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The Challenges and Opportunities for Promoting Active Healthy Ageing

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Aging".

Deadline for manuscript submissions: closed (28 February 2021) | Viewed by 43016

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Special Issue Editors

Prof. Dr. Mark A. Tully

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Guest Editor

School of Medicine, Ulster University, Londonderry BT48 7JL, UK
Interests: public health; health promotion; physical activity; sedentary behavior

Prof. Dr. Lee Smith

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Guest Editor

Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge CB1 2LZ, UK
Interests: systematic reviews; epidemiology; health behaviours; mental health; physical health
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Dr. Nicole Blackburn

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Guest Editor

School of Health Sciences, Ulster University, Newtownabbey BT37 0QB, Northern Ireland
Interests: physical activity; sedentary behaviour; exercise rehabilitation; interventions; public health
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Dr. Deepti Adlakha

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Guest Editor

School of Natural and Built Environment, Queen’s University Belfast, Belfast BT9 5AG, UK
Interests: urban design; city planning; built environment; walkability; public health; physical activity; healthy cities
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Prof. Dr. Paolo Caserotti

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Guest Editor

Center for Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark
Interests: physical activity; sedentary behaviour and exercise; nutrition; complex interventions; primary prevention; physical function and disability
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Special Issue Information

Dear Colleagues,

On behalf of IJERPH, we are organizing a Special Issue about the challenges and opportunities for promoting healthy active ageing. IJERPH is a peer-reviewed scientific journal that publishes manuscripts in the interdisciplinary area of environmental health sciences and public health.

Population ageing is a global phenomenon. By 2050, it is expected that 17% of the world’s population will be over 65 years old with greater numbers of older adults worldwide than children under 16. With countries in Asia and sub-Saharan Africa set to see some of the biggest rises. To address the associated declines in physical and mental health, many health organisations have called for evidence on how best to promote physical activity and reduce sedentary behaviour in older adults. We are therefore interested in papers that advance our knowledge of the determinants of physical activity and sedentary behaviour in older adults as well as approaches to address them. These determinants would include individual, social, and environmental influences on behaviour. We anticipate that these questions may be addressed using a variety of methods including qualitative, spatial, longitudinal approaches, alongside natural experiments, controlled trials and systematic reviews.

Studies involving the following topics are welcome for this Special issue in IJERPH:

The association between physical and mental health outcomes associated with physical activity and sedentary behaviour
Assessment of physical activity and sedentary behaviour specifically designed for older adults
The influence of individual, social and built environment factors on physical activity and sedentary behaviour in older adults
The (cost) effectiveness of interventions targeting behaviour change in older adults
Studies involving ‘younger’ and ‘older’ older adults
Studies from the Global South, including, but not limited to, aspects of intergenerational living, social networks, participatory planning and ageing-in-place

Prof. Dr. Mark Tully
Dr. Lee Smith
Dr. Nicole Blackburn
Dr. Deepti Adlakha
Prof. Dr. Paolo Caserotti
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Physical activity
Sedentary behaviour
Older adults
Determinants
Interventions

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Published Papers (8 papers)

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Research

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16 pages, 1846 KiB

Open AccessFeature PaperArticle

Profiles of Loneliness and Social Isolation in Physically Active and Inactive Older Adults in Rural England

by Jolanthe de Koning, Suzanne H Richards, Grace E R Wood and Afroditi Stathi

Int. J. Environ. Res. Public Health 2021, 18(8), 3971; https://doi.org/10.3390/ijerph18083971 - 9 Apr 2021

Cited by 8 | Viewed by 4081

Abstract

Objective: Loneliness and social isolation are associated with higher risk of morbidity and mortality and physical inactivity in older age. This study explored the socioecological context in which both physically active and inactive older adults experience loneliness and/or social isolation in a UK rural setting. Design: A mixed-methods design employed semi structured interviews and accelerometer-measured moderate-to-vigorous physical activity (MVPA). Interviews explored the personal, social and environmental factors influencing engagement with physical activities, guided by an adapted-socioecological model of physical activity behaviour. Findings: Twenty-four older adults (Mean Age = 73 (5.8 SD); 12 women) were interviewed. Transcripts were thematically analysed and seven profiles of physical activity, social isolation and loneliness were identified. The high-MVPA group had established PA habits, reported several sources of social contact and evaluated their physical environment as activity friendly. The low MVPA group had diverse experiences of past engagement in social activities. Similar to the high MVPA, they reported a range of sources of social contact but they did not perceive the physical environment as activity friendly. Conclusions: Loneliness and/or social isolation was reported by both physically active and inactive older adults. There is wide diversity and complexity in types and intensity of PA, loneliness and social isolation profiles and personal, social and environmental contexts. Full article

