Barriers to physical activity in older adults in Germany: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Data on barriers to physical activity in older adults in Germany are scarce. The aim of this study was to analyse barriers to physical activity in a cohort of older adults, allowing comparisons between men and women, and age groups.</p> <p>Methods</p> <p>1,937 older adults with a median age of 77 (range 72-93) years (53.3% female) took part in the 7-year follow-up telephone interviews of the getABI cohort. Participants who stated that they did not get enough physical activity were surveyed with respect to barriers to physical activity. Barriers were analysed for all respondents, as well as by sex and age group for cases with complete data. Multivariate logistic regression analysis was performed to evaluate differences between sexes and age groups. The level of significance (alpha < 0.05) was adjusted for multiple testing according to Bonferroni (p < .004).</p> <p>Results</p> <p>1,607 (83.0%) participants stated that they were sufficiently physically active. 286 participants rated their physical activity as insufficient and responded to questions on barriers to physical activity completely. The three most frequently cited barriers were poor health (57.7%), lack of company (43.0%), and lack of interest (36.7%). Lack of opportunities for sports or leisure activities (30.3% vs. 15.6%), and lack of transport (29.0% vs. 7.1%) were more frequently stated by female respondents than male respondents. These differences between men and women were significant (p = .003; p < .001) after adjustment for respondents' age. Analyses by age groups revealed that poor health was more frequently considered a barrier to physical activity by participants aged 80+ years compared to the younger age group (71.1% vs. 51.5%). This age-dependent difference was significant (p = .002) irrespective of the participants' sex.</p> <p>Conclusions</p> <p>The present study provides relevant data on barriers to physical activity in older adults. By revealing appreciable differences between men and women, and age groups, this study has implications for efforts to increase older adults' physical activity. Promotion and intervention strategies should consider the barriers and tailor measures to the specific needs of older adults in order to reduce their constraints to physical activity.</p

Osteosarcopenia, an Asymmetrical Overlap of Two Connected Syndromes: Data from the OsteoSys Study

Osteoporosis and sarcopenia are two chronic conditions, which widely affect older people and share common risk factors. We investigated the prevalence of low bone mineral density (BMD) and sarcopenia, including the overlap of both conditions (osteosarcopenia) in 572 older hospitalized patients (mean age 75.1 ± 10.8 years, 78% women) with known or suspected osteoporosis in this prospective observational multicenter study. Sarcopenia was assessed according to the revised defini tion of the European Working Group on Sarcopenia in Older People (EWGSOP2). Low BMD was defined according to the World Health Organization (WHO) recommendations as a T-score < −1.0. Osteosarcopenia was diagnosed when both low BMD and sarcopenia were present. Low BMD was prevalent in 76% and the prevalence of sarcopenia was 9%, with 90% of the sarcopenic patients showing the overlap of osteosarcopenia (8% of the entire population). Conversely, only few patients with low BMD demonstrated sarcopenia (11%). Osteosarcopenic patients were older and frailer and had lower BMI, fat, and muscle mass, handgrip strength, and T-score compared to nonosteosar copenic patients. We conclude that osteosarcopenia is extremely common in sarcopenic subjects. Considering the increased risk of falls in patients with sarcopenia, they should always be evaluated for osteoporosis

General practitioner advice on physical activity: Analyses in a cohort of older primary health care patients (getABI)

<p>Abstract</p> <p>Background</p> <p>Although the benefits of physical activity for health and functioning are recognized to extend throughout life, the physical activity level of most older people is insufficient with respect to current guidelines. The primary health care setting may offer an opportunity to influence and to support older people to become physically active on a regular basis. Currently, there is a lack of data concerning general practitioner (GP) advice on physical activity in Germany. Therefore, the aim of this study was to evaluate the rate and characteristics of older patients receiving advice on physical activity from their GP.</p> <p>Methods</p> <p>This is a cross-sectional study using data collected at 7 years of follow-up of a prospective cohort study (German epidemiological trial on ankle brachial index, getABI). 6,880 unselected patients aged 65 years and above in the primary health care setting in Germany were followed up since October 2001. During the 7-year follow-up telephone interview, 1,937 patients were asked whether their GP had advised them to get regular physical activity within the preceding 12 months. The interview also included questions on socio-demographic and lifestyle variables, medical conditions, and physical activity. Logistic regression analysis (unadjusted and adjusted for all covariables) was used to examine factors associated with receiving advice. Analyses comprised only complete cases with regard to the analysed variables. Results are expressed as odds ratios (ORs) with 95% confidence intervals (95% CI).</p> <p>Results</p> <p>Of the 1,627 analysed patients (median age 77; range 72-93 years; 52.5% women), 534 (32.8%) stated that they had been advised to get regular physical activity. In the adjusted model, those more likely to receive GP advice on physical activity were men (OR [95% CI] 1.34 [1.06-1.70]), patients suffering from pain (1.43 [1.13-1.81]), coronary heart disease and/or myocardial infarction (1.56 [1.21-2.01]), diabetes mellitus (1.79 [1.39-2.30]) or arthritis (1.37 [1.08-1.73]), and patients taking a high (> 5) number of medications (1.41 [1.11-1.80]).</p> <p>Conclusions</p> <p>The study revealed a relatively low rate of older primary health care patients receiving GP advice on physical activity. GPs appeared to focus their advice on patients with chronic medical conditions. However, there are likely to be many more patients who would benefit from advice.</p

