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Li Y, Lyu L, Fan X, Xu L, Li Y, Song R. Reliability, validity and minimal detectable change of the Chinese Version of the Assessment of Physical Activity in Frail Older People (APAFOP-C). BMC Geriatr 2024; 24:582. [PMID: 38971724 DOI: 10.1186/s12877-024-05167-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 06/23/2024] [Indexed: 07/08/2024] Open
Abstract
BACKGROUND Physical activity (PA) is essential in mitigating frailty syndrome, and it is necessary to measure PA in older adults with frailty. Assessment of Physical Activity in Frail Older People (APAFOP) is a suitable patient-reported outcome measure (PROM) for assessing PA among older adults with frailty. This study aimed to determine the reliability, validity and minimal detectable change of the Chinese version of the APAFOP (APAFOP-C). METHODS This cross-sectional validation study was designed to measure the reliability and criterion validity of the APAFOP-C with 124 frail community-residing older adults. APAFOP-C was completed twice within an interval of 7-17 days to determine test-retest reliability. The investigator triangulation method was used to investigate inter-rater reliability, and a pedometer was used as the reference measurement to assess the criterion validity. Reliability and criterion validity were assessed using the intraclass correlation coefficient (ICC2,1), Pearson correlation coefficient for normally distributed variables, Spearman correlation coefficient, Wilcoxon signed-rank test for skewed variables, and the minimal detectable change at 95% level of confidence (MDC95). Agreement assessment was conducted using Bland-Altman plots for inter-rater reliability and criterion validity. Kendall's W test assessed absolute agreement among three raters in inter-rater reliability. The Mann-Whitney U test was used to evaluate whether any particular day was more representative of certain daily activities. RESULTS Total PA on any arbitrarily chosen day illustrates daily activity (Z= -0.84, p = 0.40). The APAFOP-C exhibited strong-to-very strong test-retest reliability (ICC2,1=0.73-0.97; Spearman ρ = 0.67-0.89), and the total PA score demonstrated MDC95 < 10%. Inter-rater reliability was also strong-to-very strong (ICC2,1=0.96-0.98; Spearman ρ = 0.88-1.00), and moderate criterion validity when compared with total PA score on pedometer readings (Spearman ρ = 0.61). Limits of agreement among different raters regarding the APAFOP-C and the pedometer were narrow. CONCLUSION The APAFOP-C was found to have limited but acceptable psychometric properties for measuring PA among community-dwelling older adults with frailty in China. It was a feasible comparative PROM for assessing PA worldwide. Practitioners can develop individualized exercise programs for frail older adults and efficiently track changes in PA utilizing the APAFOP-C.
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Affiliation(s)
- Yuelin Li
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Linyu Lyu
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Xing Fan
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
- School of Medicine, Lishui University, Lishui, China
| | - Lijuan Xu
- School of Medicine, Lishui University, Lishui, China
| | - Yan Li
- Department of Education, Chungnam National University, Daejeon, Republic of Korea
| | - Rhayun Song
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea.
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Lu Y, Li Q, Wang W, Du L, He Q, Chen S, Zhang X, Pan Y. Associations between accelerometer-measured physical activity and sedentary behaviour with physical function among older women: a cross-sectional study. BMC Public Health 2024; 24:1754. [PMID: 38956531 PMCID: PMC11218370 DOI: 10.1186/s12889-024-19270-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 06/25/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND This study aimed to investigate the relationships between accelerometer-measured physical activity (PA) and sedentary behaviour (SB) with physical function (PF) among older Chinese women in the community. METHODS The present study comprised 1,113 community-dwelling older females, with an average age of 65 ± 2 years. We employed a linear regression analysis to investigate the relationship between patterns of PA and SB with PF. PA variables consisted of total PA time, bouted PA time (a continuous PA that lasts equal to or more than 10 min), and sporadic PA time (a continuous PA that lasts less than 10 min). SB variables included total SB time, 30-min bout of SB (a continuous SB that lasts equal to or more than 30 min), and 60-min bout of SB (a continuous SB that lasts equal to or more than 60 min). PF variables comprised handgrip strength (HGS), one-legged stance test with eyes closed (OLSTEC), usual walking speed (UWS), maximum walking speed (MWS) and chair-stand time (CT). To explore the joint effects of moderate-to-vigorous-intensity PA (MVPA) and SB on PF, we divided the duration of SB and MVPA participation in older women into different combinations: low MVPA & high SB, low MVPA & low SB, high MVPA & high SB, high MVPA & low SB. RESULTS The study revealed a significant association between 30-min bout of SB and CT, which remained after adjusting for total MVPA time (P = 0.021). Both total MVPA and bouted MVPA were found to be positively associated with better UWS, MWS, CT, and PF Z-score. When the combination of low MVPA & high SB was used as a reference, the regression coefficients for PF ascended by 1.32 (P < 0.001) in the high MVPA & high SB group and by 1.13 (P < 0.001) in the high MVPA & low SB group. CONCLUSIONS A significant association was observed between poorer lower limb function and prolonged, uninterrupted SB in older women, rather than with the total SB time. Concurrently, the insufficient engagement in MVPA may also be a crucial factor contributing to poorer PF in older women. Engaging in longer durations and higher intensity of PA, such as bouts of MVPA lasting a minimum of 10 min or longer, may contribute to better PF.
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Affiliation(s)
- Yanyu Lu
- School of Physical Education, Shandong University, Jinan, China
| | | | - Wenbo Wang
- Zaozhuang Vocational College of Science and Technology, Zaozhuang, China
| | - Litao Du
- School of Physical Education, Shandong University, Jinan, China
| | - Qiang He
- School of Physical Education, Shandong University, Jinan, China
| | - Si Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xianliang Zhang
- School of Physical Education, Shandong University, Jinan, China
| | - Yang Pan
- School of Physical Education, Shandong University, Jinan, China.
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Li T, Zong G, Peng P, Wang S, Cheng B. Accelerometer-measured physical activity and sample-based frailty in older women: does pattern really matter? Front Public Health 2024; 11:1304279. [PMID: 38332942 PMCID: PMC10850322 DOI: 10.3389/fpubh.2023.1304279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/29/2023] [Indexed: 02/10/2024] Open
Abstract
Background The relationship between the patterns of physical activity (PA) and frailty, including its various subdomains, remains poorly understood. Therefore, this study aims to investigate the correlations between the patterns of physical activity and frailty and its various subdomains in community-dwelling older women. Methods A cross-sectional study investigated the association between physical activity and frailty in 1,099 women aged between 60 to 70 years. Triaxial accelerometers were used to measure bouted PA (a minimum duration of 10 min) and sporadic PA (a duration of <10 min). Fried's frailty phenotype was utilized to evaluate the status of frailty. Data were analyzed using logistic regression and the receiver operating characteristic (ROC) curve. Results Bouted moderate-to-vigorous PA (MVPA) and sporadic MVPA were associated with decreased odds of being prefrail and frail, and the optimal cutoff values were 6 and 19.7 for the prefrail stage and 6.6 and 19.4 min/day for the frail stage, respectively. Bouted light PA (LPA) was associated with decreased odds of being prefrail, and the optimal cutoff value was 170.2 min/day. Additionally, bouted and sporadic MVPA were associated with decreased odds of being slow and their optimal cutoff values were 5 and 19.1 min/day, respectively. Sporadic MVPA was associated with decreased odds of exhaustion, and the cutoff was 19.7 min/day. Bouted MVPA and LPA were associated with decreased odds of having low PA, and the cutoff values were 4.4 and 163.2 min/day, respectively. Conclusion Any MVPA, regardless of bout duration, could be used as a suitable PA program to improve and prevent frailty in older women, such as bouted MVPA (4-5 times/week) or sporadic MVPA (20 min/day). The improvement effect of bouted and sporadic MVPA on the frailty of older people may not be affected by the subdomain. Additionally, bouted LPA was suitable for the management of prefrailty.
