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Falls are common in older adults. Falls are the number one cause of injury and death in the geriatric population. Fortunately, falls can be prevented. When evaluating falls acute triggers of falls should be distinguished from chronic predisposing factors. Syncopal/pre-syncopal episodes comprise the minority of falls causes. Gait and balance deficits are the most important culprits contributing to falls. Exercise is the only single intervention shown to prevent falls in older adults. Multicomponent medical and biomechanical interventions should be utilized to successfully treat falls.
Physical activity is fundamental for achieving healthy aging. Exercise offers older adults substantial benefits, such as reducing risks of all-cause mortality and chronic disease, preserving functional capacity, improving management of chronic conditions, and reducing health-care costs. Given the prevalence of physical inactivity and sedentary behavior among adults 65 and over, exercise needs to be more thoroughly integrated into care plans and counseling in primary care settings. A practical, three-step approach to exercise counseling is recommended. Older adults should strive to do at least 150 minutes of moderate-intensity aerobic exercise weekly, muscle-strengthening and flexibility activities twice weekly, and for those at risk of falls or with mobility problems, balance activities at least three times per week. Older adults with functional restrictions or chronic conditions should be as physically active as their abilities and conditions allow. Any amount of moderate-to-vigorous physical activity gains some health benefits. Appropriate physical activity counseling, prescription, and referral must be tailored for each patient and must take into account such factors as fitness levels, goals and motivations, access to exercise-related facilities and programs, chronic diseases, prescribed medications, common injuries, and hip and knee arthroplasties.
Running exercise courses in different sectors of the health system is one of the important steps to prepare and deploy disaster risk management programs. The present study aimed to identify and explain the components affecting the design of preparedness exercises of the health system in disasters.
This study was a qualitative content analysis. Data were collected by purposeful sampling through in-depth and semi-structured individual interviews with 25 health professionals in disasters who had experience in designing, implementing, and evaluating an exercise. The data were analyzed using the content analysis method.
The data analysis resulted in the production of 50 initial codes, 12 subcategories, 4 main categories of “Coordination, Command, and Guidance of Exercise,” “Hardware and Software Requirements of Exercise,” “Organizational Exercise Resources,” and “Communication and Exercise Public Information” with the original theme of “Exercise Design.”
This study provides a clear picture and rich, constructive information on the concept of designing health system preparedness exercises in disasters. The findings of this study can greatly increase the attention of senior managers in all areas of health, especially managers of prehospitals and hospitals who are in the front line of the response to disasters to design standard and scientific preparedness exercises.
The purpose of this study was to assess impact of different volumes of exercise as well as cumulative moderate to vigorous physical activity (MVPA) on energy intake (EI) and diet quality, as assessed by the Healthy Eating Index-2010(HEI-2010), across a 12-month weight maintenance intervention. Participants were asked to attend group behavioural sessions, eat a diet designed for weight maintenance and exercise either 150, 225 or 300 min/week. Dietary intake was assessed by 3-d food records, and MVPA was assessed by accelerometry. Two hundred and twenty-four participants (42·5 years of age, 82 % female) provided valid dietary data for at least one time point. There was no evidence of group differences in EI, total HEI-2010 score or any of the HEI-2010 component scores (all P > 0·05). After adjusting for age, sex, time, group and group-by-time interactions, there was an effect of cumulative MVPA on EI (1·08, P = 0·04), total HEI-2010 scores (–0·02, P = 0·003), Na (–0·006, P = 0·002) and empty energy scores (–0·007, P = 0·004. There was evidence of a small relationship between cumulative daily EI and weight (β: 0·00187, 95 % CI 0·001, P = 0·003). However, there was no evidence for a relationship between HEI total score (β: −0·006, 95 % CI 0·07, 0·06) or component scores (all P > 0·05) and change in weight across time. The results of this study suggest that increased cumulative MVPA is associated with clinically insignificant increases in EI and decreases in HEI.
