A Threshold of Objectively-Assessed Daily Sedentary Time for All-Cause Mortality in Older Adults: A Meta-Regression of Prospective Cohort Studies

Joint association of sedentary behavior and physical activity domains with depression in Korean adults: Cross-sectional study combining four biennial surveys (2016-2022)

Although the increased prevalence of sedentary behavior and insufficient physical activity constitutes a global public health concern, there is limited research on their effects on mental health. We investigated the combined association of sedentary behavior (daily sitting or reclining ≥10 h/day) and physical activity domains (evaluated using the Global Physical Activity Questionnaire, including occupational physical activity, leisure-time physical activity, and transportation-related physical activity) with depression (Patient Health Questionnaire-9, cutoff score: 10). This cross-sectional study utilized biennial data of 21,416 adults (age >20 years) from the Korea National Health and Nutrition Examination Survey waves 7-9 (2016-2022). Joint associations were explored by combining sedentary behavior and each physical activity domain into four levels. Sedentary behavior and occupational physical activity increased the risk of depression, leisure-time physical activity decreased the risk only in men, and transportation-related physical activity showed no significant association. Logistic regression each physical activity domain revealed, for men and women, a significantly higher risk of depression in the sedentary behavior (+)/occupational physical activity (+) group than in the sedentary behavior (-)/occupational physical activity (-) group (odds ratio: 3.05 and 2.66, respectively). The sedentary-behavior (+)/leisure-time physical-activity (-) group showed a significantly higher risk of depression than the sedentary behavior (-)/leisure-time physical activity (+) group (odds ratio: 2.50 and 2.14), and sedentary behavior (+)/transportation-related physical activity (-) group also showed a significantly higher risk of depression compared to the sedentary behavior (-)/transportation-related physical activity (+) group (odds ratio: 1.83 and 1.61). With concurrent exposure to sedentary behavior, the occupational physical activity and lack of leisure time and transportation-related physical activity synergistically increased the risk of depression. Encouraging leisure-time physical activity, minimizing rigorous occupational physical activity, and reducing sedentary behavior may reduce depressive symptoms, and research into specific domains of sedentary behavior and the quantity and quality of transportation-related physical activity is needed.

Health and sociodemographic determinants of excess mortality in Spanish nursing homes during the COVID-19 pandemic: a 2-year prospective longitudinal study

BACKGROUND

Age, multimorbidity, immunodeficiency and frailty of older people living in nursing homes make them vulnerable to COVID-19 and overall mortality.

OBJECTIVE

To estimate overall and COVID-19 mortality parameters and analyse their predictive factors in older people living in nursing homes over a 2-year period.

METHOD

Design: A 2-year prospective longitudinal multicentre study was conducted between 2020 and 2022.

SETTING

This study involved five nursing homes in Central Catalonia (Spain).

PARTICIPANTS

Residents aged 65 years or older who lived in the nursing homes on a permanent basis.

MEASUREMENTS

Date and causes of deaths were recorded. In addition, sociodemographic and health data were collected. For the effect on mortality, survival curves were performed using the Kaplan-Meier method and multivariate analysis using Cox regression.

RESULTS

The total sample of 125 subjects had a mean age of 85.10 years (standard deviation = 7.3 years). There were 59 (47.2%) deaths at 24 months (95% confidence interval, CI, 38.6-55.9) and 25 (20.0%) were due to COVID-19, mostly in the first 3 months. In multivariate analysis, functional impairment (hazard ratio, HR 2.40; 95% CI 1.33-4.32) was a significant risk factor for mortality independent of age (HR 1.17; 95% CI 0.69-2.00) and risk of sarcopenia (HR 1.40; 95% CI 0.63-3.12).

CONCLUSION

Almost half of this sample of nursing home residents died in the 2‑year period, and one fifth were attributed to COVID-19. Functional impairment was a risk factor for overall mortality and COVID-19 mortality, independent of age and risk of sarcopenia.

Enhancing mental well-being of undergraduates: establishing cut-off values and analyzing substitutive effects of physical activity on depression regulation

Objective

This study aimed to analyze the effects of physical activity (PA), sleep quality, and sedentary behavior on subthreshold depression (StD) among undergraduates.

Methods

This study included 834 undergraduates and assessed the impact of PA time, sleep quality, and sedentary behavior on depression. The receiver operating characteristic (ROC) analysis was performed to determine cut-off values for StD risk, while the isochronous substitution analysis was performed to evaluate the effects of different activities on depression regulation.

Results

Gender, age, and academic grade had no significant influence on depression levels among undergraduates (p > 0.05). However, students engaging in sedentary behavior for more than 12.1 h per day or with a Pittsburgh Sleep Quality Index score above 3.5 were at an increased risk of subclinical depression. Additionally, the isochronous substitution of light-intensity physical activity for other activities (sleep, sedentary behavior, moderate and vigorous intensity physical activity) showed statistically significant effects (p < 0.05) in both 5-min and 10-min substitution models, demonstrating a positive effect on alleviating depression.

Conclusion

The findings indicate that specific lifestyle factors, particularly high levels of sedentary behavior and poor sleep quality, are crucial determinants of subclinical depression among undergraduates, independent of demographic variables such as gender, age, and academic grade. Notably, light-intensity PA plays a key role in StD regulation, as substituting it with more intense physical activities or improving sleep quality substantially reduces depression scores. Furthermore, the benefits such substitution became more pronounced with the increase in duration of the activity.

Device-measured sedentary time and intensity-specific physical activity in relation to all-cause and cardiovascular disease mortality: the UK Biobank cohort study

BACKGROUND AND AIMS

Understanding the amounts of intensity-specific movement needed to attenuate the association between sedentary time and mortality may help to inform personalized prescription and behavioral counselling. Herein, we examined the joint associations of sedentary time and intensity-specific physical activity with all-cause and cardiovascular disease (CVD) mortality.

METHODS

Prospective cohort study including 73,729 adults from the UK Biobank who wore an Axivity AX3 accelerometer on their dominant wrist for at least 3 days, being one a weekend day, between June 2013 and December 2015. We considered the median tertile values of sedentary time and physical activity in each intensity band to determine the amount of physical activity needed to attenuate the association between sedentary time and mortality.

RESULTS

During a median of 6.9 years of follow-up (628,807 person-years), we documented 1521 deaths, including 388 from CVD. Physical activity of any intensity attenuated the detrimental association of sedentary time with mortality. Overall, at least a median of 6 min/day of vigorous physical activity, 30 min/day of MVPA, 64 min/day of moderate physical activity, or 163 min/day of light physical activity (mutually-adjusted for other intensities) attenuated the association between sedentary time and mortality. High sedentary time was associated with higher risk of CVD mortality only among participants with low MVPA (HR 1.96; 95% CI 1.23 to 3.14).

CONCLUSIONS

Different amounts of each physical activity intensity may attenuate the association between high sedentary time and mortality.

Do the associations of daily steps with mortality and incident cardiovascular disease differ by sedentary time levels? A device-based cohort study

OBJECTIVES

This study aims to examine the associations of daily step count with all-cause mortality and incident cardiovascular disease (CVD) by sedentary time levels and to determine if the minimal and optimal number of daily steps is modified by high sedentary time.

METHODS

Using data from the UK Biobank, this was a prospective dose-response analysis of total daily steps across low (<10.5 hours/day) and high (≥10.5 hours/day) sedentary time (as defined by the inflection point of the adjusted absolute risk of sedentary time with the two outcomes). Mortality and incident CVD was ascertained through 31 October 2021.

RESULTS

Among 72 174 participants (age=61.1±7.8 years), 1633 deaths and 6190 CVD events occurred over 6.9 (±0.8) years of follow-up. Compared with the referent 2200 steps/day (5th percentile), the optimal dose (nadir of the curve) for all-cause mortality ranged between 9000 and 10 500 steps/day for high (HR (95% CI)=0.61 (0.51 to 0.73)) and low (0.69 (0.52 to 0.92)) sedentary time. For incident CVD, there was a subtle gradient of association by sedentary time level with the lowest risk observed at approximately 9700 steps/day for high (0.79 (0.72 to 0.86)) and low (0.71 (0.61 to 0.83)) sedentary time. The minimal dose (steps/day associated with 50% of the optimal dose) of daily steps was between 4000 and 4500 steps/day across sedentary time groups for all-cause mortality and incident CVD.