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Affiliation(s)
- Ting Li
- School of Physical Education, Shandong University, Jinan, China
| | | | - Pan Peng
- Ezhou High School, Ezhou, Hubei, China
| | - Shiqiang Wang
- College of Physical Education, Hunan University of Technology, Zhuzhou, China
- Hunan Key Laboratory of Physical Health and Sports Fitness, Zhuzhou, China
- Hunan Research Centre in Physical Fitness, Health, and Performance Excellence, Hunan University of Technology, Hunan, China
| | - Bin Cheng
- School of Physical Education, Shandong University, Jinan, China
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Ribeiro-Castro AL, Surmacz K, Aguilera-Canon MC, Anderson MB, Van Andel D, Redfern RE, Cook CE. Early post-operative walking bouts are associated with improved gait speed and symmetry at 90 days. Gait Posture 2024; 107:130-135. [PMID: 37271590 DOI: 10.1016/j.gaitpost.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/10/2023] [Accepted: 05/16/2023] [Indexed: 06/06/2023]
Abstract
INTRODUCTION There is a paucity of literature on optimal patterns of daily walking following joint arthroplasty, which are now evaluated with consumer technologies like smartphones, and can enhance our understanding of post-operative mobility. When smartphone-recorded, daily walking patterns are captured, qualities of gait-recovery such as gait speed or symmetry can be analyzed in real-world environments. RESEARCH QUESTION Are the daily distribution of walking bouts in the early post-operative period associated with 90-day gait quality measures following hip and knee arthroplasty? METHODS Gait data was collected passively using a smartphone-based care management platform in patients undergoing hip and knee arthroplasty. As recorded via subjects' free-living smartphone-collected gait bouts, data were investigated as a function of the walking session length and were used to create a ratio to the total time logging bouts, representing the fraction of walking performed during a single session per day (aggregation score). Quantile regression was performed to evaluate the association between early walking session lengths or aggregation score at 30 days post-operatively and the gait-sampled speed and asymmetry of walking at 90 days. RESULTS In total, 2255 patients provided evaluable data. The walking session length at 30 days was positively associated with 90-day mean gait speed across procedure types where quantile regression coefficients ranged from 0.11 to 0.17. In contrast, aggregation score was negatively associated with gait speed at 90 days, with coefficients ranging from -0.18 to -0.12. SIGNIFICANCE The duration and frequency of walking bouts was associated with recovery of gait speed and symmetry following lower limb arthroplasty. The findings may help clinicians design walking protocols that are associated with improved gait metrics at 3 months.
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Affiliation(s)
| | - Karl Surmacz
- ZBAI, London, UK; Duke University Medical Center, Durham, NC, USA
| | | | - Mike B Anderson
- Zimmer Biomet, Warsaw, IN, USA; Duke University Medical Center, Durham, NC, USA
| | - Dave Van Andel
- Zimmer Biomet, Warsaw, IN, USA; Duke University Medical Center, Durham, NC, USA.
| | - Roberta E Redfern
- Zimmer Biomet, Warsaw, IN, USA; Duke University Medical Center, Durham, NC, USA
| | - Chad E Cook
- Zimmer Biomet, Warsaw, IN, USA; Duke University Medical Center, Durham, NC, USA
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Chang WN, Tzeng PL, Huang WJ, Lin YH, Lin KP, Wen CJ, Chou YC, Liao Y, Hsueh MC, Chan DC. Objective assessment of the association between frailty and sedentary behavior in older adults: a cross-sectional study. Eur Rev Aging Phys Act 2023; 20:14. [PMID: 37550620 PMCID: PMC10405382 DOI: 10.1186/s11556-023-00324-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/27/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Given the inconsistent findings of the association between frailty and sedentary behavior in older adults, this cross-sectional study investigated the aforementioned association using four different frailty criteria and two sedentary behavior indices in older adults. METHODS Data from older adults (age ≥ 65 y) who participated in health examinations or attended outpatient integrated clinics at a medical center in Taipei, Taiwan, were collected. Frailty was measured using the modified Fried Frailty Phenotype (mFFP), Clinical Frailty Scale in Chinese Translation (CFS-C), Study of Osteoporotic Fractures (SOF) index, and Clinical Frailty-Deficit Count (CF-DC) index; sedentary behavior was assessed with a waist-worn accelerometer. Adjusted linear regression ascertained the association between frailty and both sedentary behavior outcomes. RESULTS Among the 214 participants (mean age 80.82 ± 7.14 y), 116 were women. The average total sedentary time and number of sedentary bouts were 609.74 ± 79.29 min and 5.51 ± 2.09 times per day, respectively. Frail participants had a longer total sedentary time (odds ratio [OR]: 30.13, P = .01 and 39.43, P < .001) and more sedentary bouts (OR: 3.50 and 5.86, both P < .001) on mFFP and CFS-C assessments, respectively. The SOF index revealed more sedentary bouts among frail than in robust participants (OR: 2.06, P = .009), without a significant difference in the total sedentary time. Frail participants defined by the CF-DC index were more likely to have frequent sedentary bouts (OR: 2.03, P = .016), but did not have a longer total sedentary time. CONCLUSIONS Regardless of the frailty criteria adopted, frailty was positively associated with the number of sedentary bouts per day in older adults. A significant correlation between frailty and total sedentary time was detected only with mFFP and CFS-C indices. Further research may target decreasing the sedentary bouts in older adults as a strategy to improve frailty.
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Affiliation(s)
- Wen-Ning Chang
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
| | - Pei-Lin Tzeng
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
- Department of Health Promotion and Health Education, National Taiwan Normal University, No 162, Section 1, Heping E. Rd, Taipei, 106209, Taiwan
| | - Wei-Jia Huang
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
| | - Yu-Hung Lin
- Department of Health Promotion and Health Education, National Taiwan Normal University, No 162, Section 1, Heping E. Rd, Taipei, 106209, Taiwan
- National Taiwan University Hospital, Bei-Hu Branch, No. 87 Neijiang Street, Taipei, 108206, Taiwan
| | - Kun-Pei Lin
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
| | - Chiung-Jung Wen
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
- Department of Family Medicine, College of Medicine, National Taiwan University, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
| | - Yi-Chun Chou
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
- Department of Family Medicine, College of Medicine, National Taiwan University, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
| | - Yung Liao
- Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, No. 162, Section 1, Heping E. Rd, Taipei, 106209, Taiwan
| | - Ming-Chun Hsueh
- Graduate Institute of Sport Pedagogy, University of Taipei, No. 101, Sec. 2, Zhongcheng Rd, Taipei, 111036, Taiwan
| | - Ding-Cheng Chan
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan.
- Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan.
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Tsujishita S, Nagamatsu M, Sanada K. Relationships between physical, cognitive, and social frailty and locomotive and non-locomotive physical activity of moderate to vigorous intensity. J Phys Ther Sci 2023; 35:426-434. [PMID: 37266358 PMCID: PMC10231973 DOI: 10.1589/jpts.35.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 03/03/2023] [Indexed: 06/03/2023] Open
Abstract
[Purpose] The purpose of this study was to examine the relationships between physical, cognitive, and social frailty and locomotive and non-locomotive physical activity of moderate to vigorous intensity in community-dwelling older adults and to explore effective intervention methods for preventing frailty. [Participants and Methods] Participants were 82 community-dwelling Japanese older males and females. Measurement items included basic information (age, gender, height, weight, body mass index, and the number of underlying diseases), physical activity, and assessment of physical, cognitive, and social frailty. Associations of physical, cognitive, and social frailty with physical activity were analyzed by group comparisons and multivariate analyses. [Results] The comparisons of physical activity indices for each frailty type revealed that physical frailty was associated with the number of steps and locomotive physical activity of moderate to vigorous intensity, whereas cognitive frailty and social frailty were not. Two overlapping types of frailty were associated with locomotive physical activity. When adjusted for age and gender, step counts and locomotive physical activity were each associated with physical frailty. [Conclusion] Future interventions to increase step counts and locomotive physical activity of moderate to vigorous intensity may be effective for preventing physical frailty; however, interventions other than simple physical activity need to be considered for the prevention of cognitive and social frailty.
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Affiliation(s)
- Soma Tsujishita
- Department of Physical Therapy, Faculty of Rehabilitation,
Kobe International University: 9-1-6 Koyocho-naka, Higashinada-ku, Kobe, Hyogo 658-0032
Japan
| | - Masaki Nagamatsu
- Organization of Science and Technology, Faculty of
Research, Ritsumeikan University, Japan
| | - Kiyoshi Sanada
- Faculty of College of Sport and Health Science, Ritsumeikan
University, Japan
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Li N, Huang F, Li H, Lin S, Yuan Y, Zhu P. Examining the independent and interactive association of physical activity and sedentary behaviour with frailty in Chinese community-dwelling older adults. BMC Public Health 2022; 22:1414. [PMID: 35879692 PMCID: PMC9313602 DOI: 10.1186/s12889-022-13842-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While physical inactivity or prolonged sitting has been linked to an increased risk of frailty, the interaction between sitting time (ST), physical activity (PA) and frailty is not well understood. The aim of this study was to examine the dose-response relationship between PA, ST and frailty and further to evaluate the interaction effect of PA and ST on frailty in the context of regular COVID-19 epidemic prevention and control in China. METHODS A cross-sectional analysis was performed on 1458 participants (age ≥ 60) enrolled from a prospective cohort study of frailty in elderly people of Fujian Province. PA and ST levels were assessed using the International Physical Activity Questionnaire. A 40-item frailty index (FI) quantified frailty. Multivariable logistic regression and linear regression models were applied to examine the dose-response relationship between PA or ST and frailty level. Interaction plots were used to visualise the interaction effects of PA and ST on frailty. RESULTS Compared with light PA, the odds ratios (ORs) for frailty were significantly lower for moderate PA (OR, 0.609 [95% CI, 0.419, 0.885], P < .001) and vigorous PA (OR, 0.399 [95% CI, 0.236,0.673], P < .001). Comparing subjects with ST < 4 h/day, those with ST ≥ 8 h/day were significantly more likely to be diagnosed with frailty (OR, 3.140 [95% CI, 1.932, 5.106], P < .001), 6-8 h/day (OR, 1.289 [95% CI, 0.835, 1.989], P >0.05), and 4-6 h/day (OR, 1.400 [95% CI, 0.972, 2.018], P >0.05). Each one unit increase in metabolic equivalents (h/day) of PA was related to an average 0.928 (0.887, 0.971) decrease in prevalence of frailty, while each one unit increase in sitting time (h/day) was related to average 1.114 (1.046,1.185) increase in prevalence of frailty. Negative interactive effects of PA and ST on frailty were observed (P < 0.001). CONCLUSION There are nonlinear and linear dose-response relationships between PA, SB and frailty respectively. In addition, excess ST may counteract the beneficial effects of PA on frailty. Interventions that focus on reducing excess ST may be effective strategies to reduce the risk of frailty and should be taken seriously by public health authorities, especially in the context of regular epidemic prevention and control in China.
