Physical activity and years of healthy life in older adults: results from the cardiovascular health study

A nomogram for predicting disability-free survival in older adults over 15 years: A population-based cohort study

BACKGROUND

This article aimed to develop and validate a simple-to-use nomogram to predict 15-year disability-free survival among older adults.

METHODS

A cohort of 1878 disability-free participants aged ≥60 was followed for 15 years. Participants were randomly divided into a training cohort for nomogram development (n = 1314 [70 %]) and validation cohort to confirm the model's performance (n = 564 [30 %]). Information on socio-demographic, lifestyle factors, the Life Satisfaction Index A (LSI-A), chronic diseases, and Mini-Mental State Examination (MMSE) score, and biomarkers were collected through interviews, clinical and neuropsychological examinations, and medical records. Disability-free survival was defined as survival in the absence of dementia and physical disability, and the composite endpoint is first occurrence of events of death, dementia and physical disability. We developed a nomogram summing the number of risk points corresponding to weighted covariates to predict disability-free survival. Validation of the nomogram using C statistic, calibration plots, and Kaplan-Meier curves.

RESULTS

In the multivariate-adjusted model, factors associated with composite end point were younger age, high MMSE (hazard ratio [HR], 0.93; [95 % CI, 0.87-0.99]), high LSI-A (0.78, [0.64-0.97]), non-smoking (0.74, [0.59-0.94]), engagement in physical leisure activity (0.62, [0.48-0.78]), and absence of chronic diseases (0.78, [0.66-0.91]). Incorporating these 6 factors, the nomogram achieved C-statistics of 0.78 (95 % CI, 0.75-0.81) and 0.77 (95 % CI, 0.74-0.80) in predicting disability-free survival in the training and validation cohorts, respectively, and had good calibration curves.

CONCLUSION

The nomogram was able to predict long-term of disability-free survival and performed well on internal validation, and may be considered for use in effective surveillance, promote, management of clinical and public health ageing.

Social participation, loneliness, and physical inactivity over time: evidence from SHARE

OBJECTIVES

We aimed to explore the reciprocal effects of social participation, loneliness, and physical inactivity over a period of 6 years in a representative sample of European adults over 50 years old.

DESIGN

A longitudinal study with a six-year follow-up period was conducted.

SETTING

Four waves of the Survey of Health, Ageing and Retirement in Europe project were used.

PARTICIPANTS

This study includes 64,887 participants from Europe and Israel, who were aged 50 or older at the first time.

MEASUREMENTS

The relationship between participation in social activities, loneliness and physical inactivity was analyzed, controlling for age, gender, and disability. A series of cross-lagged panel models (CLPMs) were applied to analyze the relationships among these variables.

RESULTS

A CLPM with equal autoregressive cross-lagged effects across waves was the best fit to the data (χ2 = 7137.8, CFI = .972, RMSEA = .049, SRMR = .036). The autoregressive effects for the three variables showed high stability across waves, and all the cross-lagged effects in the model were statistically significant. Social activity and physical inactivity maintained a strong negative cross-lagged effect, while their cross-lagged effects on loneliness were comparatively smaller. Social activity had a positive cross-lagged effect on loneliness, while physical inactivity had a negative cross-lagged effect on loneliness.

CONCLUSIONS

These findings highlight the importance of promoting physical activity and social participation and addressing loneliness through targeted interventions in older adults.

Positive impacts of leisure-time physical activity on cardiorespiratory fitness, co-morbidity level, cardiovascular health and quality of life among midlife adults: a cross-sectional study of a Nigerian population

BACKGROUND

Regular physical activity (PA) improves general health and quality of life (QoL) of the general population. It is however not known if leisure-time PA (LTPA) behaviour will reduce co-morbidity and adiposity, and improve cardiorespiratory fitness and QoL in midlife men. This study explored the impacts of regular LTPA behaviour on co-morbidity, adiposity, cardiorespiratory fitness and QoL among male midlife sports club members in a Nigerian population.

METHODS

This cross-sectional study involved 174 age-matched male midlife adults: 87 engaging in LTPA (LTPA group) and 87 not engaging in LTPA (non-LTPA group). Information on age, body mass index (BMI), waist circumference (WC), maximal oxygen uptake (VO₂max)_, resting heart rate (RHR), QoL and co-morbidity level was collected using standardized procedures. Data were summarized using mean and standard deviation, and explored using frequency and proportion. Independent t-test, Chi Square and Mann-Whitney U test were employed to determine the impacts of LTPA at 0.05 significance level.

