Physical activity in Iranian older adults who experienced fall during the past 12 months
TL;DR: It is suggested that perceived benefits could facilitate physical activity among elderly regardless of number of falls, self-reported health and daily living activities, and indeed the findings suggest that benefits exist when designing programs to increase physical activity.
Abstract: Background: Physical activity may have several benefits for elderly people. However, the risk of falling might prevent this population from showing interest in physical activity. This research was aimed to explore facilitators and barriers to physical activity in older persons who have experienced at least one fall in the past 12 months. Methods: This cross sectional study was conducted in 2010-2011, in Tehran, Iran. Using a multistage sampling method a group of elderly people entered into the study. A multi-section questionnaire was used to collect data on demographic information, physical activity level, and different determinants that might influence physical activity. Several statistical tests including linear regression were used to analyze the data. Results: In all, 180 old people from 40 elderly centers (49 men and 131 women) took part in the study. The mean age of participants was 65.9±6.1 years. The result indicated that most participants experienced two or more falls during the last year (54.5%). Those who had more falls significantly scored lower on the Physical Activity Scale for Elderly (p < 0.0001). ‘Keeping in touch with friends’ was the most important advantage cited by participants for performing physical activity. The results obtained from linear regression analysis showed that ‘perceived benefits’ was the only significant factor that associated with physical activity (β=1.03, p <0.001). Conclusion: The findings suggest that perceived benefits could facilitate physical activity among elderly regardless of number of falls, self-reported health and daily living activities. However, we observed inverse association between number of falls and physical activity. Indeed the findings suggest that we should reinforce benefits exist when designing programs to increase physical activity among elderly population.
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TL;DR: HN was not a prevalent problem in older adults who met the inclusion criteria of this research and no significant difference has been observed between HN and bone mineral density and falls in the elderly.
Abstract: Background Hyponatremia (HN) can be associated with osteoporosis, falls and bone fractures in the elderly. Recent researches demonstrated different results about the correlation of HN with bone mineral density and bone fractures. Methods This analytic research came from the AHAP project in northern IRAN. All people aged 60 years and over were included in the study. Individuals with severe comorbidities and then who had concurrent conditions which could have impact on bone mineral densities (BMD) such as long-term use of steroids, calcium and/or vitamin D supplements, bisphosphonates, calcitonin, thiazides and hormonal medications were excluded. Results One thousand and one hundred and thirteen older persons entered in the study. More than 10 percent of the participants had HN (serum Na+ level ≤ 137mEq/L). No significant difference has been observed between hyponatremic and nonhyponatremic individuals about their balance abilities; bone mineral density; incidence of falls and/or bone fracture during the previous 6 months; dependency in activities of daily living; and osteoporosis. Conclusion HN was not a prevalent problem in older adults who met the inclusion criteria of this research. No significant difference has been observed between HN and bone mineral density and falls in the elderly.
5 citations
Cites background from "Physical activity in Iranian older ..."
...97) were evaluated in an Iranian study [19]....
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TL;DR: In this article, a qualitative and quantitative face validity of all questions by expert judgment and IS of greater than 1.5 was considered and a confirmatory factor analysis was also performed.
Abstract: Old age is associated with reduced physical ability. It is necessary to measure and evaluate the physical activity of older people. Implementing appropriate requires a valid and reliable tool. Physical Activity Scale for the Elderly (PASE) is the frequently used self-reported physical activity assessment for older adults. Therefore, this study aimed to determine the translation validity and reliability of the Persian version of the Physical Activity Scale for the Elderly. This study is a methodological, descriptive applied research was conducted on 300 older people. The translation process of the English version of PASE into Persian was carried out according to the process of translation and adaptation of scale recommended by the World Health Organization. The reliability of the scale was examined by calculating the Cronbach’s alpha, Pearson, and intraclass correlation coefficient (ICC). The reliability and validity of the scale were evaluated by following the “Consensus-Based Standards for the Selection of Health Status Measurement Instruments” (COSMIN) checklist. To assess the face and content validity, impact score (IS), the content validity ratio (CVR), and the content validity index (CVI) were determined. A confirmatory factor analysis was also performed. The experts approved the quality of the Persian version of PASE. The reliability was calculated with a Cronbach’s alpha of 0.94, an ICC of 0.99, and a test-retest correlation coefficient of 0.94. The qualitative and quantitative face validity of all questions by expert judgment and IS of greater than 1.5 was considered. Also, CVR and CVI scores of all questions were higher than 0.6 and 0.79, respectively. Confirmatory factor analysis revealed a good fit for the original three-factor structure. The Persian or Farsi version of PASE was shown to have acceptable validity and reliability. This tool is suitable for measuring the physical activity level in the Persian elderly language special in clinical environments and therapeutic interventions.
4 citations
TL;DR: Better understanding of falling risk factors can lead to the implementation of effective preventive intervention, thus reducing public health expenditure, and improving the quality of life in community-dwelling elderly.