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Affiliation(s)
- Na Li
- The Shengli Clinical Medical College of Fujian Medical University, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China.,Department of Nursing, Fujian Provincial Hospital, Fuzhou, Fujian, People's Republic of China.,The School of Nursing, Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Feng Huang
- Fujian Provincial Key Laboratory of Geriatrics, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China.,Department of Geriatric Medicine, Fujian Provincial Hospital, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China
| | - Hong Li
- The Shengli Clinical Medical College of Fujian Medical University, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China.,Department of Nursing, Fujian Provincial Hospital, Fuzhou, Fujian, People's Republic of China
| | - Siyang Lin
- Fujian Provincial Key Laboratory of Geriatrics, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China.,Department of Geriatric Medicine, Fujian Provincial Hospital, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China
| | - Yin Yuan
- Fujian Provincial Key Laboratory of Geriatrics, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China.,Department of Geriatric Medicine, Fujian Provincial Hospital, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China
| | - Pengli Zhu
- The Shengli Clinical Medical College of Fujian Medical University, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China. .,Fujian Provincial Key Laboratory of Geriatrics, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China. .,Department of Geriatric Medicine, Fujian Provincial Hospital, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China.
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Associations between objectively measured pattern of physical activity, sedentary behavior and fear of falling in Chinese community-dwelling older women. Geriatr Nurs 2022; 46:80-85. [DOI: 10.1016/j.gerinurse.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 11/19/2022]
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Brady R, Brown WJ, Hillsdon M, Mielke GI. Patterns of Accelerometer-Measured Physical Activity and Health Outcomes in Adults: A Systematic Review. Med Sci Sports Exerc 2022; 54:1155-1166. [PMID: 35220369 DOI: 10.1249/mss.0000000000002900] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE The aim of this study was to systematically review the literature on accelerometer-measured physical activity and health outcomes in adults. METHODS Eight electronic databases were searched for relevant articles published up to March 2021. Only population-based studies of adults (age ≥18 yr) that directly compared two or more categories of physical activity (i.e., bout duration, intensity, and daily/weekly frequency) with a health outcome (e.g., mortality, cardiometabolic, healthy aging, depression, sleep, and brain structure) were included. RESULTS Of the 15,923 publications retrieved, 52 articles were included. Twenty-eight studies directly compared the associations between physical activity accumulated in different bout durations, 31 studies directly compared the associations between physical activity accumulated in different intensities, and 9 studies directly compared the associations between the effects of varying daily and weekly frequencies of physical activity, with health outcomes. Most showed no differences in relationships with health outcomes when physical activity was accumulated in short (<10-min) or long (≥10-min) bouts. Overall, there were no differences in the relationships with most health outcomes when different intensities and daily/weekly frequencies were compared. However, in most studies, researchers did not adjust their analyses for total volume of physical activity. Moreover, variations in researcher-driven decisions about data collection and processing methods made it difficult to compare study findings. CONCLUSIONS These findings suggest that physical activity accumulated in many patterns of bout duration, intensity, or daily/weekly frequency is associated with a range of beneficial health outcomes in adults. Lack of adjustment for total volume of physical activity in most studies and inconsistent methods for defining components of physical activity prevent firm conclusions about which specific patterns of bout duration, intensity, and daily/weekly frequency are most important for health benefits.
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Affiliation(s)
| | - Wendy J Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, AUSTRALIA
| | - Melvyn Hillsdon
- Sport and Health Sciences, University of Exeter, Devon, UNITED KINGDOM
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Association between physical activity & sedentary time on frailty status in males and females living with diabetes mellitus: A cross-sectional analysis. Exp Gerontol 2022; 161:111741. [PMID: 35150826 DOI: 10.1016/j.exger.2022.111741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Physical activity (PA) is a cornerstone for the prevention and the treatment of diabetes mellitus (DM) and frailty. However, no consensus exists on which intensities and types of PA are associated with frailty status among individuals living with DM. To investigate the association between different intensities and types of PA on frailty status in males and females living with DM. METHODS A cross-sectional analysis of the 2003-2006 cycles from the National Health and Nutrition Examination Survey (NHANES) was performed in 711 participants living with DM. Frailty status was measured using the 43-item deficit model and DM was self-reported. Weekly PA levels were measured by accelerometer, while resistance training (RT) was measured via questionnaire. Linear and logistic regressions were performed to investigate the associations between different intensities and types of PA and frailty status. RESULTS Total time spent performing light PA was associated with a better frailty status in males (ß - 0.041 ± 0.012; p < 0.001) and females (ß - 0.070 ± 0.010; p < 0.0001), while total moderate-to-vigorous PA (MVPA) was associated with a better frailty status in females only (ß-0.235 ± 0.061; p < 0.05). However, once fully adjusted, the different intensities and types of PA were associated more with frailty status for female. When investigating whether different intensities and types of PA were associated with being considered frail, total time spent at MVPA and light PA were associated with higher odds along with total sedentary time for female (all p < 0.01). CONCLUSION Each minute engaged in PA was associated with a better frailty status in males and females living with DM, although RT does not appear associated with a better frailty status in adults with DM. Replacing sedentary time with PA is important, especially for females living with DM to have a better frailty status. These results are important as they provide insights into the prevention and the management of frailty in individuals living with DM.
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Pirôpo US, Costa SM, Ribeiro ÍJS, Freire IV, Schettino L, da Silva Passos R, Machado M, Casotti CA, Pereira R. Influence of Physically Active or Sedentary Lifestyle on Postural Control of Community-dwelling Old Adults. EXERCISE MEDICINE 2021. [DOI: 10.26644/em.2021.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives: The maintenance of the postural balance is fundamental for the daily living activities, as well as for the practice of physical exercise. However, the aging process and sedentary behavior (i.e., large sitting time) lead to changes biological systems, impairing postural balance with consequent increased falls risk. On the other hand, physical activity practice is a protective factor against these trends. The aim of this study is to investigate the influence of physical activity profile and sedentary behavior on postural control in community-dwelling old adults.Methods: This is a cross-sectional study including 208 community-dwelling old adults, which were stratified as sufficiently or insufficiently physically active and with or without sedentary behavior. Then, they were grouped as follow: G1 (sufficiently physically active and without sedentary behavior), G2 (insufficiently physically active, but without sedentary behavior), G3 (sufficiently physically active, but with sedentary behavior), and G4 (insufficiently physically active and with sedentary behavior).Results: Stabilometric parameters (sway area, total length of center of pressure [CoP] trajectory, and the mean velocity of CP displacement) were obtained to evaluate the postural control. There was significant difference between G1 and G4 on mean velocity of CoP displacement (p < 0.05).Conclusions: The coexistence of sedentary behavior and insufficient physically active profile seem to impact negatively on postural control.
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12
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Triaxial Accelerometry-Based Moderate to Vigorous Physical Activity in Older Adults Using Four Different Methods. J Aging Phys Act 2021; 30:473-481. [PMID: 34548421 DOI: 10.1123/japa.2020-0501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 08/10/2021] [Accepted: 08/17/2021] [Indexed: 11/18/2022]
Abstract
The amount of physical activity reported using accelerometry can vary depending on the method used. This study examined variability in four different methods of calculating moderate to vigorous physical activity (MVPA) among older adults, as well as lifestyle correlates of physical activity. The MVPA data were captured (n = 111; Mage = 70.3 years, SDage = 6.3) using waist-worn ActiGraph wGT3X-BT monitors and examined using 10-min bouted versus sporadic methods, and with cut points calibrated to older and younger adults. The sample, on average, did not meet national guidelines of 150 min/week of MVPA when using bouted methods, irrespective of cut point used. This was not the case for sporadic MVPA. More physical activity was reported for participants with two or more physical hobbies, but no association with social behavior was found. These results demonstrate the wide variability possible in reporting methods for accelerometry data and their relation to adherence rates for national health recommendations.
