Nancy Fey-Yensan

Health Correlates of Exercise Behavior and Stage Change in a Community-Based Exercise Intervention for the Elderly: A Pilot Study

The effects of a community-based physical activity intervention grounded in the Transtheoretical Model were investigated in a sample of older adults. The residents (n = 48, mean age = 78.24 ± 6.69, 90% female) of an independent living complex completed pre-and postintervention assessments, including physical, mental, and general health; nutrition; bodily pain; and stages of exercise behavior change. The intervention included posters with stage-based pamphlets (for inactive stages) and in-house exercise sessions (for active participants). The intervention resulted in high exercise maintenance and more progression than regression in exercise stage. More maintainers and progressers improved on the measured variables compared to relapsers. The stage model is a promising framework on which to base and evaluate interventions for this population. The overall impact of the intervention was positive, whether by providing the actual opportunity to exercise or by motivating other physical activity. These results also support the potential quality-of-life impact for this type of intervention in older adults.

Issues and Strategies Related to Fruit and Vegetable Intake in Older Adults Living in the Northeast Region

Fruits and vegetables are major dietary sources of antioxidants and other phytonutrients that may help lower chronic disease risk by reducing the oxidative damage that occurs during normal metabolism and through the aging process. Five servings of fruits and vegetables a day are recommended as a minimum goal for all age groups, yet actual intakes, including those of older adults, fall short of this target. The US Department of Agriculture (USDA) Multi-State Research Project on Aging (NE-172) has investigated through qualitative and quantitative methods (ie, focus group and survey techniques) a variety of factors that both positively and negatively influence fruit and vegetable intake. This article provides background on the importance of promoting and increasing fruit and vegetable intake in older individuals, profiles a cross-section of findings related to fruit and vegetable consumption in various segments of this population, and presents some practical considerations for the development and delivery of information and educational programs addressing the low intake of fruits and vegetables among older individuals in the community.

Food Stamp Program Participation and Perceived Food Insecurity in Older Adults

The United States Department of Agriculture (USDA) Food Stamp Program (FSP) is designed to provide additional food income as a means to enhance food intake, diet quality, and food security for all eligible persons, including older adults. This article reports a portion of survey results gleaned from a convenience sample of 200 seniors with limited incomes. It highlights how Food Stamp Program participants differ from or are similar to eligible nonparticipants in perception of food security, participation in local or federal food and nutrition programs, and other selected characteristics. Seniors participating in the FSP indicated a higher level of perceived food insecurity, had a more pronounced need for additional sources of free food, had significantly lower incomes, and presented with more indicators of physical disability than those who met eligibility requirements for participation in the FSP but were not in the program. FSP participants did not access, to any greater degree than other groups in the sample, other emergency or community food programs to increase food availability in their households. Nutrition educators and outreach workers should work to improve physical access to additional sources of food and to improve a homedelivery network of food to alleviate food anxiety in these clients. Efforts should continue to focus on enhancing the image of the FSP to expand participation by eligible nonparticipating seniors.

A Dietary Education Module for Low Income Elderly Clients With Diabetes

Abstract LEARNING OUTCOME: To describe a method of dietary education for low income elderly clients with diabetes. Diabetes education can increase the knowledge and promote long-term benefits in self-care and metabolic control for the 18% of Americans between the ages of 65 and 74 who have diabetes. We developed a diabetes education module for low income older adults with diabetes. Educational materials consisted of simple handouts with large bold print, and a food guide pyramid rather than the exchange system for recommending appropriate servings from each food group. Nutrition education consisted of two 40-minute sessions completed two days apart. The first focused on diabetes, the goals of controlling it through nutrition, the food guide pyramid, and serving sizes. Activities included categorizing real foods into each food group and demonstrating portion sizes using these foods. The second class focused on figuring calorie needs and servings per day, and it included activities to develop meal patterns and sample diets based on calorie needs. Good sources of fiber and its importance in the diet were also discussed during this session. Materials were pilot tested on a small sample in 1996 by the presenting author as part of a senior Coordinated Undergraduate Program experience and are now being revised for further outcome-based testing in a larger sample of low income older adults.

A Retrospective Evaluation of How Weight Change Varies with Gender and Living Situation in Elders with Documented Cognitive Impairment

Abstract A common concern for cognitively impaired elders is weight loss. Sixty-eight (20 men; 48 women) geriatric patients with documented cognitive impairment were retrospectively identified from a community-based geriatric assessment clinic. Subjects lived in situations that ranged from living alone to institutionalization. Inclusion of subjects was based on an initial Folstein score of less than 25. Memory test scores, level of depression and weight were recorded multiple times over a period of 6 to 30 months after initial assessment. Weight change was defined as the difference between the initial recorded weight and weight at last follow up. Adjusting for depression, men and women who lived in nursing homes gained the most weight (mean 3.5kg ± 4.7). Women living with a family member (other than a spouse) also appeared to gain weight (mean 2.1kg ± 6.2), whereas those individuals living with a spouse generally maintained weight status, with slight losses (mean −.86kg ± 4.8). Individuals living alone had slight, but the greatest, mean loss of weight (mean −1.3kg ± 4.7). Overall, women who lived with a family member (other than a spouse) or in an institution gained significantly more weight than those living alone or with a spouse ( p Although the progression of weight loss in the elderly is complex, it appears that spouse or filial caregiver nutrition education would be a first step toward reducing weight loss in cognitively impaired men living in the community. Nutrition education should include information on how to access nutrition respite services or meal programs, and provide strategies for the development of skills related to assisted feeding, easy meal preparation and/or encouragement of eating by family caregivers.

External Validity of a Geriatric Food Behavior Instrument: Scale Scores and their Association with Selected Risk Indicators

Abstract LEARNING OUTCOME: To demonstrate the external validity of a self-administered food behavior instrument for older persons The Geriatric Food Behavior Instrument (GFBI) has been demonstrated to measure eight valid and reliable constructs of food behavior that reflect nutritional risk for an older population. Construct validity was determined using principal components analysis with reliability coefficients (Cronbachs Alpha) of seven extracted components exceeding .72. In this stage of the research, the practical relevance of the food behavior constructs were examined in relation to parallel risk indicators to provide evidence of the instruments external validity. A variety of demographic and nutrition-risk variables were documented for 577 older subjects. These included age, gender, marital status, education, medical or therapeutic diets followed, and dentition. A smaller sub-sample completed a food frequency interview (n = 60). Significant differences (p≤0.05) in selected food behavior scores were detected related to gender, advanced chronological age, and marital status. Of 169 different foods, sixteen were significantly correlated with the GFBI construct Healthy Food Practices , including a positive association with fiber and vitamin A and C rich foods. Fat and sodium intake were negatively correlated. Use of canned foods and foods high in fat and salt were significantly associated with scores on the domain Easy Alternatives to Cooking . Subjects with a higher mean score on Cooking Involvement and Interest were more frequent users of vitamin A and C and fiber rich foods. Higher scores on Controlled Eating were negatively correlated with BMI (p≤0.01). The results of this phase of testing for the Geriatric Food Behavior Instrument provide substantial evidence that GFBI constructs are logically associated with several indicators commonly described as nutrition-risk indicators for older persons