RESULTS

The LTPA group had lower co-morbidity score (p = 0.05) and RHR (p = 0.004), and higher QoL (p = 0.01) and VO₂max (p = 0.003) than non-LTPA group. While heart disease (χ² = 10.99; p = 0.01) and hypertension (χ² = 15.24; p = 0.004) severity levels were associated with LTPA behaviour, hypertension (p = 0.01) was the only co-morbid condition that had a significantly lower score in the LTPA group than in the non-LTPA group.

CONCLUSIONS

Regular LTPA improves cardiovascular health, physical work capacity and QoL in the sample of Nigerian mid-life men. Regular LTPA behaviour is recommended for cardiovascular health promotion, and improved physical work capacity and life satisfaction in midlife men.

Time spent walking and disability-free survival in older Japanese: The Ohsaki Cohort 2006 Study

The extent to which long disability-free survival (DFS) time can be extended according to the amount of time spent walking has not been investigated. The aim of this study was to examine the association between time spent walking per day and DFS time in older adults. We conducted a cohort study of 14 342 disability-free individuals (aged ≥ 65 years) living in Ohsaki City, Japan. The amount of time spent walking per day (<0.5 h, 0.5-1 h, ≥1 h) by each individual in 2006 was assessed by a self-reported questionnaire. Data on 11-year incident functional disability were retrieved from the public Long-Term Care Insurance database. After estimating the multivariable-adjusted hazard ratios (HRs) of the composite outcome (incident functional disability or death), the multivariable-adjusted 50th percentile differences (50th PDs; difference in the period until the first 50% of the composite outcome occurred) were estimated according to time spent walking. Among 114 764 person-years, the composite outcome occurred in 7761 persons (67.6 per 1000 person-years). The HRs (95% confidence intervals) of the composite outcome were 1.00 (reference) for <0.5 h, 0.84 (0.79, 0.88) for 0.5-1 h, and 0.78 (0.74, 0.83) for ≥1 h (p-trend < 0.001). The 50th PDs (95% confidence intervals) of DFS time were 238 (155, 322) days longer for 0.5-1 h and 360 (265, 454) days longer for ≥1 h, in comparison with <0.5 h. The results suggest that longer time spent walking per day contributes to longer DFS time.

The Nordic prudent diet prolongs survival with good mental and physical functioning among older adults: The role of healthy lifestyle

BACKGROUND & AIMS

Healthy diet has been associated with decreased mortality, but its impact on survival without disability is less clear. We aimed to investigate the association between the Nordic Prudent Diet Pattern (NPDP) and dementia- and disability-free survival, and to assess its interaction with other healthy lifestyle behaviors.

METHODS

Within the Swedish National Study on Aging and Care-Kungsholmen, 2290 dementia- and disability-free adults aged ≥60 were followed up to 12 years to detect survival free from dementia (standard criteria) and disability (Katz's Activities of Daily Living). NPDP index was assessed at baseline with a 98-item food frequency questionnaire (characterized mainly by more frequent intakes of vegetable, fruit, cooking, cereals, whole grains, fish, and water) and was further categorized into tertiles (low, moderate, or high). Information on lifestyle factors was collected via baseline questionnaire. A favorable (vs unfavorable) lifestyle profile was determined based on smoking status, social network and physical activity. Data were analyzed using Cox proportional hazard regression models and Laplace regression.

RESULTS

During the follow-up, 1074 participants survived without dementia and disability (614 died, 518 became disabled, and 84 developed dementia). Compared to low NPDP adherence, the hazard ratio (HR) of high NPDP adherence was 1.19 (95% CI 1.04-1.34) for dementia- and disability-free survival. High NPDP adherence prolonged lifespan without mental and physical disability by an average of 1.24 years (95% CI 0.11-2.37). Further, among participants with high NPDP adherence, a favorable lifestyle profile was associated with an even higher HR (1.96, 95% CI 1.52-2.42) of dementia- and disability-free survival, corresponding to an average of 3.80 (95% CI 2.25-5.35) years longer life compared to those with low NPDP adherence and an unfavorable lifestyle profile.

CONCLUSION

High adherence to NPDP prolongs survival with good mental and physical function for more than one year, and this could increase to almost four years with a favorable lifestyle.

Transitions in frailty phenotype states and components over 8 years: Evidence from The Irish Longitudinal Study on Ageing

AIM

Fried's frailty phenotype (FP) is defined by exhaustion (EX), unexplained weight loss (WL), weakness (WK), slowness (SL) and low physical activity (LA). Three or more components define the frail state, and one or two the prefrail. We described longitudinal transitions of FP states and components in The Irish Longitudinal Study on Ageing (TILDA).

METHODS

We included participants aged ≥50 years with FP information at TILDA wave 1 (2010), who were followed-up over four longitudinal waves (2012, 2014, 2016, 2018). Next-wave transition probabilities were estimated with multi-state Markov models.

RESULTS

5683 wave 1 participants were included (2612 men and 3071 women; mean age 63.1 years). Probabilities from non-frail to prefrail, and non-frail to frail were 27% and 2%, respectively. Prefrail had a 32% probability of reversal to non-frail, and a 10% risk of progression to frail. Frail had an 18% probability of reversal to prefrail and 31% risk of death. Probabilities of transitioning from not having to having a component were: 17% for LA, 11% for SL, 9% for EX, 7% for WL and 6% for WK. Probabilities of having a FP component and dying were: 17% for WL, 15% for WK, 14% for SL, 13% for EX, and 10% for LA. Probabilities of having a component and recovering at the next wave were: 59% for WL, 58% for EX, 40% for WK, 35% for LA and 23% for SL.

CONCLUSIONS

FP states and components are characterized by dynamic longitudinal transitions. Opportunities exist for reducing the probability of adverse transitions.

Physical activity trajectories, mortality, hospitalization, and disability in the Toledo Study of Healthy Aging

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.

Physical activity, cardiovascular health and mood state in older adults

Many older adults eat poorly balanced diets and are physically inactive, posing a risk to their cardiovascular and mental health. The benefits of healthful living extend beyond cardiovascular health and disease risk reduction such that physical activity has been shown to positively affect mood state. This was a cross-sectional investigation completed at three senior lunch program sites in Charlotte, NC to assess the status and relationship of nutrition, physical activity patterns, and mood state in older adults, prior to the center offering a new nutritional and physical activity intervention. Some significant relationships between cardiovascular indicators and mood were found.

Change in physical activity and health-related quality of life in old age-A 10-year follow-up study

The aim of the study was to examine the association between change in leisure-time physical activity (LTPA) and change in health-related quality of life (HRQoL) and symptoms of depression during a 10-year follow-up. This prospective study included 1036 men and women (mean age at baseline = 61.2 years) from the Helsinki Birth Cohort Study. Leisure-time physical activity was measured with a questionnaire, HRQoL with SF36 and depression symptoms with Beck's depression inventory (BDI). The association between the change in LTPA and change in HRQoL and BDI were investigated with sex-stratified general linear models adjusted for age, smoking, educational attainment, comorbidity score, and baseline value of outcomes. One standard deviation (SD) increase in LTPA was associated with increase in physical summary component of HRQoL in women (B = 0.7 unit, 95% CI = 0.1-1.3, P = 0.032) and in men (B = 0.8 unit, 95% CI = 0.2-1.5, P = 0.014). In women, the 1SD increase in LTPA was also associated with an increase in mental summary component score (B = 1.0, 95% CI = 0.3-1.7, P = 0.005) and a reduction in depressive symptoms (B = -0.7, 95% CI = -1.1 to -0.2, P = 0.003). In conclusion, increase in the volume of LTPA over a 10-year period in late adulthood was associated with improved HRQoL in both men and women, and also diminished depressive symptoms in women. The findings support the promotion of physical activity in later years to enhance HRQoL and mental well-being.

Exceptional Human Longevity

Exceptional longevity represents an extreme phenotype. Current centenarians are survivors of a cohort who display delayed onset of age-related diseases and/or resistance to otherwise lethal illnesses occurring earlier in life. Characteristics of aging are heterogeneous, even among long-lived individuals. Associations between specific clinical or genetic biomarkers exist, but there is unlikely to be a single biomarker predictive of long life. Careful observations in the oldest old offer some empirical strategies that favor increased health span and life span, with implications for compression of disability, identification and implementation of lifestyle behaviors that promote independence, identification and measurement of more reliable markers associated with longevity, better guidance for appropriate health screenings, and promotion of anticipatory health discussions in the setting of more accurate prognostication. Comprehensive PubMed literature searches were performed, with an unbiased focus on mechanisms of longevity. Overall, the aggregate literature supports that the basis for exceptional longevity is multifactorial and involves disparate combinations of genes, environment, resiliency, and chance, all of which are influenced by culture and geography.

The Association Between Trajectories of Physical Activity and All-Cause and Cause-Specific Mortality

Background

The benefits of physical activity (PA) for health have primarily been evaluated during midlife. Whether patterns of change in late-life PA associate with overall and cause-specific mortality remains unclear.

