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Background: Most reviews investigating physical activity interventions for older people consider evidence primarily from high-income countries. This review examined physical activity interventions for older people from low- and middle-income countries. Methods: We searched 9 electronic databases to identify randomized controlled trials or quasi-randomized trials studies investigating physical activity interventions for people aged 60+ in low- and middle-income countries. Following study selection, one reviewer extracted relevant data. A second reviewer double-checked the data extraction of a randomly selected sample of interventions (20%). Data were summarized using descriptive statistics. Results: We included 234 studies from 19 countries, investigating 259 distinct physical activity interventions. Studies were mostly conducted in upper middle-income countries (89%), often assessing physical activity interventions through randomized controlled trials (82%). Most studies investigated a mixed population in terms of sex (68%), with a mean age between 65 and 70 years (36%), not selected on the basis of having a specific health condition (55%). The intervention most commonly investigated was structured exercise (63%) and "no intervention" was the most frequent comparator (47%). The outcomes measured more often were intrinsic capacity (59%) and functional ability (51%), whereas physical activity, falls, and social outcomes were rare. Only 2 studies targeted underserved populations. Conclusion: Although we identified a substantial number of randomized controlled trials, most evidence for physical activity interventions for older people in low- and middle-income countries is limited to upper middle-income countries. Gaps identified included interventions targeting populations with underserved backgrounds, using sport as an intervention, and assessing the impact of physical activity interventions on physical activity, falls, and social outcomes. [ABSTRACT FROM AUTHOR]

Background Falls and physical inactivity increase with age. However, physical activity, falls and their associations in older people born at different times are unclear. Methods Women born 1921–26 and 1946–51 who completed follow-up questionnaires in 1999 (n  = 8 403, mean (SD) age: 75 (1) years) and 2019 (n  = 7 555; 71 (1) years) in the Australian Longitudinal Study on Women's Health. Self-reported noninjurious and injurious falls in the previous 12 months and weekly amounts and types of physical activity (brisk walking, moderate- and vigorous-intensity) were compared between the cohorts using Chi-square tests. Associations between physical activity, and noninjurious and injurious falls were estimated using multinomial logistic regressions informed by a directed acyclic graph. Results A greater proportion of the later (1946–51) cohort (59%) reached 150–300 minutes of weekly physical activity, as recommended by the World Health Organization, compared to the earlier (1921–26) cohort (43%, p  < .001). A greater proportion of the later cohort reported noninjurious falls (14% vs 8%). Both cohorts reported similar proportions of injurious falls (1946–51:15%, 1921–26:14%). In both cohorts, participation in 150–300 minutes of physical activity was associated with lower odds of noninjurious falls (adjusted Odds Ratio, 95% CI: 1921–26: 0.66, 0.52–0.84; 1946–51: 0.78, 0.63–0.97) and injurious falls (1921–26: 0.72, 0.60–0.87; 1946–51: 0.78, 0.64–0.96). Conclusions Participation in recommended levels of physical activity was associated with reduced falls in both cohorts. However, generational differences were found with more falls and more physical activities in the women born later. Future studies could examine the reasons contributing to the generational differences. [ABSTRACT FROM AUTHOR]

Objectives: Accurate fall reporting is essential for assessing the effectiveness of fall prevention strategies. This study aimed to investigate the level of agreement between incident reports and resident progress notes as data sources for falls monitoring in residential aged care facilities. Methods: A retrospective observational study was conducted involving 46 older people from six residential aged care facilities who had consented to join the broader TOP UP trial. Fall events documented in the incident report system and resident progress notes over 12 months before randomisation were extracted by two independent reviewers using a standardised Excel form. Agreement between the two data collection methods was calculated using Cohen's kappa coefficient. Results: A total of 75 falls were recorded from 27 (59%) of the 46 participants who were 65% female, with an average age of 83 [SD 9] years. The incident reports captured 68 (90.7%) falls, while the progress notes captured 73 (97.3%) falls. Overall, there was a 75% agreement between falls recorded in progress notes and incident reports. Perfect agreement was identified for five facilities (n = 35), while one facility had a lower agreement rate of 29% (n = 11), which appeared to be attributable to staff shortages linked to the COVID‐19 pandemic. Conclusions: There was substantial agreement between incident reports and progress records. These findings support the use of incident reports for identifying falls in research or to investigate the effectiveness of fall prevention strategies in residential aged care facilities. [ABSTRACT FROM AUTHOR]

Background: Low back pain (LBP) is more likely to occur in people with a family history of this condition, highlighting the importance of accounting for familial factors when studying the individual risk of LBP. We conducted a study of opposite‐sex twin pairs investigating sex differences in LBP while accounting for (genetic and shared environmental) familial factors. Methods: We applied a matched co‐twin control design to study 795 adult opposite‐sex pairs from Australia, Spain, and the United States (US). We used mixed‐effects logistic regression to assess the within‐pair association between female sex and lifetime prevalence of LBP in unadjusted and adjusted models for body‐mass‐index, and depression, as well as interactions between female sex and age (

