What determines participation in sport for older adults in England: A multilevel analysis of Active Lives data.

Physical inactivity within an ageing population is an ongoing public health concern for policymakers. Engagement in sport forms a foundation of policy designed to encourage physical activity participation and improve health and wellbeing. This study aimed to (i) understand the extent to which older adults participate in sport and the (ii) correlates that predict this involvement within an English population sample of older adults. A further aim was (iii) to examine the extent in which sports participation may vary due to the opportunity provided across Active Partnerships in England. To address this, a multi-level analysis framed through COM-B was conducted of the 2021 English Active Lives dataset (i.e., during the COVID-19 pandemic). The Active Lives survey provides population-level insight into sport, exercise, and physical activity participation across England. It samples upwards of n = 180,000 participants beyond the age of 16 years and asks questions on factors that influence participation. Our findings drawn from a sample of n = 68,808 older adults (i.e., >60-years of age) indicate that when accounting for variation across regions sports participation was significantly predicted by age (ß = -.246, p = .040) and multiple deprivation (ß = .706, p = .030). Further, our analysis suggests sports participation across regions is associated with changes in the perceptions of opportunity to participate (ß = -28.70, p = .001). As the UK transitions from the COVID-19 pandemic, findings have implications for the promotion of sports participation for older adults, in that local, regional, and national stakeholders must do more to change perceptions of social and physical opportunity within an ageing population. This may be achieved through adaptations to the recreational sporting landscape, raising awareness, and supportive policy changes on a national level.

Physical Activity Patterns Within Dementia Care Dyads.

Previous research has explored the physical activity habits of people with dementia and their family carers separately, with little consideration of how physical habits are associated within dyads. In this observational study, we sought to explore the relationship between people with dementia and their carers' physical activity, at a group level and at a dyadic level. Twenty-six participant dyads (persons with dementia and their carer spouses) were asked to wear an accelerometer for 30 days continuously. Comparisons were made at a group level and a dyadic level. People with dementia did not participate in significantly more moderate to vigorous physical activity (M = 15.44 min/day; SD = 14.40) compared with carers (M = 17.95 min/day; SD = 17.01). Within dyads, there were moderately strong associations between daily moderate to vigorous physical activity (r = .48-.54), but not with overall activity levels (r = .24). Despite physical activity habits remaining relatively low within people with dementia and carers, respectively, moderate to vigorous physical activity levels appear to be correlated within dyads. Understanding mutual influence on physical activity levels within dyads is an important pathway to promote an active lifestyle.

The effect of learning to drum on behavior and brain function in autistic adolescents.

This current study aimed to investigate the impact of drum training on behavior and brain function in autistic adolescents with no prior drumming experience. Thirty-six autistic adolescents were recruited and randomly assigned to one of two groups. The drum group received individual drum tuition (two lessons per week over an 8-wk period), while the control group did not. All participants attended a testing session before and after the 8-wk period. Each session included a drumming assessment, an MRI scan, and a parent completing questionnaires relating to the participants' behavioral difficulties. Results showed that improvements in drumming performance were associated with a significant reduction in hyperactivity and inattention difficulties in drummers compared to controls. The fMRI results demonstrated increased functional connectivity in brain areas responsible for inhibitory control, action outcomes monitoring, and self-regulation. In particular, seed-to-voxel analyses revealed an increased functional connectivity in the right inferior frontal gyrus and the right dorsolateral prefrontal cortex. A multivariate pattern analysis demonstrated significant changes in the medial frontal cortex, the left and right paracingulate cortex, the subcallosal cortex, the left frontal pole, the caudate, and the left nucleus accumbens. In conclusion, this study investigates the impact of a drum-based intervention on neural and behavioral outcomes in autistic adolescents. We hope that these findings will inform further research and trials into the potential use of drum-based interventions in benefitting clinical populations with inhibition-related disorders and emotional and behavioral difficulties.

Associations between social support provided and walkability among older adults: Health self-consciousness as a moderator.

