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Suhag A, Webb TL, Holmes J. Longitudinal clustering of health behaviours and their association with multimorbidity in older adults in England: A latent class analysis. PLoS One 2024; 19:e0297422. [PMID: 38271435 PMCID: PMC10810435 DOI: 10.1371/journal.pone.0297422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 01/04/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Health-risk behaviours such as smoking, unhealthy nutrition, alcohol consumption, and physical inactivity (termed SNAP behaviours) are leading risk factors for multimorbidity and tend to cluster (i.e. occur in specific combinations within distinct subpopulations). However, little is known about how these clusters change with age in older adults, and whether and how cluster membership is associated with multimorbidity. METHODS Repeated measures latent class analysis using data from Waves 4-8 of the English Longitudinal Study of Ageing (ELSA; n = 4759) identified clusters of respondents with common patterns of SNAP behaviours over time. Disease status (from Wave 9) was used to assess disorders of eight body systems, multimorbidity, and complex multimorbidity. Multinomial and binomial logistic regressions were used to examine how clusters were associated with socio-demographic characteristics and disease status. FINDINGS Seven clusters were identified: Low-risk (13.4%), Low-risk yet inactive (16.8%), Low-risk yet heavy drinkers (11.4%), Abstainer yet inactive (20.0%), Poor diet and inactive (12.9%), Inactive, heavy drinkers (14.5%), and High-risk smokers (10.9%). There was little evidence that these clusters changed with age. People in the clusters characterised by physical inactivity (in combination with other risky behaviours) had lower levels of education and wealth. People in the heavy drinking clusters were predominantly male. Compared to other clusters, people in the Low-risk and Low-risk yet heavy drinkers had a lower prevalence of all health conditions studied. In contrast, the Abstainer but inactive cluster comprised mostly women and had the highest prevalence of multimorbidity, complex multimorbidity, and endocrine disorders. High-risk smokers were most likely to have respiratory disorders. CONCLUSIONS Health-risk behaviours tend to be stable as people age and so ought to be addressed early. We identified seven clusters of older adults with distinct patterns of behaviour, socio-demographic characteristics and multimorbidity prevalence. Intervention developers could use this information to identify high-risk subpopulations and tailor interventions to their behaviour patterns and socio-demographic profiles.
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Affiliation(s)
- Alisha Suhag
- Healthy Lifespan Institute, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Thomas L. Webb
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
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Cardona MI, Luppa M, Zülke A, Kroeber ES, Bauer A, Döhring J, Escales C, Brettschneider C, Frese T, Kosilek RP, Gensichen J, Hoffmann W, Kaduszkiewicz H, König HH, Wiese B, Riedel-Heller SG, Thyrian JR. Mediating Factors Associated With Physical Activity in Older Adults at Increased Dementia Risk. Am J Alzheimers Dis Other Demen 2024; 39:15333175241257849. [PMID: 38828622 PMCID: PMC11149443 DOI: 10.1177/15333175241257849] [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] [Indexed: 06/05/2024]
Abstract
While regular physical-activity (PA) is beneficial, multimorbid individuals at increased dementia risk may exhibit reduced PA levels. Thus, a more comprehensive understanding of mediating factors responsible for inactivity in this population is needed. This study investigated the impact of a multimodal intervention on PA changes at 24-month follow-up and associated mediating factors among community-dwelling patients aged 60-77, with increased dementia risk determined by the CAIDE Dementia Risk Score. Of 1030 participants recruited, 819 completed the assessment. Thus, a generalized estimating equations model initially assessed differences in PA over 24 months, followed by a tree analysis identifying mediating factors influencing PA changes post-intervention. While no significant effect on regular PA was found during the follow-up (P = .674), subgroup analysis revealed improved self-efficacy (P = .000) associated with increased engagement in PA. Incorporating self-efficacy elements into future strategies is crucial for promoting PA among individuals with multimorbidity and at increased dementia risk.