Methods

We examined the association between PA trajectories and subsequent mortality among 3,767 men aged ≥65 years. Men self-reported PA using the Physical Activity Scale for the Elderly (PASE) at up to four time points from 2000 through 2009 (Year 7); mortality was assessed over an average of 7.1 years after the Year 7 contact. Group-based trajectory modeling identified patterns of PA change. Cox proportional hazards models described associations between patterns of change in PA, Year 7 PA, and subsequent mortality risk.

Results

Three discrete PA patterns were identified, all with declining PA. Compared to low-activity declining men, moderate (hazard ratio [HR] = 0.78; 95% confidence interval [CI]: 0.70, 0.88) and high-activity (HR = 0.69, 95% CI: 0.57, 0.83) declining groups were associated with lower risk of all-cause mortality. Among models with a single time point, the last time point (Year 7 PA score) was a strong predictor of mortality with HR = 0.85 (95% CI: 0.78, 0.93) per SD increase in PASE score. PA patterns were not a risk factor for mortality after adjustment for the Year 7 PA score.

Conclusions

Recent PA levels are a stronger indicator of subsequent mortality risk than PA patterns reported over the prior 7 years or prior PA level, suggesting that current PA rather than history of PA is the most relevant parameter in clinical settings.

Engaging Older Men in Physical Activity: Implications for Health Promotion Practice

According to Health Canada (2016), only about 11% of older men meet recommended guidelines for physical activity, and participation decreases as men age. This places men at considerable risk of poor health, including an array of chronic diseases. A demographic shift toward a greater population of less healthy older men would substantially challenge an already beleaguered health-care system. One strategy to alter this trajectory might be gender-sensitized community-based physical activity. Therefore, a qualitative study was conducted to enhance understanding of community-dwelling older men's day-to-day experiences with physical activity. Four men over age 65 participated in a semistructured interview, three walk-along interviews, and a photovoice project. An interpretive descriptive approach to data analysis was used to identify three key themes related to men's experiences with physical activity: (a) "The things I've always done," (b) "Out and About," and (c) "You do need the group atmosphere at times." This research extends the knowledge base around intersections among older men, physical activity, and masculinities. The findings provide a glimpse of the diversity of older men and the need for physical activity programs that are unique to individual preferences and capacities. The findings are not generalized to all men but the learnings from this research may be of value to those who design programs for older men in similar contexts. Future studies might address implementation with a larger sample of older men who reside in a broad range of geographic locations and of different ethnicities.

Physical Activity, Function, and Mortality in Advanced Age: A Longitudinal Follow-Up (LiLACS NZ)

The relationship between physical activity, function, and mortality is not established in advanced age. Physical activity, function, and mortality were followed in a cohort of Māori and non-Māori adults living in advanced age for a period of 6 years. Generalized linear regression models were used to analyze the association between physical activity and Nottingham Extended Activities of Daily Living scale, whereas Kaplan–Meier survival analysis and Cox proportional hazard models were used to assess the association between the physical activity and mortality. The hazard ratio for mortality for those in the least active physical activity quartile was 4.1 for Māori and 1.8 for non-Māori compared with the most active physical activity quartile. There was an inverse relationship between physical activity and mortality, with lower hazard ratios for mortality at all levels of physical activity. Higher levels of physical activity were associated with lower mortality and higher functional status in advanced-aged adults.

Prevalence of and factors associated with successful aging in Brazilian older adults: Frailty in Brazilian older people Study (FIBRA RJ)

AIM

We aimed to estimate the factors associated with the biomedical dimension of successful aging (SA) and its prevalence in older Brazilian individuals. The conceptual framework for this approach relies on the considerable variation in the biophysiological effects of aging and the need to understand the factors that influence this process.

METHODS

Data from a total of 845 older adults were analyzed. SA operationalization included the following criteria: good physical and cognitive performance, absence of disabilities, and good health conditions. Descriptive analyses were used to estimate the prevalence of SA, and the factors associated with SA were assessed using multivariate logistic regressions.

RESULTS

The overall prevalence of SA was 25%, and the associated factors were the absence of (OR 10.5, 95% CI 5.2-21.1) or fewer than two physical morbidities (OR,3.5, 95% CI 2.1-5.9), body mass index in the overweight range (OR 1.8, 95% CI 1.02-3.3), absence of depression (OR ,2.1, 95% CI 1.07 = 4.1), high levels of physical activity (OR 1.88, 95% CI 1.14-3.2), high levels of social participation (OR 2.07, 95% CI 1.16-3.4) and younger age (65-74 years, OR 4.27, 95% CI 1.79-10.1; 75-84 years, OR 2.7, 95% CI 1.18-6.41).

