Effective interventions for indicated fall prevention are necessary for older adults with frailty. We aimed to determine the effectiveness of a Multi-system Physical Exercise (MPE) for fall prevention and Health-Related Quality of Life (HRQOL) in pre-frail older adults. This randomized control trial with allocation concealment included 72 adults aged 65 and above, identified as pre-frailty and with mild and moderate fall risk scores measured by the Physiological Profile Assessment (PPA). Randomly, using block randomization, participants were divided into two groups: an MPE group (n = 36) and a control group (n = 36). The intervention consisted mainly of proprioception, muscle strengthening, reaction time, and balance training and was carried out three days per week for 12 weeks. The primary outcome was fall risk assessed using PPA at 12 weeks post-baseline and at a 24 week follow-up. Significant differences were found in the improvement in fall risk, proprioception, muscle strength, reaction time and postural sway, and fear of fall scores in the MPE group compared with controls at week 12 and 24. In addition, HRQOL had increased significantly in the MPE group in comparison to controls. The MPE program significantly increased muscle strength and improved proprioception, reaction time, and postural sway leading to fall risk reduction in older adults with pre-frailty. Therefore, the MPE program is recommended for used in day-to-day primary care practice in the pre-frail population.

Introduction. Frailty is a condition in older adults with decreased physical and cognitive performance that can affect health outcomes associated with fracture, disability, and falls. The aim of this study was to compare fall risk with different physical frailty statuses and investigate factors associated with fall risk in community-dwelling older adults. Methods. The population studied included 367 older adults (mean age = 73.2 years ± 7.0; 237 females (64.6%) and 130 males (35.4%)) who live in Chiang Mai, Thailand. This study was of cross-sectional design. Fried’s phenotype was used to screen the physical frailty status. The physiological profile assessment (PPA) was used to screen for fall risk. One-way ANOVA analysis was used to compare the fall risk between the different levels of frailty status. Linear regression analysis was used to assess the association between frailty status and fall risk. Results. The prevalence of the frailty group was 8.7% and that of the prefrailty group was 76.8%. The three statuses of frailty identified were found to have different levels of risk of falling. The frailty group had a higher fall risk than the nonfrailty group and the prefrailty group. In addition, the nonfrailty group had a lower fall risk than the prefrailty group. Conclusion. The frailty group had the highest fall risk in this cohort of older adults living in a community-dwelling facility. Therefore, it is important to assess the frailty status among older adults as it can be a predictor for fall risk. This assessment will therefore lead to a reduction in the rate of disability and death in the community.

This study aims to determine the impact of COVID-19 on the daily lives, agricultural working lives, and mental health of farmers in northern Thailand. This cross-sectional study was carried out in September and October 2021 by interviews. From the stratified random sampling, 2046 farmers responded. There were five sections on the interview form, including demographics, daily life, agricultural working life, stress, and depression experienced during the COVID-19 pandemic. The results show that COVID-19 negatively affected the daily lives of the farmers, making it worse by 61.2%. COVID-19 increased the cost of planting (57.4%) and the cost of agrochemicals and fertilizers (69.9%). It also decreased the prices of agricultural products (73.5%) as well as agricultural extensions (66.5%). The markets and logistics of agricultural products during the pandemic were more difficult than before it (72.8% and 65.1%, respectively). Half of the farmers (50.3%) had moderate stress, and the highest scores were for the loss of household income (mean ± SD = 3.92 ± 0.94) and increased household expenses (mean ± SD = 3.92 ± 0.98). With regard to depression, 19.6% of farmers had depressive symptoms, and the multivariate analysis shows that the mental health of farmers was associated with the changes in their daily and agricultural working lives, as well as with financial problems. The remarkable findings indicate that the farmers who had high and extremely high stress levels had a higher prevalence of depression than the farmers who had no stress (adj.OR = 10.10 and 22.45, respectively). Our results lead to the conclusion that the COVID-19 crisis had an impact on the daily lives, agricultural working lives, and mental health of farmers. The results of this study can be used to provide pertinent guidance, and they have implications for government and other relevant organizations in their COVID-19 efforts to improve agricultural systems and sustain the mental health of farmers.