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Affiliation(s)
- Maria Isabel Cardona
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Andrea Zülke
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Eric S. Kroeber
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Alexander Bauer
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Juliane Döhring
- Institute of General Practice, University of Kiel, Kiel, Germany
| | | | - Christian Brettschneider
- Department of Health Economics and Health Service Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Robert P. Kosilek
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Jochen Gensichen
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Wolfgang Hoffmann
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | | | - Hans-Helmut König
- Department of Health Economics and Health Service Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Birgitt Wiese
- MHH Information Technology, Hannover Medical School, Hannover, Germany
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Jochen René Thyrian
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
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Zangger G, Bricca A, Liaghat B, Juhl CB, Mortensen SR, Andersen RM, Damsted C, Hamborg TG, Ried-Larsen M, Tang LH, Thygesen LC, Skou ST. Benefits and Harms of Digital Health Interventions Promoting Physical Activity in People With Chronic Conditions: Systematic Review and Meta-Analysis. J Med Internet Res 2023; 25:e46439. [PMID: 37410534 PMCID: PMC10359919 DOI: 10.2196/46439] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 05/20/2023] [Accepted: 05/25/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Digital health interventions for managing chronic conditions have great potential. However, the benefits and harms are still unclear. OBJECTIVE This systematic review and meta-analysis aimed to investigate the benefits and harms of digital health interventions in promoting physical activity in people with chronic conditions. METHODS We searched the MEDLINE, Embase, CINAHL, and Cochrane Central Register of Controlled Trials databases from inception to October 2022. Eligible randomized controlled trials were included if they used a digital component in physical activity promotion in adults with ≥1 of the following conditions: depression or anxiety, ischemic heart disease or heart failure, chronic obstructive pulmonary disease, knee or hip osteoarthritis, hypertension, or type 2 diabetes. The primary outcomes were objectively measured physical activity and physical function (eg, walk or step tests). We used a random effects model (restricted maximum likelihood) for meta-analyses and meta-regression analyses to assess the impact of study-level covariates. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and the certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation. RESULTS Of 14,078 hits, 130 randomized controlled trials were included. Compared with usual care or minimal intervention, digital health interventions increased objectively measured physical activity (end of intervention: standardized mean difference [SMD] 0.29, 95% CI 0.21-0.37; follow-up: SMD 0.17, 95% CI 0.04-0.31) and physical function (end of intervention: SMD 0.36, 95% CI 0.12-0.59; follow-up: SMD 0.29, 95% CI 0.01-0.57). The secondary outcomes also favored the digital health interventions for subjectively measured physical activity and physical function, depression, anxiety, and health-related quality of life at the end of the intervention but only subjectively measured physical activity at follow-up. The risk of nonserious adverse events, but not serious adverse events, was higher in the digital health interventions at the end of the intervention, but no difference was seen at follow-up. CONCLUSIONS Digital health interventions improved physical activity and physical function across various chronic conditions. Effects on depression, anxiety, and health-related quality of life were only observed at the end of the intervention. The risk of nonserious adverse events is present during the intervention, which should be addressed. Future studies should focus on better reporting, comparing the effects of different digital health solutions, and investigating how intervention effects are sustained beyond the end of the intervention. TRIAL REGISTRATION PROSPERO CRD42020189028; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=189028.
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Affiliation(s)
- Graziella Zangger
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Alessio Bricca
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Behnam Liaghat
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Centre for Evidence-Based Orthopedics (CEBO), Department of Orthopaedic Surgery, Zealand University Hospital, Køge, Denmark
| | - Carsten B Juhl
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Physiotherapy and Occupational Therapy, University Hospital of Copenhagen, Herlev and Gentofte, Denmark
| | - Sofie Rath Mortensen
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Slagelse, Denmark
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Rune Martens Andersen
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Camma Damsted
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Trine Grønbek Hamborg
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Slagelse, Denmark
| | - Mathias Ried-Larsen
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Centre for Physical Activity Research, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Lars Hermann Tang
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Søren T Skou
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Poulsen VR, Fischer LK, Aadahl M, Mortensen OS, Skou ST, Jørgensen LB, Jepsen R, Møller A, Petersen TL, Brønd JC, Tang L, Korshøj M. The association between physical activity, low-grade inflammation, and labour market attachment among people with multimorbidity: A cross-sectional study from the Lolland-Falster Health Study, Denmark. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2023; 13:26335565231195510. [PMID: 37621316 PMCID: PMC10447179 DOI: 10.1177/26335565231195510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023]