CONCLUSIONS

A small proportion of older adults met the criteria defining successful aging. Despite the great impact of biological determinants, modifiable social and lifestyle factors predicted successful aging in this population, suggesting that health promotion targeting behavioral changes might lead to tangible benefits for health and well-being in old age. Geriatr Gerontol Int 2018; 18: 1280-1285.

Physical activity level as a predictor of healthy and chronic disease-free life expectancy between ages 50 and 75

Background

physical activity promotes healthy aging. However, little is known about the relationship between physical activity levels and healthy and chronic disease-free life expectancy (LE). The study aim was to examine healthy and chronic disease-free LE between ages 50 and 75 and across various levels of physical activity by sex and different occupational statuses.

Methods

overall, 34,379 women (mean age 53.2 (SD 2.9) years) and 8,381 men (53.6 (SD 3.2) years) from the Finnish Public Sector study were categorized into five physical activity levels (inactive to vigorously active) according to self-reported physical activity and into three occupational statuses at the first observation point. Partial LE between ages 50 and 75 based on discrete-time multistate life table models was defined using two health indicators: healthy LE based on self-rated health and chronic disease-free LE based on chronic diseases. The average follow-up time for health indicators was 6.8 (SD 5.2) years.

Results

a clear dose-response relationship between higher physical activity levels and increased healthy and chronic disease-free LE in men and women, and within occupational statuses was found. On average, vigorously active men and women lived 6.3 years longer in good health and 2.9 years longer without chronic diseases between ages 50 and 75 compared to inactive individuals. The difference in years in good health between vigorously active and inactive individuals was the largest in individuals with low occupation status (6.7 years).

Conclusion

higher levels of physical activity increase healthy and chronic disease-free years similarly in men and women, but more among persons with low than with high occupational status.

Impact of habitual physical activity and type of exercise on physical performance across ages in community-living people

The maintenance of muscle function into late life protects against various negative health outcomes. The present study was undertaken to evaluate the impact of habitual physical activity and exercise types on physical performance across ages in community-living adults. The Longevity check-up 7+ (Lookup 7+) project is an ongoing cross-sectional survey conducted in unconventional settings (e.g., exhibitions, malls, and health promotion campaigns across Italy) that began on June 1st 2015. The project was designed to raise awareness in the general population on major lifestyle behaviors and risk factors for chronic diseases. Candidate participants are eligible for enrolment if they are at least 18 years of age and provide written informed consent. Physical performance is evaluated through the 5-repetition chair stand test. Analyses were conducted in 6,242 community-living adults enrolled between June 1st 2015 and June 30th 2017, after excluding 81 participants for missing values of the variables of interest. The mean age of the 6,242 participants was 54.4 years (standard deviation 15.2, range 18-98 years), and 3552 (57%) were women. The time to complete the chair stand test was similar from 18 to 40-44 years, and declined progressively across subsequent age groups. Overall, the performance on the chair stand test was better in physically active participants, who completed the test with a mean of 0.5 s less than sedentary enrollees (p < .001). After adjusting for potential confounders, a different distribution of physical performance across exercise intensities was observed, with better performance being recorded in participants engaged in more vigorous activities. Our findings suggest that regular physical activity modifies the age-related pattern of decline in physical performance, with greater benefits observed for more intensive activities. Efforts are needed from health authorities and healthcare providers to promote the large-scale adoption of an active lifestyle throughout the life course.

Self-reported Factors Associated with Engagement in Moderate to Vigorous Physical Activity among Elderly People: A Population-based Study

Background:

Physical activity (PA) typically decreases with aging, especially of moderate to vigorous level, and this change affects health outcomes of older adults. Age-related decline is not evenly distributed across elderly population and is attributed to psychosocial, physical, and environmental determinants.

Methods:

We selected a sample of 1000 elderly people from urban parts of Shiraz in Southern Iran with a two-stage random sampling procedure. Self-reported PA data and correlates of moderate to vigorous activity were collected by interview with the respondents from selected households. Bivariate associations were examined using Chi-square test. Log-binomial regression was used to weigh variables associated with more than light PA.

Results:

Some demographic variables (older age, female sex, lower education level, retirement, and single or widowed status), health problems (lower extremity pain and hypertension), and psychosocial factors (lack of motivation, fear of injury, unsafe roads, and daily life problems) were potential correlates of inadequate PA with bivariate analysis. In log-binomial regression model, lack of motivation (adjusted prevalence ratio [APR] = 2.11, 95% confidence interval [CI]: 1.25–3.56), daily life problems (APR = 1.82, 95% CI: 1.26–2.62), lower educational level (APR = 1.64, 95% CI: 1.08–2.49), unsafe roads (APR = 1.59, 95% CI: 1.02–2.49), and knee pain (APR = 1.68, 95% CI: 1.09–2.58) were associated with lower engagement in moderate to vigorous PA among Iranian older adults.

