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Chen C, Saito T, Wang L, Yokote T, Yatsugi H, Liu X, Kishimoto H. The Relationships Among Chronic Pain Subtypes, Motor Function, and Physical Activity in Community-Dwelling Japanese Older Adults: A Cross-Sectional Study. Am J Health Promot 2024; 38:1112-1120. [PMID: 38788701 DOI: 10.1177/08901171241253387] [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] [Indexed: 05/26/2024]
Abstract
PURPOSE We investigated the relationships among motor function, physical activity, and the characteristics of chronic pain (the number of pain sites, pain intensity, and pain-type). DESIGN Cross-sectional study. SETTING An ongoing community-based prospective study conducted in Itoshima, Japan. SUBJECTS Community-dwelling Japanese aged 65-75 years (n = 805; 401 men, 404 women). MEASURES Chronic pain subtypes were examined in terms of the number of pain sites, pain intensity, and pain type. Motor function was evaluated by handgrip strength, walking speed, and the 5 Times Stand-up and Sit Test (FTSST). Locomotive activity, non-locomotive activity, and sedentary time were evaluated by a tri-axial accelerometer as physical-activity parameters. ANALYSIS Multiple regression model adjusting for age, sex, education level, employment status, subjective economic status, body mass index, cognitive function, comorbidity, current tobacco use, current alcohol consumption, and regular exercise. RESULTS In a multivariate analysis, the subjects' walking speed was negatively associated with multisite, moderate-to-severe, and neuropathic-like pain. The FTSST was positively associated with single-site, moderate-to-severe, and neuropathic-like pain. There was no significant association between handgrip strength and any chronic pain subtypes. Locomotive activity was negatively related to multisite, moderate-to-severe, and neuropathic-like pain, but there was no clear association between the amount of non-locomotive activity, sedentary time, and chronic pain subtypes. CONCLUSION Severe chronic pain was associated with decreased locomotion-related motor function and physical activity.
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Affiliation(s)
- Cen Chen
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | - Takafumi Saito
- Faculty of Rehabilitation, School of Physical Therapy, Reiwa Health Sciences University, Fukuoka, Japan
| | - Lefei Wang
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | - Tsubasa Yokote
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | | | - Xin Liu
- Medical Evidence Division, Intage Healthcare Inc Tokyo, Japan
| | - Hiro Kishimoto
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
- Faculty of Arts and Science, Kyushu University, Fukuoka, Japan
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Fukushima N, Kikuchi H, Sato H, Sasai H, Kiyohara K, Sawada SS, Machida M, Amagasa S, Inoue S. Dose-Response Relationship of Physical Activity with All-Cause Mortality among Older Adults: An Umbrella Review. J Am Med Dir Assoc 2024; 25:417-430. [PMID: 37925162 DOI: 10.1016/j.jamda.2023.09.028] [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: 07/23/2023] [Revised: 09/25/2023] [Accepted: 09/25/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVES To examine the dose-response relationship between physical activity (PA) and all-cause and cardiovascular disease (CVD) mortality, specifically among older adults. DESIGN Umbrella review. SETTING AND PARTICIPANTS Eligible studies included systematic reviews with meta-analyses that investigated the association of aerobic PA, muscle-strengthening activity, and multicomponent PA, including exercise programs (such as aerobic, muscle strengthening, and balance training), with all-cause and CVD mortality among older adults aged ≥60 years. METHODS We performed a literature search in PubMed, CINAHL, and the Cochrane Library for eligible studies published between January 2017 and March 2023 to update an umbrella review initially conducted by the United States 2018 PA Guidelines Advisory Committee. Studies included in the 2018 US PA and 2020 World Health Organization (WHO) Guidelines were also reviewed. In addition, meta-analyses that reported effect sizes stratified by age and recruiting older adults (aged ≥60 years) were included. RESULTS Overall, 16 relevant systematic reviews (10 from our review and 6 from the US and WHO guidelines) met the inclusion criteria. All these reviews showed that 7.5 to 15.0 metabolic equivalents (METs)-hours/week (around the recommended PA levels outlined in the US and WHO guidelines) substantially reduced mortality risks among older adults (approximately 19%-30% for all-cause mortality and 25%-34% for CVD mortality). Moreover, 15.0 to 22.5 MET-hours/week, exceeding the guideline-recommended PA levels, resulted in greater reductions in mortality risks by 35% to 37% and 38% to 40%, respectively. CONCLUSIONS AND IMPLICATIONS PA substantially reduced all-cause and CVD mortality risks among older adults. Larger risk reductions may be achieved by engaging in PA levels higher than those recommended by the current international PA guidelines. Our findings suggest that recommending higher PA levels beyond the current guidelines may benefit older adults when developing future international PA guidelines.