Childbearing decreases HDL-cholesterol, potentially contributing to the increased risk of CVD in parous women. Large HDL particles (HDL-P) are associated with lower risk of CVD. In this secondary analysis of a randomised controlled trial, we investigated the effects of 12-week dietary and exercise treatments on HDL-P subclass concentration, size and apoA1 in lactating women with overweight/obesity. At 10–14 weeks postpartum, 68 women with pre-pregnant BMI 25–35 kg/m2 were randomised to four groups using 2 × 2 factorial design: (1) dietary treatment for weight loss; (2) exercise treatment; (3) both treatments and (4) no treatment. Lipoprotein subclass profiling by NMR spectroscopy was performed in serum at randomisation and after 3 and 12 months, and the results analysed with two-way ANCOVA. Lipid concentrations decline naturally postpartum. At 3 months (5–6 months postpartum), both diet (P = 0·003) and exercise (P = 0·008) reduced small HDL-P concentration. Concurrently, exercise limited the decline in very large HDL-P (P = 0·002) and the effect was still significant at 12 months (15 months postpartum) (P = 0·041). At 12 months, diet limited the decline in very large HDL-P (P = 0·005), large HDL-P (P = 0·001) and apoA1 (P = 0·002) as well as HDL size (P = 0·002). The dietary treatment for weight loss and the exercise treatment both showed effects on HDL-P subclasses in lactating women with overweight and obesity possibly associated with lower CVD risk. The dietary treatment had more effects than the exercise treatment at 12 months, likely associated with a 10 % weight loss.
Thermolytic responses are required in either high ambient temperatures, when conductive heat loss is low, or during states of increased heat production such as during exercise. Most of the thermolytic responses involve fluid loss, including panting (i.e., tachypnea) and evaporative cooling from skin moistened by sweating or saliva spreading. The relative contribution of these mechanisms is species dependent. In all cases, the principal systemic change produced by the fluid loss is hyperosmolarity, although hypovolemia can also be considerable. Humans and animals usually do not drink sufficient water to replace the lost fluid, resulting in a state of hypohydration. This can be partially mitigated by repeated exposure (i.e., adapation) or by providing electrolytes to drink. Sustained hypohydration and/or elevated core temperature produces loss of physical performance and, in the extreme, can be lethal. Available evidence siuggests that the OVLT and/or MnPO play important roles in detection of heat stress and execution of the thermolytic responses.
This chapter analyses the discourse surrounding four words that are frequent and statistically salient across all sections of the press: healthy, body, diet and exercise. Through these foci, the analysis explores how the press constructs a link between health and not having obesity, as well as how individuals are implored to eradicate their obesity and reduce their risk of obesity by regarding their bodies as entities that are separate to their selves and subjecting their bodies to gruelling treatment, including through extreme diets and intense exercise regimes. This chapter questions which of the weight loss methods widely reported across the press are likely to engender weight loss in readers and, more importantly, whether or not they are likely to encourage healthy attitudes towards the body and the self.
In the USA, as many as 20 % of recruits sustain stress fractures during basic training. In addition, approximately one-third of female recruits develop Fe deficiency upon completion of training. Fe is a cofactor in bone collagen formation and vitamin D activation, thus we hypothesised Fe deficiency may be contributing to altered bone microarchitecture and mechanics during 12-weeks of increased mechanical loading. Three-week old female Sprague Dawley rats were assigned to one of four groups: Fe-adequate sedentary, Fe-deficient sedentary, Fe-adequate exercise and Fe-deficient exercise. Exercise consisted of high-intensity treadmill running (54 min 3×/week). After 12-weeks, serum bone turnover markers, femoral geometry and microarchitecture, mechanical properties and fracture toughness and tibiae mineral composition and morphometry were measured. Fe deficiency increased the bone resorption markers C-terminal telopeptide type I collagen and tartate-resistant acid phosphatase 5b (TRAcP 5b). In exercised rats, Fe deficiency further increased bone TRAcP 5b, while in Fe-adequate rats, exercise increased the bone formation marker procollagen type I N-terminal propeptide. In the femur, exercise increased cortical thickness and maximum load. In the tibia, Fe deficiency increased the rate of bone formation, mineral apposition and Zn content. These data show that the femur and tibia structure and mechanical properties are not negatively impacted by Fe deficiency despite a decrease in tibiae Fe content and increase in serum bone resorption markers during 12-weeks of high-intensity running in young growing female rats.
This chapter focuses on types of emotional strategies that students are using to deal with negative emotion. It links back to Chapter Three by clarifying that dyslexic student negative emotion is an issue not only because of its prevalence; in fact, the students interviewed did not have any productive strategies to cope emotionally. Consequently, the chapter themes negative emotional coping methods under the actions of avoidance, getting stressed, worrying and crying, panicking, and withdrawing from social interaction. It confirms these themes by providing recollections from voices of students who have employed these methods. Although this may initially seem rather defeatist, the sharing of these experiences by students with dyslexia is in fact positive for dyslexic readers of the book, as they can identify with the scenarios. The second part of the chapter is themed around more productive emotional coping methods that some of the students discussed as mechanisms they found useful: talking to someone, planning and using strategies, implementing breaks, participating in exercise, seeking comfort, and using mental resilience, such as persistence and determination. Specific examples are provided through articulations of dyslexic students, and the dyslexic reader of the book is invited in to consider these approaches.
