Human movement behaviours such as physical activity (PA) and sedentary behaviour (SB) during waking time have a significant impact on health-related quality of life (HRQoL) in older adults. In this study, we aimed to analyse the association between self-reported and device-measured SB and PA with HRQoL in a cohort of community-dwelling older adults from four European countries. A subsample of 1193 participants from the SITLESS trial (61% women and 75.1 ± 6.2 years old) were included in the analysis. The association between self-reported and objective measures of SB and PA with HRQoL were quantified using Spearman’s Rho coefficients. The strength of the associations between self-reported and device-measured PA and SB with self-rated HRQoL (mental composite score, MCS; physical composite score, PCS) were assessed through multivariate multiple regression analysis. Self-reported and device-measured PA and SB levels showed significant but poor associations with PCS (p < 0.05). The association with MCS was only significant but poor with self-reported light PA (LPA) and moderate-to-vigorous PA (MVPA). In conclusion, the findings of this study suggest that both self-reported and device-measured PA of all intensities were positively and significantly associated, while SB was negatively and significantly associated with the PCS of the SF-12.

BackgroundSelf-reported disability has a strong negative impact on older people’s quality of life and is often associated with the need for assistance and health care services. Resistance training (RT) has been repeatedly shown to improve muscle function (e.g. strength) and functional capacity (e.g. gait speed, chair-rise) in older adults with functional limitations. Nevertheless, it is unclear whether such objectively assessed improvements translate into a reduction in self-reported disability.ObjectivesTo assess: i) whether and to what extent RT interventions have an effect on self-reported disability in older adults (≥65 years) with functional limitations or disability; and ii) whether the effects on self-reported disability are associated with changes in objective measures of muscle strength and functional capacity across studies.MethodsPubMed, Embase, Web of Science, CINAHL and SPORTDiscus electronic databases were searched in June 2018. Randomized controlled trials reporting effects of RT on self-reported disability/function in ≥65 year-old adults with defined, functional limitations or self-reported disability were eligible. Data on self-reported disability/function were pooled by calculating adjusted standardized mean differences (SMD) using Hedges’g. Likewise, effect sizes for three secondary outcomes: knee extensor muscle strength; gait capacity; and lower body functional capacity were calculated and fit as covariates in separate meta-regressions with self-reported disability as the dependent factor.ResultsFourteen RCTs were eligible for the primary meta-analysis on self-reported disability. The total number of participants was 651 (intervention n = 354; control n = 297). A significant moderate positive effect of RT was found (SMD: 0.59, 95% CI: 0.253 to 0.925, p = 0.001). Between-study heterogeneity was present (I2 statistic = 75,1%, p <  0.001). RT effects on objective measures of lower body functional capacity were significantly associated with effects on self-reported disability (Adj. R2 = 99%, p = 0.002, n = 12 studies), whereas no significant associations with gait capacity or knee extensor strength were found.ConclusionsThis review provides evidence that RT has a moderate positive effect on self-reported disability/function in old people with or at risk for disability. The effects are strongly associated with effects on objective measures of lower body functional capacity.

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Malnutrition is associated with accelerated loss of physical function in old adults, but the assessment of malnutrition in primary prevention is challenging. This study aimed to investigate if malnutrition risk factors; poor appetite, dysphagia, and poor dental state, were associated with reduced physical function in community-dwelling adults ≥80 years. The study is based on data from two cross-sectional studies. Physical function was assessed by the Short Physical Performance Battery (score ≤ 9 indicate reduced physical function) and poor appetite, dysphagia and poor dental status was assessed by single questions. A total of 900 participants were included (age 85.1 ± 3.7 years; 60.9% females; 62.8% had reduced physical function). Participants with reduced physical function were older, had a higher BMI, more polypharmacy, more falls, and lower quality of life. Poor appetite was reported by 10.8% and associated with reduced physical function (adjusted-OR 1.93, 95%CI 1.18–3.15). No association was identified between dysphagia, poor dental state and reduced physical function (adjusted-OR 0.96, 95%CI 0.53–1.75 and adjusted-OR 0.99, 95%CI 0.41–2.35, respectively). The assessment of appetite during primary preventive strategies was feasible and may offer an opportunity for identification of very old community-dwelling adults at risk of reduced physical function.

Background older adults face several modifiable barriers for engaging in physical activity (PA) programmes such as incontinence, loneliness and fear of falling. Enhancing PA programmes with behavioural components to support self-management of such barriers may increase the effectiveness to preserve functional capacity and independent living. Objective this study aimed at assessing the effects of a complex active lifestyle intervention (CALSTI) on objective and self-report measures of functional capacity and disability in community-dwelling older adults. Subjects and Methods about 215 older adults (79.9 ± 0.4 years) at increased risk of functional decline were randomly allocated to (i) CALSTI consisting of 12-weeks progressive explosive resistance training (24 sessions) enhanced by a 24-week multi-factorial self-management programme (8 sessions), or (ii) an extended version of the self-management intervention (SEMAI; 12 sessions) to reflect a reinforcement of usual care. The interventions were embedded in a nationally regulated preventive care pathway. Blinded assessors collected primary (the Short Physical Performance Battery; SPPB) and secondary outcome data (self-reported difficulty in activities of daily living, the short version of the Late-Life Function and Disability Index, and the EQ-health VAS scale) at baseline and after 12 and 24 weeks. Results after 24 weeks, CALSTI led to a clinically superior increase in SPPB compared with SEMAI (+0.77 points, P &lt; 0.01), and the CALSTI group also demonstrated improvements in selected self-reported outcomes. Conclusions a novel complex exercise and multi-factorial self-management intervention embedded in preventive care practice had large and clinically meaningful effects on a key measure of functional capacity and predictor of disability.