Wiebren Zijlstra

Institute of Movement and Sport Gerontology · German Sport University Cologne

Background To ensure adequate treatment, individuals with delirium superimposed on dementia (DSD) need to be differentiated reliably from those with dementia only (DO). Therefore, we aimed to examine the clinical indicators of DSD by assessing motor subtypes, cognitive performance and neuropsychiatric symptoms in DSD and DO patients. Methods Cross...

The ability to quickly adapt steps while walking is pivotal for safe mobility. In a previous study of immediate switching between the two stepping tasks, older adults (OAs) performed worse than young adults (YAs). However, it remained unclear whether this difference was due to an inability to learn the tasks or an inability to quickly switch. There...

Objectives Age-related changes in executive functions, especially inhibitory control, correlate to decreased balance control and increased fall risk. However, only a few studies focused on the performance of tasks integrating balance and inhibitory control. This study aims to determine the effects of cognitive inhibition preceding the initiation of...

Background This project aims to investigate the effects of a student-led journal club on students’ critical thinking and clinical application skills in the academic field of aging and physical activity. Methods A pre-post design analysis with data collected in four successive cohorts of the program M.Sc. Sport and Movement Gerontology was conducte...

Background Life-space mobility (LSM) is an important aspect of older adults’ real-life mobility. Studies have shown that restricted LSM is a risk factor for many adverse outcomes such as low quality of life and mortality. Therefore, an increasing number of interventions aim to enhance LSM. However, the intervention approaches differ in terms of the...

Background: Analyzing patients' mobility-related behavior may improve the assessment of motor behavior in dementia, however, few studies addressed circadian aspects of mobility. This cross-sectional explorative study analyzed the timing of peak mobility-related behavior, the prevalence of mobility-related sundowning and nocturnal mobility-related...

Objective To identify and analyze the components applied in interventions using physical activity (PA) monitoring in geriatric patients and determine their feasibility and applicability. Methods A systematic search in six databases (PubMed, Embase, SPORTDiscus, CINAHL, Web of Science, and GeroLit) was conducted to identify studies reporting interv...

Age-related effects of task switching have been extensively studied based on cognitive tasks and simple motor tasks, but less on complex cognitive-motor tasks involving dynamic balance control while walking. The latter tasks may especially be difficult and relevant for older adults in terms of safe mobility in daily life. The aim of the present stu...

Purpose: Voluntary gait adaptability is a complex construct that requires cognitive demands and dynamic balance control; it also has implications for the daily lives of older adults. This ability has been extensively studied, however, a comprehensive overview of appropriate tasks for measuring voluntary gait adaptability in older adults is lacking...

Preserving functional health and quality-of-life in old age is a major goal and global challenge in public health. The high rate of sedentary behavior that is characteristic of the older adult population exacerbates impairments of physiological and tructural systems that are typically seen in the aging process. Achieving an understanding of the pro...

Background Increasing number of falls and fall-related injuries in an aging society give rise to the need for effective fall prevention and rehabilitation strategies. Besides traditional exercise approaches, new technologies show promising options for fall prevention in older adults. As a new technology-based approach, the hunova robot can support...

Preliminary results with 8 subjects (6 young and 2 older adults) were described in the abstract. At the conference, further results with 31 subjects (15 young and 16 older adults) were presented in an oral presentation session (motor performance and learning) of the conference program.

Background Major depression is one of the main mental illnesses in old age, with acute exacerbated episodes requiring treatment in geriatric psychiatry. A meta-analysis showed that aerobic exercise in moderate intensity has large effects in older adults with major depression, but there is no evidence of aerobic exercise in geriatric psychiatry. The...

Background Delirium and dementia are prominent psychiatric diseases in old age and connected with poor outcomes for people affected. Nevertheless, there is a lack of knowledge concerning the long-term prognosis of patients with dementia and delirium. This study analyzes mortality, readmission rates and discharge destinations of patients with dement...

Background: Major depression is one of the main mental illnesses in old age, with acute exacerbated episodes requiring treatment in geriatric psychiatry. A meta-analysis showed that aerobic exercise in moderate intensity has large effects in older adults with major depression, but there is no evidence of aerobic exercise in geriatric psychiatry. Th...

