Correlates of physical activity in a community sample of older adults in Appalachia

Assessment of muscle-strengthening exercise in public health surveillance for adults: A systematic review

There is strong scientific evidence that muscle-strengthening exercise (i.e. use of weight machines, push-ups, sit-ups) is independently associated with a reduced risk of multiple chronic diseases (e.g. diabetes, hypertension, cardiovascular disease). However, prevalence rates for meeting the muscle-strengthening exercise guideline (≥2 times/week) are significantly lower (~20%) than those reported to meet the aerobic physical activity guideline (e.g. walking, jogging, cycling) (~50%). It is therefore important to understand public health surveillance approaches to assess muscle-strengthening exercise. The aim of this review was to describe muscle-strengthening exercise assessment in public health surveillance. Informed by the PRISMA guidelines, an extensive keyword search was undertaken across 7 electronic data bases. We identified 86,672 possible articles and following screening (n = 1140 in full-text) against specific inclusion criteria (adults aged ≥18 years, English, studies containing <1000 participants), extracted data from 156 manuscripts. Fifty-eight different survey systems were identified across 17 countries. Muscle-strengthening exercise frequency (85.3%), duration (23.7%) and intensity (1.3%) were recorded. Muscle-strengthening exercise questions varied significantly, with some (11.5%) requiring a singular 'yes' vs 'no' response, while others (7.7%) sought specific details (e.g. muscle groups targeted). Assessments of duration and intensity were inconsistent. Very few studies measured the validity (0.6%) and reliability (1.3%) of muscle-strengthening exercise questions. Discrepancy exists within the current assessment systems/surveys used to assess muscle-strengthening exercise in public health surveillance. This is likely to impede efforts to identify at risk groups and trends within physical activity surveillance, and to accurately assess associations between muscle-strengthening exercise and health-related outcomes.

Effects of silent myocardial ischemia on functional fitness and physical independence in 60–79-year-old adults

Objective

Methods

Results

Conclusion

Differences in Physical Activity and Diet Patterns between Non-Rural and Rural Adults

Background: It is unclear how rural occupations and lifestyles may play a role in shaping physical activity and diet behaviors that contribute to the rural–urban obesity disparity. Methods: Data come from the prospective and observational South Dakota Rural Bone Health Study, which included adults aged 20–66 years in three groups: (1) non-rural non-Hutterite, (2) rural non-Hutterite, and (3) rural Hutterite. Physical activity data were collected using 7-day physical activity questionnaires, and hours per day in physical activity categories are reported. Diet data were collected using food frequency questionnaires, and food group servings per day (svg/day) are reported. Mixed models were generated to determine group differences in physical activity and diet outcomes, and marginal group means are presented. Results: Among females, both rural groups spent more time in moderate activity (4.8 ± 0.13 h/day and 4.7 ± 0.09 h/day vs. 3.5 ± 0.11 h/day, both p < 0.001) and vigorous activity (0.58 ± 0.03 h/day and 0.53 ± 0.02 h/day vs. 0.43 ± 0.03 h/day, both p < 0.01) and less time sitting (4.4 ± 0.13 h/day and 4.3 ± 0.09 h/day vs. 5.0 ± 0.11 h/day, both p < 0.001) on weekdays than non-rural groups. Hutterite females spent fewer hours in moderate activity (2.6 ± 0.08 h/day vs. 4.5 ± 0.11 h/day, p < 0.001) and vigorous activity (0.18 ± 0.02 h/day vs. 0.46 ± 0.02 h/day, p < 0.001) on weekend days compared to rural females. Hutterite females consumed more fruits (2.2 ± 0.06 svg/day vs. 1.7 ± 0.10 svg/day, p < 0.001) and vegetables (3.6 ± 0.08 svg/day vs. 2.7 ± 0.12 svg/day, p < 0.001) than rural females. Among males, both rural groups spent more time in moderate activity (4.9 ± 0.13 h/day and 6.1 ± 0.12 h/day vs. 3.0 ± 0.16 h/day, both p < 0.001) and less time sitting (4.1 ± 0.13 h/day and 3.4 ± 0.12 h/day vs. 6.0 ± 0.15 h/day, both p < 0.001) on weekdays compared to non-rural groups. Hutterite males spent less time in moderate activity (2.1 ± 0.10 h/day vs. 4.1 ± 0.11 h/day, p < 0.001) and vigorous activity (0.15 ± 0.04 h/day vs. 0.74 ± 0.04 h/day, p < 0.001) on weekend days compared to rural males. Hutterite males consumed more vegetables (3.0 ± 0.10 svg/day vs. 2.0 ± 0.11 svg/day, p < 0.001) than rural males. Conclusions: A rural occupation and lifestyle appear to contribute to differences in physical activity, while traditional rural lifestyle practices contribute to differences in diet.

