Objectives
This study aimed: (a) to provide a detailed description of sleep, sedentary behavior (SED), light physical activity (LPA), and moderate‐to‐vigorous physical activity (MVPA) over the ...complete 24‐hours period using raw acceleration data in older adults; and (b) to examine the differences in the 24‐hours activity cycle by sex, age, education, and body mass index (BMI).
Methods
Population‐based cohort comprising 3273 community‐dwelling individuals (1739 women), aged 71.8 ± 4.5 years, participating in the Seniors‐ENRICA‐2 study. Participants wore a wrist‐worn ActiGraph GT9X accelerometer for 7 consecutive days, and the raw signal was processed using the R‐package GGIR.
Results
Participants reached 21.5 mg as mean acceleration over the whole day; 32.3% (7.7 h/d) of time was classified as sleep, 53.2% (12.7 h/d) as SED, 10.4% (148.6 min/d) as LPA, and 4.1% (59.0 min/d) as MVPA. No marked differences were found in sleep‐related variables between socio‐demographic and BMI groups. However, women showed higher LPA but lower SED and MVPA than men. Moreover, SED increased whereas LPA and MVPA decreased with age. Participants with obesity (BMI ≥ 30 kg/m2) accumulated more SED and less LPA and MVPA than those without obesity. As expected, adherence to physical activity recommendations varied widely (9.2%‐76.6%) depending on the criterion of MVPA accumulation.
Conclusion
Objective assessment of the 24‐hour activity cycle provides extensive characterization of daily activities distribution in older adults and may inform health‐promotion interventions in this population. Women, the oldest old, and those with obesity offer relevant targets of strategies to improve lifestyle patterns.
Objectives
To examine the separate and joint association between physical activity and frailty and long‐term all‐cause and cardiovascular disease (CVD) mortality in older adults.
Design
...Population‐based prospective cohort study.
Setting
Cohort representative of the noninstitutionalized Spanish population.
Participants
Individuals aged 60 and older (N=3,896) in 2000–01.
Measurements
Participants reported their physical activity using a validated instrument, and frailty was ascertained using the Fatigue, low Resistance, limitation in Ambulation, Illness and weight Loss (FRAIL) scale. Those with 0 frailty criteria were considered to be robust, with 1 or 2 criteria to be prefrail, and with 3 of more criteria to be frail. Participants were followed until 2014 to identify all‐cause and CVD deaths. Associations were summarized using hazard ratios (HRs) and Cox regression after adjustment for main covariates.
Results
During a median 14 years of follow‐up, 1,801 total deaths occurred, 672 from CVD. Compared with being robust, the multivariate hazard ratio (95% confidence interval) for all‐cause mortality was 1.29 (1.14–1.45) in prefrail individuals, and 2.16 (1.82–2.58) in frail individuals (p‐trend <.001). Compared with being physically inactive, being physically active was associated with a statistically significant 18% (1–32%), 28% (16–39%) and 39% (17–55%) lower all‐cause mortality among robust, prefrail, and frail individuals, respectively (all p <.001). Compared with participants who were robust and physically active, those who were frail and inactive showed the highest all‐cause mortality 2.45 (95%CI: 1.95–3.06); however, the hazard ratio (95% confidence interval) for all‐cause mortality in frail individuals who were physically active was comparable to that in pre‐frail and inactive participants: 1.70 (1.32–2.19) and 1.56 (1.34–1.82), respectively. Mortality of prefrail active participants was similar to that of robust inactive participants. Results were similar for CVD mortality.
Conclusion
Physical activity might partly compensate for the greater mortality risk associated with frailty in old age. J Am Geriatr Soc 66:2097–2103, 2018.
Background
Depression and anxiety are the leading mental health problems worldwide; depression is ranked as the leading cause of global disability with anxiety disorders ranked sixth. Preventive ...strategies based on the identification of modifiable factors merit exploration. The aim of the present study was to investigate the associations of handgrip strength (HGS) with incident depression and anxiety and to explore how these associations differ by socio‐demographic, lifestyle, and health‐related factors.
Methods
The analytic sample comprised 162 167 participants (55% women), aged 38–70 years, from the UK Biobank prospective cohort study. HGS was assessed at baseline using dynamometry. Depression and anxiety were extracted from primary care and hospital admission records. Cox proportional models were applied, with a 2 year landmark analysis, to investigate the associations between HGS and incident depression and anxiety.
