Assessment of a Community-Based Exercise Program for Older Adults in a Mixed Rural/Urban Catchment Area: Silver Sneakers in Central Pennsylvania

Flores, Eileen; Nakagawa, Sage; Moyer, Robinn E.; Bluethmann, Shirley M.

doi:10.5888/pcd19.210283

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…Physical activity interventions conducted in a group setting and other active interventions with social components have the potential to target both loneliness and physical activity. Some physical activity programs, such as SilverSneakers, are covered by health plans and can be accessed by Medicare Advantage beneficiaries ( 55 ) and others are offered for nominal fees via older adult centers available to local older adults in a group setting. Additionally, the use of virtual physical activity programs has proliferated since the onset of the pandemic and has the potential to connect older adults who are less mobile or live in remote settings ( 56 ).…”

Section: Discussionmentioning

confidence: 99%

Loneliness predicts decreased physical activity in widowed but not married or unmarried individuals

Pollak,

Verghese,

Blumen

2024

Front. Public Health

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BackgroundPhysical activity is associated with improved health and function in older adults, yet most older adults are sedentary. Loneliness is associated with decreased physical activity at the cross-section, but longitudinal studies are scarce. We examined longitudinal associations between loneliness and physical activity—and whether they were modified by marital status and network size (the number of children, relatives, and friends a person interacts with at least once a month).MethodsWe analyzed data from 1,931 older adults without dementia at baseline from the Rush Memory and Aging Project with a mean follow-up of 4.8 years (mean age 79.6 ± 7.7, 74.9% women). Loneliness was assessed using the de Jong Gierveld Loneliness Scale. Physical activity was assessed as the frequency with which participants engaged in five categories of activities (e.g., walking, gardening, calisthenics, bicycling, and swimming). Linear mixed effects models examined associations between baseline loneliness and change in physical activity over time after adjusting for demographics, depressive symptoms, global cognition, disability, network size, marital status, social support, and social and cognitive activities. We assessed for effect modification by marital status and network size.ResultsAssociations between loneliness and physical activity differed by marital status. In widowed individuals, baseline loneliness was associated with a 0.06 h/week greater decrease in physical activity per year compared to those who were not lonely (p = 0.005, CI -0.1, 0.02)—which equaled a 150% decrease in physical activity per year. Loneliness did not predict a statistically significant decrease in physical activity in married or unmarried individuals.DiscussionLoneliness is associated with decreased physical activity in widowed older adults and should be considered in the design of interventions to prevent or slow the decline in physical activity and promote healthy aging.

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Section: Discussionmentioning

confidence: 99%

Loneliness predicts decreased physical activity in widowed but not married or unmarried individuals

Pollak,

Verghese,

Blumen

2024

Front. Public Health

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“…Finally, older adult physical activity was emphasized again in 2018 with the updated Guidelines (U.S. Department of Health and Human Services, 2018). Along with these federal initiatives, the proliferation of evidence-based exercise and physical activity programs for older adults, such as Silver-Sneakers (Flores et al, 2022), EnhanceFitness (Snyder et al, 2014), and Walk with Ease (Arthritis Foundation, 2002) may have also contributed to increasing physical activity levels over the past two decades. Throughout the observation period, males had a higher prevalence of meeting guidelines than females.…”

Section: Discussionmentioning

confidence: 99%

Meeting the Aerobic and Muscle-Strengthening Physical Activity Guidelines Among Older US Adults, National Health Interview Survey 1998–2018

Hyde,

Brown,

Webber

et al. 2024

J Appl Gerontol

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The Physical Activity Guidelines for Americans, second edition, recommends older adults participate in ≥150 minutes per week of moderate-intensity equivalent aerobic activity and ≥2 days per week of muscle-strengthening activity. We estimated prevalence and trends of meeting the guidelines among US adults aged ≥65 years from 1998 to 2018. Using the 1998–2018 National Health Interview Survey, we estimated the prevalence of meeting aerobic, muscle-strengthening, and combined physical activity guidelines stratified by age group, sex, race and ethnicity, and education level. Within age groups, we calculated prevalence differences by sociodemographic categories. Prevalence of meeting each guideline increased for all age groups and most sociodemographic subgroups. The increased magnitude of meeting the combined guideline from 1998–2000 to 2016–2018 differed across levels of educational attainment for most age groups. Despite increasing over time, the prevalence among older adults of meeting physical activity guidelines remains low (range for combined guideline: 7.2%–17.2%).

