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Biomedical subjects

Marijke Hopman-Rock

Publications and source records attributed to Marijke Hopman-Rock.

11 recordsLinked to original sources

Detection of memory impairment in the general population: screening by questionnaire and telephone compared to subsequent face-to-face assessment.

BACKGROUND: Development of efficient methods for identifying subjects with Mild Cognitive Impairment (MCI) from the general population is warranted, because these subjects represent an important group for (epidemiological) research purposes. OBJECTIVES: (1) To describe a two-step population screening for identifying adults with MCI from the general population for research purposes, by questionnaire and telephone; (2) to compare screening by telephone (method 1) to a subsequent face-to-face assessment (method 2). METHODS: In method 1, subjects with memory complaints were identified from the general population (n = 5491) by a postal questionnaire. Subsequently, cognitive status and memory were assessed in a telephone interview using the Telephone Interview for Cognitive Status and the Ten Word Learning Test. Next, subjects with MCI according to method 1 were subjected to a face-to-face assessment for method 2, in which cognitive status and memory were assessed using the Mini Mental State Examination (MMSE) and the Auditory Verbal Learning Test (AVLT). RESULTS: Two hundred and twenty-seven subjects completed both the telephone interview and the face-to-face assessment. Ninety-three subjects (41%) had MCI according to both methods. Seven subjects (3%) failed to meet MCI criteria according to method two because of an MMSE score <24; 127 subjects (56%) failed because of normal AVLT scores. CONCLUSION: (1) The two-step population screening was able to detect a considerable number of MCI-subjects in the general population; (2) agreement between both methods was moderate. Therefore, the method of recruiting subjects for (epidemiological) studies has to be taken into consideration when interpreting results of these studies.

Aged↗

Older persons afraid of falling reduce physical activity to prevent outdoor falls.

OBJECTIVE: The aim of this study was to test the assumption that the level of outdoor physical activity mediates the relationship between fear of falling and actual outdoor falls according to the Task Difficulty Homeostasis Theory. METHOD: A prospective follow-up study of 10 months conducted in the year 2000 in three municipalities in the province of Friesland, The Netherlands. The participants were 1752 people aged 65 and older, living independently, in the community. Main baseline data were age, sex, outdoor physical activities (walking, bicycling), and fear of outdoor falls. The number of people who fell outdoors was recorded. RESULTS: People with a high fear of falling were more often low to moderately active or active compared with people who had no such fears and were more often very active. Fear of falling was not associated with outdoor falls, but it was after taking the level of physical activity into account. CONCLUSIONS: Outdoor physical activity mediates the relationship between fear of falling and actual outdoor falls. This implies that the incidence of falls as an outcome in studies does not adequately represent the impact of risk factors for falls and that level of physical activity should be taken into account.

Accidental Falls↗

Clinimetric review of motion sensors in children and adolescents.

BACKGROUND AND OBJECTIVES: To review the clinimetric quality of motion sensors used to assess physical activity in healthy children and adolescents (2-18 years). METHODS: A systematic literature search was performed in PubMed, Embase, and SpycINFO. The clinimetric quality of two pedometers (Digi-Walker, Pedoboy), four one-dimensional accelerometers (LSI, Caltrac, Actiwatch, CSA/ActiGraph), and three three-dimensional accelerometers (Tritrac-R3D, RT3, Tracmor2) was evaluated and compared using a 20-item checklist. RESULTS: Overall, the quality of the studies (n = 35), and therefore the level of evidence for the reproducibility, validity, and feasibility of the motion sensors was modest (mean = 6.4 +/- 1.6 out of 14 points). There was strong evidence for a good reproducibility of the Caltrac in adolescents (12-18 years), a poor reproducibility of the Digi-Walker in children (8-12 years), a good validity of the CSA/ActiGraph in children and adolescents (8-18 years), and a good validity of the Tritrac-R3D in children (8-12 years). CONCLUSIONS: The CSA/ActiGraph and the Caltrac are the only motion sensors in which the reproducibility, validity, and feasibility have been examined in different age groups. Further studies of the reproducibility of motion sensors in preschool children, improvement of the quality of clinimetric studies, and evaluation of the acceptability of motion sensors are warranted.

Acceleration↗

Protocol for Project FACT: a randomised controlled trial on the effect of a walking program and vitamin B supplementation on the rate of cognitive decline and psychosocial wellbeing in older adults with mild cognitive impairment [ISRCTN19227688].