(This article belongs to the Special Issue The Challenges and Opportunities for Promoting Active Healthy Ageing)

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12 pages, 333 KiB

Open AccessArticle

Designing Age-Friendly Communities: Exploring Qualitative Perspectives on Urban Green Spaces and Ageing in Two Indian Megacities

by Deepti Adlakha, Mina Chandra, Murali Krishna, Lee Smith and Mark A. Tully

Int. J. Environ. Res. Public Health 2021, 18(4), 1491; https://doi.org/10.3390/ijerph18041491 - 4 Feb 2021

Cited by 18 | Viewed by 4824

Abstract

The World Health Organization and the United Nations have increasingly acknowledged the importance of urban green space (UGS) for healthy ageing. However, low- and middle-income countries (LMICs) like India with exponential ageing populations have inadequate UGS. This qualitative study examined the relationships between UGS and healthy ageing in two megacities in India. Participants were recruited using snowball sampling in New Delhi and Chennai and semi-structured interviews were conducted with consenting participants (N = 60, female = 51%; age > 60 years; fluent in English, Hindi, or Tamil). Interviews were recorded, transcribed, translated, and analysed using inductive and thematic analysis. Benefits of UGS included community building and social capital, improved health and social resilience, physical activity promotion, reduced exposure to noise, air pollution, and heat. Poorly maintained UGS and lack of safe, age-friendly pedestrian infrastructure were identified as barriers to health promotion in later life. Neighbourhood disorder and crime constrained older adults’ use of UGS in low-income neighbourhoods. This study underscores the role of UGS in the design of age-friendly communities in India. The findings highlight the benefits of UGS for older adults, particularly those living in socially disadvantaged or underserved communities, which often have least access to high-quality parks and green areas. Full article

(This article belongs to the Special Issue The Challenges and Opportunities for Promoting Active Healthy Ageing)

13 pages, 334 KiB

Open AccessArticle

Usability and Acceptability of a Novel Secondary Prevention Initiative Targeting Physical Activity for Individuals after a Transient Ischaemic Attack or “Minor” Stroke: A Qualitative Study

by Neil Heron, Sean R. O’Connor, Frank Kee, Jonathan Mant, Margaret E. Cupples and Michael Donnelly

Int. J. Environ. Res. Public Health 2020, 17(23), 8788; https://doi.org/10.3390/ijerph17238788 - 26 Nov 2020

Cited by 4 | Viewed by 2543

Abstract

Behavioural interventions that address cardiovascular risk factors such as physical inactivity and hypertension help reduce recurrence risk following a transient ischaemic attack (TIA) or “minor” stroke, but an optimal approach for providing secondary prevention is unclear. After developing an initial draft of an innovative manual for patients, aiming to promote secondary prevention following TIA or minor stroke, we aimed to explore views about its usability and acceptability amongst relevant stakeholders. We held three focus group discussions with 18 participants (people who had experienced a TIA or minor stroke (4), carers (1), health professionals (9), and researchers (4). Reflexive thematic analysis identified the following three inter-related themes: (1) relevant information and content, (2) accessibility of format and helpful structure, and (3) strategies to optimise use and implementation in practice. Information about stroke, medication, diet, physical activity, and fatigue symptoms was valued. Easily accessed advice and practical tips were considered to provide support and reassurance and promote self-evaluation of lifestyle behaviours. Suggested refinements of the manual’s design highlighted the importance of simplifying information and providing reassurance for patients early after a TIA or minor stroke. Information about fatigue, physical activity, and supporting goal setting was viewed as a key component of this novel secondary prevention initiative. Full article

(This article belongs to the Special Issue The Challenges and Opportunities for Promoting Active Healthy Ageing)

18 pages, 1714 KiB

Open AccessArticle

Effectiveness of SaBang-DolGi Walking Exercise Program on Physical and Mental Health of Menopausal Women

by EunHee Noh, JiYoun Kim, MunHee Kim and EunSurk Yi

Int. J. Environ. Res. Public Health 2020, 17(18), 6935; https://doi.org/10.3390/ijerph17186935 - 22 Sep 2020

