Effects of Physical Activity Interventions on Health Outcomes among Older Adults Living with HIV: A Systematic Review and Meta-Analysis.
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SUBMITTER: Shim MS
PROVIDER: S-EPMC9317429 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundIn recent years, there has been a global trend toward an increase in life expectancy and the proportion of elderly people among the population. In this regard, it becomes important to promote active and healthy aging. Physical inactivity and social isolation are both risk factors of many chronic illnesses and highly prevalent in older adults. This challenges communities to develop interventions that reduce these risk factors among elderly populations. The main aims of this study were to summarize community-based interventions that aim to simultaneously promote social participation and physical activity in older adults and to examine their effects.MethodsWe performed a systematic review based on the PRISMA standards. Literature searches were conducted in six scientific databases in July 2021. Articles were included if they had an interventional design, focused on older adults living in the community and measured social participation and physical activity as an outcome. The data were summarized narratively due to the heterogeneity of studies and the variety of outcome measures.ResultsOverall, 46 articles published in English were included. The studies were grouped in (1) interventions with main focus on physical activity promotion; (2) social activities that included a physical activity component; (3) health behavior interventions/ health education interventions; (4) multicomponent interventions; (5) environmental interventions. The majority of the reviewed studies reported positive effects of interventions on physical activity and/or social participation. No study reported negative effects. Analysis of quantitative studies showed that multicomponent interventions have great positive effects on both outcomes. In qualitative studies positive effects were found regardless of intervention type.ConclusionThis review summarizes the evidence about the effects of community-based interventions that aim to promote social participation and physical activity in older adults. Multicomponent interventions seem to be most suitable for simultaneous promotion of physical activity and social participation. However, high variability in measurement methods used to assess both social participation and physical activity in the included studies made it difficult to compare studies and to indicate the most effective.Systematic review registrationwww.crd.york.ac.uk, identifier: PROSPERO [CRD42021268270].
| S-EPMC9768837 | biostudies-literature
Project description:Previous studies included in meta-analyses have highlighted the effects of physical activity on the physical and psychological health of older adults living in care settings. We conducted a systematic review of meta-analyses, of institutionalized older adults, to evaluate and conduct a narrative synthesis of the results of these meta-analyses. A literature search was conducted in three databases (PubMed, Web of Science, and Cochrane Library) until 22 March 2023. After screening the identified articles with the PRISMA criteria filters, we included 11 meta-analyses in this systematic review. Higgins' (2013) assessment tool of the meta-analyses demonstrates that the studies were of good quality although future meta-analyses need to provide more information on the treatment of missing data. A summary of the results of these meta-analyses shows that physical activity reduces the rate of falls, mobility issues, functional dependence, and depression, and improves health status. Future studies need to focus on new ways to promote and adapt physical activities to increase the participation of older adults in care settings.
| S-EPMC10341127 | biostudies-literature
Project description:This meta-analysis examined the effects of mindfulness-based interventions (MBIs) on stress, psychological symptoms, and biomarkers of disease among people living with HIV/AIDS (PLWHA). Comprehensive searches identified 16 studies that met the inclusion criteria (N = 1059; M age = 42 years; 20% women). Participants had been living with HIV for an average of 8 years (range = < 1-20 years); 65% were currently on antiretroviral therapy. Between-group analyses indicated that depressive symptoms were reduced among participants receiving the MBIs compared to controls (d+ = 0.37, 95% CI 0.03, 0.71). Within-group analyses showed reductions in psychological symptoms (i.e., less anxiety, fewer depressive symptoms) and improved quality of life over time among MBI participants (d+s = 0.40-0.85). No significant changes were observed for immunological outcomes (i.e., CD4 counts) between- or within-groups. MBIs may be a promising approach for reducing psychological symptoms and improving quality of life among PLWHA. Studies using stronger designs (i.e., randomized controlled trials) with larger sample sizes and longer follow-ups are needed to clarify the potential benefits of MBIs for PLWHA.
