Effects of motor practice on cognitive disorders in older adults

The demographics of our societies have changed drastically during the past few decades. The general population is aging rapidly as human life spans continue to expand and more adults are set to mature during the next quarter century. This aging process has numerous implications for the way we live and will have particularly important impacts on health and healthcare. In particular, substantial evidence suggests that cognitive–motor function deteriorates considerably as the result of inactive life style, biological aging, and cognitive impairments. The number of individuals with Alzheimer's disease (AD), an aging-related cognitive disorder, is expected to increase significantly during the next 40 years. The development of mild cognitive impairment (MCI) or AD can exaggerate the functional declines observed in cognitive or motor performance. The functional declines affect an array of social, cognitive, mental, physical, and motor activities in our daily lives. However, recent studies suggest that cognitive, physical, motor practice, or skill learning can improve motor speed, smoothness, and accuracy in both MCI and AD patients and their age-matched healthy peers. From theoretical and practical perspectives, this paper addresses several critical aspects of motor deficits and the kinematical characteristics of motor skill development in MCI and AD populations. Empirical data will be presented relative to the sensory–motor functions of MCI and AD, the motor skill acquisition, exercise rehabilitation in older adults with memory loss, as well as the implications for therapies. Finally, this review concludes with thoughts and suggestions for future research in these areas.     

Relationship goals of middle-aged,young-old,and old-old internet daters: An analysis of online personal ads

Purpose of the studyResearch on courtship patterns and romantic relationship in later life has not kept pace with the burgeoning number of older adults interested in dating.Design and methodsWe conducted content analyses of themes arising from 450 personal ads written by middle-aged (40–54), young-old (60–74), and old-old (75 +) participants.ResultsSignificant differences between the young-old and the middle-aged were few; those between the young-old and old-old were numerous. Compared to the old-old, the young-old and middle-aged were more likely to mention adventure, romance, sexual interests, and seeking a soul mate and less likely to mention health.ImplicationsThis study increases our understanding of relationship goals in later life and highlights the error of treating all older adults as a homogeneous group. Practice and policy can benefit from more nuanced distinctions between age groups and an enhanced recognition of the vibrant emotional, romantic, and sexual lives of older adults.     

The relevance of situation awareness in older adults’ cognitive functioning: a review

Age-related declines in cognition may have detrimental effects on older adults’ ability to complete everyday activities that young- and middle-aged individuals perform automatically. Theories of cognitive aging have found deficits in older adults’ fluid intelligence, capacity for inhibition, number of processing resources, and speed of processing, and in recent years, studies have proposed cognitive strategies to ameliorate these declines. However, few strategies directly train the cognitive strategies necessary to improve performance in dynamic environments and physical activities. One such strategy may be the enhancement of situation awareness, the capability to perceive and understand one’s environment. Although the term has typically been applied to pilots and other expert performers, situation awareness may also be relevant to cognitive aging, where older adults’ perception and comprehension of their environment become critical to everyday functioning and physical activities. If older adults’ situation awareness can be facilitated, then it may be possible to reduce the impact of age-related cognitive declines, allowing older adults to successfully participate in dynamic situations and sports where the environment is constantly changing (e.g., driving and tennis). The following review outlines cognitive deficits in aging, details their relation to situation awareness, and discusses how training in situation awareness may reduce cognitive declines. Portions of this paper were reported at the annual meeting of the North American Society for the Psychology of Sport and Physical Activity in June, 2005.     

Institutionalization,Romanian Adoptions and Executive Functioning

The impact of a traumatic environment during early childhood is linked to short-term and long-term difficulties in adoptees. This study, utilizing a non-random, cross-sectional analysis of 123 children adopted from Romania, focused on executive cognitive functioning. One-third of the sample had not been institutionalized while the other two-thirds had been institutionalized for varying lengths of time from 1 month to more than 3 years, resulting in a “natural experiment” that allowed us to compare these two groups. Information from parents and teachers was obtained regarding their perception of the child’s executive functioning. Results indicate that, after many years in their adoptive families, 40% of the adoptees had physical challenges and 36% were in at least some special education classes. The best predictor of parental perception of current executive functioning was parent perception of the current parent–child relationship and not preadoptive history.     

