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Introduction: Physical activity (PA) and exercise (EX) participation rates have not been increasing among older adults, with many not meeting recommended guidelines. This qualitative descriptive study examined factors influencing engagement in PA within and outside an older adult fitness club context, using self-determination theory (SDT). Methods: Thirty-seven community-dwelling adults 65 years and older participated in focus groups or telephone interviews. Two researchers independently coded and analyzed transcript data inductively and deductively using SDT. Results: Two broad themes, The Spectrum of Motivating Factors and Facilitators and Barriers, and nine sub-themes, Physical Activity and Exercise Brings Me Joy; Meaningful Personal Impetuses; I Get Active with a Little Help from my Spouse and Others; I See Changes and Improvements (Theme 1); I Can Do This; Connections and Sense of Belonging; I Cannot Do This; Setting, Environment, and People Supports; and Pragmatics (Theme 2), emerged from the data. All participants discussed several motivating factors: enjoyment, managing health conditions, being held 'to account' by others, opportunities for socialization, and seeing improvements in health and well-being. A lack of supportive environments, knowledgeable staff and suitable settings and programs were cited as barriers by participants who were not older adult fitness club members. Discussion: Factors along the extrinsic to intrinsic regulation continuum facilitated or hindered community-dwelling older adults to engage in and sustain PA within and outside an older adult fitness club context. The findings underscore the need for programs, settings, environments, and related components to be expressly older-adult-tailored to enhance motivation through competence, autonomy, and relatedness support for maximal engagement and participation in PA or EX. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the associations of social support factors with leisure-time physical activity (LTPA) of older people in Fuwen village. A cross-sectional study included 523 randomly selected elderly people (60+ years) whose LTPA levels were determined using the shortened version of the International Physical Activity Questionnaire (IPAQ-S). A modified version of the Physical Activity Social Support Scale (PASSS) was operated to gather perceived scores of the social support factors. A multivariate linear regression was performed to locate associations of perceived scores of social supports with leisure-time walking (LTW) and moderate and vigorous physical activity (MVPA). The results indicated that social support from family was positively and significantly related to LTW and MVPA in both models. The community factor was positively and significantly correlated with MVPA in both models. The sport club factor was related to LTW and MVPA to some extent. The results suggest that social support from family is the most important motivator for older people's LTW and MVPA in the village of Fuwen. Social support from the community is the motivator for older people's MVPA. The sport club factor has some effects on older people's LTW and MVPA as well. More future studies are needed to extend the database of the relationship between social support and rural older people's physical activity. [ABSTRACT FROM AUTHOR]

This study explored the associations between the perceived walkability of neighborhood environment, walking time, and functional mobility by community-dwelling older adults in Hong Kong SAR, China. Seventy community-dwelling older adults (Mean age = 78.00 ± 7.40 years) participated in this study. Their perceived walkability of neighborhood environment was evaluated by the Chinese abbreviated version of Neighborhood Environment Walkability Survey (NEWS-A) and their walking time within a week was self-reported. The 10-Meter Walk Test and Tinetti Performance-Oriented Mobility Assessment (POMA) were used to assess the functional mobility of the participants, regarding their gait speed, balance, and gait performance, respectively. Results suggest that the perceived walkability of neighborhood environment (Aesthetics subscale) positively associated with the gait speed (rs =.35, p =.003), scores of the POMA-Balance (rs =.389, p =.001) and POMA-Gait (rs =.343, p =.004). This exploratory analysis augmented our contemporary understanding that older adults who could walk faster and with better balance and gait performance are associated with more positive perceived walkability of their neighborhood environment. It provides useful insight that could inform future high-impact investigations. [ABSTRACT FROM AUTHOR]

