Improving walking conditions for older adults. A three-step method investigation.
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ABSTRACT:
SUBMITTER: Krogstad JR
PROVIDER: S-EPMC5549237 | biostudies-other | 2015 Sep
REPOSITORIES: biostudies-other
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Project description:Endurance exercise can cause a decrease in serum ionized calcium (iCa) and increases in parathyroid hormone (PTH) and c-terminal telopeptide of type I collagen (CTX), which may be due to Ca loss in sweat.PurposeThis study aimed to determine whether exercise in a warm environment exaggerates the decrease in iCa and increases in PTH and CTX compared with a cool environment in older adults.MethodsTwelve women and men 61-78 yr old performed two identical 60-min treadmill bouts at ~75% of maximal heart rate under warm and cool conditions. Serum iCa, PTH, and CTX were measured every 15 min starting 15 min before and continuing for 60 min after exercise. Sweat Ca loss was estimated from sweat volume and sweat Ca concentration.ResultsSweat volume was low and variable; there were no differences in sweat volume or Ca concentration between conditions. iCa decreased after 15 min of exercise, and the change was similar in both conditions. Increases in PTH (warm: 16.4, 95% confidence interval [CI] = 6.2, 26.5 pg·mL; cool: 17.3, 95% CI = 8.1, 26.4 pg·mL) and CTX (warm: 0.08, 95% CI = 0.05, 0.11 ng·mL; cool: 0.08, 95% CI = 0.01, 0.16 ng·mL) from before to immediately after exercise were statistically significant and similar between conditions. Adjusting for plasma volume shifts did not change the results.ConclusionThe increases in PTH and CTX, despite the low sweat volume, suggest that dermal Ca loss is not a major factor in the decrease in iCa and increases in PTH and CTX observed during exercise in older adults.
| S-EPMC6629497 | biostudies-literature
Project description:ObjectiveTo create and test three prospective, increasingly restrictive definitions of serious illness.Data sourcesHealth and Retirement Study, 2000-2012.Study designWe evaluated subjects' 1-year outcomes from the interview date when they first met each definition: (A) one or more severe medical conditions (Condition) and/or receiving assistance with activities of daily living (Functional Limitation); (B) Condition and/or Functional Limitation and hospital admission in the last 12 months and/or residing in a nursing home (Utilization); and (C) Condition and Functional Limitation and Utilization. Definitions are increasingly restrictive, but not mutually exclusive.Data collectionOf 11,577 eligible subjects, 5,297 met definition A; 3,151 definition B; and 1,447 definition C.Principal findingsOne-year outcomes were as follows: hospitalization 33 percent (A), 44 percent (B), 47 percent (C); total average Medicare costs $20,566 (A), $26,349 (B), and $30,828 (C); and mortality 13 percent (A), 19 percent (B), 28 percent (C). In comparison, among those meeting no definition, 12 percent had hospitalizations, total Medicare costs averaged $7,789, and 2 percent died.ConclusionsProspective identification of older adults with serious illness is feasible using clinically accessible criteria and may be a critical step toward improving health care value. These definitions may aid clinicians and health systems in targeting patients who could benefit from additional services.
| S-EPMC5264106 | biostudies-literature
Project description:Older adults who report environmental barriers in their neighborhood have a higher risk for walking difficulty. However, environmental facilitators that protect against walking difficulty are not well known. The objective of this study was to identify the effect of environmental facilitators for outdoor walking on development of walking difficulty in community-dwelling older people. This was a prospective study with a 3.5-year follow-up time on 261 community-dwelling people aged 75-81 years, who at baseline were able to walk 0.5 km without difficulty. Environmental facilitators for outdoor walking were self-reported with standardized questionnaires, including having features in one's home which make it easy to access the outdoors, having a park or other green area within a walking distance from home, having outdoor recreational facilities within a walking distance from home, having features in the nearby environment, which are attractive for outdoor activities, and perceiving the surrounding environment or facilities nearby as motivating factors for physical activity. Self-reported difficulty in walking 0.5 km was assessed every 6 months. Of the participants, 46 % developed walking difficulty during the follow-up. Having a park or other green area within a walking distance from home was the most frequently reported facilitator. Environmental facilitators decreased the risk for development of walking difficulty, hazard ratio per item 0.86, (95 % confidence interval 0.73-1.02). The results indicate that the mobility of older community-dwelling people may be promoted with outdoor recreational facilities that are easy to access and located within a walking distance from home.
