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Background: Favorable movement behavior patterns, comprising more physical activity, less sedentary behavior, and sufficient sleep, may promote the maintenance of good quality of life (QoL) with advancing age. The aim of the present study was to investigate whether movement behaviors predict future changes in QoL among community-dwelling older adults over a four-year follow-up., Methods: Participants were 75-, 80- and 85-year-old community-dwelling older adults (n = 203) followed up for 4 years. Participants wore thigh- and trunk-mounted accelerometers for 3-7 days at baseline. Proportion of time-use in physical activity, standing and sedentary behavior were assessed based on body posture and movement intensity. Time in bed was determined using an automated algorithm. QoL was assessed during a home interview using the short Older People's Quality of Life Questionnaire at baseline and follow-up (range 13-65, higher scores indicate higher QoL). Compositional linear regression analysis was used to study whether baseline time-use composition predicts changes in QoL., Results: Over the 4-year follow-up, QoL scores decreased by 5% on average. Higher physical activity in relation to the other movement behaviors was associated with increase in QoL over time (β ilr 0.94, p = 0.013), but this association attenuated after adding baseline physical function into the model. Sedentary behavior, standing, and time in bed were not associated with changes in QoL. Theoretical reallocation of 30 min of physical activity into sedentary behavior, standing or time in bed was estimated to decrease QoL by 0.5 (CI 95% -0.6 to -0.4), 0.6 (-0.7 to -0.5) and 0.4 (-0.5 to -0.3) points, respectively., Conclusions: Theoretical reallocation of physical activity into sedentary behavior, standing, and time in bed was found to be associated with prospective decline in QoL among older adults. Engaging more in physical activity and less in more passive activities may promote better QoL with advancing age., Competing Interests: Declarations Ethics approval and consent to participate Both baseline and follow-up studies were given a positive endorsement by the Central Finland Hospital County Ethics Committee (Dnro 14U/2017, Dnro4U/2021), adhered to ethical principles outlined in the Declaration of Helsinki, and all participants provided written informed consent. Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests., (© 2024. The Author(s).)

We identified data-driven multidimensional physical activity (PA) profiles using several novel accelerometer-derived metrics. Participants aged 75, 80, and 85 (n = 441) wore triaxial accelerometers for 3-7 days. PA profiles were formed with k-means cluster analysis based on PA minutes, intensity, fragmentation, sit-to-stand transitions, and gait bouts for men and women. Associations with physical capacity and life-space mobility were examined using age-adjusted general linear models. Three profiles emerged: "Exercisers" and "actives" accumulated relatively high PA minutes, with actives engaging in lighter intensity PA. "Inactives" had the highest activity fragmentation and lowest PA volume, intensity, and gait bouts. Inactives showed lower scores in physical capacity and life-space mobility compared with exercisers and actives. Exercisers and actives had similar physical capacity and life-space mobility, except female exercisers had higher walking speed in the 6-min walk test. Our findings demonstrate the importance of assessing PA as multidimensional behavior rather than focusing on a single metric.

Background: The usual accelerometry-based measures of physical activity (PA) are dependent on physical performance. We investigated the associations between PA relative to walking performance and the prevalence and incidence of early and advanced walking difficulties compared to generally used measures of PA., Methods: Perceived walking difficulty was evaluated in 994 community-dwelling participants at baseline (age 75, 80, or 85 years) and 2 years later over 2 km (early difficulty) and 500 m (advanced difficulty). We used a thigh-mounted accelerometer to assess moderate-to-vigorous PA, daily mean acceleration, and relative PA as movement beyond the intensity of preferred walking speed in a 6-minute walking test (PArel). Self-reported PA was assessed using questionnaires., Results: The prevalence and incidence were 36.2% and 18.9% for early and 22.4% and 14.9% for advanced walking difficulty, respectively. PArel was lower in participants with prevalent (mean 42 [SD 45] vs 69 [91] min/week, p < .001) but not incident early walking difficulty (53 [75] vs 72 [96] min/week, p = .15) compared to those without difficulty. The associations between absolute measures of PA and incident walking difficulty were attenuated when adjusted for preferred walking speed., Conclusions: The variation in habitual PA may not explain the differences in the development of new walking difficulty. Differences in physical performance explain a meaningful part of the association of PA with incident walking difficulty. Scaling of accelerometry to preferred walking speed demonstrated independence on physical performance and warrants future study as a promising indicator of PA in observational studies among older adults., (© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America.)

This study examined equity in physical activity (PA) by investigating whether perceived opportunity for PA was associated with willingness to be more active. Among community residents (75, 80, or 85 years old, n = 962) perceived opportunity for PA (poor and good), willingness to be more active (not at all, a bit, and a lot), and level of PA (low, moderate, and high) were assessed via questionnaires. Multinomial logistic regression showed that physical activity moderated the association between poor opportunity and willingness to increase PA. Among those with moderate PA, poor opportunity for PA increased the odds of willingness to be a lot more active (multinomial odds ratio, mOR 3.90, 95% confidence interval 2.21-6.87) than not wanting to be more active compared to those perceiving good opportunities. Associations were similar at high PA levels ( p < 0.001), but were not found at low PA levels. Those with moderate or high PA wish to increase their activity particularly when the perceived opportunities for activity are not optimal. Among those with low PA, perceived opportunities are not associated with a perceived need to increase physical activity. Increasing equity in physical activity in old age requires provision of support and opportunities at every level of physical activity.

The aim was to study various types of older adult's activity destinations (counts, frequency of visitation, and distance from home) in the pre-COVID-19 era, and to study prospectively how COVID-19-related regulations limiting mobility affected these. Using a map-based questionnaire, 75-85-year-old participants reported activity destinations, that is, any destinations for physical exercise, destinations facilitating one's outdoor mobility, and destinations for other activities, which they had visited several times during the past month. At baseline, a variety of activity destinations was reported, but during COVID-19, destinations reported markedly declined in number, they were reported predominantly for physical exercise, and they were located closer to home., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objectives: The aim of this study was to report preplanned secondary analyses of the effects of a 12-month individualized active aging counseling intervention on six mobility and physical activity outcomes. Methods: A two-arm, single-blinded randomized controlled trial was conducted among 75- and 80-year-old community-dwelling people. The intervention group (IG, n = 101) received counseling aimed at increasing self-selected, primarily out-of-home activity. The control group (CG, n = 103) received general health information. Data were analyzed with generalized estimating equations. Results: Physical performance improved in the IG more than that in the CG (group by time p = .022), self-reported physical activity increased in both groups (time p = .012), and autonomy in outdoor mobility declined in the IG and was enhanced in the CG (group by time p = .011). No change was observed for life-space mobility, proportion of persons perceiving difficulty walking 2 km, or monitored physical activity. Discussion: Individualized counseling aiming at increasing self-selected out-of-home activity had nonsystematic effects on mobility and positively affected physical performance only.

