Optimal mobility, defined as relative ease and freedom of movement in all of its forms, is central to healthy aging. Mobility is a significant consideration for research, practice, and policy in aging and public health. We examined the public health burdens of mobility disability, with a particular focus on leading public health interventions to enhance walking and driving, and the challenges and opportunities for public health action. We propose an integrated mobility agenda, which draws on the lived experience of older adults. New strategies for research, practice, and policy are needed to move beyond categorical promotion programs in walking and driving to establish a comprehensive program to enhance safe mobility in all its forms.

There is evidence from observational studies that increasing physical activity may reduce the risk of cognitive decline in older adults. Exercise intervention trials have found conflicting results. A systematic review of physical activity and exercise intervention trials on cognition in older adults was conducted. Six scientific databases and reference lists of previous reviews were searched. Thirty studies were eligible for inclusion. Articles were grouped into intervention-outcome pairings. Interventions were grouped as cardiorespiratory, strength, and multicomponent exercises. Cognitive outcomes were general cognition, executive function, memory, reaction time, attention, cognitive processing, visuospatial, and language. An eight-member multidisciplinary panel rated the quality and effectiveness of each pairing. Although there were some positive studies, the panel did not find sufficient evidence that physical activity or exercise improved cognition in older adults. Future research should report exercise adherence, use longer study durations, and determine the clinical relevance of measures used.

We contribute to knowledge about older adults with chronic illnesses by identifying positive and negative influences of family and friends on self-management. Thirteen focus groups were conducted in upstate New York with 84 African American and White men and women, 65 years old or older, with arthritis, diabetes, and/or heart disease. Specific positive and negative social network influences are discussed in the areas of disease management (medication management, dietary activities, physical activity, and health care appointments); decision-making about the illness; and psychosocial coping. Overall, we found many more positive than negative social network influences, and more negative influences from family members than from friends. We discuss differences between influences of family members versus friends, and point out a few suggestive differences by gender and race. We conclude with limitations of the study as well as implications for the design of self-management interventions involving family members and friends.

Cognitive training slows degradation of balance and improves gait while distracted, rendering it a promising approach to falls prevention.

Background: New strategies to increase physical activity among sedentary older adults are urgently needed. Objective: To examine whether low expectations regarding aging (age‐expectations) are associated with low physical activity levels among older adults. Design: Cross‐sectional survey. Participants: Six hundred and thirty‐six English‐ and Spanish‐speaking adults aged 65 years and above attending 14 community‐based senior centers in the Los Angeles region. Over 44% were non‐Latino whites, 15% were African American, and 36% were Latino. The mean age was 77 years (range 65 to 100). Measurements: Self‐administered written surveys including previously tested measures of age‐expectations and physical activity level in the previous week. Results: Over 38% of participants reported <30 minutes of moderate‐vigorous physical activity in the previous week. Older adults with lower age‐expectations were more likely to report this very low level of physical activity than those with high age‐expectations, even after controlling for the independent effect of age, sex, ethnicity, level of education, physical and mental health–related quality of life, comorbidity, activities of daily living impairment, depressive symptoms, self‐efficacy, survey language, and clustering at the senior center. Compared with the quintile of participants having the highest age‐expectations, participants with the lowest quintile of age‐expectations had an adjusted odds ratio of 2.6 (95% confidence intervals: 1.5, 4.5) of reporting <30 minutes of moderate‐vigorous physical activity in the previous week. Conclusions: In this diverse sample of older adults recruited from senior centers, low age‐expectations are independently associated with very low levels of physical activity. Harboring low age‐expectations may act as a barrier to physical activity among sedentary older adults.

Physical activity offers one of the greatest opportunities for people to extend years of active independent life and reduce functional limitations. The article identifies key practices for promoting physical activity in older adults, with a focus on those with chronic disease or low fitness and those with low levels of physical activity. Key practices identified: (a) A multidimensional activity program that includes endurance, strength, balance, and flexibility training is optimal for health and functional benefits; (b) principles of behavior change including social support, self-efficacy, active choices, health contracts, assurances of safety, and positive reinforcement enhance adherence; (c) manage risk by beginning at low intensity but gradually increasing to moderate physical activity, which has a better risk:benefit ratio and should be the goal for older adults; (d) an emergency procedure plan is prudent for community-based programs; and (e) monitoring aerobic intensity is important for progression and motivation. Selected content review of physical activity programming from major organizations and institutions is provided.

Physical activity offers one of the greatest opportunities for people to extend years of active independent life and reduce functional limitations. The purpose of this paper is to identify key practices for promoting physical activity in older adults, with a focus on older adults with chronic disease or low fitness and those with low levels of physical activity. Key practices identified in promotion activity in older adults include:(1) a multidimensional activity program that includes endurance, strength, balance, and flexibility training is optimal for health and functional benefits; (2) principles of behavior change, including social support, selfefficacy, active choices, health contracts, assurances of safety, and positive reinforcement, enhance adherence;(3) management of risk by beginning at low intensity but gradually increasing to moderate physical activity which has a better risk/benefit ratio should be the goal for older adults; (4) an emergency procedure plan is prudent for community-based programs; and (5) monitoring aerobic intensity is important for progression and for motivation. Selected content reviews of physical activity programming from major organizations and institutions are provided. Regular participation in physical activity is one of the most effective ways for older adults, including those with disabilities, to help prevent chronic disease, promote independence, and increase quality of life in old age.

HYSICAL inactivity in older adults is a major public health concern. Although increasing physical activity (PA) is a national health priority (U.S. Department of Health and Human Services [USDHHS], 2000), promoting activity in older adults has only recently been emphasized, as in the National Blueprint for Increasing Physical Activity in Adults Age 50 and Older (Robert Wood Johnson Foundation, 2001). As a result, the evidence for public health efforts to promote PA for older adults is modest and needs strengthening. In order to inform public health practice, this article presents a position paper of the Centers for Disease Control and Prevention Healthy Aging Research Network on the status of research in PA and aging. The mission of the Healthy Aging Research Network is to better understand the determinants of healthy aging, identify interventions that promote healthy aging, and assist in the translation of such research into sustainable community-based programs.The purpose of this article is to set a research agenda. To do this, we will (a) specify key issues in public health, PA, and aging, (b) identify knowledge needed to make informed public health recommendations and develop PA interventions in older adults, and (c) recommend research priorities to address those gaps. We have organized this article around four questions designed to serve as a framework for a public health agenda in PA and aging: