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Characteristics and Effects of Lifestyle Interventions for Community Dwelling Older Adults: A Systematic Review

지역사회 노인을 대상으로 적용한 라이프스타일 중재의 형태와 효과에 관한 체계적 고찰

  • Won, Kyung-A (Dept. of Occupational Therapy, Graduate School, Yonsei University) ;
  • Shin, Yun Chan (Dept. of Occupational Therapy, Graduate School, Yonsei University) ;
  • Park, Sangmi (Dept. of Occupational Therapy, Graduate School, Yonsei University) ;
  • Han, Areum (Dept. of Occupational Therapy, College of Health Science, Yonsei University) ;
  • Park, Ji-Hyuk (Dept. of Occupational Therapy, College of Health Science, Yonsei University)
  • 원경아 (연세대학교 대학원 작업치료학과) ;
  • 신윤찬 (연세대학교 대학원 작업치료학과) ;
  • 박상미 (연세대학교 대학원 작업치료학과) ;
  • 한아름 (연세대학교 보건과학대학 작업치료학과) ;
  • 박지혁 (연세대학교 보건과학대학 작업치료학과)
  • Received : 2019.02.28
  • Accepted : 2019.05.14
  • Published : 2019.05.31

Abstract

Objective : The purpose of this study was to analyze the format and effects of lifestyle intervention provided to community dwelling older adults. This systematic review was written following the PRISMA guideline. Methods : The National Digital Science Library(NDSL), RISS, PubMed, and CINAHL were used to search for articles published from January 2008 to December 2017. In total, 20 articles were selected for the analysis and the risk of bias was screened through the Physiotherapy Evidence Database Scale. Lifestyle interventions in the articles were classified according to the disease of the participants. Results : Major contents of the lifestyle interventions were increased physical activity like moderately intensive exercise and education or training to help participants have a healthy diet. Of the 20 articles, 17 included more than 2 types of contents. Examining biochemical factors was the most common measurement among the multifaceted measurements used to assess the effects of lifestyle interventions. The results of the lifestyle interventions described in each article did not indicate congruent effects. 14 of the 20 articles reported the lifestyle interventions had significant effects. Conclusions : The results of this study could help practitioners select the contents of and provide lifestyle interventions to older adults. Further study on the various applications of lifestyle interventions in a community setting is necessary.

목적 : 본 연구는 지역사회 노인에게 적용한 라이프스타일 중재의 형태와 효과를 알아보고자 하며, PRISMA 가이드라인를 통해 체계적 고찰을 시행하였다. 연구방법 : 2008년 1월부터 2017년 12월까지 국 내외 학술지에 개제된 논문을 국가과학기술정보센터(National Digital Science Library), RISS, PubMed, CINAHL을 통하여 검색하였다. 선정기준에 따라 최종적으로 20편의 연구를 분석하였으며, PEDro scale(Physiotherapy Evidence Database scale)을 사용하여 문헌의 질 평가를 하였다. 문헌에서 사용된 중재는 참가자들의 질환적 특성에 따라 분류하였다. 결과 : 라이프스타일 중재의 주요 구성요소는 중등도 이상의 운동과 같은 신체활동 증진과 건강한 식습관 형성을 위한 교육 및 훈련으로 확인되었다. 최종 분석된 20편 중 17편의 연구에서는 운동프로그램과 교육 또는 식단관리와 운동과 같이 두 가지 이상의 구성요소를 갖는 형태로 중재가 적용되었다. 노인의 건강 및 삶의 질을 평가하기 위해 다면적인 평가가 이뤄졌으며 그 중 생화학적 요인(biochemical factor)과 건강 및 웰빙(Health and well-being)을 평가하는 도구가 가장 많았다. 연구 분석 결과 지역사회 노인을 대상으로 한 라이프스타일 중재의 효과는 연구별로 상이하게 나타났으나, 14편의 연구에서 중재 직후 실험군과 대조군 간에 건강 및 삶의 질의 유의한 차이가 나타났다. 결론 : 본 연구는 노인의 질환적 특성에 따른 라이프스타일 중재기법을 선택하는데 도움을 줄 수 있을 것으로 사료된다. 향후 국내 지역사회 상황에 부합되는 중재의 개발 및 효과에 관한 연구를 통해, 작업치료적 라이프스타일 중재의 실행가능성에 관한 연구들이 체계적으로 이루어져야 할 것이다.