Background: Physical activity (PA) of higher intensity and longer duration mainly accumulates from older adults' out-of-home activities. Outdoor PA is influenced by environmental features; however, the day-to-day variability of PA and its associations with environmental features have not been widely studied. This study focused on the associations of environmental features with accelerometer-measured PA in older people on weekdays and weekend days. Methods: The study population comprised 167 community-dwelling older people aged 75-90 years. Accelerometers were worn on 7 consecutive days and a structured interview on physical functioning, health, and socioeconomic factors was administered. A geographic information system (GIS) was used to assess environmental features within a distance of 500 (number of land types, road network slope, intersection, and residential densities) or 1,000 m (habitat diversity within natural and green areas) from participants' homes. Accelerometer-based PA [number of PA bouts >10 min and minutes of moderate to vigorous physical activity (MVPA)] was analyzed for weekdays and weekend days separately. Associations between environmental features and PA were analyzed using linear regression models. Results: Participants accumulated on average 0.60 PA bouts and 34.2 MVPA minutes on weekdays and 0.50 PA bouts and 31.5 MVPA minutes on weekend days. Especially participants with low overall PA were less active at weekends. Habitat diversity in natural and green areas, intersection density, and residential density were positively associated with numbers of PA bouts and MVPA minutes on weekdays. Moreover, more diversity in natural and green areas was associated with more MVPA minutes on weekend days. A higher road network slope was negatively associated with the number of PA bouts throughout the week and with MVPA minutes on weekend days. Conclusions: Environmental features close to home, especially PA-supportive infrastructural features and services, were more strongly associated with weekday than weekend PA. This suggests that older people's out-of-home activities, typically conducted on weekdays, are related to service use. However, greater diversity of natural areas close to home seemed to motivate older adults to engage in higher MVPA throughout the week., (Copyright © 2020 Keskinen, Gao, Rantakokko, Rantanen and Portegijs.)

Accelerometer-derived estimates of physical activity (PA) and sedentary time have been an important methodological focus. However, little is known about the daily activities among older people during their normal lives. Furthermore, some older individuals would like to be more active, yet experience an unmet PA need, which is defined as the desire to engage in more PA but without the opportunity to act on the desire. This study examined the intensity of daily PA and sedentary behavior measured with accelerometers among older people, and whether PA differs between weekdays and weekends and those with and without the experience of unmet PA need, measured with self-reports. A total of 174 community-dwelling older people (64% female) aged 75 to 90 years used an accelerometer for 7 consecutive days during waking hours, and the results were classified for sedentary behavior (thresholds of 0.0167 g), light activity (0.091 g), and moderate-to-vigorous activity (MVPA, 0.414 g) based on mean amplitude deviation (g). We found that during weekdays, older people engaged slightly more in light activity and had less sedentary time than during weekends. In total, 7.6% of the participants perceived an unmet PA need. Accordingly, those with unmet PA needs spent less time in MVPA, especially during weekdays, and they might benefit from PA-enabling interventions.

Background: Fatigue related to task standardized by duration and intensity, termed fatigability, could manifest as shortening of activity bouts throughout the day causing daily activity to accumulate in a more fragmented pattern. Our purpose was to study the association of activity fragmentation with physical and mental dimensions of fatigability., Methods: A cross-sectional study of 485 community-dwelling 75-, 80-, and 85-year-old people using a thigh-worn accelerometer for 3-7 days. Activity fragmentation was studied as Active-to-Sedentary Transition Probability for 2 operational definitions of physical activity: accelerations equivalent to at least light physical activity and for upright posture. Physical fatigability was assessed as perceived exertion fatigability, performance fatigability severity, and with the Physical Fatigue Subscale of the Situational Fatigue Scale. Mental fatigability was assessed with the Mental Fatigue Subscale of the Situational Fatigue Scale and as a decrease in perceived mental alertness after a 6-minute walk test., Results: Higher activity fragmentation was associated with higher self-reported physical fatigability, perceived exertion fatigability, and performance fatigability severity, independent of total activity minutes (β = 0.13-0.33, p < .05 for all). Higher activity fragmentation was not associated with mental fatigability in the fully adjusted models. The associations with fatigability indices were similar for both activity fragmentation indicators. Associations of activity fragmentation and performance fatigability severity were similar also among those with the highest intensity-based physical activity volume., Conclusions: The findings provide support that studying fragmented activity patterns can be useful in identifying those at risk for high fatigability, even among those with relatively high physical activity level., (© The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: We examined among older women the association of sleep quality, daytime tiredness, and sleep duration with unmet physical activity need, that is, wishing to be more physically active but perceiving no opportunity for it. Method: Cross-sectional logistic regression analyses among women aged 74 to 86 years (Finnish Twin Study on Aging, third wave, n = 302). Results: Thirty-one participants reported unmet physical activity need. Short sleepers had fivefold and long sleepers threefold odds for unmet physical activity need compared with normative sleepers, while for daytime tiredness the odds were double. Presence of daytime tiredness and unmet physical activity coincided with higher prevalence of chronic diseases, depressive symptoms and walking difficulties, which partly explains the observed associations. Poor sleep quality was not associated with unmet physical activity need. Discussion: Older women with nonoptimal sleep characteristics who perceive unmet physical activity need may benefit from solutions that improve their perceived opportunities for physical activity.

Background: The current study aims to compare correlations between a range of measures of physical performance and physical activity assessing the same underlying construct in different settings, that is, in a home versus a highly standardized setting of the research center or accelerometer recording. We also evaluated the selective attrition of participants related to these different settings and how selective attrition affects the associations between variables and indicators of health, functioning and overall activity., Methods: Cross-sectional analyses comprising population-based samples of people aged 75, 80, and 85 years living independently in Jyväskylä, Finland. The AGNES study protocol involved the following phases: 1) phone interview (n = 1886), 2) face-to-face at-home interview (n = 1018), 3) assessments in the research center (n = 910), and 4) accelerometry (n = 496). Phase 2 and 3 included walking and handgrip strength tests, and phase 4 a chest-worn and thigh-worn accelerometer estimating physical activity and assessing posture, respectively, for 3-10 days in free-living conditions., Results: Older people with poorer health and functioning more likely refrained from subsequent study phases, each requiring more effort or commitment from participants. Paired measures of walking speed (R = 0.69), handgrip strength (R = 0.85), time in physical activity of at least moderate intensity (R = 0.42), and time in upright posture (R = 0.30) assessed in different settings correlated with each other, and they correlated with indicators of health, functioning and overall activity. Associations were robust regardless of limitations in health and functioning, and low overall activity., Conclusions: Correlational analyses did not clearly reveal one superior setting for assessing physical performance or physical activity. Inclusion of older people with early declines in health, functioning and overall activity in studies on physical performance and physical activity is feasible in terms of study outcomes, but challenging for recruitment.

