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Chen LJ, Steptoe A, Chien IC, Ku PW. Longitudinal association of social isolation and loneliness with physical function among in-patients living with schizophrenia. J Psychiatr Ment Health Nurs 2024. [PMID: 38506057 DOI: 10.1111/jpm.13043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 12/14/2023] [Accepted: 02/27/2024] [Indexed: 03/21/2024]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: People living with schizophrenia have reduced physical function and are more likely to experience loneliness than those without condition. Low physical function is associated with greater loneliness in people with psychosis. However, it is unclear whether social isolation and loneliness contribute to impaired physical function in this population. Loneliness is linked to an increased risk of physical function impairment among older individuals, but research on patients living with schizophrenia is limited. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This study is the first to evaluate the longitudinal association of social isolation and loneliness with physical function among inpatients living with schizophrenia. It showed that more than one third of the participants experienced a decline in physical function over a 2-year period. Loneliness, rather than social isolation, was associated with an increase in physical function impairment over 2 years among inpatients living with schizophrenia. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Healthcare professionals should recognize loneliness as a potential risk factor for impaired physical function among inpatients diagnosed with schizophrenia. It is recommended that people living with schizophrenia are assessed for loneliness and that interventions are offered to alleviate their feelings of loneliness. Implementing interventions to reduce loneliness may help improve physical function and overall quality of life for individuals living with schizophrenia. ABSTRACT INTRODUCTION: Patients living with schizophrenia often experience low physical function, which is associated with negative health outcomes. Therefore, investigating the risk factors for physical function is crucial in this population. AIM This study examined the longitudinal association of social isolation and loneliness with physical function among inpatients living with schizophrenia. METHODS Physical function was assessed using measures of activities daily living (ADL), instrumental activities daily living (IADL) and the combination scores of ADL/IADL. Social isolation was indexed with five types of social connection and loneliness was measured using UCLA Loneliness Scale. RESULTS Social isolation was not associated with the measures of physical function over 2 years. Loneliness exhibited an association with IADL and ADL/IADL at follow-up, after adjustment for baseline levels of the outcomes. These associations remained when both social isolation and loneliness were simultaneously entered into the model. DISCUSSION Loneliness, rather than social isolation, was associated with increased physical function impairment over 2 years among inpatients living with schizophrenia. IMPLICATIONS FOR PRACTICE Healthcare professionals should consider loneliness as a potential risk factor for impaired physical function. It would be beneficial to assess patients for loneliness and implement interventions to reduce feelings of loneliness.
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Affiliation(s)
- Li-Jung Chen
- Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - I-Chia Chien
- Center for the Development of Teaching and Research, Bali Psychiatric Center, Ministry of Health and Welfare, New Taipei City, Taiwan
- YuLi Hospital, Ministry of Health and Welfare, Hualien, Taiwan
| | - Po-Wen Ku
- Department of Behavioural Science and Health, University College London, London, UK
- Graduate Institute of Sports and Health Management, National Chung Hsing University, Taichung, Taiwan
- Department of Kinesiology, National Tsing Hua University, Hsinchu, Taiwan
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Hastaoglu F, Mollaoglu M. The effects of activities of daily living education on the independence and life satisfaction of elders. Perspect Psychiatr Care 2022; 58:2978-2985. [PMID: 36030386 DOI: 10.1111/ppc.13149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 07/28/2022] [Accepted: 08/17/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this study is to examine the effect of education on the independence levels and life satisfaction (LS) of the elderly in their activities of daily living (ADL). FINDINGS The level of independence in maintaining the ADLs of the elderly in the intervention group that received training increased compared to the elderly group that was not trained. LS increased in the intervention group that received training. the number of education is an effective factor in LS. As the number of education increased, the level of LS increased in the intervention group. CONCLUSION There is a linear relationship between independence in maintaining ADLs and LS in the elderly, and as the level of independence increases in the elderly, their LS also increases. In the study, there is a significant relationship between ADL and LS before and after education, and education high affected activity levels and LS.
