Search results for ‘Subject term:"older people"’ Sort:
Results 1 - 10 of 66
Interventions promoting physical activity among older adults: a systematic review and meta-analysis
- Authors:
- GRANDE Guilherme D., et al
- Journal article citation:
- Gerontologist, 60(8), 2020, pp.e583-e599.
- Publisher:
- Oxford University Press
Background and Objectives: Frequent participation in physical activity (PA) has benefits across the lifespan but is particularly important for older adults. PA levels are either measured by objective or self-reported survey methods. Objective PA measurement is used to increase accuracy. This systematic review investigated the effect of physical activity-based interventions on objectively measured PA levels among community-dwelling adults aged 60 years and older. Research Design and Methods: Literature searches were conducted in five electronic databases and four clinical trial registries. Randomized controlled trials investigating the effect of physical activity–based interventions on objectively measured PA levels (e.g., accelerometers or pedometers) in community-dwelling adults aged 60 years and older compared with no/minimal intervention were considered eligible. Data were pooled using the most conservative estimates reported from each study using the standardized mean difference (SMD). Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the overall quality of the evidence. Results: Fourteen published trials and 3 ongoing trials were identified. There were significant effects favoring physical activity–based interventions compared with minimal intervention at short-term (less than or equal to 3 months) (SMD: 0.30, 95% CI: 0.17 to 0.43) and intermediate-term (more than 3 months and less than 12 months; SMD: 0.27, 95% CI: 0.06 to 0.49) follow-ups. The quality of evidence was moderate according to GRADE (downgraded for risk of bias). Discussion and Implications: Our findings suggest that physical activity–based interventions may increase objectively measured PA levels in community-dwelling older adults. Further studies are still needed to identify the optimal dose, intensity, and mode of delivery of physical activity–based interventions. (Edited publisher abstract)
A systematic review of education for the prevention of HIV/AIDS among older adults
- Authors:
- MILASZEWSKI Dorota, et al
- Journal article citation:
- Journal of Evidence-Based Social Work, 9(3), June 2012, pp.213-230.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This literature review examined articles focused on primary prevention of HIV/AIDS for adults aged 50 and over. A total of twenty one English language articles were included. Three major challenges were identified in providing HIV/AIDS education for older adults include health professionals' ageism, older adults' reluctance to discuss sexuality, and their misconception of their HIV risk. Clinical guidelines for social workers, nurses, and physicians identified the importance of sharing information and assessing risk, considering cultural diversity, and devising creative delivery strategies. Three models of HIV/AIDS education include group education programmes delivered by social workers or other health professionals, peer education models, and one-on-one early intervention models including HIV/AIDS testing. The authors concluded that additional outreach and research on HIV/AIDS prevention among older adults is required.
Effects of gait adaptability training on falls and fall-related fractures in older adults: a systematic review and meta-analysis
- Authors:
- NORGAARD Jens Eg, et al
- Journal article citation:
- Age and Ageing, 50(6), 2021, pp.1914-1924.
- Publisher:
- Oxford University Press
Objective: falls among older adults are common and can have devastating consequences. A novel task-specific exercise modality, gait adaptability training (GAT), has shown promising preventive effects. This systematic review and meta-analysis synthesise the evidence regarding GATs effect on falls and fall-related fractures in community-dwelling older adults. Methods: electronic databases (PubMed, EMBASE, CINAHL, CENTRAL) were systematically searched from inception to 18 June 2020. Additional sources include searches of trial registrations, manual screening of reference lists and requests to experts. We included randomised controlled trials (RCTs) evaluating the effect of GAT on falls with at least 6-month follow-up among community-dwelling people aged 60+ years. Two reviewers independently screened studies against eligibility criteria, extracted relevant information and appraised studies for bias. Random-effects meta-analytic models were employed to pool effect estimates. Results: eleven studies with 1,131 participants were included. A meta-analysis in which an outlier study was excluded showed that GAT reduces fall rates by 42% (incidence rate ratio 0.58, 95% confidence interval [CI] 0.39–0.81, I2 = 0.00%; moderate certainty; seven RCTs). Moreover, proportion with fall-related fractures and proportion of fallers was reduced by 81% (risk ratio [RR] 0.19, 95% CI 0.06–0.56, I2 = 0.00%; very low certainty; two RCTs) and 43% (RR 0.57, 95% CI 0.4–to 0.8, I2 = 47.08%; low certainty; 11 RCTs), respectively. Conclusions: our results show that GAT significantly reduces the number of falls and prevents fall-related fractures in older community dwellers. GAT is a promising and feasible exercise modality; however, studies of high quality should be conducted to support a robust conclusion. (Edited publisher abstract)
Yoga-based exercise improves balance and mobility in people aged 60 and over: a systematic review and meta-analysis
- Authors:
- YOUKHANA Sabrina, et al
- Journal article citation:
- Age and Ageing, 45(1), 2016, pp.21-29.