Aging is a time-dependent functional decline in muscle mass and strength, which is reflected in poor physical performances, hormonal imbalance, and development of chronic low-grade inflammation. This study aimed to assess the effectiveness of black rice germ, bran supplement, and exercise program either alone or in combination for 24 weeks on the aging biomarkers (C-reactive protein, Interleukin-6, Insulin-like growth factor-1, and CD4:CD8 T cell ratio) physical performance, muscle strength parameters (walking speed, sit-to-stand time, grip strength) among Thai aging population. A total of 120 healthy volunteers aged 65–74 years were assigned to the exercise group (EX), black rice germ, and bran supplement (BR) group or the combination of BR and EX group (BR + EX). Over the course of the 24-week intervention, compared with baseline data (T0), the combined BR + EX intervention significantly decreased the inflammatory biomarkers (C-reactive protein and interleukin-6 levels, both p < 0.05 vs. T0) and significantly increased the insulin-like growth factor-1 levels (p < 0.001 vs. T0). Significant improvement in physical performance and muscle strength were also observed in the combined BR + EX group (decrease in sit-to-stand time and gait speed over the 24-week intervention, both p < 0.05 vs. T0, and trend toward grip strength improvement at p = 0.088 vs. T0). Overall, our results indicated a synergistic effect towards the combined intervention with the sustainable improvement in physical performances, lower-body muscle strength, and the modulation of both inflammatory and endocrine biomarkers. This study could encourage older adults to change their lifestyles to improve healthy aging and longevity.

Inappropriate use of personal protective equipment (PPE) among pesticide applicators may increase urinary organophosphate (OP) metabolite levels and subsequently increase risks of cognitive performance. Therefore, this study aims to (1) compare urinary OP metabolite levels and cognitive performance between pre-and post-pesticide application seasons; (2) PPE use and factors associated with PPE use linked to increased urinary OP metabolite levels during pesticide application; and (3) the association between urinary OP metabolite levels and cognitive performance. This longitudinal follow-up study on 79 pesticide applicators was carried out between October 2021 and January 2022. The applicators were interviewed, collected urine samples, and tested for cognitive performance in pre-and post-pesticide application seasons. The results found that the levels of urinary OP metabolites in post-application season were significantly higher than those in pre-application season (p &lt; 0.001). Multiple linear regression analysis found that increased total diethylphosphate (DEP) and total dialkylphosphate (DAP) levels were associated with not wearing gloves while mixing pesticides [beta (β) ± standard error (SE) = −43.74 ± 18.52, 95% confidence interval (95% CI) = −80.84, −6.64 for total DEP and −50.84 ± 19.26, 95% CI = −89.41, −12.26 for total DAP] and also with not wearing a mask while spraying pesticides (β ± SE = −31.76 ± 12.24, 95% CI = −56.28, −7.24 for total DEP and −33.20 ± 12.63, 95% CI = −58.49, −7.92 for total DAP) after adjusting for covariates. The scores of Montreal Cognitive Assessment-Thai, Thai Mental State Examination, and Mini-Cognitive test in post-pesticide application were significantly lower than those in pre-pesticide application (p &lt; 0.001). However, no association was found between urinary OP metabolite levels and cognitive decline. Our findings indicate that inappropriate PPE use during pesticide application was the major factor affecting urinary OP metabolite levels among pesticide applicators. Wearing gloves when mixing pesticides and a mask when spraying pesticides were key factors in reducing occupational exposure to OP. Exposure to OP at low levels and for short periods of exposure may not affect cognitive performance significantly. Therefore, long-term exposure and exposure to high levels of OP should be investigated further.