Conclusions:

Psychosocial attributes considerably influence PA behaviors in older adults. Lower extremity joint pain is a key medical concern. Interventions to promote PA among older adults should be multilevel and particularly targeting personal psychosocial factors.

Biological aging and physical fitness in men aged 20-70 years from Kraków, Poland

OBJECTIVES

The increasing problem of population aging requires appropriate economic and health-related measures to mitigate its negative effects. The aim was to categorize the biological age of men between 20 and 70 years of age and assess its relationship to their physical activity and fitness.

METHODS

Data included morphological variables, total body water, the results of five Eurofit motor tests and the percentage of maximum heart rate (HR%), during a cardiovascular test of more than 1,400 20-70 year-old men living in Kraków. Biological age was estimated with regression equations.

RESULTS

There were significant and consistent differences in physical fitness profiles between the three established groups of relations between biological and chronological age (biologically younger, equal, and older). These three categories of biological age were generally consistent with the regression analysis of physical fitness results, although declared physical activity seemed to be an independent factor.

CONCLUSIONS

The selected morphological variables represent a set of characteristics useful for the determination of the biological age. The existing relationship between physical activity and biological age indicates that physical activity may contribute to the inhibition of involutional changes, even if it had only been performed regularly in the past. Am. J. Hum. Biol. 28:503-509, 2016. © 2015 Wiley Periodicals, Inc.

Predicting Future Years of Life, Health, and Functional Ability: A Healthy Life Calculator for Older Adults

Objective: To create personalized estimates of future health and ability status for older adults. Method: Data came from the Cardiovascular Health Study (CHS), a large longitudinal study. Outcomes included years of life, years of healthy life (based on self-rated health), years of able life (based on activities of daily living), and years of healthy and able life. We developed regression estimates using the demographic and health characteristics that best predicted the four outcomes. Internal and external validity were assessed. Results: A prediction equation based on 11 variables accounted for about 40% of the variability for each outcome. Internal validity was excellent, and external validity was satisfactory. The resulting CHS Healthy Life Calculator (CHSHLC) is available at http://healthylifecalculator.org. Conclusion: CHSHLC provides a well-documented estimate of future years of healthy and able life for older adults, who may use it in planning for the future.

[Physical activity in adult working population: results from the European National Health Survey for Spain (2009)]

Objetivos

1) Describir la actividad física realizada por la población española trabajadora entre los 16 y los 70 años, y 2) determinar las variables sociodemográficas, la percepción del estado de salud y los hábitos relacionados con estilos de vida asociados a la actividad física en población adulta trabajadora.

Diseño

Estudio observacional, utilizando la Encuesta Europea de Salud en España.

Emplazamiento

Comunitario.

Participantes

Los sujetos con edades entre 16-70 años fueron 10.928 (5.628 mujeres, 5.300 hombres).

Intervenciones

No se aplicó ninguna intervención.

Mediciones principales

La actividad física y su intensidad fueron valoradas mediante preguntas incluidas en la encuesta. Se analizaron variables sociodemográficas, la percepción del estado de salud y variables de salud, utilizando modelos multivariados de regresión logística.

Resultados

No tener pareja (OR 1,44; p < 0,001), tener estudios universitarios (OR 1,62; p < 0,001), no fumar (OR 1,50; p < 0,001) y tomar medicación (OR 1,22; p < 0,5) eran predictores de actividad física intensa en los hombres. En las mujeres se asoció significativamente con los 3 primeros factores. Por el contrario, la obesidad (OR 0,58; p < 0,001) y tener 36-50 años (OR 0,68; p < 0,001) se asociaron con sedentarismo en los hombres. Tener ≥ 2 enfermedades (OR 1,30; p < 0,001), no fumar (OR 1,17; p < 0,5) y tener 36-50 años (OR 1,26; p < 0,01) estaban asociados a una actividad moderada en las mujeres. El estado mental positivo fue significativo para la actividad física intensa en ambos sexos (OR 1,01; p < 0,5).

Conclusiones

Se identifican factores que pueden influir en la actividad física de la población española trabajadora, con implicaciones para las estrategias y políticas de salud pública.