Background: We aimed to investigate trajectories of mobility limitations (MLs) over a period of 24 years. In addition, we aimed to study how shift work and leisure-time physical activity (LTPA) in midlife predict assignment to MLs trajectories separately for those retired on statutory pensions (SPs) and on disability pensions (DPs)., Methods: Subjects who responded MLs questionnaires (1985-2009, N = 3048) in Finnish Longitudinal Study on Aging Municipal Employees were included in this prospective cohort study. LTPA and shift work were measured during baseline. International Classification of Functioning was used to code MLs. Growth mixture modeling was used to identify the trajectories of MLs. Odds ratio (OR) and their 95% Confidence interval (CI) were assessed by using multinomial logistic regression., Results: We identified four trajectories of MLs, namely low persistent, low increasing, high decreasing and high persistent. Among the SP recipients, shift work with night shifts was associated with an increased risk (adjusted OR 1.49; 95% CI 1.03-2.14) of belonging to the high persistent MLs trajectory. The inactive LTPA (SP: OR 5.99, 95% CI 3.39-10.58, DP: OR 6.81, 95% CI 2.52-18.43) was similarly associated with high persistent MLs trajectory., Conclusion: Nearly two-thirds of the people retired due to disability belonged to high MLs trajectory. High persistent MLs trajectory was associated with physical inactivity in midlife among those retired on SP and on DP. Shift work with night shift predicted high persistent MLs in SP strata. Active involvement in LTPA during midlife could be beneficial to spend MLs free later life., (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)

Introduction: The most promising way to promote active life years in old age is to promote regular participation in physical activity (PA). Maintaining lower extremity muscle function with good balance has been associated with fewer falls and the need of help from others. This article describes the design and intervention of a randomised controlled trial (RCT) investigating the effectiveness of a health and PA counselling programme on life-space mobility and falls rates in community-dwelling older adults at the Health Kiosk and/or Service Centre., Methods and Analysis: Community-dwelling men and women (n=450) aged 65 years and over with early phase mobility limitation will be recruited to a 24-month RCT with a 24-month follow-up. Participants will be randomly allocated into either a health and PA counselling group (intervention) or relaxation group (control intervention). All participants will receive five group specific face-to-face counselling sessions and 11 phone calls. The counselling intervention will include individualised health counselling, strength and balance training, and guidance to regular PA. The control group will receive relaxation exercises. Outcomes will be assessed at baseline, 12, 24 and 48 months. Primary outcomes are average life-space mobility score and falls rates. Life-space mobility will be assessed by a validated questionnaire. Falls rates will be recorded from fall diaries. Secondary outcomes are data on fall-induced injuries and living arrangements, number of fallers, fracture risk, mean level of PA, physical performance, quality of life, mood, cognition, balance confidence and fear of falling. Data will be analysed using the intention-to-treat principle. Cost-effectiveness of the programme will be analysed. Ancillary analyses are planned in participants with greater adherence., Ethics and Dissemination: Ethical approval was obtained from the Ethics Committee of the Tampere University Hospital (R15160). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at international conferences., Trial Registration: ISRCTN65406039; Pre-results., Competing Interests: Competing interests: RN, University of Jyväskylä and GeroCenter Foundation, Jyväskylä, Finland, is a co-owner of the Devisys Oy, Tampere, Finland, a company that produces anti-slip devices for winter conditions., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Active aging has been established as a policy goal for aging societies. We define active aging at the individual level as striving for elements of well-being through activities in relation to a person's goals, functional capacities and opportunities. Increasing evidence suggests that any meaningful activity is beneficial for different aspects of well-being in older people. The aim of the present randomized controlled trial is to test the feasibility and effectiveness of a one-year community-based intervention on active aging. The AGNES intervention aims at increasing older peoples' participation in self-selected valued activities., Methods: The proposed study is a two-arm single-blinded randomized controlled trial. The intervention group receives individually tailored counselling for an active life (one face-to-face session, four phone calls and supportive written material) and the control group written general health information only. Two hundred older adults aged 75- and 80- year old, with intermediate mobility function and without cognitive impairment, living independently in the municipality of Jyväskylä, Finland, are recruited and randomized with a 1:1 allocation to the intervention and control group. Randomization is computer-generated stratified by sex and age. The primary outcome is active aging and secondary outcomes are well-being, depressive symptoms, quality of life, personal goals, mobility and physical activity. Measures are administered at pre-trial, mid-trial (at 6 months) and post-trial (12 months after baseline)., Discussion: The AGNES intervention study will provide new knowledge on the effects of individualized counselling on active aging and the potential of older people to promote their own well-being., Trial Registration: The trial is registered at ISRCTN - ISRCTN16172390 : Promoting well-being through active aging.

Background: Safe and stable walking is a complex process involving the interaction of neuromuscular, sensory and cognitive functions. As physical and cognitive functions deteriorate with ageing, training of both functions may have more beneficial effects on walking and falls prevention than either alone. This article describes the study design, recruitment strategies and interventions of the PASSWORD study investigating whether a combination of physical and cognitive training (PTCT) has greater effects on walking speed, dual-task cost in walking speed, fall incidence and executive functions compared to physical training (PT) alone among 70-85-year-old community-dwelling sedentary or at most moderately physically active men and women., Methods: Community-dwelling sedentary or at most moderately physically active, men and women living in the city of Jyväskylä will be recruited and randomized into physical training (PT) and physical and cognitive training (PTCT). The 12-month interventions include supervised training sessions and home exercises. Both groups attend physical training intervention, which follows the current physical activity guidelines. The PTCT group performes also a web-based computer program targeting executive functions. Outcomes will be assessed at baseline and at 6 and 12 months thereafter. Falls data are collected during the interventions and the subsequent one-year follow-up. The primary outcome is 10-m walking speed. Secondary outcomes include 6-min walking distance, dual-task cost in walking speed, fall incidence and executive function assessed with color Stroop and Trail Making A and B tests. Explanatory outcomes include e.g. body composition and bone characteristics, physical performance, physical activity, life-space mobility, fall-related self-efficacy, emotional well-being and personality characteristics., Discussion: The study is designed to capture the additive and possible synergistic effects of physical and cognitive training. When completed, the study will provide new knowledge on the effects of physical and cognitive training on the prevention of walking limitations and rate of falls in older people. The expected results will be of value in informing strategies designed to promote safe walking among older people and may have a significant health and socio-economic impact., Trial Registration: ISRCTN52388040 .

Background: This study assessed how different measures of body composition predict physical performance ten years later among older adults., Methods: The participants were 1076 men and women aged 57 to 70 years. Body mass index (BMI), waist circumference, and body composition (bioelectrical impedance analysis) were measured at baseline and physical performance (Senior Fitness Test) ten years later. Linear regression analyses were adjusted for age, education, smoking, duration of the follow-up and physical activity., Results: Greater BMI, waist circumference, fat mass, and percent body fat were associated with poorer physical performance in both sexes (standardized regression coefficient [β] from -0.32 to -0.40, p < 0.001). Lean mass to BMI ratio was positively associated with later physical performance (β = 0.31 in men, β = 0.30 in women, p < 0.001). Fat-free mass index (lean mass/height 2 ) in both sexes and lean mass in women were negatively associated with later physical performance. Lean mass residual after accounting for the effect of height and fat mass was not associated with physical performance., Conclusions: Among older adults, higher measures of adiposity predicted poorer physical performance ten years later whereas lean mass was associated with physical performance in a counterintuitive manner. The results can be used when appraising usefulness of body composition indicators for definition of sarcopenic obesity., (Copyright © 2018 Elsevier B.V. All rights reserved.)