BACKGROUND: The social support provided or given to others play a key role in healthy ageing. Empirical and anecdotal evidence suggests that walkable neighbourhoods can positively influence social support given. Higher health self-consciousness may strengthen the positive association between walkability and social support provided. AIM: This study investigated whether the association between walkability and social support provided is moderated by health self-consciousness. METHODS: A cross-sectional design with sensitivity analysis and recommended procedures against common methods bias was employed. The study's population was community-dwelling older adults living in Accra, Ghana. Data from 923 participants were analysed using the hierarchical linear regression analysis. FINDINGS: The study found a positive association between walkability and social support provided after adjusting for the ultimate confounding variables. Health self-consciousness positively moderated the association between walkability and social support provided. CONCLUSION: The study concludes that social support provided in older adults may be higher in more walkable neighbourhoods. Health self-consciousness can enhance the contribution of walkability to social support provided. Our results reinforce the importance of campaigns aimed at improving walkability of neighbourhoods.

The Relationship Between Physical Activity and Health-Related Quality of Life in People With Dementia: An Observational Study.

Recent research suggests the positive effect of physical activity on health-related quality of life in people with dementia may be mediated through improved activities of daily living and reduced depressive symptoms. One hundred and twenty-four people with dementia and their informal carers were recruited from the South East of England for this observational study. A subset of participants wore an accelerometer for 30 days. A series of bivariate analyses were completed, alongside mediation analyses. In people with mild to moderate severity dementia, weak positive associations were widely reported between physical activity indices and health-related quality of life, though only a single association reached statistical significance (rs = .25, p = .03). Mediation analysis revealed no significant indirect effects across the models after controlling for cognition. Future research needs to explore such relationships with a greater emphasis on the modality and psychosocial components of physical activity rather than just frequency, duration, and intensity.

Tailoring Sexual Health Interventions for Middle-Aged and Older Adults, Including Vulnerable Populations: A Scoping Review.

Objective: This scoping review aims to synthesize existing literature on good practice in sexual health interventions for adults over 45 years and in vulnerable groups. Methods: Using PRISMA-ScR guidelines, search terms focused on sexual health, good practice, and vulnerable groups, in over-45s. Results: Of the nine studies that met the inclusion criteria, seven were focused on HIV and risk reduction. Use of alternative methods of communication, alongside inclusion of behavioral and cognitive measures such as condom use and perceived stigma, was key to tailoring interventions. Conclusions: This review highlights the imperative for further research on sexual health interventions with these overlooked populations.

Barriers, motivators and facilitators of physical activity in people with dementia and their family carers in England: dyadic interviews.

INTRODUCTION: Physical activity may have a number of physical and mental health benefits for people with dementia and their carers. However, there is limited evidence about factors that influence physical activity participation in these groups. This study therefore looks at the barriers, facilitators and motivators of physical activity in people with dementia, from both the perspective of the person with dementia and their carer. METHOD: Thirty participants (15 sets of community-dwelling people with dementia and their family carers) were recruited from the South East of England. The participants took part in semi-structured dyadic interviews about their views of physical activity. Interviews were analysed using inductive thematic analysis at an individual level and comparisons were made between the groups. RESULTS: Common motivator themes across persons with dementia and family carers were emotional and physical wellbeing, and social connectedness. Physical health was seen as a common barrier in both groups. Physical activity in the person with dementia was encouraged and supported by the family carer. For the carer, their caring role, and limited time acted as barriers to their participation. CONCLUSION: Themes such as social connectedness, positive emotion and health were seen as key motivators to physical activity, which indicate that people with dementia and carers use physical activity as a means to maintain and improve their quality of life. Supporting family members to better facilitate such activities could encourage physical activity in people with dementia.

Drum training induces long-term plasticity in the cerebellum and connected cortical thickness.

It is unclear to what extent cerebellar networks show long-term plasticity and accompanied changes in cortical structures. Using drumming as a demanding multimodal motor training, we compared cerebellar lobular volume and white matter microstructure, as well as cortical thickness of 15 healthy non-musicians before and after learning to drum, and 16 age matched novice control participants. After 8 weeks of group drumming instruction, 3 ×30 minutes per week, we observed the cerebellum significantly changing its grey (volume increase of left VIIIa, relative decrease of VIIIb and vermis Crus I volume) and white matter microstructure in the inferior cerebellar peduncle. These plastic cerebellar changes were complemented by changes in cortical thickness (increase in left paracentral, right precuneus and right but not left superior frontal thickness), suggesting an interplay of cerebellar learning with cortical structures enabled through cerebellar pathways.