Background Age-related changes in inhibitory control (IC) affect cognitive as well as physical functioning, but how it affects performance of tasks that integrate IC and balance control is unclear. This review study aims to identify specific tasks that have been used to determine effects of IC on balance performance in older adults, and analyse tas...

Background Multimodal exercise training (MT) as a time-efficient training modality promotes a wide range of physical dimensions. Incorporating agility-like training aspects (coordination, changes of direction and velocity) into MT may further enhance physical outcomes highly relevant for activities of daily living. This meta-analysis investigated t...

Background Based on a conceptual framework, Kuspinar and colleagues analysed life-space mobility in community-dwelling older adults. However, a number of earlier mobility studies that used the same framework remained undiscussed. This correspondence article addresses similarities and differences between these studies, as well as highlight issues th...

Objectives To gain first insight into the effectiveness of a home-based exercise programme for pre-frail older adults with independent use of novel ICT technology. Methods A pilot study. Forty pre-frail older adults joined a six-month home-based exercise programme using a tablet PC for exercise administration and feedback, and a necklace-worn moti...

Background Sarcopenia is an age-related progressive and general skeletal muscle disease associated with negative consequences such as falls, disability, and mortality. An early-stage diagnosis is important to enable adequate treatment, especially in geriatric psychiatry. However, there presently is little information about the feasibility of diagno...

Disruptions of circadian motor behavior cause a significant burden for older adults as well as their caregivers and often lead to institutionalization. This cross-sectional study investigates the association between mobility-related behavior and subjectively rated circadian chronotypes in healthy older adults. The physical activity of 81 community-...

In order to design effective interventions to prevent age-related mobility loss, it is important to identify influencing factors. The concept of "motility" by Kaufmann et al. subdivides such factors into three categories: "access", "skills", and "appropriation". The aim of this study was to assemble appropriate quantitative assessment tools for the...

Background: Recent technological developments such as wearable sensors and tablets with a mobile internet connection hold promise for providing electronic health home-based programs with remote coaching for patients following total hip arthroplasty. It can be hypothesized that such a home-based rehabilitation program can offer an effective alternat...

Applicable and accurate assessment methods are required for a clinically relevant quantification of habitual physical activity (PA) levels and sedentariness in older adults. The aim of this study is to compare habitual PA and sedentariness, as assessed with (1) a wrist-worn actigraph, (2) a hybrid motion sensor attached to the lower back, and (3) a...

Background As age-related health problems are often related to a combination of physiological, psychological and social aspects, it has been proposed that multi-component interventions might be particularly effective to improve older peoples’ health. The present study used a smartphone-based approach to promote health through activities including p...

Physical exercise is an effective treatment approach for neuropsychiatric symptoms (NPS), but it is unknown whether the reduction of NPS has an impact on professional caregiver burden. A randomized controlled trial in acute dementia care with N = 70 patients, n = 35 per group, was conducted. The intervention group (IG) received an exercise program,...

PLEASE NOTE: This article is published in GeroScience which was titled AGE prior to 2017. ResearchGate has not yet updated their journal database. ABSTRACT: The ability to rapidly adjust gait to cope with unexpected mechanical perturbations declines with ageing. Previous studies however, have not ensured that gait stability pre-perturbation was e...

The ability to effectively execute compensatory steps is critical for preventing accidental falls, and consequently stepping training is an essential ingredient of fall prevention programs. In this paper, we propose a concept for stepping training that aims to maximize training effects by taking into account recent research evidence and a precise d...

Background: Reduced mobility is associated with a plethora of adverse outcomes. To support older adults in maintaining their independence, it first is important to have deeper knowledge of factors that impact on their mobility. Based on a framework that encompasses demographical, environmental, physical, cognitive, psychological and social domains...

Objectives The aim of this study was to investigate the feasibility and reliability of functional performance tests in people living with dementia and depression. Method A cross-sectional study was conducted in a geriatric psychiatry hospital. People living with dementia, depression, and healthy older adults were included. Feasibility of the timed...

Interest in global positioning system (GPS)-based mobility assessment for health and aging research is growing, and with it the demand for validated GPS-based mobility indicators. Time out of home (TOH) and number of activity locations (#ALs) are two indicators that are often derived from GPS data, despite lacking consensus regarding thresholds to...