BACKGROUND: The prevalence of individuals with cognitive decline is increasing since the number of elderly adults is growing considerably. The literature provides promising results on the beneficial effect of exercise and vitamin supplementation on cognitive function both in cognitively healthy as well as in the demented elderly. METHODS/DESIGN: The design is a two-by-two factorial randomised controlled trial. The study population consists of independently living elderly, between 70 and 80 years old, with mild cognitive impairment (MCI). In the RCT the effect of two interventions, a walking program and vitamin supplementation, is examined. The walking program (WP) is a group-based program aimed at improving cardiovascular endurance; frequency two lessons a week; lesson duration one hour; program duration one year. Non-walking groups receive a placebo activity program (PAP) (i.e. low intensive non-aerobic group exercises, like stretching) with the same frequency, lesson and program duration. Vitamin supplementation consists of a single daily vitamin supplement containing 50 mg B6, 5 mg folic acid and 0,4 mg B12 for one year. Subjects not receiving vitamin supplements are daily taking an identically looking placebo pill, also for a year. Participants are randomised to four groups 1) WP and vitamin supplements; 2) WP and placebo supplements; 3) PAP and vitamin supplements; 4) PAP and placebo supplements. Primary outcome measures are measures of cognitive function. Secondary outcomes include psychosocial wellbeing, physical activity, cardiovascular endurance and blood vitamin levels. DISCUSSION: No large intervention study has been conducted yet on the effect of physical activity and vitamin supplementation in a population-based sample of adults with MCI. The objective of the present article is to describe the design of a randomised controlled trial examining the effect of a walking program and vitamin B supplementation on the rate of cognitive decline in older adults with MCI.

Aged↗

Predicting older adults' maintenance in exercise participation using an integrated social psychological model.

Little is known about the predictors of maintenance in organized exercise programmes. The aim of this study was to investigate the behavioral predictors of maintenance of exercise participation in older adults, using an integrated social psychological model. To this end, we carried out a prospective cohort study (n = 1,725; age 50 years or older) involving 10 different types of exercise programmes, with measurements at baseline and after 6 months. Predictors of intention to continue participating and the actual maintenance of exercise participation in the exercise programme were assessed using a step-wise logistic regression model. Significant odds ratios (ORs) predicting the intention to continue with the exercise programme were found for female sex, younger age, being married, being a non-smoker, being in paid employment, having a positive attitude towards exercise and having a high self-efficacy at baseline. Significant ORs predicting actual maintenance of exercise participation were short lapses, absence of lapses, high intention at baseline, high perceived quality of the programme, positive attitude at baseline and few risk situations at baseline. In order to promote maintenance of exercise participation for older adults, effort should be taken to prevent lapses, to help people cope with risk situations for lapses, to improve the attitude towards exercise participation and to improve the quality of the programme.

Aged↗

Determinants of participation in a health education and exercise program on television.

BACKGROUND: The daily television program 'the Netherlands on the Move' (NOM-tv), which primarily targets people aged over 55 (estimated Dutch 55+ population: 4 million), was designed as part of a national campaign for promoting physical activity. The aim of the study was to identify the determinants of exercise participation and viewing NOM-tv. METHODS: The method used was baseline test by quota digit dialing in the country (n = 988, stratified age 35+ and 55+), and follow-up after 7 months (n = 362). The main outcome measures are: intention and actual participation in exercises. The determinants are: attitude, social influences, self-efficacy, age, sex, education, knowledge about the health effects of exercise, habits, stage of change in exercising, and perceived barriers. The backgrounds were: marital status, living situation, mental health and vitality. RESULTS: NOM-tv attracted at least 21% of the physically non-active people at baseline to viewing and increased knowledge. The best predictors of intention to participate were: attitude, social influences, self-efficacy, age and gender. Actual participation was best predicted by age (higher), gender (female), intention, knowledge, and the (lower) number of perceived barriers. CONCLUSIONS: NOM-tv is a successful (high number of viewers) and relatively cheap way of getting inactive, older people-especially women-to exercise.

Adult↗

The effects of physical therapists' guidance on improvement in a strength-training program for the frail elderly.

Elderly participants experiencing difficulty in chair rising and with a maximum knee-extensor torque below 87.5 N . m were randomized to different versions of a strength-training program for the knee-extensors: to a high-guidance group (HG; two group sessions supervised by a physical therapist and one unsupervised home session per week, n = 17), a medium-guidance group (MG; one supervised group session and two unsupervised home sessions per week, n = 16), or a control group (C; no exercise, n = 16). Maximal isometric knee strength increased more in HG than in C (p = .03) and with increasing guidance (p = .03). The effect was mainly the result of participants with low initial strength. Walking speed increased more for HG than for C (p = .02) and than for MG (p = .06). No statistically significant improvements were seen on other functional tests. In summary, the study shows a trend toward better results with more supervision, but more and larger studies are needed to confirm this.

Aged↗

Assessment of readiness to change in patients with osteoarthritis. development and application of a new questionnaire.

