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Cette étude visait à documenter comment un programme de familiarisation à l'utilisation du transport en commun influence l'expérience de mobilité des aînés. Ce programme a été co-construit avec des partenaires clés afin d'y inclure l'usage d'outils de planification technologiques et un accompagnement personnalisé tenant compte des incapacités des participants. Une étude de cas multiples (n = 7) a été menée selon une approche mixte convergente, combinant des méthodes qualitatives (p. ex., entrevues) et quantitatives (p. ex., cartes à puces). Les participants qui ont bénéficié davantage de la formation ont rapporté une meilleure connaissance du transport en commun et une plus grande confiance à utiliser l'autobus. Ils ont aussi effectué plus de sorties. Nos résultats suggèrent d'intégrer une destination « signifiante ¼ et l'apprentissage d'outils de planification non technologiques à la formation pour en assurer la compatibilité avec les besoins et le niveau de littératie numérique des aînés. De futures études aideront à favoriser cette option de transport en amont de la perte du permis de conduire.

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Les projets de nature intergénérationnelle sont aujourd'hui hautement valorisés par les décideurs publics et les responsables académiques. La pandémie de COVID-19 a fait ressurgir l'importance des relations entre les générations et des projets intergénérationnels ancrés dans la communauté. Cet article présente les résultats d'une étude visant à faire travailler ensemble des personnes aînées et des jeunes adultes au sein d'un projet intergénérationnel ancré dans la communauté. La particularité dans cette étude c'est qu'elle utilise une démarche méthodologique co-constructive, c'est-à-dire qu'elle jumelle des chercheurs et des chercheures académiques de différents horizons et des personnes aînées citoyennes tout au long du processus de recherche. Les résultats portent particulièrement sur les attentes des personnes participantes au projet intergénérationnel, la description du déroulement du projet (sur une période de dix mois) et les perceptions des relations intergénérationnelles au cours du projet. Nous terminons l'article par une discussion autour des constats centraux de notre étude et de notre expérience dans le cadre d'une recherche co-constructive.

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BACKGROUND:  Multiple mobility-related challenges frequently appear with aging. As a result, many older adults have difficulty getting around, to go, for example, to doctors' appointments or leisure activities. Although various means of transportation are currently available, older adults do not necessarily use them, partly because they do not know which ones are adapted to their needs and preferences. To foster older adults' autonomy and freedom in their decision-making about transportation, it is crucial to help them make informed decisions about the means that suit them best. OBJECTIVE: Our aim is to develop Mobilainés, a one-stop platform transportation planning service combining different transport modes and services to help older adults move around in their community where, when, and how they wish. More specifically, we aim to (1) define older adults' mobility needs and preferences in order to conceptualize a one-stop platform; (2) cocreate a prototype of the one-stop platform; and (3) test the prototype with users in a real-life context. METHODS: This ongoing study uses a "Living Lab" co-design approach. This approach differs from traditional research on aging by facilitating intersectoral knowledge sharing and innovative solutions by and with older adults themselves. A steering committee of 8 stakeholders from the public, scientific, and private sectors, as well as older citizens, will meet quarterly throughout the study. The design comprises three phases, each with several iterative subphases. Phase 1 is exploration: through co-design workshops and literature reviews, members of the intersectoral committee will define older adults' mobility needs and preferences to support the conceptualization of the one-stop platform. Phase 2 is experimentation: 4 personas will be produced that reflect the different needs and preferences of typical older adult end users of the platform; for development of a prototype, scenarios and mockups (static designs of the web application) will be created through co-design sessions with older adults (N=12) embodying these personas. Phase 3 is evaluation: we will test the usability of the prototype and document changes in mobility, such as the ability to move around satisfactorily and to participate in meaningful activities, by and with older adults (N=30) who use the prototype. The steering committee will identify ways to support the adoption, implementation, and scaling up of Mobilainés to ensure its sustainability. Qualitative and quantitative data will be triangulated according to each subphase objective. RESULTS:  The first phase began in September 2019. The study is scheduled for completion by mid-2023. CONCLUSIONS:  This innovative transportation planning service will merge existing transportation options in one place. By meeting a wide variety of older adults' needs and preferences, Mobilainés will help them feel comfortable and safe when moving around, which should increase their participation in meaningful activities and reduce the risk of social isolation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/33894.