| S-EPMC6344266 | biostudies-literature
Project description:BackgroundHigh sedentary time, low physical activity (PA), and low physical fitness place older adults at increased risk of chronic diseases, functional decline, and premature mortality. Mobile health (mHealth) apps, apps that run on mobile platforms, may help promote active living.ObjectiveWe aimed to quantify the effect of mHealth app interventions on sedentary time, PA, and fitness in older adults.MethodsWe systematically searched five electronic databases for trials investigating the effects of mHealth app interventions on sedentary time, PA, and fitness among community-dwelling older adults aged 55 years and older. We calculated pooled standardized mean differences (SMDs) in these outcomes between the intervention and control groups after the intervention period. We performed a Cochrane risk of bias assessment and Grading of Recommendations, Assessment, Development, and Evaluation certainty assessment.ResultsOverall, six trials (486 participants, 66.7% [324/486] women; age mean 68 [SD 6] years) were included (five of these trials were included in the meta-analysis). mHealth app interventions may be associated with decreases in sedentary time (SMD=-0.49; 95% CI -1.02 to 0.03), increases in PA (506 steps/day; 95% CI -80 to 1092), and increases in fitness (SMD=0.31; 95% CI -0.09 to 0.70) in trials of 3 months or shorter and with increases in PA (753 steps/day; 95% CI -147 to 1652) in trials of 6 months or longer. Risk of bias was low for all but one study. The quality of evidence was moderate for PA and sedentary time and low for fitness.ConclusionsmHealth app interventions have the potential to promote changes in sedentary time and PA over the short term, but the results did not achieve statistical significance, possibly because studies were underpowered by small participant numbers. We highlight a need for larger trials with longer follow-up to clarify if apps deliver sustained clinically important effects.
| S-EPMC6908977 | biostudies-literature
Project description:Purpose of the studyTo determine the overall effectiveness of interventions designed to increase physical activity (PA) behavior among community-dwelling older adults.Design and methodsComprehensive literature searching identified eligible PA intervention studies among community-dwelling adults aged 65 and older, or sample mean age of 70. Diverse study characteristics were extracted and outcome data were duplicate coded. Overall mean effect sizes (ESs) were synthesized using a random-effects model. Heterogeneity of effects was analyzed using Q and I(2) statistics. Moderator analyses were conducted using meta-analytic analogues of ANOVA and regression for dichotomous and continuous moderators, respectively.ResultsESs were calculated from 13,829 primary study subjects. The overall mean ES for two-group posttest comparisons was 0.18 (95% CI 0.10-0.26, p < .001). This represents a difference of 620 steps/day or 73 min of PA/week between treatment and control groups. Significant moderators included the use of theory, how interventions were delivered, and cognitive plus behavioral-type intervention components. Non-significant moderators include the type of interventionist, delivery setting, and various measures of intervention dose.ImplicationsPA interventions significantly improved PA behavior among community-dwelling older adults. Effective PA interventions may be efficiently delivered using already available resources and personnel. Future PA intervention research should be theoretically based, incorporate more diverse subjects, and compare intervention delivery methods.