The aim was to study the correspondence between the objective and perceived environment and to assess their associations with physical activity (PA) in older people. 848 community-dwelling older people aged 75-90 were interviewed on their difficulties in walking 500m, perceiving nature as a facilitator for outdoor mobility, and PA. The presence of water and landscape diversity were objectively assessed inside 500m and 1000m circular buffers around participants' homes. Using logistic regression, participant data were analyzed together with the objectively assessed environmental features. Our results indicate that higher habitat diversity within natural areas correlates with higher PA among older people without walking difficulties and the presence of water correlates with higher PA among those with walking difficulties., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The aim is to determine concurrent validity of a single self-report habitual physical activity (PA) question against accelerometer-based PA and mobility variables, and corresponding changes in self-reported PA and mobility. Cross-sectional and longitudinal data of the "Life-space mobility in old age" (LISPE) cohort and its substudy on PA were utilized. At baseline, 848 community-dwelling, 75- to 90-year-old people living independently in central Finland participated in home-based interviews. One and 2 years later, 816 and 761 of them were reassessed by phone, respectively. Tri-axial accelerometer data over 7 days were collected following the baseline assessments in a subsample of 174. Self-reported habitual PA was assessed based on intensity and duration using a single question with seven response options (range: mostly resting to competitive sports). Mobility variables were as follows: life-space mobility, walking difficulty over 500 m, and short physical performance battery. Statistically significant correlations were found between self-reported habitual PA and mobility (Spearman correlation coefficient Rs = 0.40-0.61) and accelerometer-based PA variables [step counts (Rs = 0.49), time in moderate (Rs = 0.49) and low intensity (Rs = 0.40) PA, and time in sedentary behavior (Rs = -0.28)]. A decline in self-reported habitual PA over time was associated with 5-10p decline in life-space mobility (PA improvement with 0-3p increase) and with developing a higher degree of walking difficulty (in 35-44% of participants). In conclusion, based on these results, the self-report question to assess habitual PA is valid and responsive to change and thus useful for epidemiological research in community-dwelling older people, also in follow-up studies., (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The aim was to study objectively assessed walkability of the environment and participant perceived environmental facilitators for outdoor mobility as predictors of physical activity in older adults with and without physical limitations. 75-90-year-old adults living independently in Central Finland were interviewed ( n = 839) and reassessed for self-reported physical activity one or two years later ( n = 787). Lower-extremity physical limitations were defined as Short Physical Performance Battery score ≤9. Number of perceived environmental facilitators was calculated from a 16-item checklist. Walkability index (land use mix, street connectivity, population density) of the home environment was calculated from geographic information and categorized into tertiles. Accelerometer-based step counts were registered for one week ( n = 174). Better walkability was associated with higher numbers of perceived environmental facilitators ( p < 0.001) and higher physical activity (self-reported p = 0.021, step count p = 0.010). Especially among those with physical limitations, reporting more environmental facilitators was associated with higher odds for reporting at least moderate physical activity ( p < 0.001), but not step counts. Perceived environmental facilitators only predicted self-reported physical activity at follow-up. To conclude, high walkability of the living environment provides opportunities for physical activity in old age, but among those with physical limitations especially, awareness of environmental facilitators may be needed to promote physical activity.

Background: physical performance is a key factor that determines how older people cope with daily tasks and maintain independency. There is strong evidence suggesting that physical activity (PA) is important in maintaining physical performance in old age. However, most studies have been done using self-reported PA. Our aim was to explore the association between objectively measured PA and physical performance in old age., Methods: we studied 695 participants (mean age 70.7 years, SD 2.7) from the Helsinki Birth Cohort Study. Physical performance was assessed with the Senior Fitness Test (SFT) and PA with a multisensory activity monitor SenseWear Pro 3 Armband., Results: total volume of PA was significantly associated with the overall SFT score (β = 0.08; 95% confidence interval: 0.07-0.10, P < 0.001). There were no significant differences between men and women. Both light and moderate to vigorous level of PA were positively associated with the overall SFT score, while sedentary time was negatively associated with the overall SFT score., Conclusions: volume of objectively measured PA among older people was positively associated with the physical performance measured with a validated fitness test battery., (© The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com)

Background: Our aim was to study the relationship between objectively measured physical activity and subsequent changes in life-space mobility over 2 years among older people. Life-space mobility refers to the area a person moves through in daily life, taking into account frequency, and need of assistance. Life-space mobility and physical activity correlate, but whether different intensities of objectively assessed physical activity predicts decline in life-space mobility is not known., Methods: Prospective cohort study of the "Life-space Mobility in Old Age" (LISPE) project accelerometer substudy. Participants were community-dwelling older people aged 75-90 (n = 164). Life-space mobility was measured with the Life-Space Assessment at baseline face-to-face home interview and telephone follow-up interviews 1 and 2 years after baseline. Physical activity (step count and time spent in moderate activity, low activity, and sedentary behavior) was measured by a tri-axial accelerometer (Hookie "AM20 Activity Meter") for 7 days at baseline. Generalized estimating equations (GEE models) were used to compare changes in life-space mobility between participants categorized according to the baseline physical activity measures., Results: Median age of the participants was 79.5 (IQR 6.7) and 64% were women. Over the 2 years, life-space mobility declined significantly among those with lower step counts and less time spent in moderate activity measured at baseline. Time spent in low activity and sedentary behavior did not predict changes in life-space mobility., Conclusions: In old age, more time spent walking outdoors and accumulation of moderate-intensity physical activity may help to maintain higher life-space mobility, a correlate of good quality of life., (© The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: To profile participants based on reported outdoor physical activity barriers using a data-driven approach, describe the profiles and study their association with unmet physical activity need., Method: Cross-sectional analyses of 848 community-dwelling men and women aged 75-90 living in Central Finland in 2012. Barriers to outdoor physical activity and unmet physical activity need were enquired with a questionnaire. The latent profiles were identified by profiling participants into latent groups using a mixture modeling technique on the multivariate set of indicators of outdoor physical activity barriers. A path model was used to study the associations of the profiles with unmet physical activity need., Results: Five barrier profiles were identified. Profile A was characterized with minor barriers, profile B with weather barriers, profile C with health and weather barriers, profile D with barriers concerning insecurity, health and weather; and profile E with mobility and health barriers. The participants in the profiles differed in the proportion of individual and environmental barriers. The risk for unmet physical activity need was highest among people whose severe mobility difficulties restricted their outdoor physical activity., Conclusion: Outdoor physical activity barriers reflect the imbalance in person-environment fit among older people, manifested as unmet physical activity need., (Copyright © 2014 Elsevier Inc. All rights reserved.)

