Background: Diaphragm thickness may affect both inspiratory and expiratory function. The ultrasound assessment of diaphragm thickness could be a valuable tool for respiratory muscle evaluation in older adults, although additional research is needed to clarify its association with respiratory functional parameters. Objectives: The primary objective was to explore the relationship between diaphragm thickness (DT), maximal inspiratory pressure (MIP), and peak expiratory flow (PEF) in institutionalized older adults. A secondary objective was to compare MIP and PEF values between participants with normal and thin diaphragm thickness. Methods: A cross-sectional exploratory study was conducted among older adults (n = 36) residing in long-term care facilities (LTCFs) in Spain. DT was measured at the end of maximum inspiration (DTi) and at the end of expiration at rest (DTe) in the supine position. The diaphragm thickening difference (DTD) and diaphragm fraction (DTF) were calculated. A thin diaphragm was defined as a diaphragm thickness (DTe) <1.6 mm in men and <1.4 mm in women. The maximum inspiratory pressure (MIP) was measured using a Powerbreath KH1 device, and the peak expiratory flow (PEF) was measured using Datospir Peak-10. Spearman’s rank correlation coefficient and linear regression models were used to explore the association between diaphragm thickness and respiratory muscle function. Statistical analysis was performed using IBM SPSS Statistics 22.0. Results: The mean age of the participants was 82.4 ± 7.9 years (24 females–12 males). Significant correlations were observed among most ultrasound-derived measures. DTi was positively associated with MIP (ρ = 0.403, 95% CI 0.065–0.658; q = 0.033) and PEF (ρ = 0.534, 95% CI 0.235–0.741; q = 0.003), DTe with MIP (ρ = 0.445, 95% CI 0.116–0.686; q = 0.020), and DTD with PEF (ρ = 0.475, 95% CI 0.158–0.703; q = 0.012). Compared with participants with normal diaphragm thickness, those with a thin diaphragm exhibited lower MIP (β = −18.43, 95% CI: −32.76 to −4.18; p = 0.013). Conclusions: Diaphragm thickness was positively associated with inspiratory muscle strength and peak expiratory flow. Participants with a thin diaphragm demonstrated lower respiratory muscle performance than those with normal diaphragm thickness. However, these findings should be interpreted with caution, and additional studies are needed to confirm these associations.
Background/Objectives: Older adults engage in diverse activities and use community facilities, but how these forms of participation connect is unclear. We examined these connections and whether the findings depended on how common each activity or facility was. Methods: Data from 10,078 participants in the 2023 National Survey of Older Koreans were used to estimate 13-node domain–facility and 20-node specific activity–facility networks with survey-weighted φ coefficients and 1000 stratified cluster-bootstrap replicates. Leisure–leisure pairs were excluded from the specific network because only two main leisure activities could be reported. Sensitivity analyses used sign-specific attainable φ limits, normalized φ, covariate-adjusted partial correlations, semantic-overlap exclusions, and subgroup log-odds-ratio contrasts. Results: The domain network retained 27 positive and one negative edge; the specific network retained 34 positive and one negative edge among 162 estimable pairs. Original and φ-limit-normalized strength rankings correlated at ρ = 0.852 (domain) and 0.968 (specific), but public cultural facilities moved from first to fourth and third, respectively, with socializing groups ranking first in both normalized networks. Eighteen of 28 domain edges and 22 of 35 specific edges were retained with the covariate-adjusted partial-correlation criterion. Public cultural facilities had the largest strength point estimates in both primary networks, although several leading nodes were not statistically distinguishable; the prominence of education/learning was also sensitive to broad removal of definitionally overlapping links. Subgroup strength rankings were similar, whereas several differential φ edges were not confirmed by log-odds-ratio contrasts. Conclusions: The networks identify disproportionate co-participation patterns rather than prevalence-free or causal relationships. Overall rank agreement under normalization was higher in the specific than the domain network, but neither preserved the leading node. Marginal constraints, item overlap, and the association measure affected interpretation.