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BACKGROUND: It is important to foster social participation and health equity, especially for older adults in situations of vulnerability. Despite growing interest in vulnerability, there is no consensus regarding how to define or measure this concept. This paper provides an inventory and synthesis of definitions of and instruments measuring vulnerability in older adults. METHODS: Using a scoping study framework, eight databases (Abstracts in Social Gerontology, Academic Search Complete, AgeLine, CINAHL, MEDLINE, SocINDEX, PsycInfo, Scopus) were searched with relevant keywords [Vulnerab* AND (Concept*, Defin*, Meaning, Terminology, Measurement, Assessment*, Indicator*, Instrument*, Scale*, Questionnaire* OR Test*) AND (Aging, Aging, Elder*, Gerontolog*, Older OR Senior*)]. RESULTS: Thirty-one original definitions and five measuring instruments were identified, content-analyzed, and compared. Vulnerability definitions mostly focused on people under conditions that increased their risk of harm because of individual physical factors, the environment, and their interaction. Considering these definitions, experts in the field of aging, including two representing older adults, participated in a workshop, and a consensus was reached to define a situation of vulnerability as "a set of circumstances in which one or more individuals experience, at a specific moment in time, one or multiple physiological, psychological, socioeconomic or social difficulties that may interact to increase their risk of being harmed or having coping challenges that have a negative impact on their life." Although none of the measures fully targeted this definition, the Perceived Vulnerability Scale (PVS) is one of the most complete measures, with 22 items considering feelings of vulnerability toward personal and environmental factors, and good psychometric properties. CONCLUSIONS: The proposed definition and the PVS help to provide a common language and measure in health and social sciences research, policy and practice identifying and reaching older adults in situations of vulnerability and intervening to foster social participation and health equity.

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Excess weight and menopause are two major factors increasing aging women's vulnerability to chronic diseases. However, social position and socioeconomic status have also been identified as major determinants influencing both health behaviors and the development of such diseases. This study focuses on the socioeconomic variations of behavioral risk factors of chronic diseases in aging women. By drawing on Bourdieu's sociocultural theory of practice, 40 semistructured interviews were conducted to investigate preventive health practices of clinically overweight, postmenopausal women from contrasting socioeconomic classes living in Canada. Findings emphasize class-based differences with respect to long-term health and preventive practices according to three major themes: priority to long-term time horizons, attention given to risk factors of diseases, and control over future health. Health care providers should strive to work in concert with all subgroups of women to better understand their values, worldviews, and needs to decrease health inequalities after menopause.

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Socioeconomic inequalities in health persist despite major investments in illness prevention campaigns and universal healthcare systems. In this context, the increased risks of chronic diseases of specific sub-groups of vulnerable populations should be further investigated. The objective of this qualitative study is to examine the interaction between socioeconomic status (SES) and body weight in order to understand underprivileged women's increased vulnerability to chronic diseases after menopause. By drawing specifically on Pierre Bourdieu's sociocultural theory of practice, 20 semi-structured interviews were conducted from May to December of 2013 to investigate the health practices of clinically overweight, postmenopausal women living an underprivileged life in Canada. Findings emphasise that poor life conditions undermine personal investment in preventive health and weight loss, showing the importance for policy makers to bring stronger consideration on upstream determinants of health.