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Affiliation(s)
- Noritoshi Fukushima
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan
| | - Hiroyuki Kikuchi
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan
| | - Hiroki Sato
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kosuke Kiyohara
- Department of Food Science, Faculty of Home Economics, Otsuma Women's University, Tokyo, Japan
| | - Susumu S Sawada
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Masaki Machida
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan
| | - Shiho Amagasa
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan; Graduate School of Public Health, Teikyo University, Tokyo, Japan
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan.
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Seino S, Abe T, Nofuji Y, Hata T, Shinkai S, Kitamura A, Fujiwara Y. Dose-response Associations of Physical Activity and Sitting Time With All-cause Mortality in Older Japanese Adults. J Epidemiol 2024; 34:23-30. [PMID: 36567129 PMCID: PMC10701252 DOI: 10.2188/jea.je20220246] [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: 08/31/2022] [Accepted: 12/11/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Although examining the dose-response curves of physical activity (PA) and sitting time with health-related outcomes is an important research agenda, the results for older Japanese adults are extremely limited. We examined the dose-response associations of PA and sitting time with all-cause mortality among older Japanese. METHODS Initially, 8,069 non-disabled residents (4,073 men; 3,996 women) aged 65-84 years of Ota City, Japan, were analyzed. Moderate-to-vigorous PA (MVPA) and sitting time were evaluated using the International Physical Activity Questionnaire-Short Form. Multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of MVPA and sitting time for all-cause mortality were calculated, and the dose-response curves were examined using restricted cubic splines (RCS). RESULTS During 4.1 years of follow-up, 458 participants (5.7%; 331 men and 127 women) died. Compared with the low MVPA (<600 metabolic equivalents [METs]·minutes/week) group, HR for mortality gradually reduced in moderate (600-3,000 METs·minutes/week) and high (>3,000 METs·minutes/week) MVPA groups (moderate: HR 0.66; 95% CI, 0.54-0.82; high: HR 0.58; 95% CI, 0.45-0.75; P < 0.001 for trend). RCS showed that the HR for mortality reduced linearly up to approximately 2,000 METs·minutes/week of MVPA, and maximal risk reduction was seen at approximately 3,000-4,500 METs·minutes/week of MVPA. No significant dose-response association of sitting time with mortality was observed. CONCLUSION Higher MVPA levels reduced all-cause mortality risk, in a significant inverse non-linear dose-response manner. Sitting time was not significantly associated with all-cause mortality. It is important to disseminate the significance of even a slight increase in the MVPA for reducing mortality risk.
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Affiliation(s)
- Satoshi Seino
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Takumi Abe
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yu Nofuji
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Toshiki Hata
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
- Department of Food and Nutritional Science, Graduate School of Applied Bioscience, Tokyo University of Agriculture, Tokyo, Japan
| | - Shoji Shinkai
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
- Department of Nutrition Sciences, Kagawa Nutrition University, Saitama, Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
- Health Town Development Science Center, Osaka, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Chen T, Chen S, Honda T, Nofuji Y, Kishimoto H, Narazaki K. Longitudinal Changes in Moderate to Vigorous Physical Activity in Community-Dwelling Older Men and Women: A 2-Year Prospective Cohort Study in Japan. J Phys Act Health 2023; 20:886-893. [PMID: 37268301 DOI: 10.1123/jpah.2022-0411] [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: 07/31/2022] [Revised: 03/27/2023] [Accepted: 04/17/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND To examine longitudinal changes in accelerometer-measured moderate to vigorous physical activity (MVPA) and associated factors of changes in MVPA among community-dwelling older Japanese men and women over 2 years of follow-up. METHODS In total, 601 participants (72.2 [5.4] y, 40.6% men) were included. MVPA was assessed at baseline (2011) and follow-up (2013) using triaxial accelerometers. Sex-stratified multiple linear regression models were used to identify associated factors of changes in MVPA. RESULTS On average, a significant decrease in MVPA over 2 years was observed only in women (P < .001). Higher baseline MVPA levels and older age were significantly associated with a decrease in MVPA over 2 years in both men and women. Men who were currently drinking (vs no) and had faster maximum gait speed showed statistically significant increases in MVPA. Women who had very poor/poor economic status (vs fair/good) and were socially isolated (vs no) showed statistically significant increases in MVPA over 2 years, while those who had fear of falling (vs no) and poor/fair self-rated health (vs good/very good) showed statistically significant decreases in MVPA over 2 years. CONCLUSIONS Our findings showed different associated factors of changes in MVPA by sex, suggesting the importance of accounting for sex differences in terms of developing specific intervention strategies for promoting MVPA among older men and women.
