Falls are a major problem for older adults. Many falls occur when a person’s attention is divided between two tasks, such as a dual task (DT) involving walking. Most recently, the role of personality in walking performance was addressed; however, its association with DT performance remains to be determined. This cross-sectional study of 73 older, community-dwelling adults explores the association between personality and DT walking and the role of gender in this relationship. Personality was evaluated using the five-factor model. Single-task (ST) and DT assessment of walking-cognitive DT performance comprised a 1-min walking task and an arithmetic task performed separately (ST) and concurrently (DT). Dual-task costs (DTCs), reflecting the proportional difference between ST and DT performance, were also calculated. Gender plays a role in the relationship between personality and DT. Extraversion was negatively associated with DTC-motor for men (ΔR2 = 0.06, p < 0.05). Conscientiousness was positively associated with DTC-cognition for women (ΔR2 = 0.08, p < 0.01). These findings may lead to effective personality-based early detection and intervention for fall prevention.

Background: Injury due to falls is a major problem among older adults. Decrements in dual-task postural control performance (simultaneously performing two tasks, at least one of which requires postural control) have been associated with an increased risk of falling. Evidence-based interventions that can be used in clinical or community settings to improve dual-task postural control may help to reduce this risk. Purpose: The aims of this systematic review are: 1) to identify clinical or community-based interventions that improved dual-task postural control among older adults; and 2) to identify the key elements of those interventions. Data sources: Studies were obtained from a search conducted through October 2013 of the following electronic databases: PubMed, CINAHL, PsycINFO, and Web of Science. Study selection: Randomized and nonrandomized controlled studies examining the effects of interventions aimed at improving dual-task postural control among community-dwelling older adults were selected. Data extraction: All studies were evaluated based on methodological quality. Intervention characteristics including study purpose, study design, and sample size were identified, and effects of dual-task interventions on various postural control and cognitive outcomes were noted. Data synthesis: Twenty-two studies fulfilled the selection criteria and were summarized in this review to identify characteristics of successful interventions. Limitations: The ability to synthesize data was limited by the heterogeneity in participant characteristics, study designs, and outcome measures. Conclusion: Dual-task postural control can be modified by specific training. There was little evidence that single-task training transferred to dual-task postural control performance. Further investigation of dual-task training using standardized outcome measurements is needed.

There is growing evidence that mobility interventions can increase in-hospital mobility and prevent hospitalization-associated functional decline among older adults. However, implementing such interventions is challenging, mainly due to site-specific constraints and limited resources. The Systems Engineering Initiative for Patient Safety (SEIPS 2.0) model has the potential to guide a sustainable, site-tailored mobility intervention. Thus, the aim of the current study is to demonstrate an adaptation process guided by the SEIPS 2.0 model to articulate site-specific, culturally based interventions to improve in-hospital mobility among older adults. Six consecutive phases addressed each of the model’s elements in the research setting. Phase-1 aimed to determine a measurable outcome: steps/d, measured with accelerometers, associated with functional decline. Phase-2 included interviews with key persons in leadership positions in the hospital to explore organizational factors affecting in-hospital mobility. Phases-3 and 4 aimed to identify attitudes, knowledge, barriers, and current behaviors of medical staff (n = 116) and patients (n = 203) related to patient mobility. Phase-5 included four focus-groups with unit staff aimed at developing an action plan while adapting existing intervention strategies to site needs. Phase-6 relied on a steering committee that developed intervention-adaptation and implementation plans. Nine hundred steps/d was defined as the intervention outcome. 40% of patients walked fewer than 900 steps/d regardless of capability. Assessing or promoting mobility did not exist as a separate task and thus was routinely overlooked. Several barriers to patients’ mobility were identified, specifically limited knowledge of practical aspects of mobility. Consequently, staff adopted practical steps to address them. Nurses were designated to assess mobility, and nursing assistants to support mobility. Mobility was defined as a quality indicator to be documented in electronic medical records and closely supervised by hospital and unit management. Preliminary analyses of the “Walk FOR” protocol demonstrates its’ ability to reduce barriers, to re-shape staff attitudes and knowledge, and to increase in-hospital mobility of older adults. The SEIPS-2.0 model can serve as a useful guide for implementing a site-tailored comprehensive mobility intervention. This process, which relies on local resources, may promise sustainable practice change that may support early effective rehabilitation and recovery.

