Objective (246/250)Physical activity (PA), especially moderate-to-vigorous intensity, could protect older adults from cognitive impairment. However, most literature is based on self-reported PA which is limited by recall bias. Light PA is popular among older adults, but a paucity of objective longitudinal data has considered the relationship between light PA and cognitive ability. We examined if a higher level of objectively measured light PA, independent of moderate-to-vigorous physical activity (MVPA), was prospectively associated with better cognitive ability in older adults. MethodsA longitudinal study over 22.12 (±1.46) months including 274 community-dwelling older adults across 14 regions in Taiwan was undertaken. Cognitive ability was obtained using a Chinese version of the Ascertain Dementia 8-item Questionnaire (AD8) and light PA and MVPA captured by 7 days accelerometer positioned on waist. Multivariable negative binomial regression adjusted for confounders were undertaken. ACCEPTED MANUSCRIPT A C C E P T E D M A N U S C R I P T ConclusionOur data suggest that light PA may offer a protective influence of future cognitive ability in community dwelling older adults. The promotion of light PA may be a valuable means to maintain cognitive ability in older age.

BackgroundAlthough advance directives (AD) have been implemented for years in western countries, the concept of AD is not promoted extensively in eastern countries. In this study we evaluate a program to systematically conduct advance care planning (ACP) communication for hospitalized patients in Taiwan and identify the factors associated with AD completion.MethodsIn this retrospective evaluation of a clinical ACP program, we identified adult patients with chronic life-limiting illness admitted to Taipei City Hospital between April 2015 and January 2016. Trained healthcare providers held an ACP meeting to discuss patients’ preference regarding end-of-life care and AD completion. A multiple logistic regression was performed to determine the factors associated with the AD completion.ResultsA total of 2878 patients were determined to be eligible for ACP during the study, among which 1798 (62.5%) completed ACP and data was available for 1411 patients (49.1%). Of the 1411 patients who received ACP communication with complete data, the rate of AD completion was 82.6%. The overall mean (SD) age was 78.2 (14.4) years. Adjusting for other variables, AD completion was associated with patients aged ≥ 85 years [adjusted odds ratio (AOR) = 1.80, 95% CI 1.21–2.67], critical illness (AOR = 1.17, 95% CI 1.06–1.30), and social workers participating in ACP meetings (AOR = 1.74, 95% CI 1.24–2.45).ConclusionThe majority of inpatients with chronic life-limiting illness had ACP communication as part of this ACP program and over 80% completed an AD. Our study demonstrates the feasibility of implementing ACP discussion in East Asia and suggests that social workers may be an important component of ACP communication with patients.

Training workshops in TB control were effective for promotion of knowledge and elimination of stigmatization in first-line caregivers. DOTS workers attached less stigma to TB patients than public health workers, and older workers who had been volunteers attached the least stigma.

Background:The use of self-report measures of physical activity is a serious methodological weakness in many studies of physical activity and depressive symptoms. It is still equivocal whether light physical activity protects older adults from depressive symptoms.Objective: This study aimed to explore whether objectively measured light physical activity, independent of sedentary and moderate-to-vigorous activity, is associated with a reduced risk of subsequent depressive symptoms in older adults. Methods: This was a 2-year prospective cohort study. A total of 285 community-dwelling older adults aged 65 years or older were interviewed in 2012. A second wave of assessment was carried out in 2014 involving 274 (96.1%) participants. Time spent in physical activity at different intensities was assessed using triaxial accelerometers. Depressive symptoms were measured using the 15-item Geriatric Depression Scale. Negative binomial regression models with adjustment for baseline depressive symptoms, accelerometer wear time, socio-demographic variables, lifestyle behaviors, and chronic disease conditions were conducted. Results: Time spent in moderate-to-vigorous and light physical activities were both inversely related to depressive symptoms at follow-up. Sedentary time was associated with an increased risk of subsequent depressive symptoms. When sedentary or moderate-to-vigorous activity were included in the multivariable-adjusted regression models with light physical activity simultaneously, only light physical activity remained significant. Sensitivity analyses for assessing confounding and reverse causation provided further support for the stability of these findings. Conclusion: Light physical activity, independent of sedentary and moderate-to-vigorous activity, is associated with a reduced risk of subsequent depressive symptoms in later life.

Most studies on the health effects of leisure time physical activity have focused on mortality. There has been limited research regarding physical activity undertaken at work or around the home and mortality. This study assessed the associations between leisure, work, and household physical activity and subsequent all-cause mortality among older adults aged 65 years and older (n = 2133) in Taiwan, over 8 years. Physical activity was evaluated with the Physical Activity Scale for the Elderly. Cox proportional hazard models were used to estimate the association of physical activity with the risk of mortality. This study demonstrated that a low level of total physical activity is predictive of increased all-cause mortality in both men and women in an East Asian population. It also indicates that leisure- and household-related but not work-related activity are significant contributors to this relationship.