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This study aims to (1) describe participation in four physical activity (PA) domains across life and (2) examine the influence of PA during adolescence, early, middle, and later adulthood on health variables at older age. This observational study was conducted in 1378 generally healthy older adults (age 67-84 at baseline in 2003-2005; 52% women) in Quebec, Canada. Using a modified version of the interviewer-administered Lifetime Total Physical Activity Questionnaire (LTPAQ) and life events calendar to facilitate the recall, participants reported the frequency, duration, and intensity of occupational (OPA), commuting (CPA), household (HPA), and leisure time (LTPA) they participated in at age 15, 25, 45, and 65, and at the first follow-up (age 68-85 in 2005-2006). Fat mass, lean body mass, body mass index, waist-to-hip ratio, fasting glucose, systolic and diastolic blood pressures, self-reported chronic diseases, and socio-demographic data were assessed at baseline. Changes in PA over time differed by sex in each domain. However, there was a general decline in all PA domains in both sexes after age 65. In multiple regression analyses, LTPA at first-follow-up was associated with more favourable waist-to-hip ratio in both sexes, fat mass in women and fat mass percentage in men, whereas CPA, OPA, and HPA across life were not consistently associated with health variables. Older adults' LTPA at first follow-up was related to health variables, but PA recalled during adolescence, early adulthood, and mid-life was not. Results support the idea that current PA is positively related to better health outcomes.

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Obesity remains a major public health concern in Western societies. In most industrialized countries, this condition, which is now associated with numerous chronic diseases and incapacities, is more prevalent in women than in men. While regular physical activity is highly recommended in the management of obesity, very few obese women invest in regular physical activity. Various social factors have been identified as influencing investment in preventive health practices such as physical activity. Weight stigmatization is now considered to be one of them. In order to contribute to a better understanding of the factors related to the investment of obese women in physical activity, this narrative review will focus on the stigmatization of obesity as a potential factor compromising their investment in regular physical activity and threatening their health. Messages from public health and exercise specialists targeting obesity have been recognized as contributing to weight stigmatization and Western women are more vulnerable than men to this type of discrimination. The authors discuss the various alternatives allowing public health and exercise professionals to review some of their interventions in order to help decrease weight stigmatization and its impacts on obese women in Western societies. Health and exercise professionals are influent actors who can collaborate in such initiatives in order to improve health and wellbeing of obese women..

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BACKGROUND: In class II and III obese individuals, lifestyle intervention is the first step to achieve weight loss and treat obesity-related comorbidities before considering bariatric surgery. A systematic review, meta-analysis, and meta-regression were performed to assess the impact of lifestyle interventions incorporating a physical activity (PA) component on health outcomes of class II and III obese individuals. METHODS: An electronic search was conducted in 4 databases (Medline, Scopus, CINAHL and Sportdiscus). Two independent investigators selected original studies assessing the impact of lifestyle interventions with PA components on anthropometric parameters, cardiometabolic risk factors (fat mass, blood pressure, lipid and glucose metabolism), behaviour modification (PA and nutritional changes), and quality of life in adults with body mass index (BMI) ≥ 35 kg/m2. Estimates were pooled using a random-effect model (DerSimonian and Laird method). Heterogeneity between studies was assessed by the Cochran's chi-square test and quantified through an estimation of the I². RESULTS: Of the 3,170 identified articles, 56 met our eligibility criteria, with a large majority of uncontrolled studies (80%). The meta-analysis based on uncontrolled studies showed significant heterogeneity among all included studies. The pooled mean difference in weight loss was 8.9 kg (95% CI, 10.2-7.7; p < 0.01) and 2.8 kg/m² in BMI loss (95% CI, 3.4-2.2; p < 0.01). Long-term interventions produced superior weight loss (11.3 kg) compared to short-term (7.2 kg) and intermediate-term (8.0 kg) interventions. A significant global effect of lifestyle intervention on fat mass, waist circumference, blood pressure, total cholesterol, LDL-C, triglycerides and fasting insulin was found (p<0.01), without significant effect on HDL-C and fasting blood glucose. CONCLUSIONS: Lifestyle interventions incorporating a PA component can improve weight and various cardiometabolic risk factors in class II and III obese individuals. However, further high quality trials are needed to confirm this evidence, especially beyond weight loss.

