A LIVE ONLINE EXERCISE PROGRAM FOR OLDER ADULTS’ IMPROVED DEPRESSIVE SYMPTOMS: A PILOT RCT

Abstract Exercise improves mental health and effectively alleviates cognitive and physical declines. Unfortunately, engagement in physical activity decreases as individuals age and this was likely exacerbated by the COVID-19 pandemic. New technologies to deliver live online home-based group exercise classes may help mitigate mental and physical health declines in older adults while maintaining social connectivity. We evaluated the feasibility of an age-appropriate and ability-modified at-home exercise program via live video stream. The impact on loneliness, anxiety, and depression in older adults were exploratory outcomes. In this two-arm pilot RCT, we randomly assigned sedentary community-dwelling adults (65-80 years) to a waitlist control (CON) or an active group (ACTIVE) of thrice-weekly, 8-wk online live exercise program delivered via Zoom by trained exercise professionals. Attendance was recorded, and participant satisfaction to ACTIVE was assessed. Pre- and post-intervention loneliness, anxiety, and depression were collected using the revised UCLA Loneliness Scale (R-UCLA), the Geriatric Anxiety Inventory (GAI), and the Geriatric Depression Scale (GDS). 32 participants were randomized (ACTIVE: n=16, mean age 70 ± 4, 69% women, 30 ± 5 kg/m2; CON: n=16, mean age 71 ± 5; 88% women; 29 ± 5 kg/m2). Attendance to online classes was >80% and all ACTIVE participants reported being satisfied with the exercise sessions. There was no intervention effect compared to CON on loneliness and anxiety. An effect of the intervention was observed for depression (ACTIVE: -1.94; CON: -0.07; p=0.015). We demonstrated good feasibility, satisfaction, and preliminary efficacy of a live online exercise program on older adults’ mental health.


DIGITAL STORYTELLING AND INTERGENERATIONAL COLLABORATIONS: OLDER ADULTS AND COLLEGE STUDENTS Angela Lavery, West Chester University, West Chester, Pennsylvania, United States
The use of digital storytelling can be a helpful tool within community work, health and social work research and policy. Digital storytelling refers to life-story telling that can be done in a variety of ways and used to encourage social change and transformation. This presentation will include experience on how this method was used in a study and an intergenerational project between older adults and university graduate and undergraduate students. This group of older adults specifically shared their experiences with equine interactions and activities, while the university students worked with the older adults to create a digital story. For this study and project, recruitment included students enrolled in different disciplines. Discussion on digital storytelling's connection to the narrative method and critical gerontology framework will be noted. Challenges and barriers, including Institutional Review Board and ethical considerations while preparing for this method will also be discussed. Gerontological research has been proven not always to succeed in engaging older migrants and their families. Various attempts are made to give voice to this underresearched population. Qualitative methods like participative action research (PAR) have been put forward as a way to engage this population. However, this approach does not always succeed to achieve this goal. Drawing on insights from decolonial frameworks, we present a learning process in engaging older migrants with and without dementia and their family members in developing a migration-sensitive reminiscence approach as a psycho-social intervention for older migrants with dementia. The emphasis of decolonial perspectives on seeing this population as the "Knower", deep reflection on own coloniality of mind as a researcher while critically looking at exclusive aspects of epistemology offers a supporting gaze to reshape PAR as an approach where this population is not only given voice but also heard. Exercise improves mental health and effectively alleviates cognitive and physical declines. Unfortunately, engagement in physical activity decreases as individuals age and this was likely exacerbated by the COVID-19 pandemic. New technologies to deliver live online home-based group exercise classes may help mitigate mental and physical health declines in older adults while maintaining social connectivity. We evaluated the feasibility of an age-appropriate and abilitymodified at-home exercise program via live video stream. The impact on loneliness, anxiety, and depression in older adults were exploratory outcomes. In this two-arm pilot RCT, we randomly assigned sedentary community-dwelling adults (65-80 years) to a waitlist control (CON) or an active group (ACTIVE) of thrice-weekly, 8-wk online live exercise program delivered via Zoom by trained exercise professionals. Attendance was recorded, and participant satisfaction to ACTIVE was assessed. Pre-and post-intervention loneliness, anxiety, and depression were collected using the revised UCLA Loneliness Scale (R-UCLA), the Geriatric Anxiety Inventory (GAI), and the Geriatric Depression Scale (GDS). 32 participants were randomized (ACTIVE: n=16, mean age 70 ± 4, 69% women, 30 ± 5 kg/m2; CON: n=16, mean age 71 ± 5; 88% women; 29 ± 5 kg/m2). Attendance to online classes was >80% and all ACTIVE participants reported being satisfied with the exercise sessions. There was no intervention effect compared to CON on loneliness and anxiety. An effect of the intervention was observed for depression (ACTIVE: -1.94; CON: -0.07; p=0.015). We demonstrated good feasibility, satisfaction, and preliminary efficacy of a live online exercise program on older adults' mental health. Introduction: Previous studies have shown the effectiveness of supervised multicomponent exercise programs on counteract age-related changes in functional capacity and quality of life in the oldest-old. During the quarantine imposed by COVID-19 pandemic, social isolation has been a barrier to implement face-to face exercise programs. Objective: To study the acceptance and adequacy of an exercise protocol in oldest-old. Methodology: Quasi-experimental study with initial, intermediate and post-intervention evaluation. The functional capacity assessment was carried out by the Vivifrail test (Short Physical Performance Battery and 4 falls risk assessment tests), by videoconference at the three moments of the project. For twelve weeks, the older adults performed multicomponent ViviFrail exercises with monitoring and acceptance assessment (with a maximum score of 24 points) by weekly contact by videoconference.