Keywords

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Figure 1. PRISMA Flow Diagram for Study Selection

Table 1. Risk of Bias Screening Result using PEDro Scale

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Table 2. Characteristic of the Subjects

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Table 7. Assessment Tools Categorized by Dependent Variable

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References

  1. Amini, D. A., Kannenberg, K., Bodison, S., Chang, P., Colaianni, D., Goodrich, B., & Lieberman, D. (2014). Occupational therapy practice framework: Domain & process 3rd edition. American Journal of Occupational Therapy, 68, 1-48. doi:10.5014/ajot.2014.682006
  2. Arbesman, M., Scheer, J., & Lieberman, D. (2008). Using AOTA's critically appraised topic (CAT) and critically appraised paper (CAP) series to link evidence to practice. OT Practice, 13(5), 18.
  3. Bamrotia, J. B., Patel, D. K., & Joshi, A. N. (2017). Evaluation of respiratory function in physically active elderly males in comparison to males having sedentary lifestyle. National Journal of Physiology, Pharmacy and Pharmacology, 7(1), 108.
  4. Belalcazar, L. M., Papandonatos, G. D., Erar, B., Peter, I., Alkofide, H., Balasubramanyam, A., ... McCaffery, J. M. (2015). Lifestyle intervention for weight loss and cardiometabolic changes in the setting of glucokinase regulatory protein (GCKR) inhibition: GCKR-Leu446Pro variant in Look AHEAD. Circulation: Genomic and Precision Medicine, CIRCGENETICS-115.
  5. Cezaretto, A., Barros, C. R. D., Almeida-Pititto, B. D., Siqueira-Catania, A., Monfort-Pires, M., Folchetti, L. G. D., & Ferreira, S. R. G. (2017). Lifestyle intervention using the psychoeducational approach is associated with greater cardiometabolic benefits and retention of individuals with worse health status. Archives of Endocrinology and Metabolism, 61(1), 36-44. https://doi.org/10.1590/2359-3997000000185
  6. Chung, J., Lee, M., & Kim, M. (2010). A study on the prevalence of chronic diseases, health-related habits and nutrients intakes according to the quality of life in Korean adults. Korean Journal of Community Nutrition, 15(4), 445-459.
  7. Clark, F., Jackson, J., Carlson, M., Chou, C. P., Cherry, B. J., Jordan-Marsh, M., ... Wilcox, R. R. (2012). Effectiveness of a lifestyle intervention in promoting the well-being of independently living older people: Results of the well elderly 2 randomised controlled trial. Journal of Epidemiology and Community Health, 66(9), 782-790. https://doi.org/10.1136/jech.2009.099754
  8. de Morton, N. A. (2009). The PEDro scale is a valid measure of the methodological quality of clinical trials: A demographic study. Australian Journal of Physiotherapy, 55(2), 129-133. https://doi.org/10.1016/S0004-9514(09)70043-1
  9. Dong, F., Zhang, Y., Huang, Y., Wang, Y., Zhang, G., Hu, X., ... Bao, Z. (2016). Long-term lifestyle interventions in middle-aged and elderly men with nonalcoholic fatty liver disease: A randomized controlled trial. Scientific Reports, 6, 36783. doi:10.1038/srep36783
  10. Dorans, K. S., Mostofsky, E., Levitan, E. B., Hakansson, N., Wolk, A., & Mittleman, M. A. (2015). Alcohol and incident heart failure among middle-aged and elderly men: The cohort of Swedish men. Circulation: Heart Failure, CIRCHEARTFAILURE-114.
  11. Dusek, J. A., Hibberd, P. L., Buczynski, B., Chang, B. H., Dusek, K. C., Johnston, J. M., ... Zusman, R. M. (2008). Stress management versus lifestyle modification on systolic hypertension and medication elimination: A randomized trial. The Journal of Alternative and Complementary Medicine, 14(2), 129-138. doi:10.1089/acm.2007.0623