This study investigated the associations of personal goals with exercise activity, as well as the relationships between exercise-related and other personal goals, among older women. Both cross-sectional and longitudinal designs were used with a sample of 308 women ages 66-79 at baseline. Women who reported exercise-related personal goals were 4 times as likely to report high exercise activity at baseline than those who did not report exercise-related goals. Longitudinal results were parallel. Goals related to cultural activities, as well as to busying oneself around the home, coincided with exercise-related goals, whereas goals related to own and other people's health and independent living lowered the odds of having exercise-related goals. Helping older adults to set realistic exercise-related goals that are compatible with their other life goals may yield an increase in their exercise activity, but this should be evaluated in a controlled trial.

Purpose: Recovery of walking outdoors after hip fracture is important for equal participation in the community. The causes of poor recovery are not fully understood. This study investigates recovery of walking outdoors and associated determinants after hip fracture., Methods: A prospective follow-up study, among clinical sample of 81 community-dwelling hip fracture patients over 60 years. Perceived difficulty in walking outdoors and 500 meters was assessed before fracture, at discharge to home (3.2 ± 2.2 weeks after surgery), and on average 6.0 ± 3.3 weeks after discharge. Potential determinants for walking recovery were assessed. Linear latent trajectory model was used to analyse changes during follow-up. Association between walking trajectories and potential determinants was analysed with a logistic regression model., Results: Two trajectories, No-to-minor-difficulty and Catastrophic, were found. Thirty-eight percent of the participants ended up in the Catastrophic trajectory for walking outdoors and 67% for 500 meters. Multivariate logistic regression analysis revealed that use of walking aid and indoor falls before fracture and prolonged pain were independently associated with catastrophic decline in both primary outcomes: difficulty in walking outdoors and 500 meters., Conclusions: A large proportion of community-dwelling older people recovering from hip fracture experienced catastrophic decline in outdoor walking. Acknowledging recovery prognoses at early stage enables individualized rehabilitation.

The aim of this study was to describe the underlying theory and the implementation of a 2-year individualized physical activity counseling intervention and to evaluate whether benefits persisted 1.5 years after the intervention. The sample included 632 sedentary 75- to 81-year-old participants. Data were collected in 2003-2005. The participants were randomly assigned to an intervention group and a control group. The intervention consisted of an individualized face-to-face meeting followed by telephone contacts every 4 months for 2 years, with the aim to increase participation in specific physical activities as well as to increase habitual physical activity. At the 2-year follow-up, the prevalence of physical activities in the intervention group vs. control group was as follows: supervised calisthenics training 20 vs. 16%, walking for fitness 69 vs. 62%, weight training 13 vs. 8% and water aerobics 19 vs. 7%. For water aerobics and walking for fitness, the treatment effect was significant [water aerobics odds ratio (OR) 2.49, 95% confidence interval (CI) 1.16-5.36, walking for fitness OR 1.58, 95% CI 1.05-2.40]. As to the other activities, the effect did not reach statistical significance. At the 1.5-year post-intervention, the follow-up results indicated that the intervention effect was still evident. The subgroup analyses suggested that physical activity counseling may be most efficacious among people with intact mobility, while those having manifest mobility limitations may not benefit from it. Older people who have manifest mobility limitations may need more face-to-face counseling.

Objectives: To examine which individual and environmental factors correlate with unmet physical activity need in old age and predict development of unmet physical activity need (the feeling that one's level of physical activity is inadequate and thus distinct from the recommended amount of physical activity) over a 2-year follow-up., Design: Observational prospective cohort study and cross-sectional analyses., Setting: Community and research center., Participants: A total of 643 community-living ambulatory people aged 75 to 81 took part in face-to-face interviews and examinations at baseline and 314 at the 2-year follow-up., Measurements: Unmet physical activity need and its potential individual and environmental correlates were assessed at baseline. Development of unmet physical activity need was assessed over the 2-year follow-up period., Results: At baseline, all participants were able to walk at least 500 m outdoors, but 14% perceived unmet physical activity need. Unmet physical activity need was more prevalent in those with musculoskeletal diseases, depressive symptoms, and mobility limitations. Hills in the nearby environment, lack of resting places, and dangerous crossroads correlated with unmet physical activity need at baseline; the association was especially strong in those with walking difficulties. Significant baseline predictors for incident unmet physical activity need (15%) included fear of moving outdoors, hills in the nearby environment, and noisy traffic., Conclusion: Unmet physical activity need is common in ambulatory community-living older people who have health and mobility problems and report negative environmental features in their neighborhood. Solutions to overcome barriers to physical activity need to be developed to promote equal opportunities for physical activity participation.

Purpose: The aim of this study was to investigate whether persistent leisure-time physical activity, adjusted for genetic liability and childhood experiences, protects against chronic diseases, early signs of disability, and loss of life satisfaction., Methods: From 5663 healthy adult twin pairs, we identified 146 pairs who were discordant for both intensity and volume of leisure physical activity in 1975 and 1981. Of them, both members of 95 pairs were alive and participated in our follow-up study in 2005 when chronic diseases (such as diabetes, cardiovascular disease, and osteoarthritis), life satisfaction, and disability were assessed by a structured telephone interview. The mean age of the participants was 58 yr (range = 47-79 yr) in 2005. Paired tests were used in the analyses., Results: At the end of follow-up, the active cotwins had a decreased risk of reporting at least one chronic diseases, whereas active monozygotic (MZ) twins had two or more chronic diseases significantly less often than their inactive cotwins (odds ratio [OR] = 0.14, P = 0.031). Overall, the risk for type 2 diabetes or glucose intolerance (OR = 0.09, P = 0.022) and elevated blood pressure (OR = 0.46, P = 0.039) was decreased among the active cotwins. These effects were seen clearly among dizygotic twins but not always among small number of monozygotic twins. The active cotwins reported greater life satisfaction (P = 0.047) and tended to be less likely to be hospitalized (P = 0.065), although active cotwins had somewhat more sports-related injuries (OR = 1.9, P = 0.051) than inactive cotwins. Studied disability variables did not differ between the active and the inactive cotwins., Conclusions: Physical activity reduces the risk for chronic diseases and helps in maintaining life satisfaction. However, genetic factors may play a role in this association because some findings emerged more clearly among dizygotic than monozygotic twins discordant for physical activity.

Objective: To examine what older obese people consider as constraints on their physical exercise and to determine whether these constraints can explain the differences in physical activity., Methods: Six hundred nineteen community-living people aged 75-81 years living in Jyväskylä, Central Finland, in 2003 were included in these cross-sectional analyses. Weight and height were measured at the research center, and physical activity and perceived constraints on physical exercise were assessed using validated questionnaires. Participants were categorized as non-obese (n=436), moderately obese (n=127) or severely obese (n=56)., Results: The risk of physical inactivity was two times higher in the moderately obese group (OR 1.99, 95% CI 1.27-3.12) and over four times higher in the severely obese group (OR 4.58, 95% CI 2.55-8.24) compared to the non-obese group. Higher prevalence of comorbidities, pain, tiredness, fear of falling and injury, discomfort and feelings of insecurity when exercising explained almost half of the increased risk of physical inactivity of older severely obese people., Conclusions: Results suggest that physical activity promotion among older obese people may be well received as long as it focuses on factors that enable participation in physical activity and takes into account their constraints on physical activity.