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Affiliation(s)
- Fatma Hastaoglu
- Department of Elderly Care, Vocational School of Healthcare, Sivas Cumhuriyet University, Sivas, Turkey.,Gerontology Studies Application and Research Center, Sivas Cumhuriyet University, Sivas, Turkey
| | - Mukadder Mollaoglu
- Departmant of Internal Medicine Nursing, Faculty of Health Science, Sivas Cumhuriyet University, Sivas, Turkey
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Ning H, Du Y, Zhao Y, Liu Q, Li X, Zhang H, Jiang D, Feng H. Longitudinal impact of metabolic syndrome and depressive symptoms on subsequent functional disability among middle-aged and older adults in China. J Affect Disord 2022; 296:216-223. [PMID: 34614438 DOI: 10.1016/j.jad.2021.09.061] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/17/2021] [Accepted: 09/21/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Few studies examining the impact of metabolic syndrome and depressive symptoms on subsequent functional disability are available. OBJECTIVES To determine the impact of baseline metabolic syndrome and depressive symptoms on subsequent functional disability. METHODS This study used data from the 2011 baseline and 2013, 2015 and 2018 follow-up waves of the China Health and Retirement Longitudinal Study (CHARLS). Functional status was assessed by activities of daily living (ADLs) and instrumental ADLs (IADLs). Analyses were restricted to middle-aged and older adults (≥50 years) free of functional disability at baseline. Metabolic syndrome, depressive symptoms, and covariates were measured at baseline. New-onset ADL and IADL disability were obtained in follow-up measurements. Competitive risks based on survival analysis were conducted to examine the impact of baseline metabolic syndrome and depressive symptoms on subsequent functional disability after covariates were controlled. RESULTS Baseline depressive symptoms significantly predicted functional disability over a 7-year follow-up after adjusting for covariates (Hazard ratio [HR] = 1.54, 95% confidence intervals [CI] = 1.40-1.70 for ADL disability; HR=1.36, 95% CI=1.25-1.48 for IADL disability). Metabolic syndrome significantly predicted ADL disability (HR=1.25, 95% CI=1.14-1.38) but not IADL disability (HR=1.02, 95% CI=0.94-1.10). No significant additive interaction between metabolic syndrome and depressive symptoms on functional disability was found. CONCLUSION The current study found that baseline depressive symptoms were significantly associated with both ADL and IADL disabilities, while metabolic syndrome significantly predicted ADL disability. In addition, some indications showed that the effect in those with both conditions was greater than the sum of the effects separately.
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Affiliation(s)
- Hongting Ning
- Xiangya School of Nursing, Central South University. Changsha, Hunan, China
| | - Yan Du
- School of Nursing, University of Texas Health Science Center at San Antonio. San Antonio, TX, United States
| | - Yinan Zhao
- Xiangya School of Nursing, Central South University. Changsha, Hunan, China
| | - Qingcai Liu
- Xiangya School of Nursing, Central South University. Changsha, Hunan, China
| | - Xiaoyang Li
- Xiangya School of Nursing, Central South University. Changsha, Hunan, China
| | - Hongyu Zhang
- Xiangya School of Nursing, Central South University. Changsha, Hunan, China
| | - Dian Jiang
- Xiangya School of Nursing, Central South University. Changsha, Hunan, China
| | - Hui Feng
- Xiangya School of Nursing, Central South University. Changsha, Hunan, China; Xiangya-Oceanwide Health Management Research Institute, Central South University. Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, China.
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4
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Nemoto Y, Sato S, Kitabatake Y, Nakamura M, Takeda N, Maruo K, Arao T. Longitudinal associations of social group engagement with physical activity among Japanese older adults. Arch Gerontol Geriatr 2020; 92:104259. [PMID: 33011428 DOI: 10.1016/j.archger.2020.104259] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/10/2020] [Accepted: 09/14/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although social group engagement (SGE) has been suggested to affect physical activity (PA) in older age, the longitudinal relationship between these variables is unclear. This study used 2-year panel data to investigate the link between changes in SGE and changes in PA among community-dwelling older adults. METHODS This study was a 2-year community-based longitudinal study enrolling older adults living in a rural municipality in Japan. The subjects were all residents in the study area aged ≥ 65 at the baseline. Mail surveys were administered in 2016 and 2018. The 3688 subjects responding to both surveys were included in the analyses. PA was evaluated with the International Physical Activity Questionnaire, and weekly time and metabolic equivalent were computed. SGE was assessed in each wave and classified as consistent engagement (engagement reported in both surveys), new engagement (non-engagement at baseline and engagement at follow-up), leaving the group (engagement at baseline and non-engagement at follow-up), and consistent non-engagement (non-engagement in both surveys). Analysis of covariance was performed to examine the associations of changes in SGE with changes in PA. RESULTS Compared with those with consistent non-engagement, who showed declines in every PA category, subjects with consistent engagement or new engagement showed significantly smaller changes in total PA, moderate-intensity PA, and brisk walking. Leaving the group (vs. consistent non-engagement) was associated with maintaining moderate-intensity PA. CONCLUSIONS SGE helps to suppress the age-associated decline in PA in older age, with new engagement and continuous engagement, especially, mitigating decreasing PA.