Abstract
Aim Evidence suggests low-grade inflammation (LGI) to be associated with multimorbidity. Furthermore, there are links between inflammation markers, physical activity (PA), and labour market participation. The aims of this study were to examine the association between PA and LGI in people with multimorbidity and if this association was moderated by self-reported labour market attachment. Methods Cross-sectional data were collected in the Lolland-Falster Health Study (LOFUS) from 2016-2020. We included 1,106 participants with multimorbidity and valid accelerometer data. PA was measured as the average counts per minute (CPM) per day during wake time and split in time spent in moderate to vigorous intensity (MVPA) and light intensity (LPA). Degree of inflammation was determined by high sensitive C-reactive protein (hsCRP) level. Associations were investigated using multiple logistic regression analyses, stratified by labour market attachment. Results The odds of having LGI was higher with lower amount of daily LPA. The highest odds of LGI was observed for CPM < 200 per day (odds ratio (OR) 2.55; 95% confidence interval (CI) 1.46-4.43), MVPA < 15 minutes per day (OR 2.97; 95 % CI 1.56-5.62), and LPA < 90 (OR 2.89; 95 % CI 1.43-5.81) with the reference groups being CPM ≥ 400 per day, MVPA ≥ 30, and LPA ≥ 180 min per day, respectively. We could not preclude an interaction between LPA and labour market attachment (p = 0.109). Conclusion PA recommendations should be developed with attention to people with chronic diseases, who may experience barriers to reach PA at high intensities. People with no labour market attachment may benefit from primary and secondary prevention of multimorbidity.
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Affiliation(s)
- Vivian Rueskov Poulsen
- Department of Occupational and Social Medicine, Holbæk Hospital, a part of Copenhagen University Hospital, Holbæk, Denmark
| | - Linda Kjær Fischer
- Department of Strategy and Plan, Zealand University Hospital, Køge, Denmark
| | - Mette Aadahl
- Centre for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ole Steen Mortensen
- Department of Occupational and Social Medicine, Holbæk Hospital, a part of Copenhagen University Hospital, Holbæk, Denmark
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Søren T Skou
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark
| | - Lars Bo Jørgensen
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark
- Department of Physiotherapy and Occupational Therapy, Zealand University Hospital, Roskilde, Denmark
| | - Randi Jepsen
- Lolland-Falster Health Study, Centre for Epidemiological Research, Nykøbing F. Hospital, Nykøbing Falster, Denmark
| | - Anne Møller
- Centre of Research and Education in General Practice, Department of Public Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- Primary Health Care Research Unit, Region Zealand, Denmark
| | - Therese Lockenwitz Petersen
- Lolland-Falster Health Study, Centre for Epidemiological Research, Nykøbing F. Hospital, Nykøbing Falster, Denmark
| | - Jan Christian Brønd
- Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Lars Tang
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark
- The Department of Regional Health Research, University of Southern, Odense, Denmark
| | - Mette Korshøj
- Department of Occupational and Social Medicine, Holbæk Hospital, a part of Copenhagen University Hospital, Holbæk, Denmark
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Jørgensen LB, Bricca A, Bernhardt A, Juhl CB, Tang LH, Mortensen SR, Eriksen JA, Walløe S, Skou ST. Objectively measured physical activity levels and adherence to physical activity guidelines in people with multimorbidity-A systematic review and meta-analysis. PLoS One 2022; 17:e0274846. [PMID: 36223336 PMCID: PMC9555650 DOI: 10.1371/journal.pone.0274846] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/06/2022] [Indexed: 11/05/2022] Open
Abstract
Objective To determine levels of objectively measured physical activity (PA) and the proportion of adults with multimorbidity that adheres to PA guidelines. Methods All studies, where PA was measured at baseline using an activity monitor in an adult (≥18 years) multimorbid (≥80% of the population had ≥2 chronic conditions) population. A systematic literature search was performed in Medline, EMBASE, CINAHL, CENTRAL, ClinicalTrials.gov, opengrey.eu and google.com from inception up until 18th of January 2022. Risk of bias was assessed with a modified version of the Quality Assessment Tool for Quantitative Studies. A random-effects meta-analyses was performed to estimate daily minutes of sedentary behavior (SB), light PA (LPA), moderate PA (MPA), moderate to vigorous PA (MVPA) and steps. Proportions adhering to PA guidelines was narratively synthesized. Certainty of evidence was determined using The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results Fifteen studies (2,172 participants) were included. The most frequent combination of conditions were type 2 diabetes and hypertension (six studies). Participants spent a daily average of 500.5 (95% CI: 407.1 to 593.9) minutes in SB, 325.6 (95% CI: 246.4 to 404.7 minutes in LPA and 32.7 (95% CI: 20.2 to 45.3) minutes in MVPA. The mean daily number of steps was 5,145 (95% CI: 4264 to 6026) for people in free-living conditions. The proportion adhering to PA guidelines ranged widely (7.4% to 43%). All studies were rated as at high risk of bias and the certainty of evidence was very low. Conclusions PA levels and adherence varied from low to above guideline recommended levels for adults with chronic conditions, depending on PA intensity. The very low certainty of evidence calls for high quality studies focusing on detailed descriptions of PA behavior in people with multimorbidity. PROSPERO registration number CRD42020172456.