Time trends in leisure time physical activity and physical fitness in the elderly: five-year follow-up of the Spanish National Health Survey (2006-2011)

OBJECTIVES

To estimate the trends in the practice of leisure time physical activity, walking up 10 steps, and walking for 1h, during the years 2006-2011, in elderly Spanish people.

STUDY DESIGN

Observational study, retrospective analysis of Spanish National Health Surveys. We analysed data collected from the Spanish National Health Surveys conducted in 2006 (n=30,072) and 2011 (n=21,007), through self-reported information. The number of subjects aged ≥65 years included in the current study was n=5756 in 2006 (19.14%) and n=4617 in 2011 (21.97%). We included responses from adults aged 65 years and older.

OUTCOME MEASURES

The main variables included leisure-time physical activity, walking up 10 steps, and walking for 1h. We analysed socio-demographic characteristics, individuals' self-rated health status, lifestyle habits, co-morbid conditions and disability using multivariable logistic regression models.

RESULTS

The total number of subjects was 10,373 (6076 women, 4297 men). The probability of self-reported capacity was significantly higher in 2006 than in 2011 for leisure-time physical activity, walking up 10 steps, and walking for 1h for both sexes (women: OR 2.20, 95%IC 1.91-5.55; OR 2.50, 95%IC 1.99-3.14; OR 1.04, 95%IC 1.01-1.07; men: OR 2.20, 95%IC 1.91-2.55; OR 2.01, 95%IC 1.40-2.89; OR 1.05, 95%IC 1.0-1.1) respectively. Both sexes were associated with a significantly lower probability of performing leisure-time physical activity, walking up 10 steps, and walking for 1h. Additionally, those over 80 years of age, on average, showed a poor or very poor perception of their health and presented with some type of disability.

CONCLUSION

A decrease in the proportion of respondents who self-reported undertaking leisure-time physical activity, walking up 10 steps, and walking for 1h was observed in the Spanish population of over 65 years between 2006 and 2011.

Brain imaging findings in elderly adults and years of life, healthy life, and able life over the ensuing 16 years: the Cardiovascular Health Study

OBJECTIVES

To determine whether elderly people with different patterns of magnetic resonance imaging (MRI) findings have different long-term outcomes.

DESIGN

Longitudinal cohort study.

SETTING

Cardiovascular Health Study.

PARTICIPANTS

Individuals aged 65 and older were recruited (N = 5,888); 3,660 of these underwent MRI, and 3,230 without a stroke before MRI were included in these analyses.

MEASUREMENTS

Cluster analysis of brain MRI findings was previously used to define five clusters: normal, atrophy, simple infarct, leukoaraiosis, and complex infarct. Participants were subsequently classified as healthy if they rated their health as excellent, very good, or good and as able if they did not report any limitations in activities of daily living (ADLs). Mean years of life (YoL), years of healthy life (YHL), and years of able life (YAL) were calculated over 16 years after the MRI and compared between clusters using unadjusted and adjusted regression analyses.

RESULTS

Mean age of participants was 75.0. With 16 years of follow-up, mean YoL was 11.3; YHL, 8.0; and YAL, 8.4. Outcomes differed significantly between clusters. With or without adjustments, outcomes were all significantly better in the normal than complex infarct cluster. The three remaining clusters had intermediate results, significantly different from the normal and complex infarct clusters but not usually from one another. Over 16 years of follow-up, participants in the complex infarct cluster (n = 368) spent the largest percentage of their 8.4 years alive being sick (38%) and not able (38%).

CONCLUSION

Findings on MRI scans in elderly adults are associated not only with long-term survival, but also with long-term self-rated health and limitation in ADLs. The combination of infarcts and leukoaraiosis carried the worst prognosis, presumably reflecting small vessel disease.

Functional Fitness and Physical Activity of Portuguese Community-Residing Older Adults

The purposes of this study were to generate functional-fitness norms for Portuguese older adults, to determine age and sex differences, and to analyze the physical activity–associated variation in functional fitness. The sample was composed of 802 older adults, 401 men and 401 women, age 60–79 yr. Functional fitness was assessed using the Senior Fitness Test. Physical activity level was estimated via the Baecke questionnaire. The P50 values decreased from 60 to 64 to 75 to 79 yr of age. A significant main effect for age group was found in all functional-fitness tests. Men scored significantly better than women in the chair stand, 8-ft up-and-go, and 6-min walk. Women scored significantly better than men in chair sit-and-reach and back scratch. Active participants scored better in functional-fitness tests than their average and nonactive peers. This study showed a decline in functional fitness with age, better performance of men, and increased proficiency in active participants.