Further information is needed on how community exercise facilities can be effectively utilised to engage people living with chronic health conditions in exercise. The aim of this study was to identify the exercise barriers, facilitators and needs of patients with chronic disease in the community; and to provide recommendations to support the transition from hospital‐based to community‐based exercise. Using a qualitative approach, four focus groups were conducted with patients who had completed hospital‐based exercise programmes (n = 11) and fitness instructors (n = 10). Data were audio recorded, member checked and transcribed verbatim for thematic analysis using NVivo. The side effects of chronic health conditions, the gym environment and a need for support when joining/attending a gym were perceived as barriers to exercising in the community. In contrast, the presence of supportive staff was perceived by patients as a facilitator to engaging in exercise in the community. A total of three themes emerged from participants views on exercise needs in the community; the referral and induction process in community gyms, fitness instructor training and experience and creating a supportive exercise environment. Themes informed eight key recommendations to support patients to exercise in the community, including supportive gym referral and induction processes for patients with chronic conditions, increased professional training for fitness instructors in the area of chronic disease management and exercise prescription, and exercise support at regular intervals for those with chronic conditions attending community gyms. This study found that there is potential for community gyms to play a key role in promoting health among people with chronic conditions. However, more can be done to foster an inclusive atmosphere in this space. Patients living with chronic conditions need information and advice on exercising in their communities. Community gyms require further support to ensure that facilities meet the exercise needs of people with chronic conditions. [ABSTRACT FROM AUTHOR]

Physical activity (PA) is believed to preserve cognitive function in older adulthood, though little is known about these relationships within the context of daily life. The present microlongitudinal pilot study explored within- and between-person relationships between daily PA and cognitive function and also examined within-person effect sizes in a sample of community-dwelling older adults. Fifty-one healthy participants (mean age = 70.1 years) wore an accelerometer and completed a cognitive assessment battery for five days. There were no significant associations between cognitive task performance and participants’ daily or average PA over the study period. Effect size estimates indicated that PA explained 0–24% of within-person variability in cognitive function, depending on cognitive task and PA dose. Results indicate that PA may have near-term cognitive effects and should be explored as a possible strategy to enhance older adults’ ability to perform cognitively complex activities within the context of daily living. [ABSTRACT FROM AUTHOR]

Purpose: To explore everyday life experiences of being active in aged adults´ with walking impairment one year after hip fracture (HF). Methods: A phenomenological-hermeneutic study design is based on Heidegger´s and Gadamer´s thinking focusing on aged adults being-in-the-world one year after HF. Individual semi-structured interviews were conducted from May to July 2017 in the homes of nine participants, who were part of a longitudinal qualitative study with four interview-rounds for a period of 18 months after the HF event. The analysis was interpretative and secured that the authors´ pre-understanding was put at stake through a five-step process of meaning condensation. Results: One theme, "Enduring life in between a sense of renewal and loss of courage", described aged adults´ experiences of being active in three sub-themes: "Facing loss and losing courage", "Taking up the challenge and maintaining courage ", and "Renewing the energy to be active". Living with being under change and increased vulnerability created a challenge in maintaining courage and reaching for possibilities to unfold their own being in life. Conclusion: This study contributes knowledge on how the aged adults´ experiences of the balance between courage and loss in being active one year after HF are profoundly connected with experiences of well-being. [ABSTRACT FROM AUTHOR]

The aim of this study was to provide information about the relationship of bone mineral content (BMC) and density (BMD) with some physical-fitness-related variables in a sample of women with fibromyalgia (FM) and age-matched women without FM. Twenty-eight women clinically diagnosed with FM (age 51.1 ± 8.4 yr, M ± SD) and 22 age-matched controls participated in the study. Whole-body BMC and BMD, lean mass, handgrip strength, quadriceps strength, and cardiovascular fitness were measured in all participants. The association between physical-fitness variables and bone-related variables was tested by linear regression controlling for body weight as a possible confounder. There were no differences in BMC or BMD between groups. Women with FM had lower values of handgrip strength, quadriceps strength, and VO2peak than the control group. Handgrip strength and aerobic capacity were associated with BMC and BMD and quadriceps strength was associated with BMD in women with FM; however, only VO2peak was associated with BMC in the group of women without FM. Bone mass of women with FM may be more susceptible to changes in physical fitness than that of the women without fibromyalgia. [ABSTRACT FROM AUTHOR]