Background: Population ageing requires community-based strategies supporting functional capacity, psychological well-being, and participation among older adults. Objective: To analyze the changes following a community-based motor education program grounded in Chilean folk dances in physical function, psychological well-being, and subjective participation experiences among older adults. Methods: A sequential explanatory mixed-methods design included a single-group pre–post quantitative phase and a qualitative phase. Physical function was assessed using the Short Physical Performance Battery (SPPB), Timed Up and Go (TUG), and single-leg stance tests. Psychological outcomes included the SF-12, life satisfaction, self-efficacy, and perceived social support. The 9-week intervention comprised two 90-min sessions weekly. Sixty-four older adults were recruited: 58 completed pre–post assessments and 17 joined a focus group. Quantitative changes were examined using the Wilcoxon signed-rank test, and qualitative data were analyzed thematically. Results: Mean age was 72.1 years, and 89.7% were women. Significant improvements were observed in SPPB scores (p = 0.003), dominant single-leg stance (p < 0.001), non-dominant single-leg stance (p < 0.001), SF-12 Mental Component (p < 0.001), self-efficacy (p = 0.010), and perceived social support (p < 0.001). No significant changes were found in TUG, the SF-12 Physical Component, or life satisfaction. Qualitative findings emphasized the instructor’s role, reduced embarrassment and fear of ridicule, and stronger social bonds. Conclusions: Participation was associated with improvements in physical and psychological outcomes, supporting culturally adapted folk dance-based motor education as a feasible strategy for active and healthy ageing.
Background: Comorbidity is common in older adults and is associated with lower physical activity (PA) and greater frailty risk. We assessed whether relationship status affects these relationships, using the Southampton Longitudinal Study of Ageing. Methods: 448 community-dwelling older participants (median age of 80 years) were analysed. A questionnaire ascertained relationship status, number of comorbidities, PA (Physical Activity Scale for the Elderly) and frailty components (weight loss, self-reported exhaustion, low PA, low self-reported walking speed, difficulty carrying 10 lb). Associations of number of comorbidities with physical activity and number of frailty components were examined using linear and Poisson regression, respectively. Models were adjusted for age, sex, BMI and smoking status and included an interaction term between number of comorbidities and relationship status. Sex-stratified analyses without interactions were also performed. Results: Evidence of interaction effects were weak (p > 0.14 for both tests). Among females, higher comorbidity was related to lower PA and a greater number of frailty components: difference in PA (95% CI) and multiplicative increase in number of frailty components (95% CI) per additional comorbidity was −0.10 (−0.17,−0.03) and 1.25 (1.16,1.34) respectively. Effect sizes for PA and number of frailty components were broadly similar among females when stratified according to relationship status. Associations were weaker among males (p > 0.27 for all associations). Conclusions: Evidence of relationship status modifying these associations was weak. Females with greater comorbidity had lower physical activity and more frailty components. Differences in observed strength of associations between males and females may reflect different comorbidity profiles.
Introduction: Periodontal disease is a major oral health problem among older adults with type 2 diabetes mellitus (T2DM). However, evidence regarding its association with oral health care behaviors in Northern Thailand is limited. This study aimed to assess oral health care behaviors and periodontitis and examine their associated factors among older adults with T2DM. Methods: A cross-sectional study was conducted among 369 older adults with T2DM in Mueang Phayao District, Northern Thailand. Seven subdistricts were selected using simple random sampling, after which eligible participants were recruited through convenience and snowball sampling. Data was collected using structured questionnaires and standardized oral examinations performed by dentists. Results: The mean oral health care behavior score was 29.51 out of 45, and periodontitis was present in 37.4% of the participants. Multivariable linear regression showed that oral health care behavior scores were significantly associated with oral health care knowledge scores (B = 1.052, p < 0.001), diabetes knowledge scores (B = 1.068, p < 0.001), FBS ≥ 126 mg/dL (B = −0.599, p = 0.027), and HbA1c ≥ 6.5% (B = −0.689, p = 0.016). Multivariable logistic regression showed higher odds of periodontitis among participants aged ≥70 years (AOR = 2.38, 95% CI: 1.45–3.89), with a diabetes duration of ≥11 years (AOR = 2.15, 95% CI: 1.21–3.82), who smoked (AOR = 12.62, 95% CI: 4.22–37.75), and with HbA1c ≥ 6.5% (AOR = 1.94, 95% CI: 1.11–3.41), while higher oral health care behavior scores were associated with lower odds (AOR = 0.88, 95% CI: 0.81–0.95). Conclusions: Advanced age, longer diabetes duration, smoking, and poor glycemic control were significantly associated with higher odds of periodontitis, whereas better oral health care behaviors were associated with lower odds. These findings support the integration of periodontal screening into diabetes care and the expansion of community-based oral health promotion for older adults with T2DM in primary care settings.