Results
Of the 162 167 participants included, 5462 (3.4%) developed depression and 6614 (4.1%) anxiety, over a median follow‐up period of 10.0 years (inter‐quartile range: 9.3–10.8) for depression and 9.9 (inter‐quartile range: 9.0–10.8) for anxiety. In the fully adjusted model, a 5 kg lower HGS was associated with a 7% (HR: 1.07 95% CI: 1.05, 1.10; P < 0.001) and 8% (HR: 1.08 95% CI: 1.06, 1.10; P < 0.001) higher risk of depression and anxiety, respectively. Compared with participants in the sex and age‐specific highest tertiles of HGS, those in the medium and lowest tertiles had an 11% (HR: 1.11 95% CI: 1.04, 1.19; P = 0.002) and 24% (HR: 1.24 95% CI: 1.16, 1.33; P < 0.001) higher risk of depression and 13% (HR: 1.13 95% CI: 1.06, 1.20; P < 0.001) and 27% (HR: 1.27 95% CI: 1.19, 1.35; P < 0.001) higher risk of anxiety, respectively. The association of HGS with depression was stronger among participants with average or brisk walking pace (vs. slow walking pace; Pinteraction < 0.001). The association with anxiety was stronger in those participants aged ≥58 years (vs. ≤58 years; Pinteraction = 0.002) and those living in more affluent areas (vs. deprived; Pinteraction = 0.001).
Conclusions
Handgrip strength was inversely associated with incident depression and anxiety. Because HGS is a simple, non‐invasive, and inexpensive measure, it could be easily used in clinical practice to stratify patients and identify those at elevated risk of mental health problems. However, future research should assess if resistance training aimed at increasing HGS can prevent the occurrence of mental health conditions.
Objective
To assess the association of physical activity (PA) type, volume, intensity, and changes over time with all‐cause mortality in older adults.
Methods
We used data from 3518 and 3273 older ...adults recruited in the Seniors‐ENRICA‐1 and 2 cohorts. PA was assessed with the EPIC questionnaire. Participants reported how many hours they spent a week in walking, cycling, gardening, do‐it‐yourself (DIY), sports, and housework. Then, time at each intensity (moderate PA MPA, vigorous PA VPA, moderate‐to‐vigorous PA MVPA and total PA) was calculated. Changes in PA were calculated from the date of the baseline interview to Wave 1. All‐cause mortality was ascertained up January 31, 2022. Analyses were performed with Cox regression models, adjusting for the main confounders.
Results
Walking, gardening, sports, and housework was associated with lower mortality (ranged 20%–46%). Also, MPA, VPA, MVPA was associated with lower risk of mortality (ranged 28%–53%). Analyses of PA change showed that, compared no PA participation (at baseline nor Wave 1), maintain walking, sports, and housework (ranged 28%–53%) and maintaining MPA, VPA, and MVPA (ranged 32%–36%) levels was linked to decreased mortality risk. Those who increased, maintained, or even decreased total PA had lower mortality (57%, 52%, and 36%, respectively) than those with consistently very low PA.
Conclusions
The lower mortality was observed in those with a high baseline level of total PA. Maintaining PA levels such as walking, gardening, and housework, or at all analyzed intensities, was related to lower mortality.
To examine the association between cognitive frailty and long-term all-cause mortality and the stratified and combined associations of physical activity and cognitive frailty with long-term all-cause ...mortality in a population-based cohort of older adults from Spain.
A representative cohort of 3677 noninstitutionalized individuals from Spain aged 60 years or older was recruited between April 17, 2000, and April 28, 2001, with follow-up through December 28, 2014. Information on self-reported physical activity and cognitive frailty status were collected at baseline. Analyses were performed with Cox regression after adjustment for confounders.
The median follow-up was 14 years (range, 0.03-14.25 years), corresponding to 40,447 person-years, with a total of 1634 deaths. The hazard ratio (HR) for all-cause mortality among participants with cognitive frailty compared with robust participants was 1.69 (95% CI, 1.43-2.01). Being active was associated with a mortality reduction of 36% (95% CI, 21%-47%) in cognitively frail individuals. Compared with those who were robust and active, participants with cognitive frailty who were inactive had the highest mortality risk (HR, 2.13; 95% CI, 1.73-2.61), which was equivalent to being 6.8 (95% CI, 5.33-7.99) years older.
Cognitive frailty was more markedly associated with increased mortality in inactive older adults, and being active reduced the mortality risk among cognitively frail individuals by 36%. These novel results highlight that engaging in physical activity could improve survival among cognitively frail older adults.
Background
This study aimed to investigate the associations of grip strength with incidence and mortality from dementia and whether these associations differ by sociodemographic and lifestyle ...factors.
Methods
A total of 466 788 participants of the UK Biobank (median age 56.5 years, 54.5% women). The outcome was all‐cause dementia incidence and mortality and the exposure was grip strength. Grip strength was assessed using a Jamar J00105 hydraulic hand dynamometer.
Results
Excluding the first 2 years of follow‐up (landmark analysis), mean follow‐up was 9.1 years (inter‐quartile range: 8.3; 9.7) for incidence and 9.3 (inter‐quartile range: 8.7; 10.0) for mortality. During this time, 4087 participants developed dementia, and 1309 died from it. Lower grip strength was associated with a higher risk of dementia incidence and mortality independent of major confounding factors (P < 0.001). Individuals in the lowest quintile of grip strength had 72% 95% confidence interval (CI): 1.55; 1.92 higher incident dementia risk and 87% 95% CI: 1.55; 2.26 higher risk of dementia mortality compared with those in the highest quintile. Our PAF analyses indicate that 30.1% of dementia cases and 32.3% of dementia deaths are attributable to having low grip strength. The association between grip strength and dementia outcomes did not differ by lifestyle or sociodemographic factors.