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Affiliation(s)
- Yuta Nemoto
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-Cho, Itabashi, Tokyo, 173-0015, Japan.
| | - Shinichiro Sato
- Faculty of Health Sciences, University of Human Arts and Sciences, 1288 Magome, Iwatsuki, Saitama, Saitama, 339-8539, Japan
| | - Yoshinori Kitabatake
- Department of Health Sciences, Saitama Prefectural University, 820 Sannomiya, Koshigaya, Saitama, 343-8540, Japan
| | - Mutsumi Nakamura
- Department of Physical Therapy, Faculty of Makuhari Human Care, Tohto University, 1-1 Hibino, Mihama, Chiba, Chiba 261-0021, Japan
| | - Noriko Takeda
- Division of Liberal Arts, Kogakuin University, 2665-1 Nakano, Hachioji, Tokyo, 192-0015, Japan
| | - Kazushi Maruo
- Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Takashi Arao
- Meiji Yasuda Life Foundation of Health and Welfare, 150 Tobuki, Hachiōji, Tokyo, 192-0001, Japan
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Fragala MS, Cadore EL, Dorgo S, Izquierdo M, Kraemer WJ, Peterson MD, Ryan ED. Resistance Training for Older Adults: Position Statement From the National Strength and Conditioning Association. J Strength Cond Res 2019; 33:2019-2052. [PMID: 31343601 DOI: 10.1519/jsc.0000000000003230] [Citation(s) in RCA: 513] [Impact Index Per Article: 102.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Fragala, MS, Cadore, EL, Dorgo, S, Izquierdo, M, Kraemer, WJ, Peterson, MD, and Ryan, ED. Resistance training for older adults: position statement from the national strength and conditioning association. J Strength Cond Res 33(8): 2019-2052, 2019-Aging, even in the absence of chronic disease, is associated with a variety of biological changes that can contribute to decreases in skeletal muscle mass, strength, and function. Such losses decrease physiologic resilience and increase vulnerability to catastrophic events. As such, strategies for both prevention and treatment are necessary for the health and well-being of older adults. The purpose of this Position Statement is to provide an overview of the current and relevant literature and provide evidence-based recommendations for resistance training for older adults. As presented in this Position Statement, current research has demonstrated that countering muscle disuse through resistance training is a powerful intervention to combat the loss of muscle strength and muscle mass, physiological vulnerability, and their debilitating consequences on physical functioning, mobility, independence, chronic disease management, psychological well-being, quality of life, and healthy life expectancy. This Position Statement provides evidence to support recommendations for successful resistance training in older adults related to 4 parts: (a) program design variables, (b) physiological adaptations, (c) functional benefits, and (d) considerations for frailty, sarcopenia, and other chronic conditions. The goal of this Position Statement is to a) help foster a more unified and holistic approach to resistance training for older adults, b) promote the health and functional benefits of resistance training for older adults, and c) prevent or minimize fears and other barriers to implementation of resistance training programs for older adults.
