Preface: Functional Fitness and Health Promotion of Older Adults No abstract available

Functional Fitness in Older Adults: A Systematic Review and Meta-analysis Background: Using multiple interventions can increase muscle strength in older adults. A functional fitness test is a useful instrument to identify the effectiveness of physical functioning among older adults. However, the results in previous studies with regard to improvements in their physical function are inconsistent. Aim: To synthesize the intensity and interval of the effective interventions on physical functioning in community-dwelling older adults. Methods: A systematic review and meta-analysis on the related literature was conducted. The databases searched were PubMed, EBSCO, and Cochrane Trials. Papers published from January 1, 2013, to December 31, 2017, were subjected to a computerized search. The inclusion criteria were that the randomized controlled trials examined a healthy and community-dwelling older adult population, and the instrument used to evaluate functional fitness was based on “functional fitness” or “senior fitness.” Two reviewers independently assessed the methodological quality of each trial, including study participants, allocation, blinding, data analysis, duration of follow-up and loss to follow-up, intervention, inclusion criteria, outcome measurements, and other biases. Results: Among the 218 trials, only 5 randomized control trials were synthesized in this systematic review. These works examined the effects of the intensity, interval, and duration of intervention programs based on elastic band exercise, aerobic training and combined aerobic and resistance training, Tai Chi with TheraBand resistance exercise, and Tai Chi and Thai Yoga exercise. Conclusions: A 1-hour intervention program, including 10 to 15 minutes of warm-up, 30 to 40 minutes of main exercise, and 5 to 10 minutes of cool-down stages, for 2 to 3 sessions per week, and continuing for 12 to 16 weeks, was the effect intervention for community-dwelling healthy older adults to enhance their upper body strength, lower body flexibility, and agility balance.

Effectiveness of Chair Yoga for Improving the Functional Fitness and Well-being of Female Community-Dwelling Older Adults With Low Physical Activities Objective: This study investigated the effect of a 12-week chair yoga program on functional fitness and well-being in community-dwelling older women with low physical activities. Methods: A total of 31 community-dwelling older women with low physical activity participated in this quasi-experimental study. Two communities of the elderly were allocated to 2 groups through lot drawing. Subjects were randomly assigned to control or intervention groups by community to avoid contamination—the experimental group of 16 people and the control group of 15 people. The participants in the experimental group trained chair yoga exercise for 12 weeks with 2 sessions per week, 110 minutes per session, whereas the control group maintained its regular daily activities. Data collection from multiple variables was conducted using questionnaire (well-being) and examination on functional fitness (handgrip strength, lower limb muscle strength, upper limb muscle strength, static balance, agility and dynamic balance, lower limb flexibility, upper limb flexibility). Results: The results showed a significant improvement for the experimental group in the handgrip strength (P = .001), upper limb muscle strength (P = .047), lower limb muscle strength (P = .007), static balance (P = .016), agility and dynamic balance (P = .009), and in the well-being (P = .003) after the intervention. The control group reveals deteriorated result in upper limb muscle strength (P = .016). Among other functional fitness and well-being variables, there is no significant difference. Conclusion: The chair yoga training provides a simple and inexpensive exercise program that improves the functional fitness and well-being effectively.

Effects of Tai Chi Combined With Theraband Training on Physical Fitness, Psychological Well-being, and Pain in Older Sedentary Office Workers: A Pilot Randomized Controlled Trial Objectives: The aim of this study was to compare the effectiveness of Tai Chi combined with Theraband training with Tai Chi exercise–only on physical fitness, psychological well-being, and pain in older sedentary office workers. Materials and Methods: Forty sedentary office workers older than 55 years were recruited and randomly assigned to an intervention or control group. Both groups received Tai Chi exercise for 12 weeks, 3 times per week, whereas participants in the intervention group also held a Theraband using 2 hands when practicing Tai Chi. Physical and psychological measurements and pain scores were collected at baseline, week 6, and week 12. Results and Conclusions: The results showed a significant improvement in lower-limb and right upper-limb strength after the Tai Chi combined with Theraband intervention. Future research might extend the length of the intervention.

Six-Minute Walk Test in Community-Dwelling Older Adults: Treadmill Versus Corridor Walking Distances Background: Comparative studies on the six-minute walk test during overground (6MWT-C) versus treadmill (6MWT-T) are limited, and the minimal detectable change (MDC) of 6MWT-T in older adults is lacking. This study was conducted to compare the distance of 6MWT-C with that of 6MWT-T in community-dwelling older adults and to explore the factors associated with the distance discrepancy between the 2 types of 6MWT. Methods: Forty community-dwelling older adults were recruited. Lower-limb muscle strength and balance (Berg Balance Scale, BBS) were assessed. The subjects randomly received 6MWT-C and 6MWT-T and returned to repeat the testing within 1 week. Physiological responses were collected before and after 6MWTs. Results: The distance of 6MWT-C was significantly greater than that of 6MWT-T. The MDC of 6MWT-C and 6MWT-T was 54.08 and 56.54 m, respectively. The distance discrepancy of the 2 types of 6MWT was not associated with lower-limb muscle strength or BBS score. Conclusion: Compared with 6MWT-C, 6MWT-T is reliable and has similar MDC in community-dwelling older adults. However, the distances of the 2 types of 6MWT are not interchangeable.

