Physical activity to improve wellbeing and promote healthy ageing among older adults:
Randomized controlled Trial

Secondary Outcomes

Secondary Outcomes

Health-related Quality of Life will be assessed using the Europol 5-Domains (EQ-5D). The self-rated questionnaire covers five areas of health, each scored from 1-3 and then combined into a total score, where lower scores indicated more serious problems. The five domains are: mobility, self-care, usual activity, pain/discomfort and anxiety/depression.           

Mobility and falls: The Modified Falls Efficacy Scale (MFES, short version) is a 14-item activity questionnaire to assess the fear of falling among older adults in various indoor and outdoor activities. Each item is scored on a 10-point likert scale (range=0-140) where higher scores indicate a greater fear of falling and lower physical mobility efficacy. The number of falls during the previous 12 months will be assessed at baseline, post-intervention and follow-up with a single question ‘during the past 12-months, how many times have you fallen down (unintentionally)? And: Did this result in an injury? If so, please describe. Further Mobility and fall risk will be assessed using Berg Balance Scale (BBS) which is a validated objective measure of balance containing fourteen functional tasks that are commonly used in everyday life (standing, sitting and bending). Each task gives a score between zero and four, resulting in a maximum of 56 points. A score of ≤42 has been shown to be a predictor of multiple or injurious falls.

Depression: The Geriatric Depression Rating Scale (GDS) is a 30-item screening instrument for older adults measuring the severity of depressive symptoms. Each item is scored ‘yes’ or ‘no’ (range=0-30). Scores above 10 indicate a severe depression, 6-10 a mild-to-moderate depression and 5 points or less no depression/remission. Additionally Geriatric Anxiety Inventory will be also measured.  

Pain: We will use the Brief Pain Inventory (BPI), which includes a severity scale and also rates how pain interferes with daily life. The BPI takes 5 minutes to complete if a person has pain and 30 seconds if a person does not have pain.

Sleep: Sleep quality during the past two weeks will be measured using the Swedish version of the Insomnia Severity Index, ISI, which consists of seven items. A score based on the points of each answer result in a number between zero and 28. Total score of 0-7 points: no clinical significant difficulties; 8-14: no criteria for insomnia; 15-21: clinical insomnia; 22-28: severe clinical insomnia.

Cognition: Ageing has been linked to deficits in each of these domains..

Cognition will be measured through the Mini-Mental State Examination (MMSE) which is most widely used cognitive screening instrument worldwide. As education and age can both influence cognitive test results, information on both will be obtained at baseline

Physical activity: We hypothesize that regular participation in yoga will lead to greater physical mobility and an overall increase in physical activity levels, compared to control. To assess this, participants in both the yoga and control group will be provided with an ActiGraph GT3X accelerometer to wear for one week (7 continuous days) before the start of the intervention, and again during week 13, one week after the intervention. The accelerometers will provide an objective assessment of baseline physical activity levels so that changes after the intervention can be examined. Changes in sedentary behaviour measured before and after the intervention will also be assessed using the accelerometers and reported. Reductions in sedentary behaviour have been linked to lowered risk of mortality and morbidity, independent of planned physical exercise. Due to cost and logistics issues accelerometer study will be done in subgroup. The International Physical Activity Questionnaire (IPAQ) is a questionnaire measuring health-related physical activity. This self-rated version includes a seven day recall of performed various physical activities with different intensity. The Simple Physical Activity Questionnaire, (SIMPAQ) is another instrument that assesses sedentary behaviour. Currently, a large validation study for the SIMPAQ is taking place.

Mood and stress: Profile of mood states (POMS) will be used to assess mood and psychological distress, which has been extensively used in physical activity research. The Perceived Stress Scale (PSS) has been broadly used in research and includes statements that the respondents score on a five-point scale, based on how you have felt the past month.

Cardio-metabolic indicators, cortisol and inflammatory markers: Blood pressure, resting heart rate, height and weight (BMI) will be assessed at baseline, post-intervention and follow-up. From blood samples taken at baseline and post-intervention, changes blood glucose, CBC, urea, creatinine and in inflammatory markers (IL-6, C-reactive protein, cortisol) will be examined.

Smoking will be assessed with three questions about tobacco use (lifetime use yes/no; frequency past year, and type), and brief question alcohol consumption yes/No (present and past)

Participant satisfaction with the intervention will be assessed using a short semi-structured interview developed by the research group. It will focus on the acceptability of the intervention in both countries.