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Affiliation(s)
- Lars Bo Jørgensen
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
- Department of Physiotherapy and Occupational Therapy, Zealand University Hospital, Roskilde, Region Zealand, Denmark
- Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark
- * E-mail:
| | - Alessio Bricca
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
- Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark
| | - Anna Bernhardt
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
| | - Carsten B. Juhl
- Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark
| | - Lars Hermann Tang
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
- The Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Sofie Rath Mortensen
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
- Department of Sports Science and Clinical Biomechanics, Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Jonas Ahler Eriksen
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
| | - Sisse Walløe
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
- Department of Clinical Research, Research Unit OPEN, University of Southern Denmark, Odense, Denmark
| | - Søren T. Skou
- Department of Physiotherapy and Occupational Therapy, The Research Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Region Zealand, Denmark
- Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark
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Behera S, Pradhan J. A combination of moderate and vigorous physical activities reduces the burden of multimorbidity: findings from Longitudinal Ageing Study in India. JOURNAL OF HEALTH, POPULATION AND NUTRITION 2022; 41:42. [PMID: 36096879 PMCID: PMC9465913 DOI: 10.1186/s41043-022-00323-9] [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: 05/12/2022] [Accepted: 09/01/2022] [Indexed: 06/14/2024] Open
Abstract
Abstract
Background
Physical inactivity is a significant factor contributing to the prevalence of non-communicable diseases (NCDs). The objective of this study is to examine the association between physical activity and multimorbidity among Indian adults aged 45 years and above by residence.
Methods
Data from Longitudinal Ageing Study in India (LASI) 2017–2018, wave 1, a nationally representative study, are used to examine the above objective. A total of 59,073 adults aged 45 years and above are enlisted in the study. Physical activities and other demographic and socioeconomic variables have been used to describe the distribution of multimorbidity and investigate their relationship. Logistic regression is employed to examine the adjusted impact of physical activity on multimorbidity among Indian adults (45 + years) by residence.
Results
The level of physical activity is inversely related to the prevalence of multimorbidity in India. The rate of multimorbidity ranges from 4 to 12% among moderately active individuals in rural areas, whereas it ranges from 9 to 34% in urban areas across the age groups of 45 to 75+ years. Notably, the individuals who engage in both moderate and vigorous activities have a lower prevalence of multimorbidity than those who engage in only moderate activities.
Conclusion
Our study shows that physical inactivity has an association with the rise in multimorbidity in both rural and urban areas; however, the intensity of multimorbidity is higher in urban areas. The policymakers should consider the influence of moderate and vigorous physical activity as a key prevention measure of non-communicable disease and multimorbidity.