OBJECTIVE: To develop a self-report measure for assessment of the stage of change in patients with osteoarthritis, in order to identify patients who would benefit from a self-management programme. METHODS: According to the 'stages of change' model a questionnaire was developed with three groups of items corresponding to the precontemplation stage (Pre), the contemplation (Cont) and the action (Act) stage. Internal consistency and factor structure of this questionnaire were investigated by assessing Cronbach's alphas and by performing factor analysis. SUBJECTS AND SETTING: The questionnaire was offered to 273 patients who entered a randomized clinical trial on self-management in a general health care setting. RESULTS: Factor analysis revealed that most items corresponded to the a priori described groups, while some items were not loading on the presumed factor. In each subgroup some items were deleted, resulting in a 15-item questionnaire. After this item reduction Cronbach's alphas were 0.72 (Pre), 0.76 (Cont) and 0.79 (Act) and all factor loadings were satisfactory (above 0.35). Classification revealed some differences between parts of the total group, for example in the proportion of patients in the preparation stage (recruited by general practitioner = 33.6%; advertisement = 49.2%). CONCLUSIONS: The Stages of Change Questionnaire in Osteoarthritis, a 15-item questionnaire to assess the 'stage of change' of a patient with osteoarthritis showed good internal consistency and adequate factor structure. These findings warrant further studies on validity and applicability in a clinical context.

Adult↗

Self-management in osteoarthritis of hip or knee: a randomized clinical trial in a primary healthcare setting.

OBJECTIVE: To assess in a primary healthcare setting the efficacy of a self-management program in middle-aged patients with osteoarthritis (OA). METHODS: This was a 2-group randomized controlled trial, with 273 patients aged 40 to 60 years with OA of the hip(s) and/or knee(s). The experimental intervention was compared with care-as-usual. Treatments and followup measurements were performed in a general healthcare setting by general practitioners. Duration of followup was 21 months after start of the intervention. Instruction in self-management techniques was given by physiotherapists. The main outcome measures were pain severity in hips and knees, other significant complaints, and functional limitations. RESULTS: To begin, 297 patients were randomized: 149 as self-management and 148 controls; before the intervention 24 withdrew for practical reasons (17 self-management, 7 controls). At 3-month followup the intervention group was significantly improved on a visual analog scale (VAS) for knee pain (score 0.67; SD 2.10) and the WOMAC (score 2.46; SD 9.49), while the control group showed stable VAS knee pain (0.01; SD 2.00) and deterioration on WOMAC (-0.53; SD 9.47). At 21-month followup the differences between the groups increased in favor of the intervention group (VAS pain knee: p values from 0.023 at 3 mo to 0.004 at 21 mo; WOMAC: p values from 0.030 to 0.022). CONCLUSION: The self-management program positively influenced knee pain and self-reported functional level in this sample of patients with OA. Differences between the study groups increased during followup in favor of the intervention group.

Adult↗

The effects of an exercise program for older adults with osteoarthritis of the hip.

OBJECTIVE: . Evaluation of an 8-week exercise program with strength training and lifestyle advice for older adults with osteoarthritis (OA) of the hip. Outcome measures were pain, hip function, disability, quality of life (QOL), and body mass index (BMI). METHODS: Inclusion criteria for this randomized controlled trial were: age >or=55 years, clinical diagnosis of OA according to American College of Rheumatology criteria, and living independently. Interview and physical data were collected at baseline, post-test, and followup (3 mo) by trained interviewers and physical therapists with validated instruments: Harris Hip Score, Sickness Impact Profile, Groningen Activity Restriction Scale, functional tests (walking, timed Up & Go, ascending and descending stairs, and toe reaching), and visual analog scales (pain and QOL). Data were analyzed on an intention-to-treat basis. Effect sizes were calculated. RESULTS: There were 109 participants (55 experimental, 54 controls). The 15 participants who dropped out were characterized by less tolerance to pain and younger age. The program had a positive effect on pain (moderate effect at post-test and small effect at followup), hip function (small effect at post-test), self-reported disability (small effect at followup), and the timed Up & Go test (small effect at followup). It did not affect QOL, other measures of observed disability, or BMI. CONCLUSION: The exercise program had positive effects on pain and hip function, which are important mediators of disability. This study fulfilled a need for older adults with hip OA and provides evidence of the benefit of exercise in the management of hip OA.

Activities of Daily Living↗

Dropout from exercise programs for seniors: a prospective cohort study.

This study examines dropout incidence, moment of dropout, and switching behavior in organized exercise programs for seniors in the Netherlands, as determined in a prospective cohort study (with baseline measurements at the start of the exercise program and follow-up after 6 months; N = 1,725, response rate 73%). Participants were community-living individuals 50+ who participated in different forms of organized exercise programs. The average dropout incidence was 0.15 per 6 months, which is lower than that for the general population. The dropout incidence and the timing of dropout differed substantially between the exercise programs. In total, 31% of people who dropped out of one type of exercise program switched to another type of exercise. The type of program and exercise had a strong effect on differences in this switching behavior. It is recommended that switching behavior be monitored in future studies.

Age Factors↗