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Vasilopoulos T, Drozda D, Vincent HK. Physical activity positively impacts disability outcomes during transition from midlife to early older age irrespective of body mass index. Arch Gerontol Geriatr 2024; 120:105339. [PMID: 38340391 DOI: 10.1016/j.archger.2024.105339] [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: 09/17/2023] [Revised: 01/17/2024] [Accepted: 01/20/2024] [Indexed: 02/12/2024]
Abstract
We examined the effects of physical activity (PA) and body mass index (BMI) longitudinal patterns (trajectories) on subjective measures of mobility, function, and disability in adults and assessed whether effects of PA trajectories on function varied due to BMI. Group-based trajectory analyses were used to determine patterns of change in PA and BMI using data from the Health and Retirement Study 1931-1941 birth cohort (n = 10,507). Physical function was assessed by Mobility Limitations (0-5 scale) and Large Muscle Function (0-4 scale) Indexes, as well as with score for activities of daily living (ADLs) and instrumental activities of daily living (IADLs), with higher scores being worse. Our analyses estimated four distinct PA trajectories: decreasing, (2) fluctuating, (3) stable high, and (4) emergent (previously low/sedentary with increased PA over the study period). Worse mobility limitations, large muscle function, ADLs, and IADLs were associated with Decreasing and Fluctuating PA groups. Better outcomes were associated with Emergent and Stable High PA groups. The five BMI trajectories were stable normal/overweight, modest decreasing, fluctuating, steep decreasing, and increasing. No significant interaction existed between PA and BMI trajectories for Mobility Limitations (P= 0.577), Large Muscle Function (P= 0.511), ADLs (P= 0.600), and IADLs (P= 0.152). These findings may empower clinicians to promote messages to midlifers that meaningful changes in PA can improve function in older age.
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Affiliation(s)
- Terrie Vasilopoulos
- Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL 32610, USA; Department of Orthopaedic Surgery and Sports Medicine, College of Medicine, University of Florida, Gainesville, FL 32611, USA.
| | - David Drozda
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL 32611, USA
| | - Heather K Vincent
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL 32611, USA
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Ahola J, Kekäläinen T, Kinnunen ML, Tolvanen A, Pitkänen T, Pulkkinen L, Saajanaho M, Kokko K. Stability in health behavior patterns in middle adulthood: a 19-year follow-up study. Psychol Health 2024:1-21. [PMID: 38389311 DOI: 10.1080/08870446.2024.2316676] [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: 06/22/2023] [Accepted: 02/06/2024] [Indexed: 02/24/2024]
Abstract
Objective: This study investigated subgroups of adults with particular health behavior patterns, their stability over 19 years, and the role of sociodemographic and personality characteristics in these. Methods and Measures: Data on smoking, alcohol consumption, and physical activity were collected at ages 42, 50, and 61 in the Jyväskylä Longitudinal Study of Personality and Social Development (n = 205-302). Latent class, latent transition, and logistic regression analyses were used. Results: Four similar classes of health behaviors were identified at each age. A class named low alcohol consumption (AC)-high physical activity (PA) included individuals with the lowest levels of alcohol consumption and the highest levels of physical activity, and a class named high AC-low PA vice versa. Classes between these extremes of alcohol consumption and physical activity levels were nonsmokers with the lowest proportion of smokers, and smokers vice versa. Although transitions emerged, class memberships were relatively stable. Women, those who were married, held a degree, had higher occupational status, and certain personality traits at age 42 were more likely to belong continuously to healthier classes compared to a stable membership in high AC-low PA. Conclusion: Health behaviors exist in patterns, are relatively stable across adulthood, and associated with sociodemographic and personality characteristics.
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Affiliation(s)
- Johanna Ahola
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tiia Kekäläinen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Marja-Liisa Kinnunen
- The Wellbeing Services County of Central Finland, Jyväskylä, Finland
- School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Asko Tolvanen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | | | - Lea Pulkkinen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Milla Saajanaho
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Katja Kokko
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Machado-Fragua MD, Sabia S, Fayosse A, Hassen CB, van der Heide F, Kivimaki M, Singh-Manoux A. Is metabolic-healthy obesity associated with risk of dementia? An age-stratified analysis of the Whitehall II cohort study. BMC Med 2023; 21:436. [PMID: 37957712 PMCID: PMC10644649 DOI: 10.1186/s12916-023-03155-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 11/06/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Metabolically healthy obesity is hypothesized to be a benign condition but whether this is the case for dementia remains debated. We examined the role of age at assessment of metabolic-obesity phenotypes in associations with incident dementia. METHODS Obesity (body mass index ≥ 30 kg/m2) and poor metabolic health (≥ 2 of elevated serum triglycerides, low HDL-C, elevated blood pressure, and elevated serum fasting glucose) were used to define four metabolic-obesity phenotypes (metabolically healthy (MHNO) and unhealthy non-obesity (MUNO), metabolically healthy (MHO) and unhealthy obesity (MUO)) at < 60, 60 to < 70, and ≥ 70 years using 6 waves of data from the Whitehall II study and their associations with incident dementia was examined using Cox regression. RESULTS Analyses with exposures measured < 60, 60 to < 70, and ≥ 70 years involved 410 (5.8%), 379 (5.6%), and 262 (7.4%) incident dementia cases over a median follow-up of 20.8, 10.3, and 4.2 years respectively. In analyses of individual components, obesity before 60 years (HR 1.41, 95% CI: [1.08, 1.85]) but not at older ages was associated with dementia; unhealthy metabolic status when present < 60 years (HR 1.33, 95% CI: [1.08, 1.62]) and 60 to < 70 years (HR 1.32, 95% CI: [1.07, 1.62]) was associated with dementia. Compared to the metabolically healthy non-obesity group, the risk of dementia was higher in those with metabolically healthy obesity before 60 years (1.69; 95% CI: [1.16, 2.45]); this was not the case when metabolic-obesity phenotype was present at 60 to < 70 years or ≥ 70 years. Analyses at older ages were on smaller numbers due to death and drop-out but inverse probability weighting to account for missing data yielded similar results. CONCLUSIONS Individuals with metabolically healthy obesity before age 60 had a higher risk of incident dementia over a 27-year follow-up; the excess risk dissipates when metabolic health and obesity are measured after 70 years.
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Affiliation(s)
- Marcos D Machado-Fragua
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France.
| | - Séverine Sabia
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
- Faculty of Brain Sciences, University College London, London, UK
| | - Aurore Fayosse
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Céline Ben Hassen
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Frank van der Heide
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Mika Kivimaki
- Faculty of Brain Sciences, University College London, London, UK
| | - Archana Singh-Manoux
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
- Faculty of Brain Sciences, University College London, London, UK
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Kekäläinen T, Karvonen J, Törmäkangas T, Pulkkinen L, Kokko K. Pathways from childhood socioemotional characteristics and cognitive skills to midlife health behaviours. Psychol Health 2023; 38:1683-1701. [PMID: 35225111 DOI: 10.1080/08870446.2022.2041639] [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: 08/12/2021] [Revised: 01/14/2022] [Accepted: 02/09/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This longitudinal study investigated the pathways from childhood socioemotional characteristics and cognitive skills to health behaviours in midlife. Methods: Participants in the Jyväskylä Longitudinal Study of Personality and Social Development (JYLS) were followed from age 8 (n = 369) to age 50 (n = 271). Outcomes included physical activity, smoking, alcohol consumption and body mass index (BMI) assessed at ages 36, 42 and 50. Predictors were socioemotional characteristics (behavioural activity, negative emotionality, and well-controlled behaviour) and parents' occupational status collected at age 8, cognitive skills (school success at age 14 and the highest education at age 27) and adulthood personality traits (extraversion, neuroticism and conscientiousness). Longitudinal path modelling was used for analyses. Results: Well-controlled behaviour and extraversion predicted physical activity in women. Behavioural activity predicted alcohol consumption in women and smoking in men. Negative emotionality was not directly connected to health behaviours. Adulthood neuroticism was associated with smoking in men and with alcohol-related problems in both men and women. There were some indirect paths from childhood socioemotional characteristics to midlife health behaviours through cognitive skills. None of the study variables predicted midlife BMI. Conclusions: Childhood socioemotional characteristics have some predictive value on midlife health behaviours, both directly and through cognitive skills. Supplemental data for this article is available online at https://doi.org/10.1080/08870446.2022.2041639 .
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Affiliation(s)
- Tiia Kekäläinen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland
| | - Jenni Karvonen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland
- The Finnish Rheumatism Association, Helsinki, Finland
| | - Timo Törmäkangas
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland
| | - Lea Pulkkinen
- Department of Psychology, University of Jyväskylä, Jyvaskyla, Finland
| | - Katja Kokko
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland
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Dalene KE, Lergenmuller S, Sund ER, Hopstock LA, Robsahm TE, Nilssen Y, Nystad W, Larsen IK, Ariansen I. Clustering and trajectories of key noncommunicable disease risk factors in Norway: the NCDNOR project. Sci Rep 2023; 13:14479. [PMID: 37660221 PMCID: PMC10475033 DOI: 10.1038/s41598-023-41660-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/29/2023] [Indexed: 09/04/2023] Open
Abstract
Noncommunicable diseases (NCDs) are a leading cause of premature death globally and have common preventable risk factors. In Norway, the NCDNOR-project aims at establishing new knowledge in the prevention of NCDs by combining information from national registries with data from population-based health studies. In the present study, we aimed to harmonize data on key NCD risk factors from the health studies, describe clustering of risk factors using intersection diagrams and latent class analysis, and identify long-term risk factor trajectories using latent class mixed models. The harmonized study sample consisted of 808,732 individuals (1,197,158 participations). Two-thirds were exposed to ≥ 1 NCD risk factor (daily smoking, physical inactivity, obesity, hypertension, hypercholesterolaemia or hypertriglyceridaemia). In individuals exposed to ≥ 2 risk factors (24%), we identified five distinct clusters, all characterized by fewer years of education and lower income compared to individuals exposed to < 2 risk factors. We identified distinct long-term trajectories of smoking intensity, leisure-time physical activity, body mass index, blood pressure, and blood lipids. Individuals in the trajectories tended to differ across sex, education, and body mass index. This provides important insights into the mechanisms by which NCD risk factors can occur and may help the development of interventions aimed at preventing NCDs.