Acceptability and feasibility of wearing activity monitors in community-dwelling older adults with dementia.

OBJECTIVES: Measuring physical activity is complicated particularly in people with dementia, where activity levels are low and subjective measures are susceptible to inaccurate recall. Activity monitors are increasingly being used within research; however, it is unclear how people with dementia view wearing such devices and what aspects of the device effect wear time. The aim of the study was to evaluate the acceptability and feasibility of people with dementia wearing activity monitors. METHODS: Twenty-six, community-dwelling, people with mild dementia were asked to wear an activity monitor (GENEactiv Original) over a 1-month period. Perceptions of the device were measured using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) 2.0, alongside qualitative interviews. Device diary and activity monitor data were used to assess compliance. RESULTS: Participants tended to find wearing the activity monitors acceptable, with only three participants (12%) withdrawing prior to the study end date. Participants were generally satisfied with wearing the devices as measured by the QUEST (Mdn = 4.4, IQR = 1.1). Four themes were identified that influenced perceptions of wearing the device: external influences, design, routine, and perceived benefits. DISCUSSION: Asking people with dementia to wear a wrist-worn activity monitor for prolonged periods appears to be both feasible and acceptable. Researchers need to consider the needs and preferences of the sample population prior to selecting activity monitors.

Use of Physical Activity Questionnaires in People With Dementia: A Scoping Review.

Physical activity questionnaires are an important means to assess habitual physical activity. It remains unclear what questionnaires are used and whether they are appropriate for people with dementia who have impaired information recall but are also often largely sedentary. This scoping review aimed to identify and quantify the use of physical activity questionnaires within a dementia population. Eighteen studies met the inclusion criteria for this review. The majority of studies used questionnaires that were validated for use within an older adult population (e.g., Modified Baecke Questionnaire for the Elderly), though none had specifically been validated for use in people with dementia. Interestingly, just over half of the studies (N = 10, 55.6%) adapted the questionnaires from the original validated version by allowing a proxy to provide input to the responses. Future research needs to robustly validate the use of proxy-report measures of physical activity in people with dementia.

The Validity of Consumer-Level Activity Monitors in Healthy Older Adults in Free-Living Conditions.

Consumer-level activity monitors, such as Fitbit and Misfit devices, are a popular and low-cost means of measuring physical activity. This study aims to compare the accuracy of step counts from two consumer-level activity monitors against two reference devices in healthy, community-dwelling older adults in free-living conditions. Twenty-five older adults (aged 65-84) simultaneously wore 5 devices (e.g., Misfit Shine and Fitbit Charge HR) over 7 consecutive days. All consumer-level activity monitors positively correlated with reference devices (p < .001). There was also substantial to near perfect agreement between all consumer-level activity monitors and reference devices. Compared to the ActiGraph GT3X+, the waist-worn Misfit Shine displayed the highest agreement amongst the devices worn (ICC = 0.96, 95% 0.91 to 0.99). The wrist-worn devices showed poorer agreement to reference devices. Future research needs to consider that not all consumer-level activity monitors are equal in terms of accuracy, design, and function.

Rock drumming enhances motor and psychosocial skills of children with emotional and behavioral difficulties.