Profile of energy expenditure in people with rheumatoid arthritis

BACKGROUND

No definitive conclusions have been made on the levels of physical activity in the rheumatoid arthritis (RA) population. Similarly no clear consensus has been reached on the correlates and predictors of physical activity in the population.

OBJECTIVE

To profile total energy expenditure (TEE), resting energy expenditure (REE) and physical activity related energy expenditure (PAEE) levels using a validated objective measurement tool and to determine demographic and health related factors which influence and predict TEE and PAEE levels in individuals with RA.

METHODS

Fifty nine (41 female, 18 male) individuals with RA were recruited to this cross sectional study. Energy expenditure was measured over seven days using SenseWear Armband. Correlational analysis and logistic regression were used to examine the relationship between demographic and health related factors and TEE, REE and PAEE.

RESULTS

A profile of energy expenditure in RA individuals was developed in terms of levels, differences between genders and differences between weekdays and weekend days. Median TEE, PAEE and REE were 2204.0, 409.5 and 1506.2 kcal/day respectively. Energy expenditure was associated with factors such as gender, age, body mass index, employment status, disease severity and smoking.

CONCLUSION

The findings add to the growing research assessing energy expenditure in the RA population and strengthen the position due to the use of an objective validated tool. Some recommendations on what factors are associated with energy expenditure in the RA population are made, thus unveiling ways to tailor physical activity type interventions in this group.

Environmental influences on physical activity in rural Midwestern adults: a qualitative approach

Qualitative research can be used to examine multiple factors associated with physical activity and help practitioners identify language used by the rural adult population when discussing this behavior. Three focus groups were conducted among 19 residents of multiple towns in a rural Midwestern county to examine the language and influences on rural physical activity. Focus group members were asked to define physical activity, exercise, community, and neighborhood. They were asked about the activities they engaged in and facilitators and barriers to those activities. A guidebook was developed to capture major themes and common patterns that emerged in the responses to the topics discussed. The data were reviewed for repeated statements and points that were agreed on by multiple participants. Important factors associated with physical activity include the importance of social support and modeling physical activity behavior. Also, the influence of pets and children was important for engaging these adults in physical activity. The focus group members engaged in walking and bicycling in their neighborhood streets and community trails, and desired to see community buildings be open to the public for exercise. This study revealed contextual issues and culturally relevant language for practitioners to use in tailoring physical activity measurement tools or designing interventions for a rural adult population. Social support (specifically, seeing others being active and using pets as motivators for being active) and policy attitudes may be targeted for interventions to increase physical activity in rural adults.

The prevalence and correlates of meeting the current physical activity for health guidelines in older people: a cross-sectional study in Brazilian women

This study aimed to identify the prevalence and correlates of meeting the current physical activity for health (PAfH) guidelines, proposed by the World Health Organization in 2010, in community-dwelling older women from Brazil. A cross-sectional study was performed with 1806 women (aged 60.0-92.7 years) who were randomly selected from eighteen care centers. The short version of the International Physical Activity Questionnaire was used to determine the weekly time spent in physical activities, and this variable was categorized into three categories (0<150min/wk; 1: 150-299.9min/wk; 2: ≥300min/wk). Age, race/ethnicity, economic class, education level, occupational and marital status, body mass index and blood pressure status, medical conditions, use of medications, and self-rated health status were the potential correlates. The ordinal logistic regression was used as a measure of association. From the total group of participants, 49.9% followed the current recommendations related to basic health benefits (150-299min/wk), and 35.9% met the guidelines for additional health effects (300 or more min/wk). Women with secondary complete education (OR=1.43, 95% confidence interval [CI]: 1.17-1.74), positive self-rated health (OR=5.25, 95% CI: 2.10-13.09), and high blood pressure (OR=1.33, 95% CI: 1.09-1.62) were more likely to meet the current PAfH guidelines than their peers with primary incomplete education, negative self-rated health, and normal blood pressure. Increasing age was inversely associated with meeting the PAfH guidelines (odds ranging: 0.77-0.48). These results highlighted the elderly population subgroups, in a developing country, that needspecific guidelinesfor inclusion inhealth programs andmotivation toparticipate in physical activities.

Physical activity patterns in older men and women in Germany: a cross-sectional study

Background

Data on physical activity in older adults in Germany is scarce. The aim of this study was to analyze physical activity patterns and to explore factors associated with physical activity in different domains, i.e. sporting activities (SA) and domestic activities (DA), in older men and women.