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Affiliation(s)
- Knut Eirik Dalene
- Department of Chronic Diseases, Norwegian Institute of Public Health, PO Box 222, 0213, Oslo, Skøyen, Norway.
| | - Simon Lergenmuller
- Department of Registration, Cancer Registry of Norway, PO Box 5313, 0304, Oslo, Majorstuen, Norway
| | - Erik R Sund
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Oslo, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Laila A Hopstock
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Oslo, Norway
| | | | - Yngvar Nilssen
- Department of Registration, Cancer Registry of Norway, PO Box 5313, 0304, Oslo, Majorstuen, Norway
| | - Wenche Nystad
- Department of Chronic Diseases, Norwegian Institute of Public Health, PO Box 222, 0213, Oslo, Skøyen, Norway
| | - Inger Kristin Larsen
- Department of Registration, Cancer Registry of Norway, PO Box 5313, 0304, Oslo, Majorstuen, Norway
| | - Inger Ariansen
- Department of Chronic Diseases, Norwegian Institute of Public Health, PO Box 222, 0213, Oslo, Skøyen, Norway
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Nontarak J, Bundhamcharoen K, Prasitsiriphon O, Aekplakorn W. The Association of Sociodemographic Variables and Unhealthy Behaviors With Limitations in Activities of Daily Living Among Thai Older Adults: Cross-sectional Study and Projected Trends Over the Next 20 Years. Asian Pac Isl Nurs J 2023; 7:e42205. [PMID: 37279055 DOI: 10.2196/42205] [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: 08/26/2022] [Revised: 04/14/2023] [Accepted: 05/09/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Extended life spans have led to an increase in the number of older people and an increase in the prevalence of disability among people older than 60 years of age. OBJECTIVE This study aims to investigate the association of sociodemographic variables and unhealthy behaviors with limitations in activities of daily living (ADL) among Thai older adults. The study also projects the number of older individuals likely to experience ADL limitations in the next 20 years. METHODS We performed sex-specific multinomial logistic regression analysis based on the 5th Thai National Health Examination Survey in 2014 to investigate the association between sociodemographic variables and health behaviors with ADL limitations among Thai older adults. Age- and sex-specific prevalence estimates of ADL limitations were obtained by applying the same models. These estimates were combined with population projections up to 2040 from the Office of the National Economic and Social Development Board, Thailand, to generate projections of older individuals with ADL limitations. RESULTS Age and physical activity were significant factors for both sexes, with age positively associated with the level of ADL limitations and low physical activity associated with an increased relative probability of mild or moderate to severe ADL limitations compared to individuals with no ADL limitation (1.2-2.2 times). Other variables such as education, marital status, diabetes, hypertension, smoking, alcohol consumption, and having a fruit- and vegetable-based diet showed significant associations, but the results varied regarding sex and levels of ADL limitations. This study also projected the number of older adults with mild and moderate to severe ADL limitations over the next 20 years from 2020 to 2040, revealing an increase of 3.2 and 3.1 times, respectively, along with a significant increase in men compared to that in women. CONCLUSIONS This study identified age and physical activity as significant factors associated with ADL limitations in older adults, while other factors showed varying associations. Over the next 2 decades, projections suggest a significant increase in the number of older adults with ADL limitations, particularly men. Our findings emphasize the importance of interventions to reduce ADL limitations, and health care providers should consider various factors impacting them.
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Affiliation(s)
- Jiraluck Nontarak
- Department of Epidemiology, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | | | | | - Wichai Aekplakorn
- Department of Community Medicine, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand
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Modifiable healthy behaviours and incident disability in older adults: Analysis of combined data from two cohort studies in Japan. Exp Gerontol 2023; 173:112094. [PMID: 36681130 DOI: 10.1016/j.exger.2023.112094] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 01/03/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
Healthy behaviours reduce the risk of incident disability; however, their components require further consideration. Specifically, little evidence exists on healthy behaviours that comprise modifiable factors, including social aspects, and their effects on those who do not engage in them. This study aimed to examine the association between engaging in healthy behaviours with modifiable factors and incident disability among community-dwelling older adults; as well as identify factors associated with nonengagement in healthy behaviours. We analysed data obtained from 1357 older adults aged 65 years and more without disabilities at baseline. The outcome was incident disability, which was defined based on the long-term care insurance certification in Japan. This study included regular exercise (≥1 day/week), favourable eating habits (≥4 dietary variety score), and social participation (engaging in two or more social activities) as components of healthy behaviours. We used the Cox proportional hazards model to calculate hazard ratios (HR) for incident disabilities. The proportion of those who satisfied all healthy behaviours was 21 %. During the follow-up period (median: 6.3 years), 282 incident disabilities were confirmed. Compared to those who engaged in one healthy behaviour, those who satisfied all healthy behaviours showed a 31 % (95 % confidence interval: 0.48, 0.98) lower HR of incident disability after adjusting for covariates. Current smoking and depressive mood were associated with non-engagement in healthy behaviours. This study found that having physically and socially active lifestyles and favourable eating habits are effective in reducing the risk of incident disability. Meanwhile, several older adults lack the components of a healthy lifestyle. Approaches that focus on multiple healthy behaviours are necessary to enhance the benefits of healthy lifestyles.
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Watanabe D, Murakami H, Gando Y, Kawakami R, Tanisawa K, Ohno H, Konishi K, Sasaki A, Morishita A, Miyatake N, Miyachi M. Factors associated with changes in the objectively measured physical activity among Japanese adults: A longitudinal and dynamic panel data analysis. PLoS One 2023; 18:e0280927. [PMID: 36795780 PMCID: PMC9934362 DOI: 10.1371/journal.pone.0280927] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 01/11/2023] [Indexed: 02/17/2023] Open
Abstract
Factors associated with dynamic changes in the objectively measured physical activity have not been well understood. We aimed to 1) evaluate the longitudinal change in the physical activity trajectory according to sex which is associated with age and to 2) determine the factors associated with the dynamic change in physical activity-related variables across a wide age range among Japanese adults. This longitudinal prospective study included 689 Japanese adults (3914 measurements) aged 26-85 years, whose physical activity data in at least two surveys were available. Physical activity-related variables, such as intensity (inactive, light [LPA; 1.5 to 2.9 metabolic equivalents (METs)], moderate-to-vigorous [MVPA; ≥3.0 METs]), total energy expenditure (TEE), physical activity level (PAL), and step count, were evaluated using a validated triaxial accelerometer. Statistical analysis involved the latent growth curve models and random-effect panel data multivariate regression analysis. During a mean follow-up period of 6.8 years, physical activity was assessed an average of 5.1 times in men and 5.9 times in women. The profiles for the inactive time, LPA (only men), MVPA, step count, PAL, and TEE showed clear curvature, indicating an accelerated rate of change around the age of 70. In contrast, other variables exhibited minimal or no curvature over the age span. The MVPA trajectory was positively associated with alcohol consumption, hand grips, leg power, and trunk flexibility and negatively associated with age, local area, body mass index (BMI), comorbidity score, and heart rate over time. Our results indicated that the physical activity trajectory revealed clear curvature, accelerated rate of change around the age of 70, and determined physical health and fitness and BMI as dynamic factors associated with physical activity changes. These findings may be useful to help support populations to achieve and maintain the recommended level of physical activity.
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Affiliation(s)
- Daiki Watanabe
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Shinjuku-ku, Tokyo, Japan
- Institute for Active Health, Kyoto University of Advanced Science, Sogabe-cho, Kameoka-city, Kyoto, Japan
| | - Haruka Murakami
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu-city, Shiga, Japan
| | - Yuko Gando
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Shinjuku-ku, Tokyo, Japan
- Faculty of Sport Science, Surugadai University, Saitama, Japan
| | - Ryoko Kawakami
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Kumpei Tanisawa
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Harumi Ohno
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Shinjuku-ku, Tokyo, Japan
| | - Kana Konishi
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Shinjuku-ku, Tokyo, Japan
- Faculty of Food and Nutritional Sciences, Toyo University, Ora-gun, Gunma, Japan
| | - Azusa Sasaki
- Department of Food and Nutrition, Jumonji University, Niiza, Saitama, Japan
| | - Akie Morishita
- Okayama Southern Institute of Health, Okayama Health Foundation, Okayama-city, Okayama, Japan
| | | | - Motohiko Miyachi
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Shinjuku-ku, Tokyo, Japan
- * E-mail: ,
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Norris T, Blodgett J, Rogers N, Hamer M, Pinto Pereira S. Obesity in early adulthood and physical functioning in mid-life: Investigating the mediating role of c-reactive protein. Brain Behav Immun 2022; 102:325-332. [PMID: 35301057 PMCID: PMC9048926 DOI: 10.1016/j.bbi.2022.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/07/2022] [Accepted: 03/12/2022] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Obesity in adulthood is associated with reduced physical functioning (PF) at older ages. However, mechanisms underpinning this association are not well understood. We investigated whether and the extent to which C-reactive protein (CRP) mediates the association between early-adult obesity and mid-life PF. METHODS We used data from 8495 participants in the 1958 British birth cohort study. Body mass index (BMI), CRP and PF were measured at 33, 45 and 50y, respectively. Poor PF was defined as the lowest (sex-specific) 10% on the Short-form 36 Physical Functioning subscale. We accounted for prospectively measured confounders in early-life (e.g., social class at birth) and in mid-adulthood (e.g., 42y comorbidities). We decomposed the total effect of early-adult obesity on mid-life PF into direct and indirect (via CRP) effects, by employing a mediation analysis based on parametric g-computation. RESULTS The estimated total effect of obesity at 33y on poor PF at 50y, expressed as an odds ratio (OR), was 2.41 (95% CI: 1.89, 3.08). The direct effect of obesity on poor PF (i.e., not operating via CRP), was 1.97 (95% CI: 1.51, 2.56), with an indirect effect of 1.23 (95% CI: 1.10, 1.37). As such, the proportion of the total effect which was mediated by the effect of obesity on CRP at 45y, was 23.27% (95% CI: 8.64%, 37.90%). CONCLUSION Obesity in early-adulthood was associated with over twice the odds of poor PF in mid-life, with approximately 23% of the obesity effect operating via a downstream effect on CRP. As current younger generations are likely to spend greater proportions of their life course in older age and with obesity, both of which are associated with poor PF, there is an urgent need to identify mechanisms, and thus potential modifiable intermediaries, linking obesity to poor PF.
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Affiliation(s)
- T. Norris
- Institute of Sport, Exercise and Health, Division of Surgery and Interventional Science, Faculty of Medical Sciences, UCL, London, United Kingdom
| | - J.M. Blodgett
- Institute of Sport, Exercise and Health, Division of Surgery and Interventional Science, Faculty of Medical Sciences, UCL, London, United Kingdom
| | - N.T. Rogers
- Centre for Diet and Activity Research, MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - M. Hamer
- Institute of Sport, Exercise and Health, Division of Surgery and Interventional Science, Faculty of Medical Sciences, UCL, London, United Kingdom
| | - S.M. Pinto Pereira
- Institute of Sport, Exercise and Health, Division of Surgery and Interventional Science, Faculty of Medical Sciences, UCL, London, United Kingdom,Corresponding author at: Institute of Sport, Exercise and Health, Division of Surgery and Interventional Science, Faculty of Medical Sciences, UCL, London, United Kingdom.
