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Pang B, Moullin JC, Thompson C, Thøgersen-Ntoumani C, Stamatakis E, McVeigh JA. Barriers and Facilitators to Participation in Vigorous Lifestyle Physical Activity in Adults Aged 55-75 Years: A Scoping Review. J Aging Phys Act 2024; 32:446-459. [PMID: 38237573 DOI: 10.1123/japa.2022-0405] [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: 12/02/2022] [Revised: 06/29/2023] [Accepted: 10/03/2023] [Indexed: 05/15/2024]
Abstract
Despite the well-known benefits of physical activity, less than half of adults aged 55-75 years participate in sufficient physical activity. Short bouts of vigorous intermittent lifestyle physical activity (VILPA) accumulated throughout the day can contribute toward the recommended volume of physical activity. A rich characterization of the barriers and facilitators to participation in VILPA is needed to develop targeted interventions. This scoping review aimed to identify barriers and facilitators to participation in different components of VILPA in adults aged 55-75 years, and to map barriers and facilitators to the Theoretical Domains Framework. Within the 18 eligible studies, the most prevalent barriers were related to a person's skills, environmental context, and social influences. Most facilitators were related to a person's goals, social influences, and environmental context. Interventions to promote VILPA should test the effectiveness of behavioral change measures related to the unique barriers and facilitators in this age group.
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Affiliation(s)
| | - Joanna C Moullin
- Curtin University, Bentley, WA, Australia
- enAble Institute, Curtin University, Bentley, WA, Australia
| | - Craig Thompson
- Curtin University, Bentley, WA, Australia
- enAble Institute, Curtin University, Bentley, WA, Australia
| | | | | | - Joanne A McVeigh
- Curtin University, Bentley, WA, Australia
- enAble Institute, Curtin University, Bentley, WA, Australia
- Movement Physiology Laboratory, University of Witwatersrand, Johannesburg, South Africa
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Dzando G, Ward P, Gesesew HA, Tyndall J, Ambagtsheer RC. Prevalence, perceptions, and experiences of frailty among older migrants from Low- and Middle-Income Countries to High Income Countries: A mixed method systematic review. Arch Gerontol Geriatr 2024; 121:105360. [PMID: 38341959 DOI: 10.1016/j.archger.2024.105360] [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: 10/22/2023] [Revised: 01/18/2024] [Accepted: 01/29/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND Frailty is increasingly becoming a public health concern, especially among vulnerable populations. Older migrants from Low- and Middle-Income Countries to High Income Countries present with poorer health and are at increased risk of becoming frail. This review aims to explore the prevalence, perceptions, and experiences of frailty among older migrants from Low- and Middle-Income Countries to High Income Countries. METHODS This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Five electronic databases were comprehensively searched for relevant literature published from January 1, 2000, to April 30, 2023. Quality appraisal for the quantitative studies was done with the Joanna Brigg's critical appraisal tool for analytic cross-sectional studies, and the qualitative studies were assessed with the Critical Appraisal Skill Program tool for qualitative studies. RESULT Seven studies met the inclusion criteria. Frailty was assessed using modified versions of the Frailty Phenotype and Frailty Index. The prevalence of frailty using the Frailty Phenotype was 16.6 %, and 17 % to 61.9 % according to the Frailty Index. The perceptions and experiences of frailty were characterised by chronic ill-health and a review of healthy pre-migration and early migration lives. CONCLUSION Despite the variation in frailty assessment methods, the high prevalence of frailty among older migrants was highlighted across the included studies. The perceptions and experiences of frailty reflect a state of resignation which can complicate the state of frailty. There is the need for ongoing research among migrant groups to identify their predisposition to frailty for early intervention.
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Affiliation(s)
- Gideon Dzando
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, SA, Australia.
| | - Paul Ward
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, SA, Australia
| | - Hailay Abrha Gesesew
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, SA, Australia; College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Jessica Tyndall
- Library, Torrens University Australia, Adelaide, SA, Australia
| | - Rachel C Ambagtsheer
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, SA, Australia
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Yokote T, Yatsugi H, Chu T, Liu X, Wang L, Kishimoto H. Association of the Combination of Moderate-to-Vigorous Physical Activity and Sleep Quality with Physical Frailty. Geriatrics (Basel) 2024; 9:31. [PMID: 38525748 PMCID: PMC10961777 DOI: 10.3390/geriatrics9020031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 02/22/2024] [Accepted: 02/26/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND The association of the individual and combined effects of moderate-to-vigorous physical activity (MVPA) and sleep quality with physical frailty in community-dwelling older adults is still unknown. SUBJECTS AND METHODS A cross-sectional study was conducted with a sample of older adults who had not required nursing care or support services. Physical frailty was assessed using Liu's definition based on Fried's concept. MVPA was measured by a triaxial accelerometer, and individuals who met either moderate physical activity (MPA) for ≥300 min/week, vigorous physical activity (VPA) for ≥150 min/week, or both were defined as "MVA+". "SLP+" was defined as a Pittsburgh Sleep Quality Index score of <5.5 points. RESULTS A total of 811 participants were included in the final analysis. After adjusting for the multivariable confounding factors, the odds ratios (ORs) and 95% confidence intervals (CIs) for physical pre-frailty and frailty in the MVA-SLP+ (OR, 2.56; 95%CI, 1.80-3.62) and the MVA-SLP- group (OR, 3.97; 95%CI, 2.33-6.74) were significantly higher compared with the MVA+SLP+ group. CONCLUSION Community-dwelling older adults who did not meet the MVPA criteria, regardless of sleep quality, had a higher prevalence of physical frailty.