Cited by 7 | Viewed by 6344

Abstract

Objective: We investigated the effectiveness of a 12-week SaBang-DolGi walking exercise program on the physical and mental health of menopausal women and aimed to provide the basic data needed to develop health promotion programs for the active and healthy aging of menopausal women. Materials and methods: The participants comprised 40 women aged 50–65 years who were divided into two randomly selected groups in training sessions (exercising group, n = 21 and control group, n = 19). A physical (grip, muscle and endurance) test and mental health test (simple mental health test II) were conducted using questionnaires with the aim of examining subjects’ physical and mental health before and after exercise. Results: After the intervention, the participants experienced positive changes in the physical dimension, with significant enhancements particularly in mental well-being and menopause-related health and subdomains. Controlled and regular exercise for 12 weeks was significantly correlated with a positive change in vitality and mental health. Conclusions: We found that the SaBang-DolGi walking exercise program helps to promote the physical and mental health of menopausal women who are exposed to the various stresses and depressions that accompany physical deterioration; the program was found to encourage active and healthy aging. Full article

(This article belongs to the Special Issue The Challenges and Opportunities for Promoting Active Healthy Ageing)

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14 pages, 814 KiB

Open AccessArticle

The Effectiveness of Individual or Group Physiotherapy in the Management of Sub-Acromial Impingement: A Randomised Controlled Trial and Health Economic Analysis

by Ian Ryans, Rhona Galway, Annette Harte, Rejina Verghis, Ashley Agus, Neil Heron and Roland McKane

Int. J. Environ. Res. Public Health 2020, 17(15), 5565; https://doi.org/10.3390/ijerph17155565 - 1 Aug 2020

Cited by 4 | Viewed by 4036

Abstract

Background: Shoulder pain is common in primary care. The management of subacromial impingement (SAI) can include corticosteroid injections and physiotherapy. Physiotherapy can be on an individual or group basis. Aim: To examine the clinical effectiveness and make an economic analysis of individual versus group physiotherapy, following corticosteroid injection for SAI. Design and Setting: A single-blind, open-label, randomised equivalence study comparing group and individual physiotherapy. Patients referred by local general practitioners and physiotherapists were considered for inclusion. Method: Patients were randomised to individual or group physiotherapy groups, and all received corticosteroid injection before physiotherapy. The primary outcome measure was shoulder pain and disability index (SPADI) at 26 weeks. An economic analysis was conducted. Results and Conclusion: 136 patients were recruited, 68 randomised to each group. Recruitment was 68% of the target 200 participants. SPADI (from baseline to 26 weeks) demonstrated a difference (SE) in mean change between groups of −0.43 (5.7) (p-value = 0.050001), and the TOST (two-one-sided test for equivalence) 90% CI for this difference was (−10.0 to 9.14). This was borderline. In a secondary analysis using inputted data, patients without SPADI at week 26 were analysed by carrying forward scores at week 12 (mean difference (95% CI) = −0.14 (−7.5 to 7.3), p-value = 0.014). There is little difference in outcome at 26 weeks. Group physiotherapy was cheaper to deliver per patient (£252 versus £84). Group physiotherapy for SAI produces similar clinical outcomes to individual physiotherapy with potential cost savings. Due to low recruitment to our study, firm conclusions are difficult and further research is required to give a definitive answer to this research question. (NCT Clinical Trial Registration Number NCT04058522). Full article

(This article belongs to the Special Issue The Challenges and Opportunities for Promoting Active Healthy Ageing)

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10 pages, 1138 KiB

Open AccessArticle

The Association Between Sedentary Behavior and Sarcopenia Among Adults Aged ≥65 Years in Low- and Middle-Income Countries

by Lee Smith, Mark Tully, Louis Jacob, Nicole Blackburn, Deepti Adlakha, Paolo Caserotti, Pinar Soysal, Nicola Veronese, Guillermo F. López Sánchez, Davy Vancampfort and Ai Koyanagi

Int. J. Environ. Res. Public Health 2020, 17(5), 1708; https://doi.org/10.3390/ijerph17051708 - 5 Mar 2020

Cited by 51 | Viewed by 5399

Abstract

The present study aimed to assess the association between sedentary behavior and sarcopenia among adults aged ≥65 years. Cross-sectional data from the Study on Global Ageing and Adult Health were analyzed. Sarcopenia was defined as having low skeletal muscle mass and either a slow gait speed or a weak handgrip strength. Self-reported sedentary behavior was assessed as a continuous variable (hours per day) and also as a categorical variable (0–<4, 4–<8, 8–<11, ≥11 hours/day). Multivariable logistic regression was conducted to assess the association between sedentary behavior and sarcopenia. Analyses using the overall sample and country-wise samples were conducted. A total of 14,585 participants aged ≥65 years were included in the analysis. Their mean age was 72.6 (standard deviation, 11.5) years and 55% were females. Compared to sedentary behavior of 0–<4 hours/day, ≥11 hours/day was significantly associated with 2.14 (95% CI = 1.06–4.33) times higher odds for sarcopenia. The country-wise analysis showed that overall, a one-hour increase in sedentary behavior per day was associated with 1.06 (95% CI = 1.04–1.10) times higher odds for sarcopenia, while the level of between-country heterogeneity was low (I² = 12.9%). Public health and healthcare practitioners may wish to target reductions in sedentary behavior to aid in the prevention of sarcopenia in older adults. Full article

