Nicole L. Rogers

Methods to assess and improve the physical parameters associated with fall risk in older adults.

BACKGROUND Falls are common among older adults. Many physical parameters including reduced postural stability, decreased dynamic balance, gait disorders, strength deficits, difficulty standing from a chair, and other impairments have been shown to be strongly associated with fall risk in the elderly. ASSESSMENTS To identify those at risk for falls, tools that accurately measure physical performance parameters associated with falls are essential. Several tools are available to measure these parameters including clinical evaluations, functional performance tests, and questionnaires. The article describes many of the tools that can be used to evaluate the physical parameters associated with fall risk in older adults. CONCLUSIONS The described instruments can help in identifying those who are most likely to fall, and those who would benefit from targeted interventions. The final part of the article includes a brief discussion of the potential role of exercise training interventions to improve these physical parameters and prevent falls.

Effects of Dumbbell and Elastic Band Training on Physical Function in Older Inner-City African-American Women

ABSTRACT Providing inner-city minorities with inexpensive exercise programs may be a means of reducing frailty and maintaining independent lifestyles in this population. To determine the efficacy of such a program, 22 African-American women aged 62–94 years were recruited from a senior center in the Wichita urban community. Sixteen women (age = 74.8 ± 8.8 yr) participated in exercise training (3 days per week for 4 weeks) and 6 women (age = 74.7 ± 4.5 yr) served as controls. Training consisted of chair-based exercises using elastic resistance bands (upper and lower body) and dumbbells (upper body). Elastic band training improved (p < 0.05) lower body strength (30-second chair stand, time for 5 stands) by approximately 20% and the combination of bands and dumbbell training improved upper body strength (30-second dumbbell curl) by 24%. Grip strength improved by 5%. Up-&-Go performance improved by 10% al though balance and mobility exercises were not a fundamental element of the training program. Upper and lower body flexibility did not change. Changes were not observed for any variable in the control group. This study suggests that exercising with equipment that costs only a few dollars per participant improves upper and lower body fitness in older African-American women who live in an urban setting.

Considering accreditation in gerontology: the importance of interprofessional collaborative competencies to ensure quality health care for older adults.

The health care needs of older adults can be complex and multifaceted. Safe, effective, equitable, and person-centered service provision relies on skilled interprofessional, team-based practice. Too often, students seeking a career specializing in gerontology are not exposed to such interprofessional, team-based learning and practice during their coursework. This article details the core interprofessional collaborative competencies that need to be an integral component of any program providing quality education on issues in aging.

Health Literacy and Older Adults A Systematic Review

Objective: The objective of this review was to assess published literature relating to health literacy and older adults. Method: The current review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses. Results: Eight articles met inclusion criteria. All studies were conducted in urban settings in the United States. Study sample size ranged from 33 to 3,000 participants. Two studies evaluated health-related outcomes and reported significant associations between low health literacy and poorer health outcomes. Two other studies investigated the impact of health literacy on medication management, reporting mixed findings. Discussion: The findings of this review highlight the importance of working to improve health care strategies for older adults with low health literacy and highlight the need for a standardized and validated clinical health literacy screening tool for older adults.

Pattern of age-associated decline of static and dynamic balance in community-dwelling older women

Falling is the leading cause of injury‐related deaths in older adults, and a loss of balance is often the precursor to a fall. However, little is known about the rate at which balance declines with age. The objective of the present study was to determine whether there is an age‐associated decline in static (SB) and/or dynamic (DB) balance in community‐dwelling older women.

Text Messaging to Motivate Exercise Among Latino Adults at Risk for Vascular Disease: A Pilot Study, 2013

In 2013, we administered a 15-item survey to determine the extent of text message usage among Latino adults in Kansas; for a subset of the survey participants, we also conducted a 6-week pilot trial to determine the effect of text messaging on exercise behaviors. Among the 82 survey participants, 78% had unlimited text messaging. At baseline, all trial participants were at the stage of contemplation; at 6 weeks, one (9%) trial participant remained at the contemplation stage and the other 10 (91%) participants progressed to the action/maintenance/termination stage. Use of text messaging to motivate exercise is feasible and potentially efficacious among Latinos.