Objectives: Drumming may have therapeutic and learning benefits but there exists little causal evidence regarding the benefits for children with emotional and behavioral difficulties (EBD) such as Autistic Spectrum Disorder. Methods: Six EBD pupils (EBD Drum) and six peers (Peer Drum) were given 2, 30-min rock drumming lessons per week, over 5 weeks. Six matched individuals received no drumming instruction (3 = EBD Control; 3 = Peer Control). An exploratory, mixed-methods analysis was used to explore quantitative changes in skills and qualitative perspectives of the teaching staff. All pupils were tested two times (pretest and posttest) on drumming ability and Motor skills (Movement Assessment Battery for Children, version 2). Teacher's rating of social behavior (Strength and Difficulties Questionnaire; SDQ) was tested two times (pretest and retention). Results: Significant differences in total SDQ difficulties between the four groups (χ2(3) = 8.210, p = 0.042) and the hyperactivity subscale (χ2(3) = 10.641, p = 0.014) were observed. The EBD Drum group had greater reductions in total difficulties compared to the Peer Drum (p = 0.009) group and specifically greater reductions in hyperactivity compared to Peer Drum (p = 0.046) and the EBD Control (p = 0.006) group. In follow-up interviews, staff spoke positively about changes in pupil's attitudes toward learning and social confidence. Conclusions: The positive changes to social and behavioral skills reported in this pilot study are similar to those recorded for other music modalities.

Motor Learning Induces Plasticity in the Resting Brain-Drumming Up a Connection.

Neuroimaging methods have recently been used to investigate plasticity-induced changes in brain structure. However, little is known about the dynamic interactions between different brain regions after extensive coordinated motor learning such as drumming. In this article, we have compared the resting-state functional connectivity (rs-FC) in 15 novice healthy participants before and after a course of drumming (30-min drumming sessions, 3 days a week for 8 weeks) and 16 age-matched novice comparison participants. To identify brain regions showing significant FC differences before and after drumming, without a priori regions of interest, a multivariate pattern analysis was performed. Drum training was associated with an increased FC between the posterior part of bilateral superior temporal gyri (pSTG) and the rest of the brain (i.e., all other voxels). These regions were then used to perform seed-to-voxel analysis. The pSTG presented an increased FC with the premotor and motor regions, the right parietal lobe and a decreased FC with the cerebellum. Perspectives and the potential for rehabilitation treatments with exercise-based intervention to overcome impairments due to brain diseases are also discussed.

Older adults' satisfaction of wearing consumer-level activity monitors.

There is a growing body of evidence to suggest that consumer-level activity monitors are a valid means of measuring physical activity in older adults. Understanding whether older adults are satisfied with wearing these activity monitors is an important step to ensuring that devices can be successfully implemented in clinical and research settings. Twenty-five older adults (mean age = 72.5 years, standard deviation = 4.9) wore two consumer-level activity monitors (Misfit Shine and Fitbit Charge HR) for seven consecutive days. After the week, participants were asked for their views and satisfaction of wearing each device, measured in part by the Quebec User Evaluation of Satisfaction with assistive Technology. Participants were generally satisfied with most aspects of the devices, though they were significantly more satisfied with the Misfit Shine. Participants were critical about their ability to adjust the fit of both the Misfit Shine and Fitbit Charge HR. Interestingly, the perceived satisfaction with the device was not associated with participants' consideration of wearing the device again. Future research needs to consider whether the design of consumer-level activity monitors are best suited for older adults.

Walking on prescription: the utility of a pedometer pack for increasing physical activity in primary care.

OBJECTIVE: This study used a multi-method approach to examine the effectiveness of a pedometer-based intervention delivered by health professionals for increasing walking. METHODS: Pedometer packs were distributed to 374 patients who undertook a 12-week walking programme. Changes in walking were assessed at three months (using self-reported step-counts [n=139] and questionnaire data [n=104]) and at six months (using patient questionnaire data [n=112]). Qualitative data were collected at both time points to identify underlying mechanisms. RESULTS: After 12 weeks patients had increased their step-counts by 4532 steps/day (p<.001) and at six months were achieving 2977 more steps/day (equivalent to around 30 min/day) than at baseline. Over half the patients reported achieving this target on at least 5 days/week. Qualitative data indicated that the pedometer pack was perceived to be most effective when patients were ready to change and when ongoing support was made available. CONCLUSION: These findings support the use of pedometer-based interventions in primary care and suggest that the pedometer pack could lead to sustainable changes in walking. Further investigation, using a randomised controlled trial design, is warranted. PRACTICE IMPLICATIONS: Provision of social support and accurate identification of patient readiness to change are important considerations in future implementation of the intervention.

The effect of a pedometer-based community walking intervention "Walking for Wellbeing in the West" on physical activity levels and health outcomes: a 12-week randomized controlled trial.