Responses to the COVID-19 pandemic have included lockdowns and social distancing with considerable disruptions to people's lives. These changes may have particularly impacted on those with mental health problems, leading to a worsening of inequalities in the behaviours which influence health.
We used data from four national longitudinal British cohort studies (N = 10 666). Respondents reported mental health (psychological distress and anxiety/depression symptoms) and health behaviours (alcohol, diet, physical activity and sleep) before and during the pandemic. Associations between pre-pandemic mental ill-health and pandemic mental ill-health and health behaviours were examined using logistic regression; pooled effects were estimated using meta-analysis.
Worse mental health was related to adverse health behaviours; effect sizes were largest for sleep, exercise and diet, and weaker for alcohol. The associations between poor mental health and adverse health behaviours were larger during the May lockdown than pre-pandemic. In September, when restrictions had eased, inequalities had largely reverted to pre-pandemic levels. A notable exception was for sleep, where differences by mental health status remained high. Risk differences for adverse sleep for those with the highest level of prior mental ill-health compared to those with the lowest were 21.2% (95% CI 16.2–26.2) before lockdown, 25.5% (20.0–30.3) in May and 28.2% (21.2–35.2) in September.
Taken together, our findings suggest that mental health is an increasingly important factor in health behaviour inequality in the COVID era. The promotion of mental health may thus be an important component of improving post-COVID population health.
We discuss physical changes that are encountered in aging and how music may be a part of optimizing health outcomes and wellness. This chapter presents how music affects thinking, feeling, and acting. Other topics include effects of noise, biological theories of aging, physical changes with aging, longevity, mind-body interactions, music in a Utopian environment, and exercise. Finally, a discussion ensues on retirement centers that celebrate living, such as Casa Verdi, Triangle Partnership, and The George Center.
Little is known about the effects of physical exercise on sleep-dependent consolidation of procedural memory in individuals with schizophrenia. We conducted a randomized controlled trial (RCT) to assess the effectiveness of physical exercise in improving this cognitive function in schizophrenia.
A three-arm parallel open-labeled RCT took place in a university hospital. Participants were randomized and allocated into either the high-intensity-interval-training group (HIIT), aerobic-endurance exercise group (AE), or psychoeducation group for 12 weeks, with three sessions per week. Seventy-nine individuals with schizophrenia spectrum disorder were contacted and screened for their eligibility. A total of 51 were successfully recruited in the study. The primary outcome was sleep-dependent procedural memory consolidation performance as measured by the finger-tapping motor sequence task (MST). Assessments were conducted during baseline and follow-up on week 12.
The MST performance scored significantly higher in the HIIT (n = 17) compared to the psychoeducation group (n = 18) after the week 12 intervention (p < 0.001). The performance differences between the AE (n = 16) and the psychoeducation (p = 0.057), and between the AE and the HIIT (p = 0.999) were not significant. Yet, both HIIT (p < 0.0001) and AE (p < 0.05) showed significant within-group post-intervention improvement.
Our results show that HIIT and AE were effective at reverting the defective sleep-dependent procedural memory consolidation in individuals with schizophrenia. Moreover, HIIT had a more distinctive effect compared to the control group. These findings suggest that HIIT may be a more effective treatment to improve sleep-dependent memory functions in individuals with schizophrenia than AE alone.
Current first-line treatments for paediatric depression demonstrate mild-to-moderate effectiveness. This has spurred a growing body of literature on lifestyle recommendations pertaining to nutrition, sleep and exercise for treating paediatric depression.
Paediatric depression clinical practice guidelines (CPGs) were reviewed for quality and to catalogue recommendations on nutrition, sleep and exercise made by higher-quality CPGs.
Searches were conducted in Medline, EMBASE, PsycINFO, Web of Science and CINAHL, and grey literature CPGs databases for relevant CPGs. Eligible CPGs with a minimum or high-quality level, as determined by the Appraisal of Guidelines for Research and Evaluation, Second Edition instrument, were included if they were (a) paediatric; (b) CPGs, practice parameter or consensus or expert committee recommendations; (c) for depression; (d) the latest version and (e) lifestyle recommendations for nutrition, sleep or exercise. Key information extracted included author(s), language, year of publication, country, the institutional body issuing the CPG, target disorder, age group, lifestyle recommendation and the methods used to determine CPG lifestyle recommendations.
