Associations between walking limitations and reported activity destinations among older adults

In old age, walking difficulty may reduce opportunities to reach valued activity destinations. Walking modifications, e.g., slower pace or using a walking aid, may enable individuals to continue going where they wish, and hence postpone the consequences of the onset of walking difficulties. We studied visited activity destinations (type, distance) among older people with varying degrees of walking limitations. Community-dwelling 75-85-year-old people living in Jyväskylä (N = 901) were asked to state whether they had no difficulty walking 2 km, had modified their walking, or had difficulty walking. On a digital map, participants located physical exercise, attractive, and regular destinations they had visited during the past month. Destination counts and median distance to destinations from home were computed. Participants with intact walking reported higher counts of physical exercise (IRR = 1.45, 95% CI [1.31, 1.61]) and attractive destinations (IRR = 1.23, 95% CI [1.10, 1.40]) than those with walking difficulty and also visited these destinations further away from home than the others (b = 0.46, 95% CI [0.20, 0.71]). Those with walking modifications reported higher counts of physical exercise destinations than those with walking difficulty (IRR = 1.23, 95% CI [1.09, 1.40]). Counts of regular destinations and distance traveled were not associated with walking limitations. Walking modifications may help people with walking difficulty reach destinations further away from home, potentially contributing to their sense of autonomy. For those with walking difficulty, a low count of destinations other than regular destinations, e.g., shops or healthcare facilities, may signal their abandonment of recreational activities and a decrease in their life space, potentially leading to reduced well-being.</p

MOBIlity assessment with modern TEChnology in older patients' real-life by the General Practitioner: The MOBITEC-GP study protocol

Background: Mobility limitations in older adults are associated with poor clinical outcomes including higher mortality and disability rates. A decline in mobility (including physical function and life-space) is detectable and should be discovered as early as possible, as it can still be stabilized or even reversed in early stages by targeted interventions. General practitioners (GPs) would be in the ideal position to monitor the mobility of their older patients. However, easy-to-use and valid instruments for GPs to conduct mobility assessment in the real-life practice setting are missing. Modern technologies such as the global positioning system (GPS) and inertial measurement units (IMUs) - nowadays embedded in every smartphone - could facilitate monitoring of different aspects of mobility in the GP's practice. Methods: This project's aim is to provide GPs with a novel smartphone application that allows them to quantify their older patients' mobility. The project consists of three parts: development of the GPS- and IMU-based application, evaluation of its validity and reliability (Study 1), and evaluation of its applicability and acceptance (Study 2). In Study 1, participants (target N = 72, aged 65+, ≥2 chronic diseases) will perform a battery of walking tests (varying distances; varying levels of standardization). Besides videotaping and timing (gold standard), a high-end GPS device, a medium-accuracy GPS/IMU logger and three different smartphone models will be used to determine mobility parameters such as gait speed. Furthermore, participants will wear the medium-accuracy GPS/IMU logger and a smartphone for a week to determine their life-space mobility. Participants will be re-assessed after 1 week. In Study 2, participants (target N = 60, aged 65+, ≥2 chronic diseases) will be instructed on how to use the application by themselves. Participants will perform mobility assessments independently at their own homes. Aggregated test results will also be presented to GPs. Acceptance of the application will be assessed among patients and GPs. The application will then be finalized and publicly released. Discussion: If successful, the MOBITEC-GP application will offer health care providers the opportunity to follow their patients' mobility over time and to recognize impending needs (e.g. for targeted exercise) within pre-clinical stages of decline

The Role of Environmental Factors in Technology-Assisted Physical Activity Intervention Studies Among Older Adults: Scoping Review

BACKGROUND: The rapidly emerging integration of both technological applications and environmental factors in physical activity (PA) interventions among older adults highlights the need for an overarching investigation. OBJECTIVE: This scoping review compiled the current literature and aimed to provide an overview of the role of physical, social, socioeconomic, and systemic environmental factors in technology-assisted PA interventions for older adults. METHODS: We systematically searched 6 common databases up to September 16, 2024, for original longitudinal studies (with at least one preintervention measurement and one postintervention measurement) that reported on the role of environmental factors in technology-assisted PA interventions for independently living, community-dwelling older adults. In a stepwise process, data on study characteristics (step 1), environmental factors and their role in the included studies (step 2), and intervention outcomes and effects by type of environmental factor (step 3) were summarized. RESULTS: A total of 8020 articles were screened, and 25 (0.31%) were included. Most studies were conducted in Europe (11/25, 44%), followed by North America (5/25, 20%), Asia (5/25, 20%), and Oceania (4/25, 16%). Social environmental factors were most often considered (19/25, 76%), followed by factors from the physical (8/25, 32%), socioeconomic (1/25, 4%), and systemic environment (1/25, 4%). Environmental factors were used as the outcome (8/25, 32%), setting variable (7/25, 28%), moderator or facilitator (8/25, 32%), and intervention component (3/25, 12%). In most studies (19/25, 76%), the intervention had a beneficial effect on the outcome of interest, and the included environmental factor played a supportive role in achieving this effect. In some studies, no effect (3/25, 12%), mixed effects (2/25, 8%), or adverse effects (1/25, 4%) of the interventions were reported. CONCLUSIONS: This is the first comprehensive description of how environmental factors interact with technology-assisted interventions to increase or optimize PA in older adults. It was found that the investigation of environmental factors in this field is at an early stage. Environmental factors were found to play a supportive role in achieving beneficial effects of technology-assisted PA interventions, but the findings were based on a heterogeneous empirical platform. Still, certain aspects such as the application of virtual reality environments and social (or peer) comparison have shown significant potential that remains to be leveraged. A better understanding of intervention results and support in tailoring intervention programs can be provided through the inclusion of environmental aspects in technology-assisted PA interventions for older adults

How Many Hours Do You Have to Work to Be Integrated? Full Time and Part Time Employment of Native and Ethnic Minority Women in the Netherlands

Labor market participation is a central factor in the economic integration of migrants in their host country. Labor market integration of ethnic minority women is of special interest, as they may experience a double disadvantage: both as a woman and as a migrant. Since the late nineties this presumed double disadvantage has become more and more the focus of both Dutch integration and Dutch emancipation policy. To test several assumptions underlying Dutch policy this paper focuses on the employment patterns of ethnic minority and native women in the Netherlands. In particular, we analyze to what extent labor market participation of different groups of women and the hours they work are influenced by human capital and household characteristics. Our results show some remarkable differences in employment patterns between native Dutch and ethnic minority women. Controlling for educational level, partnership and the presence of children, native Dutch women are working more often in part time jobs than Mediterranean and Caribbean women. For all women the educational level is an important determinant of employment and the number of hours worked. Whereas the number of children influences both the employment decision and the number of hours worked of native Dutch women, for Mediterranean and Caribbean women there is only an effect of the number of children on the odds of having a full time job

Physical activity compensates for increased mortality risk among older people with poor muscle strength

The aim of the study was to determine whether habitual physical activity can compensate for the increased mortality risk among older people with poor muscle strength. Mortality was followed up for 10 years after laboratory examination in 558 community dwelling 75- and 80-year-old men and women. Maximal isometric strength of five muscle groups was measured and tertile cut-off points were used to categorize participants. Participants, who reported moderate physical activity for at least 4 h a week, were categorized as physically active and the others as sedentary. High muscle strength and physical activity both protected from mortality, but their effect was not additive. Within each muscle strength tertile, physically active people had a lower mortality risk than sedentary people, the effect being most pronounced among those with lower strength in all muscle groups. A high level of physical activity may thus compensate for the increased mortality associated with low muscle strengt