  12. Gilbert, S. E., Tew, G. A., Fairhurst, C., Bourke, L., Saxton, J. M., Winter, E. M., & Rosario, D. J. (2016). Effects of a lifestyle intervention on endothelial function in men on long-term androgen deprivation therapy for prostate cancer. British Journal of Cancer, 114(4), 401-408. doi:10.1038/bjc.2015.479
  13. Ip, E. H., Church, T., Marshall, S. A., Zhang, Q., Marsh, A. P., Guralnik, J., ... LIFE-P Study Investigators. (2012). Physical activity increases gains in and prevents loss of physical function: Results from the lifestyle interventions and independence for elders pilot study. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 68(4), 426-432. doi:10.1093/gerona/gls186
  14. Kang, J. K. (2003). Concept of lifestyle-related disease. The Korean Journal of Medicine, 65(1), 121-125.
  15. Kim, D. J. (2012). Social difference of the aged people who live alone and alternative welfare solutions. Korean Academy of Social Welfare Support, 7, 217-239.
  16. Kim, M. H. (2013). Characteristics of nutrient intake according metabolic syndrome in korean elderly-using data from the korea national health and nutrition examination survey 2010-. The Korean Journal of Food and Nutrition, 26(3), 515-525. doi:10.9799/ksfan.2013.26.3.515
  17. Korean Association of Occupational Therapist. (2017). Statistical material of Occupational Therapy. Retrieved from https://www.kaot.org/start.aspp
  18. Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P., ... Moher, D. (2009). The PRISMA statement for reporting systematic reviews and metaanalyses of studies that evaluate health care interventions: Explanation and elaboration. PLOS Medicine, 6(7), e1000100. doi:10.1371/journal.pmed.1000100
  19. Lin, A., Zhang, G., Liu, Z., Gu, J., Chen, W., & Luo, F. (2014). Community-based lifestyle intervention for reducing blood pressure and glucose among middle-aged and older adults in China: A Pilot Study. International Journal of Environmental Research and Public Health, 11(11), 11645-11663. doi:10.3390/ijerph111111645
  20. Look AHEAD Research Group. (2013). Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. New England Journal of Medicine, 369(2), 145-154. doi:10.1056/NEJMoa1212914
  21. Maher, C. G., Sherrington, C., Herbert, R. D., Moseley, A. M., & Elkins, M. (2003). Reliability of the PEDro scale for rating quality of randomized controlled trials. Physical Therapy, 83(8), 713-721. https://doi.org/10.1093/ptj/83.8.713
  22. Marsh, A. P., Applegate, W. B., Guralnik, J. M., Jack Rejeski, W., Church, T. S., Fielding, R. A., ... McDermott, M. M. (2016). Hospitalizations during a physical activity intervention in older adults at risk of mobility disability: Analyses from the lifestyle interventions and independence for elders randomized clinical trial. Journal of the American Geriatrics Society, 64(5), 933-943. doi:10.1111/jgs.14114
  23. Matthews, M. M., Hsu, F. C., Walkup, M. P., Barry, L. C., Patel, K. V., & Blair, S. N. (2011). Depressive symptoms and physical performance in the lifestyle interventions and independence for elders pilot study. Journal of the American Geriatrics Society, 59(3), 495-500. doi:10.1111/j.1532-5415.2011.03319.x
  24. Ministry of Health & Welfare. (2018). 2017 an investigation report of elderly people. Retrieved from http://www.mohw.go.kr
  25. Mons, U., Muezzinler, A., Gellert, C., Schottker, B., Abnet, C. C., Bobak, M., ... Kromhout, D. (2015). Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults: Meta-analysis of individual participant data from prospective cohort studies of the CHANCES consortium. British Medical Journal, 350, h1551. https://doi.org/10.1136/bmj.h1551