The effect of three different exercise training modalities on cognitive and physical function in a healthy older population

Background

Older adults are encouraged to participate in regular physical activity to counter the age-related declines in physical and cognitive health. Literature on the effect of different exercise training modalities (aerobic vs resistance) on these health-related outcomes is not only sparse, but results are inconsistent. In general, it is believed that exercise has a positive effect on executive cognitive function, possibly because of the physiological adaptations through increases in fitness. Indications are that high-intensity interval training is a potent stimulus to improve cardiovascular fitness, even in older adults; however, its effect on cognitive function has not been studied before.Therefore, the purpose of this study was to compare the effects of resistance training, high-intensity aerobic interval training and moderate continuous aerobic training on the cognitive and physical functioning of healthy older adults.

Methods

Sixty-seven inactive individuals (55 to 75 years) were randomly assigned to a resistance training (RT) group (n = 22), high-intensity aerobic interval training (HIIT) group (n = 13), moderate continuous aerobic training (MCT) group (n = 13) and a control (CON) group (n = 19) for a period of 16 weeks. Cognitive function was assessed with a Stroop task and physical function with the Timed-Up-and-Go (TUG) and submaximal Bruce treadmill tests.

Results

No significant GROUP x TIME interaction was found for Stroop reaction time (P > .05). The HIIT group showed the greatest practical significant improvement in reaction time on the information processing task, i.e. Stroop Neutral (ES = 1.11). MCT group participants had very large practical significant improvements in reaction time on the executive cognitive tasks, i.e. Stroop Incongruent and Interference (ES = 1.28 and 1.31, respectively). The HIIT group showed the largest practically significant increase in measures of physical function, i.e. walking endurance (ES = 0.91) and functional mobility (ES = 0.36).

Conclusions

MCT and RT proved to be superior to HIIT for the enhancement of older individuals’ executive cognitive function; whereas HIIT were most beneficial for improvement in information processing speed. HIIT also induced the largest gains in physical function.

     

The impact of high-calorie-expenditure exercise on quality of life in older adults with coronary heart disease

The acceptability of a high-calorie-expenditure (HCE) exercise program in older coronary heart disease patients participating in a behavioral weight-control program was evaluated. Seventy-four overweight patients (median age 63 yr) were randomly assigned to a 5-mo intervention of HCE exercise (3,000-3,500 kcal/wk daily walking) or standard cardiac-rehabilitation (CR) exercise (700-800 kcal/wk). Both groups received counseling to achieve a dietary caloric deficit of 3,500 kcal/ wk. Assessments at baseline and 5 mo included self-reported measures of quality of life and psychosocial variables. The HCE group experienced significantly greater weight loss (8.2 ± 4 vs. 3.7 ± 5 kg, p < .001). Changes from baseline to 5 mo on scores of physical, emotional, and social functioning were greater for the HCE than CR group (p < .05). HCE exercise also resulted in greater positive change in exercise enjoyment (p = .05), which was mediated by weight change. Even high-risk older adults can be successful in an HCE exercise program and experience no adverse physical or emotional changes.     

Exercises for mental wellness. Couldn't we all benefit?

For most of us, our cognitive functioning could be improved in many ways. Many of us struggle with our thinking skills at times, especially during times of stress and information overload. Some of the research that supports the use of prescribed cognitive exercises to slow cognitive decline in older adults may ultimately prove to be beneficial for all of us. Mental health nurses should encourage regular daily mental workouts, along with aerobic physical exercises, for everyone, not just older adults. Personal fitness training should focus not only on physical fitness, but also on mental fitness.     

Habitat fragmentation and conservation strategies for a rare forest habitat in the Florida Keys archipelago

Habitat loss and fragmentation are principal causes for population declines and the loss of biodiversity across the globe. In the United States, tropical hardwood hammock is a threatened forest ecosystem that occurs only in extreme south Florida, primarily on the Florida Keys archipelago. This rare forest type is characterized by high plant diversity that is strongly influenced by tropical, mast-producing trees and shrubs of West Indian origin. Tropical hardwood hammocks in the Florida Keys provide important habitat for resident and migratory birds, particularly Neotropical species that rely on suitable stopover habitat during migration. The Florida Keys are under intense development pressure, particularly in higher elevation sites where tropical hardwood hammock occurs. With exception of a survey completed during 1991 in the Upper Keys, information regarding habitat loss and current coverage, conservation status, and how best to conserve remaining patches of this rare forest habitat are lacking. We used a Geographic Information Systems approach to assess the extent of loss and fragmentation of tropical hardwood hammock in the upper Keys during 1991–2004, quantify area and number of hammock patches under private ownership and in conservation status throughout the Florida Keys as of 2004, and evaluate strategies to most effectively conserve large blocks of remaining tropical hardwood hammock. Total remaining hammock habitat throughout the Keys encompassed 3,712 ha and hammock habitat declined by 31% in the upper Keys during 1991–2004. Hammock habitat in the upper Keys encompassed 1,962 ha among 124 habitat patches (median = 1.5 ha, range = 0.1–205.7 ha), of which 1,066 ha (54%) were under conservation status. Hammock habitat in the lower Keys encompassed 1,750 ha among 102 patches (median = 4.4 ha, range = 0.3–96.3 ha), of which 1,283 ha (73%) were protected under conservation status. Approximately 37% of total remaining hammock habitat remained unprotected. However, our analyses revealed that many unprotected areas >20 ha were contiguous with protected hammocks. Safeguarding 22 partially protected patches >20 ha (17% of remaining patches) would protect an additional 750 ha of hammock habitat, which represents 55% of all remaining unprotected hammock habitat in the Keys, and would increase the mean patch size of these larger forest patches from 55 to 89 ha. Consequently, strategically focusing conservation efforts on remaining forest patches of tropical hardwood hammock >20 ha in size and contiguous to existing protected areas represents the most effective use of conservation dollars and would provide greater ecological benefits than conservation of small patches of highly fragmented habitat.     