CONCLUSIONS

Any amount of daily steps above the referent 2200 steps/day was associated with lower mortality and incident CVD risk, for low and high sedentary time. Accruing 9000-10 500 steps/day was associated with the lowest mortality risk independent of sedentary time. For a roughly equivalent number of steps/day, the risk of incident CVD was lower for low sedentary time compared with high sedentary time.

Is education level, as a proxy for socio-economic position, related to device-measured and self-reported sedentary behavior in European older adults? A cross-sectional study from the SITLESS project

Background

Sedentary behavior (SB) is a determinant of health in older adult people. Educational level is a primary driver of health disparities and is demonstrated to be a reliable measure of socioeconomic position. We aimed to examine the associations between educational level and self-reported along with device-measured SB in older adults living in Europe and the association of mentally active and passive SB domains with the educational level and gender in these associations.

Methods

The design is cross-sectional. One thousand three hundred and sixty participants aged 65 and over (75.3±6.3 years old, 61.8% women) participated. Inclusion criteria were scored with the Short Physical Performance Battery. Variables that describe the sample were assessed with an interview, and device-measured SB was assessed with an accelerometer. SB was assessed with the Sedentary Behavior Questionnaire and an accelerometer. Multiple linear regression models were used to study the association between the level of education and SB.

Results

Participants self-reported an average of 7.82 (SD: 3.02) daily waking hours of SB during weekend days, and the average of device-measured SB was 11.39 (1.23) h. Total mentally active SB (weekdays and weekends) was associated with the education level (p < 0.000). Participants were more sedentary during the week than during weekends, regardless of level of education (p < 0.000). Education level was significantly associated with self-reported mean hours per day in 46SB (p = 0.000; R=0.026; 95%CI).

Conclusion

Low education level in older adults is associated with self-reported SB but not with objective SB measures.

Device-Measured Physical Activity and Sedentary Behavior in Relation to Cardiovascular Diseases and All-Cause Mortality: Systematic Review and Meta-Analysis of Prospective Cohort Studies

Introduction

This review synthesized evidence from prospective cohort studies on the association of device-measured physical activity and sedentary behavior with cardiovascular disease and all-cause mortality among adults.

Methods

Five databases were searched from 2000 through April 29, 2020. Study quality was appraised using the NIH Quality Assessment Tool. Pooled hazard ratio and 95% CI were obtained from random-effects meta-analyses. Subgroup analyses by age and sex were conducted for studies on all-cause mortality.

Results

Of 29 articles included in the systematic review, 5 studies on cardiovascular disease mortality and 15 studies on all-cause mortality were included in meta-analyses. Comparing the highest with the lowest exposure categories, the pooled hazard ratios (95% CIs) for cardiovascular disease mortality were 0.29 (CI=0.18, 0.47) for total physical activity, 0.37 (CI=0.25, 0.55) for moderate-to-vigorous physical activity, 0.62 (0.41-0.93) for light physical activity, and 1.89 (CI=1.09, 3.29) for sedentary behavior. The pooled hazard ratios (95% CIs) for all-cause mortality were 0.42 (CI=0.34, 0.53) for total physical activity, 0.43 (CI=0.35, 0.53) for moderate-to-vigorous physical activity, 0.58 (CI=0.43, 0.80) for light physical activity, and 1.58 (CI=1.19, 2.09) for sedentary behavior. The pooled hazard ratio (95% CI) for all-cause mortality was 0.35 (CI=0.29, 0.42) for steps per day, but the studies available for analysis were conducted in older adults. The results of subgroup analyses were consistent with the main results.

Discussion

Rapidly accumulating evidence suggests that more physical activity and less sedentary behavior are associated with a lower risk of cardiovascular disease and all-cause mortality. Similar beneficial relationships were found for step counts and all-cause mortality among older adults. Future studies employing standardized research methodologies and up-to-date data processing approaches are warranted to recommend specific amounts of physical activity and limits to sedentary behavior.

Multiple health risk behaviors, including high consumption of ultra-processed foods and their implications for mental health during the COVID-19 pandemic

Background and aim

The growing increase in diet- and behavior-related illnesses has drawn the attention of many epidemiologists who attribute such changes to the epidemiological and nutritional transition. Thus, this study aims to evaluate the association between the combined occurrence of health risk behaviors, such as sedentary lifestyles, high weekly consumption of ultra-processed foods (UPFs), and non-daily consumption of fruits and vegetables, and symptoms of anxiety or depression in adults.