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Affiliation(s)
| | - Eduardo L Cadore
- School of Physical Education, Physiotherapy and Dance, Exercise Research Laboratory, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Sandor Dorgo
- Department of Kinesiology, University of Texas at El Paso, El Paso, Texas
| | - Mikel Izquierdo
- Department of Health Sciences, Public University of Navarre, CIBER of Frailty and Healthy Aging (CIBERFES), Navarrabiomed, Pamplona, Navarre, Spain
| | - William J Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, Ohio
| | - Mark D Peterson
- Department of Physical Medicine and Rehabilitation, University of Michigan-Medicine, Ann Arbor, Michigan
| | - Eric D Ryan
- Department of Exercise and Sport Science, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
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Wang F, Zhang LY, Zhang P, Cheng Y, Ye BZ, He MA, Guo H, Zhang XM, Yuan J, Chen WH, Wang YJ, Yao P, Wei S, Zhu YM, Liang Y. Effect of Physical Activity on Hospital Service Use and Expenditures of Patients with Coronary Heart Disease: Results from Dongfeng-Tongji Cohort Study in China. Curr Med Sci 2019; 39:483-492. [PMID: 31209822 DOI: 10.1007/s11596-019-2063-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 11/30/2018] [Indexed: 01/09/2023]
Abstract
The intervention of behaviors, including physical activity (PA), has become a strategy for many hospitals dealing with patients with chronic diseases. Given the limited evidence available about PA and healthcare use with chronic diseases, this study explored the association between different levels of PA and annual hospital service use and expenditure for inpatients with coronary heart disease (CHD) in China. We analyzed PA information from the first follow-up survey (2013) of the Dongfeng-Tongji cohort study of 1460 CHD inpatients. We examined factors such as PA exercise volume and years of PA and their associations with the number of inpatient visits, number of hospital days, and inpatient costs and total medical costs. We found that the number of hospital days and the number of inpatient visits were negatively associated with intensity of PA level. Similarly, total inpatient and outpatient costs declined when the PA exercise volume levels increased. Furthermore, there were also significant associations between the number of hospital days, inpatient costs or total medical costs and levels of PA years. This study provides the first empirical evidence about the effects of the intensity and years of PA on hospital service use and expenditure of CHD in China. It suggests that the patients' PA, especially the vigorous PA, should be promoted widely to the public and patients in order to relieve the financial burden of CHD.
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Affiliation(s)
- Fang Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Liu-Yi Zhang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ping Zhang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yao Cheng
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Bei-Zhu Ye
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Mei-An He
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Huan Guo
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiao-Min Zhang
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jing Yuan
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wei-Hong Chen
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - You-Jie Wang
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ping Yao
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Sheng Wei
- Department of Epidemiology and Biostatistics and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yi-Mei Zhu
- School of Media, Communication and Sociology, University of Leicester, Leicester, LE1 7JA, UK
| | - Yuan Liang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Chigateri NG, Kerse N, Wheeler L, MacDonald B, Klenk J. Validation of an accelerometer for measurement of activity in frail older people. Gait Posture 2018; 66:114-117. [PMID: 30172217 DOI: 10.1016/j.gaitpost.2018.08.024] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 07/30/2018] [Accepted: 08/20/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Specific gait parameters are associated with falls and injury. It is important to identify walking episodes in order to determine the associated gait parameters. Frail older people have a greater risk of falling due to increased probability of inactivity. Therefore, detection and analysis of their physical activities becomes significant. Furthermore, ascertainment of gait parameters and non-sedentary activities for frail older group is difficult in free living environments - an area which hasn't been explored much. METHODS Participants were 23 older people residing in independent-living retirement homes. Data was inertial sensor signals, attached to the L5 vertebral area using a belt, from scripted activities (a timed up and go, and sit to stand activities) and unscripted activities of daily living collected in a free-living environment. An algorithm designed to identify walking, standing/sitting and lying is applied to the uSense wearable accelerometer data which has been analysed by processing the raw data with a gait detection algorithm and the results were compared against annotated videos which served as the gold standard. Validity of gait assessment was based on the percentage of agreement between the analysed accelerometer data and the corresponding reference video with 100Hz sampling frequency and 0.01 frames/second. RESULTS The median overall agreement between the processed accelerometer data and the annotated video was a match of approximately 92.8% and 95.1% for walking episodes for unscripted and scripted activities respectively. SIGNIFICANCE The tri-axial accelerometer with a sampling frequency of 100 Hz provides a valid measure of gait detection in frail older people aged above 75 years. Since a limited number of studies have reported the use of accelerometers for older people in a free-living context, performance evaluation and establishing the validity of body worn sensors for physical activity and gait recognition is the key goal achieved.
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Affiliation(s)
- Nethra Ganesh Chigateri
- Department of Electrical and Computer Engineering, Faculty of Engineering, The University of Auckland, 314-390 Khyber Pass Rd, Newmarket, Auckland 1023, New Zealand.