Exercícios físicos, força muscular e atividades de vida diária em mulheres idosas

O objetivo foi investigar as relações entre força muscular nos membros inferiores e nos superiores, prática de exercícios físicos e atividades de vida diária em mulheres idosas recrutadas na comunidade. Um mil quinhentas e trinta e oito idosas com idade média = 72,07 ± 5,46, renda familiar média = 3,59 ± 3,96 SM, sem déficit cognitivo sugestivo de demência. Foram submetidas a medidas de força de preensão manual e velocidade de marcha; a itens de autorrelato sobre prática regular de exercícios físicos; de desempenho de 13 atividades avançadas de vida diária (AAVD) de natureza social (ex: trabalhar, viajar e frequentar igreja) e de 3 atividades instrumentais de vida diária (AIVD) manejar dinheiro, fazer compras e usar transporte, 1.538 idosas com idade média = 72,07 ± 5,46, renda familiar média = 3,59 ± 3,96 SM, sem déficit cognitivo sugestivo de demência. Foram preditivos de pior desempenho em atividades de vida diária (AVD): baixa força muscular (OR = 2,48 para comprometimento da preensão e da marcha e 1,66 para comprometimento em qualquer dos critérios), baixa renda (OR = 2,46 e 2,45 para < 1 e para 1,1 a 3,0 SM) e sedentarismo (OR 2,08). A funcionalidade de mulheres idosas é afetada pelo envelhecimento fisiológico e por condições contextuais e de estilo de vida.

Time trends in leisure time physical activity and physical fitness in elderly people: 20 year follow-up of the Spanish population national health survey (1987-2006)

BACKGROUND

To estimate trends in leisure time physical activity and physical fitness between 1987-2006 in older Spanish people.

METHODS

We analyzed data collected from the Spanish National Health Surveys conducted in 1987 (n = 29,647), 1993 (n = 20,707), 1995-1997 (n = 12,800), 2001 (n = 21,058), 2003 (n = 21,650), and 2006 (n = 29,478). The number of subjects aged ≥ 65 years included in the current study was 29,263 (1987: n = 4,958-16.7%; 1993: n = 3,751-17.8%; 1995-97: n = 2,229-17.4%; 2001: n = 4,356-20.7%; 2003: 6,134-28.3%; 2006: 7,835-26.5%). Main variables included leisure-time physical activity and physical fitness. We analyzed socio-demographic characteristics, self-rated health status, lifestyle habit and co-morbid conditions using multivariate logistic regression models.

RESULTS

Women exhibited lower prevalence of leisure time physical activity and physical fitness compared to men (P < 0.05). The multivariate analysis for time trends found that practising leisure time physical activity increased from 1987 to 2006 (P < 0.001). Variables associated with a lower likelihood of practicing leisure time physical activity were: age ≥ 80 years old, ≥ 2 co-morbid chronic conditions, and obesity. Variables associated with lower physical fitness included: age ≥ 80 years, worse self rated health; ≥ 2 medications (only for walking), and obesity.

CONCLUSIONS

We found an increase in leisure time physical activity in the older Spanish population. Older age, married status, co-morbid conditions, obesity, and worse self-perceived health status were associated with lower activity. Identification of these factors can help to identify individuals at risk for physical inactivity.

Physical activity, quality of life and symptoms of depression in community-dwelling and institutionalized older adults

This study was aimed to investigate in a sample of Spanish elderly whether measures of physical activity are related to health-related quality of life (HRQoL) and symptoms of depression in community dwelling and institutionalized elderly. The sample was a cohort of 436 elderly (234 women and 202 men, aged 60-98 years) from the North of Spain. 58% were community-dwellers and 42% were institutionalized in senior residences. Participants completed measures of physical activity (Yale Physical Activity Survey, YPAS), HRQoL (Medical Outcomes Study 36-item Short Form Health Survey, SF-36) and symptoms of depression (Geriatric Depression Scale, GDS). All SF-36 domains, except role-emotional, were significantly correlated with the YPAS activity dimension summary index. Physical function, role-physical, general health and vitality correlated with total time activity, and correlations were observed between weekly energy expenditure and physical function, role physical, vitality and mental health. Depressive symptom scores correlated significantly with the YPAS activity dimension summary index and the weekly energy expenditure. Scores for various domains of the SF-36 and for depressive symptoms significantly differed among less and more active individuals of the same sex and institutionalization category. Differences generally reached a higher extent in institutionalized subjects in comparison to community dwellers. In conclusion, physical activity was related to different domains of both the physical and mental components of HRQoL and to decreased depressive symptoms. Results emphasize the positive effects of physical activity in both community-dwelling and institutionalized older adults.