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13
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Mañas A, Del Pozo-Cruz B, Rodríguez-Gómez I, Losa-Reyna J, Júdice PB, Sardinha LB, Rodríguez-Mañas L, García-García FJ, Ara I. Breaking Sedentary Time Predicts Future Frailty in Inactive Older Adults: A Cross-Lagged Panel Model. J Gerontol A Biol Sci Med Sci 2021; 76:893-900. [PMID: 32592584 DOI: 10.1093/gerona/glaa159] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Cross-sectional evidence exists on the beneficial effects of breaks in sedentary time (BST) on frailty in older adults. Nonetheless, the longitudinal nature of these associations is unknown. This study aimed to investigate the direction and temporal order of the association between accelerometer-derived BST and frailty over time in older adults. METHODS This longitudinal study analyzed a total of 186 older adults aged 67-90 (76.7 ± 3.9 years; 52.7% females) from the Toledo Study for Healthy Aging over a 4-year period. Number of daily BST was measured by accelerometry. Frailty was assessed with the Frailty Trait Scale. Multiple cross-lagged panel models were used to test the temporal and reciprocal relationship between BST and frailty. RESULTS For those physically inactive (n = 126), our analyses revealed a reciprocal inverse relationship between BST and frailty, such as higher initial BST predicted lower levels of later frailty (standardized regression coefficient [β] = -0.150, 95% confidence interval [CI] = -0.281, -0.018; p < .05); as well as initial lower frailty levels predicted higher future BST (β = -0.161, 95% CI = -0.310, -0.011; p < .05). Conversely, no significant pathway was found in the active participants (n = 60). CONCLUSIONS In physically inactive older adults, the relationship between BST and frailty is bidirectional, while in active individuals no associations were found. This investigation provides preliminary longitudinal evidence that breaking-up sedentary time more often reduces frailty in those older adults who do not meet physical activity recommendations. Targeting frequent BST may bring a feasible approach to decrease the burden of frailty among more at-risk inactive older adults.
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Affiliation(s)
- Asier Mañas
- GENUD Toledo Research Group, University of Castilla-La Mancha, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Borja Del Pozo-Cruz
- Motivation and Behaviour Research Program, Institute for Positive Psychology and Education, Faculty of Health Sciences, Australian Catholic University, Sydney, Australia
| | - Irene Rodríguez-Gómez
- GENUD Toledo Research Group, University of Castilla-La Mancha, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - José Losa-Reyna
- GENUD Toledo Research Group, University of Castilla-La Mancha, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.,Geriatric Department, Hospital Virgen del Valle, Toledo, Spain
| | - Pedro B Júdice
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal
| | - Leocadio Rodríguez-Mañas
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.,Geriatric Department, Hospital Universitario de Getafe, Spain
| | - Francisco J García-García
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.,Geriatric Department, Hospital Virgen del Valle, Toledo, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, University of Castilla-La Mancha, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
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14
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Tolley APL, Ramsey KA, Rojer AGM, Reijnierse EM, Maier AB. Objectively measured physical activity is associated with frailty in community-dwelling older adults: A systematic review. J Clin Epidemiol 2021; 137:218-230. [PMID: 33915264 DOI: 10.1016/j.jclinepi.2021.04.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/10/2021] [Accepted: 04/20/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The later-age shift towards physical inactivity and sedentary behaviour is associated with comorbidity and reduced function: markers of frailty. Whether these behaviours relate to frailty has yet to be thoroughly studied using objective measurements. This study aimed to summarise the associations of objectively measured habitual physical activity and sedentary behaviour with frailty in community-dwelling older adults. STUDY DESIGN AND SETTING Six databases were searched from inception to July 21st 2020. Articles analyzing objectively measured physical activity and/or sedentary behaviour with frailty in community-dwelling adults ≥60 years old were included. Synthesis of included articles was performed using effect direction heat maps and albatross plots. RESULTS The search identified 23 articles across 18 cohorts, including 7,696 total participants with a mean age of 69.3±8.1 years, and 56.9% female. All but one article were cross-sectional. Lower moderate-to-vigorous and total physical activity, steps, postural transitions, and energy expenditure were associated with frailty. The use of multifactorial or physical frailty definitions did not alter associations. Median effect sizes for the associations of all physical activity and sedentary behaviour measures with frailty were β = -0.272 [-0.381, -0.107] and β = 0.100 [0.001, 0.249], respectively. CONCLUSION Objective measures of physical activity are associated with frailty, regardless of frailty definition.
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Affiliation(s)
- Alec P L Tolley
- Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Keenan A Ramsey
- Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Anna G M Rojer
- Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Andrea B Maier
- Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia; Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands; Healthy Longevity Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, National University Health System, Singapore.
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15
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Wang Y, Chen Z, Zhou C. Social engagement and physical frailty in later life: does marital status matter? BMC Geriatr 2021; 21:248. [PMID: 33858354 PMCID: PMC8047563 DOI: 10.1186/s12877-021-02194-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 04/01/2021] [Indexed: 04/11/2023] Open
Abstract
BACKGROUND Physical frailty is a common characteristic of older people with the ageing process and has been viewed as a major public health issue. The longitudinal association between different social engagement and physical frailty among older people has not been explored adequately in China. Marital status forms a critical context for the link between social engagement and frailty among older people, which might constitute a moderating process. The purpose of the present study is to investigate the longitudinal association between social engagement and the changes in physical frailty among Chinese older adults, and to examine whether the association between social engagement and frailty differs by marital status. METHODS The data use in this study were from the data from the China Health and Retirement Longitudinal Study aged 60+ years from 2011 to 2015. A total of 6575 respondents who participated in at least one follow-up wave were included in the analysis. The relationship between social engagement and changes in frailty over time, and the moderating role of marital status were estimated using individual fixed-effects models. Sensitive analyses were conducted to test the robustness of the results. RESULTS After adjusting the confounders, participants who interact with friends (Coef: -1.309, P < 0.001), engaging in hobby groups (Coef: -1.189, P < 0.001), engaging in sports groups (Coef: -0.945, P = 0.001), and volunteering (Coef: -1.957, P = 0.001) with a frequency of almost daily had a significantly lower frailty risk than participants who never engaging in those activities. The association between frequent engaging in hobby groups and physical frailty was strongest for unmarried than married older adults (Coef: -1.325, P = 0.031). CONCLUSIONS Frequent social engagement might help to decrease the risk of frailty in the Chinese older population. This finding has important implications for public health policy and encourages the incorporation of a broad range of social engagement into the daily lives of older individuals. Specially, encouraging unmarried older adults to engage in intellectual activities, such as playing chess or Mahjong with others, may be an effective way to reduce physical frailty.
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Affiliation(s)
- Yi Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China
| | - Zhuo Chen
- College of Public Health, University of Georgia, Athens, GA 30602 USA
- School of Economics, University of Nottingham Ningbo China, Ningbo, 315100 China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China
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16
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Chambonniere C, Lambert C, Tardieu M, Fillon A, Genin P, Larras B, Melsens P, Baker JS, Pereira B, Tremblay A, Thivel D, Duclos M. Physical Activity and Sedentary Behavior of Elderly Populations during Confinement: Results from the FRENCH COVID-19 ONAPS Survey. Exp Aging Res 2021; 47:401-413. [PMID: 33827390 DOI: 10.1080/0361073x.2021.1908750] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Introduction: A national confinement was imposed in France in March 2020 during 55 days to prevent the spread of the virus and protect vulnerable people such as older individuals. This study aimed to describe the movement behaviors, and their determinants, of elderly people (≥ 65 years) during the confinement.Methods: An online survey was conducted from April 1st, 2020 to May 6th, 2020 by the National Observatory for Physical Activity and Sedentary behaviors. This study compared the level of physical activity (PA), sitting and screen time before and during the confinement and identified the impact of initial PA, sedentary profiles of the participants and housing conditions.Results: 1,178 people were included in this study. Reaching PA recommendations before lock-down was associated with the change in PA level during lock-down (p < .001). Besides, geographic location was associated with the change in PA, sitting time and screen time during lock-down (respectively p = .03, p = .02, p = .02).Conclusion: This study confirm the negative impact of confinement on senior movement behaviors, whether or not they met with public health recommendations prior to the pandemic. The housing conditions of older people must be also taken into future public health policies.