| | - Ngaire Kerse
- Department of General Practice and Primary Healthcare, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Laurian Wheeler
- Department of General Practice and Primary Healthcare, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Bruce MacDonald
- Department of Electrical and Computer Engineering, Faculty of Engineering, The University of Auckland, 314-390 Khyber Pass Rd, Newmarket, Auckland 1023, New Zealand
| | - Jochen Klenk
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany; Department of Clinical Gerontology and Rehabilitation, Robert-Bosch Hospital, Stuttgart, Germany
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8
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Chen LJ, Fox KR, Sun WJ, Tsai PS, Ku PW, Chu D. Associations between walking parameters and subsequent sleep difficulty in older adults: A 2-year follow-up study. JOURNAL OF SPORT AND HEALTH SCIENCE 2018; 7:95-101. [PMID: 30356469 PMCID: PMC6180541 DOI: 10.1016/j.jshs.2017.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 06/26/2016] [Accepted: 11/28/2016] [Indexed: 06/08/2023]
Abstract
PURPOSE This 2-year follow-up study aimed to examine the associations between total volume, frequency, duration, and speed of walking with subsequent sleep difficulty in older adults. METHODS A total of 800 older adults aged 65 years and over participated in the first survey in 2012 and 511 of them were followed 2 years later. The 5-item Athens Insomnia Scale (AIS-5) was used to measure sleep difficulty. Frequency, duration, and speed of outdoor walking were self-reported. Walking speed was assigned a metabolic equivalent value (MET) from 2.5 to 4.5. Total walking volume in MET-h/week was calculated as frequency × duration × speed. Negative binomial regressions were performed to examine the associations between volume and components of walking with subsequent sleep difficulty with covariates of age, sex, education, marital status, living arrangement, smoking, alcohol consumption, mental health, Charlson Index, exercise (excluding walking), and sleep difficulty at baseline. RESULTS Participants with low walking volume had a higher level of sleep difficulty 2 years later compared with those with high walking volume (incident rate ratios = 1.61, p = 0.004). When speed, frequency, and duration of walking were simultaneously entered into 1 model, only walking speed was significantly associated with subsequent sleep difficulty (after the model was adjusted for covariates and baseline sleep difficulty). Sensitivity analyses showed that walking duration emerged as a significant predictor among 3 walking parameters, with 2-year changes of sleep scores as dependent variable. CONCLUSION Total amount of walking (especially faster walking and lasting for more than 20 min) is associated with less subsequent sleep difficulty after 2 years among older adults.
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Affiliation(s)
- Li-Jung Chen
- Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan 40404, China
- Department of Epidemiology and Public Health, University College London, London WC1E 7HB, UK
| | - Kenneth R. Fox
- Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol BS8 1TH, UK
| | - Wen-Jung Sun
- Family Medicine Department, Taipei City Hospital Zhongxing Branch, Taipei, Taiwan 10341, China
| | - Pei-Shu Tsai
- Graduate Institute of Translation and Interpretation, National Changhua University of Education, Changhua, Taiwan 50007, China
| | - Po-Wen Ku
- Department of Epidemiology and Public Health, University College London, London WC1E 7HB, UK
- Graduate Institute of Sports and Health, National Changhua University of Education, Changhua, Taiwan 50007, China
| | - Dachen Chu
- Department of Neurosurgery, Taipei City Hospital and Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan 11221, China
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9
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Yu B, Steptoe A, Niu K, Ku PW, Chen LJ. Prospective associations of social isolation and loneliness with poor sleep quality in older adults. Qual Life Res 2017; 27:683-691. [PMID: 29188485 DOI: 10.1007/s11136-017-1752-9] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE There is evidence for negative associations between social isolation and loneliness and sleep quality in older adults. However, it is unclear to what extent these two factors independently affect sleep quality. This study examined the simultaneous associations of social isolation and loneliness with sleep quality in a longitudinal study of older adults. METHODS Data were analyzed from the Social Environment and Biomarkers of Aging Study in Taiwan collected in 2000 and 2006, involving a cohort of 639 participants (mean age = 66.14, SD 7.26). Poisson regression models were conducted to examine the association of social isolation and/or loneliness with sleep quality at follow-up after adjusting for multiple confounding variables. RESULTS Univariate analysis showed that sleep quality was inversely associated with both social isolation and loneliness. After demographic, health, cognitive factors, and depressive symptoms were controlled in multivariable analysis, social isolation at the baseline still predicted poor sleep quality 6 years later (incident rate ratio, IRR 1.14; 95% CI 1.04-1.24; p < 0.01), while the association between loneliness and sleep quality was no longer significant (IRR 1.08; 95% CI 0.94-1.23; p = 0.27). The results were unchanged when participants who had poor sleep quality at the baseline were excluded from the analysis. CONCLUSIONS These findings confirm an adverse effect of social isolation on the sleep quality of older adults, but indicate that this effect is independent of loneliness. Social isolation and loneliness seem to have distinct pathways in affecting the sleep quality of older adults.
