Characterization of Street Food Consumption in Palermo: Possible Effects on Health

Background: Street Food (SF) consists of out-of-home food consumption and has old, historical roots with complex social-economic and cultural implications. Despite the emergence of modern fast food, traditional SF persists worldwide, but the relationship of SF consumption with overall health, well-being, and obesity is unknown. Methods: This is an observational, cross-sectional study. The study was performed in Palermo, the largest town of Sicily, Italy. Two groups were identified: consumers of SF (n = 687) and conventional restaurant food (RES) consumers (n = 315). Study subjects answered a questionnaire concerning their health conditions, nutritional preferences, frequency of consumption of SF and a score relative to SF consumption ranging from 0 to 20 was calculated

Telemedicine and Primary Care Obesity Management in Rural Areas– Innovative Approach for Older Adults?

Background: The growing prevalence of obesity is paralleling a rise in the older adult population creating an increased risk of functional impairment, nursing home placement and early mortality. The Centers for Medicare and Medicaid recognized the importance of treating obesity and instituted a benefit in primary care settings to encourage intensive behavioral therapy in beneficiaries by primary care clinicians. This benefit covers frequent, brief, clinic visits designed to address older adult obesity. Discussion: We describe the challenges in the implementation and delivery into real-world settings. The challenges in rural settings that have the fastest growing elderly population, high obesity rates, but also workforce shortages and lack of specialized services are emphasized. The use of Telemedicine has successfully been implemented in other specialties and could be a useful modality in delivering much needed intensive behavioral therapy, particularly in distant, under-resourced environments. This review outlines some of the challenges with the current benefit and proposed solutions in overcoming rural primary care barriers to implementation, including changes in staffing models. Conclusions: Recommendations to extend the benefit’s coverage to be more inclusive of non-physician team members is needed but also for improvement in reimbursement for telemedicine services for older adults with obesity

ActivityAware: an App for Real-Time Daily Activity Level Monitoring on the Amulet Wrist-Worn Device

Physical activity helps reduce the risk of cardiovascular disease, hypertension and obesity. The ability to monitor a person\u27s daily activity level can inform self-management of physical activity and related interventions. For older adults with obesity, the importance of regular, physical activity is critical to reduce the risk of long-term disability. In this work, we present ActivityAware, an application on the Amulet wrist-worn device that measures daily activity levels (sedentary, moderate and vigorous) of individuals, continuously and in real-time. The app implements an activity-level detection model, continuously collects acceleration data on the Amulet, classifies the current activity level, updates the day\u27s accumulated time spent at that activity level, logs the data for later analysis, and displays the results on the screen. We developed an activity-level detection model using a Support Vector Machine (SVM). We trained our classifiers using data from a user study, where subjects performed the following physical activities: sit, stand, lay down, walk and run. With 10-fold cross validation and leave-one-subject-out (LOSO) cross validation, we obtained preliminary results that suggest accuracies up to 98%, for n=14 subjects. Testing the ActivityAware app revealed a projected battery life of up to 4 weeks before needing to recharge. The results are promising, indicating that the app may be used for activity-level monitoring, and eventually for the development of interventions that could improve the health of individuals

What weight changes really happened during COVID-19 among older adults?

Worldwide, the coronavirus disease 19 (COVID-19) pandemic disrupted life for individuals of all ages, but it had a particularly negative impact on older adults aged 65 and older. As a result of the illness, older adults faced a higher degree of medical complications, hospitalizations, cognitive dysfunction, and weakness. Socio-environmental factors including physical distancing, quarantines, and stay-at-home orders prevented individuals in their ability to conduct usual daily activities. These all further exacerbated the development of existing and new mental health manifestations

Dynapenic Obesity and the Effect on Long-Term Physical Function and Quality of Life: Data from the Osteoarthritis Initiative

Obesity is associated with functional impairment, institutionalization, and increased mortality risk in elders. Dynapenia is defined as reduced muscle strength and is a known independent predictor of adverse events and disability. The synergy between dynapenia and obesity leads to worse outcomes than either independently. We identified the impact of dynapenic obesity in a cohort at risk for and with knee osteoarthritis on function

Muscle Strength, Physical Activity, and Functional Limitations in Older Adults with Central Obesity

Background: Obesity and muscle weakness are independently associated with increased risk of physical and functional impairment in older adults. It is unknown whether physical activity (PA) and muscle strength combined provide added protection against functional impairment. This study examines the association between muscle strength, PA, and functional outcomes in older adults with central obesity. Methods: Prevalence and odds of physical (PL), ADL, and IADL limitation were calculated for 6,388 community dwelling adults aged ≥ 60 with central obesity. Individuals were stratified by sex-specific hand grip tertiles and PA. Logistic models were adjusted for age, education, comorbidities, and body-mass index and weighted. Results: Overall prevalence of PL and ADL and IADL limitations were progressively lower by grip category. Within grip categories, prevalence was lower for individuals who were active than those who were inactive. Adjusted models showed significantly lower odds of PL OR 0.42 [0.31, 0.56]; ADL OR 0.60 [0.43, 0.84], and IADL OR 0.46 0.35, 0.61] for those in the highest grip strength category as compared to those in the lowest grip category. Conclusion: Improving grip strength in obese elders who are not able to engage in traditional exercise is important for reducing odds of physical and functional impairment

Development of a ‘Smart’ Resistance Exercise Band to Assess Strength

https://digitalcommons.dartmouth.edu/wetterhahnsymposium-2018/1004/thumbnail.jp

The Impact of Waist Circumference on Function and Physical Activity in Older Adults: Longitudinal Observational Data from the Osteoarthritis Initiative

Background: We previously demonstrated that BMI is associated with functional decline and reduced quality of life. While BMI in older adults is fraught with challenges, waist circumference (WC) is a marker of visceral adiposity that can also predict mortality. However, its association with function and quality of life in older adults is not well understood and hence we sought to examine the impact of WC on six-year outcomes. Methods: We identified adults aged ≥60 years from the longitudinal Osteoarthritis Initiative and stratified the cohort into quartiles based on WC. Our primary outcome measures of function at six year follow-up included: self-reported quality of life [Short Form-12 (SF-12)], physical function [Physical Activity Scale for the Elderly (PASE)] and disability [Late-life Disability Index (LLDI)]. Linear regression analyses predicted 6-year outcomes based on WC quartile category (lowest = referent), adjusted for age, sex, race, education, knee pain, smoking status, a modified Charlson co-morbidity index and baseline scores, where available

Technology for Behavioral Change in Rural Older Adults with Obesity

Background: Mobile health (mHealth) technologies comprise a multidisciplinary treatment strategy providing potential solutions for overcoming challenges of successfully delivering health promotion interventions in rural areas. We evaluated the potential of using technology in a high-risk population. Methods: We conducted a convergent, parallel mixed-methods study using semi-structured interviews, focus groups, and self-reported questionnaires, using purposive sampling of 29 older adults, 4 community leaders and 7 clinicians in a rural setting. We developed codes informed by thematic analysis and assessed the quantitative data using descriptive statistics. Results: All groups expressed that mHealth could improve health behaviors. Older adults were optimistic that mHealth could track health. Participants believed they could improve patient insight into health, motivating change and assuring accountability. Barriers to using technology were described, including infrastructure. Conclusions: Older rural adults with obesity expressed excitement about the use of mHealth technologies to improve their health, yet barriers to implementation exist