Physical activity (PA) can improve functional abilities, well-being, and independence in older adults with insomnia. Studies have shown that PA may be linked to changes in the gut microbiota composition and its metabolites’ concentrations. This association among older adults with insomnia, however, is yet to be determined. We explored the relationships between physical activity (PA) levels, gut microbiota composition, and short-chain fatty acid (SCFA) levels in this population. Forty-nine community-dwelling adults with insomnia symptoms, aged 65 and older, participated in this study. Their average daily step-count and sleep continuity measures over a two-week period were calculated based on Actigraphic recordings. Each participant provided fecal samples for the microbiome and SCFA analyses, anthropometric measures, and information via questionnaires on medical history and food consumption. The gut microbiota composition and SCFA concentrations were determined by next-generation sequencing and Gas chromatography-mass spectrometry, respectively. Participants were divided into two groups (more and less active) according to their median step/day count. We compared the microbiota abundance and SCFA concentrations between groups and performed correlation analysis between gut microbiota abundances and study variables. Different microbiota taxa in each PA group and increased SCFAs in feces of less active individuals were found. Changes in step counts were positively or negatively associated with the relative abundance of 19 ASVs, 3 microorganisms at the family level, and 11 microorganisms at the genus level. Furthermore, significant associations were discovered among physical activity, gut microbiota, SCFAs, and sleep parameters. Our findings provide new insights on the relationship between PA, gut microbiota composition, and primary metabolites in older adults with insomnia.

Back pain is among the most prevalent pain disorders causing chronic disability among adults, and insomnia is a common co-morbidity. However, whether insomnia precedes back pain or vice versa remains unclear. The current study tested the temporal association between insomnia and back pain. A longitudinal design was used to investigate whether changes in insomnia over time predict the onset of back pain and vice versa. The study was conducted on a cohort of active healthy working adults (N = 2,131, 34% women) at three time points (T1, T2, and T3) over a period of 3.7 years (range = 2.2–5.12) years. Logistic regression analysis was used to test whether increased insomnia symptoms from T1 to T2 predicted the onset of new back pain. Ordinary least squares regression was used to test whether the existence of back pain at T2 predicted an increase in insomnia from T2 to T3. The results indicated that after controlling for socioeconomic variables, self-reported health, lifestyle behaviors, and anthropometrics, a T1–T2 increase in insomnia symptoms was associated with a 1.40-fold increased risk of back pain at T3 (OR = 1.40; 95% CI = 1.10–1.71). No support was found for reverse causation; i.e., that back pain predicts subsequent increase in insomnia. Insomnia appears to be a risk factor in the development of back pain in healthy individuals. However, no evidence of reverse causation was found.

Spatio-temporal parameters of human gait, currently measured using different methods, provide valuable information on health. Inertial Measurement Units (IMUs) are one such method of gait analysis, with smartphone IMUs serving as a good substitute for current gold-standard techniques. Here we investigate the concurrent validity of a smartphone placed in a front-facing pocket to perform gait analysis. Sixty community-dwelling healthy adults equipped with a smartphone and an application for gait analysis completed a 2-min walk on a marked path. Concurrent validity was assessed against an APDM mobility lab (APDM Inc.; Portland, OR, USA). Bland–Altman plots and intraclass correlation coefficients (agreement and consistency) for gait speed, cadence, and step length indicate good to excellent agreement (ICC_2,1 > 0.8). For right leg stance and swing % of gait cycle and double support % of gait cycle, results were moderate (0.52 < ICC_2,1 < 0.62). For left leg stance and swing % of gait cycle left results show poor agreement (ICC_2,1 < 0.5). Consistency of results was good to excellent for all tested parameters (ICC_3,1 > 0.8). Thus we have a valid and reliable instrument for measuring healthy adults’ spatio-temporal gait parameters in a controlled walking environment.