- Publisher:
- Oxford University Press
Objective: One-third of community-dwelling older adults fall annually. Exercise that challenges balance is proven to prevent falls. The authors conducted a systematic review with meta-analysis to determine the impact of yoga-based exercise on balance and physical mobility in people aged 60+ years. Methods: Searches for relevant trials were conducted on the following electronic databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, Allied and Complementary Medicine Database and the Physiotherapy Evidence Database (PEDro) from inception to February 2015. Trials were included if they evaluated the effect of physical yoga (excluding meditation and breathing exercises alone) on balance in people aged 60+ years. We extracted data on balance and the secondary outcome of physical mobility. Standardised mean differences and 95% confidence intervals (CI) were calculated using random-effects models. Methodological quality of trials was assessed using the 10-point Physiotherapy Evidence Database (PEDro) Scale. Results: Six trials of relatively high methodological quality, totalling 307 participants, were identified and had data that could be included in a meta-analysis. Overall, yoga interventions had a small effect on balance performance (Hedges' g = 0.40, 95% CI 0.15–0.65, 6 trials) and a medium effect on physical mobility (Hedges' g = 0.50, 95% CI 0.06–0.95, 3 trials). Conclusion: yoga interventions resulted in small improvements in balance and medium improvements in physical mobility in people aged 60+ years. Further research is required to determine whether yoga-related improvements in balance and mobility translate to prevention of falls in older people. (Publisher abstract)
Translating falls prevention knowledge to community-dwelling older PLWD: a mixed-method systematic review
- Authors:
- MEYER Claudia, et al
- Journal article citation:
- Gerontologist, 55(4), 2015, pp.560-574.
- Publisher:
- Oxford University Press
Purpose of the Study: This mixed-method systematic review aimed to integrate evidence of falls prevention efficacy with views/experiences of people living with dementia (PLWD). Design and Methods: Eight electronic databases were searched. Inclusion criteria included quantitative or qualitative studies examining knowledge translation of falls prevention strategies in community-dwelling PLWD and/or their caregiver. Study quality was assessed, and findings are narratively described. Results: Six quantitative and five qualitative studies were included. Study quality was mixed. Quantitative studies showed limited evidence of effectiveness on reduction in falls risk, falls and hospitalization rates, nursing home admission, decline in activities of daily living, and adherence to strategies. Qualitative themes showed inclusion of caregiver and health professionals as key to programme success, but many factors influence participation. Implications: Synthesising the findings generated a new understanding of falls prevention for this high-risk group. A focus upon health professional and caregiver involvement and accommodation of individual preferences may result in increased engagement with falls prevention strategies. (Edited publisher abstract)
Does the ‘Otago exercise programme’ reduce mortality and falls in older adults?: a systematic review and meta-analysis
- Authors:
- THOMAS Susie, MACKINTOSH Shylie, HALBERT Julie
- Journal article citation:
- Age and Ageing, 39(6), November 2010, pp.681-687.
- Publisher:
- Oxford University Press
A systematic review with meta-analysis was conducted to evaluate the effectiveness of a strength and balance retraining programme designed to prevent falls in older people living in the community, the Otago exercise programme. The meta-analysis included seven trials, involving 1503 participants. Outcomes of interest included risk of death, number of falls, number of injurious falls and compliance to the exercise programme. The Otago exercise programme was found to significantly reduced the risk of death over 12 months, and significantly reduced fall rates. There was no significant difference in the risk of a serious or moderate injury occurring as the result of a fall . Of the 747 participants who remained in the studies at 12 months, 274 (36.7%) were still exercising three or more times per week.
Effect of community-based intervention using depression screening on elderly suicide risk: a meta-analysis of the evidence from Japan
- Authors:
- OYAMA Hirofumi, et al
- Journal article citation:
- Community Mental Health Journal, 44(5), October 2008, pp.311-320.
- Publisher:
- Springer
A systematic review was undertaken to quantify the effect of community-based depression screening (CDS) with follow-up on the completed suicide risk for residents aged 65 and over. Five quasi-experimental studies in Japanese regions with high suicide rates were included in the meta-analysis. Combined incidence rate ratios (95% confidence intervals) by the Mantel–Haenszel method and by the DerSimonian–Laird method in two homogenous studies implementing the follow-up conducted by psychiatrists were 0.30 (0.13–0.68) and 0.33 (0.14–0.80) in men, and 0.33 (0.19–0.58) and 0.33 (0.19–0.60) in women, respectively; and those in three homogenous studies implementing the follow-up conducted by general practitioners were 0.73 (0.45–1.18) and 0.74 (0.45–1.23) in men, and 0.36 (0.21–0.60) and 0.39 (0.22–0.66) in women, respectively. There are very few studies included, however, to demonstrate an association between CDS and the reduced risk, suggesting gender difference in the effectiveness.
