Current Aging Science - Volume 5, Issue 1, 2012

The effects of age on control of fingertip forces, across five days of practice, were determined for an isometric precision pinch grip task. The task involved controlling a computer cursor so that it traveled upward and horizontally on a 45 degree template line by applying X-axis isometric force with contraction of the thumb, and Y-axis force with the index finger. Upon reaching a reverse circle target, the cursor was returned to the start by controlling the steady release of isometric force. Participants' control across the 6 segments of the template line (3 applying and 3 releasing force) was examined. Healthy participants comprised three age groups: Y20 (mean = 21 ± 4 years), O70 (mean = 70 ± 3 years) and O80 (mean = 79 ± 3 years). The results indicated that 1) overall the Y20 group was faster in completing the task than the O80 group, 2) age differences in task duration time (speed) increased over 4 days, 3) the Y20 and O70 groups, but not the O80 group, improved performance (increased accuracy and decreased within-participant variability for time and accuracy) with practice, 4) circle target proximity (segments 3 and 6) was a potent factor; all groups were slower, less accurate, and less consistent irrespective of force direction in the segments approaching a circle target goal (reverse/end). A task maneuver preceding a directional reversal of force modulation, from increasing to decreasing, was the most difficult element for the O80 group followed by the O70 and Y20 groups. These old adults improved tracing accuracy and consistency, but not performance speed with practice on this precision pinch force control task.

It is important to know about how frail older people experience their physical decline and how they adapt to their bodily changes so that the health system can design preventive interventions targeting this group early on in the disability process.The aim of this study was to explore how older people perceive their physical decline. The study is qualitative in design and based on interviews with older persons, who were in an acute care process. Fourteen people, five men and nine women, aged 74 - 92 years (mean 81 years) were included in the study. Content analysis was used. The main finding was that physical decline was marked as occurring in two dimensions. One dimension was the physical decline and its impact on the individual's physical body (labelled individual body). The other dimension was the impact on the body in its environmental context such as the home or the society (labelled contextual body). The strategies for adapting constituted the two sub-themes, which were labeled compensating/controlling and accepting/resignation. The strategies were executed both on an intellectual level and practical level. For healthcare workers striving to increase physical activity, knowledge about how closely related self-image and physical ability are is useful when helping the frail older people. Increasing coping strategies for handling the general life situation may be a useful way of increasing physical activity and making it feel meaningful, despite the person's frail health situation with limited physical and sometimes psychological resources.

Tai Chi is a traditional Chinese form of conditioning exercise derived from martial arts and rooted in eastern philosophy and Chinese Medicine. Based on the inter-relatedness of mind, body and spirit this form of exercise focuses on producing an inner calmness which is thought to have both physical and psychological therapeutic value. This article provides a brief overview of selected current evidence examining the relationship between Tai Chi and physical, neurocognitive and psychosocial outcomes in older people. This is an emerging and growing area of research and improvements have often been reported in health functioning, physical and emotional health, reducing falls, fear of falling and risk of falls, and possibly enhancing cardiovascular functioning in older adults although the effects on bone density, cognitive and immunological functioning are less clear. Results overall are inconsistent and health improvements have not been evident in all studies. Tai Chi is becoming increasingly popular in practice, and more recent evidence is emerging which is based on experimental and longitudinal designs, although many of the proposed benefits of Tai Chi are yet to be validated in large, randomised controlled trials.

Parkinson's disease (PD) is clinically characterized by symptoms of akinesia, rigidity, and resting tremor, which are related to a dopaminergic deficiency of the nigrostriatal pathway. Disorders of gait are common symptoms of PD that affect the quality of life in these patients. One of the main focuses of physical rehabilitation in PD is to improve the gait deficits in the patients. In the last decade, a small number of studies have investigated the use of the treadmill for the rehabilitation of gait in PD patients. Although, the results of these studies are promising, the mechanisms underlying the therapeutic effect of the treadmill in PD are still largely unknown. This paper reviews 10 years of investigation of treadmill training in PD, focusing on the possible mechanisms involved in the therapeutic effect of the treadmill. Understanding these mechanisms may improve the prescription and design of physical therapy programs for PD patients.

Background: Urinary incontinence (UI) is a distressing condition that affects the lifestyle of older people. To investigate the relationship between UI and physical activity among older adults, a community-based study was conducted in Japan. Methods: A total of 700 men and 300 women (mean age 66.2, SD 7.7 years) were recruited from the community in middle and southern Japan. The International Consultation on Incontinence Questionnaire-Short Form was administered by face-to-face interviews to ascertain UI status. Habitual physical activity levels (walking, moderate and vigorous activities) were assessed using the International Physical Activity Questionnaire and measured in terms of energy expenditure as metabolic equivalent tasks (MET). Results: The prevalence of UI was 7.2% (n = 49) among the 683 eligible male participants and 27.5% (n = 82) among the 298 female participants, who had experienced urine leakage for 2.6 (SD 1.9) years and 4.2 (SD 5.1) years, respectively. Habitual walking levels were lower among incontinent subjects than others without the condition. The adjusted risk of UI was 0.36 (95% confidence interval (CI) 0.14, 0.92) for men and 0.43 (95% CI 0.20, 0.96) for women, when comparing frequent walkers with over 1000 MET minutes of walking per week to completely sedentary participants. The prevalence of UI also decreased with total and moderate activity levels, but the corresponding reductions in risk were not statistically significant. Conclusion: The finding of an inverse association between UI and walking has important implications for the prevention and treatment of this distressing condition.

