Test-retest reliability of Yale Physical Activity Survey among older Mexican American adults: a pilot investigation

Simplified Chinese adaptation of the Yale Physical Activity Survey: reliability and validity measurement in mainland China elderly women

Objective

To verify the reliability and validity of the simplified Chinese version of the Yale Physical Activity Survey (YPAS) scale in the measurement of physical activity of elderly women in mainland China to provide a new standardized scale for evaluating the level of physical activity.

Methods

Twenty-one healthy elderly women completed all the research procedures. The participants completed the questions on the YPAS and wore an Omegawave Sport Technology®System diagnostic system that recorded maximum oxygen uptake and the adaptation index of the energy metabolism system. The reliability of the YPAS was evaluated based on the consistency of the two measurements (pre-test and post-test), and its validity was verified based on the relevant indicators in the Omegawave diagnostic system. Descriptive statistics, intraclass correlation coefficient and Pearson correlation analysis were used. The significance level was set at p < 0.05.

Results

In terms of reliability, the Pearson correlation coefficient and ICC of the total physical activity time of YPAS (r = 0.917, ICC = 0.897) was high. In terms of total calories, the Pearson correlation coefficient and ICC of the two test results was high (r = 0.958, ICC = 0.934). On the YPAS total index, the Pearson correlation coefficient and ICC of the two test was high (r = 0.930, ICC = 0.920). In terms of validity, there was a moderate correlation between the energy metabolism system adaptation index and the YPAS-total time (r = 0.472) and a moderate correlation with total calories (r = 0.472). There was a high correlation between the YPAS-total index and the maximum oxygen uptake (r = 0.782).

Conclusion

The simplified Chinese version of the YPAS can measure the level of physical activity and energy metabolism of elderly women in mainland China. It is a reliable tool for measuring the physical activity of the elderly.

Effects of incidental physical activity on morphosyntactic processing in aging

Older adults have difficulties in sentence comprehension when working memory (WM) load increases (e.g., multiple embedded clauses). Structured physical activity has been related to improvements in cognition; however, incidental physical activity (PA, i.e., unstructured daily physical activities), particularly incidental vigorous activity has been poorly studied in relation to its effects on behavior. Furthermore, no positive effect on language has been reported in either form of physical activity. The aim of this study was to evaluate how two levels of PA (high or low) affect WM processing and how this, in turn, may affect morphosyntactic processing in older adults. Individuals with high PA (n = 18) had a higher WM load effect than those with low PA (n = 18), both behaviorally (greater differences between high and low WM loads in correct responses) and in terms of event-related potentials (only subjects with high PA showed LAN and P600b amplitude differences between high and low WM loads). These findings suggest that PA promotes cognitive strategies to face WM loads and morphosyntactic processing.

Polish Adaptation of the Yale Physical Activity Survey: Measurement Properties

The aim of this study was to assess the measurement properties of a Polish adaptation of the Yale Physical Activity Survey (YPAS-PL). The Polish cultural adaptation of the YPAS was administered to a group of 104 people aged 65 to 89 years (mean age 72 ± 5). To assess the reliability of the YPAS-PL, a test-retest procedure was applied. Validity was assessed by comparing the results of the YPAS-PL with accelerometery (ActiGraph wGT3X+). The indicators based on the YPAS-PL activities checklist were characterized by high repeatability and had better reliability values than the YPAS-PL activity dimension indices (energy expenditure interclass correlation coefficient (ICC) = 0.81, total time physical activity ICC = 0.86). We noted a significant positive relationship between energy expenditure measured by an accelerometer and the YPAS-PL (r = 0.23). We can conclude that the YPAS-PL is an adequate tool for assessing energy expenditure related to physical activity in a Polish population of older adults. We also recommend the cautious and well thought-out use of the YPAS-PL activity dimension indices (summary, vigorous, leisurely walking, moving, standing, and sitting indexes).

Effects of intermittent fasting on health markers in those with type 2 diabetes: A pilot study

AIM

To determine the short-term biochemical effects and clinical tolerability of intermittent fasting (IF) in adults with type 2 diabetes mellitus (T2DM).

METHODS

We describe a three-phase observational study (baseline 2 wk, intervention 2 wk, follow-up 2 wk) designed to determine the clinical, biochemical, and tolerability of IF in community-dwelling volunteer adults with T2DM. Biochemical, anthropometric, and physical activity measurements (using the Yale Physical Activity Survey) were taken at the end of each phase. Participants reported morning, afternoon and evening self-monitored blood glucose (SMBG) and fasting duration on a daily basis throughout all study stages, in addition to completing a remote food photography diary three times within each study phase. Fasting blood samples were collected on the final days of each study phase.

