Cognitive and Psychosocial Factors Associated with Sarcopenia in Older Adults

Objectives: To describe the muscle mass, strength, and function of older adults living in residential care apartment complexes (RCACs) and examine the association between self-efficacy for exercise, depressive symptoms, social support and sarcopenia. The convergent validity of Muscle Mechanography (MM) when compared to the traditional muscle function and strength tests was also tested. Design: Secondary data analysis of baseline data from a clinical trial. Setting: One RCAC in the Midwestern United States. Participants: Thirty-one older adults living in one RCAC. Measurement: Muscle mass was measured by bioelectrical impedance spectroscopy. Muscle function was evaluated by the Short Physical Performance Battery test, Timed Up and Go test, and MM. Grip strength was measured by a Jamar® hand dynamometer. Self-efficacy for exercise was measured by the Self-efficacy for Exercise Scale. Depressive symptoms were measured by the Geriatric Depression Scale. Social support was measured by the Lubben Social Network Scale. Results: Participants had lower values of muscle mass, strength, and function compared to values obtained in previous research. A sex difference exists for muscle mass, strength, and function. The findings showed a trend for individuals with high self-efficacy, without depressive symptoms, and with strong social support to present greater muscle mass, strength, and function. The findings also demonstrated convergent validity across all the examined measures of muscle function and strength. Conclusion: This study is only one of a few to describe the muscle outcomes and evaluate the relationship between selected cognitive and psychosocial factors and sarcopenia among older adults living in RCACs. The preliminary findings of this study warrant further investigation of an intervention aimed at maintaining or improving the muscle outcomes of RCAC residents. While the interpretation of findings should be presented with caution and replicated with other samples, this study may provide a new understanding about the muscle outcomes and the relationship between self-efficacy for exercise, depressive symptoms, and social support and sarcopenia. Improved understanding of muscle outcomes and the relationship between cognitive and psychosocial factors and sarcopenia is crucial. The findings also provided a new evidence about MM as a new technology to quantitively assess muscle function in older adults, potentially making this a valuable research tool

Semi-Recumbent Vibration Exercise in Older Adults: A Pilot Study of Methodology, Feasibility, and Safety

Objectives: Older adults with impaired physical function are at risk for further functional decline in part due to limited ability to engage in regular exercise. Effective approaches to exercise in this vulnerable population are needed to improve functional capacity and optimize independence. Methods: Thirty-two residential care apartment complex (RCAC) residents, age ≥70, with low short physical performance battery (SPPB) scores were recruited and randomly assigned to a crossover-design study exploring feasibility and safety of semi-recumbent vibration exercise in older adults living in one RCAC. The primary outcomes were retention and adherence rates and adverse events. Results: The retention rate was 78%. Adherence rate was 79.7% and 78.6% during the vibration and control training sessions, respectively. Thirty-eight adverse events (AEs) occurred. Mild muscle soreness and knee pain were the only AEs related to vibration exercise. No serious adverse events (SAEs) were study-related. Participants were able to increase training intensity and load and rated the training enjoyable. Conclusion: Semi-recumbent vibration exercise was feasible, well tolerated, and safe in RCAC residents with reduced physical function. Future studies need to examine the effect of this type of exercise on physical function, mobility, falls, and quality of life

Do Daytime Activity, Mood and Unit Tumult Predict Nighttime Sleep Quality of Long-Term Care Residents?

Based on the premise that stressors can have a cumulative effect on people with dementia throughout the day that contributes to negative consequences later in the day, we examined if daytime activity, unit tumult, and mood were associated with sleep quality. A convenience sample of 53 long-term care (LTC) residents participated in this correlational study. Objective sleep quality was measured using actigraphy, and comorbid illness and level of dementia were control variables. Half of the sample had a sleep efficiency that was less than 80% and was awake for more than 90 min at night. Comorbid illness, negative mood at bedtime, and daytime activity level accounted for 26.1% of the variance in total sleep minutes. Census changes and the use of temporary agency staff were associated with poor sleep. Findings suggest daytime activity, mood at bedtime, and unit tumult should be considered when designing and testing interventions to improve sleep quality

Do Daytime Activity, Mood and Unit Tumult Predict Nighttime Sleep Quality of Long-Term Care Residents?