| S-EPMC5549184 | biostudies-other
Project description:There is lack of data on the physiological characteristics of over ground walking and walking recommendations for Chinese young adult. The purpose of the study was to measure walking-related energy expenditure during field testing, to identify step-rate cut-point associated with moderate and vigorous intensity, and to translate physical activity (PA) guidelines into walking goals for Chinese young adults. Cross-sectional analytic study. Two communities from Beijing and Shanghai in China. A sample of 226 Chinese adults (117 men, 109 women) with a mean age of 21.7 (±0.2) years, volunteered to participate in the study. All Participants were recreationally active without orthopaedic limitations, free of chronic diseases, not taking any medications that affect metabolism and non-smokers. All the participants completed four 6 minincremental over ground walking at different speeds of 3.8, 4.8, 5.6 and 6.4 km/h, respectively. Indirect calorimeter was used to measure energy expenditure at each speed. Receiver operating characteristic curves were used to determine the step-rate cut-points associated with moderate and vigorous intensity activity. At the same walking speed, step counts per minute were higher in women than in men. No significant differences were found in VO(2) per weight (ml/kg/min) between women and men. Step-rate cut-point associated with walking at 3 metabolic equivalents (METs) and 6METs were 105 and 130 step/min when analysing men and women together. There were slight differences on the cut-points between women and men if data were analysed separately. In order to meet PA guidelines, Chinese young adult should walk 30 min with at least 105 step/min or 3150 steps or 2 km with the same step-rate per day. Walking at a higher speed of 130 step/min might provide additional health benefit.
| S-EPMC3549247 | biostudies-literature
Project description:BackgroundWalking requires frequent maneuvers to navigate changing environments with shifting goals. Humans accomplish maneuvers and simultaneously maintain balance primarily by modulating their foot placement, but a direct trade-off between these two objectives has been proposed. As older adults rely more on foot placement to maintain lateral balance, they may be less able to adequately adapt stepping to perform lateral maneuvers.Research questionHow do older adults adapt stepping to enact lateral lane-change maneuvers, and how do physical and perceived ability influence their task performance?MethodsTwenty young (21.7 ± 2.6 yrs) and 18 older (71.6 ± 6.0 yrs) adults walked on a motorized treadmill in a virtual environment. Following an audible and visual cue, participants switched between two parallel paths, centered 0.6m apart, to continue walking on their new path. We quantified when participants initiated the maneuver following the cue, as well as their step width, lateral position, and stepping variability ellipses at each maneuver step.ResultsYoung and older adults did not differ in when they initiated the maneuver, but participants with lower perceived ability took longer to do so. Young and older adults also did not exhibit differences in step width or lateral positions at any maneuver step, but participants with greater physical ability reached their new path faster. While only older adults exhibited stepping adaptations prior to initiating the maneuver, both groups traded-off stability for maneuverability to enact the lateral maneuver.SignificancePhysical and perceived balance ability, rather than age per se, differentially influenced maneuver task performance. Humans must make decisions related to the task of walking itself and do so based on both physical and perceived factors. Understanding and targeting these interactions may help improve walking performance among older adults.
| S-EPMC10002645 | biostudies-literature
Project description:The health benefits of walking through greenspace have earned widespread academic attention in recent years and have been termed 'therapeutic mobilities'. As a result, walking groups are actively encouraged by health professionals as a way to promote 'healthy ageing'. This paper examines whether the promotion of community-led walking groups relies upon overly optimistic understandings that portray walking in greenspace as an inherently therapeutic practice. Accordingly, this paper introduces the concept of 'detrimental mobilities' to explore how the shared movement promoted via walking groups may not always be inherently therapeutic and may have some detrimental impacts on the individuals who take part in these activities. Drawing on findings from in-depth walking interviews with older members of the 'Walking for Health' scheme in Southampton, England, this paper examines how mobilities have the potential to disable, as much as they enable, health and wellbeing.
| S-EPMC7186191 | biostudies-literature
Project description:BackgroundAmong older adults, walking performance is a reliable indicator of adverse health outcomes including incident mobility impairment. Whereas, attention and executive functions have been implicated in cognitive control of locomotion, much less is known about the role of cognitive reserve (CR) in predicting mobility impairments among older adults. Specifically, whether CR moderates the relationship between gait performance and incident mobility impairment has not been reported. To address this gap in the literature, we examined whether gait performance under single-task walk (STW) and dual-task walk (DTW) conditions predicted incident mobility impairment and whether CR moderated this relationship.MethodParticipants were 176 (mean age = 75.57; % female = 53) older adults with baseline Short Physical Performance Battery (SPPB) scores of 10-12. Participants completed neuropsychological testing, the SPPB, and a DTW protocol. CR was evaluated using the Wide Range Achievement Test, third edition. Participants were followed for 3 years; individuals whose SPPB scores declined below 10 were defined as incident cases of mobility impairment (n = 42).ResultsModeration analyses revealed significant interaction effects of CR with walking velocity under STW (b = 0.09, 95% CI [0.01, 0.17], z = 2.30, p = .02) and DTW (b = 0.10, 95% CI [0.02, 0.17], z = 2.55, p = .01) conditions, wherein slower gait predicted increased risk of incident mobility impairment among individuals with lower CR.ConclusionThese findings extend knowledge about the interrelation of cognitive and mobility functions, revealing the critical role of CR in identifying older adults at risk of developing incident mobility impairment.
