Increased Physical Activity and Fitness above the 50^th Percentile Avoid the Threat of Older Adults Becoming Institutionalized: A Cross-sectional Pilot Study

Abstract

Objective: To analyze the impact of physical fitness and physical activity on the threat of older adults without cognitive impairment becoming institutionalized. Methods: This cross-sectional study involved 195 non-institutionalized (80.1±4.4yrs) and 186 institutionalized (83.8±5.2yrs) participants. Cognitive impairment was assessed using Mini-Mental State Examination, measures of physical fitness were determined by the Senior Fitness Test, and physical activity was assessed using the International Physical Activity Questionnaire. Results: Multivariate binary logistic analysis selected 4 main determinants of institutionalization in both genders: the likelihood of becoming institutionalized increased by +18.6% for each additional year of age, while it decreased by -24.8% by each fewer kg/m2 in BMI, by -0.9% for each additional meter performed in the aerobic endurance test and by -2.0% for each additional 100MET-min/wk of physical activity expenditure (p<0.05). Values ≤50th percentile (age ≥81yrs, BMI ≥26.7kg/m2, aerobic endurance 367.6m, and physical activity 693MET-min/wk) were computed using Receiver Operating Characteristics analysis as cut-offs discriminating institutionalized from non-institutionalized older adults. Conclusions: The performance of physical activity, allied to an improvement in physical fitness (mainly BMI and aerobic endurance), may avoid the threat of institutionalization of older adults without cognitive impairment only if they are above the 50th percentile; the following is highly recommend: expending ≥693MET-min/wk on physical activity, being ≤26.7kg/m2 on BMI, and being able to walk ≥367.6m in the aerobic endurance test, especially above the age of 80 years. The discovery of this trigger justifies the development of physical activity programs targeting the pointed cut-offs in old, and very old adults.

Stepping-forward affordance perception test cut-offs: Red-flags to identify community-dwelling older adults at high risk of falling and of recurrent falling

“…For that, an overestimation error-tendency was coded as 0, and an underestimation error-tendency was coded as 1. Therefore, the internal validation of both most parsimonious and fit models (fallers vs. non-fallers and recurrent-fallers vs. non-fallers) was tested by using a resampling or cross-validation procedure [23]. For crossvalidation, participants were clustered into ten equal groups by sampling randomly without replacement.…”

“…For cross-validation, participants were clustered into ten equal groups by sampling randomly without replacement. The area under the ROC curve (AUC) was calculated using the probabilities that were generated by cross-validation [ 24 ]. Finally, multivariate binary logistic regression analysis and ROC analysis were used again to establish the cut-offs of risk of falling and of recurrent-falling.…”

“…The same procedure was used to establish the cut-offs regarding falling recurrently. A similar methodology has been previously carried out [ 24 ].…”

Physical activity and fitness are associated with verbal memory, quality of life and depression among nursing home residents: preliminary data of a randomized controlled trial

“…Continuous variables were expressed as means with standard deviations (SD), and categorical variables as frequency counts and percentages (%). Taking into account that up-to-date reference values for the dependent variables MEC-35, Trail Making A, RAVLT-AT, and QoL-AD have not been reported for older adults living in nursing homes, the cut-off point in the current study was determined according to the median, as used in other studies [ 31 , 32 ]. Thus, the dependent continuous variables were transformed into binary variables according to whether they had a value above or below their median.…”

Prática de exercício físico ou esporte dos idosos jovens e longevos e o conhecimento dos mesmos em programas públicos: Pesquisa Nacional de Saúde 2013

“…9 Considerando que a saúde do idoso está amplamente relacionada com hábitos de vida e nível de atividade física e/ou exercício físico, encontra-se descrito na literatura especializada que, em idades mais avançadas, (acima dos 80 anos) um nível de atividade física inferior a ≤693 MET-min/sem (equivalente metabólico da tarefa) e uma capacidade de deslocamento inferior a ≤367,6m são fatores preditores para o idoso longevo vir a institucionalizar-se. 10 Isto é, neste enquadramento, a inatividade física é considerada uma ameaça à condição de dependência. Apesar dos estudos aumentarem em cascata as evidências da importância dos exercícios na melhora da saúde do idoso, ainda se faz necessário conhecer como esta população encara a prática de exercício físico ou esporte, bem como o nível de conhecimento dos programas públicos municipais.…”