Methods

This is a cross-sectional study based on an epidemiological survey in two Brazilian cities. The outcome, anxiety, and depression symptoms were assessed using the Generalized Anxiety Disorder 7-item (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9). Food consumption was assessed using a qualitative food frequency questionnaire (FFQ) with reference to consumption in the last 3 months and categorized into the consumption of fruits and vegetables and the consumption of UPFs according to the NOVA classification. Sedentary behavior was assessed by considering the amount of sitting or reclining time per day reported by participants and categorized as less than 9 h of sitting or reclining and 9 h or more. For the analysis, adjusted Poisson regression (PR) was used to estimate the prevalence ratio and the 95% confidence interval (CI).

Results

Those with the health risk behaviors, non-daily consumption of fruits and vegetables, and high consumption of UPFs had a 2.6 higher prevalence ratio for symptoms of mental disorder (PR: 2.6 and 95%CI: 1.1–6.5), as well as those with all three health risk behaviors, had a 2.8 higher prevalence ratio for symptoms of mental disorder (PR: 2.8 and 95%CI: 1.3–6.1).

Conclusion

This study revealed that the existence of a combination of two and three health risk behaviors led to a higher prevalence of symptoms of anxiety or depression.

Association between Accelerometer-Measured Light-Intensity Physical Activity and Cognitive Function in Older Adults

OBJECTIVES

This study aimed to investigate whether accelerometer-measured light physical activity (LPA) is associated with cognitive function and whether engaging in ≥3 h/day of LPA can reduce the chance of cognitive impairment among a sample of older adults in Taiwan.

DESIGN

Cross-sectional study.

SETTING

An outpatient department in a medical center.

PARTICIPANTS

Participants were community-dwelling older adults aged 65 years and older who were able to walk independently from September 2020 to March 2021.

MEASUREMENTS

A tri-axial accelerometer was used to measure LPA for 7 consecutive days, and the Mini-Mental State Examination (MMSE) scale was used to assess the chance of cognitive impairment. Multiple linear regression model and binary logistic regression model were performed to examine the association between LPA and MMSE scores.

RESULTS

145 older Taiwanese adults (51.7% men; 81.2±6.8 years; 6.9% at chance of cognitive impairment) were included. After adjusting for moderate-to-vigorous physical activity (MVPA) and wear time, we found that there was a significant association between LPA and cognitive function (95% confidence interval [CI]: 0.64-1.65; P<0.001), and further found that those who engaged in LPA ≥3 h/day were at reduced chance of cognitive impairment compared with people who engaged in LPA <3 h/day (odds ratio [OR]: 0.16; 95% CI: 0.03-0.80; P=0.025).

CONCLUSION

This study demonstrated that engaging in LPA ≥3 h/day could be viewed as a protective factor for maintaining cognitive function in older adults. We recommend further longitudinal research to elucidate the association between intensity-specific LPA and cognitive function.

Associations of the audited residential neighborhood built-environment attributes with objectively-measured sedentary time among adults: a systematic review

This study systematically reviewed the relevant studies and summarized the associations of objective measures of residential neighborhood built-environment attributes with sedentary time among adults. Published studies were obtained from PubMed and Scopus, restricting to those published in English language peer-reviewed journals to Oct. 2021. There were nine studies and 48 instances of estimated associations. Most instances showed no statistical-significant associations; by contrast, few instances showed that adults living in a neighborhood characterized by a high density of local destinations and connected intersections were associated with less sedentary time. The findings suggest that a high density of destinations and street intersections around residence may provide opportunities to transfer and access to services, thus reducing the sedentary time. Future research strengthening the research design and measurements are needed to investigate the potential explanations of the associations between residential neighborhood built environments and sedentary time in adults.

Revisiting the association of sedentary behavior and physical activity with all-cause mortality using a compositional approach: the Women's Health Study

BACKGROUND

While physical activity has consistently been associated with decreased mortality rates, it remains unknown if there is a single "ideal" combination of time in physical activities of different intensities and sedentary behavior (SB) associated with the lowest rate. This study examined the associations of combinations of time in moderate-to-vigorous intensity (MVPA), higher-light intensity (HLPA), lower-light intensity activities (LLPA), and SB with mortality rates in older women.

