Cessation of exercise in the institutionalized elderly: effects on physical function.

PURPOSE: The objectives of this study were (1) to examine the effects of a 12-week exercise cessation period separating two 12-week exercise sessions on physical variables in an elderly institutionalized population and (2) to explore overall programme effectiveness. METHODS: The functional mobility of 25 elderly institutionalized adults participating in an existing exercise programme was examined using a one-group, interrupted time-series design. Functional mobility was evaluated at four time points during two cycles of a 12-week exercise programme, alternating with a 12-week period of no formal exercise. RESULTS: The primary outcome was the change in functional mobility scores, assessed at baseline, 12, 24 and 36 weeks. In both the higher-functioning (HF) group and the lower-functioning (LF) group, the cessation of exercise was associated with deterioration in physical function. The overall non-continuous nature of the programming under study also seemed to be detrimental to the physical function of the LF group. CONCLUSIONS: Findings of this small-sample study support the need to modify common practices in exercise programming for older, institutionalized people.

Differential item functioning in the Mini-Mental State Examination in English- and Spanish-speaking older adults.

The purpose of this study was to determine if the Mini-Mental State Examination (MMS; M. F. Folstein, S. E. Folstein, & P. R. McHugh, 1975) demonstrates item bias with respect to measuring cognitive functioning of older Hispanics and non-Hispanics. Assessment of differential item functioning (DIF) of individual MMS items across 3 language/ethnicity groups (English test administration/non-Hispanic ethnicity, English test administration/Hispanic ethnicity, and Spanish test administration/Hispanic ethnicity) was performed by using a logistic regression procedure. Fifteen of the 26 MMS items were significantly related to total score and were shown to provide unbiased measurement across the 3 groups. Normative data are presented for older Hispanics (n = 365) and non-Hispanics (n = 388) on the raw MMS, a 15-item version in which items with significant DIF were eliminated, and a total score statistically adjusted for effects of education and age.