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Affiliation(s)
- Tsubasa Yokote
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka 819-0395, Japan; (T.Y.); (T.C.); (L.W.)
| | - Harukaze Yatsugi
- Faculty of Arts and Science, Kyushu University, Fukuoka 819-0395, Japan;
| | - Tianshu Chu
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka 819-0395, Japan; (T.Y.); (T.C.); (L.W.)
| | - Xin Liu
- Epidemiological Study Group, Medical Evidence Division, Intage Healthcare Inc., Tokyo 101-0062, Japan;
| | - Lefei Wang
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka 819-0395, Japan; (T.Y.); (T.C.); (L.W.)
| | - Hiro Kishimoto
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka 819-0395, Japan; (T.Y.); (T.C.); (L.W.)
- Faculty of Arts and Science, Kyushu University, Fukuoka 819-0395, Japan;
- Center for Health Science and Counseling, Kyushu University, Fukuoka 819-0395, Japan
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Yokote T, Yatsugi H, Chu T, Liu X, Kishimoto H. Associations between various types of activity and physical frailty in older Japanese: a cross-sectional study. BMC Geriatr 2023; 23:785. [PMID: 38030967 PMCID: PMC10685653 DOI: 10.1186/s12877-023-04501-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 11/21/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Physical activity is known to help prevent physical frailty, but it is not clear which physical activities practiced alone or in combination are most closely associated with a lower risk of physical frailty. We investigated differences in the associations of exercise habit, social participation, and moderate-to-vigorous physical activity (MVPA) with physical frailty and its components among community-dwelling older Japanese adults. SUBJECTS AND METHODS A total of 831 older adults participated in this cross-sectional study. Physical frailty was defined based on the Fried et al. criteria. Exercise habit was defined as exercising ≥ 30 min per day for ≥ 2 days per week for ≥ 1 year. Social participation was defined as participating in community activities ≥ 1/week. MVPA was defined as ≥ 300 min/week of moderate physical activity (MPA) or 150 min/week of vigorous physical activity (VPA). We classified the participants into eight groups according to the presence/absence of these activities, and we performed a logistic regression analysis to investigate the association between different activities, both alone and in combination, and physical frailty. RESULTS The prevalence of physical pre-frailty + frailty was 74.8% in the None group, 65.0% in the Exercise habit group, 76.3% in the Social participation group, 56.5% in the MVPA group, 58.7% in the Exercise habit + Social participation group, 44.0% in the Exercise habit + MVPA group, 41.3% in the Social participation + MVPA group, and 38.0% in the All group. Compared to the None group, the groups in which participants were engaged in any combination of two or more types of activity, as well as the MVPA-alone group had significantly lower risks of physical pre-frailty + frailty. CONCLUSION Community-dwelling older Japanese adults who engaged in MVPA or any combination of two or more types of physical activity as defined herein had lower risks of physical pre-frailty and frailty.
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Affiliation(s)
- Tsubasa Yokote
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, 819-0395, Japan
| | - Harukaze Yatsugi
- Faculty of Arts and Science, Kyushu University, 744 Motooka Nishi-ku, Fukuoka, 819-0395, Japan
| | - Tianshu Chu
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, 819-0395, Japan
| | - Xin Liu
- Epidemiological Study Group, Medical Evidence Division, Intage Healthcare Inc., Tokyo, 101-0062, Japan
| | - Hiro Kishimoto
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, 819-0395, Japan.
- Faculty of Arts and Science, Kyushu University, 744 Motooka Nishi-ku, Fukuoka, 819-0395, Japan.
- Center for Health Science and Counseling, Kyushu University, Fukuoka, 819-0395, Japan.
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Elshahat S, Moffat T, Morshed M, Alkhawaldeh H, Madani K, Mohamed A, Nadeem N, Emira S, Newbold KB, Donnelly M. A Scoping Review of the Relationship Between Physical Activity and Mental Health Among Immigrants in Western Countries: An Integrated Bio-Psycho-Socio-Cultural Lens. J Immigr Minor Health 2023; 25:1137-1151. [PMID: 37402074 DOI: 10.1007/s10903-023-01518-w] [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] [Accepted: 06/14/2023] [Indexed: 07/05/2023]
Abstract
Epidemiological evidence suggests that regular physical activity (PA) positively impacts individuals' mental health (MH). The PA-MH relationship may be critical among immigrants owing to psycho-social-cultural influences. This scoping review of 61 studies employed a holistic bio-psycho-socio-cultural framework to thoroughly investigate the complex relationship between PA (across life domains) and immigrants' MH in Western countries. A systematic search of five electronic databases (Medline, PubMed, Embase, PsycINFO and Anthropology Plus) was conducted to locate relevant articles. No limitations were applied to study design, age, gender, home country, MH condition or PA type. A bio-psycho-socio-cultural-informed conceptual model guided the analysis of the multi-domain PA-MH relationship. Immigrant PA-MH studies were conducted and reported most commonly in the USA (38%), Australia (18%), and Canada (11%). Overall, PA was positively related to MH. Each domain-specific PA appeared to be associated with unique MH-promoting pathways/mechanisms. Leisure-related PA may support MH by enhancing self-agency and minimizing risky behaviors, whilst travel- and domestic-related PA may promote self-accomplishment and physical engagement. Ethnic sports appeared to enhance resilience. Occupational-related PA was associated with either positive or negative MH, depending on the type of occupation. A bio-psycho-socio-cultural-informed model is required to gain an encompassing and integrated understanding of immigrants' health. The first iteration of such a model is presented here, along with an illustration of how the model may be used to deepen analysis and understanding of the multi-domain PA-MH relationship among immigrants and inform public health planners and practitioners.
