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Physical activity programs can be adapted to older adults. They may include walking, water exercises, balance or flexibility exercises, and weight training. They can be done individually at home or with other people. The activities should produce a sensation of warmth, and make you breathe harder. You should be able to hold a conversation while exercising but be too short of breath to sing.
For every 100 older adults who are physically active, 12 improve their ability to perform daily activities due to physical activity.
Ability to perform daily activities is improved for... | ||
---|---|---|
47% of older adults |
35% of older adults |
12% of older adults |
With | Without | Impact |
Design: Systematic review of 19 randomized controlled trials, including 6 trials on ADL; Participants: 594 individuals aged 65 and older with moderate dependence in terms of mobility; Intervention: Physical activity (e. g., aerobic, balance, flexibility, endurance, strength activities, or other activities related to maintaining and improving performance in ADL); Follow-up: Varied from the end of intervention to 6 months.
For every 100 older adults who are physically active, 2 increase their walking speed due to physical activity.
Walking speed is increased for... | ||
---|---|---|
34% of older adults |
32% of older adults |
2% of older adults |
With | Without | Impact |
Design: Systematic review of 19 randomized controlled trials, including 5 trials on gait speed; Participants: 532 individuals aged 65 and older with moderate dependence in terms of mobility; Intervention: Physical activity (e.g., aerobic, balance, flexibility, endurance, strength activities, or other activities related to maintaining and improving performance in ADL); Follow-up: variable among studies, from the end of intervention to 6 months.
For every 100 older adults who are physically active, 16 increase their endurance due to physical activity.
Endurance is increased for... | ||
---|---|---|
48% of older adults |
32% of older adults |
16% of older adults |
With | Without | Impact |
Design: Systematic review of 19 randomized controlled trials, including 2 trials on endurance; Participants: 81 individuals aged 65 and older with moderate dependence in terms of mobility; Intervention: Physical activity (e.g., aerobic, balance, flexibility, endurance, strength activities, or other activities related to maintaining and improving performance in ADL; Follow-up: Varied among studies, from the end of intervention to 6 months.
Older adults who are physically active experience inconsistent effects on their balance. Some tests suggest they increase their balance, while others suggest they do not.
Design: Systematic review of 19 randomized controlled trials, including 13 trials on balance; Participants: 532 older adults with moderate dependence with regard to mobility; Intervention: Physical activity (e.g., aerobic, balance, flexibility, endurance, strength, or other activities related to maintaining and improving performance in ADL); Follow-up: Varied from the end of intervention to 6 months.
Regular physical activity has several additional benefits, for example:
Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association.
Some older adults feel temporary muscle soreness after exercising. They can also experience muscle, bone or joint problems (for example minor strains, tendonitis, exacerbation of osteoarthritis, or joint pain).
Design: Systematic review of 17 randomised controlled trials; Participants: 4,305 older adults aged 60 years and more living at home; Intervention: Physical activity (e.g., Tai chi, balance or strength exercises) with the aim of preventing falls.
Design: Systematic review of 121 randomised controlled trials; Participants: 6,700 older adults aged 60 years and more; Intervention: Progressive resistance strength training; Follow-up: Varied from the end of the intervention to 1 year.
In general, to experience positive impacts from physical activity, people must be physically active at least 3 weeks, either for 20 minutes 3 times a week, or for 2 hours once a week. Whatever the duration and frequency of the exercise, it takes time.
Design: Systematic review of 19 randomized controlled trials, including 6 trials on ADL; Participants: 594 individuals aged 65 and older with moderate dependence in terms of mobility; Intervention: Physical activity (e.g., aerobic, balance, flexibility, endurance, strength activities, or other activities related to maintaining and improving performance in ADL); Follow-up: Varied from the end of intervention to 6 months.
Watchful waiting consists of actively monitoring the person's health without them undertaking treatment or making lifestyle changes.
Among the older adults who make changes improve their independence in daily activities, a certain proportion do not experience any improvement. They may be disappointed that the steps they took did not allow them to reach their goals.
All the available options to improve mental capacities cause some inconveniences. These inconveniences are reviewed in the previous pages of this document. People who do not undertake any new treatment or changes to their lifestyle do not experience any of these inconveniences.
For every 100 older adults experiencing a loss of autonomy, about 49 experience an improvement in their independence without undertaking any change to their lifestyle.
People who experience a loss of independence in daily activities may wish to take some time to find solutions by themselves, and to try to develop strategies that best suit their needs.
People who choose watchful waiting without making any changes are less likely to improve their independence than those who choose one of the other options presented
Actively monitoring the health of older adults identified as at rik of loosing their independence, increases their risk of dying.