Objective: This non-blinded, three-armed randomized controlled trial aimed at comparing the effects of volitional step training under stable and unstable conditions on balance, mobility and strength adaptations. Methods: Fivty-five healthy and active older adults (age = 69.4 ± 5.6 years; BMI = 27.4 ± 4.6, physical activity = 9.2 ± 5.1 h/week) were...

Background: GPS tracking is increasingly used in health and aging research to objectively and unobtrusively assess individuals' daily-life mobility. However, mobility is a complex concept and its thorough description based on GPS-derived mobility indicators remains challenging. Methods: With the aim of reflecting the breadth of aspects incorpora...

The ability to rapidly adjust gait to cope with unexpected mechanical perturbations declines with ageing. Previous studies however, have not ensured that pre-perturbation gait stability was equivalent, meaning that differences in unperturbed gait stability may have influenced the outcomes, which this study addresses. We also examine if interlimb tr...

BACKGROUND AND AIM: The ability to conduct rapid and precise corrective steps in all directions in order to maintain balance during complex daily life activities is crucial for avoiding a fall. Falls often happen during dual-task conditions, e.g. when a mechanically challenging activity is combined with additional cognitive tasks. Such additional c...

Promoting healthy ageing requires a multi-dimensional prevention approach, which targets important domains of functioning. Information and communication technologies (ICT) can support preventive health care, but they need to be tweaked to specific individual needs. The My Active and Healthy Aging (My-AHA) ICT platform aims to prevent frailty by spe...

Sustaining an appropriate level of attention over time is critical for completing many tasks in daily life such as driving, maintaining a conversation etc. Unfortunately, attention is not deployed consistently but rather fluctuates between optimal and suboptimal states. In case remaining focussed is required for a longer period of time, attentional...

Promoting healthy ageing requires a multi-dimensional prevention approach, which targets important domains of functioning. Information and communication technologies (ICT) can support preventive health care, but they need to be tweaked to specific individual needs. The My Active and Healthy Aging (My-AHA) ICT platform aims to prevent frailty by spe...

BACKGROUND Recent technological developments such as wearable sensors and tablet PC use with mobile internet connection look promising for providing e-health home-based programs with remote coaching. It can be hypothesized that in the end, such a home-based rehabilitation program can be an alternative to regular physiotherapy. OBJECTIVE To determi...

Background Recent technological developments such as wearable sensors and tablets with a mobile internet connection hold promise for providing electronic health home-based programs with remote coaching for patients following total hip arthroplasty. It can be hypothesized that such a home-based rehabilitation program can offer an effective alternati...

Reactive locomotor adaptations are crucial for safe mobility, but remain relatively unexplored. Here we assess reactive gait adaptations, and their retention, savings and interlimb transfer. Using new methods to normalise walking speed and perturbation magnitude, we expose eighteen healthy adults to ten unexpected treadmill belt accelerations durin...

Stepping training is one type of exercise-based interventions that is effective in reducing fall risk (1). However, it is offered mostly in form of exergames which require costly equipment and lack the benefits of the social aspect of group training. Furthermore, additional studies are needed to gain insight in dose-response relationships of steppi...

To maximize effectiveness, falls-prevention exercise programs need to implement research evidence into practice. The ability to execute steps that vary in amplitude, speed, accuracy (1) in single and multi-task conditions (2) is critical for preventing accidental falls. For that reason, stepping training has been found to be particularly effective...

Introduction To objectively quantify patients’ physical activity and analyze the relationships between physical activity levels, psychopathology and sedative medication in acute hospital dementia care. Materials and Methods In this cross‐sectional study we assessed the patients’ physical activity based on data collection by hybrid motion sensors a...

Defizite in der funktionellen Leistungsfähigkeit spielen eine zentrale Rolle in der gerontopsychiatrischen Akutversorgung (z.B. hohe Inzidenz von Gangstörungen und Stürzen). Die Ausführung motorischer Tests zur Erfassung der funktionellen Leistungsfähigkeit beansprucht höhere kognitive Verarbeitungsprozesse (Hauer & Oster, 2008). Einschränkungen de...

Introduction Frailty increases the risk of poor health outcomes, disability, hospitalization, and death in older adults and affects 7%–12% of the aging population. Secondary impacts of frailty on psychological health and socialization are significant negative contributors to poor outcomes for frail older adults. Method The My Active and Healthy Ag...