RESULTS

At baseline, the ten participants had a confirmed diagnosis of T2DM and were all taking metformin, and on average were obese [mean body mass index (BMI) 36.90 kg/m²]. We report here that a short-term period of IF in a small group of individuals with T2DM led to significant group decreases in weight (-1.395 kg, P = 0.009), BMI (-0.517, P = 0.013), and at-target morning glucose (SMBG). Although not a study requirement, all participants preferentially chose eating hours starting in the midafternoon. There was a significant increase (P < 0.001) in daily hours fasted in the IF phase (+5.22 h), although few attained the 18-20 h fasting goal (mean 16.82 ± 1.18). The increased fasting duration improved at-goal (< 7.0 mmol/L) morning SMBG to 34.1%, from a baseline of 13.8%. Ordinal Logistic Regression models revealed a positive relationship between the increase in hours fasted and fasting glucose reaching target values (χ² likelihood ratio = 8.36, P = 0.004) but not for afternoon or evening SMBG (all P > 0.1). Postprandial SMBGs were also improved during the IF phase, with 60.5% readings below 9.05 mmol/L, compared to 52.6% at baseline, and with less glucose variation. Neither insulin resistance (HOMA-IR), nor inflammatory markers (C-reactive protein) normalized during the IF phase. IF led to an overall spontaneous decrease in caloric intake as measured by food photography (Remote Food Photography Method). The data demonstrated discernable trends during IF for lower energy, carbohydrate, and fat intake when compared to baseline. Physical activity, collected by a standardized measurement tool (Yale Physical Activity Survey), increased during the intervention phase and subsequently decreased in the follow-up phase. IF was well tolerated in the majority of individuals with 6/10 participants stating they would continue with the IF regimen after the completion of the study, in a full or modified capacity (i.e., every other day or reduced fasting hours).

CONCLUSION

The results from this pilot study indicate that short-term daily IF may be a safe, tolerable, dietary intervention in T2DM patients that may improve key outcomes including body weight, fasting glucose and postprandial variability. These findings should be viewed as exploratory, and a larger, longer study is necessary to corroborate these findings.

Physical Activity, Physical Performance, and Biological Markers of Health among Sedentary Older Latinos

Background. Physical activity is associated with better physical health, possibly by changing biological markers of health such as waist circumference and inflammation, but these relationships are unclear and even less understood among older Latinos-a group with high rates of sedentary lifestyle. Methods. Participants were 120 sedentary older Latino adults from senior centers. Community-partnered research methods were used to recruit participants. Inflammatory (C-reactive protein) and metabolic markers of health (waist circumference, HDL-cholesterol, triglycerides, insulin, and glucose), physical activity (Yale physical activity survey), and physical performance (short physical performance NIA battery) were measured at baseline and 6-month followup. Results. Eighty percent of the sample was female. In final adjusted cross-sectional models, better physical activity indices were associated with faster gait speed (P < 0.05). In adjusted longitudinal analyses, change in self-reported physical activity level correlated inversely with change in CRP (β = -0.05; P = 0.03) and change in waist circumference (β = -0.16; P = 0.02). Biological markers of health did not mediate the relationship between physical activity and physical performance. Conclusion. In this community-partnered study, higher physical activity was associated with better physical performance in cross-sectional analyses. In longitudinal analysis, increased physical activity was associated with improvements in some metabolic and inflammatory markers of health.

Development and validation of a Spanish translation of the Yale activity questionnaire

Background

Valid measures of physical activity are critical research tools. The objective of this study was to develop a Spanish translation of the Yale Physical Activity Survey, and to provide preliminary evidence of its validity in a population of Dominican patients with lower extremity arthritis.

Methods

A Dominican bilingual health care professional translated the Yale Physical Activity Survey (YPAS) from English to Spanish. Several Dominican adults reviewed the translation to ensure it was linguistically and culturally appropriate. The questionnaire was back-translated to English by a North American researcher who is fluent in Spanish. Discrepancies between the original and back-translated versions were resolved by the translator and back-translator. The Spanish translation was administered to 108 Dominican subjects with advanced hip or knee arthritis prior to (N = 44) or one to four years following (N = 64) total joint replacement. We assessed construct validity by examining the association of YPAS scores and measures of functional status and pain (WOMAC), quality of life (EQ-5D) and the number of painful lower extremity joints.