Abstract: Purpose
Falling was distinguished as leading cause of fatal and non-fatal injuries among elderly; there is a lack of information regarding the falling risk factors in developing countries. The purpose of this paper is to investigate the falling risk and correlated factors in community-dwelling elderly.
Design/methodology/approach
This cross-sectional study was performed on 280 elderly using a multi-sectional questionnaire in Karaj, Iran. The simple stratified random sampling was used. Adult who were over the age of 60, living independently, able to ambulate independently and safely, no cognition problem and speaking in Persian entered in the study. Exclusion criteria were residing in assisted living facility or unwilling to participate. Several statistical tests including logistic regression analysis were used to analyse the data.
Findings
The mean age of participants was 69.55±8.82 and 51 per cent of them were female. The results showed that there are significant differences between low-, medium- and high-risk groups regarding age, marital status, diabetes, blood pressure and osteoarthritis (p<0.05). Due to finding, the main predictors to higher chance of falling were age (OR=1.61; 95% CI 1.025–1.097), marital status (OR=1.485; 95% CI 1.170–1.279), vision acuity (OR=1.603; 95% CI 1.297–2.223), activities of daily living (OR=2.10; 95% CI 1.047–3.859), heart disease (OR=1.448; 95% CI 1.268–1.728), osteoarthritis (OR=1.238; 95% CI 1.711–2.127), falling history (OR=1.026; 95% CI 1.015–1.089) and medication (OR=5.975; 95% CI 1.525–23.412).
Practical implications
Better understanding of falling risk factors can lead to the implementation of effective preventive intervention, thus reducing public health expenditure, and improving the quality of life.
Originality/value
This study was conducted for the first time to assess the risk of falling in older people in Iran.
2 citations
TL;DR: This paper presents the results of a two-year study of community medicine and biostatistics in the context of non-Communicable Diseases Research Center at Babol University of Medical Sciences, Babol, Iran.
Abstract: Background and purpose: Nowadays, immobility is known to be the fourth risk factor for mortality. The aim of the present study was to investigate the relationship between fall experience over the previous year and levels of physical activity in the elderly.Materials and Methods: The study was performed with 1616 participants of 60≤ years. The relationship between physical activities in the elderly with age, sex, educational level, body mass index, comorbidities, and fall experience over the previous year was evaluated. Physical activity in the elderly was evaluated using the physical activity scale for the elderly.Results: In the multiple regression model, the age (β: -1.6, 95% CI: -2.0- -1.1), sex, female (β: 11.0, 95% CI: 4.3-17.6), and comorbidities (β: -6.8, 95% CI: -13.5 - -0.1) had a significant relationship with the physical activity score. On the contrary, there was no significant difference between the score of physical activity and both groups with and without the experience of fall over the previous year (β: 0.09, 95% CI: -8.0 - 8.2).Conclusion: Increasing age with comorbidity resulted in a decrease in the average physical activity score in the studied elderly population. However, the experience of fall had no relationship with it. Providing the conditions alongside the training required to carry out physical activities, especially in the elderly people with the disease, was suggested.
1 citations
Cites background or result from "Physical activity in Iranian older ..."
...studies have reported that the elderly who experienced a fall in the previous year had lower levels of physical activity than those who did not have this experience (9)....
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...Two other studies (9, 28) reported an inverse relationship...
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...the elderly and the physical activity score of the elderly, which was consistent with the results of previous studies (9)....
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References
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TL;DR: A critical review of 29 HBM-related investigations published during the period 1974-1984, tabulates the findings from 17 studies conducted prior to 1974, and provides a summary of the total 46 HBM studies.
Abstract: Since the last comprehensive review in 1974, the Health Belief Model (HBM) has continued to be the focus of considerable theoretical and research attention. This article presents a critical review of 29 HBM-related investigations published during the period of 1974-1984, tabulates the findings from 17 studies conducted prior to 1974, and provides a summary of the total 46 HBM studies (18 prospective, 28 retrospective). Twenty-four studies examined preventive-health behaviors (PHB), 19 explored sick-role behaviors (SRB), and three addressed clinic utilization. A "significance ratio" was constructed which divides the number of positive, statistically-significant findings for an HBM dimension by the total number of studies reporting significance levels for that dimension. Summary results provide substantial empirical support for the HBM, with findings from prospective studies at least as favorable as those obtained from retrospective research. "Perceived barriers" proved to be the most powerful of the HBM dimensions across the various study designs and behaviors. While both were important overall, "perceived susceptibility" was a stronger contributor to understanding PHB than SRB, while the reverse was true for "perceived benefits." "Perceived severity" produced the lowest overall significance ratios; however, while only weakly associated with PHB, this dimension was strongly related to SRB. On the basis of the evidence compiled, it is recommended that consideration of HBM dimensions be a part of health education programming. Suggestions are offered for further research.