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Affiliation(s)
- C Chambonniere
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), CRNH Auvergne, Clermont-Ferrand, France.,Inrae, Umr Clermont-Ferrand, France
| | - C Lambert
- National Observatory for Physical Activity and Sedentary Behaviors (ONAPS), Clermont-Ferrand, France.,Clermont-Ferrand University Hospital, Biostatistics Unit (DRCI), Clermont-Ferrand, France
| | - M Tardieu
- National Observatory for Physical Activity and Sedentary Behaviors (ONAPS), Clermont-Ferrand, France
| | - A Fillon
- National Observatory for Physical Activity and Sedentary Behaviors (ONAPS), Clermont-Ferrand, France
| | - P Genin
- National Observatory for Physical Activity and Sedentary Behaviors (ONAPS), Clermont-Ferrand, France
| | - B Larras
- National Observatory for Physical Activity and Sedentary Behaviors (ONAPS), Clermont-Ferrand, France
| | - P Melsens
- National Observatory for Physical Activity and Sedentary Behaviors (ONAPS), Clermont-Ferrand, France
| | - J S Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - B Pereira
- National Observatory for Physical Activity and Sedentary Behaviors (ONAPS), Clermont-Ferrand, France.,Clermont-Ferrand University Hospital, Biostatistics Unit (DRCI), Clermont-Ferrand, France
| | - A Tremblay
- National Observatory for Physical Activity and Sedentary Behaviors (ONAPS), Clermont-Ferrand, France.,Department of Kinesiology, Faculty of Medicine, University of Laval, Quebec City. Canada
| | - D Thivel
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), CRNH Auvergne, Clermont-Ferrand, France.,National Observatory for Physical Activity and Sedentary Behaviors (ONAPS), Clermont-Ferrand, France
| | - M Duclos
- Inrae, Umr Clermont-Ferrand, France.,National Observatory for Physical Activity and Sedentary Behaviors (ONAPS), Clermont-Ferrand, France.,University Clermont 1, UFR Medicine, Clermont-Ferrand, France.,Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, France
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17
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Lefferts EC, Bakker EA, Carbone S, Lavie CJ, Lee DC. Associations of total and aerobic steps with the prevalence and incidence of frailty in older adults with hypertension. Prog Cardiovasc Dis 2021; 67:18-25. [PMID: 33640357 DOI: 10.1016/j.pcad.2021.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 02/16/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To examine the associations of total steps/day and faster aerobic steps/day (≥60 steps/min) with the development of frailty in older adults with hypertension (HTN) using a two-phased cross-sectional and prospective approach. METHODS The sample consisted of 427 older adults with HTN from the Physical Activity and Aging Study (PAAS), aged ≥65 years, with valid step data from an accelerometer-based pedometer. Participants were classified into tertiles of total steps/day (low, mid, high) and three categories of aerobic steps/day (none, low, high). Frailty was defined using a modified Fried score with 5 subdomains including shrinking, weakness, slowness, low physical activity (PA), and exhaustion. RESULTS We observed a negative dose-response relationship across categories of total steps/day and aerobic steps/day for the prevalence of frailty and the subdomains of slowness, low PA, and exhaustion (all p for trends <0.05). Greater aerobic steps/day, but not total steps/day, was associated with lower incidence of developing frailty in the 241 participants with a follow-up examination who had no frailty at baseline. CONCLUSION Higher aerobic steps/day were more strongly associated with the lower prevalence and incidence of frailty compared to total steps/day, suggesting that faster aerobic walking may potentially provide greater benefits regarding frailty in older adults with HTN.
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Affiliation(s)
- Elizabeth C Lefferts
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, IA, United States
| | - Esmée A Bakker
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands; Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Salvatore Carbone
- Department of Kinesiology & Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, VA, United States; Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, LA, United States
| | - Carl J Lavie
- Pauley Heart Center, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Duck-Chul Lee
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, IA, United States.
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19
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Ruiz JG, Dent E, Morley JE, Merchant RA, Beilby J, Beard J, Tripathy C, Sorin M, Andrieu S, Aprahamian I, Arai H, Aubertin-Leheudre M, Bauer JM, Cesari M, Chen LK, Cruz-Jentoft AJ, De Souto Barreto P, Dong B, Ferrucci L, Fielding R, Flicker L, Lundy J, Reginster JY, Rodriguez-Mañas L, Rolland Y, Sanford AM, Sinclair AJ, Viña J, Waters DL, Won Won C, Woo J, Vellas B. Screening for and Managing the Person with Frailty in Primary Care: ICFSR Consensus Guidelines. J Nutr Health Aging 2021; 24:920-927. [PMID: 33155616 PMCID: PMC7568453 DOI: 10.1007/s12603-020-1492-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- J G Ruiz
- John E. Morley, MB, BCh, Division of Geriatric Medicine, Saint Louis University, SLUCare Academic Pavilion, Section 2500 1008 S. Spring Ave., 2nd Floor, St. Louis, MO 63110, USA, , Twitter: @drjohnmorley
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20
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Xie B, Ma C, Chen Y, Wang J. Prevalence and risk factors of the co-occurrence of physical frailty and cognitive impairment in Chinese community-dwelling older adults. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:294-303. [PMID: 32657490 DOI: 10.1111/hsc.13092] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 06/03/2020] [Accepted: 06/16/2020] [Indexed: 06/11/2023]
Abstract
This cross-sectional study aimed to determine the prevalence of the co-occurrence of physical frailty and cognitive impairment and to identify its associated demographic, psychosocial and behavioural factors. Participants were recruited from 32 neighbourhoods using multistage sampling method in Xuhui District, Shanghai, China. A total of 1585 older adults were included who lived in community, were 75 years or older and without a clinical diagnosis of dementia. Based on the presences of frailty (using the modified frailty phenotype criteria) and/or cognitive impairment (using Chinese version Mini-Mental Status Examination stratified by educational level), the participants were classified into four groups: normal, cognitive impairment alone, frailty alone and co-occurrence. Multinomial logistic regression analyses were conducted to identify the demographic, psychosocial (depression, social participation and social support) and behavioural (sedentary lifestyle and sleep problems) characteristics associated with the co-occurrence of physical frailty and cognitive impairment. The prevalence of frailty alone, cognitive impairment alone and the co-occurrence of physical frailty and cognitive impairment in the study sample were 7%, 26.94% and 7.19% respectively. The results of multinomial logistic regression show the following characteristics significantly associated with the co-occurrence of physical frailty and cognitive impairment: advanced age (81-85 years old, Odds Ratio, OR = 1.99, 95% CI = 1.10-3.59; 86 years or older, OR = 6.43, 95% CI = 3.66-11.29), number of co-morbidities (OR = 1.34, 95% CI = 1.01-1.77), depression (OR = 3.88, 95% CI = 2.39-6.29), social participation (OR = 0.61, 95% CI = 0.39-0.96), sedentary lifestyle (OR = 2.69, 95% CI = 1.66-4.34) and sleep problems (insomnia occasionally, OR = 1.84, 95% CI = 1.07-3.17; insomnia every day, OR = 2.38, 95% CI = 1.33-4.26). The co-occurrence of physical frailty and cognitive impairment is a prevalent health issue in oldest old community-dwelling older adults. Advanced age, co-morbidity, depression, sedentary lifestyle and sleep problems are risk factors for cognitive frailty while good social participation may have a protective effect on it.
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Affiliation(s)
- Boqin Xie
- Fudan University School of Nursing, Shanghai, China
| | - Chenjuan Ma
- New York University Rory Meyers College of Nursing, New York, NY, USA
| | - Yu Chen
- Fudan University School of Nursing, Shanghai, China
| | - Junqiao Wang
- Fudan University School of Nursing, Shanghai, China
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21
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Kikuchi H, Inoue S, Amagasa S, Fukushima N, Machida M, Murayama H, Fujiwara T, Chastin S, Owen N, Shobugawa Y. Associations of older adults' physical activity and bout-specific sedentary time with frailty status: Compositional analyses from the NEIGE study. Exp Gerontol 2020; 143:111149. [PMID: 33181316 DOI: 10.1016/j.exger.2020.111149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 10/07/2020] [Accepted: 11/04/2020] [Indexed: 10/23/2022]
Abstract
AIM To examine associations of intensity-specific physical activity and bout-specific sedentary time with frailty status among Japanese community-dwelling older adults, taking into account the interrelationships of these behaviors. METHODS Participants were 511 community-dwelling older adults. Physical activity and sedentary time were assessed using a tri-axial accelerometer. Frailty status (frail, pre-frail, or robust) was determined, based on the phenotypic model and used established criteria for Japanese older adults. Associations with frailty status of intensity-specific physical activity and bout-specific sedentary behavior (SB) time were examined using compositional data analysis, adjusted for potential confounders. RESULTS Participants included 13 (2.6%) who were frail, 234 (45.8%) pre-frail, and 264 (51.6%) who were robust. For the frail and pre-frail, the proportion of time spent in moderate-to-vigorous physical activity (MVPA) was less than for those who were robust. Frail older adults has larger proportion of time spent in prolonged (≥30 min/bouts) sedentary behavior (SB), and less in short-bout (<30 min/bout) SB, compared to the robust. No statistically-significant differences in the proportion of time spent in light-intensity physical activity was found across frailty levels. CONCLUSION Pre-frail and frail older adults spend proportionally less time in MVPA and more time in prolonged SB, compared with those who were robust. These findings need to be confirmed by evidence from larger and more-diverse study samples and by evidence from prospective studies, in order to better understand whether or not avoiding prolonged periods of sitting could be a potential strategy for preventing frailty among community-dwelling older adults.