Estimation of energy expenditure using accelerometers and activity-based energy models��validation of a new device

Over the last few years, the estimation of energy expenditure with accelerometers has become more and more accurate due to improvements in sensor technology. Significant enhancement could be reached by model-based estimation regarding different activity types. The kmsMove-sensor (movisens GmbH, Karlsruhe, Germany) is a device that is used to compute human energy expenditure using motion-dependent calculation models. It is outfitted with an accelerometer to measure body acceleration during certain movements and activities. To validate its accuracy, the sensor was compared to indirect calorimetry as criterion measure. For this experiment, nine subjects (all males, age 46.4 ± 10.9 years, 28–64 years) were equipped with the kmsMove-sensor as well as a portable indirect calorimeter and their energy consumption was measured over a time period of 100 min. Additionally, the energy consumption of seven out of the above-mentioned nine subjects was measured over an average of 7 h. The measurements took place in a rehabilitation clinic, where the subjects completed their regular daily rehabilitation activities. An analysis of the data revealed ICCs between the kmsMove-sensor and indirect calorimetry for the time period of 100 min of 0.82 (0.38–0.96; p = 0.003) and for an averaged measuring time of 7 h of 0.81 (0.22–0.97; p = 0.01). Furthermore, a Bland–Altman analysis for the time period of 100 min led to a difference of the means of 4.3 kcal (limits of agreement: −94.3 and 102.9 kcal) and for the time period of an average of 7 h to −14.0 kcal (limits of agreement: −320.0 and 292.0 kcal). These findings indicate that the kmsMove-sensor is an appropriate measuring device with relatively good accuracy to assess human energy expenditure in rehabilitation patients. However, this study has some limiting aspects (small sample size, artificial setting) which could influence validity.     

Predictors of falling in older Maryland drivers: a structural-equation model

Falls can impair health and reduce quality of life among older adults. Although many factors are related to falling, few analyses examine causal models of this behavior. In this study, factors associated with falling were explored simultaneously using structural-equation modeling. A variety of cognitive, physical-performance, and health measures were administered to 694 older adult drivers from the state of Maryland. The observed and latent variables of age, cognitive ability, physical functioning, health, and falling behavior were used to create a causal model. The model revealed that being older was associated with declines in cognition, and such cognitive declines predicted increased falling. Similarly, poorer health was related to poorer physical functioning, which, in turn, also predicted increased falling. This model indicates that in addition to existing fall-prevention interventions aimed at improving physical functioning, interventions to improve cognition and health might also be effective. It is speculated that fear of falling, which often results in reduced mobility among older adults, might account for the lack of a direct relationship between age and falling. This hypothesis should be examined in further research.     

Effects of 12 weeks of Nordic Walking and XCO Walking training on the endurance capacity of older adults

Background

Several studies have already examined the positive effects of various forms of endurance training in patient groups and in healthy adults up to 60 years old. The aim of this study was to analyse the effects of Nordic Walking (NW) and XCO Walking (XCO) training on endurance capacity in healthy older adults, aged 60 years and older.

Methods

Twenty-three older participants (mean age: 69.9 ± 5.4 years) were randomly assigned to either the NW group or the XCO group. All participants were measured before and after the 12 weeks of endurance training (2 sessions/week) to examine oxygen uptake (VO₂) and energy consumption during an outdoor field test. In addition, heart rates were recorded and lactate samples were collected.

Results

NW mainly demonstrated some significant (p < 0.05) decreases in heart rate, lactate concentration at lower to moderate walking speeds, whereas XCO Walking revealed significant (p < 0.05) decreases in lactate concentration and VO₂ at low to higher walking speeds.