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Affiliation(s)
- Tao Chen
- Sports and Health Research Center, Department of Physical Education, Tongji University, Shanghai,China
| | - Sanmei Chen
- Global Health Nursing, Department of Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima,Japan
| | - Takanori Honda
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka,Japan
| | - Yu Nofuji
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo,Japan
| | - Hiro Kishimoto
- Faculty of Arts and Science, Kyushu University, Fukuoka,Japan
| | - Kenji Narazaki
- Center for Liberal Arts, Fukuoka Institute of Technology, Fukuoka,Japan
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Yatsugi H, Chen T, Chen S, Liu X, Kishimoto H. The Associations between Objectively Measured Physical Activity and Physical Function in Community-Dwelling Older Japanese Men and Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010369. [PMID: 35010628 PMCID: PMC8744806 DOI: 10.3390/ijerph19010369] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/20/2021] [Accepted: 12/28/2021] [Indexed: 01/06/2023]
Abstract
Objective: The relationships between physical activity (PA) and physical function (PF) among older Japanese adults have been examined before, with some studies reporting that moderate-to-vigorous physical activity (MVPA) is positively associated with PF. However, it is unclear whether the observed associations differ between men and women. In this study, we investigated the associations of objectively measured MVPA, light physical activity (LPA), and sedentary time (ST) with different PF levels in older Japanese men and women. Subjects and Methods: A total of 810 community-dwelling subjects aged 65–75 years were investigated (52.1% women, 47.9% men). The PF variables included grip strength, one-leg standing, usual and maximum walking speeds, and chair-standing time. PA (MVPA, LPA, and ST) and the number of steps taken daily were assessed for seven consecutive days by a tri-axial accelerometer. We determined the sex-specific quartiles of MVPA, LPA, and ST and analyzed their associations with physical function in separate models for each exposure measure. Results: In the crude analysis, MVPA was significantly associated with all PF variables in the men, and with the usual walking speed, max. walking speed, and chair-standing time in the women. Neither LPA nor ST was significantly associated with any PF variables. After adjusting potential confounding factors, significant associations between MVPA and usual walking speed remained in the men and women. Conclusions: Only greater moderate-to-vigorous physical activity (MVPA) was significantly associated with higher levels of PF variables in both men and women. Thus, time spent in moderate-to-vigorous physical activity (MVPA) can help older adults maintain or improve their physical function.
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Affiliation(s)
- Harukaze Yatsugi
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 744 Motooka Nishi-ku, Fukuoka 819-0395, Japan; (H.Y.); (X.L.)
| | - Tao Chen
- Sports and Health Research Center, Department of Physical Education, Tongji University, Shanghai 200092, China;
| | - Si Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Jinan 250012, China;
| | - Xin Liu
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 744 Motooka Nishi-ku, Fukuoka 819-0395, Japan; (H.Y.); (X.L.)
| | - Hiro Kishimoto
- Department of Behavior and Health Sciences, Graduate School of Human-Environment Studies, Kyushu University, 744 Motooka Nishi-ku, Fukuoka 819-0395, Japan; (H.Y.); (X.L.)
- Faculty of Arts and Science, IC15, Kyushu University, 744 Motooka Nishi-ku, Fukuoka 819-0395, Japan
- Correspondence:
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