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Yang HL, Mo BR, Molassiotis A, Wang M, He GL, Xie YJ. Relationship between multimorbidity and composite lifestyle status in Shenzhen, China. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2022; 12:26335565221123990. [PMID: 36090662 PMCID: PMC9449505 DOI: 10.1177/26335565221123990] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective The study aimed to understand multimorbidity among adults in a high-tech city in southern coastal China that has undergone rapid economic development and to investigate its relationship with lifestyle status. Methods A population-based survey was conducted among 24 community centers in the Nanshan District of Shenzhen from February to December of 2018. Participants were recruited using a stratified random sampling approach. A self-administered questionnaire on typical chronic diseases, lifestyle factors, body composition, and social demographics was used to collect data. Multimorbidity was defined as two or more chronic diseases coexisting in a single person. An algorithm on body mass index, physical activity, drinking, smoking, and sleep quality was used to calculate lifestyle scores (0-9), with higher scores predicting a healthier lifestyle. Results A total of 2,905 participants were included in the analysis, with men accounting for 52.4%, and single for 25%. The prevalence of multimorbidity was 4.8%, and the mean lifestyle score was 4.79 ± 1.55. People who were old, retired, married, and had less education were more likely to have multimorbidity (all P < .05). A higher prevalence of multimorbidity was found among those who were obese, less engaged in physical activity, consumed more alcohol, and had poorer sleep quality (all p < .05). After adjusting for age, employment, education, and marital status, one unit increase in lifestyle score was associated with 0.74 times lower to have multimorbidity (OR: 0.74; 95% CI: 0.63-0.87, p < .05). Conclusion The prevalence of multimorbidity was relatively low in economically developed Shenzhen. Keeping a healthy lifestyle was related to the lower possibility of suffering from multiple chronic diseases.
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Affiliation(s)
- Hua-Lu Yang
- Department of Nursing, Huazhong University of Science and
Technology Union Shenzhen Hospital, Shenzhen, China,School of Nursing, The Hong Kong Polytechnic
University, Hong Kong SAR, China
| | - Bei-Rong Mo
- Department of Nursing, Huazhong University of Science and
Technology Union Shenzhen Hospital, Shenzhen, China
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic
University, Hong Kong SAR, China
| | - Mian Wang
- School of Nursing, The Hong Kong Polytechnic
University, Hong Kong SAR, China
| | - Gui-Lan He
- Department of Nursing, Huazhong University of Science and
Technology Union Shenzhen Hospital, Shenzhen, China
| | - Yao Jie Xie
- School of Nursing, The Hong Kong Polytechnic
University, Hong Kong SAR, China,Yao Jie Xie, School of Nursing, The Hong
Kong Polytechnic University, FG424, PolyU, Hong Kong SAR 999077, China.
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Bevilacqua G, Zhang J, Parsons C, Laskou F, Fuggle N, Cooper C, Dennison E. Medical history, medication use and physical activity in adults in their eighth and ninth decade of life in the Hertfordshire Cohort Study. EXCLI JOURNAL 2022; 21:695-703. [PMID: 35721573 PMCID: PMC9203985 DOI: 10.17179/excli2022-4874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 04/12/2022] [Indexed: 11/10/2022]
Abstract
While there are many known health benefits to maintained physical activity levels in late adulthood, there have been very few studies that have considered relationships between morbidity profile and physical activity in the eighth decade of life. We studied 1097 participants, 555 men and 542 women from the Hertfordshire Cohort Study, a UK community based sample. Validated questionnaire based data were used to relate self-reported physical activity (PA) levels to medical history, and medication use. Regression analyses were adjusted for age, BMI, smoker status, alcohol consumption. The mean (SD) age of participants in the study was 80.2 (2.7) years for men and 80.2 (2.6) for women. A higher proportion of men (33.7 %) than women (24 %) were in the high activity score group. 20.8 % of female participants and 22.6 % male participants reported having no comorbid disease; 10.5 % men and 8.4 % women were taking no medication. Higher number of chronic conditions was associated with lower levels of PA [men (OR 0.73, 95 % CI 0.63-0.84, p<0.001); women (OR 0.74, 95 % CI 0.64-0.86, p<0.001)] as was being prescribed a higher number of medications [men (OR 0.88, 95 % CI 0.84-0.93, p<0.001); women (OR 0.86, 95 % CI 0.82-0.91, p<0.001)]. All these associations remained robust following adjustments. Strong relationships were seen in both sexes between PA and taking medication for disorders of the central nervous system and gastrointestinal system, with relationships generally stronger in men. We have observed relationships between comorbid medical history and medication use with physical activity in a cohort of community dwelling older adults. These highlight the need to consider medical history when considering how best to optimize PA in older adults.