Conclusions

NW as well as XCO training increase the efficiency of the cardio-vascular system in older subjects. Both training approaches are suitable options for endurance training, which may serve to counteract age- and inactivity-related decreases in cardio-vascular functioning as well as aid in maintaining overall performance in older adults.

     

Does the theory of planned behavior elements mediate the relationship between perceived constraints and intention to participate in physical activities? A study among older individuals

This study aimed to investigate the degree to which the elements of the theory of planned behavior mediate the relationship between constraints and intention to continuing participation in physical activities. The sample of the study consisted of 119 (N = 119) older individuals who participated in organized physical activity programs. The results indicated that attitudes and perceived behavioral control were negatively correlated with constraints, whereas the subjective norm variable had no relationship with them. In terms of the mediation role of the elements of the theory of planned behavior, the results indicated that both attitudes and perceived behavioral control partially mediated the relationship between constraints and intention, with the perceived behavioral control variable being the strongest mediator. These findings suggest that the theory of planned behavior elements mediate the constraints–intention relationship and determine, in a large degree, the older individuals’ intention to continuing taking part in physical activities.     

Masters or pawns? Examining injury and chronic disease in male Masters Athletes and chess players compared to population norms from the Canadian Community Health Survey

Background

Identifying the optimal type and amount of activity for the maintenance of function in older adults has proved challenging. On the one hand, Masters Athletes have been proposed as the ideal model of successful aging but most of this research has focused on physical functioning. On the other hand, the importance of cognitive engagement has been emphasized, which may be more strongly related to activities such as playing chess. The current study aimed to compare physical health outcomes (i.e., prevalence of physical injury and chronic disease) among older athletes and chess players. Masters Athletes and chess players were recruited from track and field and chess competitions within the province of Ontario. In addition to these primary groups, moderately active and inactive older adults from Canadian Community Health Survey were also included for comparison.

Results

Masters Athletes had significantly higher rates of injury with the lowest rates of chronic disease, compared to all other activity groups. In contrast, chess players reported lower rates of injury compared to Masters Athletes as well as lower prevalence of chronic diseases compared to the moderately active and inactive groups. The normative groups reported the lowest rate of injury, but increased prevalence of chronic diseases compared to Masters Athletes and chess players.

Conclusions

Findings from this study indicate that both athletic and cognitive engagement may be positively related to the physical health of older adults, since Masters Athletes and chess players reported a lower prevalence of chronic disease. Importantly, the results expand our current understanding of health by providing evidence for physical health outcomes associated with an activity that is primarily associated with cognitive health.

     

Promoting walking among older adults living in retirement communities

The authors tested the feasibility and acceptability, and explored the outcomes, of 2 walking interventions based on ecological models among older adults living in retirement communities. An enhanced intervention (EI) was compared with a standard walking intervention (SI) among residents in 4 retirement facilities (N = 87 at baseline; mean age = 84.1 yr). All participants received a walking intervention including pedometers, printed materials, and biweekly group sessions. EI participants also received phone counseling and environmental-awareness components. Measures included pedometer step counts, activities of daily living, environment-related variables, physical function, depression, cognitive function, satisfaction, and adherence. Results indicated improvements among the total sample for step counts, neighborhood barriers, cognitive function, and satisfaction with walking opportunities. Satisfaction and adherence were high. Both walking interventions were feasible to implement among facility-dwelling older adults. Future studies can build on this multilevel approach.     

Promoting self-management of urinary incontinence in a geropsychiatric day treatment program

As the number of older adults in the United States increases, the number of older adults with mental illnesses also will increase. There will be a corresponding increase in prevalence of UI and its associated problems--medical problems, loss of independence or need for institutionalized care, diminished quality of life, and increased costs. Psychiatric nurses are in a position to help older adults with mental illnesses improve their overall health and quality of life by preventing the problems associated with untreated UI. Within their practice, psychiatric nurses have the opportunity to ensure clients receive the comprehensive assessments needed to establish their functional, physical, behavioral, emotional, and social support status--information that forms the foundation for developing individualized treatment interventions. Psychiatric nurses have the expertise to integrate physical and mental health care for older adults with mental illnesses and co-occurring conditions, such as UI. Promoting self-management of UI among older adults with mental illnesses potentially will enable them to participate in psychiatric rehabilitation programs; improve their overall health and quality of life; prevent falls and fractures that often cause them to lose their independent community living status and to be admitted to long-term care facilities; and reduce the cost to mental health care providers of managing UI in the treatment setting.     