Methods

As part of the 7-year follow-up telephone interviews of the getABI cohort (community-dwelling older adults in Germany), the PRISCUS-PAQ was used to survey participants about their everyday physical activity patterns. Time per week (hh:mm) spent in SA and DA (heavy housework, gardening) was analyzed for men and women. Multivariate logistic regression analyses were performed in order to assess the odds of participating in SA and DA for at least 2.5 hours/week in association with sociodemographic factors, a broad range of physical health-related factors and interview date (season of the year).

Results

A total of 1,610 primary health care patients (51.6% women) with a median age of 77 (range 72-93) years were included in the analyses. Men engaged in SA more often than women (01:45 vs. 01:10), whereas women did more DA per week than men (04:00 vs. 03:00).

Being interviewed in spring or summer was associated with increased performance of DA in both sexes. Participation in these activities was reduced in more highly educated men and women. Living alone increased the odds of sports participation in women, but not in men. Most physical health-related factors were only selectively associated with either SA or DA, in men or women, respectively. The need for a walking aid was the only factor that consistently lowered the odds of being active in both activity domains and sexes.

Conclusions

This exploratory study delivers reliable and relevant data on the participation in and correlates of sporting and domestic activities of community-dwelling older adults for whom there had previously been only limited information at a population level in Germany. Findings are discussed and implications for epidemiological research and health promotion practice are provided.

Effects of the built environment on physical activity of adults living in rural settings

OBJECTIVE

To conduct a systematic review of the literature to examine the influence of the built environment (BE) on the physical activity (PA) of adults in rural settings.

DATA SOURCE

Key word searches of Academic Search Premier, PubMed, CINAHL, Web of Science, and Sport Discus were conducted.

STUDY INCLUSION AND EXCLUSION CRITERIA

Studies published prior to June 2008 were included if they assessed one or more elements of the BE, examined relationships between the BE and PA, and focused on rural locales. Studies only reporting descriptive statistics or assessing the reliability of measures were excluded.

DATA EXTRACTION

Objective(s), sample size, sampling technique, geographic location, and definition of rural were extracted from each study. Methods of assessment and outcomes were extracted from the quantitative literature, and overarching themes were identified from the qualitative literature.

DATA SYNTHESIS

Key characteristics and findings from the data are summarized in Tables 1 through 3.

RESULTS

Twenty studies met inclusion and exclusion criteria. Positive associations were found among pleasant aesthetics, trails, safety/crime, parks, and walkable destinations.

CONCLUSIONS

Research in this area is limited. Associations among elements of the BE and PA among adults appear to differ between rural and urban areas. Considerations for future studies include identifying parameters used to define rural, longitudinal research, and more diverse geographic sampling. Development and refinement of BE assessment tools specific to rural locations are also warranted.

Correlates of sport participation among community-dwelling elderly people in Germany: a cross-sectional study

The aims of this study were (1) to analyze the sport participation in a cohort of community-dwelling elderly people in Germany and (2) to evaluate associations between sport participation, sociodemographic factors, cardiovascular risk factors, and health status. In a monitored prospective cohort study (getABI), 6,880 unselected patients ≥65 years have been followed up by 344 general practitioners beginning in 2001. As part of the 5-year follow-up telephone interview, a sample of 1,376 participants was interviewed on sport participation. The association between participation in at least one sporting activity (“sporty” yes/no) during the past week (cycling) or month (other sports) and the following parameters was analyzed by logistic regression: age, sex, immigration background, education, waist circumference, smoking, self-reported health, history of vascular events, diabetes mellitus, lipometabolic disorder, and arterial hypertension. Analysis of activities (n = 1,304; median age 76 (70–94) years; 55.1% women) showed that 27.6% of participants rode a bicycle during the previous week. During the previous month, 24.9% of participants did gymnastics or strength training, and 16.5% swam. Of all participants, 53.8% were sporty. Multivariate analysis revealed several independent factors to be associated with being sporty (p < 0.05): younger age, male sex, higher education, nonsmoking, better self-reported health, and not being diagnosed with diabetes. Immigration background, waist circumference, history of vascular events, lipometabolic disorder, and hypertension did not show a statistically significant association (p ≥ 0.05) with sport participation. Summing up, the most frequently performed sporting activities were cycling, gymnastics or strength training, and swimming. Sport participation was associated with, for example, age and sex.

Extra-individual correlates of physical activity attainment in rural older adults

CONTEXT

Challenged with a higher incidence of disease, reduced social support, and less access to physical activity facilities and services, rural older adults may find healthy active living a challenge. Despite these challenges, some rural older adults manage to achieve active lifestyles.

PURPOSE

This study investigates the relative importance of 4 extra-individual correlates of physical activity to physical activity achievement in rural seniors.

METHODS

Data were drawn from mail questionnaires completed by 454 adults age 65 and over in 7 rural North Carolina counties.