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Affiliation(s)
- Sarah Elshahat
- Faculty of Social Sciences, McMaster University, Chester New Hall, Hamilton, ON, Ontario, L8S 4L9, Canada.
| | - Tina Moffat
- Faculty of Social Sciences, McMaster University, Chester New Hall, Hamilton, ON, Ontario, L8S 4L9, Canada
| | - Mahira Morshed
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | | | - Keon Madani
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
| | - Aya Mohamed
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Naya Nadeem
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Sara Emira
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - K Bruce Newbold
- School of Earth, Environment & Society, McMaster University, Hamilton, ON, Canada
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, UK
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Charitha Koneru S, Sikand G, Agarwala A. Optimizing Dietary Patterns and Lifestyle to Reduce Atherosclerotic Cardiovascular Risk Among South Asian Individuals. Am J Cardiol 2023; 203:113-121. [PMID: 37487405 DOI: 10.1016/j.amjcard.2023.06.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/01/2023] [Accepted: 06/14/2023] [Indexed: 07/26/2023]
Abstract
South Asians are at an elevated risk of atherosclerotic cardiovascular disease (ASCVD) when compared with other age-matched subjects of varied ethnicities. The elevated ASCVD risk is multifactorial including a constellation of hypertension, dyslipidemia, metabolic syndrome, overweight/obesity, prediabetes, and type 2 diabetes mellitus. Although traditional ASCVD risk factors remain highly prevalent in South Asians living in the United States, modifiable risk factors of diet, lack of physical activity/increased sedentary time, smoking (of all forms), and excessive alcohol consumption further accelerate the disease process. In this review, we take a deep dive into optimizing lifestyle to reduce the risk of cardiovascular disease in this high-risk ethnic group.
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Affiliation(s)
- Sri Charitha Koneru
- Center for Cardiovascular Disease Prevention, Cardiovascular Division, Baylor Scott and White Health Heart Hospital Baylor Plano, Plano, Texas
| | - Geeta Sikand
- Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, California
| | - Anandita Agarwala
- Center for Cardiovascular Disease Prevention, Cardiovascular Division, Baylor Scott and White Health Heart Hospital Baylor Plano, Plano, Texas.
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Chang WN, Tzeng PL, Huang WJ, Lin YH, Lin KP, Wen CJ, Chou YC, Liao Y, Hsueh MC, Chan DC. Objective assessment of the association between frailty and sedentary behavior in older adults: a cross-sectional study. Eur Rev Aging Phys Act 2023; 20:14. [PMID: 37550620 PMCID: PMC10405382 DOI: 10.1186/s11556-023-00324-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/27/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Given the inconsistent findings of the association between frailty and sedentary behavior in older adults, this cross-sectional study investigated the aforementioned association using four different frailty criteria and two sedentary behavior indices in older adults. METHODS Data from older adults (age ≥ 65 y) who participated in health examinations or attended outpatient integrated clinics at a medical center in Taipei, Taiwan, were collected. Frailty was measured using the modified Fried Frailty Phenotype (mFFP), Clinical Frailty Scale in Chinese Translation (CFS-C), Study of Osteoporotic Fractures (SOF) index, and Clinical Frailty-Deficit Count (CF-DC) index; sedentary behavior was assessed with a waist-worn accelerometer. Adjusted linear regression ascertained the association between frailty and both sedentary behavior outcomes. RESULTS Among the 214 participants (mean age 80.82 ± 7.14 y), 116 were women. The average total sedentary time and number of sedentary bouts were 609.74 ± 79.29 min and 5.51 ± 2.09 times per day, respectively. Frail participants had a longer total sedentary time (odds ratio [OR]: 30.13, P = .01 and 39.43, P < .001) and more sedentary bouts (OR: 3.50 and 5.86, both P < .001) on mFFP and CFS-C assessments, respectively. The SOF index revealed more sedentary bouts among frail than in robust participants (OR: 2.06, P = .009), without a significant difference in the total sedentary time. Frail participants defined by the CF-DC index were more likely to have frequent sedentary bouts (OR: 2.03, P = .016), but did not have a longer total sedentary time. CONCLUSIONS Regardless of the frailty criteria adopted, frailty was positively associated with the number of sedentary bouts per day in older adults. A significant correlation between frailty and total sedentary time was detected only with mFFP and CFS-C indices. Further research may target decreasing the sedentary bouts in older adults as a strategy to improve frailty.