Death occurs within 7 years for... | ||
---|---|---|
51% of independent older adult |
71% of older adults lacking independence in daily activitie |
20% of older adults |
With | Without | Impact |
Design: longitudinal cohort study; Participants: 1,203 individuals aged 75 years and older, living in the community and institutions; Intervention: watchful waiting; Follow-up: 5 and 7 years.
Actively monitoring the health of older adults identified as at risk of loosing their independence, increases their risk of being admitted to a long-term care facility.
Admission to a long-termcare facility occurs within 7 years for... | ||
---|---|---|
5% of independent older adult |
17% of older adults lacking independence in daily activities |
12% of older adults |
With | Without | Impact |
Design: longitudinal cohort study; Participants: 1,203 individuals aged 75 years and older, living in the community and institutions; Intervention: watchful waiting; Follow-up: 5 and 7 years.
Failing to make changes to one's lifestyle or undertake treatment to prevent loss of independence in daily activities can lead to feelings of helplessness and distress.
Design: randomized controlled study; Participants: 30 individuals aged 75 years and older; Intervention: watchful waiting vs. self-care telephone talks; Follow-up: 19 weeks.
Design: longitudinal study; Participants: 692 individuals aged 65 years or older who had high functional health status at the baseline; Intervention: watchful waiting across time (between baseline and 2 years); Follow-up: 2 years.
Design: Systematic review; Participants: older adults living in the community (mean age >72 years ); Intervention: ADL interventions (included an activity-based or occupation-based component); Follow-up: varied from 10 weeks to 5 years.
Actively monitoring the heal of older adults identified at risk of loosing their independence, increases their risk of experiencing a decrease in their quality of life.
Design: Systematic review; Participants: older adults living in the community (mean age >72 years ); Intervention: IADL interventions (included an activity-based or occupation-based component); Follow-up: varied from 10 weeks to 5 years.
Consists of doing activities and games that stimulate mental capacities, e.g., reading, crosswords, sudoku. These activities can either be done individually, or in a group under the supervision of a professional.
For every 100 older adults who do brain exercises, 11 maintain or improve their ability to perform daily activities due to the exercises.
Ability to perform daily activities is maintained or improved for... | ||
---|---|---|
60% of older adults |
49% of older adults |
11% of older adults |
With | Without | Impact |
Design: randomized controlled trial; Participants: 2,832 older adults with mean age of 73.6 years; Intervention: memory training, reasoning training and speed processing; Follow-up: 10 years.
For every 100 older adults who do brain exercises, 22 maintain or increased their processing speed due to the exercises.
Processing speed is maintained or increased by... | ||
---|---|---|
70% of older adults |
48% of older adults |
22% of older adults |
With | Without | Impact |
Design: randomized controlled trial; Participants: 2,832 older adults with mean age of 73.6 years; Intervention: memory training, reasoning training and speed processing; Follow-up: 10 years.
Older adults may feel some anxiety to do well if brain exercises are done in a group.
Design: Systematic literature review including 38 experimental studies; Participants: 3,205 individuals aged 55 years old or more, presenting with mild cognitive impairment; Intervention: Computer-based cognitive training during 2-68 weeks, and from 20-120 minutes a day, depending on the study.
Self-management support programs are educational and supportive interventions provided by healthcare staff to encourage people living with chronic diseases to take a more active role in their health. They aim to increase the person's skills and confidence in managing their own health problems. These programmes can include information about the disease; education to offer knowledge, skills, and strategies to manage the consequences of the disease/disability; social support through communication with other patients or professionals; and training.
Older adults who participate in self-management support programs are more likely to be independent in their daily activities compared to those who do not take part in such programs.
Design: Systematic review of 12 randomized clinical trials; Participants: 3,101 individuals living in the community aged 64 and older; Intervention: Self-management support program defined as an educational and supportive intervention with the aim of increasing patients’ skills and confidence in managing their health problems; Follow-up: 12 weeks to 24 months.
For every 100 adults who participate to a self management program, 12 to 17 avoid hospitalization during the first 30-day episode of homecare due to the program.
With self-management done by telephone, unplanned hospital readmissions are avoided by... | ||
---|---|---|
72% of older adults |
55% of older adults |
17% of older adults |
With | Without | Impact |
With self-management provided in the home, unplanned hospital readmissions are avoided by... | ||
---|---|---|
67% of older adults |
55% of older adults |
12% of older adults |
With | Without | Impact |
Design: randomized clinical trial; Participants: 281 individuals aged 65 years and older hospital-discharged with comorbidities; Intervention: nurse-led case management program; Follow-up: 12 weeks.
Current research does not show any effect self-management support programs on mobility of oder adults.