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Affiliation(s)
- Bin Yu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.,Department of Epidemiology and Public Health, University College London, London, UK.,Institute of Psychology, Tianjin Medical University, Tianjin, China
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Po-Wen Ku
- Department of Epidemiology and Public Health, University College London, London, UK. .,Graduate Institute of Sports and Health, National Changhua University of Education, No. 1 Jin-De Rd., Changhua City, 500, Taiwan.
| | - Li-Jung Chen
- Department of Epidemiology and Public Health, University College London, London, UK. .,Department of Exercise Health Science, National Taiwan University of Sport, No. 16, Section 1, Shuang-Shih Rd, Taichung, 404, Taiwan.
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10
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Yeh CY, Chang CK, Yang FA. Applying a Treatment Effects Model to Investigate Public Amenity Effect on Physical Activity of the Elderly. J Aging Soc Policy 2017; 30:72-86. [PMID: 28885131 DOI: 10.1080/08959420.2017.1376844] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The increasing elderly population puts significant health, economic, and social burdens on society. Physical activity is one of the most cost-effective ways to maintain the health of the elderly. This study adopts a treatment effects model to investigate the causal relationship between environment attributes and physical activity among the elderly, while taking endogeneity into account. The data were collected from 274 participants by face-to-face interviews in Taichung, Taiwan. Performing physical activity regularly in parks is the most important measure of the amount of physical activity by the elderly. Providing sufficient and accessible parks in metropolitan residential neighborhoods could be one of the most cost-effective ways to promote physical activity for the elderly living in midsize Asian cities.
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Affiliation(s)
- Chia-Yu Yeh
- a Associate Professor, Department of Economics , National Chi Nan University , Nantou , Taiwan
| | - Chen-Kang Chang
- b Professor, Sport Science Research Center , National Taiwan University of Sport , Taichung , Taiwan
| | - Feng-An Yang
- c PhD Student, Department of Agricultural , Environmental and Development Economics, The Ohio State University , Columbus , Ohio , USA
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11
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Matsunaga T, Naito M, Wakai K, Ukawa S, Zhao W, Okabayashi S, Ando M, Kawamura T, Tamakoshi A. Leisure-time physical activity and risk of disability incidence: A 12-year prospective cohort study among young elderly of the same age at baseline. J Epidemiol 2017; 27:538-545. [PMID: 28606710 PMCID: PMC5608599 DOI: 10.1016/j.je.2016.11.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 11/16/2016] [Indexed: 11/28/2022] Open
Abstract
Background To clarify the role of physical activity in preventing disability in Japan, we investigated the association between amount of leisure-time physical activity and incidence of disability among the young elderly. Methods In the New Integrated Suburban Seniority Investigation (NISSIN) project conducted from 1996 to 2013, we followed 2888 community-dwelling adults aged 64–65 years with no history of cerebrovascular disease for a median follow-up of 11.6 years. Disabilities were defined as follows based on the classifications of the Japanese long-term care insurance system: 1) support or care levels (support levels 1–2 or care levels 1–5); 2) care levels 2–5; 3) support or care levels with dementia; and 4) care levels 2–5 or death. In addition, we also assessed 5) all-cause mortality. Results After controlling for sociodemographic, lifestyle, and medical factors, male participants reporting an activity level of 18.1 metabolic equivalent (MET)-hours/week (the median among those with activities) or more had 52% less risk of being classified as support or care levels with dementia compared with the no activity group (hazard ratio 0.48; 95% confidence interval, 0.25–0.94). No significant association was found among women between amount of leisure-time physical activity and incidence of disability. Conclusion We identified an inverse dose–response relationship between the amount of leisure-time physical activity and the risk of disability with dementia in men. Therefore, a higher level of physical activity should be recommended to young elderly men to prevent disability with dementia. We examined associations between physical activity and disability incidence. We quantified amount of leisure-time physical activity. A dose–response relationship was found for the risk of disability with dementia.