METHODS

This prospective cohort study included 16,676 older women from throughout the United States enrolled in the Women's Health Study. Women wore accelerometers on their hip from 2011 to 2015 and were followed through 2017 (mean (SD) of 4.3 (1.1) years). Deaths were confirmed with medical records, death certificates, or the National Death Index. Compositional Cox regression models were used.

RESULTS

The mean (SD) age was 72 (5.7) years at accelerometer wear; 503 women died. Compared to the least active women (mean, 3 min/day MVPA, 27 min/day HLPA, 162 min/day LLPA, and 701 min/day SB): compositional models showed an inverse L-shaped dose-response association of MVPA replacing other behaviors with mortality rates mortality rates (P = .02); SB relative to LLPA, HLPA, and MVPA was directly associated with mortality rates in a curvilinear dose-response manner (P < .001); replacing 10 min of SB for MVPA (HR (95% CI) = .86 (.73-.98)) or for HLPA (HR (95% CI.94 (.88-1.00)) associated with 14 and 6% lower mortality rates, respectively; a 47% risk reduction (HR [95% CI] = .53 [.42-.64]) was observed among women meeting physical activity guidelines (mean, 36 min/day MVPA, 79 min/day HLPA, 227 min/day LLPA and 549 min/day SB); and similar mortality rate reductions of 43% (HR (95% CI) = .57 (.41-.73)) were observed with increases in HLPA and LLPA without increasing MVPA, e.g., reallocating SB to 90 min/day of HLPA plus 120 min/day of LLPA.

CONCLUSIONS

There was no "ideal" combination of physical activities of different intensities and SB associated with the lowest mortality rates. Of particular relevance to older women, replacing SB with light intensity activity was associated with lower mortality rates, and "mixing and matching" times in different intensities yielded equivalent mortality risk reductions.

Cross-sectional and longitudinal associations of outdoor walking with overall mental health in later life

PURPOSE

This study aimed to examine the cross-sectional and longitudinal associations of three walking parameters (frequency, duration, and intensity) with overall mental health in older adults.

METHODS

A cross-sectional survey was conducted in 2014 with 1255 community-dwelling older adults aged 65 years and older in Taipei, Taiwan. Among them, 408 participants completed the one-year follow-up survey in 2015. Self-reported outdoor walking during the past 7 days was measured by asking the frequency, duration, and intensity. Metabolic equivalent (MET) values (<2.5, 2.5-<3.5, 3.5-<4.5, and ≥4.5 MET) were assigned to the four levels of speed (slow pace, average, brisk, and fast pace) based on the average walking distance per minute. Overall mental health was assessed using the Five-item Brief Symptom Rating Scale (BSRS-5). Multivariable linear regression models were conducted to explore the cross-sectional and longitudinal associations between outdoor walking and overall mental health, adjusting for socio-demographic factors, lifestyle behaviors, comorbidity and health status.

RESULTS

Among the walking parameters, only walking intensity emerged as a significant predictor of subsequent overall mental health. Multivariable regression analysis showed that light-to-moderate intensity (approximately 2.5-<4.5 METs) was significantly associated with better overall mental health at 12-month follow-up.

CONCLUSIONS

Outdoor walking at light-to-moderate intensity is prospectively associated with better overall mental health in later life.

A dose response relationship between accelerometer assessed daily steps and depressive symptoms in older adults: a two-year cohort study

OBJECTIVES

this study investigated the prospective associations of accelerometer assessed daily steps with subsequent depressive symptoms in older adults.

METHODS

a 2-year prospective study was performed in the community. A total of 285 older adults ≥65 years (mean age = 74.5) attended the baseline assessment in 2012. The second wave of assessment was carried out in 2014 including 274 (96.1%) participants. Daily step counts were measured with a triaxial accelerometer (ActiGraph GT3X+), and participants were divided into three categories (<3,500, 3,500-6,999 and ≥ 7,000 steps/day). The 15-item Geriatric Depression Scale was used to measure depressive symptoms. Negative binomial regression models with multivariable adjustment for covariates (baseline depressive symptoms, accelerometer wear time, age, gender, education, chronic disease, activities of daily living) were conducted to examine the association between daily steps and subsequent depressive symptoms.

