Objective assessment and promotion of physical activity in older adults living in residential care facilities

The world's population is aging rapidly, as both life expectancy and the proportion of older people are increasing. This aging of the population is an indicator of improved health conditions and should be considered as a success story. However, it is also one of the main challenges that the world is facing because there is a growing need to prevent age-associated declines and diseases such as cardiovascular disease, diabetes, dementia, and osteoporosis. Physicalnbsp;(PA) has been identified as a major public health priority because it can help to prevent, or even reverse age-associated declines and losses of many physical and psychological variables. The present doctoral thesis, entitled 'Objective assessment and promotion of PA in older adults living in residential care facilities' focuses on three interrelated aims: assessment (CHAPTER 1), screening (CHAPTER 2), and intervention (CHAPTER 3). The first aim was to investigate the validity of two motion sensors in institutionalized older adults (Paper 1 and Paper 2). Accurate quantification of both PA and sedentary behavior isnbsp;for screening, goal setting, and program evaluation. The second aim was to examine the link between muscle strength and functional performance, and to identify functionally relevant cut-off values for knee extension strength in older adults (Paper 3). It is important to determine physical characteristics related to functional deterioration, as this will eventually lead to a loss of independence and institutionalization, and an increase in healthcare costs. Finally, thenbsp;aim was to examine the short- andnbsp;effects on PA, functional performance and muscle strength of a 10-week cycle ergometer intervention in assisted living facilities (Paper 4). PA promotion in older adults is important because a large proportion of the older population is not regularly involved in PA. Paper 1 examined the accuracy of a hip-worn and ankle-worn piezoelectric pedometer and the multisensornbsp;Mini (SWMini) in measuring steps during daily life activities in nursing home residents (N=68; mean age=86 years). The results revealed that the multisensor and hip- and ankle-worn pedometer significantly underestimated step counts, although measurement accuracy was higher when the pedometer was worn at the ankle. Moreover, pedometer accuracy improved as walking speed increased. The ankle-worn piezoelectric pedometer proved to be acceptably accurate for quantifying steps at walking speeds of ≥2.35 km/h. Next