By 2030, the population of individuals living in the United States aged 65 or older is estimated to reach 71.88 million people. In turn, rehabilitation professionals will be tasked with meeting increased levels of need. One approach for promoting health and well-being is physical activity (PA) which holds potential for reducing secondary health conditions and disability. This article examined (a) student attitudes toward PA interventions for aging individuals living with functional limitations, and (b) how student attitudes toward PA interventions might change following a service learning activity. A pre-test/post-test design was utilized. Results indicated that students tended to hold favorable attitudes regarding PA as a health promoting intervention. As a class cohort, no significant changes in student attitudes were observed. However, when evaluated by major, evidence for the value of experiential learning was noted, in addition to interesting changes in the attitudes of non-rehabilitation and human services majors. [ABSTRACT FROM AUTHOR]

Objectives. We examined the association of health literacy with physical activity and physical activity guideline adherence in older adults. Methods.Weused cross-sectional data from a 2012 population-based study in Alberta, Canada, assessing health literacy, and deriving moderate-to-vigorous physical activity (MVPA) and metabolic equivalent of task (MET) minutes per week from the Godin Leisure-Time Exercise Questionnaire, and steps per day via a pedometer. Results. Mean age of participants (n = 1296) was 66.4 (SD = 8.2) years, 57% were female, and 94% were White. Nine percent had inadequate health literacy, and 46% met guidelines for self-reported physical activity and 18% for steps per day. Participants with inadequate health literacy had nonsignificant adjusted decrements of 58 MVPA minutes and 218 MET minutes per week and were less likely to meet physical activity guidelines (MVPA: odds ratio = 0.63; 95% confidence interval [CI] = 0.41, 0.97; P = .037; MET: odds ratio = 0.65; 95% CI = 0.42, 1.01; P = .057) compared with their health-literate counterparts. Such differences were nonsignificant for steps per day. Conclusions. Inadequate health literacy was associated with less likelihood of meeting MVPA guidelines based on self-reported physical activity, but not based on an objective measure of steps per day. [ABSTRACT FROM AUTHOR]

Background/Aims: Existing cognitive measures for moderate-to-severe dementia have shown floor effects and an inability to assess the remaining cognitive function, especially for profound dementia. Methods: We constructed the Cognitive Test for Severe Dementia (CTSD), which consists of 13 items covering 7 cognitive domains, and examined its reliability and validity. Results: Cronbach's α in severe dementia participants was 0.896. Interrater and test-retest reliability were 0.961 and 0.969, respectively. The CTSD showed a significant correlation with 3 other measures of cognitive function (Mini-Mental State Examination, Severe Cognitive Impairment Rating Scale, and Hasegawa Dementia Scale-Revised: r values = 0.870-0.922, p values <0.001). While the other measures showed floor effects, the CTSD did not. Conclusion: The CTSD was able to sensitively capture the remaining cognitive function in severe dementia patients when compared with other cognitive tests. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Gardens and outdoor environments offer multiple therapeutic possibilities for the residents in nursing homes. Web-based questionnaires were sent to 488 nursing home leaders and 121 leaders responded. The clinical impressions of the leaders and staff regarding the benefits of sensory gardens (SGs) to the residents were consistent with previous research. SGs facilitated taking residents outdoors, offered convenient topics for communication and facilitated social privacy for relatives. For improved clinical use of SGs and outdoor environments, systematic assessment of residents' interests, performance and experiences when outdoors, implementation of seasonal clinical programmes and educational programmes for leaders and staff are recommended. [ABSTRACT FROM AUTHOR]

The aim of this pilot study was to determine whether a lifestyle and functional exercise program (LiFE) was suitable for delivery in a restorative home care service. Eight restorative home care clients and four care managers participated in the study. The LiFE program was successfully delivered to all eight clients; however, the paperwork requested of both the client and care manager was extensive and we recommended some changes for this setting. Despite this, LiFE was found to be suitable for delivery in the restorative home care service and its effectiveness should be tested in a randomized controlled trial. [ABSTRACT FROM AUTHOR]