RESULTS

each 1,000-step increase in daily walking was linearly associated with a reduced rate of subsequent depressive symptoms (rate ratio [RR] = 0.95, 95% confidence interval [CI] = 0.92-0.98). Participants with daily step count in 3,500-6,999 (RR = 0.84, 95% CI = 0.70-0.99) and ≥7,000 steps (RR = 0.71, 95% CI = 0.55-0.92) per day had fewer depressive symptoms at follow-up. Sensitivity analyses assessing confounding and reverse causation provided further support for the stability of our findings.

CONCLUSION

older adults engaging in more daily steps had fewer depressive symptoms after 2 years. Even as few as 3,500-6,999 steps a day was associated with a protecting effect. Accumulating ≥7,000 steps a day could provide the greatest protection against depressive symptoms.

Accelerometer-Measured Sedentary and Physical Activity Time and Their Correlates in European Older Adults: The SITLESS Study

Background

Sedentary behavior (SB) and physical activity (PA) are important determinants of health in older adults. This study aimed to describe the composition of accelerometer-measured SB and PA in older adults, to explore self-reported context-specific SB, and to assess sociodemographic and functional correlates of engaging in higher levels of SB in participants of a multicenter study including four European countries.

Method

One thousand three hundred and sixty community-dwelling older adults from the SITLESS study (61.8% women; 75.3 ± 6.3 years) completed a self-reported SB questionnaire and wore an ActiGraph accelerometer for 7 days. Accelerometer-determined compositional descriptive statistics were calculated. A fixed-effects regression analysis was conducted to assess the sociodemographic (country, age, sex, civil status, education, and medications) and functional (body mass index and gait speed) correlates.

Results

Older adults spent 78.8% of waking time in SB, 18.6% in light-intensity PA, and 2.6% in moderate-to-vigorous PA. Accelerometry showed that women engaged in more light-intensity PA and walking and men engaged in higher amounts of moderate-to-vigorous PA. Watching television and reading accounted for 47.2% of waking time. Older age, being a man, single, taking more medications, being obese and overweight, and having a slower gait speed were statistically significant correlates of more sedentary time.

Conclusions

The high amount of SB of our participants justifies the need to develop and evaluate interventions to reduce sitting time. A clinically relevant change in gait speed can decrease almost 0.45 percentage points of sedentary time. The distribution of context-specific sedentary activities by country and sex showed minor differences, albeit worth noting.

New global guidelines on sedentary behaviour and health for adults: broadening the behavioural targets

BACKGROUND

In 2018, the World Health Organisation (WHO) commenced a program of work to update the 2010 Global Recommendations on Physical Activity for Health, for the first-time providing population-based guidelines on sedentary behaviour. This paper briefly summarizes and highlights the scientific evidence behind the new sedentary behaviour guidelines for all adults and discusses its strengths and limitations, including evidence gaps/research needs and potential implications for public health practice.

METHODS

An overview of the scope and methods used to update the evidence is provided, along with quality assessment and grading methods for the eligible new systematic reviews. The literature search update was conducted for WHO by an external team and reviewers used the AMSTAR 2 (Assessment of Multiple Systematic Reviews) tool for critical appraisal of the systematic reviews under consideration for inclusion. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was used to rate the certainty (i.e. very low to high) of the evidence.

RESULTS

The updated systematic review identified 22 new reviews published from 2017 up to August 2019, 14 of which were incorporated into the final evidence profiles. Overall, there was moderate certainty evidence that higher amounts of sedentary behaviour increase the risk for all-cause, cardiovascular disease (CVD) and cancer mortality, as well as incidence of CVD, cancer, and type 2 diabetes. However, evidence was deemed insufficient at present to set quantified (time-based) recommendations for sedentary time. Moderate certainty evidence also showed that associations between sedentary behaviour and all-cause, CVD and cancer mortality vary by level of moderate-to-vigorous physical activity (MVPA), which underpinned additional guidance around MVPA in the context of high sedentary time. Finally, there was insufficient or low-certainty systematic review evidence on the type or domain of sedentary behaviour, or the frequency and/or duration of bouts or breaks in sedentary behaviour, to make specific recommendations for the health outcomes examined.