7,512 citations
"Physical activity in Iranian older ..." refers background in this paper
...It is believed that this model is one of the most appropriate models that could explain and predict health-related behaviors [23]....
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TL;DR: The PASE is a brief, easily scored, reliable and valid instrument for the assessment of physical activity in epidemiologic studies of older people.
2,714 citations
TL;DR: It is indicated that about one-third of elderly people develop a fear of falling after an incident fall and this issue should be specifically addressed in any rehabilitation programme.
Abstract: Objectives To identify the characteristics of elderly persons who develop a fear of falling after experiencing a fall and to investigate the association of this fear with changes in health status over time. Design A prospective study of falls over a 2-year period (1991-92). Falls were ascertained using bimonthly postcards plus telephone interview with a standardized (World Health Organisation) questionnaire for circumstances, fear of falling and consequences of each reported fall. Each participant underwent a physical exam and subjective health assessment each year form 1990 to 1993. Setting New-Mexico Aging Process Study, USA. Subjects 487 elderly subjects (> 60 years) living independently in the community. Main outcome measures Fear of falling after experiencing a fall. Results 70 (32%) of 219 subjects who experienced a fall during the 2 year study period reported a fear of falling. Women were more likely than men to report fear of falling (74% vs 26%). Fallers who were afraid of falling again had significantly ore balance (31.9% vs 12.8%) and gait disorders (31.9% vs 7.4%) at entry in the study in 1990. Among sex, age, mental status, balance and gait abnormalities, economic resource and physical health, logistic regression analysis show gait abnormalities and poor self-perception of physical health, cognitive status and economic resources to be significantly associated with fear of falling. Subjects who reported a fear of falling experienced a greater increase in balance (P = 0.08), gait (P Conclusion The study indicated that about one-third of elderly people develop a fear of falling after an incident fall and this issue should be specifically addressed in any rehabilitation programme.
908 citations
"Physical activity in Iranian older ..." refers background in this paper
...Approximately 30% of older adults who have experienced a fall reported that they have a fear of falling [12] and the fear of falling was found to be high in elderly who had fallen during the previous year [13]....
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TL;DR: In this paper, the authors investigated the trans-theoretical model of behavior change with respect to the area of exercise adoption with a total of 778 men and women, recruited from four worksites, answered a 40-item questionnaire consisting of statements.
Abstract: Motivational and cognitive processes of behavior change with respect to the area of exercise adoption were investigated. A total of 778 men and women, recruited from four worksites, answered a 40-item questionnaire consisting of statements based on constructs from the trans-theoretical model of behavior change. Principal-components analysis identified two factors--one a 6-item component representing avoidance of exercise (Cons), the other a 10-item component representing positive perceptions of exercise (Pros). Analysis of variance showed that the Pros, Cons, and a Decisional Balance measure (Pros minus Cons) were significantly associated with stage of exercise adoption. Results are consistent with applications of the model to smoking cessation and other areas of behavior change. Distinctions between exercise adoption and behaviors such as smoking cessation, weight loss, and alcoholism are discussed.
585 citations
Journal Article•
TL;DR: Examination of barriers and facilitators to physical activity and exercise among underserved, ethnically diverse older adults suggested strategies for culture-specific programming of community-based physical activity programs.
Abstract: Introduction Increasing physical activity is a goal of Healthy People 2010. Although the health benefits of physical activity are documented, older adults are less physically active than any other age group. The purpose of this study was to examine barriers and facilitators to physical activity and exercise among underserved, ethnically diverse older adults. Methods Seventy-one older adults were recruited through community agencies to participate in seven ethnic-specific focus groups: American Indian/Alaska Native, African American, Filipino, Chinese, Latino, Korean, and Vietnamese. Groups were conducted in the participants' primary language and ranged in size from 7-13 participants. Mean age was 71.6 years (range from 52 to 85 years; SD +/- 7.39). Professional translators transcribed audiotapes into the language of the group and then translated the transcript into English. Transcripts were systematically reviewed using content analysis. Results Suggested features of physical activity programs to enhance participation among ethnically diverse minority older adults included fostering relationships among participants; providing culture-specific exercise; offering programs at residential sites; partnering with and offering classes prior to or after social service programs; educating families about the importance of physical activity for older adults and ways they could help; offering low- or no-cost classes; and involving older adults in program development. Walking was the exercise of choice across all ethnic groups. Health served as both a motivator and a barrier to physical activity. Other factors influencing physical activity were weather, transportation, and personal safety. Conclusion Findings from this study suggest strategies for culture-specific programming of community-based physical activity programs.
366 citations
"Physical activity in Iranian older ..." refers background in this paper
...However although many researchers from Iran and other countries have explored the perceptions of older adults towards exercise and fitness [11,16,17], few studies aimed to explore perceptions of older adults who experienced falls [18]....
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