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Gajda R, Raczkowska E, Wyka J, Suliga E, Sobaś K. Differentiation of the Nutritional Risk of Polish Elderly People According to Selected Demographic Characteristics and Declared Socioeconomic Status. Nutrients 2022; 14:nu14081582. [PMID: 35458144 PMCID: PMC9027789 DOI: 10.3390/nu14081582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/04/2022] [Accepted: 04/09/2022] [Indexed: 01/10/2023] Open
Abstract
Nutritional risk screening in older people can help to not only identify health risks but also to treat them effectively. The aim of this work was to assess the relationship between the demographic characteristics (age, gender and place of residence) and socioeconomic status of older people in the community and nutritional risk. The Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN-14) questionnaire was used to evaluate the nutritional risk. The study was conducted in 417 people (312 women and 105 men) between 60 and 95 years old (70.8 ± 6.73 years). Multivariate correspondence analysis (MCA) was used to determine the relationships between the categories of variables describing the level of nutritional risk, demographic characteristics and the value of the socioeconomic status (SES) index. To assess the relationship between identified nutritional risks, demographics and SES index variables, we used logistic regression analysis. Based on these studies, nutritional risk factors for older people in Poland were identified. It has been shown that larger cities and low socioeconomic status are closely linked to higher nutritional risk. At the same time, age and gender were not significant factors influencing nutritional risk. Identifying the factors that increase the nutritional risk of older people can help to improve their quality of life.
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Affiliation(s)
- Robert Gajda
- Department of Human Nutrition, Faculty of Biotechnology and Food Science, Wrocław University of Environmental and Life Sciences, 51-630 Wrocław, Poland; (R.G.); (J.W.)
| | - Ewa Raczkowska
- Department of Human Nutrition, Faculty of Biotechnology and Food Science, Wrocław University of Environmental and Life Sciences, 51-630 Wrocław, Poland; (R.G.); (J.W.)
- Correspondence: ; Tel.: +48-71-320-7756
| | - Joanna Wyka
- Department of Human Nutrition, Faculty of Biotechnology and Food Science, Wrocław University of Environmental and Life Sciences, 51-630 Wrocław, Poland; (R.G.); (J.W.)
| | - Edyta Suliga
- Institute of Health Sciences, Medical College, Jan Kochanowski University, 25-516 Kielce, Poland; (E.S.); (K.S.)
| | - Kamila Sobaś
- Institute of Health Sciences, Medical College, Jan Kochanowski University, 25-516 Kielce, Poland; (E.S.); (K.S.)
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Ortiz C, López-Cuadrado T, Rodríguez-Blázquez C, Pastor-Barriuso R, Galán I. Clustering of unhealthy lifestyle behaviors, self-rated health and disability. Prev Med 2022; 155:106911. [PMID: 34922996 DOI: 10.1016/j.ypmed.2021.106911] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/20/2021] [Accepted: 12/12/2021] [Indexed: 11/18/2022]
Abstract
The main objective was to identify sociodemographic characteristics of the population at risk for a greater clustering of unhealthy behaviors and to evaluate the association of such clustering with self-rated health status and disability. Data come from the 2017 Spanish National Health Survey with a sample of 21,947 participants of 15 years of age or older. Based on tobacco consumption, risk drinking, unbalanced diet, sedentarism, and body mass index <18.5/≥25 we created two indicators of risk factor clustering: 1) Number of unhealthy behaviors (0-5); and 2) Unhealthy lifestyle index (score: 0-15). Self-rated health was dichotomized into "optimal" and "suboptimal," and disability was classified as "no disability," "mild," and "severe" based on the Global Activity Limitation Index (GALI). We estimated prevalence ratios (PR) adjusted for covariates using generalized linear models using the clustering count variable, and dose-response curves using the unhealthy lifestyle index. Most participants (77.4%) reported 2 or more risk factors, with men, middle-age individuals, and those with low socioeconomic status being more likely to do so. Compared to those with 0-1 risk factors, the PR for suboptimal health was 1.26 (95% CI:1.18-1.34) for those reporting 2-3 factors, reaching 1.43 (95% CI:1.31-1.55) for 4-5 factors. The PR for severe activity limitation was 1.66 (95% CI:1.35-2.03) for those reporting 2-3 factors and 2.06 (95% CI:1.59-2.67) for 4-5 factors. The prevalence of both health indicators increased in a non-linear fashion as the unhealthy lifestyle index score increased, increasing rapidly up to 5 points, slowing down between 5 and 10 points, and plateauing afterwards.
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Affiliation(s)
- Cristina Ortiz
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Teresa López-Cuadrado
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, Autonomous University of Madrid/IdiPAZ, Madrid, Spain
| | | | - Roberto Pastor-Barriuso
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Iñaki Galán
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain; Department of Preventive Medicine and Public Health, Autonomous University of Madrid/IdiPAZ, Madrid, Spain.
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12
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Ribeiro MCM, Sañudo A, Simões EJ, Ramos LR. Relationship between physical activity and functional capacity change in aged cohort in São Paulo, Brazil. Rev Bras Enferm 2021; 75:e20200837. [PMID: 34787237 PMCID: PMC9885500 DOI: 10.1590/0034-7167-2020-0837] [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: 09/07/2020] [Accepted: 08/22/2021] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES to evaluate the relationship between leisure-time physical activity and functional capacity change among aged people. METHODS we analyzed data of an aged cohort looking for determinants of functional capacity at follow-up. Baseline data were collected between 2007 and 2008 - average follow-up of 3,5 years. A full multivariate linear regression model was built to evaluate functional capacity at the end of the follow-up, controlling for functional capacity at baseline, sociodemographic, health and behavioral characteristics and amount of leisure-time physical activity in the period. RESULTS final model showed functional capacity independently correlated with age (p<0.001), body mass (p=0.013) and the number of activities of daily living compromised at baseline (p<0.001). Functional capacity improved with increased physical activity but loss statistical significance after adjustments (p=0.384). CONCLUSIONS functional capacity decreases with increased age, increased loss of functional capacity at baseline and increased body mass. Albeit a non-significant association, leisure-time physical activity appears as an important modifiable factor.
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Affiliation(s)
| | - Adriana Sañudo
- Universidade Federal de São Paulo. São Paulo, São Paulo, Brazil
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13
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Zhang A, Fang J, Wan Y, Su P, Tao F, Sun Y. Joint trajectories of life style indicators and their links to psychopathological outcomes in the adolescence. BMC Psychiatry 2021; 21:407. [PMID: 34404392 PMCID: PMC8369712 DOI: 10.1186/s12888-021-03403-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 07/31/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Rapid socio-economic development makes China a unique laboratory for examining how lifestyle changes affect adolescent mental health. This study aims to identify joint trajectories of modifiable lifestyle indicators during pubertal transition and its associations with psychopathological outcomes. METHODS A cohort of 1974 children aged 7-9 years were recruited in Anhui Province, China during March 2013. The assessment of lifestyle behaviors (screen time, physical activity, sleep duration and beverage intake) and depressive symptoms were conducted from Wave 1 to Wave 4 (2018). Suicide ideation, non-suicidal self-harm (NSSI) and alcohol use were self-reported at Wave 4. Longitudinal trajectories of lifestyle patterns were defined using group-based multi-trajectory models in 2019. RESULTS Four lifestyle trajectories were identified: persistent healthy (39.9%), suboptimal healthy (25.3%), unhealthy mitigation (17.2%), and persistent unhealthy (17.7%). Compared with persistent healthy group, the risk of subsequent suicide ideation [odds ratio (OR): 2.86, 95%CI: 2.15-3.81], depressive symptoms (OR: 2.16, 95%CI: 1.39-3.35), alcohol use (OR: 2.53, 95%CI: 1.78-3.61) and non-suicidal self-harm (OR: 1.35, 95%CI: 1.09-1.67) was significantly higher in persistent unhealthy group. CONCLUSIONS This study provided convincing evidence that unhealthy lifestyle trajectory during adolescence is associated with more than two-fold elevated odds for multiple domains of psychopathological outcomes over 5 years.
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Affiliation(s)
- Anhui Zhang
- Department of Child Health Care, Wuhu Maternal and Child Health (MCH) Center, Wuhu, 230000 Anhui Province China
| | - Jiao Fang
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032 Anhui Province China
| | - Yuhui Wan
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032 Anhui Province China ,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, 230032 Anhui Province China
| | - Puyu Su
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032 Anhui Province China ,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, 230032 Anhui Province China
| | - Fangbiao Tao
- grid.186775.a0000 0000 9490 772XDepartment of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032 Anhui Province China ,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, 230032 Anhui Province China
| | - Ying Sun
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui Province, China. .,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, 230032, Anhui Province, China.
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14
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Pinto Pereira SM, De Stavola BL, Rogers NT, Hardy R, Cooper R, Power C. Adult obesity and mid-life physical functioning in two British birth cohorts: investigating the mediating role of physical inactivity. Int J Epidemiol 2021; 49:845-856. [PMID: 32142119 PMCID: PMC7394955 DOI: 10.1093/ije/dyaa014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 01/17/2020] [Indexed: 12/31/2022] Open
Abstract
Background Associations between obesity and physical inactivity are bi-directional. Both are associated with physical functioning (PF, ability to perform physical tasks of daily living) but whether obesity influences PF via inactivity is unknown. We investigated whether mid-adult obesity trajectories were associated with subsequent PF and mediated by inactivity. Methods Body mass index (BMI; kg/m²) and inactivity were recorded at: 36, 43, 53 and 60–64 years in the 1946 Medical Research Council (MRC) National Survey of Health and Development (1946-NSHD; n = 2427), and at 33, 42 and 50 years in the 1958 National Child Development Study (1958-NCDS; n = 8674). Poor PF was defined as the lowest (gender and cohort-specific) 10% on the Short-form 36 Physical Component Summary subscale at 60–64 years (1946-NSHD) and 50 years (1958-NCDS). Estimated randomized-interventional-analogue natural direct (rNDE) and indirect (rNIE) effects of obesity trajectories on PF via inactivity are expressed as risk ratios [overall total effect (rTE) is rNDE multiplied by rNIE]. Results In both cohorts, most individuals (∼68%) were never obese in adulthood, 16–30% became obese and ≤11% were always obese. In 1946-NSHD, rTE of incident obesity at 43 years (vs never) on poor PF was 2.32 (1.13, 3.51); at 53 years it was 1.53 (0.91, 2.15). rNIEs via inactivity were 1.02 (0.97, 1.07) and 1.02 (0.99, 1.04), respectively. Estimated rTE of persistent obesity from 36 years was 2.91 (1.14, 4.69), with rNIE of 1.03 (0.96, 1.10). In 1958-NCDS, patterns of association were similar, albeit weaker. Conclusions Longer duration of obesity was associated with increased risk of poor PF. Inactivity played a small mediating role. Findings reinforce the importance of preventing and delaying obesity onset to protect against poor PF.