| S-EPMC4542588 | biostudies-literature
Project description:BACKGROUND:Community health worker (CHW) interventions are a successful strategy to promote health among HIV-negative and persons living with HIV (PLWH). Psychosocial factors are critical dimensions of HIV/AIDS care contributing to prognosis of the disease, yet it is unclear how CHW interventions improve psychosocial outcomes in PLWH. The purpose of this study was to critically appraise the types, scope, and nature of CHW interventions designed to address psychosocial outcomes in PLWH. METHODS:We performed database searches-PubMed, EMBASE, CINAHL, and Cochrane-to identify randomized controlled trials published in English before April 2017. Fourteen articles met the eligibility criteria. RESULTS:Half of the studies were conducted in the United States. Social cognitive theory was used more than once in nine theory-guided studies. CHW interventions were largely focused on reducing depression (n = 6) or stigma related to HIV (n = 4), or promoting quality of life (n = 4), social support (n = 4), and self-efficacy (n = 4). Didactic methods and role-playing were used to train CHWs. CHWs played multiple roles in delivering intervention, including a counselor and a supporter (n = 10), educator (n = 5), or a navigator (n = 3). CHW intervention fidelity was assessed in 4 studies. Five studies found positive changes in six psychosocial outcomes including quality of life (2 of 4) and self-efficacy (2 of 4). CHW interventions had no effect on social support in 2 of 4 studies, and stigma in 3 of 4 studies. None of the CHW interventions were successful in reducing depressive symptoms among PLWH. CONCLUSIONS:Evidence partially supported the use of CHWs in promoting psychosocial outcomes in PLWH. Future CHW intervention should be expanded in scope to address key psychosocial determinants of HIV/AIDS outcomes such as health literacy. Further, fidelity measures should be incorporated into intervention delivery.
| S-EPMC5915269 | biostudies-literature
Project description:Background: Both physical exercise and cognitive training can effectively improve executive functions in older adults. However, whether physical activity combined with cognitive training is more effective than a single intervention remains controversial. The aim of this study was to perform a meta-analysis to evaluate the effect of combined physical and cognitive interventions on executive functions in older adults aged 65-80 years old. Methods: Randomized controlled trials of combined physical and cognitive interventions on executive functions in older adults were searched using the Web of Science, Elsevier Science, PubMed, EBSCO, Springer-Link, and NATURE databases. Data extraction and quality evaluation were done by Comprehensive Meta-Analysis, V3. Results: A total of 21 studies were included. The results showed that the combined physical and cognitive interventions produced significantly larger gains in executive functions, compared to the control group (standardized mean difference (SMD) = 0.26, 95% confidence interval (CI) [0.14, 0.39], p < 0.01). Furthermore, the effects of the combined physical and cognitive interventions were moderated by the study quality, intervention length, and intervention frequency. No significant differences were found between the combined interventions and the physical intervention alone (SMD = 0.13, 95% CI [-0.07, 0.33], p > 0.05) or the cognitive intervention alone (SMD = 0.13, 95% CI [-0.05, 0.30], p > 0.05). Conclusions: The combined physical and cognitive interventions effectively delayed the decrease of executive functions in older adults and this effect was influenced by the length and frequency of the intervention as well as the research quality. However, the effect of the combined physical and cognitive interventions was not significantly better than that of each intervention alone.
| S-EPMC7504145 | biostudies-literature
Project description:Valid, reliable, and direct measures of physical activity (PA) are critical to assessing the impact of lifestyle PA interventions. However, little is known about the extent to which objective measures have been used to assess the outcomes of lifestyle PA interventions. This systematic review had two aims: 1) evaluate the extent to which PA is measured objectively in lifestyle PA interventions targeting adults and 2) explore and summarize what objective measures have been used and what PA dimensions and metrics have been reported. Pubmed, Cochrane Central Register, and PsychInfo were searched for lifestyle PA interventions conducted between 2006 and 2016. Of the 342 articles that met the inclusion criteria, 239 studies measured PA via subjective measures and 103 studies measured PA via objective measures. The proportion of studies using objective measures increased from 4.4% to 70.6% from 2006 to 2016. All studies measuring PA objectively utilized wearable devices; half (50.5%) used pedometers only and 40.8% used accelerometers only. A majority of the 103 studies reported steps (73.8%) as their PA metric. Incorporating objective measures of PA should continue to be a priority in PA research. More work is needed to address the challenges of comprehensive and consistent collecting, reporting, and analyzing of PA metrics.
