Elderly Health Journal

Prevalence and Factors Associated with Obesity among Community-Dwelling Persons 80 Years and Older: Longitudinal National Evidence from the Health, Aging, and Retirement in Thailand Study, 2015-2022

2026-06-27T14:35:01+00:00

Introduction: Few studies have longitudinally assessed the prevalence and factors associated with obesity among persons 80 years and older. This study aimed to estimate these based on 4-wave national longitudinal data from Thailand.

Methods: Data from the Health, Aging, and Retirement in Thailand study from 2015, 2017, 2020 and 2022 were utilized. The sample was restricted to community-dwelling persons 80 years and older with complete self-reported body weight and height values (analytic sample: n=2986 observations). For the pooled sample, the average age was 85.3 years (range 80-107 years). Thai obesity was defined using Thai criteria (body mass index-BMI ≥25 kg/m2) and World Health Organization (WHO) criteria (BMI ≥30 kg/m2). Random effects (RE) logistic regressions were utilized to estimate the factors associated with Thai and WHO obesity.

Results: The average BMI was 21.6 (SD = 4.4), 23.0% were underweight, 17.4% had Thai obesity, and 3.6% had WHO obesity. RE regssions showed that age and male sex were negatively associated with Thai and WHO obesity. Being married or cohabiting and higher subjective economic status were associated with WHO obesity. Having no exercise was associated with WHO obesity. Living alone was negatively associated with Thai obesity, and having a greater number of chronic conditions was associated with both Thai and WHO obesity.

Conclusion: This longitudinal study enhances our understanding of the factors associated with obesity among people 80 years of age and older. Strategies to delay or decrease chronic conditions and increase physical activity may help reduce obesity.

The Effect of Mind-Body Relaxation Exercises on Gait Smoothness and Gait Profile in Elderly Women

2026-06-27T14:35:00+00:00

Introduction: The present study aimed to investigate the effects of mind‑body relaxation exercises on qualitative gait parameters, including movement smoothness and gait profile, in elderly women. This research focuses on how such interventions might enhance gait quality, potentially by strengthening core muscles, improving pelvic stability, and boosting neuromuscular coordination, which could play a vital role in optimizing gait patterns and reducing fall risk among this population.

Methods: In this quasi-experimental study, twenty‑four elderly women aged over 55 years voluntarily participated and were randomly assigned to either an experimental or a control group. The experimental group engaged in a six-week training program consisting of three sessions per week. Gait kinematic data were recorded using a three-dimensional motion capture system at a sampling rate of 120 Hz. The smoothness index was calculated based on the integral of angular jerk, whereas the gait profile score was determined as the mean deviation of joint angles from a normative gait pattern. Data were analyzed using two-way repeated measures ANOVA.

Results: The results demonstrated no significant main effects of group or time, nor a significant group × time interaction, for the movement smoothness index (all p > 0.05). In contrast, for the gait profile score, significant main effects of group (p = 0.041) and time (p = 0.001), as well as a significant group × time interaction effect (p = 0.016), were observed. These findings indicate that the six-week mind–body exercise intervention significantly improved gait movement patterns and reduced gait deviations in elderly women, whereas no significant changes were observed in movement smoothness.

Conclusion: Mind-body relaxation exercises appear to enhance gait patterns and reduce fall risk in elderly women through mechanisms such as core muscle strengthening, pelvic stability improvement, and better neuromuscular coordination. Nevertheless, the lack of significant change in smoothness suggests that assessing the effects of these interventions on fine motor control may require longer training periods and more sensitive measurement tools.

The Effects of Aerobic and Strength Training on Plasma Sestrin 2 Levels in Inactive Elderly Men

2026-06-27T14:34:59+00:00

Introduction: Aging is associated with increased oxidative stress and decreased Sestrin 2 levels.The aim of the present study was to investigate the effect of eight weeks of aerobic and strength training on plasma levels of Sestrin2 in inactive elderly men.