Entwicklung und Evaluation des Fragebogens PRISCUS-PAQ zur Erfassung der körperlichen Aktivität von Personen im Alter von 70 Jahren und älter

Über das Aktivitätsverhalten der älteren Bevölkerung in Deutschland ist wenig bekannt. Um die Aktivität von älteren Erwachsener zu erfassen, fehlte bislang ein geeignetes Messinstrument. Das Ziel dieser Arbeit war, den Fragebogen PRISCUS-PAQ zur Erfassung der körperlichen Aktivität älterer Erwachsener zu entwickeln und zu evaluieren. PRISCUS-PAQ erfasst die körperliche Aktivität der vergangenen sieben Tage. Insgesamt zehn Fragen ermöglichen die Berechnung des PRISCUS-PAQ-Gesamtscores, der dem wöchentlichen Energieverbrauch entspricht. Die Gütekriterien des PRISCUS-PAQ wurden an 114 Teilnehmenden im mittleren Alter von 76 $\pm$ 5 Jahren ermittelt. Die Retest-Reliabilität lag bei Intraklassenkorrelation=0,59 (95% KI: 0,43-0,71); die Übereinstimmung des PRISCUS-PAQ-Gesamtscores mit den durch Akzelerometrie ermittelten Beschleunigungswerten betrug r$_{s}$=0,28 (95% KI: 0,10-0,44). PRISCUS-PAQ kann nun zur Erfassung der körperlichen Aktivität von Personen im höheren Lebensalter eingesetzt werden

Körperliche Aktivität bei multimorbiden Patienten

Große Teile insbesondere der älteren Bevölkerung leiden an Multimorbidität. In der Therapie zahlreicher Erkrankungen spielt körperliche Aktivität eine anerkannte Rolle. Eine wesentliche Aufgabe in der Vermittlung körperlicher Aktivität an multimorbide Patienten kommt dem Hausarzt zu. Zur Gestaltung und Umsetzung von Aktivitätsprogrammen auf Grundlage einer umfassenden Gesundheitsbeurteilung bedarf es allerdings der engen Kooperation mit spezialisierten Berufsgruppen

Reliability of accelerometric measurement of physical activity in older adults - the benefit of using the trimmed sum

There is general consensus that physical activity is important for preserving functional capacities of older adults and positively influencing quality of life. While accelerometry is widely accepted and applied to assess physical activity in studies, several problems with this method remain (e.g., low retest reliability, measurement errors). The aim of this study was to test the intra-instrumental retest reliability of a wrist-worn accelerometer in a 3-day measurement of physical activity in older adults and to compare different estimators. A sample of 123 older adults (76.5 ± 5.1 years, 59 % female) wore a uniaxial accelerometer continuously for 1 week. The data were split into two repeated measurement values (week set) of 3 days each. The sum, the 80-99th quantiles and the 80-99th trimmed sums were built for each week set. Retest reliability was assessed for each estimator and graphically demonstrated by Bland-Altman plots. The intraclass correlation of the retest reliability ranged from 0.22 to 0.91. Retest reliability increases when a more robust estimator than the overall sum is used. Therefore, the trimmed sum can be recommended as a conservative estimate of the physical activity level of older adults

Die Eignung von Fragebögen zur Erfassung der körperlichen Aktivität älterer Erwachsener für den Einsatz in einer epidemiologischen Studie