Results

A higher YPAS Part II Activity Dimensions Summary Index score had weak to modest correlations with worse function and quality of life as measured with the WOMAC function scale (r = 0.21, p = 0.03), SF-36 Physical Activity Scale (r = 0.29, p = 0.004) and EQ-5D (r = 0.34, p = 0.0007). Total minutes of vigorous activity and walking had weak to modest correlation with these measures (WOMAC Function Scale (r = 0.15, p = 0.15), SF-36 Physical Activity Scale (r = 0.21, p = 0.04) and EQ-5D utility (r = 0.24, p = 0.02)). Correlations between the YPAS Part I energy expenditure score and these measures were lower (WOMAC Function Scale (r = 0.07, p = 0.49), SF-36 Physical Activity Scale (r = 0.03, p = 0.74) and EQ-5D utility (r = 0.18, p = 0.07)).

Conclusions

We have developed a new Spanish translation of the Yale Physical Activity Survey and provided evidence of convergent validity in a sample of Dominican patients prior to or 1–4 years following total joint replacement.

Validity and reliability of two brief physical activity questionnaires among Spanish-speaking individuals of Mexican descent

BACKGROUND

Mexican Americans are the largest minority group in the US and suffer disproportionate rates of diseases related to the lack of physical activity (PA). Since many of these Mexican Americans are Spanish-speaking, it is important to validate a Spanish language physical activity assessment tool that can be used in epidemiology as well as clinical practice. This study explored the utility of two Spanish translated physical activity questionnaires, the Stanford Brief Activity Survey (SBAS) and the Rapid Assessment of Physical Activity (RAPA), for use among Spanish-speaking Mexican Americans.

METHODS

Thirty-four participants (13 M, 21 F; 37.6 ± 9.5 y) completed each of the two PA surveys twice, one week apart. During that week 31 participants also wore an ActiGraph GT1M accelerometer for 7 days to objectively measure PA. Minutes of moderate and vigorous PA (MVPA) were determined from the accelerometer data using Freedson and Matthews cut points.

RESULTS

Validity, determined by Spearman correlation coefficients between questionnaire scores and minutes of ActiGraph measured MVPA were 0.38 and 0.45 for the SBAS and RAPA, respectively. Test-retest reliability was 0.61 for the SBAS and 0.65 for the RAPA. Sensitivity and specificity were 0.60 and 0.47 for the SBAS, and 0.73 and 0.75 for the RAPA. Participants who were classified as meeting the 2008 National Physical Activity Guidelines by the RAPA engaged in significantly (p < 0.05) more minutes of MVPA than those who were not, while there were no significant differences in minutes of MVPA classified by the SBAS.

CONCLUSIONS

The SBAS and the RAPA are both reasonably valid measures for quickly assessing PA and determining compliance to the PA guidelines in Spanish-speaking Mexican Americans. Although the two questionnaires had comparable reliability, the RAPA was better able to distinguish between those who met and did not meet National PA Guidelines.

The longitudinal relationship between depression and walking behavior in older Latinos: The "¡Caminemos!" study

OBJECTIVE

This study sought to evaluate the relationship between baseline depression and prospective engagement in walking and exercise behavior after enrollment in an exercise intervention.

METHODS

The study used baseline, 1-month, 12-month, and 24-month in-person interview and pedometer data collected from Latinos aged >60 years participating in an exercise intervention (¡Caminemos!) at 27 senior centers (n = 572).

RESULTS

After joining an exercise intervention, and when using continuous pedometer data and scores from the Yale Physical Activity Survey (YPAS) as the outcomes of interest, older adults with baseline depression exhibited comparable levels of physical activity across time when compared to their nondepressed counterparts. Significant difference in physical activity levels between the depressed and nondepressed subgroups no longer existed within one month of initiating the exercise intervention.

DISCUSSION

Among sedentary older Latino adults, having depression may not delay exercise initiation nor does it appear to prevent achievement or maintenance of an exercise program.

Correlation between the Yale Physical Activity Survey (YPAS) and a submaximal performance-based test: a study in a population of elderly Spanish women

The aim of this study is to research the degree of correlation between the Spanish version of the questionnaire YPAS and the 6-minute walking test (6MWT) in women over 60. In addition, the authors analyzed the relationship between the variables age and body mass index (BMI) and the walked distance. The study was carried out with 44 elderly women (68.1 ± 5.4 years) who filled in the questionnaire and immediately afterwards performed the 6MWT. Total time and energy expenditure (EE) values obtained in the questionnaire are significantly correlated with the 6MWT (p=0.02; p=0.01, respectively), while BMI and age showed an inverse association (r=-0.433; r=-0.318, respectively) with the walked distance. The Spanish version of YPAS is beginning to be considered as a valid and useful tool for habitual physical activity (PA) measurement and can be used among elderly Spanish speaking women.