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Affiliation(s)
- Snehal M Pinto Pereira
- UCL Research Department of Epidemiology & Public Health, London WC1E 7HB, UK.,MRC Unit for Lifelong Health and Ageing at UCL, London WC1E 7HB, UK
| | - Bianca L De Stavola
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK
| | - Nina T Rogers
- UCL Research Department of Epidemiology & Public Health, London WC1E 7HB, UK.,MRC Unit for Lifelong Health and Ageing at UCL, London WC1E 7HB, UK
| | - Rebecca Hardy
- MRC Unit for Lifelong Health and Ageing at UCL, London WC1E 7HB, UK.,CLOSER, Department of Social Science, UCL Institute of Education, London WC1H 0AL, UK
| | - Rachel Cooper
- Musculoskeletal Science and Sports Medicine Research Centre, Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester M15 6BH, UK
| | - Chris Power
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK
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15
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Greaney ML, Cohen SA, Xu F, Ward-Ritacco CL, Riebe D. Healthcare provider counselling for weight management behaviours among adults with overweight or obesity: a cross-sectional analysis of National Health and Nutrition Examination Survey, 2011-2018. BMJ Open 2020; 10:e039295. [PMID: 33234635 PMCID: PMC7684803 DOI: 10.1136/bmjopen-2020-039295] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To determine if adults with overweight or obesity received counselling from their healthcare providers (HCPs) to lose weight and/or adopt healthful behaviours associated with weight loss, and whether they took action on their HCPs' recommendations. DESIGN Cross-sectional analysis of 2011-2018 National Health and Nutrition Examination Survey (NHANES) data. SAMPLE NHANES respondents aged 18+ who were overweight/obese and had seen an HCP in the previous 12 months (n=13 158). METHODS Respondents reported if their HCPs recommended they control/lose weight, increase exercise/physical activity (PA) and/or reduce fat/calorie intake, and if they adopted the offered recommendation(s). Weighted logistic regression models examined receipt of HCP counselling by sex, age, race/ethnicity, and weight status accounting for demographic characteristics and complex sampling. Similar analyses examined reported adoption of HCPs' recommendations. RESULTS The sample was 53.1% women, 45.0% were overweight and 55.0% had obesity. In total, 40.4% received counselling to control/lose weight, 49.5% to increase exercise/PA and 38.9% to reduce fat/calorie intake. The following groups were less likely (p<0.001) to receive counselling: men; younger adults (aged 18-39) versus middle-aged (aged 40-64) and older adults (aged 65+); White versus Black and Hispanic respondents; overweight respondents versus respondents with obesity. Approximately half of those advised to make changes reported doing so (53.6% controlled/lost weight, 57.3% increased exercise/PA, 51.8% reduced fat/calorie intake). Differences in the adoption of recommendations were identified by sex, age group, race/ethnicity and weight status (all p<0.05); women, middle-aged and older adults, Black and Hispanic respondents and individuals with obesity were more likely to adopt one or more recommendations. CONCLUSION Most respondents did not receive HCP counselling, and approximately half of those who received counselling reported taking action. HCPs may need training to provide counselling and to offer recommendations tailored to the social contexts of populations less likely to adopt weight control related recommendations.
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Affiliation(s)
- Mary L Greaney
- Department of Health Studies, University of Rhode Island, Kingston, Rhode Island, USA
| | - Steven A Cohen
- Department of Health Studies, University of Rhode Island, Kingston, Rhode Island, USA
| | - Furong Xu
- Kinesiology Department, University of Rhode Island, Kingston, Rhode Island, USA
| | | | - Deborah Riebe
- Kinesiology Department, University of Rhode Island, Kingston, Rhode Island, USA
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16
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Sanchez-Sanchez JL, Izquierdo M, Carnicero-Carreño JA, García-García FJ, Rodríguez-Mañas L. Physical activity trajectories, mortality, hospitalization, and disability in the Toledo Study of Healthy Aging. J Cachexia Sarcopenia Muscle 2020; 11:1007-1017. [PMID: 32163233 PMCID: PMC7432572 DOI: 10.1002/jcsm.12566] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/03/2019] [Accepted: 02/09/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Physical activity (PA) is a recognized contributor to healthy aging. However, the majority of studies exploring its associations with adverse outcomes in cohorts of older adults use single-time PA estimates, which do not consider its dynamic nature. The aim of the present study is to explore the presence of different PA trajectories in the Toledo Study of Healthy Aging and their association with adverse outcomes. Our hypothesis is that prospectively maintaining or increasing PA is associated with a reduced risk of adverse outcomes. METHODS We used data from 1679 participants enrolled in the Toledo Study of Healthy Aging. Trajectories based on the Physical Activity Scale for the Elderly were identified using group-based trajectory modelling. Cox and logistic regression were used to investigate associations between PA trajectories and mortality and hospitalization, and incident and worsening disability, respectively. Mortality was ascertained by linkage to the Spanish National Death Index; disability was evaluated through the Katz Index; and hospitalization was defined as the first admission to Toledo Hospital. Models were adjusted by age, sex, smoking, Charlson Index, education, cognitive impairment, polypharmacy, and Katz Index at Wave 2. RESULTS We found four PA-decreasing and one PA-increasing trajectories: high PA-consistent (n = 566), moderate PA-mildly decreasing (n = 392), low PA-increasing (n = 237), moderate PA-consistent (n = 191), and low PA-decreasing (n = 293). Belonging to the high PA-consistent trajectory group was associated with reduced risks of mortality as compared with the low PA-decreasing group [hazard ratio (HR) 1.68; 95% confidence interval (CI) = 1.21-2.31] and hospitalization compared with the low PA-increasing and low PA-decreasing trajectory groups (HR 1.24; 95% CI = 1.004-1.54 and HR 1.25; 95% CI = 1.01-1.55, respectively) and with lower rates of incident [odds ratio (OR) 3.14; 95% CI = 1.59-6.19] and worsening disability (OR 2.16; 95% CI = 1.35-3.45) in relation to the low PA-decreasing trajectory group and at follow-up. Increasing PA during late life (low PA-increasing group) was associated with lower incident disability rates (OR 0.38; 95% CI = 0.19-0.82) compared with decreasing PA (low PA-decreasing group), despite similar baseline PA. CONCLUSIONS Our results suggest that sustaining higher PA levels during aging might lead to healthy aging, characterized by a reduction in adverse outcomes. Our study supports the need for enhancing PA participation among older populations, with the goal of reducing personal and economic burden in a worldwide aging population.
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Affiliation(s)
- Juan Luis Sanchez-Sanchez
- Navarrabiomed, Complejo Hospitalario de Navarra-Universidad Pública de Navarra, IDISNA, Pamplona, Navarra, Spain
| | - Mikel Izquierdo
- Navarrabiomed, Complejo Hospitalario de Navarra-Universidad Pública de Navarra, IDISNA, Pamplona, Navarra, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose Antonio Carnicero-Carreño
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.,Biomedical Research Foundation, Getafe University Hospital, Getafe, Spain
| | - Fransico José García-García
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.,Geriatrics Department, Virgen Del Valle Hospital, Toledo, Spain
| | - Leocadio Rodríguez-Mañas
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.,Geriatrics Department, Getafe University Hospital, Ctra. de Toledo, Getafe, Spain
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17
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Gil-Salcedo A, Dugravot A, Fayosse A, Dumurgier J, Bouillon K, Schnitzler A, Kivimäki M, Singh-Manoux A, Sabia S. Healthy behaviors at age 50 years and frailty at older ages in a 20-year follow-up of the UK Whitehall II cohort: A longitudinal study. PLoS Med 2020; 17:e1003147. [PMID: 32628661 PMCID: PMC7337284 DOI: 10.1371/journal.pmed.1003147] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 06/11/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Frailty is associated with increased risk of various health conditions, disability, and death. Health behaviors are thought to be a potential target for frailty prevention, but the evidence from previous studies is based on older populations with short follow-ups, making results susceptible to reverse causation bias. We examined the associations of healthy behaviors at age 50, singly and in combination, as well as 10-year change in the number of healthy behaviors over midlife with future risk of frailty. METHODS AND FINDINGS In this prospective cohort study of 6,357 (29.2% women; 91.7% white) participants from the British Whitehall II cohort, healthy behaviors-nonsmoking, moderate alcohol consumption, ≥2.5 hours per week of moderate to vigorous physical activity, and consumption of fruits or vegetables at least twice a day-were measured at age 50, and change in behaviors was measured between 1985 (mean age = 44.4) and 1997 (mean age = 54.8). Fried's frailty phenotype was assessed in clinical examinations in 2002, 2007, 2012, and 2015. Participants were classified as frail if they had ≥3 of the following criteria: slow walking speed, low grip strength, weight loss, exhaustion, and low physical activity. An illness-death model accounting for both competing risk of death and interval censoring was used to examine the association between healthy behaviors and risk of frailty. Over an average follow-up of 20.4 years (standard deviation, 5.9), 445 participants developed frailty. Each healthy behavior at age 50 was associated with lower risk of incident frailty: hazard ratio (HR) after adjustment for other health behaviors and baseline characteristics 0.56 (95% confidence interval [CI] 0.44-0.71; p < 0.001) in nonsmokers, 0.73 (95% CI 0.61-0.88; p < 0.001) for moderate alcohol consumption, 0.66 (95% CI 0.54-0.81; p < 0.001) for ≥2.5 hours of physical activity per week, and 0.76 (95% CI 0.59-0.98; p = 0.03) for consumption of fruits or vegetables at least twice a day. A greater number of healthy behaviors was associated with reduced risk of frailty, with the HR for each additional healthy behavior being 0.69 (95% CI 0.62-0.76; p < 0.001) and the HR for having all versus no healthy behaviors at age 50 being 0.28 (95% CI 0.15-0.52; p < 0.001). Among participants with no or 1 healthy behavior in 1985, those who increased the number of healthy behaviors by 1997 were at a lower risk of frailty (mean follow-up = 16 years) compared with those with no such increase: the HR was 0.64 (95% CI 0.44-0.94; p = 0.02) for change to 2 healthy behaviors and 0.57 (95% CI 0.38-0.87; p < 0.001) for change to 3-4 healthy behaviors in 1997. The primary limitation of this study is potential selection bias during the follow-up due to missing data on frailty components. CONCLUSIONS Our findings suggest that healthy behaviors at age 50, as well as improvements in behaviors over midlife, are associated with a lower risk of frailty later in life. Their benefit accumulates so that risk of frailty decreases with greater number of healthy behaviors. These results suggest that healthy behaviors in midlife are a good target for frailty prevention.