Introduction The paucity of training in physical activity (PA) promotion in UK medical schools is a barrier to health professionals' promotion of PA to their patients. Doctors who are more physically active are more likely to counsel patients in this regard. We used a randomised controlled trial (RCT) to examine the effect of an intervention which engaged students in goal-setting, using pedometer step counts, on their PA behaviour and intentions to promote PA in future practice. Methods We invited fourth-year medical students to participate in the study during their four-week placement in primary care. Following baseline pedometer measurement of daily step counts for one week, students were randomly allocated to intervention (individual step count goal-setting) or control groups. Using pedometers, both groups monitored their PA during the following week. Intentions to promote PA were assessed using a questionnaire based on the theory of planned behaviour at baseline, four weeks and nine weeks. Focus groups explored the students' experiences of PA measurement, goalsetting for behaviour change and health promotion teaching. Results One-hundred and thirty-six students participated (70 intervention; 66 control). The mean change in daily step count was greater (P=0.001) in the intervention group (1245, 95% CI 762 to 1727) than in the control group (-65, 95% CI -644 to 573). Scores for perceived behavioural control over PA counselling increased in both groups, with a trend for higher scores in the intervention group. Intervention group students described how experience of personal PA behaviour change gave insights into barriers patients may face and improved their confidence in PA counselling. Conclusions Medical students' personal experience of goal setting in increasing PA appears to lead to a more positive perception of their ability to deliver effective PA promotion in future practice. Inclusion of this learning experience within the undergraduate curriculum may improve doctors' skills in health promotion. [ABSTRACT FROM AUTHOR]

Objectives: To identify factors associated with survival to the age of 90 years old in 70+ elderly people. Design: The PAQUID prospective cohort on brain and functional ageing. Setting: 75 randomly selected administrative communities in Gironde and Dordogne (France). Participants: A sub-sample of 2,578 community dwellers aged 70 years and over at baseline in 1988 and followed-up over 20 years, all participants of the PAQUID study. Measurements: Data on socio-material environments, lifestyle, health, perceived health, and family background were collected at home every 2–3 years over 20 years, with a prospective update of vital status. Participants were compared according to their survival status (subjects who reached 90 compared to those who did not). The factors associated with survival were investigated separately for men and women by Cox regression with, as much as possible, time-dependent variables. Results: Some factors associated with survival were common to both genders, whereas some others appeared gender specific. For men, tenant status (HR=1.46), former or current smoking (HR=1.17), disability (respective HR of 1.50, 1.78 and 2.81 for mild, moderate and severe level), dementia (HR=1.51), a recent hospitalisation (HR=1.32), dyspnoea (HR=1.32), and cardiovascular symptoms (HR=1.15) were associated with lower chance of becoming nonagenarian. Conversely, regular physical activity (HR=0.74) was associated with higher chance of survival. For women, the presence of a professional help (HR=1.19), living arrangements (HR=1.29 and HR=1.33), disability (respective HR of 1.55, 1.95 and 2.70 for mild, moderate and severe disability), dementia (HR=1.54), a recent hospitalisation (HR=1.19), diabetes (HR=1.49), and dyspnoea (HR=1.20) were associated with lower chance of becoming nonagenarian. Conversely, satisfaction of level income (HR=0.87), comfortable housing (HR=0.81), length of living in the dwelling (HR=0.80 upper to 6 years), regular physical activity (HR=0.89) and a medium (HR=0.79) or good (HR=0.68) subjective health, were associated with higher chance of becoming nonagenarian. Conclusion: Our findings confirm that survival up to 90 is a multifactorial phenomenon with similarities and specificities by gender. Consequently, primary prevention and global consideration of ageing (social, material, financial, psychological) are necessary to promote not only longevity but also successful ageing in order to face the future societal challenges due to demographic ageing. [ABSTRACT FROM AUTHOR]

An abstract of the article " Monitoring Exercise Delivery to Increase Participation Adherence in Older Adults with Alzheimer's Disease" by Elle Watson is presented.