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Affiliation(s)
- Takashi Matsunaga
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Mariko Naito
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shigekazu Ukawa
- Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Wenjing Zhao
- Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | | | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | | | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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12
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Chen LJ, Steptoe A, Ku PW. Obesity, Apolipoprotein E ε4, and Difficulties in Activities of Daily Living Among Older Adults: a 6-Year Follow-up Study. Ann Behav Med 2016; 51:251-260. [PMID: 27738971 DOI: 10.1007/s12160-016-9848-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Obesity has been associated with increased physical limitations among older adults, although few studies have adjusted for important covariates. There is limited information about the relationship between apolipoprotein E (APOE) polymorphisms and physical limitations, and the findings have been inconsistent. PURPOSE This study examined the longitudinal associations of obesity and APOE ε4 with difficulties in activities of daily living (ADLs) over a 6-year follow-up period controlling for multiple covariates. METHODS Data were analyzed from the Social Environment and Biomarkers of Aging Study (SEBAS) in Taiwan collected in 2000 and 2006, involving a cohort of 639 participants (mean age = 66). Body mass index (BMI) was used to define obesity at a baseline, and the APOE genotype was classified into an APOE ε4 carrier and non-carrier status. The combination of basic and instrumental activities of daily living (ADLs and IADLs) was used to define impaired ADLs. RESULTS APOE ε4 carriers had greater difficulties in combined ADLs (incident rate ratio; IRR = 1.87, 95 % CI = 1.40-2.51) than non-carriers. Obese but not overweight adults had greater difficulties in activities of daily living (IRR = 1.59, 95 % CI = 1.20-2.10) compared with the normal/underweight group. Obese older adults without APOE ε4 had greater subsequent difficulties in ADLs than non-obese non-carriers. Among APOE ε4 carriers, obesity was not a significant risk factor for the development of impaired ADLs in older adults, indicating an interaction between genotype and obesity. CONCLUSIONS The interaction between genotype and obesity phenotype adds new information about the determinants of physical impairment.
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Affiliation(s)
- Li-Jung Chen
- Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan.,Department of Epidemiology and Public Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Po-Wen Ku
- Department of Epidemiology and Public Health, University College London, London, UK. .,Graduate Institute of Sports and Health, National Changhua University of Education, No.1, Jinde Rd, Changhua City, 500, Taiwan.
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13
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Barnett A, Cerin E, Zhang CJP, Sit CHP, Johnston JM, Cheung MMC, Lee RSY. Associations between the neighbourhood environment characteristics and physical activity in older adults with specific types of chronic conditions: the ALECS cross-sectional study. Int J Behav Nutr Phys Act 2016; 13:53. [PMID: 27105954 PMCID: PMC5477845 DOI: 10.1186/s12966-016-0377-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 04/14/2016] [Indexed: 12/14/2022] Open
Abstract
Background Neighbourhood characteristics may influence physical activity (PA), which has positive effects on the health of older adults. Older adults with chronic conditions are less active and possibly more affected by environmental factors than their peers. Understanding neighbourhood characteristics associated with PA specific to older adults with chronic conditions is currently lacking. This cross-sectional study aimed to assess the associations between the neighbourhood environment and various forms of PA in older adults with and without visual impairment, hearing impairment, musculoskeletal disease and/or genitourinary disease. Methods Neighbourhood environment and PA data were collected in Hong Kong older adults (N = 909) from 124 preselected neighbourhoods stratified for walkability and socioeconomic status. Generalized linear models and zero-inflated negative binomial models with robust standard errors were used to examine associations of perceived neighbourhood environment characteristics, and the moderating effects of having specific chronic conditions, with PA outcomes. Results Thirteen perceived neighbourhood characteristics were associated with older adults’ PA in the expected direction irrespective of their health condition. Nine neighbourhood characteristics had associations with PA that were dependent on hearing impairment, vision impairment, musculoskeletal disease or genitourinary disease. In general, they were stronger in participants with than without a specific chronic condition. Conclusions Maximizing the potential for PA in older adults who have lower levels of physical functionality due to chronic conditions may require neighbourhood characteristics specific to these groups.
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Affiliation(s)
- Anthony Barnett
- Institute of Health and Ageing, Australian Catholic University, Melbourne, VIC, Australia.
| | - Ester Cerin
- Institute of Health and Ageing, Australian Catholic University, Melbourne, VIC, Australia.,School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Casper J P Zhang
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Cindy H P Sit
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Janice M Johnston
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Martin M C Cheung
- Elderly Health Service, Department of Health, The Government of Hong Kong Special Administrative Region, Hong Kong, China
| | - Ruby S Y Lee
- Elderly Health Service, Department of Health, The Government of Hong Kong Special Administrative Region, Hong Kong, China
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