Methods: In the present quasi -experimental study, forty-five elderly men with an age range of 60 to 74 years were selected using convenience sampling and then randomly assigned to three groups: an aerobic training group, a strength training group, and a control group. The aerobic training group trained for eight weeks, three sessions per week, at an intensity of 55-70% of heart rate reserve (HRR) based on the principle of progressive overload. The Strength training group also performed upper and lower body resistance training, three days a week and for eight weeks at an intensity of 30 to 80 percent of one Repetition Maximum(1RM). The control group did not participate in any training program. Blood samples were collected from all three groups 48 hours before and after the training intervention. Plasma Sestrin2 levels were measured using an ELISA kit. Analysis of Covariance (ANCOVA) along with Tukey's post hoc test was employed to compare the variables in the three groups. The data were analyzed at a significance level of 0.05 and using SPSS-23 software.

Results: Eight weeks of aerobic and strength training resulted in a significant increase in plasma Sestrin2 levels (p < 0.05), and no significant difference was observed between the two aerobic and strength training groups (p > 0.05).

Conclusion: Elderly people benefit from aerobic and resistance training to reduce oxidative stress caused by aging and, consequently, reduce the diseases caused by it.

The Role of Health Anxiety in Illness Perception: The Mediating Effect of Bodily Symptom Vigilance among Elderly Patients Attending Medical Clinics in Urmia

2026-06-27T14:34:58+00:00

Introduction: Health anxiety is recognized as an important psychological factor influencing individuals’ perception of illness, particularly among older adults. However, the mechanisms underlying this relationship, especially the mediating role of bodily symptom vigilance, remain insufficiently explored. The present study aimed to investigate the role of health anxiety in illness perception, emphasizing the mediating effect of bodily symptom vigilance among elderly individuals attending medical clinics in Urmia.

Methods: This fundamental study employed a descriptive-correlational design using structural equation modeling. The statistical population included individuals aged 60 years and older who visited medical centers in Urmia in 2024. A convenience sample of 200 participants was selected. Data were collected using the Health Anxiety Inventory, the Brief Illness Perception Questionnaire, and the Body Vigilance Scale. Data analysis was performed using SPSS and SmartPLS software.

Results: Health anxiety significantly predicted illness perception both directly (β = 0.313, t = 5.04, p < 0.001) and indirectly through bodily symptom vigilance (β = 0.200, t = 4.26, p < 0.001). Health anxiety also significantly predicted bodily symptom vigilance (β = 0.323, t = 5.27, p < 0.001), while bodily symptom vigilance significantly predicted illness perception (β = 0.620, t = 10.60, p < 0.001). Model fit indices indicated an acceptable fit of the proposed model (SRMR = 0.089, NFI = 0.891).

Conclusion: Health anxiety and heightened bodily vigilance play a crucial role in shaping illness perception among older adults. These findings highlight the importance of addressing psychological factors in developing mental health policies and interventions for the elderly population.

The Effect of an Eight-Week Low-Volume High-Intensity Interval Training Compared to Moderate-Intensity Continuous Training on Liver Enzymes and Anthropometric Indices: A Comparison of Obese and Lean Men with Non-Alcoholic Fatty Liver Disease

2026-06-27T14:34:57+00:00

Introduction: Nonalcoholic fatty liver disease (NAFLD) is a prevalent metabolic liver disorder associated with insulin resistance, excess adiposity, and increased cardiovascular risk. Although obesity is a major risk factor, many individuals with NAFLD are lean, and their responses to exercise remain unclear. This study compared the effects of eight weeks of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on liver enzymes and anthropometric indices in obese and lean men with NAFLD.

Methods: In this quasi-experimental study, 56 men with ultrasound confirmed NAFLD (grade ≥ 2) were randomly allocated to four groups: obese + HIIT, obese + MICT, lean + HIIT, and lean + MICT. Participants completed supervised exercise sessions three times per week for eight weeks. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), body mass index (BMI), and waist to hip ratio (WHR) were measured before and after the intervention. Between group differences were analyzed using analysis of covariance (ANCOVA), with baseline values as covariates. Effect sizes were reported using partial eta squared (η²).