ACCEPTABILITY OF A VIDEOCONFERENCE-BASED MULTICOMPONENT EXERCISE PROGRAM (VIVIFRAIL) FOR THE OLDEST-OLD
Results: This study concluded 14 oldest-old (89.07 ± 6.30 years). In the 12 weeks, the participants showed an average increase of 4.2 points in acceptance, with a significant correlation (p < 0.001). It was possible to observe an improvement in the functional capacity of the oldest old, although not significant, with a decrease in the time to perform the Time Up and Go tests, sit and stand, and in walking time, which is the most evident change.
Conclusions: This study demonstrated that a home training program with weekly monitoring by videoconference was well accepted and suitable for oldest-old people in a period of social isolation imposed by COVID-19. In addition, it proved to be an effective intervention for maintaining and improving the functional capacity of oldest-old people.

IMPACT OF FRAILTY ON THE DIGNITY OF COMMUNITY-DWELLING OLDER PEOPLE Ali Darvishpoor Kakhki, Fereshteh Moradoghli, and Roghayeh Esmaeili, Shahid Beheshti University of Medical Sciences, Tehran, Tehran, Iran
The population of people aged 60 and older is rapidly increasing in developing countries such as Iran due to declining birth rates and increased life expectancy. Old age is associated with increased risk for frailty and reduced dignity.
This study investigated the impact of frailty on the dignity of older people in Tehran, Iran. This cross-sectional study was conducted on 200 individuals aged 60 years and older. Data collection relied on the Demographic Questionnaire, Frailty Index for Elders (FIFE) and the Patient Dignity Inventory (PDI). Data were analyzed with SPSS 25. The mean age of the participants was 68 (±5.05) years; 62% of the participants were at risk for frailty, and 69% had few dignity-related problems. The multiple regression results showed that frailty was significantly associated with dignity (ß = -0.571, p < 0.001). The association was significant across all the dimensions of dignity measured by the PDI. The highest predictors of frailty included dependency (ß = -0.584, p < 0.001), followed by existential distress (ß = -0.560, p < 0.001), symptom distress (ß = -0.400, p = 0.400), social support (ß = -0.391, p < 0.001), and peace of mind (ß = -0.338, p < 0.001) in dignity. The results show that higher levels of frailty in older people are associated with decreases in their dignity, and frailty was the leading predictor of dignity. Providers should develop programs to prevent and reduce frailty in those at risk and to enhance the dignity of the already frail.

PHYSICAL ACTIVITY TRENDS IN A NATIONWIDE MHEALTH PROGRAM: A POPULATION-BASED COHORT STUDY
Gregory Ang 1 , Sarah Edney 1 , Chuen Seng Tan 1 , Nicole Lim 2 , Jeremy Tan 2 , Falk Riemenschneider 1 , and Cynthia Chen 3 , 1. National University of Singapore, Singapore, Singapore, 2. Health Promotion Board, Singapore, Singapore, 3. National University of Singapore, Singapore, Singapore Physical inactivity is a global public health challenge, leading to an increase in chronic diseases. Effective large-scale physical activity interventions are needed. We examined the effectiveness of a nationwide mHealth intervention in Singapore, National Steps Challenge Season 3 (NSC3). NSC3 included gain-framed financial incentives for reaching pre-defined daily step targets, nudging via reminders and real-time feedback on physical activity levels. Our study includes 411,528 participants, with 53,371 (13.0%) participants aged 59 and above. Regression discontinuity design examined changes to daily step counts prior to and during NSC3. NSC3 was associated with an overall mean increase of 1437 steps per day (95% CI: 1408 to 1467). Participants in older age groups were associated with larger mean step increases. Females aged between 59 to 68 and 69 and above were associated with average increases of 1640 steps per day (95% CI: 1510 to 1770) and 2300 steps per day (95% CI: 2050 to 2550), respectively. Males in the same age groups were associated with average increases of 1360 steps per day (95% CI: 1200 to 1520) and 1640 steps per day (95% CI: 1370 to 1900), respectively. We provide real-world evidence that suggests NSC3 improved participants' step counts, with a larger increase among older adults. As older adults have a higher risk of chronic diseases, lower physical inactivity has potential health benefits such as reducing the incidence of hypertension and improving cardiovascular health biomarkers. While results are promising, further investigations are necessary to ensure sustained engagement among older adults.