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Affiliation(s)
| | - Jean Zhang
- MRC Lifecourse Epidemiology Centre, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Camille Parsons
- MRC Lifecourse Epidemiology Centre, Southampton SO16 6YD, UK
| | - Faidra Laskou
- MRC Lifecourse Epidemiology Centre, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Nicholas Fuggle
- MRC Lifecourse Epidemiology Centre, Southampton SO16 6YD, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Centre, Southampton SO16 6YD, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
- Victoria University of Wellington, Wellington, New Zealand
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Physical Activity Determinants in Older German Adults at Increased Dementia Risk with Multimorbidity: Baseline Results of the AgeWell.de Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063164. [PMID: 35328854 PMCID: PMC8951006 DOI: 10.3390/ijerph19063164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 11/23/2022]
Abstract
Background: Multimorbidity is a common issue in aging societies and is usually associated with dementia in older people. Physical activity (PA) may be a beneficial nonpharmacological strategy for patients with complex health needs. However, insufficient PA is predominant in this population. Thus, there is an evident need to expand the knowledge on potential determinants influencing PA engagement among elderly persons at risk of dementia and multimorbidity. Methods: We used baseline data from the multicenter, cluster-randomized controlled AgeWell.de study. The main aim was to describe PA engagement and identify potential PA determinants in a sample of community-dwelling Germans aged 60−77 years old with an increased risk of dementia and multimorbidity. Results: Of the 1030 included participants, approximately half (51.8%) engaged in PA ≥2 times/week for at least 30 min at baseline. We identified self-efficacy (beta = 0.202, (p < 0.001) and BMI (beta = −0.055, (p < 0.001) as potential PA determinants. Conclusions: The identified determinants, self-efficacy, and BMI are consistent with those reported in the literature. Specific knowledge on PA determinants and stages of change in persons with risk of dementia and multimorbidity might guide the development of effective future prevention measures and health services tailored to this population. Trial registration: German Clinical Trials Register (reference number: DRKS00013555).
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Gan DRY, Wister AV, Best JR. Environmental Influences on Life Satisfaction and Depressive Symptoms Among Older Adults With Multimorbidity: Path Analysis Through Loneliness in the Canadian Longitudinal Study on Aging. THE GERONTOLOGIST 2022; 62:855-864. [PMID: 35034124 PMCID: PMC9290896 DOI: 10.1093/geront/gnac004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND AND OBJECTIVES More older adults with multimorbidity are aging in place than ever before. Knowing how the environment affects their mental well-being could enhance the efficacy of age-friendly interventions for multimorbidity resilience. With reference to the Transdisciplinary Neighborhood Health Framework, we construct and examine a priori models of environmental influences on life satisfaction and depressive symptoms. RESEARCH DESIGN AND METHODS Baseline and follow-up data (after 3 years) were drawn from the Canadian Longitudinal Study on Aging to identify a subsample (n = 14,301) of participants aged at least 65 years with at least 2 chronic diseases. Path analysis examined sociobehavioral attributes (i.e., social support, social participation, walking) and loneliness as primary and secondary mediators, controlling for age, sex, education, and outcomes during baseline. RESULTS Good model fit was found (TFI = 1.00; CFI = 1.00; RMSEA < 0.001; SRMR < 0.001). The total effects of housing quality (rtotal = 0.08, -0.07) and neighborhood cohesion (rtotal = 0.03, -0.06) were weak but statistically significant in the expected direction. The mediators explained 21%-31% of the total effects of housing quality and 67%-100% of the total effects of neighborhood cohesion. Loneliness mediated 27%-29% of these environmental influences on mental well-being, whereas walking mediated a mere 0.4%-0.9% of the total effects. Walking did not explain the relationship between housing quality and mental well-being. DISCUSSION AND IMPLICATIONS Data supported a priori pathways from environment to mental well-being through sociobehavioral attributes and loneliness. If these pathways from neighborhood cohesion to life satisfaction reflect causal effects, community-based age-friendly interventions should focus on enhancing neighborhood cohesion to mitigate loneliness among multimorbid older adults for their mental well-being.