Based on the premise that stressors can have a cumulative effect on people with dementia throughout the day that contributes to negative consequences later in the day, we examined if daytime activity, unit tumult, and mood were associated with sleep quality. A convenience sample of 53 long-term care (LTC) residents participated in this correlational study. Objective sleep quality was measured using actigraphy, and comorbid illness and level of dementia were control variables. Half of the sample had a sleep efficiency that was less than 80% and was awake for more than 90 min at night. Comorbid illness, negative mood at bedtime, and daytime activity level accounted for 26.1% of the variance in total sleep minutes. Census changes and the use of temporary agency staff were associated with poor sleep. Findings suggest daytime activity, mood at bedtime, and unit tumult should be considered when designing and testing interventions to improve sleep quality

Malnutrition–Sarcopenia Syndrome and Self-Management Behaviors in Continuing-Care Retirement Community Residents

Malnutrition–sarcopenia syndrome (MSS) might put older adults at higher risk for disability, frailty, and mortality. This study examined the prevalence and association of the self-management-process factors (i.e., self-efficacy and aging expectations) and behaviors (protein and caloric intake and sedentary and physical-activity behaviors) to MSS among older adults living in continuing care retirement communities (CCRCs). Using a cross-sectional correlational design, data of 96 CCRC residents (82.4 ± 7.4 years) were analyzed. Muscle mass, strength, function, nutritional status, sedentary time, physical activity levels, protein and caloric intake, self-efficacy for physical activity, aging expectations, and physical and mental health-related quality of life were measured. Results show that 36 (37.5%) had sarcopenia, 21 (21.9%) had malnutrition risk, 13 (13.4%) had malnutrition, and 12 (12.5%) had MSS. We also found that high time spent in sedentary behaviors (OR = 1.041; 95% CI: 1.011–1.071) was associated with higher odds of having MSS and high expectations regarding aging (OR = 0.896; 95% CI: 0.806–0.997) were associated with less likelihood of having MSS. Findings suggest that CCRC residents should be screened for MSS. Self-management interventions that consider the self-management-process factors are needed to prevent MSS and mitigate its negative outcomes among CRCC residents

How do clinical nurses implement ‘What Matters to You’ for hospitalized older adults?

Background The Age Friendly Health System (AFHS) 4Ms framework is designed to be clinically implemented to provide reliable, high-quality age-friendly care to older adults with reduced harm and hospital-associated complications. The 4M concept of ‘What Matters to You’ (WMTY) refers to engaging clinicians in assessing and aligning a patient’s specific health outcome goals and care preferences to ensure patient-centered care. There is limited empirical evidence on the WMTY concept and none describing the implementation and impact when used by clinical nurses in hospital settings. Purpose The purpose is to gain an in-depth understanding of the knowledge, perceptions, and experiences of nurses who implement and use the WMTY concept and to evaluate the implementation and impact for older adults. Methods A qualitative, descriptive, phenomenology study will be conducted using focus group discussions to capture key themes and achieve study aims. Research subjects will be recruited from six hospitals who have implemented the AFHS 4 Ms model including implementation leaders and a representative sample of clinical nurses who use the WMTY concept in their daily practice. After informed consent, subjects will complete a demographic survey and participate in a 90 minute virtual focus group using videoconferencing software with recording. Groups will be led by a skilled moderator using a discussion guide based on the 4Ms literature with loose, broad, and open-ended questions. Recordings will be transcribed without identifiers and uploaded into NVivo software. Results Descriptive statistics will be used to identify similarities and differences in participant characteristics across sites. Data will be inductively coded and categorized by two reviewers and iteratively analyzed to identify significant themes. Conclusions/Implications Findings will lay the foundation for designing clinical nurse-targeted interventions to successfully implement WMTY and identifying supportive strategies for partnering with patients and their caregivers to ensure that their goals/preferences are fully integrated into care