The Dose-Response Relationships of Different Dimensions of Physical Activity with Daily Physical Function and Cognitive Function in Chinese Adults with Hypertension: A Cross-Sectional Study

Loneliness status transitions and risk of cardiovascular disease among middle-aged and older adults

BACKGROUND AND AIMS

Loneliness is a risk factor for cardiovascular disease (CVD), and the levels at which individuals experience it can transition over time. However, the impact of increased loneliness or decreased loneliness on later CVD risk remains unexplored. We aimed to identify the age-specific association between loneliness status transitions and subsequent CVD incidences in middle-aged and older adults.

METHODS AND RESULTS

Data was extracted from the China Health and Retirement Longitudinal Study (CHARLS) on 8463 adults to evaluate how loneliness status transitions across two data collection points were associated with the subsequent CVD incidence at a five-year follow-up. Loneliness status transitions were divided into four categories: stable low loneliness, decreased loneliness, increased loneliness, and stable high loneliness. Data were analyzed using a Cox-proportional hazards model with age subgroups, accounting for covariates at baseline. During follow-up, the incidence rate of CVD per 1000 person-years was lower for the stable low loneliness group and decreased loneliness group compared to the increased loneliness and stable high loneliness group. Increased loneliness is associated with the highest risk of overall CVD and heart disease (HR 2.44, P < 0.001; HR 2.34, P < 0.001), while stable high loneliness is associated with the highest risk of stroke among the four loneliness categories (HR 4.29, P < 0.05). The age-specific analyses revealed no statistically significant interaction in terms of loneliness status transitions and age group.

CONCLUSION

Increased loneliness and stable high loneliness are associated with higher CVD risk. In clinical practice, it is important to monitor patients' loneliness status transitions to reduce CVD incidences.

The role of physical activity on healthcare utilization in China

BACKGROUND

Evidence on the role of physical activity (PA) on healthcare utilization and expenditure is limited in China. We aimed to examine the association between the total physical activity (TPA) per week, healthcare service use and expenditure.

METHODS

We extracted the data from China Health and Retirement Longitudinal Study (CHARLS) 2011, 2013, and 2015. Participants more than 50 years old who completed the follow-up for the three waves were enrolled. We converted the volume of vigorous physical activity (VPA) into an equivalent volume of moderate physical activity (MPA) and calculated the TPA per week for each participant. 12,927 of the 17,708 participants in CHARLS were included in our analysis. More than one-third of participants over 50 years old never participate in any moderate or intensity activity, and the median of self-reported moderate or intensity PA was about 525 (IQR 0-1680) MET-minutes per week in 2015.

RESULTS

Compared to inactive subjects, the highest level of TPA was significantly related to the decreased risk number of inpatient visits (IRR: 0.58; 95% CI:0.50-0.67, p < 0.001), inpatient hospital days (IRR: 0.60; 95% CI: 0.42-0.84, p < 0.01), healthcare expenditure (IRR: 0.71; 95% CI: 0.65-0.79, p < 0.001) and catastrophic health expenditures (OR: 0.57; 95% CI: 0.45-0.72, p < 0.001) after adjusting for covariates.

CONCLUSIONS

Engaging in moderate-to-vigorous PA may drive a potential decrease in healthcare utilization, healthcare expenditure and household financial risk with a dose-response relationship in China, and some possible policy implications in public health may be considered to promote exercise in the middle-aged and elderly to reduce the medical burden on individuals and healthcare systems.

The influence of different levels of physical activity and sports performance on the accuracy of dynamic lower limbs balance assessment among Chinese physical education college students