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Affiliation(s)
- Wen-Ning Chang
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
| | - Pei-Lin Tzeng
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
- Department of Health Promotion and Health Education, National Taiwan Normal University, No 162, Section 1, Heping E. Rd, Taipei, 106209, Taiwan
| | - Wei-Jia Huang
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
| | - Yu-Hung Lin
- Department of Health Promotion and Health Education, National Taiwan Normal University, No 162, Section 1, Heping E. Rd, Taipei, 106209, Taiwan
- National Taiwan University Hospital, Bei-Hu Branch, No. 87 Neijiang Street, Taipei, 108206, Taiwan
| | - Kun-Pei Lin
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
| | - Chiung-Jung Wen
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
- Department of Family Medicine, College of Medicine, National Taiwan University, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
| | - Yi-Chun Chou
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
- Department of Family Medicine, College of Medicine, National Taiwan University, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan
| | - Yung Liao
- Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, No. 162, Section 1, Heping E. Rd, Taipei, 106209, Taiwan
| | - Ming-Chun Hsueh
- Graduate Institute of Sport Pedagogy, University of Taipei, No. 101, Sec. 2, Zhongcheng Rd, Taipei, 111036, Taiwan
| | - Ding-Cheng Chan
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan.
- Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chungshan S. Rd, Taipei, 100225, Taiwan.
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Device-worn measures of sedentary time and physical activity in South Asian adults at high risk for type 2 diabetes in Metro-Vancouver, Canada. PLoS One 2022; 17:e0266599. [PMID: 35511949 PMCID: PMC9070884 DOI: 10.1371/journal.pone.0266599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/23/2022] [Indexed: 11/19/2022] Open
Abstract
Background South Asians have high incidence of chronic disease. Physical activity (PA) and sedentary time are modifiable risk factors for chronic disease but their assessment in South Asians has been primarily based on self-report. This study presents directly-measured PA and sedentary time in South Asian adults in Canada. Methods A subset of 100 South Asian participants from a larger study who were identified at being at a higher risk for type 2 diabetes wore Actical accelerometers for 7 days. Anthropometric measures were taken and socio-demographic factors including age, income, education level, years since immigration, presence of children under the age of 12 years in the household and employment status were self-reported. Results Ninety-one participants (mean age 65.6 years) provided valid accelerometer data. Participants accumulated mean 673.5 (95% CI: 656.6, 691.0) min/day sedentary time, 130.5 (95% CI: 117.3, 145.3) min/day light PA (LPA) and 2.3 (95% CI: 1.3, 4.2) min/day moderate-to-vigorous PA (MVPA). For sedentary time and LPA, sex and BMI explained 51% of variability. For MVPA, BMI, season of assessment and employment status explained 23% variability with those who were employed accumulating significantly higher mean min/day of MVPA compared to those who were unemployed; (5.8, 95% CI: 1.5, 21.7) vs (1.5, 95% CI: 5.3, 20.0) respectively. Conclusion High sedentary time, and low MVPA indicates the need to focus health promotion efforts on shifting sedentary time into LPA while trying to increase MVPA. Future studies need to be based on larger, representative samples of South Asians.
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Wang S, Ma W, Wang SM, Yi X. Regular Physical Activities and Related Factors among Middle-Aged and Older Adults in Jinan, China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910362. [PMID: 34639662 PMCID: PMC8507899 DOI: 10.3390/ijerph181910362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/20/2021] [Accepted: 09/29/2021] [Indexed: 12/28/2022]
Abstract
The objective of this study was to investigate the prevalence of regular physical activity (RPA) among middle-aged and older adults in urban communities in Jinan, China, and to identify the factors related to RPA. A cross-sectional survey was conducted among middle-aged and elderly urban residents. A total of 1406 participants were included in the final data analysis. The results of the four models consistently showed that the relevant factors of RPA were educational level, previously diagnosed hypertension (PDH) and depression. In terms of educational level, compared with illiteracy, from the first model to the fourth model, the odds ratios (ORs) and 95% confidence intervals (CIs) of senior middle school were 2.072 (1.418, 3.026), 2.072 (1.418, 3.026), 1.905 (1.289, 2.816) and 1.926 (1.302, 2.848), respectively, and the ORs and 95% CIs of college or above were 2.364 (1.462, 3.823), 2.364 (1.462, 3.823), 2.001 (1.208, 3.312) and 2.054 (1.239, 3.405). In terms of PDH, compared with those with PDH, from the first model to the fourth model, ORs and 95% CIs of non-PDH were 1.259 (1.003, 1.580), 1.259 (1.003, 1.580), 1.263 (1.006, 1.585) and 1.261 (1.004, 1.584), respectively. For depression, compared with those without depression, also from the first model to the fourth model, ORs and 95% CIs of depression were 0.702 (0.517, 0.951), 0.702 (0.517, 0.951), 0.722 (0.532, 0.981) and 0.719 (0.529, 0.977), respectively. In conclusion, the results of this study showed that participation in RPA among middle-aged and older adults in Jinan urban communities was significantly associated with education level, PDH and depression.