Ten paediatric CPGs for depression with a minimum or high-quality level contained recommendations on nutrition, sleep or exercise. Lifestyle recommendations were predominately qualitative, with quantitative details only outlined in two CPGs for exercise. Most recommendations were brief general statements, with 50% lacking supporting evidence from the literature.
Interest in lifestyle interventions for treatment in child and youth depression is growing. However, current CPG lifestyle recommendations for nutrition, sleep or exercise are based on expert opinion rather than clinical trials.
Alzheimer’s disease (AD) is the most common major neurocognitive disorder of ageing. Although largely ignored until about a decade ago, accumulating evidence suggests that deteriorating brain energy metabolism plays a key role in the development and/or progression of AD-associated cognitive decline. Brain glucose hypometabolism is a well-established biomarker in AD but was mostly assumed to be a consequence of neuronal dysfunction and death. However, its presence in cognitively asymptomatic populations at higher risk of AD strongly suggests that it is actually a pre-symptomatic component in the development of AD. The question then arises as to whether progressive AD-related cognitive decline could be prevented or slowed down by correcting or bypassing this progressive ‘brain energy gap’. In this review, we provide an overview of research on brain glucose and ketone metabolism in AD and its prodromal condition – mild cognitive impairment (MCI) – to provide a clearer basis for proposing keto-therapeutics as a strategy for brain energy rescue in AD. We also discuss studies using ketogenic interventions and their impact on plasma ketone levels, brain energetics and cognitive performance in MCI and AD. Given that exercise has several overlapping metabolic effects with ketones, we propose that in combination these two approaches might be synergistic for brain health during ageing. As cause-and-effect relationships between the different hallmarks of AD are emerging, further research efforts should focus on optimising the efficacy, acceptability and accessibility of keto-therapeutics in AD and populations at risk of AD.
Exercise has been found to be important in maintaining neurocognitive health. However, the effect of exercise intensity level remains relatively underexplored. Thus, to test the hypothesis that self-paced high-intensity exercise and cardiorespiratory fitness (peak aerobic capacity; VO2peak) increase grey matter (GM) volume, we examined the effect of a 6-month exercise intervention on frontal lobe GM regions that support the executive functions in older adults.
Ninety-eight cognitively normal participants (age = 69.06 ± 5.2 years; n = 54 female) were randomised into either a self-paced high- or moderate-intensity cycle-based exercise intervention group, or a no-intervention control group. Participants underwent magnetic resonance imaging and fitness assessment pre-intervention, immediately post-intervention, and 12-months post-intervention.
The intervention was found to increase fitness in the exercise groups, as compared with the control group (F = 9.88, p = <0.001). Changes in pre-to-post-intervention fitness were associated with increased volume in the right frontal lobe (β = 0.29, p = 0.036, r = 0.27), right supplementary motor area (β = 0.30, p = 0.031, r = 0.29), and both right (β = 0.32, p = 0.034, r = 0.30) and left gyrus rectus (β = 0.30, p = 0.037, r = 0.29) for intervention, but not control participants. No differences in volume were observed across groups.
At an aggregate level, six months of self-paced high- or moderate-intensity exercise did not increase frontal GM volume. However, experimentally-induced changes in individual cardiorespiratory fitness was positively associated with frontal GM volume in our sample of older adults. These results provide evidence of individual variability in exercise-induced fitness on brain structure.
Reducing sedentary behaviour (SB) and increasing physical activity (PA) by sitting less and standing/walking more is advised to prevent chronic diseases. However, the mechanisms underlying this recommendation are not well established, especially in individuals with obesity living in low-income regions. The present study evaluated whether there are associations between PA indicators (PAI – standing time, walking time and the number of steps/d) and SB indicators (SBI – sitting/lying down time) with the hormonal profile and resting energy expenditure (REE) of adult women living in a low-income region. This is a cross-sectional study. We collected data on hormones (insulin resistance, leptin and thyroid axis), body composition (tetrapolar bioimpedance), REE (indirect calorimetry), and PAI and SBI (triaxial accelerometers, ActivPAL). Multivariable linear models adjusting for age and fat-free mass were performed. Fifty-eight women (mean age of 31 years and BMI of 33 kg/m2) were included. The mean sitting/lying down time and standing time were 16·08 and 5·52 h/d, respectively. Sitting/lying down time showed a direct association with free thyroxine (FT4) (β = 0·56 ng/dl; 95 % CI = −1·10, −0·02). Standing time showed a direct association with FT4 (β = 0·75 ng/dl; 95 % CI = 0·01; 1·48) and inverse association with free triiodothyronine (β = −2·83 pg/ml 95 % CI = −5·56, −0·10). There were no associations between PAI and SBI with the REE, insulin resistance, leptin and thyroid-stimulating hormone. Thus, decreased SB is associated with thyroid hormones levels but not with REE, insulin resistance or leptin in women with obesity living in low-income regions.