  26. Mountain, G., Windle, G., Hind, D., Walters, S., Keertharuth, A., Chatters, R., ... Chater, T. (2017). A preventative lifestyle intervention for older adults (lifestyle matters): A randomised controlled trial. Age and Ageing, 46(4), 627-634. https://doi.org/10.1093/ageing/afx021
  27. Opdenacker, J., Delecluse, C., & Boen, F. (2009). The longitudinal effects of a lifestyle physical activity intervention and a structured exercise intervention on physical self-perceptions and self-esteem in older adults. Journal of Sport and Exercise Psychology, 31(6), 743-760. https://doi.org/10.1123/jsep.31.6.743
  28. Peralta-Catipon, T., & Hwang, J. E. (2011). Personal factors predictive of health-related lifestyles of community-dwelling older adults. American Journal of Occupational Therapy, 65(3), 329-337. doi:10.5014/ajot.2011.000505
  29. Rejeski, W. J., Bray, G. A., Chen, S. H., Clark, J. M., Evans, M., Hill, J. O., ... Look AHEAD Research Group. (2014). Aging and physical function in type 2 diabetes: 8 years of an intensive lifestyle intervention. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 70(3), 345-353.
  30. Rejeski, W. J., Marsh, A. P., Chmelo, E., Prescott, A. J., Dobrosielski, M., Walkup, M. P., ... Kritchevsky, S. (2009). The lifestyle interventions and independence for elders pilot (LIFE-P): 2-year follow-up. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 64(4), 462-467. doi:10.1093/gerona/gln041
  31. Solomon, T. P., Haus, J. M., Cook, M. A., Flask, C. A., & Kirwan, J. P. (2013). A low-glycemic diet lifestyle intervention improves fat utilization during exercise in older obese humans. Obesity, 21(11), 2272-2278. https://doi.org/10.1002/oby.20411
  32. Statistics Korea. (2016). The difficulties experienced by the elderly. Retrieved from http://kostat.go.kr
  33. Statistics Korea. (2017). Life expectancy at birth & disability adjusted life expectancy. Retrieved from http://kostat.go.kr
  34. Statistics Korea. (2018). A population by age. Retrieved from http://kostat.go.kr/wn search/search.jsp
  35. Stoutenberg, M., Stanzilis, K., & Falcon, A. (2015). Translation of lifestyle modification programs focused on physical activity and dietary habits delivered in community settings. International Journal of Behavioral Medicine, 22(3), 312-327. doi:10.1007/s12529-014 -9438-y
  36. Trento, M., Gamba, S., Gentile, L., Grassi, G., Miselli, V., Morone, G., ... Cavallo, F. (2010). Rethink Organization to iMprove Education and Outcomes (ROMEO): A multicenter randomized trial of lifestyle intervention by group care to manage type 2 diabetes. Diabetes Care, 33(4), 745-747. doi:10.2337/dc09-2024
  37. Vrdoljak, D., Markovic, B. B., Puljak, L., Lalic, D. I., Kranjcevic, K., & Vucak, J. (2014). Lifestyle intervention in general practice for physical activity, smoking, alcohol consumption and diet in elderly: A randomized controlled trial. Archives of Gerontology and Geriatrics, 58(1), 160-169. doi:10.1016/j.archger.2013.08.007
  38. Zhang, P., Hire, D., Espeland, M. A., Knowler, W. C., Thomas, S., Tsai, A. G., ... Look AHEAD Research Group. (2016). Impact of intensive lifestyle intervention on preferencebased quality of life in type 2 diabetes: Results from the Look AHEAD trial. Obesity, 24(4), 856-864. https://doi.org/10.1002/oby.21445
  39. Ziv, A., Vogel, O., Keret, D., Pintov, S., Bodenstein, E., Wolkomir, K., ... Efrati, S. (2013). Comprehensive Approach to Lower Blood Pressure (CALM-BP): A randomized controlled trial of a multifactorial lifestyle intervention. Journal of Human Hypertension, 27(10), 594. doi:10.1038/jhh.2013.29

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