This longitudinal study examined whether habit strength moderates the intention–physical activity (PA) relationship in older adults, within the framework of the attitude–social influences–efficacy (ASE) model and the theory of planned behaviour (TPB). A total of 1836 older adults (Mage = 62.95 years,SDage = 8.17) completed a questionnaire on social cognitive constructs and PA habit strength at baseline, and six months later a measure of PA. Three PA habit groups (i.e. low, medium and high) were composed, based on tertiles of the mean index score. Multi-group structural equation modelling analyses showed that intention significantly determined PA behaviour only in participants with a low or medium habit strength towards PA. This result suggests that PA is not intentional at high levels of habit strength and demonstrates the usefulness of incorporating habit in the ASE and TPB models. Results also showed that about half of the participants with a strong PA habit did not meet the recommended PA level. As strong habits may prevent intentional behavioural change and may hinder the receptiveness and openness for informational PA change strategies, additional intervention strategies, such as awareness raising and the use of implementation intentions, are needed for strongly habitual, but insufficiently active older adults. [ABSTRACT FROM PUBLISHER]

The aim of the study was to identify the motivators and barriers to being physically active for older people receiving either restorative or 'usual' home care services. The study used a mixed method descriptive design including questionnaire and interviews. Questionnaires were sent to 1,490 clients who received either service between 2006-2009; 506 (34%) responded, and 190 indicated willingness to participate in a follow-up interview. Of the latter, 20 were purposively selected and interviewed. 'Well-being" and 'health and fitness" were the top two reasons participants gave for being active. 'Ongoing injury/illness" and feeling 'too old" were the highest ranked barriers. The qualitative findings confirmed that older home care clients know physical activity is good for health and well-being, however, due to ongoing injury/illness and thinking they are too old, they may not be as active as they could be. This may impact on the number of home care services older people need over the longer term. [ABSTRACT FROM AUTHOR]

Little is known about cardiorespiratory fitness and aerobic exercise training in older adults with Alzheimer's disease (AD). The purposes of this article are to describe the change in cardiorespiratory fitness after 2 months of aerobic training and the feasibility of aerobic training in 4 men with moderate-to-severe AD. A one-group, pretest-posttest test design was used to measure cardiorespiratory fitness using symptom limited, graded cycle ergometer testing. In exit interviews, participants and spouses identified exercise facilitators and barriers. The results show that cardiorespiratory fitness increased in 2 participants with moderate AD but decreased in 2 with severe AD. Participants showed great variability in exercise progression and doses actually delivered. In conclusion, older men with moderate-to-severe AD can engage in aerobic training. Two months might be better used as the adaptive period for longer duration aerobic training, such as a 6-month program. Suggestions and implications for future exercise research in AD are detailed. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the efficiency of a short-term Intermittent Work Exercise Program (IWEP) among healthy elderly subjects. Study design and setting: This longitudinal prospective study took place at the Strasbourg University Hospital geriatric department. Study participants: One hundred and fifty older volunteers, previously determined as being free from cardiac and pulmonary disease, were separated into two age groups: the 'young senior' (60.2 ± 3.1 yr) and the 'older senior' groups (70.8 ± 5.2 yr).These groups were then subdivided by gender into the 'young female senior', 'young male senior' 'older female senior' and 'older male senior' groups. Intervention: Before and after the IWEP, all subjects were asked to perform an incremental cycle exercise to obtain their first ventilatory threshold (VT), maximal tolerated power (MTP), peak oxygen uptake (VO) and maximal minute ventilation (MMV). The IWEP consisted of a 30-min cycling exercise which took place twice a week, and was divided into six 5-min stages consisting of 4 min at VT intensity and 1 min at 90% MTP. Measurements: An assessment was made of the effects of the IWEP on maximal cardio-respiratory function (MTP, VO, MMV) and endurance parameters (VT, heart rate [HR] measured at pretraining VT and lactate concentrations at pre-training MTP). Results: This short-term training program resulted in a significant increase of MTP (from 13.2% to 20.6%), VO (from 8.9% to 16.6%) and MMV (from 11.1% to 21.8%) in all groups (p<0.05). VT1 improved from 21% at pretraining to 27%, while HR at pre-training VT1 as well as lactate concentrations at pre-training MTP decreased significantly in all groups (p<0.05). The post-training values for VO and MMV of the 'older seniors' were not significantly different (p>0.05) from the 'young seniors' pre-training values for the same parameters. Conclusion: The most striking finding in this study is that after only 9 weeks, our short-term 'individually-tailored' IWEP significantly improved both maximal cardio-respiratory function and endurance parameters in healthy, previously untrained seniors. [ABSTRACT FROM AUTHOR]