The aim of this study was to analyze social welfare and healthcare costs and fall-related healthcare costs after a group-based exercise program. The 10-week exercise program, which started after discharge from the hospital, was designed to improve physical fitness, mood, and functional abilities in frail elderly women. Sixty-eight acutely hospitalized and mobility-impaired women (mean age 83.0, SD 3.9 years) were randomized into either group-based (intervention) or home exercise (control) groups. Information on costs was collected during 1 year after hospital discharge. There were no differences between the intervention and control groups in the mean individual healthcare costs: 4381 euros (SD 3829 euros) vs 3539 euros (SD 3967 euros), P=0.477, in the social welfare costs: 3336 euros (SD 4418 euros) vs 4073 euros (SD 5973 euros), P=0.770, or in the fall-related healthcare costs: 996 euros (SD 2612 euros) vs 306 euros (SD 915), P=0.314, respectively. This exercise intervention, which has earlier proved to be effective in improving physical fitness and mood, did not result in any financial savings in municipal costs. These results serve as a pilot study and further studies are needed to establish the cost-effectiveness of this exercise intervention for elderly people.

Purpose of Review: Older obese persons with decreased muscle mass or strength are at special risk for adverse outcomes. We discuss potential pathways to muscle impairment in obese individuals and the consequences that joint obesity and muscle impairment may have on health and disability. Tantamount to this discussion is whether low muscle mass or, rather, muscle weakness should be used for the definition., Recent Findings: Excess energy intake, physical inactivity, low-grade inflammation, insulin resistance and changes in hormonal milieu may lead to the development of so-called 'sarcopenic obesity'. It was originally believed that the culprit of age-related muscle weakness was a reduction in muscle mass, but it is now clear that changes in muscle composition and quality are predominant. We propose that the risk of adverse outcomes, such as functional limitation and mortality, is better estimated by considering jointly obesity and muscle strength rather than obesity and muscle mass and the term 'sarcopenic obesity' should be revisited., Summary: Recognition of obese patients who have associated muscle problems is an essential goal for clinicians. Further research is needed to identify new target for prevention and cure of this important geriatric syndrome.

Objectives: To examine the effects of physical activity counseling on mood among older people unselected for their depressive symptomatology., Methods: Data are from "Screening and Counseling for Physical Activity and Mobility in Older People" project (SCAMOB), conducted in Finland during 2003-2005. SCAMOB was a 2-year single-blinded randomized controlled trial among 624 participants 75 years and older randomized into physical activity counseling group and control group. Depressive symptoms were assessed at baseline and after 24 months using Center for the Epidemiologic Studies Depression Scale., Results: Among all the study participants, no effect of intervention was observed. However, among subgroup with minor depressive symptoms at baseline, a significant treatment effect was observed, where depressive symptoms decreased in the intervention group and increased in the control group., Conclusions: These findings suggest that physical activity counseling may reduce depression among those with minor depressive symptoms, which warrants for future studies.

Background: Muscle strength declines on average by one percent annually from midlife on. In postmenopausal women this decrement coincides with a rapid decline in estrogen production. The genetics underlying the effects of estrogen on skeletal muscle remains unclear. In the present study, we examined whether polymorphisms within COMT and ESR1 are associated with muscle properties and assessed their interaction and their combined effects with physical activity., Methodology/principal Findings: A cross-sectional data analysis was conducted with 434 63-76-year-old women from the population-based Finnish Twin Study on Aging. Body anthropometry, muscle cross-sectional area (mCSA), isometric hand grip and knee extension strengths, and leg extension power were measured. COMT Val158Met and ESR1 PvuII genotypes were determined by the RFLP method. mCSA differed by COMT genotypes (p = 0.014) being significantly larger in LL than HL individuals in unadjusted (p = 0.001) and age- and height-adjusted model (p = 0.004). When physical activity and age were entered into GEE model, COMT genotype had a significant main effect (p = 0.038) on mCSA. Furthermore, sedentary individuals with the HH genotype had lower muscle mass, strength and power, but they also appeared to benefit the most from physical activity. No association of ESR1 PvuII polymorphism with any of the muscle outcomes was observed., Conclusions/significance: The present study suggests that the COMT polymorphism, affecting the activity of the enzyme, is associated with muscle mass. Furthermore, sedentary individuals with potential high enzyme activity were the weakest group, but they may potentially benefit the most from physical activity. This observation elucidates the importance of both environmental and genetic factors in muscle properties.

Background and Aims: Feasible and lowcost exercise programmes targeting fall risk factors may decrease the risk of falling in older adults. The purpose of this study was to compare the effects of square-stepping exercise (SSE) training, which is a new and low-cost method designed to improve lower-extremity functional fitness, with strength and balance (SB) training., Methods: The study included 39 community-dwelling adults aged 65 to 74 years. The participants were randomized to either group SSE (n=20) or SB (n=19). They engaged in 70- min group exercise sessions twice a week for 12 weeks. The efficacy of the program was measured with both a 9- item test battery for assessment of physical performance and self-reported scales (fear of falling, pleasure in exercise, perceived health status). Fall incidence was followed up for 14 months., Results: The results of a 2-way ANOVA revealed that the time effect in 7 of the 9 performance tests was significant, although group-by-time interactions were not. No significant changes were observed in the self reported scales. During the 14-month follow-up period, 7 falls in 6 participants in the SSE group and 12 falls in 11 participants in the SB group were reported. The incidence rate per person in the SSE group (30.0%) was not significantly different from that in the SB group (57.9%). The rate of falls per trip [falls/(falls + trips)] in the SSE group (17.1%) was significantly lower than in the SB group (50.0%)., Conclusions: SSE is as equally effective as SB training in improving lower-extremity functional fitness. SSE may also be recommended for older adults, due to its low cost and effectiveness.

The purpose of this study was to investigate what older adults with severe, moderate, or no mobility limitation consider motives for and barriers to engaging in physical exercise. Community-dwelling adults (N=645) age 75-81 years completed a questionnaire about their motives for and barriers to physical exercise and answered interview questions on mobility limitation. Those with severely limited mobility more often reported poor health, fear and negative experiences, lack of company, and an unsuitable environment as barriers to exercise than did those with no mobility limitation. They also accentuated disease management as a motive for exercise, whereas those with no or moderate mobility limitation emphasized health promotion and positive experiences related to exercise. Information about differences in motives for and barriers to exercise among people with and without mobility limitation helps tailor support systems that support engagement in physical activity among older adults.