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Affiliation(s)
- Shukang Wang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44, Wenhuaxi Street, Jinan 250012, China;
- Institute for Medical Dataology, Shandong University, 12550, Erhuandong Street, Jinan 250002, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44, Wenhuaxi Street, Jinan 250012, China; (W.M.); (S.-M.W.)
| | - Shu-Mei Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44, Wenhuaxi Street, Jinan 250012, China; (W.M.); (S.-M.W.)
| | - Xiangren Yi
- Department of Sport and Health, The College of Physical Education, Shandong University, 17923, Jingshi Street, Jinan 250061, China
- Correspondence: ; Tel.: +86-0531-88396626
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Dey KC, Zakrzewski-Fruer JK, Smith LR, Jones RL, Bailey DP. The Prevalence of Daily Sedentary Time in South Asian Adults: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179275. [PMID: 34501864 PMCID: PMC8431135 DOI: 10.3390/ijerph18179275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/27/2021] [Accepted: 08/29/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to systematically review total daily sedentary time in South Asian adults. Seven electronic databases were searched, identifying relevant articles published in peer-reviewed journals between March 1990 and March 2021. The study was designed in accordance with PRISMA guidelines. Prospective or cross-sectional design studies reporting total daily sedentary time in South Asian adults (aged ≥18 years), reported in English, were included. Study quality and risk of bias were assessed, and the weighted mean total daily sedentary time was calculated. Fourteen full texts were included in this systematic review from studies that were conducted in Bangladesh, India, Norway, Singapore, and the United Kingdom. Pooled sedentary time across all studies was 424 ± 8 min/day. Sedentary time was measured using self-report questionnaires in seven studies, with a weighted mean daily sedentary time of 416 ± 19 min/day. Eight studies used accelerometers and inclinometers with a weighted mean sedentary time of 527 ± 11 min/day. South Asian adults spend a large proportion of their time being sedentary, especially when recorded using objective measures (~9 h/day). These findings suggest that South Asians are an important target population for public health efforts to reduced sedentary time, and researchers and practitioners should seek to standardise and carefully consider the tools used when measuring sedentary time in this population.
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Affiliation(s)
- Kamalesh C. Dey
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Bedford MK41 9EA, UK; (K.C.D.); (L.R.S.); (R.L.J.); (D.P.B.)
| | - Julia K. Zakrzewski-Fruer
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Bedford MK41 9EA, UK; (K.C.D.); (L.R.S.); (R.L.J.); (D.P.B.)
- Correspondence: ; Tel.: +44-(0)1234-793410
| | - Lindsey R. Smith
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Bedford MK41 9EA, UK; (K.C.D.); (L.R.S.); (R.L.J.); (D.P.B.)
| | - Rebecca L. Jones
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Bedford MK41 9EA, UK; (K.C.D.); (L.R.S.); (R.L.J.); (D.P.B.)
| | - Daniel P. Bailey
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Bedford MK41 9EA, UK; (K.C.D.); (L.R.S.); (R.L.J.); (D.P.B.)
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK
- Sedentary Behaviour, Health and Disease Research Group, Brunel University London, Uxbridge UB8 3PH, UK
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11
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Edelstein OE, Vered I, Sarid O. Correlates of participation in physical activity among older women in Israel: does ethno-cultural background matter? Health Promot Int 2021; 36:34-45. [PMID: 32277810 DOI: 10.1093/heapro/daaa030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Osteoporosis and its related fractures are major public health concerns. Physical activity (PA) is crucial for bone density preservation and fractures prevention. Yet, gaps in understanding exist regarding how ethno-cultural backgrounds might shape attitudes, intentions and actual PA participation. Based on the theory of planned behaviour (TPB) for predicting PA, the aims of this study were: (i) to compare attitudes, subjective norms, perceived control, intentions and knowledge, across four ethno-cultural groups; (ii) to evaluate the fit of the model we constructed across four ethno-cultural groups of women: Israeli-born Jews and Israeli-born Bedouin-Muslims, immigrants from the Former Soviet Union (FSU) and Ethiopian immigrants. Four hundred women (one hundred from each group), aged >65, completed valid and reliable questionnaires assessing knowledge, TPB components and actual PA. The level of knowledge on osteoporosis was relatively low among all four ethno-cultural groups. Intention to participate in PA was the only variable that directly predicted actual PA. Intention to participate in PA served as a mediator among attitudes, subjective norms, perceived control and actual PA. The structural equation models (SEMs) revealed that among Israeli-born Jews and Ethiopian immigrants, TPB components mediated the link between knowledge and intention to participate in PA. Among FSU immigrants and Israeli Bedouin-Muslims, the knowledge variable was not included in the final model, as its contribution was not significant. It is essential to better understand and augment interventions that enhance PA in the community, and to address the unique needs of each ethno-cultural group.
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Affiliation(s)
- Offer E Edelstein
- The Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva 841050, Israel
| | - Iris Vered
- Division of Endocrinology, Diabetes and Metabolism, The Chaim Sheba Medical Centre, Tel Hashomer 5262000, Israel
| | - Orly Sarid
- The Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva 841050, Israel
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Barros D, Borges-Machado F, Andrade da Silva W, Nascimento A, Carvalho J, Bohn L. Different subjective and objective measures and cut-points of physical activity in frailty phenotype screening: A need for standardization? Arch Gerontol Geriatr 2021; 96:104479. [PMID: 34274874 DOI: 10.1016/j.archger.2021.104479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/02/2021] [Accepted: 07/04/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Frailty phenotype has been extensively modified. Among the five criteria, the low physical activity (PA) is often changed, however, it is still uncertain how this modification might impact frailty classification. AIMS To examine the variance in the prevalence of frailty by modifying PA criterion using different cut-points of both subjective and objective measures, and to determine the agreement between these on classifying individuals with low PA. Finally, a surrogate PA criterion of frailty phenotype was proposed using objectively measured moderate-to-vigorous physical activity (MVPA). METHODS This cross-sectional study comprised a convenience sample of 135 community-dwelling older adults. Frailty was evaluated using a modified frailty phenotype. PA was assessed using International Physical Activity Questionnaire-short form (IPAQ-SF) and objectively measured using a uniaxial accelerometer for 7 days. Four different low PA criteria were created and compared (population dependent and independent cut-points) using subjective and objective measures. RESULTS Different measures and cut-points resulted in an overall variation of 12.5% on frailty prevalence. The agreement in the categorization of participants with low PA between population dependent cut-points of both IPAQ-SF and accelerometer was none to slight (%Overallagreement = 43.70%; Kappa = 0.082, p = 0.114). Results from ROC curve analysis showed an optimal threshold of 15.13 min/day of MVPA to discriminate between non-frail and pre-frail individuals. CONCLUSION Modifications of the low PA criterion of frailty phenotype can greatly impact frailty classification. MVPA measured through an accelerometer may present a possible solution to standardize this criterion, and improve frailty screening and between-studies comparability.