Design: randomized clinical trial; Participants: 201 chronically ill adults aged 70 and older recruited through medical practices; Intervention: A targeted, multi-component disability prevention and disease self-management program led by a geriatric nurse practitioner [GNP]; Follow-up: 12 months.
Some older adults who take part in self-management programs find them strenuous due to the time involved.
Design: randomized clinical trial; Participants: 139 people aged 59 or older with different comorbidities (lung disease, heart disease, diabetes, or arthritis); Intervention: The Chronic Disease Self-Management Program; Follow-up: 6 months.
Smart homes feature technologies that are integrated into the infrastructure of the residence to monitor what is happening and improve residents' experience at home. In healthcare, these technologies may be used to monitor the occupant’s health, for exemple their weight, pulse, blood pressure, falls and movements. They can also help maintain their well-being, for example by controlling the quality of the air.
Older adults who live in smart homes are more likely to be able to perform daily activities compared to those who don't.
Design: randomized controlled trial; Participants: 106 individuals with a mean age of 72 in intervention group and 75.6 in control group; Intervention: a computer with Internet access and X10-based smart home technology; Follow-up: 24 months.
Design: randomized controlled trial; Participants: 205 individuals aged 60 years and older; Intervention: daily home telemonitoring; Follow-up: 12 months.
For every 100 adult who live in smart homes, 7 avoid hospitalization during the first 30-day episode of homecare due to the technologies.
Hospitalizations during the first 30-day episode of homecare are avoided by ... | ||
---|---|---|
90% of older adults |
83% of older adults |
7% of older adults |
With | Without | Impact |
Design: retrospective nonexperimental study; Participants: 5,873 Medicare beneficiaries aged 65 years and older, receiving home health services through a network of community-based home health agencies operating in the states of Texas and Louisiana; Intervention: integrated, clinician-focused telehealth monitoring system; Follow-up: 1 year.
The current research shows smart home technologies do not help older adults avoid disease, illness, or injury.
Design: Systematic review; Participants: older adults, people with cognitive impairment and general population; Intervention: technologies for functional monitoring, safety monitoring, physiological monitoring, cognitive support sensory aids, and to increase social interaction; Follow-up: not mentioned.
Some older adults are worried about becoming overly reliant on these technologies.
Design: Integrative literature review including 16 studies with multiple designs; Participants: 7 to 119 older adults and caregivers; Intervention: smart home technologies (various sensors: motion, bed, stove, door, etc.); Follow-up: not mentioned.
In most cases, living in smart homes requires the purchase and installation of equipment. If the technology needs to be connected to the Internet or to a Web portal, then a monthly fee is also charged (ranging from $130 to $150 per month).
Design: longitudinal study; Participants: 12 individuals aged 55 years and older living at home; Intervention: sensor technology for remote monitoring; Follow-up: 12 months.
Some older adults who live in remote or under-served urban areas may have difficulty accessing smart home technologies.
Design: Integrative literature review including 16 studies with multiple designs; Participants: 7 to 119 older adults and caregivers; Intervention: smart home technologies (various sensors: motion, bed, stove, door, etc.); Follow-up: not mentioned.
Some older adults lack familiarity with computers and it can be difficult for them to learn how to use smart home technologies.
Design: randomized controlled trial; Participants: 106 individuals with a mean age of 72 in intervention group and 75.6 in control group; Intervention: a computer with Internet access and X10-based smart home technology; Follow-up: 24 months.
Location of technologies in the home (i.e., in the bedroom or bathroom) or types and size of devices may be obtrusive.
Design: Integrative literature review including 16 studies with multiple designs; Participants: 7 to 119 older adults and caregivers; Intervention: smart home technologies (various sensors: motion, bed, stove, door, etc.); Follow-up: not mentioned.
Rehab (rehabilitation) or occupational therapy at home is provided by healthcare workers in various professions, as part of homecare services, more often occupational therapist, physiotherapists, and nurses. It allows people to continue to go about their daily activities and tasks in an independent manner, based on their own goals. After an initial assessment, the healthcare provider prepares an action plan detailing care, preventative measures, and rehabilitation to help compensate for the person's limitations. It can take at least 6 weeks to complete, depending on the person's needs.
For every 100 older adults receiving rehab or occupational therapy at home, 25 improve their ability to perform daily activities due to this intervention.
Ability to perform daily activities is improved for... | ||
---|---|---|
56% of older adults |
31% of older adults |
25% of older adults |
With | Without | Impact |
Design: Randomized clinical trial; Participants: 61 home-dwelling older adults with functional decline in one or more daily activities living in rural areas (Norway); Intervention: reablement intervention including maximum rehabilitation period of 3 months, training in daily activities, adaptations to the environment or the activity, and exercise programs; Follow-up: 9 months.
Current research shows that receiving rehab or occupational therapy at home does not reduce older adults' risk of dying.