Background and Aims: The purpose of this prospective population-based study was to examine the combined effects of motor speed and knee extension strength on risk of fall-related bone fractures in elderly individuals over a 10-year period., Methods: Participants were 307 men and women aged 75 or 80 years at baseline, who visited the research laboratory at the University of Jyväskylä, Finland. Multi-choice motor speed tests and maximal isometric knee extension strength tests were carried out at baseline. Information on fractures was collected from hospital and health center records. The presence of impairment was defined as a score in the lowest tertile of sex- and age-stratified distribution of results in each test., Results: During the 10-year period, 93 participants had at least one fracture. In Cox proportional hazards models for motor speed and knee extension strength, the risk of fracture was almost double in the lowest vs the highest tertile of each test score. For those in the poorest speed and strength tertiles compared with the best speed and strength tertiles, the relative risk of fracture adjusted for age, sex and bone mineral density was 4.69 (95% confidence interval 1.72-12.81)., Conclusions: Increased risk of fracture was observed for those with either slow motor speed or poor lower extremity strength; however, a combination of these impairments increased the fracture risk significantly when compared with those with no impairments. A co-impairment approach may prove useful in gaining better understanding of the risk of fall-related bone fractures and the development of effective interventions.

Background and Aims: An acute illness may place older frail people at increased risk of losing independence in functional abilities. Physical exercise may reduce the risk by improving muscle strength and balance. However, the effects of physical training on functional abilities have not been studied among frail, very old people recovering from an acute illness. The aim of this study was to determine the effects of a group-based exercise program on their ability to carry out self-care (ADL) and instrumental activities (IADL) relevant to daily life after discharge from hospital., Methods: This randomized controlled trial examined 68 community-dwelling women aged 75 years or older (mean age 83.0, SD 3.9) who were hospitalized due to an acute illness, and were mobility-impaired at admission. Participants were recruited from the geriatric ward of a primary-care health-center hospital, and were randomized into group-based strength training (n=34) and control (n=34) groups. The 10-week group-based intervention included strength training and functional exercises. The control group received instructions for a home exercise training program, including functional exercises but no further encouragement to exercise. The level of independence in ADL and IADL was evaluated, using a 13-item scale with stepwise grading from fully independent to fully dependent. Measurements took place immediately before and after the intervention, and three and nine months later., Results: The intervention did not have any significant main effect (p = 0.407), nor was there any significant interaction between follow-up time and intervention (p = 0.854)., Conclusions: The multicomponent outpatient strength training program did not improve autonomy in expert-evaluated ADL/IADL functions.

Background: Little is known about how health care professionals advice older people with chronic conditions about physical exercise. This study investigated exercise counseling in the context of health care as perceived by older people, and factors associated with perceived advice., Design and Methods: Participants were 580 non-institutional 73- to 92-year-old people who reported at least one contact with health care during the previous 12 months., Results: Of all the participants, 23% recalled solely recommendations to exercise, and 9% solely warnings against exercise. Additionally, 34% recalled receiving both recommendations for and warnings against physical activity, and 34% did not recall exercise-related advice at all. Recalling solely recommendations to exercise was associated with having musculoskeletal diseases and impaired mobility. Reporting solely warnings against physical activity was more common among those having heart conditions. Recalling both recommendations for and warnings against exercise was associated with being physically active despite of having heart conditions, musculoskeletal diseases, and impaired mobility. Recalling no exercise-related advice was most common among people who were sedentary and older, had fewer chronic conditions and reported no mobility limitation., Conclusions: A substantial proportion of older people recalled negative, no, or contradicting advice about exercise. As warnings against physical activity may outweigh recommendations to exercise, special attention should be paid to the content of advice in order to avoid discouraging older people from being active.

The aim of this study was to investigate whether advice by health care professionals is associated with increased exercise activity in older people. As part of the Evergreen follow-up study, self-report data on exercise related advice were collected in 1996 and physical activity in 1988 and 1996 among 611 non-institutional people initially aged 65-84 years. Logistic regression analyses were used to study the association of recollection of having received exercise counseling with increased activity. Of all the subjects, 92% reported having been in contact with health care professionals during the follow-up period, and 58% of them recalled having been advised to exercise. Those men and women who recalled having received advice, started to participate in supervised exercise classes 5-6 times more often than those who did not recall being advised. The odds ratio (95% confidence interval) in men was 6.27 (1.19-32.9), and in women 5.27 (1.97-14.1). For calisthenics at home, the corresponding figure was 12.5 (3.52-44.4) in men. We concluded that initiating new physical activities in old age is strongly connected to encouragement to exercise by health care professionals. Health care professionals should be supported to promote exercise among older patients.

Objective: In older people, mobility impairments and physical inactivity are risk factors for further disability and death. We studied the interaction of physical activity and mobility impairment as a predictor of dependence and mortality., Design: A population-based, prospective study. The data were collected in structured interviews in the year 1988 and 8 years later in the year 1996 as part of the Evergreen Project., Participants: Subjects were 1109 independently living, at baseline 65- to 84-year-old people in the city of Jyvaskyla, in central Finland., Methods: Participants were ranked into four groups: (1) Intact mobility and physically active (Mobile-Active), (2) Intact mobility and sedentary (Mobile-Sedentary), (3) Impaired mobility and physically active (Impaired-Active), and (4) Impaired mobility and sedentary (Impaired-Sedentary). The confounders adjusted for in the models included age, marital status, education, chronic conditions, smoking, and physical exercise earlier in life., Results: In men and women, the relative risk of death was two times greater in Impaired-Active and three times greater in Impaired-Sedentary groups than the risk of death in Mobile-Active groups. However, the risk of death did not differ between Mobile-Active and Mobile-Sedentary groups. The odds ratio for dependency (95% confidence interval) in Impaired-Sedentary men was 5.21 (1.44-18.70) and in Impaired-Sedentary women was 2.92 (1.52-5.60) compared to Mobile-Active groups. The risk of dependence did not differ significantly between Mobile-Active, Mobile-Sedentary, and Impaired-Active groups., Conclusions: Mobility impairments predicted mortality and dependence. However, among people with impaired mobility, physical activity was associated with lower risks, whereas the risk did not differ according to activity level among those with intact mobility. Despite of their overall greater risk, mobility-impaired people may be able to prevent further disability and mortality by physical exercise.

This study investigated the continuity of life-span physical activity by examining the predictors of the maintenance of a high level of physical activity over 8 years among subjects aged 65-84 years at the baseline, in 1988, in Jyväskylä, Finland. Age, education, marital status and chronic conditions and past physical activity were studied at the baseline. In men and women, self-reported competitive sport participation from as early as 10-19 years of age was a significant predictor for maintaining activity in old age. Also women's participation in recreational sports at the age of 40-64 years predicted activity. We concluded that past physical activity is strongly connected to maintaining a high level of physical activity in old age regardless of chronic conditions that may develop.