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Affiliation(s)
- Andres Gil-Salcedo
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, France
| | - Aline Dugravot
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, France
| | - Aurore Fayosse
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, France
| | - Julien Dumurgier
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, France
| | - Kim Bouillon
- Département d’Information Médicale, Centre Hospitalier de Saint-Brieuc, Saint-Brieuc, France
| | - Alexis Schnitzler
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, France
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
- Helsinki Institute of Life Sciences, University of Helsinki, Helsinki, Finland
| | - Archana Singh-Manoux
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, France
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Séverine Sabia
- Université de Paris, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, France
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
- * E-mail:
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18
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Fittipaldi EODS, Dornelas de Andrade A, Santos ACO, Campos SL, Souza HCMD, Fernandes J, Catanho MTJDA. Cardiorespiratory Performance and Acute Effect of High-intensity Exercise on Lipid Profile in Hypertensive Sedentary Older Adults with and without Diabetes Mellitus. Arch Gerontol Geriatr 2020; 89:104061. [PMID: 32325307 DOI: 10.1016/j.archger.2020.104061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/20/2020] [Accepted: 03/28/2020] [Indexed: 12/29/2022]
Abstract
PURPOSE The aim of this study was to verify if the association of hypertension and diabetes mellitus could lead to the differences on cardiorespiratory fitness and lipid profile in older adults. METHODS 40 older adults were divided into two groups: Hypertensive (HTN) and Hypertensive-diabetic (HTN + T2DM). Maximum exercise test on a treadmill was conducted. Lipid profiles assessment was conducted before and after exercise. The cardiorespiratory fitness (CRF) variables were peak oxygen consumption (VO2peak), time to reach peak oxygen consumption (TVO2peak), carbon dioxide ventilatory equivalent (VE/VCO2) and carbon dioxide production (VCO2). To test intergroup and intragroup analyses independent and paired t-tests were used before and after acute exercise. Multiple linear regression was performed to test the influence of coexistence of HTN and T2DM on CRF. RESULTS CRF measures such as VO2peak (β = -3.90), VCO2 (β = -3.87) and TVO2peak (β= -115.79) were significantly (p-value <0.01) lower in HTN + T2DM group. After acute exercise, there was an increase in the levels of lipid profile variables, however without differences between groups. CONCLUSION HTN + T2DM older adults had poorer CRF. Acute changes in lipemia were similar in both groups.
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Affiliation(s)
| | | | | | - Shirley Lima Campos
- Postgraduate Program of Physiotherapy, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Helga Cecília Muniz de Souza
- Laboratory of Cardiopulmonary Physiotherapy, Department of Physiotherapy, Universidade Federal de Pernambuco, Recife, Brazil
| | - Juliana Fernandes
- Laboratory of Cardiopulmonary Physiotherapy, Department of Physiotherapy, Universidade Federal de Pernambuco, Recife, Brazil
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19
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Urtamo A, Jyväkorpi SK, Kautiainen H, Pitkälä KH, Strandberg TE. Major cardiovascular disease (CVD) risk factors in midlife and extreme longevity. Aging Clin Exp Res 2020; 32:299-304. [PMID: 31612429 PMCID: PMC7033063 DOI: 10.1007/s40520-019-01364-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 09/21/2019] [Indexed: 12/19/2022]
Abstract
Background The studies on the association of various midlife risk factors with reaching 90 years or more are scarce. We studied this association in a socioeconomically homogenous cohort of businessmen. Methods The study consists of men (n = 970) from the Helsinki Businessmen Study cohort (born 1919–1928). Five major cardiovascular disease (CVD) risk factors (smoking, BMI, blood pressure, serum lipids, fasting glucose), consumption of alcohol and coffee, self-rated health and self-rated fitness, were assessed in 1974, at an average age of 50 years. The number of major risk factors was tested as a risk burden. The Charlson Comorbidity Index and the RAND-36 (SF-36) Physical and Mental health summary scores were calculated from surveys in year 2000, at age of 73 years. Mortality dates were retrieved through 31 March 2018 from the Population Information System of Finland. Results 244 men survived to the age of 90 representing 25.2% of the study cohort. The survivors had less risk factor burden in midlife, and less morbidity and higher physical health summary score in 2000. Of those with five major risk factors only 7% survived up to 90 years, whereas 51% of those without any risk factors reached that age. Single risk factors reducing odds of reaching 90 years were smoking (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.34–0.67), glucose (0.66, 0.49–0.88), BMI (0.63, 0.46–0.86), and cholesterol (0.71, 0.53–0.96). Conclusion Lack of five major CVD risk factors in midlife strongly increased odds of reaching 90 years of age and also predicted factors related to successful ageing in late life.
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Affiliation(s)
- Annele Urtamo
- Department of General Practice and Primary Health Care, Helsinki University Central Hospital, Unit of Primary Health Care, University of Helsinki, Helsinki, Finland.
| | - Satu K Jyväkorpi
- Department of General Practice and Primary Health Care, Helsinki University Central Hospital, Unit of Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, Helsinki University Central Hospital, Unit of Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Kaisu H Pitkälä
- Department of General Practice and Primary Health Care, Helsinki University Central Hospital, Unit of Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Timo E Strandberg
- Clinicum, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
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20
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Ribeiro MCM, Sañudo A, Ramos LR. Leisure-time physical activity as a protective factor for functional capacity loss in community dwelling elders. REVISTA BRASILEIRA DE CIÊNCIAS DO ESPORTE 2020. [DOI: 10.1590/rbce.42.2019.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Populational aging led to the emergence of chronic diseases, all potentially incapacitating, thus affecting functional capacity (FC) of elders. Despite health evidences in favour of having regular physical activity, the majority of elders are not sufficiently active. Baseline data of an urban elder cohort in Brazil showed that only 28% were active and 68% had some functional loss, a figure that went up to 73% among the inactives. FC was associated with a network of sociodemographic, health and behavioral factors. In a multivariate analysis, the inactives showed twice the odds of being severely dependent when compared to the actives. Noteworthy that inactivity is as a modifiable factor that might prevent FC loss. Longitudinal studies are needed to verify.
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Rissanen I, Oura P, Paananen M, Miettunen J, Geerlings MI. Smoking trajectories and risk of stroke until age of 50 years - The Northern Finland Birth Cohort 1966. PLoS One 2019; 14:e0225909. [PMID: 31846462 PMCID: PMC6917292 DOI: 10.1371/journal.pone.0225909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 11/14/2019] [Indexed: 11/18/2022] Open
Abstract
Background Smoking is a well-known risk factor for stroke. However, the relationship between smoking trajectories during the life course and stroke is not known. Aims We aimed to study the association of smoking trajectories and smoked pack-years with risk of ischemic and haemorrhagic strokes in a population-based birth cohort followed up to 50 years of age. Methods Within the Northern Finland Birth Cohort 1966, 11,999 persons were followed from antenatal period to age 50 years. The smoking behaviour was assessed with postal questionnaires at ages 14, 31 and 46 years. Stroke diagnoses were collected from nationwide registers using unique study number linkage. The associations between smoking behaviour and stroke risk were estimated using Cox regression models. Results Six different patterns in smoking habits throughout the life course were found in trajectory modelling. During 542,140 person-years of follow-up, 352 (2.9%) persons had a stroke. Continuous smoking during the life course was associated with increased stroke risk (HR = 1.69; 95% CI 1.10–2.60) after adjusting for sex, educational level, family history of strokes, leisure-time physical activity, body mass index, alcohol consumption, hypertension, hypercholesterolemia, and diabetes. Per every smoked pack-year the stroke risk increased 1.04-fold (95% CI 1.03–1.06). Other smoking trajectories were not significantly associated with stroke risk, nor were starting or ending age of smoking. Conclusion Accumulation of smoking history is associated with increased risk of stroke until age of 50 years. The increased stroke risk does not depend on the age at which smoking started. Given that the majority starts smoking at young age, primary prevention of strokes should focus on adolescent smoking.
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Affiliation(s)
- Ina Rissanen
- Department of Neurology, Oulu University Hospital, Oulu, Finland
- Department of Neurosurgery, Oulu University Hospital, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
- * E-mail:
| | - Petteri Oura
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- The Center For Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Markus Paananen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- The Center For Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Jouko Miettunen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- The Center For Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Mirjam I. Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
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Amiri S, Behnezhad S. Smoking as a risk factor for physical impairment: a systematic review and meta-analysis of 18 cohort studies. J Addict Dis 2019; 38:19-32. [PMID: 31809656 DOI: 10.1080/10550887.2019.1690928] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Sohrab Amiri
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Prakash KC, Neupane S, Leino-Arjas P, Härmä M, von Bonsdorff MB, Rantanen T, von Bonsdorff ME, Hinrichs T, Seitsamo J, Ilmarinen J, Nygård CH. Trajectories of mobility limitations over 24 years and their characterization by shift work and leisure-time physical activity in midlife. Eur J Public Health 2019; 29:882-888. [PMID: 31008505 DOI: 10.1093/eurpub/ckz069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND We aimed to investigate trajectories of mobility limitations (MLs) over a period of 24 years. In addition, we aimed to study how shift work and leisure-time physical activity (LTPA) in midlife predict assignment to MLs trajectories separately for those retired on statutory pensions (SPs) and on disability pensions (DPs). METHODS Subjects who responded MLs questionnaires (1985-2009, N = 3048) in Finnish Longitudinal Study on Aging Municipal Employees were included in this prospective cohort study. LTPA and shift work were measured during baseline. International Classification of Functioning was used to code MLs. Growth mixture modeling was used to identify the trajectories of MLs. Odds ratio (OR) and their 95% Confidence interval (CI) were assessed by using multinomial logistic regression. RESULTS We identified four trajectories of MLs, namely low persistent, low increasing, high decreasing and high persistent. Among the SP recipients, shift work with night shifts was associated with an increased risk (adjusted OR 1.49; 95% CI 1.03-2.14) of belonging to the high persistent MLs trajectory. The inactive LTPA (SP: OR 5.99, 95% CI 3.39-10.58, DP: OR 6.81, 95% CI 2.52-18.43) was similarly associated with high persistent MLs trajectory. CONCLUSION Nearly two-thirds of the people retired due to disability belonged to high MLs trajectory. High persistent MLs trajectory was associated with physical inactivity in midlife among those retired on SP and on DP. Shift work with night shift predicted high persistent MLs in SP strata. Active involvement in LTPA during midlife could be beneficial to spend MLs free later life.