Design: Randomized controlled trial; Participants: 750 older adults with a mean age of 82 years, needing assistance with one or more activities of living; Intervention: homecare reablement including strength, balance and endurance exercises to improve or maintain mobility; Follow-up: 24 months.
For every 100 older adults who receive rehab or occupational therapy at home, 10 avoid emergency department visits due to this intervention.
Emergency department visits are avoided by.. | ||
---|---|---|
90% of older adults |
80% of older adults |
10% of older adults |
With | Without | Impact |
Design: Controlled clinical trial; Participants: 691 individuals aged 65 years or older at risk of functional decline after acute illness or hospitalization but with the potential for maintaining or improving their function; Intervention: Restorative care; Follow-up: 2 years.
The current research does not show any effect of rehab or occupational therapy at home to avoid hospital admission of older adults.
Design: Randomized controlled trial; Participants: 750 older adults with a mean age of 82.28 years, needing assistance with one or more activities of living; Intervention: homecare reablement including strength, balance and endurance exercises to improve or maintain mobility; Follow-up: 24 months.
For every 100 older adults receiving rehab or occupational therapy in the home, 11 avoid admission to a long-term care facility due to this intervention.
Admission to a long-term care facility is avoided by... | ||
---|---|---|
82% of older adults |
71 % of older adults |
11 % of older adults |
With | Without | Impact |
Design: Controlled clinical trial; Participants: 691 individuals aged 65 years or older at risk of functional decline after acute illness or hospitalization but with the potential for maintaining or improving their function; Intervention: Restorative care; Follow-up: 2 years.
Some older adults feel that rehab or occupational therapy in the home do not meet all their needs because...
Design: cross-sectional survey; Participants: 1,161 Northern Irish adults aged 65 years and older receiving domiciliary care service and their carers; Intervention: Domiciliary care; Follow-up: no follow-up.
Design: longitudinal study; Participants: 1,015 individuals aged 65 years and older; Intervention: homecare reablement services offered in five councils; Follow-up: 12 months.
There may be delays in accessing public rehabilitation or occupational therapy services. This type of service is also offered in the private sector, but it must be paid for.
Yoga includes physical, mental, and spiritual practices that originated in ancient India. It involves holding stretches as a kind of low-impact physical exercise, and may involve meditation, visualization, breathing exercises, and music.
For every 100 older adults who do yoga, 63 increase their balance due to yoga.
Balance is increased for... | ||
---|---|---|
100% of older adults |
37% of older adults |
63% of older adults |
With | Without | Impact |
Design: Systematic review and meta analysis of 5 randomized controlled trials on balance; Participants: 307 older people with a mean age ranging from 63 to 84 years; Intervention: 60–90 min of yoga, 1–2 times per week, for 8–24 weeks in total; Follow-up: Varied from 8 to 24 weeks.
Older people who do yoga are more likely to have a normal mobility compared to those who don't.
Design: Systematic review and meta analysis of 3 randomized controlled trials on mobility; Participants: 307 older people with a mean age ranging from 63 to 84 years; Intervention: 60–90 min of yoga, 1–2 times per week, for 8–24 weeks in total; Follow-up: Varied from 8 to 24 weeks.
Older adults who do yoga may experience minor adverse events such as knee pain, lower back pain, or minor muscle strain. Some may also experience a worsening of existing lower back pain.
Design: Systematic review with meta-analysis of 6 randomized controlled trials, including 3 trials on physical mobility; Participants: 307 people with a mean age ranging from 63 to 84 years; Intervention: 60–90 min of yoga, 1–2 times per week; Follow-up: Varied from 8 to 24 weeks.
Design: Pilot randomized controlled trial reporting results on mobility; Participants: 54 people aged 59 to 87 years with a mean age of 68 years; Intervention: twice-weekly group-based program of Iyengar-style yoga; Follow-up: 12 weeks.
Design: Pilot randomized controlled trial reporting results on osteoarthritis outcomes; Participants: 36 people with a mean age of 72 years; Intervention: one 60-minute Hatha yoga class per week; Follow-up: from 8 to 20 weeks.
To feel the benefits, the person generally needs to do yoga for 60 minutes or more at a time, 1 to 2 times a week, and for at least 8 weeks. This takes time.
Design: Systematic review of 6 randomized controlled trials, including 3 trials on physical mobility; Participants: 90 older adults with a mean age ranging from 63 to 84 years; Intervention: 60–90 min of yoga, 1–2 times per week, for 8–24 weeks in total; Follow-up: Varied from 8 to 24 weeks.
Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Downgraded because of risk of bias (missing information about random sequence generation, allocation concealment or blinding of participants and assessors in more than 50% of the studies) and heterogeneity of the results