| S-EPMC8691058 | biostudies-literature
Project description:Evidence suggests that built environment characteristics affect older adults' travel activity behaviors, e.g., walking and cycling, which have well-established health benefits. However, the relationship between urban greenery and walking behaviors remains unclear, partly due to methodological limitation. Previous studies often measured urban greenery from a bird's eye perspective, which may mismatch with the pedestrian's perception from the street. In this study, we measured greenery view index from eye-level streetscape photos retrieved from Baidu Street View, an online mapping service provider. Walking behaviors of 180 older adults in six neighborhoods were collected from questionnaires. We also measured land use diversity, pedestrian-oriented design (street connectivity), and population density-the three Ds of the built environment. Results show that street greenery view index contributes to walking time of older adults, suggesting street greenery should be taken into design consideration to promote walking behaviors of older adults.
| S-EPMC7503975 | biostudies-literature
Project description:Background and objectivesWalking while talking is a dual cognitive-motor task that predicts frailty, falls, and cognitive decline in the general elderly population. Adults with CKD have gait abnormalities during usual walking. It is unknown whether they have greater gait abnormalities and cognitive-motor interference during walking while talking.Design, setting, participants, & measurementsCommunity-dwelling, nondisabled adults (n=330) ≥65 years of age underwent quantitative gait analysis, including walking while talking. Differences in walking-while-talking performance by CKD status were evaluated, and relative changes between walking-while-talking and walking alone performance were computed to quantify cognitive-motor interference (dual-task cost). Associations were tested using multivariable linear spline regression models, and independent gait domains were derived using factor analysis. CKD was defined as an eGFR<60 ml/min per 1.73 m2.ResultsCKD was present in 134 (41%) participants. Participants with CKD had slower gait speed along with various gait cycle abnormalities during walking while talking: among those with CKD, every 10-ml/min per 1.73 m2 lower eGFR was associated with 3.3-cm/s (95% confidence interval, 0.4 to 6.1) slower gait speed, 1.8-cm (95% confidence interval, 0.6 to 3.0) shorter step length, 1.1% (95% confidence interval, 0.6 to 1.7) less time in the swing phase, and 1.4% (95% confidence interval, 0.5 to 2.3) greater time in double support after multivariable adjustment. When comparing walking while talking with walking alone, every 10-ml/min per 1.73 m2 lower eGFR was associated with 1.8% (95% confidence interval, 0.5 to 3.2) greater decrease in time in the swing phase and 0.9% (95% confidence interval, 0.2 to 1.5) greater increase in time in the stance phase. Factor analysis identified three walking-while-talking domains and three dual-task cost domains: eGFR was associated specifically with the rhythm domain for both walking-while-talking and dual-task cost. Every 10-ml/min per 1.73 m2 lower eGFR was associated with a poorer performance of 0.2 SD (95% confidence interval, 0.1 to 0.3) for walking while talking and 0.2 SD (95% confidence interval, 0.03 to 0.3) for dual-task cost.ConclusionsDuring walking while talking, CKD is associated with gait abnormalities, possibly due to increased cognitive-motor interference.
| S-EPMC7269215 | biostudies-literature
Project description:BACKGROUND: Depression is common among older cancer patients, but little is known about the optimal approach to caring for this population. This analysis evaluates the effectiveness of the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) program, a stepped care management program for depression in primary care patients who had an ICD-9 cancer diagnosis. METHODS: Two hundred fifteen cancer patients were identified from the 1,801 participants in the parent study. Subjects were 60 years or older with major depression (18%), dysthymic disorder (33%), or both (49%), recruited from 18 primary care clinics belonging to 8 health-care organizations in 5 states. Patients were randomly assigned to the IMPACT intervention (n = 112) or usual care (n = 103). Intervention patients had access for up to 12 months to a depression care manager who was supervised by a psychiatrist and a primary care provider and who offered education, care management, support of antidepressant management, and brief, structured psychosocial interventions including behavioral activation and problem-solving treatment. RESULTS: At 6 and 12 months, 55% and 39% of intervention patients had a 50% or greater reduction in depressive symptoms (SCL-20) from baseline compared to 34% and 20% of usual care participants (P = 0.003 and P = 0.029). Intervention patients also experienced greater remission rates (P = 0.031), more depression-free days (P < 0.001), less functional impairment (P = 0.011), and greater quality of life (P = 0.039) at 12 months than usual care participants. CONCLUSIONS: The IMPACT collaborative care program appears to be feasible and effective for depression among older cancer patients in diverse primary care settings.
| S-EPMC2763171 | biostudies-other