Upper body and neck range of motion (ROM) are important for safe walking and driving. The purpose of this study was to determine whether stretching would improve neck, trunk, and shoulder ROM. Forty-eight community-dwelling women (75 ± 3 years of age) were randomly allocated to intervention (upper body stretching, n = 15) and control conditions (lower body power training, n = 33). All participants exercised in supervised 45-minute sessions twice weekly for 12 weeks. Testing of upper body ROM included a cervical ROM, device-based measurement and field tests of the neck, trunk, and shoulder ranges. Shoulder ROM was the only movement that improved in the intervention group beyond levels seen in control participants (33% increase, p < 0.01). Neck and trunk ROM did not change in response to a specific stretching program. Older adults with ROM limitations may need to explore other exercise options or focus on compensatory strategies for safe community mobility.
Global awareness about an increase of chronic diseases and premature mortality due to ‘unhealthy eating’ and ‘sedentary lifestyles’ is embedded in various discourses shaped by relationships and power. In this article, I investigate the role of physical activity in the lives of middle-aged women in Australia and how their experiences with exercise influence the way they position themselves within the context of inter-discursivity regarding fitness and ‘healthy ageing’. Results reveal how ‘knowledge’ about ‘healthy lifestyles’ is created and accessed, and how women make sense of the healthism discourse, the obesity crisis, and discourses around menopause and ageing. The participants for this study are nine women in their forties to sixties who volunteered to participate in semi-structured interviews after completing an online survey about physical activity that was part of a larger project. Their accounts of health and fitness, healthy eating, weight management, mental wellbeing and ageing are categorised and interpreted in a post-structuralist framework through the lens of feminist relational discourse analysis. Results show that all women are influenced by healthism discourses as well as being affected by assumptions and recommendations for ageing, menopausal women. They shape female identity by adopting, but also by resisting, discourses around their bodies and minds.
Depression is a heterogeneous syndrome linked to significant structural brain abnormalities, such as volumetric reductions in the hippocampus, anterior cingulate cortex and prefrontal cortex, as well as compromised white matter integrity. Recent growing evidence suggests that exercise is a promising and compelling treatment for depression in adults, showing effects that are comparable to other first-line treatments for depression.
This review aims to improve our understanding of the biological pathways involved in both the pathophysiology of depression and the antidepressant effects of exercise.
This literature review considers the latest available scientific research addressing a comprehensive analysis of the antidepressant effect of physical exercise and the biological pathways involved.
Physical activity has been shown to have a multimodal effect that stimulates biochemical pathways and restores neuronal structures disturbed in depression. Experimental evidence supports exercise-induced increases in hippocampal, anterior cingulate cortex and prefrontal cortex volume, suggesting that exercise and antidepressant medication may alleviate depression through common neuromolecular mechanisms. However, the benefits of exercise may also persist beyond the end of treatment, unlike antidepressant medication.
Given the undeniable scientific evidence favoring physical exercise in alleviating depression, it is of crucial importance to recommend this treatment in adjunct to psychotherapy and medication. Individuals at risk for depression also greatly benefit from it’s neuroprotective effects and should prioritize lifestyle changes. In older adults, there is a greater need for non-pharmaceutical treatments for depression due to limited efficacy of pharmaceutical treatments in this population.
Dementia is characterized by a decrease in mental functions, while disorders of balance, coordination of movements and gait are gradually added. In recent years there has been a growing interest in the role of exercise as a therapeutic strategy for people with dementia.
The aim of this study was to investigate the effect of different types of exercise and its parameters on cognitive and physical function in patients with dementia after reviewing the relevant literature.
Review of the literature based on the research of original scientific articles published in the electronic databases PubMed / Medline and Google scholar using as keywords the terms dementia, cognitive function, physical function, functionality, aerobic exercise, resistance exercise.
A review in the literature highlights the beneficial effect of exercise on patients with dementia. Aerobic exercise and mixed interventions have been studied more, while resistance interventions have been less studied. All three types of exercise have shown positive effects. The methodology differences of the studies make it difficult to draw definitive conclusions about the optimal intervention in the cognitive and physical function for the optimal result, the type of exercise, the duration, the frequency and the intensity.
Exercise (physical) may help maintain or improve cognitive function and functionality in patients with dementia but additional study is needed to clarify optimal intervention and establish guidelines.