Positive influences of physical activity both on many chronic diseases and on preservation of mobility are well documented. But chronically ill or mobility restricted elderly living in their own homes are difficult to reach for interventions. The general practitioner's (GP) surgery offers one of the few opportunities to give advice for physical activity to those people. We used program theory to sound out knowledge on GP-centered physical activity counseling. The “conceptual theory” (evidence for training effects in old age) and the “implementation theory” (unique position of the GP) were reviewed narratively. The “action theory” (effects of GP counseling) was reviewed systematically. According to program theory, appropriate MeSH (Medical subject headings) concepts were Aged OR Aged, 80 and over (Target group), Physicians, Family OR Primary Health Care (Implementation/Setting), Counseling OR Patient Education as Topic OR Disease Management OR Health promotion (Intervention), Exercise OR Motor Activity OR Physical Fitness OR Sports (Determinants). The resulting six review papers (Pubmed, 2000-2009) were presented using the STARLITE mnemonic. Authors agree, that the GP plays a central role in the promotion of physical activity to elderly people, but there is conflicting evidence concerning counseling effectiveness. Utilizing behavioral change strategies and the collaboration between GPs and specialised professions are recommended and currently under research.

Gait disorders have been identified as one of the most influential physical impairments associated with deterioration in daily living activities among the elderly. A better understanding of the mechanisms responsible for gait disorders is important for developing intervention strategies for the elderly. In recent years, positron emission tomography (PET) and [18F]fluorodeoxyglucose (FDG) have been used to monitor glucose uptake by skeletal muscle during exercise. This review discusses recent studies in which FDG PET has been used to measure muscular glucose uptake, differences between young adults and the elderly in muscular glucose uptake during walking, and the usefulness of FDG PET for determining the effects of exercise intervention in the elderly.

Background: Although regular physical activity can facilitate healthy aging, improve functional capacity, and prevent chronic diseases in the elderly, many of the Japanese elderly are not sufficiently active. Thus, examining the determinants is an important prerequisite for designing effective programs. The present study investigated the demographic, behavioral, psychosocial, and environmental determinants of meeting the national pedometer-determined physical activity recommendations for the elderly Japanese. Method: Data were analyzed for 137 community-dwelling elderly Japanese aged 70 to 89 years (47% male, mean age = 74.5 years), who completed a questionnaire and wore a pedometer. Demographic (gender, age, marital status), behavioral (BMI, smoking, alcohol consumption), psychosocial (self-efficacy, social support, health professional advice), and environmental (perceived neighborhood environment) variables were self-reported. Averaged daily steps were obtained using 1-year pedometer measurements. Based on the national physical activity recommendations in Japan (males: 6700 steps; females: 5900 steps), the participants were divided into two categories—sufficiently active and insufficiently active. An adjusted logistic regression model was utilized. Results: Totally, 47.4% of the participants (males: 51.5%; females: 43.8%) met the national recommendations. When adjusting for all other variables, a higher self-efficacy for exercise (AOR = 1.16; 95% CI: 1.04-1.28) and positive perception of the neighborhood environment (AOR = 1.43; 95% CI: 1.03-1.98) significantly influenced the meeting of the national recommendations. Conclusions: The findings clarified the need to identify effective intervention strategies to promote physical activity and suggest that an intervention design that accounts for these determinants may more effectively promote physical activity among the elderly Japanese.

Background: The benefits of physical activity in old age are well documented. However, studies have shown that older adults are insufficiently active. One of the reported barriers to physical activity is fear of injuries. Objective: To review available data on the rate of injuries related to sport and purposeful physical activity in advanced aged. Methods: A systematic review of reports published in English, identified by searching four data bases and the reference lists of reviewed articles. Eligible reports were full articles in a peer-reviewed journal, and the study report had to include the injury rate of individuals aged 45 and above and the kind of activities that led to the injury. Seven reports met the inclusion criteria. Results: Studies on injuries in advanced age are scarce, and lack information on the rate of injuries relative to the extent of exercise. The rate of injuries occurring during physical activity in advanced age, based on existing data, is very low compared to other ages. The injury rate of men is almost twice that of women. Men tend to get injured while engaging in ball games and bicycling, while women mostly during exercise. The most frequent reported injuries in the general population including older adults are strains and sprains, followed by fractures in the lower and upper extremities. Conclusions: Since older adults are being encouraged to increase their habitual physical activity even beyond the basic recommended guidelines, more studies are needed to assess the risk of injuries relative to the extent of exercise.

Individuals with knee osteoarthritis, a painful debilitating joint disease affecting many aging adults, are commonly encouraged to pursue a variety of exercise regimens. However, very few studies have specifically focused on barriers and facilitators of exercise adherence as related to knee osteoarthritis. This review focuses on what is known about exercise adherence, as well as those factors that influence exercise adherence, both generally, and in the context of knee osteoarthritis. To this end, a wide array of related studies were retrieved and reviewed. The objective was to better understand the relationship between this disabling health condition and exercise, and factors that might specifically determine long-term exercise participation among this population. Results of this search revealed: 1) strong support for the application of exercise to allay the progression and/or severity of knee osteoarthritis and its consequences, but poor adherence rates in reality; 2) a vast array of disease-associated, as well as other exercise adherence barriers; 3) many recommendations for promoting exercise adherence including improving the nature of the patient-provider relationship, and the importance of individualized exercise prescriptions. It is concluded that life-long exercise is crucial for maximizing the well-being and function of adults with knee osteoarthritis, but recommendations to exercise are often pursued inconsistently. To encourage exercise adherence among this cohort, a comprehensive individualized assessment, active patient involvement in the decision-making process, and long-term monitoring are indicated.