CONCLUSIONS

The WHO 2020 guidelines are based on the latest evidence on sedentary behaviour and health, along with interactions between sedentary behaviour and MVPA, and support implementing public health programmes and policies aimed at increasing MVPA and limiting sedentary behaviour. Important evidence gaps and research opportunities are identified.

Initial impact of the COVID-19 pandemic on physical activity and sedentary behavior in hypertensive older adults: An accelerometer-based analysis

Background

This study reports the accelerometer-based physical activity (PA) and sedentary behavior (SB) before and during the COVID-19 pandemic in hypertensive older adults.

Methods

Thirty-five hypertensive older adults were included in this observational study. Accelerometer-based PA and SB measures were assessed before (January to March 2020) and during (June 2020) the COVID-19 pandemic. Linear mixed models were used to assess within-group changes in PA and SB measures, adjusted by accelerometer wear time.

Results

Before COVID-19 pandemic participants presented: 5809 steps/day (SE = 366), 303.1 min/day (SE = 11.9) of light PA, 15.5 min/day (SE = 2.2) of moderate-vigorous PA, and 653.0 min/day (SE = 12.6) of SB. During COVID-19 pandemic there was a decrease in steps/day (β = −886 steps/day, SE = 361, p = 0.018), in moderate-vigorous PA (β = −2.8 min/day, SE = 2.4, p = 0.018), and a trend in light PA (β = −26.6 min/day, SE = 13.4, p = 0.053). In addition, SB increased during the COVID-19 pandemic (β = 29.6 min/day, SE = 13.4, p = 0.032). The magnitude of changes was greater on the weekend, mainly for steps/day (β = −1739 steps/day, SE = 424, p < 0.001) and the SB pattern (more time spent in bouts of ≥10 and 30 min, less breaks/day and breaks/h).

Conclusions

The COVID-19 pandemic may elicit unhealthy changes in movement behavior in hypertensive older adults. Lower PA, higher and more prolonged SB on the weekend are the main features of the behavioral changes.

•

Unhealthy changes in movement behavior were observed during the COVID-19 pandemic.

•

Hypertensive older adults decreased steps/day and time spent in physical activities.

•

An increase in time spent in sedentary behavior (SB) was observed.

•

The time spent in prolonged SB increased and the breaks in SB decreased.

•

Greater unhealthy changes in movement behavior occurred on weekend.

Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep

The Canadian Society for Exercise Physiology assembled a Consensus Panel representing national organizations, content experts, methodologists, stakeholders, and end-users and followed an established guideline development procedure to create the Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. These guidelines underscore the importance of movement behaviours across the whole 24-h day. The development process followed the strategy outlined in the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. A large body of evidence was used to inform the guidelines including 2 de novo systematic reviews and 4 overviews of reviews examining the relationships among movement behaviours (physical activity, sedentary behaviour, sleep, and all behaviours together) and several health outcomes. Draft guideline recommendations were discussed at a 4-day in-person Consensus Panel meeting. Feedback from stakeholders was obtained by survey (n = 877) and the draft guidelines were revised accordingly. The final guidelines provide evidence-based recommendations for a healthy day (24-h), comprising a combination of sleep, sedentary behaviours, and light-intensity and moderate-to-vigorous-intensity physical activity. Dissemination and implementation efforts with corresponding evaluation plans are in place to help ensure that guideline awareness and use are optimized.

Novelty First ever 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older with consideration of a balanced approach to physical activity, sedentary behaviour, and sleep Finalizes the suite of 24-Hour Movement Guidelines for Canadians across the lifespan

Associations of older adults' excursions from home with health-related physical activity and sedentary behavior

BACKGROUND

As people age, they spend more time in and around their domestic environments, within which opportunities for health-enhancing physical activity (PA) may be limited. We examined the associations of frequency of excursions from home with accelerometer-determined PA and the total and prolonged sedentary behavior (SB, sitting for ≥30 min) among community-dwelling older adults.