Zur Erfassung der körperlichen Aktivität älterer Personen in einer epidemiologischen Beobachtungsstudie wurde ein altersspezifischer Fragebogen gesucht. Ziele dieser Arbeit waren die Darstellung und Beurteilung bestehender Fragebögen hinsichtlich ihrer Eignung für den Einsatz in dieser Studie. In der Datenbank PubMed wurde eine systematische Literaturrecherche durchgeführt. Dargestellt werden Modified Baecke Questionnaire for Older Adults, Zutphen Physical Activity Questionnaire, Physical Activity Scale for the Elderly, Yale Physical Activity Survey und CHAMPS Physical Activity Questionnaire for Older Adults. Diese Fragebögen unterscheiden sich u.a. in: Art der Befragung (z.B. persönliches oder telefonisches Interview), abgefragtes Zeitfenster (eine Woche bis ein Jahr), Berücksichtigung von Alltagsaktivitäten, Form der Fragen (offen bzw. geschlossen), Ermittlung eines Gesamtscores, Dauer der Erfassung (fünf bis 30 Minuten), Anzahl der Befragten (21 bis 254 Personen), Anteil der männlichen Teilnehmer (41 bis 100%), Abstand zur Messwiederholung (zwei Wochen bis sechs Monate), eingesetztes Außenkriterium (z.B. Tagebuchaufzeichnung, Körperfettanteil) und Ergebnisse der Gütekriterien (Reliabilität: r =0,57 bis 0,93 und Intra-Klassen-Korrelation=0,62 bis 0,67; Validität: r =-0,13 bis 0,79). Im Hinblick auf die dargestellten Bewertungskriterien für den Einsatz in einer epidemiologischen Beobachtungsstudie erschien keiner der beschriebenen Fragebögen hinreichend geeignet, um die körperliche Aktivität älterer Erwachsener zu erfassen. Folglich sollte ein neuer Fragebogen entwickelt bzw. anhand der bestehenden Fragebögen adaptiert werden, der die körperliche Aktivität der vergangenen Woche in den Bereichen Sport, Freizeit, Haushalt und Garten mit kurzer Befragungsdauer in geschlossenen Fragen erfasst und Rückschlüsse auf den Energieverbrauch zulässt

Inflammation as a diagnostic criterion in the GLIM definition of malnutrition-what CRP-threshold relates to reduced food intake in older patients with acute disease?

BACKGROUND/OBJECTIVES: In the recently introduced GLIM diagnosis of malnutrition (Global Leadership Initiative on Malnutrition), details of how to classify inflammation as an etiologic criterion are lacking. This study aimed to determine at what level of serum C-reactive protein (CRP) the risk of low food intake increases in acutely ill older hospitalized patients. SUBJECTS/METHODS: A total of 377 patients, who were consecutively admitted to a geriatric acute care ward, were analyzed. Nutritional intake was determined using the food intake item of Nutritional Risk Screening and the plate diagram method and patients were grouped into three categories as &gt;75%, 50-75% and ≤50% of requirements. CRP was analyzed according to standard procedures and patients were classified into different CRP groups as follows: 0.0-0.99 mg/dl, 1.0-1.99 mg/dl, 2.0-2.99 mg/dl, 3.0-4.99 mg/dl, 5.0-9.99 mg/dl and ≥10.0 mg/dl. RESULTS: Of the total population (mean age of 82.2 ± 6.6 years; 241 females), 82 (22%) had intake &lt;50% of requirements and 126 (33%) demonstrated moderate to severe inflammation. Patients with food intake &lt;50% of requirements had a significantly higher median CRP level compared to patients with food intake &gt;75% of requirements (P &lt; 0.001). The group with serum-CRP levels above 3.0 mg/dl had a markedly higher proportion of patients with low food intake; i.e., &lt;50% and &lt;75% of the requirements. CONCLUSION: A serum-CRP of 3.0 mg/dl appears to be a reasonable threshold of acute inflammation leading to reduced food intake to serve as an orientation with regard to the inflammation criterion of the GLIM diagnosis in acutely ill older patients

Optimal Jamar dynamometer handle position to assess maximal isometric hand grip strength in epidemiological studies

Hand grip strength is an indicator of general muscle strength that is measured using a hand dynamometer. In some studies, a subject's grip strength is taken to be the maximal grip strength achieved from measurements taken at several different dynamometer handle positions. However, little is known about the influence of these different positions on the measured grip strength. The aim of the study was to identify one standard handle position that could be used to assess the grip strength of all subjects.; Grip strength was assessed with a hand dynamometer (Jamar Plus+; Sammons Preston, Rolyon, Bolingbrook, IL). Each participant's grip strength was measured 3 times in each of 5 different handle positions with each hand. The best position for each participant was defined as the position at which they achieved maximal grip strength.; The mean (± standard deviation) age of the 50 participants was 41 (± 13) years. Maximal grip strength was 43.7 (± 12.4) kg for all participants; 55.0 (± 10.2) kg for men and 35.4 (± 5.2) kg for women. Handle position 2 was the best position for 70% of participants. The mean difference between the grip strength achieved by each participant at handle position 2 and that achieved at each participant's best position was 0.8 (± 1.78) kg.; Our results show that measurements taken at a single standard handle position are sufficiently accurate to assess grip strengths for all subjects. We therefore recommend handle position 2 as the standard position for measuring grip strength with the Jamar Plus+ hand dynamometer.; The assessment of grip strength with the Jamar Plus+ dynamometer is easier and faster if a single, standard handle position is used rather than multiple different positions. As well as providing accurate results, a single, standard handle position also reduces fatigue and increases the comparability of results between subjects