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Affiliation(s)
- K C Prakash
- Department of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Gerontology Research Center, Tampere University, Tampere, Finland
| | - Subas Neupane
- Department of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Gerontology Research Center, Tampere University, Tampere, Finland
| | | | - Mikko Härmä
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mikaela B von Bonsdorff
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Taina Rantanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Monika E von Bonsdorff
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Folkhälsan Research Center, Helsinki, Finland
- School of Management, Kokkola University Consortium Chydenius, University of Vaasa, Kokkola, Finland
| | - Timo Hinrichs
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Jorma Seitsamo
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Clas-Håkan Nygård
- Department of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Gerontology Research Center, Tampere University, Tampere, Finland
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Nutrient Intakes from Meals and Snacks Differ with Age in Middle-Aged and Older Americans. Nutrients 2019; 11:nu11061301. [PMID: 31181765 PMCID: PMC6627320 DOI: 10.3390/nu11061301] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 05/30/2019] [Accepted: 06/06/2019] [Indexed: 12/13/2022] Open
Abstract
The present study investigated the meal patterns across demographic characteristics in middle-aged and older US adults. Study participants were noninstitutionalized participants from the 2005–2016 National Health and Nutrition Examination Survey, an observational cross-sectional study. Data from 17,361 adults were categorized into 45–59 years (n = 7366), 60–70 years (n = 5348), and 71+ years (n = 4647) to compare demographics, nutrient intakes, and meal patterns. Dietary recalls were collected using the multiple-pass method. Data analyses were weighted to create a nationally representative sample. Two-thirds of adults reported consuming three meals on the day of intake. Lunch was the most often skipped meal across all age groups. A greater proportion of adults over 70 years reported consuming breakfast, while a smaller proportion reported consuming snacks. Significant differences were observed in total energy and nutrient intakes and proportion of the day’s intakes by meal. Grain, milk, and dairy food group intakes were highest at breakfast, while the protein food group intakes were highest at lunch and dinner. Age-related differences in meal consumption and composition provide valuable formative data to support targeted nutritional education and intervention opportunities to promote and encourage healthy food choices.
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Wahlich J, Orlu M, Mair A, Stegemann S, van Riet-Nales D. Age-Related Medicine. Pharmaceutics 2019; 11:E172. [PMID: 30970554 PMCID: PMC6523864 DOI: 10.3390/pharmaceutics11040172] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 04/02/2019] [Indexed: 12/12/2022] Open
Abstract
A meeting organised by the Academy of Pharmaceutical Sciences focussed on the challenges of developing medicines for older adults. International experts discussed the complexity introduced by polypharmacy and multiple morbidities and how the risk⁻benefit ratio of a medicine changes as an individual ages. The way in which regulatory authorities are encouraging the development of age-appropriate medicines was highlighted. Examples were provided of the difficulties faced by the older population with some medicinal products and suggestions given as to how the pharmaceutical scientist can build the requirements of the older population into their development of new medicines, as well as improvements to existing ones.
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Affiliation(s)
- John Wahlich
- Academy of Pharmaceutical Sciences, 4 Heydon Road, Great Chishill, Royston, Herts SG8 8SR, UK.
| | - Mine Orlu
- Department of Pharmaceutics, School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK.
| | - Alpana Mair
- Effective Prescribing and Therapeutics, Health and Social Care Directorate, Scottish Government, Edinburgh EH6 5NL, Scotland, UK.
| | - Sven Stegemann
- Institute of Process and Particle Engineering, Graz University of Technology, Inffeldgasse 13, 8010 Graz, Austria.
| | - Diana van Riet-Nales
- Medicines Evaluation Board in the Netherlands, Quality Department, Chemical Pharmaceutical Assessments, P.O. Box 8275, 3503 RG Utrecht, The Netherlands.
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The stability of health-related behaviour clustering during mid-adulthood and the influence of social circumstances on health-related behaviour change. Prev Med 2019; 121:141-148. [PMID: 30790608 DOI: 10.1016/j.ypmed.2019.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/21/2018] [Accepted: 02/08/2019] [Indexed: 11/21/2022]
Abstract
Evidence suggests that health-related behaviours (HRBs) cluster in mid-adulthood and are associated with social circumstances (i.e. economic circumstances, cultural norms, employment relations) at the same age. However, little is known about the level of stability in HRB cluster membership during mid-adulthood and how social circumstances in early mid-adulthood may influence movement between HRB clusters during mid-life. Data were taken from a British cohort born in 1958 (N = 12,784), to examine the stability of membership of three HRB clusters: 'Risky', 'Moderate Smokers' and 'Mainstream' (the latter pattern consisting of more beneficial HRBs such as not smoking, moderate alcohol consumption, being physically active), between ages 33 and 42. The relationship between social circumstances at age 33 and movement between HRB clusters during mid-adulthood was also examined. HRB cluster membership was relatively stable during mid-adulthood, over 60% of the participants remained in the same cluster at both ages. However, there was considerable probability of movement from the 'Risky' and 'Moderate Smokers' clusters at age 33 to the 'Mainstream' cluster at age 42. Members of the 'Risky' cluster had a lower probability of transitioning to the 'Mainstream' cluster (men = 17%, women = 9%, p < 0.001) in comparison to the 'Moderate Smokers' cluster (men = 26%, women = 27%, p < 0.001). Social circumstances at age 33 did not influence change in HRB cluster membership between ages 33 and 42 (p > 0.05). Movement from the 'Risky' and 'Moderate Smokers' cluster to the 'Mainstream' cluster during mid-adulthood highlights improvements for most HRBs. Person-centred interventions are required to prevent persistent negative HRBs amongst 'Risky' cluster members.
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Salin K, Kankaanpää A, Hirvensalo M, Lounassalo I, Yang X, Magnussen CG, Hutri-Kähönen N, Rovio S, Viikari J, Raitakari OT, Tammelin TH. Smoking and Physical Activity Trajectories from Childhood to Midlife. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E974. [PMID: 30889897 PMCID: PMC6466084 DOI: 10.3390/ijerph16060974] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/05/2019] [Accepted: 03/12/2019] [Indexed: 02/04/2023]
Abstract
Introduction: Despite substantial interest in the development of health behaviors, there is limited research that has examined the longitudinal relationship between physical activity (PA) and smoking trajectories from youth to adulthood in a Finnish population. This study aimed to identify trajectories of smoking and PA for males and females, and study the relationship between these trajectories from youth to adulthood. Methods: Latent profile analysis (LPA) was used to identify trajectories of smoking and PA separately for males and females among 3355 Finnish adults (52.1% females). Participants' smoking and PA were assessed five to eight times over a 31-year period (3⁻18 years old at the baseline, 34⁻49 years at last follow-up). Multinomial logistic regression analysis was used to study the relationship between the trajectories of smoking and PA. Results: Five smoking trajectories and four to five PA trajectories were identified for males and females. Of the PA trajectory groups, the persistently active group were least likely to follow the trajectories of regular smoking and the inactive and low active groups were least likely to follow non-smoking trajectory group. Likewise, inactive (women only) and low active groups were less likely to belong to the non-smokers group. Conclusions: The study suggests that those who are persistently active or increasingly active have substantially reduced probabilities of being in the highest-risk smoking categories.
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Affiliation(s)
- Kasper Salin
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland.
| | - Anna Kankaanpää
- LIKES Research Centre for Physical Activity and Health, 40014 Jyväskylä, Finland.
| | - Mirja Hirvensalo
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland.
| | - Irinja Lounassalo
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland.
| | - Xiaolin Yang
- LIKES Research Centre for Physical Activity and Health, 40014 Jyväskylä, Finland.
| | - Costan G Magnussen
- Department of Medicine and Division of Medicine, University of Turku and Turku University Hospital, 20500 Turku, Finland.
- Menzies Institute for Medical Research, University of Tasmania, 7005 Hobart, Australia.
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere and Tampere University Hospital, 33100 Tampere, Finland.
| | - Suvi Rovio
- Department of Medicine and Division of Medicine, University of Turku and Turku University Hospital, 20500 Turku, Finland.
| | - Jorma Viikari
- Department of Medicine and Division of Medicine, University of Turku and Turku University Hospital, 20500 Turku, Finland.
| | - Olli T Raitakari
- Department of Medicine and Division of Medicine, University of Turku and Turku University Hospital, 20500 Turku, Finland.
| | - Tuija H Tammelin
- LIKES Research Centre for Physical Activity and Health, 40014 Jyväskylä, Finland.
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Lounassalo I, Salin K, Kankaanpää A, Hirvensalo M, Palomäki S, Tolvanen A, Yang X, Tammelin TH. Distinct trajectories of physical activity and related factors during the life course in the general population: a systematic review. BMC Public Health 2019; 19:271. [PMID: 30841921 PMCID: PMC6404287 DOI: 10.1186/s12889-019-6513-y] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 02/04/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND In recent years, researchers have begun applying a trajectory approach to identify homogeneous subgroups of physical activity (PA) in heterogeneous populations. This study systematically reviewed the articles identifying longitudinal PA trajectory classes and the related factors (e.g., determinants, predictors, and outcomes) in the general population during different life phases. METHODS The included studies used finite mixture models for identifying trajectories of PA, exercise, or sport participation. Three electronic databases, PubMed (Medline), Web of Science, and CINAHL, were searched from the year 2000 to 13 February 2018. The study was conducted according to the PRISMA recommendations. RESULTS Twenty-seven articles were included and organized into three age group: youngest (eleven articles), middle (eight articles), and oldest (eight articles). The youngest group consisted mainly of youth, the middle group of adults and the oldest group of late middle-aged and older adults. Most commonly, three or four trajectory classes were reported. Several trajectories describing a decline in PA were reported, especially in the youngest group, whereas trajectories of consistently increasing PA were observed in the middle and oldest group. While the proportion of persistently physically inactive individuals increased with age, the proportion was relatively high at all ages. Generally, male gender, being Caucasian, non-smoking, having low television viewing time, higher socioeconomic status, no chronic illnesses, and family support for PA were associated either with persistent or increasing PA. CONCLUSIONS The reviewed articles identified various PA subgroups, indicating that finite mixture modeling can yield new information on the complexity of PA behavior compared to studying population mean PA level only. The studies also provided novel information how different factors relate to changes in PA during life course. The recognition of the PA subgroups and their determinants is important for the more precise targeting of PA promotion and PA interventions. TRIAL REGISTRATION PROSPERO registration number: CRD42018088120 .
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Affiliation(s)
- Irinja Lounassalo
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Kasper Salin
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Anna Kankaanpää
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Mirja Hirvensalo
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Sanna Palomäki
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Asko Tolvanen
- Methodology Center for Human Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Xiaolin Yang
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Tuija H. Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
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Pérez-Hernández B, Rubio-Valverde JR, Nusselder WJ, Mackenbach JP. Socioeconomic inequalities in disability in Europe: contribution of behavioral, work-related and living conditions. Eur J Public Health 2019; 29:640-647. [DOI: 10.1093/eurpub/ckz009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Previous studies have shown the existence of social inequalities in disability in many European countries. However, it is not clear what factors are associated with these inequalities. The aim of this study was to assess the contribution of behavioral factors, work-related factors and living conditions to educational inequalities in disability.