METHODS

Overall, 434 older adults (men, 57.1 %; age, 70-79 years) wore an accelerometer (HJA-350IT, Omron Healthcare) for 7 days. Time spent in SB, light-intensity PA (LPA), moderate-to-vigorous PA (MVPA), and prolonged SB bout (≥30 min) were calculated. Frequencies of excursions from home were categorized as 0-3, 4-5, and 6-7 days/week. Associations of excursions with PA and SB were tested by analysis of covariance adjusted for sociodemographic characteristics.

RESULTS

Frequencies were 14.3 %, 31.1 %, and 54.6 % for excursions 0-3, 4-5, and 6-7 days/week, respectively. For men, less frequent excursions from home were significantly associated with less MVPA and more total and prolonged SB times (estimated means [minutes/day]: MVPA, 32, 42, and 48; total SB, 589, 549, and 539; prolonged SB, 344, 288, and 265; respectively; p < 0.05). LPA was not statistically significant (p = 0.09). For women, less frequent excursions were significantly associated with all PA outcomes (SB: 536, 497, and 467; prolonged SB: 260, 213, and 204; LPA: 328, 363, and 379; MVPA: 36, 39, and 54, respectively).

CONCLUSIONS

Among community-dwelling Japanese older adults, more frequent excursions from home were associated with more PA, less SB, and more-favorable SB patterns, suggesting a potential strategy for preventive-health initiatives.

Objectively assessed physical activity patterns and physical function in community-dwelling older adults: a cross-sectional study in Taiwan

OBJECTIVES

To objectively assess light physical activity (PA), moderate-to-vigorous PA (MVPA), step counts and number of 10 min MVPA bouts and their association with physical function among older adults.

DESIGN

Cross-sectional design.

SETTING

Urban community setting in Taiwan.

PARTICIPANTS

127 Taiwanese older adults aged over 65 years (mean age=70.8±5.3 years; 72% women).

PRIMARY AND SECONDARY OUTCOME MEASURES

Triaxial accelerometers were used to measure PA variables for 10 hours/day for seven consecutive days. Then, five physical function components (handgrip strength, single-leg stance, 5-metre walk speed, timed up and go and sit-to-stand test) were measured. Multiple linear regressions were used to perform separate analyses for older men and women.

RESULTS

For older women, daily MVPA time (β: 0.39, 95% CI: 0.12, 0.64; p=0.004), daily step counts (β: 0.46, 95% CI: 0.12, 0.78; p=0.009) and number of 10 min MVPA bouts (β: 0.27, 95% CI: 0.001, 0.53; p=0.049) were positively associated with handgrip strength after adjusting for accelerometer wear time, sedentary time and other confounders. Furthermore, daily MVPA time was positively associated with a single-leg stance (β: 0.25, 95% CI: 0.02, 0.49; p=0.036) and higher daily step counts were associated with shorter walking speed performance (β: -0.31, 95% CI: -0.57, -0.001; p=0.049). None of the variables of the objectively assessed PA patterns was associated with physical function outcomes among older men due to their small sample size.

CONCLUSIONS

Daily MVPA, MVPA bouts of at least 10 min and accumulated daily steps are important for improving physical function among older women. Future prospective research should establish causal associations between PA patterns and functional ability among older adults.

Independent and Joint Associations of Physical Activity and Dietary Behavior with Older Adults' Lower Limb Strength

Studies have indicated that sufficient physical activity levels and balanced dietary behavior are independently related to physical function in older populations; however, their joint association with physical function remain unclear. This study examined the independent and combined associations of sufficient physical activity and balanced selection of foods with lower limb strength among 122 older Taiwanese adults living in community (mean age: 69.9 ± 5.0 years). The assessments included accelerometer-measured moderate-to-vigorous physical activity (MVPA) and self-reported selection of foods. Lower limb strength performance was measured using the five times sit-to-stand test. Binary logistic regression analyses were performed to estimate the associations in question before and after adjusting for potential confounders. The results showed that in the adjusted model, lower limb strength had no significant independent association with either meeting the recommended level of MVPA or balanced selection of foods. Compared to older adults who neither met the recommended MVPA level nor reported a balanced selection of foods, those who conformed to both these criteria were more likely to have better lower limb strength (odds ratio = 6.28, 95% confidence interval = 1.36–29.01) after adjusting for covariates. Health promotion initiatives addressing disability prevention for older adults need to consider promoting both MVPA and food selection.