(This article belongs to the Special Issue The Challenges and Opportunities for Promoting Active Healthy Ageing)

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Review

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17 pages, 846 KiB

Open AccessReview

The Effect of Chair-Based Exercise on Physical Function in Older Adults: A Systematic Review and Meta-Analysis

by Natalie Klempel, Nicole E. Blackburn, Ilona L. McMullan, Jason J. Wilson, Lee Smith, Conor Cunningham, Roger O’Sullivan, Paolo Caserotti and Mark A. Tully

Int. J. Environ. Res. Public Health 2021, 18(4), 1902; https://doi.org/10.3390/ijerph18041902 - 16 Feb 2021

Cited by 20 | Viewed by 10665

Abstract

Physical activity is an important determinant of health in later life. The public health restrictions in response to COVID-19 have interrupted habitual physical activity behaviours in older adults. In response, numerous exercise programmes have been developed for older adults, many involving chair-based exercise. The aim of this systematic review was to synthesise the effects of chair-based exercise on the health of older adults. Ovid Medline, EMBASE, CINAHL, AMED, PyscInfo and SPORTDiscus databases were searched from inception to 1 April 2020. Chair-based exercise programmes in adults ≥50 years, lasting for at least 2 weeks and measuring the impact on physical function were included. Risk of bias of included studies were assessed using Cochrane risk of bias tool v2. Intervention content was described using TiDieR Criteria. Where sufficient studies (≥3 studies) reported data on an outcome, a random effects meta-analysis was performed. In total, 25 studies were included, with 19 studies in the meta-analyses. Seventeen studies had a low risk of bias and five had a high risk of bias. In this systematic review including 1388 participants, results demonstrated that chair-based exercise programmes improve upper extremity (handgrip strength: MD = 2.10; 95% CI = 0.76, 3.43 and 30 s arm curl test: MD = 2.82; 95% CI = 1.34, 4.31) and lower extremity function (30 s chair stand: MD 2.25; 95% CI = 0.64, 3.86). The findings suggest that chair-based exercises are effective and should be promoted as simple and easily implemented activities to maintain and develop strength for older adults. Full article

(This article belongs to the Special Issue The Challenges and Opportunities for Promoting Active Healthy Ageing)

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Other

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16 pages, 500 KiB

Open AccessProtocol

Increasing Physical Activity in Empty Nest and Retired Populations Online: A Randomized Feasibility Trial Protocol

by Amy Cox and Ryan Rhodes

Int. J. Environ. Res. Public Health 2020, 17(10), 3544; https://doi.org/10.3390/ijerph17103544 - 19 May 2020

Cited by 5 | Viewed by 3682

Abstract

Despite the extensive evidence on the benefits of physical activity (PA) in older adults, including reduced risk of disease, mortality, falls, and cognitive and functional decline, most do not attain sufficient PA levels. Theoretical work suggests that behavioral change interventions are most effective during life transitions, and as such, a theory-based, online intervention tailored for recently retired and empty nest individuals could lend support for increasing levels of PA. The aim of this study is to examine the feasibility of the intervention and study procedures for a future controlled trial. This study has a randomized controlled trial design with an embedded qualitative and quantitative process evaluation. Participants are randomized at 1:1 between the intervention and waitlist controls. Potential participants are within six months of their final child leaving the familial home or within six months of retiring (self-defined), currently not meeting the Canadian PA guidelines, have no serious contraindications to exercise, and are residing in Victoria, British Columbia, Canada. Participants are recruited by online and print flyers as well as in-person at community events. The study aims to recruit 40 empty nest and 40 retired participants; half of each group received the intervention during the study period. The internet-delivered intervention is delivered over a 10-week period, comprising 10 modules addressing behavior change techniques associated with PA. Primary outcomes relate to recruitment, attrition, data collection, intervention delivery, and acceptability. Secondary behavioral outcomes are measured at baseline and post-treatment (10 weeks). Intervention-selected participants are invited to an optional qualitative exit interview. The results of this feasibility study will inform the planning of a randomized effectiveness trial, that will examine the behavior change, health-related fitness, and well-being outcomes by exploring how reflexive processes of habit and identity may bridge adoption and maintenance in behavioral adherence. Full article

(This article belongs to the Special Issue The Challenges and Opportunities for Promoting Active Healthy Ageing)

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