Effects of modular course training on mobility in older adults aged 79-90 years

Purpose : To determine the effectiveness of an intervention programme utilizing modules specifically designed to challenge mobility in older adults. Method : Twelve older adults aged 79-90 years (84.3 - 3.2; mean - SD) living in a retirement community participated in a 10-week (3 sessions per week, 50 minutes per session) training programme. Performance on a modular course, comprised of nine stations representing common environmental conditions, provided information about dynamic balance and mobility before and after the intervention programme. Stations consisted of walking across carpet and foam pathways, walking up and down ramps and stairs, walking through a slalom course of eight plastic cones, and stepping over foam props. Performance on the mobility course was videotaped to determine the time to complete each station. The training intervention consisted of performing sections of the mobility course and standing on foam pads with the eyes open or closed. Results : Using the Bonferroni-adjusted level of significance for multiple comparisons ( p - 0.005), paired sample t -tests indicated significant improvement for total time to complete the course (pre=100.9 - 40.5 s, post=79.6 - 40.3 s) and for all individual stations except stepping over props. Conclusions : These results indicate that an intervention programme utilizing functionally-oriented modules can improve mobility in older adults.

Falling Less in Kansas: Development of a Fall Risk Reduction Toolkit

Falls are a serious health risk for older adults. But for those living in rural and frontier areas of the USA, the risks are higher because of limited access to health care providers and resources. This study employed a community-based participatory research approach to develop a fall prevention toolkit to be used by residents of rural and frontier areas without the assistance of health care providers. Qualitative data were gathered from both key informant interviews and focus groups with a broad range of participants. Data analysis revealed that to be effective and accepted, the toolkit should be not only evidence based but also practical, low-cost, self-explanatory, and usable without the assistance of a health care provider. Materials must be engaging, visually interesting, empowering, sensitive to reading level, and appropriate for low-vision users. These findings should be useful to other researchers developing education and awareness materials for older adults in rural areas.

Passive and active exercises are similarly effective in elderly nursing home residents.

[Purpose] The aim of this study was to compare the efficacy of passive motion exercise and active motion exercise on functional fitness in elderly nursing home residents. [Subjects and Methods] Twenty-three (female 22 and male 1) nursing home residents (84.8±4.3 yr) volunteered for this study. They were divided into a passive motion exercise group (n=12) and an active motion exercise group (n=11) and performed 30-min sessions of training twice a week for 12 weeks. Functional fitness (Arm Curl, Chair Stand, Up & Go, Sit & Reach, Back Scratch, functional Reach, and 12-min Walk tests) was evaluated before and after the intervention. [Results] No significant baseline difference was noted between the groups in measured variables. Following the 12 week intervention, no significant interaction (group × time) was noted in functional fitness variables between the groups, except for the functional reach scores (active motion exercise 40%, passive motion exercise 9%). Significant improvement over time was noted in passive motion exercise group in Arm Curl (19%), Chair Stand (15%), Up & Go (6%), and 12-min Walk (12%) scores; and in the active motion exercise group in Arm Curl (14%), Chair Stand (19%), Up & Go (11%), functional Reach (40%) and 12-min Walk (13%) scores. The adherence rates in the passive and active motion exercise groups were 95.8% and 93.1% respectively. [Conclusion] Passive motion exercise and active motion exercise were found to be similarly effective for improving the functional fitness of elderly nursing home residents.

The Impact of an Active Lifestyle on the Functional Fitness Level of Older Women

The American College of Sports Medicine recommends that to maintain health, adults should engage in 150 min of moderate/vigorous physical activity (MVPA) per week. The purpose of the current study was to investigate the lowest MVPA dose possible to maintain functional fitness. Functional fitness was assessed using the Senior Fitness Test in 101 women (75.0 ± 7.2 years) from two Midwestern communities. Accelerometer determined daily activity level was assessed for 7 days as participants went about their normal daily activities. MVPA was determined via proprietary filtering, and time spent in this intensity was calculated. A 5-day average of time spent in MVPA was organized into four groups. ANOVAs revealed significant differences between activity groups on all functional fitness measures except back scratch and sit and reach. Results indicate that to maintain lower body function in older women, a threshold of 20 min/day of MVPA for 5 days is needed.