Objective: To research the natural changes in maximal isometric strength, over a period of 5 years, in men and women aged 75 at baseline, and to study the effect of everyday physical activity on strength alterations., Design: A 5-year longitudinal study., Setting: Exercise laboratory., Participants: The target group in 1989 was the total 75-year-old population of Jyväskylä. One hundred one men (81%) and 186 women (75%) participated in baseline strength tests, and after 5 years, 55 men and 111 women (70% and 72% of the survivors) took part in the follow-up measurements., Methods: Maximal isometric hand grip, arm flexion, knee extension, trunk flexion, and trunk extension forces were measured using dynamometers. Self-rated physical activity was recorded using a scale by Grimby (1986). Strength changes were compared between groups based on the amount of everyday physical activity: (1) remained active (AA, 24 men, 24 women); (2) remained sedentary (SS, 11 men, 43 women); (3) decreased activity (AS, 11 women); and (4) increased activity (SA, 32 women). AS and SA could be formed for women only because of the small number of men. All analyses were stratified by gender., Main Results: The average percentage change in strength over 5 years among survivors varied from a 4% increase in knee extension strength observed in men and women to a 16% decrease in grip strength in women. The grip strength decrease was greater in women than men. The AA men maintained their trunk extension strength at a higher level than the SS men. Time by group interactions in men were not significant. In women, the rate of decline in AS was 32% in grip and 27% in elbow flexion strength, which was greater than in the other activity groups. The AA women retained their knee extension strength at a higher level than the other groups. Those who died before follow-up tests exhibited poorer strength test results at baseline. Physical activity decreased over follow-up., Conclusions: Strength alterations with age differed between muscle groups. Undertaking everyday physical activities such as household work, walking, and gardening, which are also the most common physically demanding activities of older people, may play an important role in maintaining strength at an adequate level for independent living.

The aim of this study was to examine the role of socio-economic status and the practice of physical exercise in explaining variation in muscle strength in 50 to 60-year-old women. Consequently, four study groups combining education and physical activity were formed: (1) university education, physically active; (2) university education, sedentary; (3) vocational or lower level of education, physically active; (4) vocational or lower level of education, sedentary. Maximal isometric strength of hand grip, arm flexion, body flexion and extension as well as dynamic power of the abdominal muscles were measured in 112 women. The results of the maximal isometric strength measurements were standardised by body mass index. The means of the maximal isometric strength results and sit-up tests were compared between the groups using two-way analysis of variance. The physically active women performed better than the sedentary in both the isometric and dynamic tests. Greater muscle strength was also found among the more highly educated compared with the less educated. The less educated sedentary women showed the poorest performance in the strength tests.

The bone mineral density (BMD) of the calcaneus was measured utilizing a single energy photon absorption method in 108 women, aged 50-60 years. The women who participated in vigorous exercise two or more times a week or whose total physical activity amounted to 4 h a week had significantly higher BMD values than those who exercised less than two times a week or did less than 4 h physical activity a week. The physically active women also showed higher values for leg extension force and maximal oxygen uptake. BMD and leg extension force were positively correlated, whereas correlations between BMD and body mass, and the width of the calcaneus were negative. When other life-style variables were taken into account, such as smoking and drinking, a significant difference in BMD was found between physically active and sedentary women, but not between the smokers and non-smokers, or the drinkers and non-drinkers.

Objective: To study the effect of age on the association between body fat percentage and maximal walking speed in older people. Design and participants: Cross-sectional analysis of data collected in the Finnish population-based Health 2000 Survey involving 916 men and 1 222 women aged 55 years and older with complete data on body composition and a walking speed test. Methods: Body fat percentage was assessed using bioelectrical impedance analysis and maximal walking speed based on a timed walking test over a distance of 6.1 meters. Linear regression models were used to study the effect of age on association between body fat percentage and maximal walking speed. Results: The association between body fat percentage quartiles and maximal walking speed differed significantly between persons of different ages (p for age interaction = 0.027). In the agestratified analyses, the association between body fat percentage and maximal walking speed remained significant among 60-69-year olds and 70-79-year olds, but disappeared among 55-59-year-olds and 80-year and older after adjustment for potential covariates. Body fat percentage explained 11% of the variation in maximal walking speed among 55-59-year-olds, 21% among 60-69-year-olds, 17% among 70-79-year-olds and 11% among 80-year and older. Conclusion: Association between body fat percentage and maximal walking speed was strongest between the ages of 60 and 79 years. The results suggest that the effects of excess body fatness are especially harmful for physical functioning among adults in their sixties and seventies and they could benefit from interventions. [ABSTRACT FROM AUTHOR]

In this study self-reported ability to walk 2 km and six-minute walking test (6MWT) performance were examined as predictors of all-cause mortality in 434 women, aged 63-76 years. The primary outcome measure was all-cause mortality (follow-up: 8 years). Predictors were self-reported difficulties in walking 2 km and 6-min walking distance tertiles of ≤ 495, 496 - 560 and ≥ 561 m, and no test result due to refusal by the physician to grant permission to perform the test or participant's inability or unwillingness to perform the test. During the follow-up, 39 participants died. Participants reporting minor (age- and body mass index-adjusted hazard ratio 2.53, 95 % confidence interval 1.12 - 5.69) or major (7.93, 3.49 - 18.05) difficulties in walking 2 km had increased risk of death compared with those reporting no difficulties. Participants with no 6MWT result (6.99, 2.46 - 19.86) were at an increased risk of death when compared with participants who walked ≥ 561 m. A similar trend (2.47, 0.81 - 7.56) was found for participants with walking distance of ≤ 495 m during the 6MWT. The trends remained similar after adjustments for other confounders. In conclusion, self-reported difficulties in walking 2 km are associated with an increased risk of death in older community-dwelling women. Objectively measured walking ability gives similar results. [ABSTRACT FROM AUTHOR]

The aim of the study was to determine whether habitual physical activity can compensate for the increased mortality risk among older people with poor muscle strength. Mortality was followed up for 10 years after laboratory examination in 558 community dwelling 75- and 80-year-old men and women. Maximal isometric strength of five muscle groups was measured and tertile cut-off points were used to categorize participants. Participants, who reported moderate physical activity for at least 4 h a week, were categorized as physically active and the others as sedentary. High muscle strength and physical activity both protected from mortality, but their effect was not additive. Within each muscle strength tertile, physically active people had a lower mortality risk than sedentary people, the effect being most pronounced among those with lower strength in all muscle groups. A high level of physical activity may thus compensate for the increased mortality associated with low muscle strength. [ABSTRACT FROM AUTHOR]

Background Older people with somatic illnesses are at increased risk of depression. It is not known whether exercise alleviates depressive symptoms in frail, very old people recuperating from an acute illness. Objective To determine the effects of a group-based exercise training program on mood. Methods Sixty-eight women (mean age 83.0, SD 3.9 years) who were hospitalized due to an acute illness, and were mobility impaired at admission, were randomized into group-based 10-week strength training intervention (N=34) and home exercise control (N=34) groups. Twenty-four women in the training and 28 in the control group completed the follow-up. Measures of mood state with the Zung Self-Rating Depression Scale (ZSDS) were performed before and after the training intervention, and follow-up data was collected 3 and 9 months after the end of the intervention. Results After the intervention, there was a significant improvement in mood in the intervention group compared to the home exercise control group: -3.1 (SD 9.0) points vs +1.3 (SD 7.6) points (p =0.048) and the positive effect was still apparent three months after the intervention ceased: -2.6 (SD 7.7) points vs +3.5 (SD 9.7) points (p =0.015). Improvement of mood state at the first follow-up measurement was associated with the improvement in lower limb isometric muscle strength. Conclusions Group-based exercise program organized in the context of a Finnish health care organization improved mood in frail older women recuperating from an acute illness. Copyright © 2002 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]