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Phytoestrogens and training could be effective to reduce cardiovascular and type 2 diabetes mellitus risk factors in postmenopausal women. Nevertheless, the impact of their combination on adipokines and systemic inflammation was never investigated. The objective was to verify if 6 months of mixed training combined with phytoestrogens could have an additional effect on adipokine levels and systemic inflammation in obese postmenopausal women. Fifty-two obese women aged between 50 and 70 years were randomly assigned to (1) exercise with placebo (EX + PL; n = 25) or (2) exercise with phytoestrogens (EX + PHY; n = 27). Body weight, waist circumference, fat mass, and lean body mass (dual-energy x-ray absorptiometry) were assessed. Fasting plasma glucose and insulin, adiponectin, leptin, and C-reactive protein (CRP) levels were obtained after a 12-hour overnight fast. Total energy intake was measured with a 3-day dietary record. All measurements were performed before and after the 6-month intervention. Although energy intake remained unchanged, body composition was improved in all women (all Ps < .02). Plasma CRP and leptin levels decreased in both groups similarly (all Ps < .03), whereas plasma adiponectin and insulin did not change with exercise combined with placebo or phytoestrogens. Correlation analyses showed that homeostasis model assessment of insulin resistance (r = -0.58, P = .02) and fasting insulin levels (r = -0.42, P = .02) at baseline were both correlated with changes in leptin levels. Baseline fasting glucose (r = -0.36, P = .03) and adiponectin (r = 0.45, P = .005) levels were associated with changes in CRP concentrations. Although mixed exercise program combined with phytoestrogens does not seem to provide any additional effect, mixed training improves systemic inflammation and leptin concentrations in obese postmenopausal women.

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OBJECTIVE: We showed that isoflavones and exercise improve total and abdominal fat mass (FM) to a greater extent than does exercise alone in postmenopausal women, but not other cardiovascular disease (CVD) risk factors. Fat-free mass (FFM) showed a wide variability of responses, with 60% of women having increased FFM and 40% having decreased FFM. We thus wondered if women who had decreased FFM could be considered as nonresponders (NRs) to exercise and if this masked a potential synergistic effect of phytoestrogens (PHY) and exercise. The aim of this study was to verify if PHYs enhance the response obtained after aerobic and resistance exercises in CVD risk profile in exercise responders. METHODS: Among 21 women who participated in a 6-month exercise program and received PHY or placebo (PLA), 14 were exercise responders (PHY, n = 8; PLA, n = 6) whereas 7 were NRs. Body weight, waist circumference, FM, and FFM were assessed (dual-energy x-ray absorptiometry). Plasma glucose, insulin, sex hormone-binding globulin, and testosterone levels were obtained after a 12-hour overnight fast. Total energy intake was measured with a 3-day dietary record. All measurements were performed before and after the intervention. RESULTS: After exercise training, the PHY and PLA groups, but not the NR group, had increased FFM (0.01 < P < 0.03). On the other hand, body weight, FM, and systolic and diastolic blood pressure (0.01 < P < 0.05) decreased in the PHY group only. Furthermore, plasma insulin level (P = 0.04) and homeostasis model assessment significantly decreased (P = 0.03) while plasma sex hormone-binding globulin increased (P = 0.04) after training in the PHY group, whereas energy intake remained unchanged in both groups (0.10 < P < 0.59) after the intervention. CONCLUSION: PHYs combined with exercise compared with exercise alone seem to improve body composition and CVD risk profile in exercise-responder women.

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OBJECTIVES: Physical activity can prevent or retard the loss of muscle mass associated with aging. On the other hand, it has been suggested that HRT may also help prevent sarcopenia in postmenopausal women. We thus examined if HRT provides additional beneficial effect in physically active postmenopausal women. METHODS: Forty postmenopausal women aged between 55 and 65 years old (normal weight, healthy and no medication) were recruited. Seventeen women were already taking HRT for at least one year whereas 23 were never submitted to HRT. Body composition was measured by DXA and physical activity metabolism was obtained by the use of accelerometry. Subjects were divided in tertile groups based on their daily physical activity energy expenditure (PAEE). RESULTS: Physical activity groups were similar for age, HRT users distribution, BMI, trunk fat-free mass (FFM), and all fat mass (FM) components. The group of women who were the most physically active significantly displayed greater total FFM, appendicular FFM, and muscle mass index (MMI) compared to the group of less active women (P < 0.05) whereas HRT added no additional effect on any FFM components. CONCLUSIONS: Our results suggest that in active postmenopausal women, HRT does not provide any additional beneficial effect on body composition.

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