Physical Activity Programming for Older Adults in Assisted Living: Residents' Perspectives.

Decreasing sedentary behavior and increasing light physical activity could promote the maintenance of functional abilities for older adults in assisted living (AL). The purpose of this qualitative study was to gather residents' recommendations about a proposed self-efficacy enhancing intervention to replace sedentary behavior with light physical activity. We interviewed 20 residents (mean age 83.1; 60% women). Topics included their current activities and thoughts about physical activity. We presented the intervention and asked questions to inform its modification. Data were analyzed with content and thematic analysis. Specific recommendations included shorter one-hour sessions and framing the intervention as increasing light physical activity rather than decreasing sedentary behavior. The thematic analysis identified multiple factors that could influence intervention implementation, including motivation to be active, safety concerns, ageist attitudes about physical activity, varying abilities of residents, social influences, and limited opportunities for physical activity. These results will inform physical activity intervention implementation for AL residents.

Device-measured sedentary behavior in oldest old adults: A systematic review and meta-analysis.

Sedentary behavior contributes to health decline and frailty in older adults, especially the oldest old. The purpose of this systematic review was to synthesize evidence describing the volume of device-measured sedentary behavior and factors that influence sedentary behavior in community-dwelling adults aged 80 and older. Four electronic databases were searched in August 2018; the search was updated in September 2019 and December 2020. Twenty-one articles representing 16 unique datasets from six countries met inclusion criteria. Various devices and data processing methods were used to measure sedentary behavior; the most common device was the ActiGraph accelerometer. Sedentary time during the waking day ranged from 7.6 to 13.4 h/day. Studies using similar measurement methods (hip-worn ActiGraph with uniaxial cut-point <100 counts per minute) had a weighted mean of 10.6 h/day. Subgroup analyses revealed that male gender and age ≥85 may contribute to increased sedentary behavior. Only seven individual articles examined factors that influence sedentary behavior in the 80 and older age group; older age, male gender, non-Hispanic white race/ethnicity, social disadvantage, and declining cognitive function (in men) were associated with increased sedentary behavior. In conclusion, the oldest old are highly sedentary and little is known about factors that influence their sedentary behavior.

Assisted Living Residents' Sense of Belonging and Psychosocial Outcomes.

Little is known about the psychosocial adjustment of older adults in the assisted living environment. A sense of belonging has been linked to psychological health and a lack of belonging could lead to loneliness. We conducted a cross-sectional descriptive study to examine relationships between social engagement, sense of belonging, and psychological outcomes. Seventy female and 30 male assisted living residents participated. The mean age was 83.9 (range 65-99) years. Structural equation modeling (SEM) revealed that older age, higher physical function, and greater sense of belonging were associated with fewer negative psychosocial outcomes (depression and loneliness) and that sense of belonging functioned as a mediator between social engagement and psychosocial outcomes. Additional work is needed to fully understand how sense of belonging and other factors influence psychosocial outcomes.

Falls in community-dwelling older adults with heart failure: A retrospective cohort study.

BACKGROUND: While heart failure (HF) in older adults is associated with fall risk, little is known about this in the U.S. OBJECTIVE: To examine the independent effect of functional impairments related to HF on falls among community-dwelling older adults in the U.S. METHODS: A retrospective cohort study was conducted with 17,712 community-dwelling older adults aged 65 and above with (n = 1693) and without HF, using mixed-effects logistic regression to examine the association between HF and falls. RESULTS: HF patients had 14% greater odds of falling than those without HF. Moreover, HF patients with functional difficulties in mobility, large muscle difficulty, instrumental activities of daily living difficulty, poor vision, and urinary incontinence demonstrated an increased likelihood of falling. CONCLUSION: Community-dwelling older adults with HF and functional difficulties have a higher fall risk than those without HF, indicating that fall prevention programs should be developed, tested, and implemented for this population.

The Experience and Meaning of Physical Activity in Assisted Living Facility Residents.

Assisted living (AL) residents engage in very low levels of physical activity (PA), placing them at increased risk for mobility disability and frailty. But many residents in AL may not perceive the need to increase their PA. This study explored the experience, meaning, and perceptions of PA in 20 older adults in AL. The factors associated with PA were also examined. Qualitative data were collected using semistructured interviews and analyzed using phenomenological methodology. Six themes were identified: PA was experienced as planned exercise, activities of daily living, and social activities based on a schedule or routine; PA meant independence and confidence in the future; residents perceived themselves as being physically active; social comparisons influenced perception of PA; personal health influenced PA; motivations and preferences influenced PA. The findings highlight the importance of residents' personal perceptions of PA and effects of the social milieu in the congregate setting on PA.

Influences on neighborhood walking in older adults.

The purpose of this cross-sectional survey study was to examine the influence of self-efficacy, outcome expectations, and environment on neighborhood walking in older adults with (n = 163, mean age = 78.7, SD = 7.96 years) and without (n = 163, mean age = 73.6, SD = 7.93 years) mobility limitations, controlling for demographic characteristics. Multiple regression revealed that in mobility-limited older adults, demographic characteristics, self-efficacy, and outcome expectations explained 17.4% of variance in neighborhood walking, while environment (neighborhood destinations and design) explained 9.4%. Destinations, self-efficacy, sex, and outcome expectations influenced walking. In those without mobility limitations, demographic characteristics, self-efficacy, and outcome expectations explained 15.6% of the variance, while environment explained 5.6%. Self-efficacy, sex, and design influenced walking. Neighborhood walking interventions for older adults should include self-efficacy strategies tailored to mobility status and neighborhood characteristics.