Results: After adjustment for baseline values, no significant between-group differences were observed for ALT or AST, although both enzymes showed numerical reductions in all groups. Significant between-group differences were found for anthropometric outcomes. HIIT produced greater reductions in BMI (p < 0.001, partial η² = 0.38) and WHR (p < 0.001, partial η² = 0.29) than MICT, with the greatest improvements observed in obese participants.

Conclusion: An eight-week HIIT program was more effective than MICT in improving body composition, particularly overall and central adiposity, in men with NAFLD. Although exercise was associated with favorable trends in liver enzyme levels, these changes did not reach statistical significance between groups. These findings support HIIT as a time efficient strategy for improving anthropometric outcomes in men with NAFLD

Interaction of Concurrent Exercise Training and Milk thistle Extract on Hippocampi, NF-κB, and Serotonin of PTSD in Male Rats

2026-06-27T14:34:56+00:00

Introduction: Post-traumatic stress disorder (PTSD) is characterized by chronic neuroinflammation, impaired serotonergic signaling, and structural damage in both central and peripheral tissues, including the hippocampus and liver. Nuclear factor kappa B (NF-κB) plays a central role in stress-induced inflammatory responses. Exercise and phytotherapeutic agents such as milk thistle (Silybum marianum) have been suggested as potential non-pharmacological strategies for attenuating PTSD-related pathophysiology.

Methods: Fifty-five male Wistar rats were randomly assigned to five groups: healthy control, PTSD, PTSD with concurrent exercise training, PTSD with milk thistle extract, and PTSD with concurrent exercise training plus milk thistle extract. PTSD was induced using a multi-stage stress protocol. The concurrent exercise training program was conducted for 4 weeks, consisting of resistance training on even days and aerobic training on odd days. Resistance training was performed with progressively increasing loads from 50% to 80% of body weight, and aerobic training from 50% to 80% of VO₂max. Milk thistle extract was administered daily at a dose of 300 mg/kg. After the intervention, hippocampal and liver tissues were collected. NF-κB mRNA expression was measured using real-time PCR, and serotonin levels were measured by ELISA. Histopathological alterations were assessed by hematoxylin and eosin staining. Data were analyzed using ANOVA and Tukey statistical tests.

Results: PTSD induction significantly increased NF-κB mRNA expression and decreased serotonin levels in both hippocampal and liver tissues compared with healthy controls. Concurrent exercise training and milk thistle extract each significantly attenuated NF-κB overexpression and partially restored serotonin levels (p < 0.05). Histopathological analysis revealed severe neuronal degeneration in the hippocampus and marked structural damage in liver tissue in PTSD rats, whereas both interventions, particularly their combination, markedly improved tissue morphology.

Conclusion: Concurrent exercise training and milk thistle extract exert synergistic neuroprotective and hepatoprotective effects in a rat model of PTSD. These benefits appear to be mediated through suppression of NF-κB–dependent inflammatory pathways and restoration of serotonergic homeostasis

Prediction of Existential Anxiety in Older Adults: The Effects of Meaning in Life and Dark Personality Traits Through Loneliness

2026-06-27T14:34:55+00:00

Introduction: Existential anxiety is a fundamental psychological experience related to awareness of mortality, isolation, and meaninglessness, and it becomes more prominent in older adulthood due to aging-related changes. The present study aimed to examine the relationships among dark personality traits, meaning in life, loneliness, and existential anxiety in older adults, with emphasis on the mediating role of loneliness.

Methods: This quantitative, cross-sectional correlational study was conducted using Structural Equation Modeling. The sample consisted of 204 older adults aged 60 years and above living in Khoy city, West Azerbaijan Province (2025–2026), selected through convenience sampling. Data were collected using standardized questionnaires assessing existential anxiety, meaning in life, dark personality traits, and loneliness. Analyses were performed using SPSS and SmartPLS, including Pearson correlation, SEM, and bootstrapping.