Background: Frailty and sarcopenia are common age-related conditions associated with adverse outcomes. Physical activity has been identified as a potential preventive strategy for both frailty and sarcopenia. The authors aimed to investigate the association between physical activity and prevention of frailty and sarcopenia in people aged 65 years and older. Methods: The authors searched for systematic reviews (January 2008 to November 2019) and individual studies (January 2010 to March 2020) in PubMed. Eligible studies were randomized controlled trials and longitudinal studies that investigated the effect of physical activity on frailty and/or sarcopenia in people aged 65 years and older. The Grading of Recommendations Assessment, Development and Evaluation approach was used to rate certainty of evidence. Results: Meta-analysis showed that physical activity probably prevents frailty (4 studies; frailty score pooled standardized mean difference, 0.24; 95% confidence interval, 0.04–0.43; P =.017, I2 = 57%, moderate certainty evidence). Only one trial investigated physical activity for sarcopenia prevention and did not provide conclusive evidence (risk ratio 1.08; 95% confidence interval, 0.10–12.19). Five observational studies showed positive associations between physical activity and frailty or sarcopenia prevention. Conclusions: Physical activity probably prevents frailty among people aged 65 years and older. The impact of physical activity on the prevention of sarcopenia remains unknown, but observational studies indicate the preventive role of physical activity. [ABSTRACT FROM AUTHOR]

Objective: To investigate the trial-based cost-effectiveness of the addition of a tailored digitally enabled exercise intervention to usual care shown to be clinically effective in improving mobility in the Activity and MObility UsiNg Technology (AMOUNT) rehabilitation trial compared to usual care alone. Design: Economic evaluation alongside a pragmatic randomized controlled trial. Participants: 300 people receiving inpatient aged and neurological rehabilitation were randomized to the intervention (n = 149) or usual care control group (n = 151). Main measures: Incremental cost effectiveness ratios were calculated for the additional costs per additional person demonstrating a meaningful improvement in mobility (3-point in Short Physical Performance Battery) and quality-adjusted life years gained at 6 months (primary analysis). The joint probability distribution of costs and outcomes was examined using bootstrapping. Results: The mean cost saving for the intervention group at 6 months was AU$2286 (95% Bootstrapped cost CI: −$11,190 to $6410) per participant; 68% and 67% of bootstraps showed the intervention to be dominant (i.e. more effective and cost saving) for mobility and quality-adjusted life years, respectively. The probability of the intervention being cost-effective considering a willingness to pay threshold of AU$50,000 per additional person with a meaningful improvement in mobility or quality-adjusted life year gained was 93% and 77%, respectively. Conclusions: The AMOUNT intervention had a high probability of being cost-effective if decision makers are willing to pay AU$50,000 per meaningful improvement in mobility or per quality-adjusted life year gained, and a moderate probability of being cost-saving and effective considering both outcomes at 6 months post randomization. [ABSTRACT FROM AUTHOR]

Objectives: To summarise evidence of benefits of sport for health among people aged 60+.Design: Systematic review with meta-analysis of randomised controlled trials (RCTs).Data Sources: Medline, CINAHL, SPORTDiscus, the Physiotherapy Evidence Database from inception to April 2021.Study Selection: RCTs investigating the effect of sport on health-related outcomes in people aged 60+ compared with non-active control.Data Synthesis and Analysis: Pooled effect sizes were calculated using random-effect models. Standardised mean differences (SMD), and mean difference (MD) were calculated. The Grading of Recommendations Assessment, Development and Evaluation system was used to assess the certainty of the evidence for analyses with ≥3 studies.Results: Nine trials (628 participants) reported in 15 articles were included. Participation in sport improved cardiorespiratory fitness (n=5 trials; SMD=0.43, 95% CI 0.17 to 0.70; low certainty evidence), physical function (n=4; SMD=0.62, 95% CI 0.05 to 1.18; very low certainty evidence), and mental health (n=2; SMD=0.28, 95% CI 0.06 to 0.51) and reduced fat mass (n=6; MD=-0.99 kg, 95% CI -1.75kg to -0.23 kg; low certainty evidence) among older people. We found no significant effects of sport on overall physical activity participation, strength, balance, lean mass and bone mineral density (BMD). One study investigating quality of life reported a positive, but non-significant effect of sport.Conclusion: Sport may have a positive impact on health outcomes in people aged 60+. There was uncertainty on the effect of sport on strength, balance, lean mass and BMD. Further research is needed to investigate the optimal type and dose of sport to maximise the long-term benefits among older people. [ABSTRACT FROM AUTHOR]

Objectives: To examine the possible bidirectional association between insomnia and comorbid chronic low back pain (LBP) and lower limb pain and to explore whether high-sensitivity C-reactive protein (hsCRP) amplifies these associations. Methods: We calculated adjusted risk ratios (RR) with 95% confidence intervals (CI) for the development of insomnia and mild-to-severe chronic LBP and lower limb pain at 11 years follow-up in participants aged ≥32 years and with hsCRP ≤10 mg/L at baseline in 2007-2008: 3,714 without chronic LBP or lower limb pain (sample 1) and 7,892 without insomnia (sample 2). Results: Compared to participants without chronic pain, participants with comorbid chronic LBP and lower limb pain had a RR of insomnia of 1.37 (95% CI 1.12-1.66). Compared with participants without insomnia, participants with insomnia did not have an increased risk of comorbid chronic LBP and lower limb pain (RR: 1.06, 95% CI 0.76-1.46); however, participants with insomnia had a RR of chronic LBP of 1.20 (95% CI 1.02-1.42). There was no strong amplifying effect of elevated hsCRP (3.00-10.0 mg/L) on these associations. Conclusions: These findings suggest that elevated hsCRP does not amplify the associations between insomnia and mild-to-severe chronic LBP and lower limb pain. Further research using data on the temporal relation between insomnia, chronic pain, and inflammatory responses are required to fully understand the causal pathways. [ABSTRACT FROM AUTHOR]