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Affiliation(s)
- Duarte Barros
- Faculdade de Desporto da Universidade do Porto, Porto, Portugal; CIAFEL, Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal.
| | - Flávia Borges-Machado
- Faculdade de Desporto da Universidade do Porto, Porto, Portugal; CIAFEL, Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
| | - Wagner Andrade da Silva
- CIAFEL, Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
| | - Alinne Nascimento
- CIAFEL, Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
| | - Joana Carvalho
- Faculdade de Desporto da Universidade do Porto, Porto, Portugal; CIAFEL, Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal
| | - Lucimere Bohn
- Faculdade de Desporto da Universidade do Porto, Porto, Portugal; CIAFEL, Centro de Investigação em Atividade Física, Saúde e Lazer, Universidade do Porto, Porto, Portugal; Universidade Lusófona do Porto, Porto, Portugal
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13
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Vavasour G, Giggins OM, Doyle J, Kelly D. How wearable sensors have been utilised to evaluate frailty in older adults: a systematic review. J Neuroeng Rehabil 2021; 18:112. [PMID: 34238323 PMCID: PMC8268245 DOI: 10.1186/s12984-021-00909-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 06/28/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Globally the population of older adults is increasing. It is estimated that by 2050 the number of adults over the age of 60 will represent over 21% of the world's population. Frailty is a clinical condition associated with ageing resulting in an increase in adverse outcomes. It is considered the greatest challenge facing an ageing population affecting an estimated 16% of community-dwelling populations worldwide. AIM The aim of this systematic review is to explore how wearable sensors have been used to assess frailty in older adults. METHOD Electronic databases Medline, Science Direct, Scopus, and CINAHL were systematically searched March 2020 and November 2020. A search constraint of articles published in English, between January 2010 and November 2020 was applied. Papers included were primary observational studies involving; older adults aged > 60 years, used a wearable sensor to provide quantitative measurements of physical activity (PA) or mobility and a measure of frailty. Studies were excluded if they used non-wearable sensors for outcome measurement or outlined an algorithm or application development exclusively. The methodological quality of the selected studies was assessed using the Appraisal Tool for Cross-sectional Studies (AXIS). RESULTS Twenty-nine studies examining the use of wearable sensors to assess and discriminate between stages of frailty in older adults were included. Thirteen different body-worn sensors were used in eight different body-locations. Participants were community-dwelling older adults. Studies were performed in home, laboratory or hospital settings. Postural transitions, number of steps, percentage of time in PA and intensity of PA together were the most frequently measured parameters followed closely by gait speed. All but one study demonstrated an association between PA and level of frailty. All reports of gait speed indicate correlation with frailty. CONCLUSIONS Wearable sensors have been successfully used to evaluate frailty in older adults. Further research is needed to identify a feasible, user-friendly device and body-location that can be used to identify signs of pre-frailty in community-dwelling older adults. This would facilitate early identification and targeted intervention to reduce the burden of frailty in an ageing population.
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Affiliation(s)
- Grainne Vavasour
- NetwellCASALA, Dundalk Institute of Technology. Co, Louth, A91 K584, Ireland.
| | - Oonagh M Giggins
- NetwellCASALA, Dundalk Institute of Technology. Co, Louth, A91 K584, Ireland
| | - Julie Doyle
- NetwellCASALA, Dundalk Institute of Technology. Co, Louth, A91 K584, Ireland
| | - Daniel Kelly
- Ulster University Faculty of Computing Engineering and The Built Environment, Derry(Londonderry), BT48 7JL, Northern Ireland
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14
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Tolley APL, Ramsey KA, Rojer AGM, Reijnierse EM, Maier AB. Objectively measured physical activity is associated with frailty in community-dwelling older adults: A systematic review. J Clin Epidemiol 2021; 137:218-230. [PMID: 33915264 DOI: 10.1016/j.jclinepi.2021.04.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/10/2021] [Accepted: 04/20/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The later-age shift towards physical inactivity and sedentary behaviour is associated with comorbidity and reduced function: markers of frailty. Whether these behaviours relate to frailty has yet to be thoroughly studied using objective measurements. This study aimed to summarise the associations of objectively measured habitual physical activity and sedentary behaviour with frailty in community-dwelling older adults. STUDY DESIGN AND SETTING Six databases were searched from inception to July 21st 2020. Articles analyzing objectively measured physical activity and/or sedentary behaviour with frailty in community-dwelling adults ≥60 years old were included. Synthesis of included articles was performed using effect direction heat maps and albatross plots. RESULTS The search identified 23 articles across 18 cohorts, including 7,696 total participants with a mean age of 69.3±8.1 years, and 56.9% female. All but one article were cross-sectional. Lower moderate-to-vigorous and total physical activity, steps, postural transitions, and energy expenditure were associated with frailty. The use of multifactorial or physical frailty definitions did not alter associations. Median effect sizes for the associations of all physical activity and sedentary behaviour measures with frailty were β = -0.272 [-0.381, -0.107] and β = 0.100 [0.001, 0.249], respectively. CONCLUSION Objective measures of physical activity are associated with frailty, regardless of frailty definition.