FINDINGS

Results from an analysis of covariance indicate that respondents who approached CDC/ACSM recommended levels of physical activity were significantly more likely to report that they lived within walking distance to parks, perceived they had transportation to physical activity areas, had a partner with whom to be active, and felt activity facilities were safe. Next, 7 extra-individual correlates of physical activity were entered into a backward logistic regression. The resultant model predicting physical activity achievement among rural older adults included social support for physical activity, a safe environment for physical activity, and reported ability to walk to a local park.

CONCLUSIONS

Interventions designed to provide social support, heighten safety at activity areas and improve park infrastructure may provide opportunities to increase physical activity among seniors.

Perceived barriers to physical activity according to stage of change and body mass index in the west virginia wisewoman population

PURPOSE

Low-income Appalachian women aged 40-64 years are an understudied population relative to physical activity barriers. To inform a cardiovascular risk factor intervention targeting this population through the West Virginia WISEWOMAN program, we determined at baseline participants' perceptions about the presence of 6 barriers to physical activity and respective differences according to stage of readiness for change (SOC).

METHODS

Low-income women aged 40-64 who had participated in a state cancer screening program were recruited through 13 clinics. Participants were interviewed at clinics using a health risk/behavioral survey that included questions about barriers to and SOC for physical activity. Weight, height, and waist circumference were measured.

PRINCIPAL FINDINGS

Baseline screening was completed by 733 women; 84% were overweight (body mass index [BMI] 25-29.9 [24.1%]) or obese (BMI > or = 30 [59.8%]). The prevalence of barriers was greatest for lack of support (52.4%) and lack of willpower (50.8%); lack of time was reported by only 30.1%. On chi(2) test, significant differences were revealed across SOC for time (p = .026), don't need more physical activity (p = .003), and willpower (p < 001); and for time (p = .006) and don't need more (p < .000) across BMI categories. Time increased from precontemplation (21.1%) to maintenance (35%). Obese participants reported time less frequently (25.7%) than participants of normal weight (40.2%).

CONCLUSIONS

Lack of willpower and support-not time-seem to be the dominant physical activity barriers in the West Virginia WISEWOMAN population. Interventions targeting willpower in early SOC and in obese participants may be promising toward increasing physical activity.

Confusion and conflict in assessing the physical activity status of middle-aged men

BACKGROUND

Physical activity (including exercise) is prescribed for health and there are various recommendations that can be used to gauge physical activity status. The objective of the current study was to determine whether twelve commonly-used physical activity recommendations similarly classified middle-aged men as sufficiently active for general health.

METHODS AND FINDINGS

We examined the commonality in the classification of physical activity status between twelve variations of physical activity recommendations for general health in ninety men aged 45-64 years. Physical activity was assessed using synchronised accelerometry and heart rate. Using different guidelines but the same raw data, the proportion of men defined as active ranged from to 11% to 98% for individual recommendations (median 73%, IQR 30% to 87%). There was very poor absolute agreement between the recommendations, with an intraclass correlation coefficient (A,1) of 0.24 (95% CI, 0.15 to 0.34). Only 8% of men met all 12 recommendations and would therefore be unanimously classified as active and only one man failed to meet every recommendation and would therefore be unanimously classified as not sufficiently active. The wide variability in physical activity classification was explained by ostensibly subtle differences between the 12 recommendations for thresholds related to activity volume (time or energy), distribution (e.g., number of days of the week), moderate intensity cut-point (e.g., 3 vs. 4 metabolic equivalents or METs), and duration (including bout length).

CONCLUSIONS

Physical activity status varies enormously depending on the physical activity recommendation that is applied and even ostensibly small differences have a major impact. Approximately nine out of every ten men in the present study could be variably described as either active or not sufficiently active. Either the effective dose or prescription that underlies each physical activity recommendation is different or each recommendation is seeking the same prescriptive outcome but with variable success.

Everyday physical activity as a predictor of late-life mortality

PURPOSE

The present study hypothesized that simple, everyday physical activity (EPA) would decline with advancing age; that women would have a more favorable EPA profile than would men; and that EPA would have a survival benefit.

DESIGN AND METHODS

Community-dwelling participants (aged 80-98 years, n = 198) wore mechanical actigraphs in order for EPA to be assessed. Individuals were classified as active, inactive, and sedentary based on their level of EPA exhibited over a substantial part of the day. Survival status was available at approximately 2 years.

RESULTS

Mean EPA scores decreased with advancing age and, in contrast to men, women in their early eighties appeared to be protected from declining EPA. This partially supported the hypothesis that women would have a more favorable EPA profile. What is most important is that mean EPA scores predicted mortality. Moreover, when compared with their less sedentary counterparts, sedentary adults were more than three times as likely to be deceased 2 years later.

IMPLICATIONS

Researchers need to conduct new trials to determine whether or how physical activity is associated with mortality.