Methods
We pooled data from the seventh wave of the European Social Survey (2014) which included self-reported disability measured with the Global Activity Limitations Indicator for 19 European countries. We used multivariate logistic regression to determine the contributions of behavioral factors, work-related and living conditions to educational inequalities in disability among respondents aged 30–79.
Results
We found that adjusting simultaneously for three groups of determinants (behavioral, work-related and living conditions) reduces the greatest proportion of inequalities in disability in both men and women, in a range >70%. Each group of determinants contributes substantially to explain inequalities in disability.
Conclusions
Inequalities in disability are a major challenge for public health in most European countries. Our findings suggest that these inequalities can be reduced by diminishing inequalities in exposure to well-known health determinants.
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Affiliation(s)
- Bibiana Pérez-Hernández
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Wilma J Nusselder
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Johan P Mackenbach
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
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30
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Timmermans EJ, Huisman M, Kok AAL, Kunst AE. Smoking Cessation and 16-year Trajectories of Functional Limitations Among Dutch Older Adults: Results from the Longitudinal Aging Study Amsterdam. J Gerontol A Biol Sci Med Sci 2018; 73:1722-1728. [PMID: 29462269 DOI: 10.1093/gerona/gly009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Indexed: 11/13/2022] Open
Abstract
Background This study examined whether smoking cessation in middle age and old age is associated with following a successful trajectory of functional limitations over time in Dutch older adults. Methods We used 16-year longitudinal data from 645 participants of the Longitudinal Aging Study Amsterdam. Three types of trajectories regarding functional limitations over time were defined: successful (high initial level of functioning and limited decline), late decline (high initial level of functioning and late onset of decline), and early decline (lower initial level of functioning and early onset of decline). Smoking cessation status was self-reported and categorized into: early quitters (stopped in middle age [35-40 years]), late quitters (already smoked in middle age and stopped in old age [≥55 years]), and continued smokers (smoked in middle age and still smoking in old age). Multinomial Logistic Regression Analyses were used to assess the association between smoking cessation and trajectory membership. Results The sample (55-85 years at baseline) consisted of 20.3% early quitters, 22.9% late quitters, and 56.8% continued smokers. After adjustment for confounders, the model showed that late quitters were less likely to follow an early decline trajectory instead of a successful trajectory compared to continued smokers (odds ratio [OR] = 0.48, 95% confidence interval [CI] = 0.24-0.97). After adjustment for clinically relevant level of depressive symptoms, this association remained substantial but was no longer statistically significant (OR = 0.50, 95% CI = 0.24-1.02). Conclusions Although not statistically significant in the full model, the observed associations suggest that smoking cessation in old age may have an important impact on daily functioning in old age.
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Affiliation(s)
- Erik J Timmermans
- Academic Medical Center, University of Amsterdam, Department of Public Health, Amsterdam Public Health Research Institute, the Netherlands
| | - Martijn Huisman
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, the Netherlands.,Department of Sociology, Faculty of Social Sciences, VU University Amsterdam, the Netherlands
| | - Almar A L Kok
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, the Netherlands.,Department of Sociology, Faculty of Social Sciences, VU University Amsterdam, the Netherlands
| | - Anton E Kunst
- Academic Medical Center, University of Amsterdam, Department of Public Health, Amsterdam Public Health Research Institute, the Netherlands
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Aggio D, Papachristou E, Papacosta O, Lennon LT, Ash S, Whincup PH, Wannamethee SG, Jefferis BJ. Association Between 20-Year Trajectories of Nonoccupational Physical Activity From Midlife to Old Age and Biomarkers of Cardiovascular Disease: A 20-Year Longitudinal Study of British Men. Am J Epidemiol 2018; 187:2315-2323. [PMID: 30124747 PMCID: PMC6211233 DOI: 10.1093/aje/kwy157] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 01/31/2023] Open
Abstract
The trajectories of physical activity (PA) from midlife into old age and their associations with established and novel cardiovascular disease (CVD) risk factors in later life remain unclear. This study examined associations between 20-year nonoccupational PA trajectories and a range of CVD biomarkers at ages 60-79 years. We used data from a sample of 3,331 men (mean baseline age = 50.2 ± 5.8 years) recruited in 1978-1980, with follow-up after 12, 16, and 20 years, reporting habitual nonoccupational PA at each wave. At the 20-year follow-up, surviving men attended a physical examination and provided a fasting blood sample. Group-based trajectory modeling was used to identify trajectories. Adjusted regression analyses examined the association between trajectory-group membership and several cardiometabolic, cardiac, and inflammatory markers at follow-up. Three distinct 20-year trajectories were identified: low/decreasing (21.3%), light/stable (51.8%), and moderate/increasing (27.0%). Compared with the low/decreasing group, membership in the light/stable and moderate/increasing trajectory groups was associated with a more favorable cardiometabolic profile and lower levels of inflammation and endothelial dysfunction. Although following a moderate-increasing PA trajectory was most favorable, more modest but sustained doses of PA into old age may be sufficient to lower CVD risk.
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Affiliation(s)
- Daniel Aggio
- Department of Primary Care and Population Health, University College London, London, United Kingdom
- University College London Physical Activity Research Group, London, United Kingdom
| | - Efstathios Papachristou
- Department of Psychology and Human Development, University College London, London, United Kingdom
| | - Olia Papacosta
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Lucy T Lennon
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Sarah Ash
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Peter H Whincup
- Population Health Research Institute, St George’s University of London, London, United Kingdom
| | - S Goya Wannamethee
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Barbara J Jefferis
- Department of Primary Care and Population Health, University College London, London, United Kingdom
- University College London Physical Activity Research Group, London, United Kingdom
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32
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Shin CN, Lee YS, Belyea M. Physical activity, benefits, and barriers across the aging continuum. Appl Nurs Res 2018; 44:107-112. [PMID: 30389054 DOI: 10.1016/j.apnr.2018.10.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 09/24/2018] [Accepted: 10/14/2018] [Indexed: 01/29/2023]
Abstract
BACKGROUND A growing body of evidence indicates the importance of physical activity during midlife period linked to the likelihood of healthy aging, while the likelihood of an individual engaging in physical activity depends largely on their perceived benefits and barriers to being physically active. AIM This study was to examine physical activity levels of midlife Korean American adults and their perceived benefits and barriers to physical activity compared with young and older adults. METHODS We conducted a secondary analysis of data collected for a larger descriptive, cross-sectional study that was conducted with a sample of 517 Korean American adults in a Midwestern city. Data were collected using a survey questionnaire. RESULTS A little more than half of the sample were women (57.1%), with a mean age of 41.6 (± 13.4). The study sample met the current guidelines for physical activity far less than the general U.S. population (30.4% -34.6 vs. 51.7%). Less midlife adults met the guidelines for moderate-intensity physical activity than older adults (34.2% vs. 57.4%), while less midlife adults met the guidelines for vigorous-intensity physical activity than young adults (24.8% vs. 40.6%). Midlife adults perceived fewer benefits than did young and older adults. CONCLUSION The findings indicate that midlife adults are less likely to engage in physical activity and probably more at risk for unhealthy ageing than young and older adults. Understanding benefits and barriers of target population is the first step in developing culturally and age-appropriate intervention to promote physical activity.
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Affiliation(s)
- Cha-Nam Shin
- College of Nursing and Health Innovation, Arizona State University, United States of America.
| | - Young-Shin Lee
- School of Nursing, San Diego State University, United States of America.
| | - Michael Belyea
- College of Nursing and Health Innovation, Arizona State University, United States of America.
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Parsons TJ, Papachristou E, Atkins JL, Papacosta O, Ash S, Lennon LT, Whincup PH, Ramsay SE, Wannamethee SG. Healthier diet quality and dietary patterns are associated with lower risk of mobility limitation in older men. Eur J Nutr 2018; 58:2335-2343. [PMID: 30039434 PMCID: PMC6689276 DOI: 10.1007/s00394-018-1786-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 07/17/2018] [Indexed: 11/16/2022]
Abstract
Purpose To investigate associations between diet quality, dietary patterns and mobility limitation 15 years later in a population-based sample of older British men. Methods We used longitudinal data from 1234 men from the British Regional Heart Study, mean age 66 years at baseline. Mobility limitation was defined as difficulty going up- or downstairs or walking 400 yards as a result of a long-term health problem. Dietary intake was measured using a food frequency questionnaire data from which the Healthy Diet Indicator (HDI), the Elderly Dietary Index (EDI), and three a posteriori dietary patterns were derived. The a posteriori dietary patterns were identified using principal components analysis: (1) high fat/low fibre, (2) prudent and (3) high sugar. Results Men with greater adherence to the EDI or HDI were less likely to have mobility limitation at follow-up, top vs bottom category odds ratio for the EDI OR 0.50, 95% CI 0.34, 0.75, and for the HDI OR 0.55, 95% CI 0.35, 0.85, after adjusting for age, social class, region of residence, smoking, alcohol consumption and energy intake. Men with a higher score for the high-fat/low-fibre pattern at baseline were more likely to have mobility limitation at follow-up, top vs bottom quartile odds ratio OR 3.28 95% CI 2.05, 5.24. These associations were little changed by adjusting for BMI and physical activity. Conclusion Our study provides evidence that healthier eating patterns could contribute to prevention or delay of mobility limitation in older British men. Electronic supplementary material The online version of this article (10.1007/s00394-018-1786-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tessa J Parsons
- UCL Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London, NW3 2PF, UK.
| | - Efstathios Papachristou
- Psychology and Human Development, UCL Institute of Education, 25 Woburn Square, London, WC1H 0AA, UK
| | - Janice L Atkins
- Epidemiology and Public Health Group, Medical School, University of Exeter, RILD Building, Barrack Road, Exeter, EX2 5DW, UK
| | - Olia Papacosta
- UCL Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London, NW3 2PF, UK
| | - Sarah Ash
- UCL Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London, NW3 2PF, UK
| | - Lucy T Lennon
- UCL Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London, NW3 2PF, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Sheena E Ramsay
- Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne, NE2 4AX, UK
| | - S Goya Wannamethee
- UCL Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London, NW3 2PF, UK
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Zhang S, Tomata Y, Newson RB, Sugawara Y, Tsuji I. Combined healthy lifestyle behaviours and incident disability in an elderly population: the Ohsaki Cohort 2006 Study. J Epidemiol Community Health 2018; 72:679-684. [PMID: 29627784 DOI: 10.1136/jech-2018-210464] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/15/2018] [Accepted: 03/23/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND The joint impact of healthy lifestyle behaviours (HLBs) on incident disability among elderly populations is still uncertain. This cohort study was conducted to estimate the population-attributable fraction (PAF) of combined HLBs for disability reduction in elderly Japanese. METHODS We analysed 10-year follow-up data for 9910 community-dwelling elderly people (≥65 years) in a prospective cohort study. Information on lifestyle behaviours and food consumption was collected via a questionnaire in 2006. The exposure variable was defined as a healthy lifestyle index (HLI), which represented the summed number of HLBs ('never or former smoker', 'time spent walking ≥0.5 hour/day' and 'vegetable and fruit consumption volume ≥median'). Data on incident disability were retrieved from the public Long term Care Insurance database. HRs and 95% CIs were estimated by Cox proportional regression and the PAFs and their 95% CIs were estimated with the multivariate-adjusted model. RESULTS The 10-year incidence of disability was 35.7%. An inverse dose-response relationship was observed (HR (95% CI): 0.85(0.81 to 0.90) for each one-point increase of the HLI score, p-trend <0.001). Based on multivariate-adjustment, adherence to each one additional HLB gives PAF of 10.5%(95% CI 9.0% to 12.0%) for disability reduction. The PAF would have been 25.9%(14.2% to 36.0%) if all subjects had adhered to all three HLBs. CONCLUSION Combined HLBs may have a substantial impact on reducing the risk of incident disability among elderly people. Even having one more healthy lifestyle habit may bring considerable benefit.
