Usability Assessment of a Bluetooth-Enabled Resistance Exercise Band Among Young Adults.

BACKGROUND: Resistance-based exercises effectively enhance muscle strength, which is especially important in older populations as it reduces the risk of disability. Our group developed a Bluetooth-enabled handle for resistance exercise bands that wirelessly transmits relative force data through low-energy Bluetooth to a local smartphone or similar device. We present a usability assessment that evaluates an exercise system featuring a novel Bluetooth-enabled resistance exercise band, ultimately intended to expand the accessibility of resistance training through technology-enhanced home-based exercise programs for older adults. Although our target population is older adults, we assess the user experience among younger adults as a convenient and meaningful starting point in the testing and development of our device. METHODS: There were 32 young adults participating in three exercise sessions with the exercise band, after which each completed an adapted version of the Usefulness, Satisfaction, and Ease (USE) questionnaire to characterize the exercise system's strengths and weaknesses in usability. RESULTS: Questionnaire data reflected a positive and consistent user experience, with all 20 items receiving mean scores greater than 5.0 on a seven-point Likert scale. There were no specific areas of significant weakness in the device's user experience. CONCLUSIONS: The positive reception among young adults is a promising indication that the device can be successfully incorporated into exercise interventions and that the system can be further developed and tested for the target population of older adults.

Impact of Diet and Exercise on Weight and Cognition in Older Adults: A Rapid Review.

OBJECTIVE: To determine where the current literature stands in regard to diet/exercise interventions on cognition in overweight or obese individuals. DATA SOURCE: A rapid review was conducted of English-language studies published in Medline from January 1965 to January 2020. STUDY INCLUSION AND EXCLUSION CRITERIA: Included studies were intervention studies lasting ≥12 weeks, with participants aged ≥65 years, with a body mass index ≥25 kg/m2. DATA EXTRACTION: Data extracted included study population, duration, intervention design, outcomes, and results. DATA SYNTHESIS: Outcomes were qualitatively measured due to paucity of RTC. RESULTS: 1845 citations were identified, 31 full-text articles were reviewed, and 5 studies were included. Studies had usual care control groups and combined exercise/diet intervention groups with 31-3,526 participants randomized to each arm. Mean age of participants was 69.2-83.4 years. Studies reporting on cognitive changes showed marginally significant positive changes in cognition, and those that reported BMI indicated potential improvements in cognition. CONCLUSIONS: The number of interventions assessing the combined effects of both diet and exercise is low. Future studies should evaluate the impact of combined effects to ascertain whether cognitive decline may be reversed in older adults with a BMI ≥25 kg/m2.

Weight change and risk of the foundation of National Institute of Health Sarcopenia-defined low lean mass: Data from the National Health and Nutrition examination surveys 1999-2004.

BACKGROUND: Self-reported weight change may lead to adverse outcomes. We evaluated weight change with cutpoints of low lean mass (LLM) in older adults. METHODS: Of 4984 subjects ≥60 years from NHANES 1999-2004, we applied LLM cutoffs of appendicular lean mass (ALM):body mass index (BMI) males<0.789, females<0.512. Self-reported weight was assessed at time of survey, and questions asked participants their weight one and 10 years earlier, and at age 25. Weight changes were categorized as greater/less/none than 5%. Logistic regression assessed weight change (gain, loss, no change) on LLM, after adjustment. RESULTS: Of 4984 participants (56.5% female), mean age and BMI were 71.1 years and 28.2 kg/m2. Mean ALM was 19.7 kg. In those with LLM, 13.5% and 16.3% gained/lost weight in the past year, while 48.9% and 19.4% gained/lost weight in the past decade. Compared to weight at age 25, 85.2 and 6.1% of LLM participants gained and lost ≥5% of their weight, respectively. Weight gain over the past year was associated with a higher risk of LLM (OR 1.35 [0.99,1.87]) compared to weight loss ≥5% over the past year (0.89 [0.70,1.12]). Weight gain (≥5%) over 10-years was associated with a higher risk of LLM (OR 2.03 [1.66, 2.49]) while weight loss (≥5%) was associated with a lower risk (OR 0.98 [0.76,1.28]). Results were robust compared to weight at 25 years (gain OR 2.37 [1.76,3.20]; loss OR 0.95 [0.65,1.39]). CONCLUSION: Self-reported weight gain suggests an increased risk of LLM. Future studies need to verify the relationship with physical function.

Effectiveness of Ambulatory Telemedicine Care in Older Adults: A Systematic Review.

BACKGROUND: Disparities in healthcare access and delivery, caused by transportation and health workforce difficulties, negatively impact individuals living in rural areas. These challenges are especially prominent in older adults. DESIGN: We systematically evaluated the feasibility, acceptability, and effectiveness in providing telemedicine (TMed), searching the English-language literature for studies (January 2012 to July 2018) in the following databases: Medline (PubMed); Cochrane Library (Wiley); Web of Science; CINAHL; EMBASE (Ovid); and PsycINFO (EBSCO). PARTICIPANTS: Older adults (mean age = 65 years or older, and none were younger than 60 years). INTERVENTIONS: Interventions consisted of live, synchronous, two-way videoconferencing communication in nonhospital settings. All medical interventions were included. MEASUREMENTS: Quality assessment, using the Cochrane Collaboration's Risk-of-Bias Tool, was applied on all included articles, including a qualitative summary of all articles. RESULTS: Of 6616 citations, we reviewed the full text of 1173 articles, excluding 1047 that did not meet criteria. Of the 17 randomized controlled trials, the United States was the country with the most trials (6 [35%]), with cohort sizes ranging from 3 to 844 (median = 35) participants. Risk of bias among included studies varied from low to high. Our qualitative analysis suggests that TMed can improve health outcomes in older adults and that it could be used in this population. CONCLUSIONS: TMed is feasible and acceptable in delivering care to older adults. Research should focus on well-designed randomized trials to overcome the high degree of bias observed in our synthesis. Clinicians should consider using TMed in routine practice to overcome barriers of distance and access to care. J Am Geriatr Soc 67:1737-1749, 2019.