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Affiliation(s)
- Alec P L Tolley
- Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Keenan A Ramsey
- Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Anna G M Rojer
- Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Esmee M Reijnierse
- Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Andrea B Maier
- Department of Medicine and Aged Care, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia; Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands; Healthy Longevity Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Centre for Healthy Longevity, National University Health System, Singapore.
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15
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Rodríguez-Gómez I, Mañas A, Losa-Reyna J, Alegre LM, Rodríguez-Mañas L, García-García FJ, Ara I. Relationship between Physical Performance and Frailty Syndrome in Older Adults: The Mediating Role of Physical Activity, Sedentary Time and Body Composition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010203. [PMID: 33383967 PMCID: PMC7794741 DOI: 10.3390/ijerph18010203] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/22/2020] [Accepted: 12/24/2020] [Indexed: 01/03/2023]
Abstract
The objectives were to clarify whether the relationship between physical performance and frailty was independently and jointly mediated by movement behaviors and body composition. We analyzed 871 older adults (476 women) from The Toledo Study for Healthy Aging. Skeletal muscle index (SMI) and fat index (FI) were determined using bone densitometry. Sedentary time (ST) and moderate-to-vigorous physical activity (MVPA) were assessed using accelerometry. The Frailty Trait Scale and The Short Physical Performance Battery (SPPB) were used to evaluate frailty and physical performance, respectively. Simple and multiple mediation analyses were carried out to determine the role of movement behaviors and body composition, adjusted for potential confounders. ST and MVPA acted independently as mediators in the relationship between SPPB and frailty (0.06% for ST and 16.89% for MVPA). FI also acted as an independent mediator in the same relationship (36.47%), while the mediation role of SMI was not significant. MVPA and FI both acted jointly as mediators in this previous relationship explaining 58.15% of the model. Our data support the fact that interventions should simultaneously encourage the promotion of MVPA and strategies to decrease the FI in order to prevent or treat frailty through physical performance improvement.
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Affiliation(s)
- Irene Rodríguez-Gómez
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, 45071 Toledo, Spain; (I.R.-G.); (A.M.); (J.L.-R.); (L.M.A.)
- CIBER of Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain; (L.R.-M.); (F.J.G.-G.)
| | - Asier Mañas
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, 45071 Toledo, Spain; (I.R.-G.); (A.M.); (J.L.-R.); (L.M.A.)
- CIBER of Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain; (L.R.-M.); (F.J.G.-G.)
| | - José Losa-Reyna
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, 45071 Toledo, Spain; (I.R.-G.); (A.M.); (J.L.-R.); (L.M.A.)
- CIBER of Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain; (L.R.-M.); (F.J.G.-G.)
- Geriatric Department, Hospital Virgen del Valle, 45071 Toledo, Spain
| | - Luis M. Alegre
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, 45071 Toledo, Spain; (I.R.-G.); (A.M.); (J.L.-R.); (L.M.A.)
- CIBER of Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain; (L.R.-M.); (F.J.G.-G.)
| | - Leocadio Rodríguez-Mañas
- CIBER of Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain; (L.R.-M.); (F.J.G.-G.)
- Geriatric Department, Hospital Universitario de Getafe, 28905 Getafe, Spain
| | - Francisco J. García-García
- CIBER of Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain; (L.R.-M.); (F.J.G.-G.)
- Geriatric Department, Hospital Virgen del Valle, 45071 Toledo, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, 45071 Toledo, Spain; (I.R.-G.); (A.M.); (J.L.-R.); (L.M.A.)
- CIBER of Frailty and Healthy Aging (CIBERFES), 28029 Madrid, Spain; (L.R.-M.); (F.J.G.-G.)