Background: Balance ability is the basis of human actions. Improving the accuracy of dynamic balance assessment can increase the efficiency of sports injury prediction. Objectives: This study aimed to investigate how physical activity and sports performance affect the dynamic balance ability of lower limbs and validate whether the Lower Quarter Y-Balance Test (YBT-LQ) is a reliable predictor of sports injury risk among Chinese physical education college students. Materials and Methods: In total, 169 voluntary participants completed the YBT-LQ at the beginning of a semester and provided some physiological information and an injury report at the end of the semester. The correlation between YBT-LQ performance and selected factors that can affect the dynamic balance control was analyzed based on data statistics. The receiver operating characteristic (ROC) and the area under curve (AUC) of the composite scores of the YBT-LQ were calculated to explore an optimal cutoff value for predicting sports injury risk. Results: The composite scores of the YBT-LQ exhibited strong correlations with both the sports performance level and sports injury, as well as a moderate correlation with physical activity level, age (negative), and metabolic equivalent (MET). In the entire study population, the area under the receiver operating characteristic (ROC) curves for the binary classification of composite YBT-LQ scores of the left and right legs to predict sports injury risk were 0.78 and 0.74, respectively. Stratifying the study participants based on their levels of physical activity and sports performance had an effect on the AUC values of ROC curves. The optimal cutoff scores of the YBT-LQ for predicting sports injury risk were variable, with values more or less than 95%. Specifically, the cutoff scores for participants with the highest level of sports performance were notably higher, reaching up to 106.5% (left) and 107.2% (right). Conclusion: Physical activity and sports performance can influence human dynamic balance control. Composite scores of the YBT-LQ can be used with acceptable efficiency to predict sports injury. Stratifying participants based on their levels of physical activity and sports performance leads to different optimal cutoff values of the YBT-LQ composite scores in predicting sports injury. This approach is preferable to relying solely on a uniform 95% cutoff. It is recommended to analyze individuals with higher levels of sports performance, such as elite athletes, separately from those with lower levels. This is because the former group has a higher optimal cutoff value compared to the latter.

The functional movement screen predicts sports injuries in Chinese college students at different levels of physical activity and sports performance

Background

Functional Movement Screen (FMS) is used to evaluate the movement quality of an individual. However, the FMS composite score used to predict sports injuries is currently ambiguous. Further refinement of the FMS scoring method may be required to more accurately predict sports injuries.

Objectives

To investigate whether FMS scores could accurately predict sports injuries in college students with different levels of physical activity (PA) and sports performance (SP).

Methods

One hundred eighty-seven college students aged 18 to 22 were prospectively screened by the FMS test and grouped by the levels of PA and SP. Sports injury occurrences were monitored and collected 12 months later. Spearman's rank coefficients and binary logistic regression were used to identify the risk factors for sports injuries. The receiver operating characteristic (ROC) curve and the total area under the curve (AUC) value were used to determine the optimal FMS cut-off point for sports injuries.

Results

The FMS composite score (sum of the seven FMS tests) exhibited a fair association with sports injuries (r = -0.434, P < 0.001). Those with an FMS cut-off point of 17.5 were more likely to acquire sports injuries. The AUC value of the ROC curves was 0.764 (95% CI: 0.618-0.909) in the low PA students, 0.781 (95% CI: 0.729-0.936) in the moderate PA students, and 0.721 (95% CI: 0.613-0.879) in the high PA students. Furthermore, students stratified by SP level showed an AUC value of 0.730 (95% CI 0.607-0.853) in the low SP group and 0.778 (95% CI 0.662-0.894) in the moderate SP group, while it declined to 0.705 (95% CI 0.511-0.800) in the high SP group. The FMS cut-off score successfully identified individuals who reported sports injuries at a higher rate in the low (PA, 84.62%; SP, 90.48%) and moderate (PA, 93.75%; SP, 77.78%) groups than in the high groups (PA, 65.52%; SP, 57.89%).

Conclusions

The FMS composite score could be used to predict sports injuries in college students with an FMS cut-off value of 17.5. Population stratification by the levels of PA and SP seems to influence the predictive accuracy of the FMS.

Longitudinal association between falls and motoric cognitive risk syndrome among community-dwelling older adults

The motoric cognitive risk (MCR) syndrome is a predementia syndrome associated with dementia and mortality risk. This longitudinal study aimed to investigated the longitudinal association between MCR and falls in older adults, including 3,720 participants in the China Health and Retirement Longitudinal Study. A total of 482 participants (13.0%) met the MCR requirements at baseline. There were 226 incident cases of MCR (13.0%) throughout follow-up (duration: 4 years). Controlling for microsystem factors, a single fall (OR: 2.412, 95 % CI: 1.100-5.290; p < .05) was associated with incident MCR at baseline and to almost 2.0 times (HR: 2.021, 95 % CI: 1.031-3.961; p < .05) more inclined to develop MCR over time, compared to those without falls. These associations remained significant when meso/ exosystem factors and macrosystem factors were included in the analytic models. Falls may be useful in predicting MCR risk in the near future among Chinese older adults.