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"Feeling more self-confident, cheerful and safe”. Experiences from a health-promoting intervention in community dwelling older adults — A qualitative study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food Studies, Nutrition and Dietetics.
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2018 (English)In: Journal of Nutrition Health and Aging, Vol. 22, no 4, p. 541-548Article in journal (Refereed) Published
Abstract [en]

Objectives: Studies show that regular exercise in combination with nutritional support can be effective in managing sarcopenia, which is age-related involuntary loss of skeletal muscle mass and strength. Qualitative investigations of participants' experiences from interventions in this domain are scarce. In this study, we explored older persons' experiences from an intervention designed to prevent sarcopenia, with the aim of capturing the participants' thoughts and opinions.

Design: A qualitative study embedded in the multicenter randomized clinical trial The Vitality and Vigor in the Elderly study, VIVE2. Focus group interviews were conducted. Manifest and latent content analyses were performed.

Participants: Community dwelling older adults (n=20) 71-86 years of age with minor limitations in mobility.

Results: The experiences from the intervention were categorized and interpreted in one overall theme "Feeling more self-confident, cheerful and safe". The theme encompasses the categories psychological effects of participating in the intervention, physical effects of participating in the intervention, the importance of social support and the importance of a tailored set-up. The participants described their motives for participating in the intervention as being based on concerns regarding the negative health effects of continuing a sedentary lifestyle, difficulties of getting started on their own and lack of confidence in accomplishing change on their own. Participants also expressed that one main objective for participating was to lose weight.

Conclusion: In this study we have captured the experiences of older adults with minor mobility limitations who participated in a lifestyle intervention. The experiences are interpreted in one overall theme "Feeling more self-confident, cheerful and safe". The central understanding of the participants' experiences was that the intervention affected them in several ways, both psychologically and physically, and that supporting factors included the social support, which became a prerequisite for success. A noticeable finding was the discrepancy between the motive of the participants, to lose weight, and the aim of the study, to improve muscle function. The expectation to lose weight seems to reflect what is commonly known as to be healthy. To our knowledge, at least in Sweden, there are no campaigns or public information highlighting the risks of sarcopenia and the complex issue of if, and when weight loss is desirable for older individuals. This finding highlights the importance of providing such information to this target group. The findings in this study provide valuable knowledge for research teams, practitioners and decision makers when designing and setting objectives for health-promoting interventions for older individuals.

Place, publisher, year, edition, pages
2018. Vol. 22, no 4, p. 541-548
National Category
Public Health, Global Health and Social Medicine
Identifiers
URN: urn:nbn:se:uu:diva-342680DOI: 10.1007/s12603-017-0981-5ISI: 000428385500013PubMedID: 29582895OAI: oai:DiVA.org:uu-342680DiVA, id: diva2:1185002
Available from: 2018-02-22 Created: 2018-02-22 Last updated: 2025-02-21Bibliographically approved
In thesis
1. Nutrition, exercise and body composition in community-dwelling older adults: Effects on function, wellbeing and mortality
Open this publication in new window or tab >>Nutrition, exercise and body composition in community-dwelling older adults: Effects on function, wellbeing and mortality
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: The demographic shift in society with more people reaching a high age provides new challenges for both society and the healthcare system.

Aim: The overall aim of this thesis was to examine the impact of nutrition, exercise and body composition on function, wellbeing and mortality in community-dwelling older adults.

The thesis is based on 1) data from the Vitality, Independence and Vigor in the Elderly 2 study (VIVE2) (Papers I-III), i.e. 149 community-dwelling participants >70 years who took part in an exercise program, and were randomized to take either a protein- and vitamin D-rich supplement or a placebo for 6 months and 2) three cohorts from two Swedish population studies on older adults (Paper IV). Quantitative (Papers I, II and IV) and qualitative methods (Paper III) were used. Results: Paper I reports cross-sectional data showing that there was no clear association between serum levels of serum 25(OH)D and physical performance in mobility-limited adults.

In Paper II, the results of the VIVE2 study indicated positive effects on mental health from exercise but no additional effect from supplementation was detected.

In Paper III, the qualitative interview investigation indicated that the VIVE2 intervention had positive effects, both psychologically and physically. Another finding was that weight loss was a main reason for participants wanting to take part in the study, whereas the aim of the study was to improve muscle function.

Paper IV shows from prospective observational data that 75-year-old women with sarcopenic obesity had an increased mortality risk within 10 years, while a similar result could not be found among 75-year-old or 88-year-old men.

Conclusion: The exercise intervention improved the mental status of the participants based on both quantitative and qualitative studies. No effect could be attributed to the protein- and vitamin D-rich nutritional supplement, a finding that needs to be evaluated in light of the participants’ good nutritional status. No clear association was revealed between physical function and serum 25(OH)D. Sarcopenic obesity may be associated with mortality but such associations may depend on age and gender.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2019. p. 81
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1545
Keywords
Older adults, function, nutrition, wellbeing, mortality, exercise, sarcopenic obesity
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-377873 (URN)978-91-513-0584-4 (ISBN)
Public defence
2019-04-17, Sal A1:111a, Biomedicinsk Centrum (BMC), Husargatan 3, Uppsala, 09:00 (Swedish)
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Supervisors
Available from: 2019-03-27 Created: 2019-02-27 Last updated: 2019-05-07

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von Berens, ÅsaKoochek, AfsanehNydahl, MargarethaCederholm, Tommy
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