Physical activity and functional fitness in institutionalized vs. independently living elderly: a comparison of 70-80-year-old city-dwellers

The purpose of the study was to compare the level of energy expenditure due to physical activity (EEPA) and functional fitness (FF) in 59 women and 82 men aged 70-80 years, divided into three groups: permanent residents in assisted-living facilities (ALFs), participants in adult day care centers (DCCs) and older people living independently, members in community senior centers (CSCs). EEPA and FF were analyzed taking into consideration sex differences. The energy expenditure tended to be lower in DCCs and ALFs subjects than in CSCs members, but significant differences were obtained only in women. Women in different living settings differed only in endurance. In men, the differences were clear in most tests (endurance, strength, agility/dynamic balance) except for flexibility. Institutionalization was connected with a significantly lower level of FF and equalization of sex differences. Education seemed to be an important factor influencing the level of FF in men.

[Instrument for the assessment of middle-aged and older adults' physical activity: design, eliability and application of the German-PAQ-50+]

Existing physical activity questionnaires have focused either on young and middle-aged adults or on the elderly. They have mainly assessed only a portion of possible physical activities or contained nation-specific sports. As there is no gold standard for a questionnaire-based assessment of physical activity in the over-50 population, recommendations for such a questionnaire relating to German-speaking countries were developed. This work included a systematic literature research, a survey of experts, and the design of a questionnaire based on validated measuring instruments. Finally, to test its reliability and application in the field, the complete questionnaire, including a retest, was applied by telephone interview (n = 57). The test-retest-correlation was r = 0.60 for the total time of physical activity and r = 0.52 for total energy expenditure. The researchers determined that the instrument is comprehensive in its coverage of all relevant domains of physical activity for the over-50 population; it is economically feasible and showed good acceptance.

Comparison Style, Physical Self-Perceptions, and Fitness among Older Women

This study examined the relationships between older women’s comparison styles, physical self-perceptions, and functional fitness. Participants were community-dwelling women (N= 102, age 65-99) living in the mid-Atlantic region of the United States. Individuals were categorized as relying primarily on social comparisons, temporal comparisons, or a combination of both styles. Also of interest was whether individuals evaluated themselves positively or negatively when making comparisons. Participants who evaluated themselves positively as compared with others were found to have higher levels of physical self-perception. Analyses revealed that women who relied primarily on temporal comparisons had higher self-perceptions of their functional ability than those who relied on a combination of comparison styles. An avoidance of both temporal and social comparisons was also related to higher levels of physical self-perception.

Religious service attendance and decline in pulmonary function in a high-functioning elderly cohort

BACKGROUND

Pulmonary function is an important indicator of respiratory and overall health, yet little is known about the psychosocial factors that predict pulmonary function itself. At the same time, religious activity is emerging as a potential health promoting factor, especially among the elderly. Whether there is a connection between religious activity and pulmonary function is unknown.

PURPOSE

In this study, we sought to examine the association between religious attendance and rate of decline in pulmonary function.

METHODS

The sample consisted of 1,174 healthy elderly persons enrolled in the MacArthur Study of Successful Aging who were followed for an average of 4.6 years. Information on frequency of religious service attendance and peak expiratory flow rate (PEFR) was collected over 3 waves. A linear mixed model with repeated measures was used to compare rate of decline in PEFR between those who attended religious services regularly and those who did not.

RESULTS

Regular religious service attendance was associated with a slower pulmonary function decline among men (by 3.71 L/min per year, p = .02) and women (by 3.27 L/min per year, p = .02), compared to those who never attend services. The findings could not be explained by differences in smoking or physical activity.

CONCLUSIONS

Overall findings support the hypothesis that religious activity may play a protective role in maintaining pulmonary health among the elderly.

Lifelong physical activity patterns of sedentary Mexican American women

Increasing physical activity, especially for high-risk groups, is a national priority; yet little is known about the lifelong patterns of physical activity of older Mexican American women. This article describes Mexican American women's current sedentary status by reviewing their physical activity history. Interventions aimed at promoting health in older adults require an understanding of the impact of prior experiences on current health behaviors. Thus, in-depth semistructured interviews were conducted with 71 Mexican American women (aged 50 years or older) recruited from local churches and senior centers. Household, occupational, and leisure activities from age 15 years to present time were reviewed. A lifelong pattern of low occupational and leisure activity and low to moderate household activity were found, with sedentary occupations and no leisure activities predominating. Most believed that current household, occupational and leisure activities provide enough physical activity, thus influencing participation in exercise programs or activities. Attempts to increase physical activity for this group need to begin by teaching them age-appropriate and culturally acceptable physical activities.