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Affiliation(s)
- Hiroyuki Kikuchi
- Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan.
| | - Shiho Amagasa
- Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Noritoshi Fukushima
- Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Masaki Machida
- Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Hiroshi Murayama
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan
| | - Sebastien Chastin
- School of Health and Life Science, Institute of Applied Health Research, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, United Kingdom; Department of Sport and Movement Science, Ghent University, 9000 Ghent, Belgium
| | - Neville Owen
- Behavioral Epidemiology Laboratory, Baker Heart & Diabetes Institute, Level 4, 99 Commercial Road, Melbourne, Vic 3004, Australia; Centre for Urban Transitions, Swinburne University of Technology, PO Box 218, Hawthorn, Melbourne, Australia
| | - Yugo Shobugawa
- Division of Public Health, Department of Infectious Control and International Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757, Asahimachi-dori, Niigata City, Niigata 951-8510, Japan
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22
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Bernstein IA, Roxbury CR, Lin SY, Rowan NR. The association of frailty with olfactory and gustatory dysfunction in older adults: a nationally representative sample. Int Forum Allergy Rhinol 2020; 11:866-876. [PMID: 33131203 DOI: 10.1002/alr.22718] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/19/2020] [Accepted: 10/05/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Olfaction and gustation are associated with age-related decline. Deficits in these chemosenses have been associated with significant comorbidities. Meanwhile, frailty, defined as a reduced physiological reserve, is well correlated with mortality and worse health outcomes. We sought to analyze a nationally representative patient population to determine the association between chemosensory dysfunction and frailty. METHODS Cross-sectional analysis of U.S. National Health and Nutrition Examination Survey (NHANES) 2013-2014 was performed, using multivariate logistic regression to examine the association between chemosensory dysfunction and frailty in adults aged ≥40 years (n = 3547). Self-reported olfactory dysfunction (sOD) and gustatory dysfunction (sGD), and measured olfactory dysfunction (mOD) and gustatory dysfunction (mGD) were assessed for all participants. Frailty was operationalized using a 39-item frailty index (FI) and stratified into 4 groups using validated cutoffs. RESULTS Participants with sOD and mOD had significantly higher mean FI scores (sOD: 0.18 vs 0.13, p < 0.001; mOD: 0.20 vs 0.14, p < 0.001), whereas subjects with sGD, but not mGD, had higher mean FI scores (sGD: 0.21 vs 0.13, p < 0.001; mGD: 0.14 vs 0.14, p = 0.953). Multivariate logistic regression demonstrated frail participants had significantly greater odds of sGD (odds ratio [OR] 4.11; 95% confidence interval [CI], 3.46 to 4.88), sOD (OR 2.35; 95% CI, 1.98 to 2.78), and mOD (OR 1.58; 95% CI, 1.22 to 2.05), but not mGD (OR 1.21; 95% CI, 0.91 to 1.61). This association was strongest in the frailest group. CONCLUSION Self-reported chemosensory dysfunction and mOD are independently associated with measures of frailty, suggesting a novel method to assess or predict frailty.
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Affiliation(s)
- Isaac A Bernstein
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Christopher R Roxbury
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Chicago Medicine, Chicago, IL
| | - Sandra Y Lin
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Nicholas R Rowan
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
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23
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Association between physical function and various patterns of physical activity in older adults: a cross-sectional analysis. Aging Clin Exp Res 2020; 32:1017-1024. [PMID: 31377998 DOI: 10.1007/s40520-019-01288-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 07/20/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND To improve physical function, physical activity (PA) guidelines for older adults recommend completing PA in bouts of 10 min or more. Spontaneous PA (< 10 min) can also benefit older adults. However, a paucity of research exists examining if shorter bouts of PA are associated with greater physical function. AIM To determine the association between various patterns of PA and the likelihood of greater physical function in older adults. METHODS Older adults from the 2003-2004 and 2005-2006 cycles of the National Health and Nutrition Examination Survey were included for analysis. PA lasting 1, 5, 10, 30, and 60 min was quantified using accelerometers. Physical function was assessed using a Likert scale reflecting the self-reported capability to complete 11 tasks. A single function score was then computed using factor analysis. Logistic regression analyses calculated the association between PA bout length and the likelihood of above average function. RESULTS PA performed in 1-min (odds ratio [OR] 1.02; 95% confidence interval [CI] 1.01-1.03), 5-min (OR 1.02; CI 1.01-1.03), or 10-min bouts (OR 1.02; CI 1.01-1.03) was associated with greater physical function following adjustment for confounders. When scaled to represent an accumulation of 10 min of MVPA, likelihoods increased for both 1-min ([OR] 1.25; 95% [CI] 1.11-1.39) and 5-min (OR 1.22; 95% CI 1.08-1.37) bouts. DISCUSSION/CONCLUSIONS Our findings suggest bouts of PA lasting 10 min or shorter in duration are associated with greater physical function in older adults.
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Mañas A, Del Pozo-Cruz B, Rodríguez-Gómez I, Losa-Reyna J, Rodríguez-Mañas L, García-García FJ, Ara I. Which one came first: movement behavior or frailty? A cross-lagged panel model in the Toledo Study for Healthy Aging. J Cachexia Sarcopenia Muscle 2020; 11:415-423. [PMID: 31912990 PMCID: PMC7113532 DOI: 10.1002/jcsm.12511] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 08/05/2019] [Accepted: 09/25/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND There has been limited longitudinal assessment of the relationship between moderate-to-vigorous physical activity (MVPA) and sedentary behaviour (SB) with frailty, and no studies have explored the possibility of reverse causality. This study aimed to determine the potential bidirectionality of the relationship between accelerometer-assessed MVPA, SB, and frailty over time in older adults. METHODS Participants were from the Toledo Study for Healthy Aging. We analysed 186 older people aged 67 to 90 (76.7 ± 3.9; 52.7% female participants) over a 4-year period. Time spent in SB and MVPA was assessed by accelerometry. Frailty Trait Scale was used to determine frailty levels. A cross-lagged panel model design was used to test the reciprocal relationships between MVPA/SB and frailty. RESULTS Frailty Trait Scale score changed from 35.4 to 43.8 points between the two times (P < 0.05). We also found a reduction of 7 min/day in the time spent on MVPA (P < 0.05), and participants tended to spend more time on SB (P = 0.076). Our analyses revealed that lower levels of initial MVPA predicted higher levels of later frailty [std. β = -0.126; confidence interval (CI) = -0.231, -0.021; P < 0.05], whereas initial spent time on SB did not predict later frailty (std. β = -0.049; CI = -0.185, 0.087; P = 0.48). Conversely, an initial increased frailty status predicted higher levels of later SB (std. β = 0.167; CI = 0.026, 0.307; P < 0.05) but not those of MVPA (std. β = 0.071; CI = -0.033, 0.175; P = 0.18). CONCLUSIONS Our observations suggest that the relationship between MVPA/SB and frailty is unidirectional: individuals who spent less time on MVPA at baseline are more likely to increase their frailty score, and individuals who are more frail are more likely to spent more time on SB at follow-up. Interventions and policies should aim to increase MVPA levels from earlier stages to promote successful aging.
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Affiliation(s)
- Asier Mañas
- GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Borja Del Pozo-Cruz
- Motivation and Behaviour Research Program, Institute for Positive Psychology and Education, Faculty of Health Sciences, Australian Catholic University, Sydney, NSW, Australia
| | - Irene Rodríguez-Gómez
- GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - José Losa-Reyna
- GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.,Geriatric Department, Hospital Virgen del Valle, Toledo, Spain
| | - Leocadio Rodríguez-Mañas
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.,Geriatric Department, Hospital Universitario de Getafe, Getafe, Spain
| | - Francisco J García-García
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.,Geriatric Department, Hospital Virgen del Valle, Toledo, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
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25
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Sedentary Time Accumulated in Bouts is Positively Associated with Disease Severity in Fibromyalgia: The Al-Ándalus Project. J Clin Med 2020; 9:jcm9030733. [PMID: 32182753 PMCID: PMC7141225 DOI: 10.3390/jcm9030733] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/21/2020] [Accepted: 03/04/2020] [Indexed: 01/10/2023] Open
Abstract
To examine the associations of prolonged sedentary time (ST) with disease severity in women with fibromyalgia, and to analyse the combined association of total ST and prolonged ST with the disease severity in this population. Women (n = 451; 51.3 ± 7.6 years old) with fibromyalgia participated. Sedentary time and moderate-to-vigorous physical activity (MVPA) were measured using triaxial accelerometry and ST was processed into 30- and 60-min bouts. Dimensions of fibromyalgia (function, overall, symptoms) and the overall disease impact were assessed with the Revised Fibromyalgia Impact Questionnaire (FIQR). Body fat percentage was assessed using a bio-impedance analyser, and physical fitness was assessed with the Senior Fitness Tests Battery. Greater percentage of ST in 30-min bouts and 60-min bouts were associated with worse function, overall, symptoms and the overall impact of the disease (all, P < 0.05). Overall, these associations were statistically significant when additionally controlling for MVPA and overall physical fitness. Participants with low levels of total ST and prolonged ST (>60-min bouts) presented lower overall impact compared to participants with high levels of total ST and prolonged ST (mean difference = 6.56; 95% confidence interval (CI) = 1.83 to 11.29, P = 0.002). Greater percentage of ST accumulated in 30- and 60-min bouts and a combination of high levels of total and prolonged ST are related to worse disease severity. Although unable to conclude on causality, results suggest it might be advisable to motivate women with fibromyalgia to break prolonged ST and reduce their total daily ST.