Combining Multifactorial Assessment Tools and Dimensionality Reduction Analysis for Fall Risk Classification in Community-Dwelling Older Adults Background and Purpose: Optimal approaches in fall risk assessment involve interdisciplinary collaboration of assessment. This current work aimed at screening the fall risk characteristics from the objective balance and mobility tests between older fallers and nonfallers and further assessing the feasibility of 2 statistical dimensionality reduction models, Linear Discriminant Analysis (LDA) and Generalized Discriminant Analysis (GDA) for discriminating older nonspecific fallers. We hypothesized that the high-dimensionality objective sensor-based parameters, followed by a feature selection and dimensionality reduction process, would be able to discriminate older nonspecific fallers. Methods: Thirty-one community-living older individuals who were older than 60 years (faller: n = 15; nonfaller: n = 16) were recruited. The measurements include gait, balance, and ankle proprioception performances. LDA and GDA were further applied to obtain more discriminative feature space. Receiver-operating characteristic (ROC) curves were constructed to compare the classification quality in all the features. Results: Although some features in single objective measure reached statistical significance, the original features still resulted in high within-class and low between-class variances in the feature space. By further applying LDA and GDA on the original features, the performance of LDA in the feature space was improved. The area under the curve of ROC was GDA dimensionality reduction feature (1), LDA dimensionality reduction feature (0.99), proprioception (0.752), inertial measurement unit (0.745), and center of pressure (0.72), respectively. Conclusions: Experimental results showed the GDA feature has the best classification quality and the additional advantage in combination of interdisciplinary multifactorial fall risk assessment.

Physical Activity, Muscle Strength, and Functional Fitness: Comparing Older Adults With and Without Alzheimer Dementia Background: Muscle strength and fitness are important in supporting an independent lifestyle in the elderly, especially those with Alzheimer disease (AD). Objectives: To establish the relationships of physical activity, key muscle strength, and functional fitness on the elderly with and without AD. Methods: Twenty AD patients and 20 non-AD elderly were tested for senior functional fitness test, handgrip strength, and muscle strength of elbow flexors and knee extensors. The Physical Activity Scale for the Elderly was also documented. Results: Handgrip strength and elbow flexor strength were significantly lower in the AD group, especially in those with mild severity. They also showed worst agility and least amount of physical activity weekly. Handgrip and elbow flexor strength of the AD group also correlated with the Physical Activity Scale for the Elderly. Conclusions: Older people with AD appear to engage less in physical activity as the disease progresses. The decline in muscle strength and agility might contribute further to limited physical activity and dependent lifestyle.

Aging Adults' Preferences for Wellness Program Activities and Delivery Characteristics: A Cross-Sectional Survey Background: Lifestyle wellness programs help prevent and manage chronic diseases, yet few are designed for aging adults. Purpose: Identify characteristics associated with aging adults' preferences for wellness program activities and delivery characteristics. Subjects/Methods: Cross-sectional, self-administered survey of a convenience sample of 386 adults aged 55 years and older. Logistic regression models identified characteristics influencing preferences. Results: Current healthy behaviors, gender, and age influenced many preferences, while body mass index, multiple chronic conditions, self-rated general health status, and quality of life did not. Discussion: Incorporating aging adults' preferences for wellness programs will help design appealing and engaging programs.

Cognitive and Physical Factors Affecting High-Speed Driving Ability in Older Adults Background and Purpose: The ability to drive is important for the elderly to maintain their mobility and independence. Therefore, to investigate age-related changes in driving-related functions and their relation to the braking ability of drivers driving at high speeds, subjects were organized by age into study groups (younger, middle-aged, and older). Methods: For a correlational comparative study, 36 male participants were recruited and instructed to complete the Assessment of Driving-Related Skills (ADReS), lower limbs muscle test, and driving tasks on a driving simulator under 3 speed conditions. For the driving tasks, 3 event phases were analyzed: perception-reaction time (PRT), brake-movement time, and fast pressing time. Results: Older drivers demonstrated a significant decline in certain driving-related cognitive and motor abilities, as well as hip flexion and knee extension muscle strength, and exhibited a significantly longer PRT under moderate- and high-speed conditions compared with younger drivers. A longer PRT under moderate- and high-speed conditions was significantly associated with poor driving-related cognitive and motor abilities. Conclusion: The increased PRT for older drivers under moderate- and high-speed conditions might increase their risk of vehicular accidents on highways.

The Outcomes of Cognitive Stimulation Therapy (CST) for Community-Dwelling Older Adults With Cognitive Decline in Taiwan Aim: To assess the impact of cognitive stimulation therapy (CST) on cognition, quality of life, and mood in Taiwanese elders with cognitive impairment attending a day care center. Methods: Twenty-five adults aged 65 years and older were assigned into the CST (n =12) and control (n = 13) groups. Weekly 90-minute CST sessions for 14 weeks were conducted by occupational therapists and occupational therapist students. The Alzheimer's Disease Assessment Scale—Cognitive subscale (ADAS-Cog), the Quality of Life in Alzheimer's Disease (QOL-AD), and the Hospital Anxiety and Depression Scale (HADS) were used for pre- and posttest measurements. Within- and between-group comparisons of test scores were performed. Results: Significant between-group differences were found for the ADAS-Cog change scores. Specifically, there was significant cognitive improvement for participants in CST group at posttest, with no observable change for the controls. No significant pre-/postgains were noted in the QoL-AD and HADS scores for the 2 groups. Conclusion: The once-a-week CST approach seems to be a viable alternative to twice-a-week CST for community-dwelling older adults with mild to moderate cognitive deficits. Further investigation is required to determine the optimal dose of CST for the elderly.