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“…79 A retrospective cohort study in Washington state found an association between intermittent Silver Sneakers use and lower falls risk compared with nonusers (HR, 0.93; 95% CI, 0.90-0.97; absolute benefit not reported). 80 Free online fall exercise programs are available for those in rural areas or those without reliable transportation 81 although effectiveness data are lacking. Home safety evaluations by occupational therapy can be ordered for homebound older adults who are receiving skilled home care services.…”

Section: Practical Considerations and Application Of Evidencementioning

confidence: 99%

Risk Assessment and Prevention of Falls in Older Community-Dwelling Adults

Colón-Emeric,

McDermott,

Lee

et al. 2024

JAMA

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ImportanceFalls are reported by more than 14 million US adults aged 65 years or older annually and can result in substantial morbidity, mortality, and health care expenditures.ObservationsFalls result from age-related physiologic changes compounded by multiple intrinsic and extrinsic risk factors. Major modifiable risk factors among community-dwelling older adults include gait and balance disorders, orthostatic hypotension, sensory impairment, medications, and environmental hazards. Guidelines recommend that individuals who report a fall in the prior year, have concerns about falling, or have gait speed less than 0.8 to 1 m/s should receive fall prevention interventions. In a meta-analysis of 59 randomized clinical trials (RCTs) in average-risk to high-risk populations, exercise interventions to reduce falls were associated with 655 falls per 1000 patient-years in intervention groups vs 850 falls per 1000 patient-years in nonexercise control groups (rate ratio [RR] for falls, 0.77; 95% CI, 0.71-0.83; risk ratio for number of people who fall, 0.85; 95% CI, 0.81-0.89; risk difference, 7.2%; 95% CI, 5.2%-9.1%), with most trials assessing balance and functional exercises. In a meta-analysis of 43 RCTs of interventions that systematically assessed and addressed multiple risk factors among individuals at high risk, multifactorial interventions were associated with 1784 falls per 1000 patient-years in intervention groups vs 2317 falls per 1000 patient-years in control groups (RR, 0.77; 95% CI, 0.67-0.87) without a significant difference in the number of individuals who fell. Other interventions associated with decreased falls in meta-analysis of RCTs and quasi-randomized trials include surgery to remove cataracts (8 studies with 1834 patients; risk ratio [RR], 0.68; 95% CI, 0.48-0.96), multicomponent podiatry interventions (3 studies with 1358 patients; RR, 0.77; 95% CI, 0.61-0.99), and environmental modifications for individuals at high risk (12 studies with 5293 patients; RR, 0.74; 95% CI, 0.61-0.91). Meta-analysis of RCTs of programs to stop medications associated with falls have not found a significant reduction, although deprescribing is a component of many successful multifactorial interventions.Conclusions and RelevanceMore than 25% of older adults fall each year, and falls are the leading cause of injury-related death in persons aged 65 years or older. Functional exercises to improve leg strength and balance are recommended for fall prevention in average-risk to high-risk populations. Multifactorial risk reduction based on a systematic clinical assessment for modifiable risk factors may reduce fall rates among those at high risk.

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Assessment of a Community-Based Exercise Program for Older Adults in a Mixed Rural/Urban Catchment Area: Silver Sneakers in Central Pennsylvania

Cited by 3 publications

References 10 publications

Loneliness predicts decreased physical activity in widowed but not married or unmarried individuals

Loneliness predicts decreased physical activity in widowed but not married or unmarried individuals

Meeting the Aerobic and Muscle-Strengthening Physical Activity Guidelines Among Older US Adults, National Health Interview Survey 1998–2018

Risk Assessment and Prevention of Falls in Older Community-Dwelling Adults

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