BACKGROUND: Recent systematic reviews have suggested that pedometers may be effective motivational tools to promote walking. However, studies tend to be of a relatively short duration, with small clinical based samples. Further research is required to demonstrate their effectiveness in adequately powered, community based studies. OBJECTIVE: Using a randomized controlled trial design, this study assessed the impact of a 12-week graduated pedometer-based walking intervention on daily step-counts, self-reported physical activity and health outcomes in a Scottish community sample not meeting current physical activity recommendations. METHOD: Sixty-three women and 16 men (49.2 years +/- 8.8) were randomly assigned to either an intervention (physical activity consultation and 12-week pedometer-based walking program) or control (no action) group. Measures for step-counts, 7-day physical activity recall, affect, quality of life (n = 79), body mass, BMI, % body fat, waist and hip circumference (n = 76), systolic/diastolic blood pressure, total cholesterol and HDL cholesterol (n = 66) were taken at baseline and week 12. Analyses were performed on an intention to treat basis using 2-way mixed factorial analyses of variance for parametric data and Mann Whitney and Wilcoxon tests for non-parametric data. RESULTS: Significant increases were found in the intervention group for step-counts (p < .001), time spent in leisure walking (p = .02) and positive affect (p = .027). Significant decreases were found in this group for time spent in weekday (p = .003), weekend (p = .001) and total sitting (p = .001) with no corresponding changes in the control group. No significant changes in any other health outcomes were found in either group. In comparison with the control group at week 12, the intervention group reported a significantly greater number of minutes spent in leisure time (p = .008), occupational (p = .045) and total walking (p = .03), and significantly fewer minutes in time spent in weekend (p = .003) and total sitting (p = .022). CONCLUSION: A pedometer-based walking program, incorporating a physical activity consultation, is effective in promoting walking and improving positive affect over 12 weeks in community based individuals. The discussion examines possible explanations for the lack of significant changes in health outcomes. Continued follow-up of this study will examine adherence to the intervention and possible resulting effects on health outcomes.

The 'Walking for Wellbeing in the West' randomised controlled trial of a pedometer-based walking programme in combination with physical activity consultation with 12 month follow-up: rationale and study design.

BACKGROUND: Scotland has a policy aimed at increasing physical activity levels in the population, but evidence on how to achieve this is still developing. Studies that focus on encouraging real world participants to start physical activity in their settings are needed. The Walking for Well-being in the West study was designed to assess the effectiveness of a pedometer-based walking programme in combination with physical activity consultation. The study was multi-disciplinary and based in the community. Walking for Well-being in the West investigated whether Scottish men and women, who were not achieving the current physical activity recommendation, increased and maintained walking behaviour over a 12 month period. This paper outlines the rationale and design of this innovative and pragmatic study. METHODS: Participants were randomised into two groups: Group 1: Intervention (pedometer-based walking programme combined with a series of physical activity consultations); Group 2: Waiting list control for 12 weeks (followed by minimal pedometer-based intervention). Physical activity (primary outcome) was measured using pedometer step counts (7 day) and the International Physical Activity Questionnaire (long version). Psychological processes were measured using questionnaires relating to the Transtheoretical Model of Behaviour Change, mood (Positive and Negative Affect Schedule) and quality of life (Euroqol EQ-5D instrument). Physiological measures included anthropometric and metabolic outcomes. Environmental influences were assessed subjectively (Neighbourhood Quality of Life Survey) and objectively (neighbourhood audit tool and GIS mapping). The qualitative evaluation employed observation, semi-structured interviews and focus groups. A supplementary study undertook an economic evaluation. DISCUSSION: Data analysis is on-going. Walking for Well-being in the West will demonstrate if a pedometer based walking programme, in combination with physical activity consultation results in a sustainable increase in walking behaviour in this sample of Scottish adults over a 12 month period. The study will examine the complex relationships between behavioural change, health consequences and the role of the environment, in conjunction with the cost effectiveness of this approach and a detailed insight into the participants' experiences of the intervention. TRIAL REGISTRATION: Current Controlled Trials ISRCTN88907382.