- Correspondence: ; Tel.: +34-925-268-800 (ext. 5543)
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16
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Mahmood B, Tang TS, Afshar R, Ashe MC. Objective measurement of physical activity and sedentary behavior among South Asian adults: A systematic review. PLoS One 2020; 15:e0236573. [PMID: 32756595 PMCID: PMC7406035 DOI: 10.1371/journal.pone.0236573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 07/09/2020] [Indexed: 12/22/2022] Open
Abstract
Background South Asians are one of the fastest growing ethnic groups in western countries with a high incidence of chronic diseases like metabolic syndrome and cardiovascular disease occurring at younger ages and lower body weight compared with white Europeans. Physically active lifestyle and reduced sedentary time are modifiable risk factors that can decrease burden of chronic diseases. Population-level surveys based on self-report show South Asians engage in low levels of physical activity. Because of known limitations with self-report data, we aimed to synthesize available evidence to generate a physical activity /sedentary time profile of South Asians from studies using accelerometry. Methods We systematically searched Medline, EMBASE, CINAHL, PsycINFO, and SportDiscus. We included studies applying accelerometry to measure physical activity /sedentary time under free-living. Studies with an exclusive focus on drugs or including participants with health conditions/physical disability, and special populations (athletes/pregnant women) were excluded. Two authors independently adjudicated inclusion of citations at title/abstract and full text. We applied a standardized data abstraction form to extract relevant data. We evaluated methodological quality using Newcastle Ottawa Quality Assessment Scale. Due to variability and inconsistencies in measurement and reporting of physical activity /sedentary time, we only provide a narrative synthesis. Findings We identified only 14 studies(n = 1,338). Despite using similar accelerometry assumptions, we noted variability in reported outcomes for physical activity and sedentary time. Sedentary time ranged from 482(98) to 587 min/day. Mean light physical activity ranged from 211.69(67. 38) to 574(227) min/day. Moderate to vigorous physical activity among South Asian women ranged from 17–41 min/day and among men, 32–43 min/day. Conclusion South Asians exhibited higher levels of physical activity when compared to the Canadian population level survey but not when compared to the American population level survey. Overall, fewer studies, and small sample sizes led to considerable variability limiting any effective comparisons. Results highlight the importance of conducting methodologically robust studies based on random sampling to advance the field, and to capture true levels of sedentary time and physical activity in the South Asian population.
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Affiliation(s)
- Bushra Mahmood
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- * E-mail:
| | - Tricia S. Tang
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Rowshanak Afshar
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Maureen C. Ashe
- Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
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Pradhananga S, Regmi K, Razzaq N, Ettefaghian A, Dey AB, Hewson D. Ethnic differences in the prevalence of frailty in the United Kingdom assessed using the electronic Frailty Index. Aging Med (Milton) 2019; 2:168-173. [PMID: 31942531 PMCID: PMC6880682 DOI: 10.1002/agm2.12083] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/05/2019] [Accepted: 08/02/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE There have been few studies in which the prevalence of frailty of different ethnic groups has been assessed in multiethnic countries. The aim of this study was to evaluate the prevalence of frailty in different ethnic groups in the United Kingdom. METHODS Anonymized electronic health records (EHR) of 13 510 people aged 65 years and over were extracted from the database of a network of general practitioners, covering 16 clinical commissioning groups in London. Frailty was determined using the electronic Frailty Index (eFI), which was automatically calculated using EHR data. The eFI was used as a categorical variable with fit and mild frailty grouped together, and moderate and severe frailty grouped as frail. RESULTS The overall prevalence of frailty was 18.1% (95% confidence interval [CI], 17.4%-18.9%). The prevalence of frailty increased with age (odds ratio [OR], 1.11; 95% CI, 1.10-1.12) and body mass index (BMI; OR, 1.05; 95% CI, 1.04-1.06). The highest prevalence of frailty was observed for Bangladeshis, with 32.9% classified as frail (95% CI, 29.2-36.7); and the lowest prevalence of 14.0% (95% CI, 12.6-15.5) was observed for the Black ethnic group. Stepwise logistic regression retained ethnicity, age, and BMI as predictors of frailty. CONCLUSION This pilot study identified differences in the prevalence of frailty between ethnic groups in a sample of older people living in London. Additional studies are warranted to determine the causes of such differences, including migration and socioeconomic status. It would be worthwhile carrying out a validation study of the eFI in different ethnic populations.
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Affiliation(s)
| | - Krishna Regmi
- Institute for Health ResearchUniversity of BedfordshireLutonUK
| | - Nasrin Razzaq
- Business Intelligence DepartmentAT Medics LtdLondonUK
| | | | - Aparajit Ballav Dey
- Department of Geriatric MedicineAll India Institute of Medical SciencesNew DelhiIndia
| | - David Hewson
- Institute for Health ResearchUniversity of BedfordshireLutonUK
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18
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Perceptions and Factors Influencing Eating Behaviours and Physical Function in Community-Dwelling Ethnically Diverse Older Adults: A Longitudinal Qualitative Study. Nutrients 2019; 11:nu11061224. [PMID: 31146443 PMCID: PMC6627566 DOI: 10.3390/nu11061224] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 05/21/2019] [Accepted: 05/23/2019] [Indexed: 01/11/2023] Open
Abstract
Ethnic minorities have a high prevalence of non-communicable diseases relating to unhealthy lifestyle practices. Several factors have been identified as influencing unhealthy lifestyle practices among this population; however, there is little evidence about how these factors differ among a heterogeneous sample living in a super-diverse city. This study aimed to: (1) identify and compare factors influencing eating behaviours and physical function among ethnic older minorities living in Birmingham, United Kingdom; and (2) understand how these factors and their association with healthy eating and physical function changed over 8-months. An in-depth interviewing approach was used at baseline (n = 92) and after 8-months (n = 81). Interviews were transcribed verbatim and analysed using directed content analysis. Healthy eating was viewed as more important than, and unrelated to, physical function. Personal, social and cultural/environmental factors were identified as the main factors influencing eating behaviours and physical function, which differed by ethnicity, age, and sex. At 8-month interviews, more men than women reported adverse changes. The study provides unique and useful insights regarding perceived eating behaviours and physical function in a relatively large and diverse sample of older adults that can be used to design new, and adapt existing, culturally-tailored community interventions to support healthy ageing.
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