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Affiliation(s)
- Daniel R Y Gan
- Address correspondence to: Daniel R. Y. Gan, PhD, Gerontology Research Centre, Simon Fraser University, #2800-515 West Hastings Street, Vancouver, BC V6B 5K3, Canada. E-mail:
| | - Andrew V Wister
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada
| | - John R Best
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada,Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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Abstract
PURPOSE OF REVIEW The aim of this study was to highlight recent evidence on protein requirement and physical activity recommendations in older adults and their interrelationship. RECENT FINDINGS Higher protein intake in older adults is beneficial for better physical function, reduced fracture risk, healthy ageing and lower mortality. However, the association between protein quality and health remains inconsistent. Higher physical activity is associated with a lower risk of physical dependence, frailty, cognitive impairment and mortality. Prospectively increasing or even sustaining physical activity can be protective against adverse health outcomes compared with decreasing physical activity. There is a synergistic protective effect of protein intake and physical activity on health. Data on the bidirectional link between protein intake and physical activity are scarce. Whether increasing physical activity can help to increase energy intake (and thus protein intake) and vice versa require further research. SUMMARY The key role of protein intake and physical activity in optimizing health in older adults is well established. The synergistic effects of these two modifiable lifestyle factors strengthen the need to consider dietary and physical activity recommendations together. Future research may examine the bidirectional link between diet and physical activity, which could potentially be one of the strategies to increase the uptake of recommendations for protein intake and physical activity in older adults.
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Affiliation(s)
- Suey S Y Yeung
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Ruth S M Chan
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong
| | - Jean Woo
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
- Centre for Nutritional Studies, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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12
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Gomes RDS, Barbosa AR, Meneghini V, Confortin SC, d’Orsi E, Rech CR. Association between chronic diseases, multimorbidity and insufficient physical activity among older adults in southern Brazil: a cross-sectional study. SAO PAULO MED J 2020; 138:545-553. [PMID: 33331604 PMCID: PMC9685583 DOI: 10.1590/1516-3180.2020.0282.r1.15092020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 09/15/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Being active has been shown to have beneficial effects for the health of individuals with chronic diseases. However, data on the association between multimorbidity and physical activity are limited. OBJECTIVE To investigate the association between chronic diseases, multimorbidity and insufficient physical activity among older adults in southern Brazil, according to sex. DESIGN AND SETTING Cross-sectional population-based and household-based study derived from the second wave (2013-2014) of the EpiFloripa Aging Cohort Study. METHODS Insufficiency of physical activity (outcome) was ascertained using the long version of the International Physical Activity Questionnaire (≤ 150 minutes/week). Eleven self-reported chronic diseases were identified. Multimorbidity was defined from the number of chronic diseases (none; 2 or 3; or 4 or more). The adjustment variables were age, schooling, marital status, income, smoking, alcohol consumption and cognition. Additionally, each chronic disease was adjusted for the others. Associations were tested using logistic regression (crude and adjusted). RESULTS Among the 1197 participants (≥ 63 years), women (54.0%) were more likely than men (39.6%) to be insufficiently active. In the adjusted analysis, women and men with depressive symptoms, and men with diabetes, were more likely to be insufficiently active than those without symptoms. Multimorbid women were more likely to be insufficiently active, and the magnitude of the effect was strongest for 4 or more diseases. CONCLUSION This study indicates that the associations were sex-specific. Depressive symptoms and multimorbidity were associated with insufficient physical activity among women, while diabetes was associated with insufficient physical activity among men.
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Affiliation(s)
- Roselaine da Silva Gomes
- BSc. Master’s Student, Postgraduate Program in Physical Education, Universidade Federal de Santa Catarina (UFSC), Florianópolis (SC), Brazil.
| | - Aline Rodrigues Barbosa
- PhD. Associate Professor, School of Sports, Universidade Federal de Santa Catarina (UFSC), Florianópolis (SC), Brazil.
| | - Vandrize Meneghini
- MSc. Doctoral Student, Postgraduate Program in Physical Education, Universidade Federal de Santa Catarina (UFSC), Florianópolis (SC), Brazil.
| | - Susana Cararo Confortin
- PhD. Postdoctoral Researcher, Center for Biological and Health Sciences, Universidade Federal do Maranhão (UFMA), São Luís (MA), Brazil.
| | - Eleonora d’Orsi
- MD, PhD. Associate Professor, School of Health Sciences, Universidade Federal de Santa Catarina (UFSC), Campus Trindade, Florianópolis (SC), Brazil.
| | - Cassiano Ricardo Rech
- PhD. Adjunct Professor, School of Sports, Universidade Federal de Santa Catarina (UFSC), Florianópolis (SC), Brazil.
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