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26
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Replacing Sedentary Time with Light or Moderate-Vigorous Physical Activity Across Levels of Frailty. J Aging Phys Act 2020; 28:18-23. [PMID: 31141439 DOI: 10.1123/japa.2018-0361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We sought to examine how much sedentary times needs to be replaced by light or moderate-vigorous physical activity in order to reduce frailty and protect against mortality. We built isotemporal substitution models to assess the theoretical effect of replacing sedentary behavior with and equal amount of light or moderate-vigorous activity on frailty and mortality in community-based adults aged 50 years and older. Controlling for age, sex, body mass index, marital status, race, education, employment status, and National Health and Nutrition Examination Study cycle, replacing one hour of sedentary time with moderate-vigorous or light physical activity daily was associated with a lower Frailty Index. For mortality, results varied based on frailty level. Replacing sedentary behavior with moderate-vigorous exercise was associated with lower mortality risk in vulnerable individuals, however, replacing sedentary behavior with light activity was associated with lower mortality risk in frailer individuals.
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27
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Jakicic JM, Kraus WE, Powell KE, Campbell WW, Janz KF, Troiano RP, Sprow K, Torres A, Piercy KL. Association between Bout Duration of Physical Activity and Health: Systematic Review. Med Sci Sports Exerc 2019; 51:1213-1219. [PMID: 31095078 DOI: 10.1249/mss.0000000000001933] [Citation(s) in RCA: 123] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE This study aimed to conduct a systematic literature review to determine whether physical activity episodes of <10 min in duration have health-related benefits or, alternatively, if the benefits are only realized when the duration of physical activity episodes is ≥10 min. METHODS The primary literature search was conducted for the 2018 Physical Activity Guidelines Advisory Committee Report and encompassed literature through June 2017, with an additional literature search conducted to include literature published through March 2018 for inclusion in this systematic review. RESULTS The literature review identified 29 articles that were pertinent to the research question that used either cross-sectional, prospective cohort, or randomized designs. One prospective cohort study (N = 4840) reported similar associations between moderate to vigorous physical activity (MVPA) and all-cause mortality when examined as total MVPA, MVPA in bouts ≥5 min in duration, or MVPA in bouts ≥10 min in duration. Additional evidence was identified from cross-sectional and prospective studies to support that bouts of physical activity <10 min in duration are associated with a variety of health outcomes. Randomized studies only examined bouts of physical activity ≥10 min in duration. CONCLUSIONS The current evidence, from cross-sectional and prospective cohort studies, supports that physical activity of any bout duration is associated with improved health outcomes, which includes all-cause mortality. This may suggest the need for a contemporary paradigm shift in public health recommendations for physical activity, which supports total MVPA as an important lifestyle behavior regardless of the bout duration.
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Affiliation(s)
- John M Jakicic
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA
| | - William E Kraus
- Department and School of Medicine, Duke University, Durham, NC
| | | | - Wayne W Campbell
- Department of Nutrition Science, Purdue University, West Lafayette, IN
| | - Kathleen F Janz
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA
| | - Richard P Troiano
- Division of Cancer Control and Population Sciences, National Cancer Institute, U.S. Department of Health and Human Services, Rockville, MD
| | - Kyle Sprow
- Division of Cancer Control and Population Sciences, National Cancer Institute, U.S. Department of Health and Human Services, Rockville, MD
| | | | - Katrina L Piercy
- Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services, Rockville, MD
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28
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Kehler DS, Clara I, Hiebert B, Stammers AN, Hay JL, Schultz A, Arora RC, Tangri N, Duhamel TA. Sex-differences in relation to the association between patterns of physical activity and sedentary behavior with frailty. Arch Gerontol Geriatr 2019; 87:103972. [PMID: 31739110 DOI: 10.1016/j.archger.2019.103972] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 11/01/2019] [Accepted: 11/04/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate the sex-difference in relation to the association between moderate-vigorous physical activity (MVPA) and sedentary time (ST) patterns with frailty. METHOD Accelerometry from ≥50 year olds from the National Health and Nutrition Examination Survey (2003-04/2005-06 cycles) were included. Bouted and sporadic MVPA were defined as MVPA in ≥10 min or <10 min durations, respectively. MVPA was analyzed based on meeting 0 %, 1-49 %, 50-99 %, and ≥100 % of the physical activity guidelines of 150 min/week. A duration of ≥30 minutes defined prolonged ST. The frequency (≥1 min interruption in ST), intensity and duration of breaks from ST were calculated. A 46-item frailty index (FI) quantified frailty. Multivariable linear regression models adjusted for demographics, total sedentary time, and accelerometer wear time. RESULTS There were 1143 females and 1174 males available for analysis. Bouted MVPA was associated with lower frailty levels; the association peaked at meeting 50-99 % of the guidelines in females and ≥1.0 % in males (p = NS for sex-interaction). Meeting a higher proportion of the guidelines through sporadic MVPA was significantly associated with a lower FI in males only (p = NS for sex-interaction). Prolonged ST bouts were associated with worse frailty in females but not males (p < 0.05 sex-interaction). Average break intensity was associated with a lower FI in both sexes, whereas, total sedentary breaks were not (p = NS for sex-interaction). Average break duration was associated with frailty in males (p = NS for sex-interaction). CONCLUSION Prolonged ST was more detrimentally associated with frailty in females than males, which could influence tailored movement prescriptions and guidelines.
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Affiliation(s)
- D Scott Kehler
- School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, Canada.
| | - Ian Clara
- Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Canada
| | - Brett Hiebert
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Canada
| | - Andrew N Stammers
- Health, Leisure & Human Performance Research Institute, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Canada; Institute of Cardiovascular Sciences, St. Boniface Hospital Research Centre, Winnipeg, Canada
| | - Jacqueline L Hay
- Health, Leisure & Human Performance Research Institute, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Canada; Institute of Cardiovascular Sciences, St. Boniface Hospital Research Centre, Winnipeg, Canada
| | - Annette Schultz
- College of Nursing, Max Rady College of Medicine, Faculty of Heath Sciences, University of Manitoba Winnipeg, Canada
| | - Rakesh C Arora
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Canada; Institute of Cardiovascular Sciences, St. Boniface Hospital Research Centre, Winnipeg, Canada; Cardiac Sciences Program, St. Boniface Hospital, Winnipeg, Canada
| | | | - Todd A Duhamel
- Department of Surgery, Max Rady College of Medicine, University of Manitoba, Canada; Health, Leisure & Human Performance Research Institute, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Canada; Institute of Cardiovascular Sciences, St. Boniface Hospital Research Centre, Winnipeg, Canada
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Boreskie KF, Hay JL, Kehler DS, Johnston NM, Rose AV, Oldfield CJ, Kumar K, Toleva O, Arora RC, Duhamel TA. Prehabilitation. Clin Geriatr Med 2019; 35:571-585. [DOI: 10.1016/j.cger.2019.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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30
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Mañas A, Del Pozo-Cruz B, Rodríguez-Gómez I, Leal-Martín J, Losa-Reyna J, Rodríguez-Mañas L, García-García FJ, Ara I. Dose-response association between physical activity and sedentary time categories on ageing biomarkers. BMC Geriatr 2019; 19:270. [PMID: 31615446 PMCID: PMC6794876 DOI: 10.1186/s12877-019-1284-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 09/16/2019] [Indexed: 12/29/2022] Open
Abstract
Background Physical activity and sedentary behaviour have been suggested to independently affect a number of health outcomes. To what extent different combinations of physical activity and sedentary behaviour may influence physical function and frailty outcomes in older adults is unknown. The aim of this study was to examine the combination of mutually exclusive categories of accelerometer-measured physical activity and sedentary time on physical function and frailty in older adults. Methods 771 older adults (54% women; 76.8 ± 4.9 years) from the Toledo Study for Healthy Aging participated in this cross-sectional study. Physical activity and sedentary time were measured by accelerometry. Physically active was defined as meeting current aerobic guidelines for older adults proposed by the World Health Organization. Low sedentary was defined as residing in the lowest quartile of the light physical activity-to-sedentary time ratio. Participants were then classified into one of four mutually exclusive movement patterns: (1) ‘physically active & low sedentary’, (2) ‘physically active & high sedentary’, (3) ‘physically inactive & low sedentary’, and (4) ‘physically inactive & high sedentary’. The Short Physical Performance Battery was used to measure physical function and frailty was assessed using the Frailty Trait Scale. Results ‘Physically active & low sedentary’ and ‘physically active & high sedentary’ individuals had significantly higher levels of physical function (β = 1.73 and β = 1.30 respectively; all p < 0.001) and lower frailty (β = − 13.96 and β = − 8.71 respectively; all p < 0.001) compared to ‘physically inactive & high sedentary’ participants. Likewise, ‘physically inactive & low sedentary’ group had significantly lower frailty (β = − 2.50; p = 0.05), but significance was not reached for physical function. Conclusions We found a dose-response association of the different movement patterns analysed in this study with physical function and frailty. Meeting the physical activity guidelines was associated with the most beneficial physical function and frailty profiles in our sample. Among inactive people, more light intensity relative to sedentary time was associated with better frailty status. These results point out to the possibility of stepwise interventions (i.e. targeting less strenuous activities) to promote successful aging, particularly in inactive older adults.