| S-EPMC6030233 | biostudies-other
Project description:Importance:Chronic noncancer pain (hereafter referred to as chronic pain) is common among older adults and managed frequently with pharmacotherapies that produce suboptimal outcomes. Psychological treatments are recommended, but little information is available regarding their efficacy in older adults. Objective:To determine the efficacy of psychological interventions in older adults with chronic pain and whether treatment effects vary by participant, intervention, and study characteristics. Data Sources:MEDLINE, Embase, PsycINFO, and the Cochrane Library were searched from inception to March 29, 2017. Study Selection:Analysis included studies that (1) used a randomized trial design, (2) evaluated a psychological intervention that used cognitive behavioral modalities alone or in combination with another strategy, (3) enrolled individuals with chronic pain (pain ≥3 months) with a sample mean age of 60 years or older, and (4) reported preintervention and postintervention quantitative data. Data Extraction and Synthesis:Two of the authors independently extracted data. A mixed-model meta-analysis tested the effects of treatment on outcomes. Analyses were performed to investigate the association between participant (eg, age), intervention (eg, treatment mode delivery), and study (eg, methodologic quality) characteristics with outcomes. Main Outcomes and Measures:Pain intensity was the primary outcome; secondary outcomes included pain interference, depressive symptoms, anxiety, catastrophizing beliefs, self-efficacy for managing pain, physical function, and physical health. Results:Twenty-two studies with 2608 participants (1799 [69.0%] women) were analyzed. Participants' mean (SD) age was 71.9 (7.1) years. Differences of standardized mean differences (dD) at posttreatment were pain intensity (dD = -0.181, P = .006), pain interference (dD = -0.133, P = .12), depressive symptoms (dD = -0.128, P = .14), anxiety (dD = -0.205, P = .09), catastrophizing beliefs (dD = -0.184, P = .046), self-efficacy (dD = 0.193, P = .02), physical function (dD = 0.006, P = .96), and physical health (dD = 0.160, P = .24). There was evidence of effects persisting beyond the posttreatment assessment only for pain (dD = -0.251, P = .002). In moderator analyses, only mode of therapy (group vs individual) demonstrated a consistent effect in favor of group-based therapy. Conclusions and Relevance:Psychological interventions for the treatment of chronic pain in older adults have small benefits, including reducing pain and catastrophizing beliefs and improving pain self-efficacy for managing pain. These results were strongest when delivered using group-based approaches. Research is needed to develop and test strategies that enhance the efficacy of psychological approaches and sustainability of treatment effects among older adults with chronic pain.
| S-EPMC6145761 | biostudies-literature
Project description:BackgroundThe evidence concerning which physical exercise characteristics are most effective for older adults is fragmented. We aimed to characterize the extent of this diversity and inconsistency and identify future directions for research by undertaking a systematic review of meta-analyses of exercise interventions in older adults.MethodsWe searched the Cochrane Database of Systematic Reviews, PsycInfo, MEDLINE, Embase, CINAHL, AMED, SPORTDiscus, and Web of Science for articles that met the following criteria: (1) meta-analyses that synthesized measures of improvement (e.g., effect sizes) on any outcome identified in studies of exercise interventions; (2) participants in the studies meta-analyzed were adults aged 65+ or had a mean age of 70+; (3) meta-analyses that included studies of any type of exercise, including its duration, frequency, intensity, and mode of delivery; (4) interventions that included multiple components (e.g., exercise and cognitive stimulation), with effect sizes that were computed separately for the exercise component; and (5) meta-analyses that were published in any year or language. The characteristics of the reviews, of the interventions, and of the parameters improved through exercise were reported through narrative synthesis. Identification of the interventions linked to the largest improvements was carried out by identifying the highest values for improvement recorded across the reviews. The study included 56 meta-analyses that were heterogeneous in relation to population, sample size, settings, outcomes, and intervention characteristics.ResultsThe largest effect sizes for improvement were found for resistance training, meditative movement interventions, and exercise-based active videogames.ConclusionThe review identified important gaps in research, including a lack of studies investigating the benefits of group interventions, the characteristics of professionals delivering the interventions associated with better outcomes, and the impact of motivational strategies and of significant others (e.g., carers) on intervention delivery and outcomes.
| S-EPMC7858023 | biostudies-literature