Background: Recent developments in technology are promising for providing home-based exercise programs. Objective: The objective of this study was to evaluate the feasibility and patient experience of a home-based rehabilitation program after total hip arthroplasty (THA) delivered using videos on a tablet personal computer (PC) and a necklace-wo...

BACKGROUND Recent developments in technology are promising for providing home-based exercise programs. OBJECTIVE The objective of this study was to evaluate the feasibility and patient experience of a home-based rehabilitation program after total hip arthroplasty (THA) delivered using videos on a tablet personal computer (PC) and a necklace-worn m...

https://link.springer.com/epdf/10.1007/s10433-017-0434-3?author_access_token=1ft2-iLsqL9Bjnw2N24Cdfe4RwlQNchNByi7wbcMAY5egaAcG4zOrs34CPgb7MIeiLRxMR5qiavsydlnrtyBpWZTfZsDgJjD9sEOXAUw3Wzv3fZFRUNUWH8DTEuNSic_cWzLc2tViXXmwhc3naXNsg==

Background and purpose: Over 40 million people worldwide are currently living with dementia. Physical activity is one treatment option for this target group and delays the occurrence of symptoms, such as forgetfulness or disorientation. So far, it is unclear whether integrating serious games, which combine multimedia, entertainment, and training, i...

Age-related impairments in sensory and motor functions result in changes in physical and cognitive performance and therefore pose an increased risk for accidental falls in older adults. A plethora of falls-prevention exercise programs currently exist, however most of them fail to comply with two of the most important principles of training, namely...

In health and aging studies that include GPS assessments, mobility is often represented by a single indicator such as the number of activity locations, the size of the activity space, or the total distance covered. We argue, however, that mobility is a multi-dimensional construct. In this paper, we first provide a framework to categorize and system...

Fall rates from 3.2 to 17.1 falls per 1,000 hospital days in geriatric psychiatry facilities have been reported to date. Up to 5% of the falls result in severe injuries, but data concerning medical consequences are scare. This brief report presents a retrospective analysis of one year fall protocols from a geriatric psychiatry department focusing o...

Background The primary objective of this trial is to investigate the effects of a short-term exercise program on neuropsychiatric signs and symptoms in acute hospital dementia care. Methods Within a hospital-based randomized controlled trial, the intervention group conducted a 2-week exercise program with four 20-min exercise sessions on 3 days pe...

Background: Lying on the floor for a long time after falls, regardless of whether an injury results, remains an unsolved health care problem. In order to develop efficient and acceptable fall detection and reaction approaches, it is relevant to improve the understanding of the circumstances and the characteristics of post-impact responses and the...

Objective This paper aims to present a new approach for stimulating physical activity in older people. We created a new activity app to introduce older people to planning trips in their hometown using a smartphone, and hence increase activity. This paper presents our methodological approach and the functionality of our new app. Furthermore, we will...

Studies have shown that limited mobility is associated with morbidity, increased fall risk, loss of independence, institutionalization, and increased mortality. To support older people in maintaining independent mobility, it is important to have knowledge of factors that impact on mobility. Although literature demonstrates the multi-dimensionality...

With ageing, everyday functioning suffers from age-associated changes in physical and cognitive functioning. One of the abilities impacted by age-related cognitive decline is divided attention (Frasel et al., 2013). Dual-task paradigms have been used to assess the attentional demands of motor tasks and to identify individuals at risk for falls (Bea...

Background Falls are a leading cause of injury among older adults and most often occur during walking. While strength and balance training moderately improve falls risk, training reactive recovery responses following sudden perturbations during walking may be more task-specific for falls prevention. The aim of this review was to determine the varie...

Introduction Stimulation of a physically active lifestyle among older adults is essential to health and well-being. The objective of this study was to evaluate the feasibility and user opinion of a home-based exercise program supported by a sensor and tablet application for frail older adults. Methods Community-dwelling older adults (aged ≥70 y) l...

Observational and interventional studies indicate a direct link between the patients' physical activity and the extent of behavioral and psychological symptoms of dementia (BPSD). At present, there are no evidence-based recommendations for physical exercise in the acute dementia care settings. Hence, this systematic review investigates the effects...

Background Real-world fall events objectively measured by body-worn sensors can improve the understanding of fall events in older people. However, these events are rare and hence challenging to capture. Therefore, the FARSEEING (FAll Repository for the design of Smart and sElf-adaptive Environments prolonging Independent livinG) consortium and asso...