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Affiliation(s)
- Asier Mañas
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Borja Del Pozo-Cruz
- Motivation and Behaviour Research Program, Institute for Positive Psychology and Education, Faculty of Health Sciences, Australian Catholic University, Sydney, Australia
| | - Irene Rodríguez-Gómez
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Javier Leal-Martín
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - José Losa-Reyna
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.,Geriatric Department, Hospital Virgen del Valle, Toledo, Spain
| | - Leocadio Rodríguez-Mañas
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.,Geriatric Department, Hospital Universitario de Getafe, Getafe, Spain
| | - Francisco J García-García
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.,Geriatric Department, Hospital Virgen del Valle, Toledo, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III s/n, 45071, Toledo, Spain. .,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.
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31
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Kehler DS, Theou O. The impact of physical activity and sedentary behaviors on frailty levels. Mech Ageing Dev 2019; 180:29-41. [PMID: 30926562 DOI: 10.1016/j.mad.2019.03.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 03/12/2019] [Accepted: 03/25/2019] [Indexed: 12/17/2022]
Abstract
Heterogeneity in aging can be explained by frailty. Lifestyle behaviors such as physical activity can help manage frailty levels. Conversely, sedentary behaviours are associated with frailty independently of physical activity. Here, we summarize epidemiological and clinical trial evidence concerning the impact of physical activity and sedentary behaviors on frailty levels. We also analysed the National Health and Nutrition Examination Survey (NHANES) data to describe physical activity and sedentary behavior accumulation patterns across frailty levels and their impact on mortality risk. The few prospective and intervention studies demonstrate that higher physical activity levels are associated with a lower incidence of frailty. There are no interventions published which limit sedentary behaviors to manage frailty. Using the NHANES data we demonstrate that individuals are less likely to meet physical activity guidelines and are more likely to accumulate sedentary time in prolonged bouts. Prolonged sedentary bouts and total sedentary time were associated with a higher mortality risk in frail individuals but not in the fit group. Non-bouted sedentary time was not associated with mortality risk. Our review and novel data suggest that there is a need for more intervention studies which focus on increasing physical activity or minimizing sedentary time to manage frailty levels.
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Affiliation(s)
| | - Olga Theou
- Department of Medicine, Dalhousie University, Halifax, NS, Canada
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Kehler DS, Clara I, Hiebert B, Stammers AN, Hay J, Schultz A, Arora RC, Tangri N, Duhamel TA. The association between patterns of physical activity and sedentary time with frailty in relation to cardiovascular disease. Aging Med (Milton) 2019; 2:18-26. [PMID: 31942509 PMCID: PMC6880736 DOI: 10.1002/agm2.12059] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 02/27/2019] [Accepted: 02/28/2019] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE The associations of moderate-vigorous physical activity (MVPA) bouts and patterns of sedentary time (ST) with frailty according to cardiovascular disease (CVD) status are unknown. METHODS Accelerometry in adults ≥50 years old from the 2003-2004 and 2005-2006 National Health and Nutrition Examination Survey were used. Bouted and sporadic MVPA in ≥10-minute or <1-minute bouts were assessed based on meeting a percentage of physical activity guidelines of 150 minutes/wk, respectively. ST patterns included: prolonged ST lasting ≥30 minutes, and the frequency, intensity, and duration of breaks from ST. A 46-item frailty index defined frailty. Multivariable linear regression was used. RESULTS There were 827 and 1490 CVD-free and CVD participants, respectively. Meeting a higher percentage of the physical activity guidelines through bouted MVPA was associated with lower frailty in CVD-only participants (P < 0.05 for CVD interaction). Sporadic MVPA was associated with lower frailty levels in both groups. Prolonged ST was associated with worse frailty in CVD (P > 0.05 for CVD interaction). Frequency of ST breaks was not associated with frailty. Average ST break intensity was protective in both groups. The duration of breaks in ST was associated with lower frailty in CVD participants only (P > 0.05 for CVD interaction). CONCLUSION Insufficient MVPA and prolonged ST are detrimental despite CVD status.
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Affiliation(s)
- Dustin Scott Kehler
- Health, Leisure & Human Performance Research InstituteFaculty of Kinesiology and Recreation ManagementUniversity of ManitobaWinnipegManitobaCanada
- Institute of Cardiovascular SciencesSt. Boniface Hospital Research CentreWinnipegManitobaCanada
- Present address:
QEII Health Sciences CentreHalifaxNova ScotiaCanada
| | - Ian Clara
- Department of Community Health SciencesMax Rady College of MedicineRady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
| | - Brett Hiebert
- Department of SurgeryMax Rady College of MedicineRady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
| | - Andrew Nicholas Stammers
- Health, Leisure & Human Performance Research InstituteFaculty of Kinesiology and Recreation ManagementUniversity of ManitobaWinnipegManitobaCanada
- Institute of Cardiovascular SciencesSt. Boniface Hospital Research CentreWinnipegManitobaCanada
| | - Jacqueline Hay
- Health, Leisure & Human Performance Research InstituteFaculty of Kinesiology and Recreation ManagementUniversity of ManitobaWinnipegManitobaCanada
- Institute of Cardiovascular SciencesSt. Boniface Hospital Research CentreWinnipegManitobaCanada
| | - Annette Schultz
- College of NursingMax Rady College of MedicineRady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
| | - Rakesh Christopher Arora
- Department of SurgeryMax Rady College of MedicineRady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
- Cardiac Sciences ProgramSt. Boniface HospitalWinnipegManitobaCanada
| | - Navdeep Tangri
- Seven Oaks Hospital Research CentreWinnipegManitobaCanada
| | - Todd Ashley Duhamel
- Health, Leisure & Human Performance Research InstituteFaculty of Kinesiology and Recreation ManagementUniversity of ManitobaWinnipegManitobaCanada
- Institute of Cardiovascular SciencesSt. Boniface Hospital Research CentreWinnipegManitobaCanada
- Department of SurgeryMax Rady College of MedicineRady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
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Mañas A, Pozo-Cruz BD, Rodríguez-Gómez I, Losa-Reyna J, Rodríguez-Mañas L, García-García FJ, Ara I. Can Physical Activity Offset the Detrimental Consequences of Sedentary Time on Frailty? A Moderation Analysis in 749 Older Adults Measured With Accelerometers. J Am Med Dir Assoc 2019; 20:634-638.e1. [PMID: 30738823 DOI: 10.1016/j.jamda.2018.12.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 12/12/2018] [Accepted: 12/16/2018] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To determine whether or not and to what extent the association between sedentary time and frailty was moderated by moderate-to-vigorous physical activity in older adults. DESIGN Cross-sectional. SETTING Community-dwelling individuals. PARTICIPANTS 749 (403 females and 346 males) white older adults. MEASUREMENTS Sedentary time and moderate-to-vigorous physical activity were measured with accelerometers. Frailty was objectively measured using the Frailty Trait Scale. All models were adjusted for age, sex, education, income, marital status, body mass index, moderate-to-vigorous physical activity, and accelerometer wear time. RESULTS The regression model reported a significant effect of sedentary time on frailty (P < .05). Nevertheless, the results indicated that moderate-to-vigorous physical activity moderates the relationship between frailty status and sedentary time. The Johnson-Neyman technique determined that the estimated moderate-to-vigorous physical activity point was 27.25 minutes/d, from which sedentary time has no significant effect on frailty. CONCLUSIONS Moderate-to-vigorous physical activity is a moderator in the relationship between sedentary time and frailty in older adults, offsetting the harmful effects of sedentary behavior with 27 minutes/d of moderate-to-vigorous activity. Engaging in moderate-to-vigorous physical activities should be encouraged. Reducing sedentary behavior may also be beneficial, particularly among inactive older adults.
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Affiliation(s)
- Asier Mañas
- GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Borja Del Pozo-Cruz
- Motivation and Behaviour Research Program, Institute for Positive Psychology and Education, Faculty of Health Sciences, Australian Catholic University, Sydney, Australia
| | - Irene Rodríguez-Gómez
- GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - José Losa-Reyna
- GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain; Geriatric Department, Hospital Virgen del Valle, Toledo, Spain
| | - Leocadio Rodríguez-Mañas
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain; Geriatric Department, Hospital Universitario de Getafe, Getafe, Spain
| | - Francisco J García-García
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain; Geriatric Department, Hospital Virgen del Valle, Toledo, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.
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Kehler DS, Hay JL, Stammers AN, Hamm NC, Kimber DE, Schultz AS, Szwajcer A, Arora RC, Tangri N, Duhamel TA. A systematic review of the association between sedentary behaviors with frailty. Exp Gerontol 2018; 114:1-12. [DOI: 10.1016/j.exger.2018.10.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 10/10/2018] [Accepted: 10/13/2018] [Indexed: 12/11/2022]
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