The effects of fall prevention trials on depressive symptoms and fear of falling among the aged: a systematic review
- Authors:
- SJOSTEN N., VAAPIO S., KIVELA S. L.
- Journal article citation:
- Aging and Mental Health, 12(1), January 2008, pp.30-46.
- Publisher:
- Taylor and Francis
Firstly, to explore whether depressive symptoms and fear of falling have been used as outcome measures in fall prevention trials. Secondly, to determine the effects of fall prevention trials on these variables among the aged. A literature search covering various medical databases was conducted to identify randomised controlled trials regarding the effects of fall prevention programmes on depressive symptoms and fear of falling among the aged. The studies were classified according to the intervention method (single/multifactorial) and study results (positive/negative) regarding depressive symptoms or fear of falling. Methodological quality was assessed in relation to blinding at outcome assessment, follow-up and whether intention-to-treat analysis was used. Depressive symptoms were used as an outcome measure in eight and fear of falling in 21 studies. A multifactorial approach seems the most effective method in reducing fear of falling, while some single methods such as Tai Chi also seem beneficial. Little evidence was found relating to the effects of fall prevention trials on depressive symptoms. Fear of falling may be reduced by fall prevention programmes. More studies assessing the effects on depressive symptoms, especially among the depressed aged are needed.
Interventions to reduce fear of falling in community-living older people: a systematic review
- Authors:
- ZIJLSTRA G. A .R., et al
- Journal article citation:
- Journal of the American Geriatrics Society, 55(4), 2007, pp.603-615.
- Publisher:
- Blackwells Publishing
This review of 19 randomised controlled trials (12 judged to be of higher methodological quality) was conducted according to Cochrane principles and shows the following approaches to be effective in reducing the fear of falling: five fall-related multifactorial interventions (three home- and two group-based); three group-based tai chi programmes; two home-based exercise interventions; and a hip protector intervention. The primary aim of most of these interventions was to reduce falls rather than the fear of falling, and most also succeeded in this respect. The authors conclude that there is limited but fairly consistent evidence in favour of these interventions, and that more high quality, well reported and directly comparable research is needed.
Interventions for preventing falls and fall-related fractures in community-dwelling older adults: a systematic review and network meta-analysis
- Authors:
- DAUTZENBERG Lauren, et al
- Journal article citation:
- Journal of the American Geriatrics Society, ealry cite July 2021,
- Publisher:
- Blackwells Publishing
Objective: To compare the effectiveness of single, multiple, and multifactorial interventions to prevent falls and fall-related fractures in community-dwelling older persons. Methods: MEDLINE, Embase, and Cochrane Central Register of Controlled Trials were systematically searched for randomized controlled trials (RCTs) evaluating the effectiveness of fall prevention interventions in community-dwelling adults aged ≥65 years, from inception until February 27, 2019. Two large RCTs (published in 2020 after the search closed) were included in post hoc analyses. Pairwise meta-analysis and network meta-analysis (NMA) were conducted. Results: NMA including 192 studies revealed that the following single interventions, compared with usual care, were associated with reductions in number of fallers: exercise (risk ratio [RR] 0.83; 95% confidence interval [CI] 0.77–0.89) and quality improvement strategies (e.g., patient education) (RR 0.90; 95% CI 0.83–0.98). Exercise as a single intervention was associated with a reduction in falls rate (RR 0.79; 95% CI 0.73–0.86). Common components of multiple interventions significantly associated with a reduction in number of fallers and falls rate were exercise, assistive technology, environmental assessment and modifications, quality improvement strategies, and basic falls risk assessment (e.g., medication review). Multifactorial interventions were associated with a reduction in falls rate (RR 0.87; 95% CI 0.80–0.95), but not with a reduction in number of fallers (RR 0.95; 95% CI 0.89–1.01). The following single interventions, compared with usual care, were associated with reductions in number of fall-related fractures: basic falls risk assessment (RR 0.60; 95% CI 0.39–0.94) and exercise (RR 0.62; 95% CI 0.42–0.90). Conclusions: In keeping with Tricco et al. (2017), several single and multiple fall prevention interventions are associated with fewer falls. In addition to Tricco, we observe a benefit at the NMA-level of some single interventions on preventing fall-related fractures. (Edited publisher abstract)