hypertension: A Systematic Review and Meta-Analysis.

Background: Although there are a considerable number of clinical studies on nitrate (NO3) rich beetroot juice (BRJ) and hypertension, it is difficult to indicate the real effects of NO3 from BRJ on the BP of hypertensive patients because there are still no estimates of the effects of NO3 derived from BRJ on the BP of hypertension patients. Objective: To clarify these effects, we developed a systematic literature review with a meta-analysis of randomized clinical trials (RCTs). Design: The searches were accomplished through EMBASE, Cochrane Library, MEDLINE, CINAHL, Web of Science, and LILACS databases. The study included single or double-blinded RCTs and participants older than 18 years with hypertension [systolic BP (SBP) > 130 mmHg and diastolic BP (DBP) > 80 mmHg]. NO3 BRJ was required to be consumed in a format that possibly blinded participants/researchers. These studies should also report the SBP and DBP values (mmHg) measured before and after the treatment. Risk of Bias tools and GRADE were enforced. Results: Seven studies were included (218 participants). BRJ intervention time ranged from 3 to 60 days with daily dosages of 70-250 mL of BRJ. After the intervention with NO3 from BRJ, SBP underwent significant changes (p < 0.001) of -4.95 (95% CI: -8.88; -1.01) (GRADE: ⊕⊕⊕○ Moderate), but not for DBP (p = 0.06) -0.90 mmHg (95% CI: -3.16; 1.36) (GRADE: ⊕⊕⊕○ Moderate), compared to the control group. Conclusions: The NO3 derived from BRJ reduces SBP, but not DBP in patients with arterial hypertension. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=269339.

Effect of Flexibility Training Associated with Multicomponent Training on Posture and Quality of Movement in Physically Inactive Older Women: A Randomized Study.

BACKGROUND: Multicomponent training has considerable adherence among older populations, but there is a lack of literature on the benefits of this training on older people's posture. Literature also lacks stretching protocols that work the body in an integrated/unified way and respect the principle of individuality in exercise training. We evaluated the effect of a multicomponent training protocol combined or not with flexibility training in improving the posture and quality of movement in physically inactive older women, according to a score lower than 9.11 in the Modified Baecke Questionnaire for the Elderly (MBQE). METHODS: 142 participants were evaluated and randomized in three training groups: multicomponent training (MT = 52), multicomponent and flexibility training (MFT = 43), and a control group (CG = 47). We evaluated joint amplitude using goniometry, flexibility with sit and reach and hands behind the back tests, quality of movement with the functional movement screen, and posture using biophotogammetry. RESULTS: The MFT group had 15 parameters-flexibility and posture-with a very large effect size (ES > 1.30) and nine with average ES (0.50-0.79). MT presented two variables with large ES (0.80-1.25) and seven with average ES. CG presented three variables with high ES and five with average ES. Both interventions improved the quality of movement. CONCLUSIONS: These results demonstrate that 14 weeks of multicomponent and flexibility training in a group intervention can improve flexibility and posture levels in physically inactive older women.

Quality of Movement Is Associated With Cognitive Function in Physically Inactive Older Women.

The relationship between the quality of movement, considering different global and universal basic patterns of movement and cognition domains in older adults remain unclear. The current study explored this association in physically inactive older women. In total, 187 participants, aged 60-70 years (mean = 64.9, SD = 6.9 years), were recruited from a physical education program in a public university. The older adults performed the following tests: Functional Movement Screen, Montreal Cognitive Assessment, and Modified Baecke Questionnaire for the Older Adults. The regression analysis showed an association between age (ß = -0.11, 95% confidence interval, CI, [-0.10, 0.30], p = .03); visuospatial abilities (ß = 0.36, 95% CI [0.24, 1.23], p < .001); language (ß = 0.23, 95% CI [0.20, 1.08], p < .001); and orientation domains (ß = 0.13, 95% CI [0.11, 1.22], p = .016) of the Montreal Cognitive Assessment and the Functional Movement Screen. The quality of movement was related to both age and cognitive performance, such as the visuospatial abilities, language, and orientation domains, in physically inactive older women.

Effect of Combined Training on Muscle Co-Activation and Functional Capacity in Older Women: a Pilot Study / Efeito do Treinamento Combinado na Coativação Muscular e Capacidade Funcional em Mulheres Idosas: um Estudo Piloto

Aging is characterized by morphological and functional declines, including impairment in muscle performance and functional capacity. Herein, changes were investigated in strength promoted by combined training and its effects on muscle co-activation in older women. After tree-week adaptation period, thirteen healthy older women (60.2 ± 6.2 years) underwent a 12-week training program, three sessions a week, one hour per session, divided into 30 minutes of aerobic exercise on a treadmill or cycle ergometer and 30 minutes of strength training. Muscle strength tests and cardiopulmonary fitness assessment were performed before and after the intervention. The results herein showed improvements in strength, functional capacity, and lower limb muscle activation, but no differences in muscle co-activation. In conclusion, the data of this study suggest that 12weeks of combined training exercise may not be effective in inducing muscle co-activation but may help prevent or mitigate the decline in muscle performance and functional capacity in the older population. (AU)

O envelhecimento é caracterizado por declínios morfológicos e funcionais, incluindo prejuízo no desempenho muscular e capacidade funcional. Aqui, investigamos as mudanças na força promovidas pelo treinamento combinado e seus efeitos na coativação muscular em mulheres idosas. Após três semanas de adaptação, treze idosas saudáveis (60,2 ± 6,2 anos) realizaram um programa de treinamento por 12 semanas, três sessões semanais, uma hora por sessão, divididas em 30 minutos de exercício aeróbio em esteira ou cicloergômetro e 30 minutos de treinamento de força. Testes de força muscular e avaliação da aptidão cardiopulmonar foram realizados antes e após à intervenção. Nossos resultados mostraram melhorias na força, capacidade funcional e ativação muscular dos membros inferiores, mas nenhuma diferença na coativação muscular. Em conclusão, nossos dados sugerem que 12 semanas de exercícios de treinamento combinado podem não ser eficazes na indução da coativação muscular, mas podem ajudar a prevenir ou diminuir o declínio muscular e a melhora da capacidade funcional na população idosa. (AU)

Stretching and Multicomponent Training to Functional Capacities of Older Women: A Randomized Study.

BACKGROUND AND PURPOSE: The real benefits of stretching when used as training for the older adult population and for developing other physical capacities are still uncertain. Thus, the objective of the present work is to investigate the effects of stretching training combined with multi-component training on the physical capacities of physically inactive older women. METHODS: Women aged 60 to 70 years were randomized into three groups: multicomponent training (MT), multicomponent training combined with flexibility training (CT), and control group (CG). Both training interventions were carried out for 14 weeks, with two weekly sessions. Participants were assessed for agility, muscle strength (sitting and standing and elbow flexion/extension), and cardiorespiratory fitness (6-min walk). RESULTS AND DISCUSSION: Multicomponent training with flexibility presented a very large effect on the variables of strength, agility, and aerobic fitness, while multicomponent training had a medium effect on agility and a large and very large effect on muscle strength variables. This is the first study in the literature to analyze the effect of flexibility training, associated with multicomponent training, on other physical capacities. CONCLUSIONS: The results of the current study suggest that adding flexibility training to a multicomponent training program generates additional benefits to the development of other physical capacities.