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Affiliation(s)
- Shu Zhang
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
| | - Yasutake Tomata
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
| | - Roger B Newson
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Yumi Sugawara
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
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Abstract
Alongside declining activity levels, energy needs fall in older age and eating less is expected. However, as total food consumption declines, intakes of many nutrients are also likely to fall; while energy requirements may be met, other nutrient needs may not. Although this highlights the importance of nutrient-dense foods and overall diet quality in older age to ensure nutrient intakes are sufficient, maintaining or increasing diet quality may be difficult at a time when food access and preparation are becoming more challenging, and diets may be more monotonous. Poor nutrition, even in developed settings, is common. Older malnourished adults are more likely to have poorer health outcomes, longer hospital stays and increased mortality. Thus, apart from the evident personal costs, the economic burden of disease-related malnutrition is significant, and effective preventive strategies to promote good nutrition among older populations are needed. In particular, there is a need for wider recognition of malnutrition risk among older adults, including implementation of routine screening of nutritional status and early diagnosis. Design of future interventions to support older community-dwelling adults requires a clear understanding of the personal and contextual influences that affect patterns of food choice and consumption, including consideration of the importance of social and psychological factors. In addition, there are opportunities to intervene earlier in the lifecourse; the most effective preventive efforts to promote good nutrition in older age may need to start ahead of age-related changes in physiology and function, including younger adulthood and at the retirement transition.
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Rovio SP, Yang X, Kankaanpää A, Aalto V, Hirvensalo M, Telama R, Pahkala K, Hutri-Kähönen N, Viikari JSA, Raitakari OT, Tammelin TH. Longitudinal physical activity trajectories from childhood to adulthood and their determinants: The Young Finns Study. Scand J Med Sci Sports 2017; 28:1073-1083. [PMID: 28981988 DOI: 10.1111/sms.12988] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2017] [Indexed: 12/14/2022]
Abstract
Determining lifelong physical activity (PA) trajectories and their determinants is essential to promote a physically active lifestyle throughout the life-course. We aimed to identify PA trajectories from childhood to midlife and their determinants in a longitudinal population-based cohort. This study is a part of the Cardiovascular Risk in Young Finns Study. From 1980, a population-based cohort (N = 3596; 1764 boys/1832 girls, age 3-18 years) has been followed up for 31 years. PA indices were formed based on self-reported data (between age 9-49 years) on frequency, duration, and intensity of leisure (during childhood) or high-intensity (at later age) PA and on sports club participation/competitions. PA trajectories were analyzed using group-based trajectory modeling. Childhood (age 12 years), young adulthood (age 24 years), and early midlife (age 37 years) determinants were analyzed. Five PA trajectories were identified: persistently active (6.6%), decreasingly active (13.9%), increasingly active (13.5%), persistently low active (51.4%, reference group), persistently inactive (14.6%). In childhood, rural residential area (OR 0.45, 95% CI 0.21-0.96) and high academic performance (OR 2.18; 95% CI 1.58-3.00) associated with persistently active group. In early midlife, smoking (OR 1.66; 95% CI 1.07-2.58) associated with persistently inactive group, regular alcohol drinking (OR 2.91; 95% CI 1.12-7.55) with persistently active group and having children (OR 2.07; 95% CI 1.27-3.38) with decreasingly active group. High adulthood education associated with both decreasingly (OR 1.87; 95% CI 1.05-3.35) and increasingly (OR 2.09; 95% CI 1.19-3.68) active groups. We identified five PA trajectories from childhood into midlife. Most prominent determinants were academic achievement, education, having children and health habits (i.e. smoking/alcohol use).
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Affiliation(s)
- S P Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - X Yang
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - A Kankaanpää
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - V Aalto
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - M Hirvensalo
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - R Telama
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - K Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Health and Physical Activity, University of Turku, Turku, Finland
| | - N Hutri-Kähönen
- Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - J S A Viikari
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - O T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - T H Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
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Zhang Y, Duffy JF, De Castillero ER. Do sleep disturbances mediate the association between work-family conflict and depressive symptoms among nurses? A cross-sectional study. J Psychiatr Ment Health Nurs 2017; 24. [PMID: 28635074 PMCID: PMC5585039 DOI: 10.1111/jpm.12409] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT Nurses are at a high risk for work-family conflict due to long and irregular work hours and multiple physical and psychosocial stressors in their work environment. Nurses report higher rates of depressive symptoms than the general public, leading to a high rate of burnout, absenteeism, and turnover. Work-family conflict is associated with negative consequences in nurses including physical illnesses and mental disorders. WHAT THIS STUDY ADDS TO EXISTING KNOWLEDGE Past research on this topic has not examined the mechanisms for the effect of work family conflict on depression. Studies rarely examine the influence of health behaviors such as sleep in explaining this association. Our study identified significant association of sleep disturbances with both work-family conflict and depressive symptoms in nurses. Our main contribution is reporting the important role of sleep disturbances in translating the effect of work-family conflict on depressive symptoms among nurses. WHAT ARE THE IMPLICATIONS FOR PRACTICE Nurses need to receive training in best practices for maintaining their own sleep and mental health. Organizations should include sleep health education and training in workplace health programs. Evidence-based interventions to promote healthy sleep practices such as cognitive behavioral therapy and complementary and integrative approaches should be evaluated for their effectiveness in addressing the impact of work-family conflict on the mental health of nurses. Healthcare organizations should incorporate mental health services as part of their Employee Assistance Program for nurses and include psychological and sleep disorders screening, counseling, and follow-up. ABSTRACT Introduction Depression has been identified as the leading cause of disability worldwide. Nurses report higher rates of depression than the general public. Work-family conflict is challenging for nurses and may lead to depression and poor health. However, the mechanisms for the effect of work-family conflict on depression have not been well understood. Aim The objective is to use a cross-sectional design to examine the role of sleep disturbances in the association between work-family conflict and depressive symptoms in nurses. Methods Questionnaires, measuring working conditions, work-family conflict, sleep disturbances and depressive symptoms were collected from 397 nurses at a not-for-profit community hospital in the north-eastern United States. Results We observed a significant association between work-family conflict and depressive symptoms (β = 2.22, p < .001) among nurses. Sleep disturbances partially mediated this association by 40.54%. Discussion Sleep disturbances play an important role in translating work-family conflict into depressive symptoms. Implications Evidence-based interventions to promote healthy sleep practices should be evaluated for their effectiveness in addressing the impact of work-family conflict on mental health. Organizations should include sleep education and training as a component of workplace health promotion and employee assistance programmes to mitigate the effect of work-family conflict and promote overall health in nurses.
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Affiliation(s)
- Y Zhang
- Susan and Alan Solomont School of Nursing, University of Massachusetts Lowell, Lowell, MA, USA
| | - J F Duffy
- Division of Sleep and Circadian Disorders, Brigham Women's Hospital, Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
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Zhang Y, Punnett L, Nannini A. Work-Family Conflict, Sleep, and Mental Health of Nursing Assistants Working in Nursing Homes. Workplace Health Saf 2017; 65:295-303. [PMID: 27794076 PMCID: PMC8556705 DOI: 10.1177/2165079916665397] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Work-family conflict is challenging for workers and may lead to depression, anxiety, and overall poor health. Sleep plays an important role in the maintenance of mental health; however, the role of sleep in the association between work-family conflict and mental health is not well-studied. Questionnaires were collected from 650 nursing assistants in 15 nursing homes. Multivariate linear regression modeling demonstrated that increased work-family conflict was associated with lower mental health scores (β = -2.56, p < .01). More work-family conflict was correlated with more job demands, less job control, less social support, and longer work hours. Poor sleep quality, but not short sleep duration, mediated the association between work-family conflict and mental health. Workplace interventions to improve nursing assistants' mental health should increase their control over work schedules and responsibilities, provide support to meet their work and family needs, and address healthy sleep practices.
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Matsunaga T, Naito M, Wakai K, Ukawa S, Zhao W, Okabayashi S, Ando M, Kawamura T, Tamakoshi A. Leisure-time physical activity and risk of disability incidence: A 12-year prospective cohort study among young elderly of the same age at baseline. J Epidemiol 2017; 27:538-545. [PMID: 28606710 PMCID: PMC5608599 DOI: 10.1016/j.je.2016.11.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 11/16/2016] [Indexed: 11/28/2022] Open
Abstract
Background To clarify the role of physical activity in preventing disability in Japan, we investigated the association between amount of leisure-time physical activity and incidence of disability among the young elderly. Methods In the New Integrated Suburban Seniority Investigation (NISSIN) project conducted from 1996 to 2013, we followed 2888 community-dwelling adults aged 64–65 years with no history of cerebrovascular disease for a median follow-up of 11.6 years. Disabilities were defined as follows based on the classifications of the Japanese long-term care insurance system: 1) support or care levels (support levels 1–2 or care levels 1–5); 2) care levels 2–5; 3) support or care levels with dementia; and 4) care levels 2–5 or death. In addition, we also assessed 5) all-cause mortality. Results After controlling for sociodemographic, lifestyle, and medical factors, male participants reporting an activity level of 18.1 metabolic equivalent (MET)-hours/week (the median among those with activities) or more had 52% less risk of being classified as support or care levels with dementia compared with the no activity group (hazard ratio 0.48; 95% confidence interval, 0.25–0.94). No significant association was found among women between amount of leisure-time physical activity and incidence of disability. Conclusion We identified an inverse dose–response relationship between the amount of leisure-time physical activity and the risk of disability with dementia in men. Therefore, a higher level of physical activity should be recommended to young elderly men to prevent disability with dementia. We examined associations between physical activity and disability incidence. We quantified amount of leisure-time physical activity. A dose–response relationship was found for the risk of disability with dementia.
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Affiliation(s)
- Takashi Matsunaga
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Mariko Naito
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shigekazu Ukawa
- Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Wenjing Zhao
- Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | | | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | | | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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