Exercise behavior in older adults: a test of the transtheoretical model

The transtheoretical model (TTM) was developed as a guide for understanding behavior change. Little attention has been given, however, to the appropriateness of the TTM for explaining the adoption of exercise behavior in older adults. The purposes of this study were to determine the reliability of the TTM instruments and validate TTM predictions in 86 community-dwelling older adults (mean age 75.1 +/- 7.0 years, 87% women) who were participants in a 16-week walking program. TTM construct scales--self-efficacy, decisional balance (pros and cons), and processes of change (behavioral and cognitive)--were generally reliable (all>.78). Behavioral processes of change increased from baseline to follow-up, but pros, cons, and cognitive processes did not change among participants who became regular exercisers. Stage of change did not predict exercise adoption, but baseline self-efficacy predicted walking behavior. These results lend partial support to the TTM in predicting exercise behavior.     

Differential Item Functioning of Pathological Gambling Criteria: An Examination of Gender, Race/Ethnicity, and Age

This study tested for the presence of differential item functioning (DIF) in DSM-IV Pathological Gambling Disorder (PGD) criteria based on gender, race/ethnicity and age. Using a nationally representative sample of adults from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), indicating current gambling (n = 10,899), Multiple Indicator-Multiple Cause (MIMIC) models tested for DIF, controlling for income, education, and marital status. Compared to the reference groups (i.e., Male, Caucasian, and ages 25–59 years), women (OR = 0.62; P < .001) and Asian Americans (OR = 0.33; P < .001) were less likely to endorse preoccupation (Criterion 1). Women were more likely to endorse gambling to escape (Criterion 5) (OR = 2.22; P < .001) but young adults (OR = 0.62; P < .05) were less likely to endorse it. African Americans (OR = 2.50; P < .001) and Hispanics were more likely to endorse trying to cut back (Criterion 3) (OR = 2.01; P < .01). African Americans were more likely to endorse the suffering losses (OR = 2.27; P < .01) criterion. Young adults were more likely to endorse chasing losses (Criterion 9) (OR = 1.81; P < .01) while older adults were less likely to endorse this criterion (OR = 0.76; P < .05). Further research is needed to identify factors contributing to DIF, address criteria level bias, and examine differential test functioning.     

Reproduction, juvenile survival and retention in an urban fox squirrel population

Fox squirrels in an urban environment had an average litter size of 2.83 (95% CI 2.5, 3.16) which was similar to rural populations. Nonetheless, the proportion of squirrels reproductively active during the summer/fall breeding season (0.73) and annually (spring + summer/fall) was higher (1.23) than previously recorded for non-manipulated rural populations. The average monthly survival rate () of urban juvenile fox squirrels during the first 14 weeks of life was higher than reported for adult populations in the area. High rates of reproduction and juvenile survival yielded high juvenile to adult ratios (juveniles/adults) averaging 0.44. Retention of juveniles after 6 months (15%) was significantly less (χ ² = 7.24, p = 0.0071) than adults/subadults (40%). Results suggest that the urban environment provides quality habitat for fox squirrels and fox squirrels in urban environments have the potential to be a source population for surrounding suburban and rural environments.     

Relationships Among Active Engagement in Life Activities and Quality of Life for Assisted-Living Residents

This cross-sectional research explored the relationships between active engagement in life activities (leisure, social, and instrumental activities of daily living) and quality of life for seniors aged 65 and older residing in assisted living facilities. It is increasingly recognized that active participation in diverse physical, cognitive, and social activities can promote older adults’ quality of life, including physical and mental health, but there is limited information about this in the population of residents in assisted living facilities. It is estimated that there are one million older adults residing in assisted living facilities, making assisted living facilities a rapidly growing segment of senior housing. Older adults who relocate to assisted living facilities commonly experience lifestyle changes, often related to their altered physical and social environment, reduced demands regarding household chores and meal preparation, and new opportunities for recreation and socialization. In this study, interviews were conducted with 131 ambulatory residents from assisted living facilities in the New York City metropolitan area using the 55-Item Activity Checklist, SF-36v2, Life Satisfaction Index-Z, and demographic questions. Results found significant low to moderate correlations between retained engagement in life activities (leisure, social, and instrumental activities of daily living) and life satisfaction, and several quality of life domains, including physical functioning, mental health, general health, and vitality. Older adults continued to engage in a greater percentage of everyday life activities they identified as important. This data supports exploration of client-centered activity programs to promote participation of residents in assisted living facilities in diverse activities to both maintain resident functional abilities and manage functional decline.