Results: The results showed that dark personality traits were positively associated with loneliness (β = 0.48, p < 0.001) and existential anxiety (β = 0.51, p < 0.001). Meaning in life was negatively associated with loneliness (β = -0.46, p < 0.001) and existential anxiety (β = -0.58, p < 0.001). Loneliness also positively predicted existential anxiety (β = 0.55, p < 0.001). In addition, dark personality traits had a significant indirect effect on existential anxiety through loneliness (β = 0.26, p < 0.001), while meaning in life had a significant negative indirect effect through loneliness (β = -0.25, p < 0.001).

Conclusion: Existential anxiety in older adults is influenced by both maladaptive personality traits and meaning in life, with loneliness playing a central mediating role. Strengthening meaning in life and reducing loneliness may be effective targets for reducing existential distress in late adulthood.

Effectiveness of Tele-nursing Supportive Educational Intervention Based on Health Belief Model on Preventive Behaviors of Urinary Tract Infection in People with Spinal Cord Injury: A Protocol Study

2026-06-27T14:34:53+00:00

Introduction: Urinary tract infection (UTI) is one of the complications of people with spinal cord injury (SCI). The present study aims to design a protocol for the effectiveness of a telenursing educational intervention based on the health belief model (HBM) on preventive behaviors against UTI in people with SCI in Iran.

Methods: The present study is a randomized controlled trial protocol that will be conducted in 44 individuals with SCI and UTI in rehabilitation centers in Shahrekord, Iran in 2025. The design of this study includes three phases. The first phase of the study is to design a researcher-made questionnaire based on the Health Belief Model (HBM) to assess knowledge, attitude, and preventive behavior of UTI in people with SCI. In the second phase of the study, a telenursing educational-support program will be designed. The third phase will include a pre-test, implementation of the educational intervention, and a post-test two months after the intervention in the intervention and control groups. Data analysis will be performed with SPSS-23 software.

Discussion: This study presents a novel approach to promote preventive behaviors against UTI in individuals with SCI by designing an integrated educational protocol based on telenursing and the HBM. The findings of this study can lead to a significant reduction in complications from UTI and improve the quality of life of these patients.

Yogic Dietary Interventions for Nutritional Health and Well-Being in Older Adults: A Systematic Review and Conceptual Framework

2026-06-27T14:34:52+00:00

Introduction: Geriatric malnutrition is a pervasive clinical and public health challenge linked to functional decline, increased hospitalization rates, and diminished quality of life. Traditional Indian dietary systems, rooted in the classical frameworks of Yoga and Ayurveda, offer structured, culturally embedded philosophical approaches to nutritional management in older adults. Despite growing scholarly and clinical interest, the evidence base for Yogic dietary interventions in geriatric populations has not yet been formally synthesized.

Methods: A systematic literature search was conducted across PubMed/MEDLINE, ScienceDirect, Google Scholar, Semantic Scholar, JSTOR, and Indian databases (IAMJ, IndMED, Cureus), supplemented by hand-searching classical primary sources. Studies enrolling community-dwelling older adults who received Yogic or Ayurvedic dietary interventions and reported validated nutritional outcomes were eligible. Two reviewers independently screened records, extracted data, and assessed methodological quality.

Results: Six empirical studies and four classical textual sources were included. Yogic dietary interventions consistently improved Mini-Nutritional Assessment (MNA) scores across studies. Two RCTs and two pre-post interventional studies demonstrated consistent improvements in MNA scores and malnutrition risk reduction following dietary and nutrition education interventions. The methodologically strongest available Indian evidence demonstrated a rise in mean MNA from 21.4 ± 1.12 to 23.15 ± 1.71 (p < 0.001), substantially improving mean MNA scores from the at-risk range (21.4) to near the normal threshold (23.15). A community-based interventional study (n = 205) confirmed a significant reduction in malnutrition prevalence from 40.5% to 30.7% (p < 0.05). A novel Panchakosha-Nutritional Integration Model is proposed, mapping classical Yogic constructs onto five modern nutritional and well-being domains.

Conclusion: Yogic dietary interventions appear to be associated with improved nutritional well-being in older adults, though causal inference is limited by the observational nature of most included studies. The proposed Panchakosha model offers a translational framework for integrating these ancient principles into geriatric nutrition research and practice. Larger, multi-centre trials incorporating biochemical markers and extended follow-up are recommended.