Conclusions
Lower grip strength was associated with a higher risk of all‐cause dementia incidence and mortality, independently of important confounding factors.
Abstract
The role of polymorphism rs9939609 of the
FTO
gene has been related with fat mass and cardiovascular risk in adults, but it remains unclear in children and adolescents. Hence, the main aim ...of this study was to determine the
FTO
polymorphism effects on body composition, cardiorespiratory fitness (CRF), physical activity (PA), inflammatory markers, and cardiovascular risk both in cross‐sectional analysis and after two‐years of follow‐up in children and adolescents. A total of 2129 participants were included in this study. The rs9939609 polymorphism was genotyped. Body composition measurements, CRF, and moderate‐to‐vigorous PA (MVPA) were determined at baseline and after two‐year of follow‐up. Moreover, plasma leptin and adiponectin were also determined as inflammatory markers. Furthermore, an index of cardiovascular disease risk factors (CVDRF‐I) was calculated. Codominant (TT vs. TA vs. AA) and dominant (AA+AT vs. TT) models were applied for statistical analysis. The results showed a main effect of the
FTO
genotype on body composition measures in both first and third year (
p
< 0.05), with lower adiposity in TT compared with AA or AA+AT group. These differences were maintained after accounting for pubertal maturity, sex, age, VO
2
max, and MVPA. Moreover, lower leptin level was observed in TT compared to AA+AT group in the third year. An interaction in Gene*Time*Sex was found in height and neck circumference in dominant model (
p
= 0.047;
p
= 0.020, respectively). No differences were found in CRF, MVPA nor CVDRF‐I between groups. Hence, homozygous TT allele could be a protective factor against weight gain from early childhood.
Trajectories of physical activity and sedentary time (SED) may differ between subgroups of youth. The aim of this study was to identify group‐based dual trajectories of physical activity and SED and ...explore individual, social, and environmental correlates of these trajectories. Longitudinal data (three time points, baseline 2011‐2012) of Spanish youth (n = 1597, mean age = 11.94 ± 2.52, 50.9% boys) were used. Moderate‐to‐vigorous physical activity (MVPA) and SED were assessed objectively at each time point, and 21 potential correlates were self‐reported at baseline. Parallel process growth mixture models identified shared categorical latent groups, adjusting for school and age. Multinomial logistic regression models identified baseline correlates of a given trajectory. Four shared categorical latent groups were identified: (1) stable MVPA and decreasing SED (4%); (2) stable MVPA and increasing SED (3%); (3) consistently higher MVPA (18%); and (4) stable low MVPA and slight increase in SED (75%). Multinomial logistic regression models with group 3 as reference found: negative affect (RRR = 0.90, 95% CI 0.84‐0.97), parental screen‐time rules (RRR = 1.15, 95% CI 1.00‐1.33), and household media equipment (RRR = 1.17, 95% CI 1.05‐1.30) predicted likelihood of group 1 membership; cons of reducing SED (RRR = 2.70, 95% CI 1.77‐4.10) predicted likelihood of group 2 membership; and co‐participation in physical activity with friends (RRR = 0.80, 95% CI 0.69‐0.94), fathers’ modeling of TV viewing (RRR = 1.22, 95% CI 1.02‐1.47), and household media equipment (RRR = 1.16, 95% CI 1.02‐1.31) predicted likelihood of group 4 membership. Results suggest that strategies to improve MVPA and SED behaviors among youth may need to be multifaceted, targeting all levels of influence.
The study aimed (a) to examine changes in physical activity (PA) during the whole day, school hours, recess, and physical education classes (PEC) during a 2‐year period in primary and secondary ...students; (b) to identify changes in the proportion of compliance with specific PA recommendations for these periods; and (c) to examine whether PA levels at baseline are associated with PA levels 2 years later. Eight hundred and fourteen (51.8% boys) children and 658 (50.1% boys) adolescents from 41 Spanish schools participated in the study. Hip‐worn accelerometers were used to assess PA during different time periods. Light PA (LPA) declined during the whole day, school hours, recess (all P < 0.001, except child girls for recess), and PEC (all, P < 0.05) in children and adolescents. Moderate‐to‐vigorous PA (MVPA) during the whole day and recess declined in child boys (P < 0.01 and P < 0.001, respectively) and adolescent boys (P < 0.001 and P < 0.05, respectively). MVPA during PEC declined in adolescent boys (P < 0.001) and adolescent girls (all P < 0.05). The proportion of compliance with the specific PA recommendations for these periods declined (P < 0.05), except for PEC in adolescent girls. PA during the whole day at baseline was moderately associated with PA during the whole day years later (ICCs = 0.210‐0.544, with one exception), but this association was lower for the school‐based PA. In conclusion, time spent in MVPA and LPA during the whole day and recess declined over time in child and adolescent boys and during PEC in adolescents. These findings highlight the need to promote PA interventions in these settings.
Most studies on the effects of sleep, sedentary behavior (SB), and physical activity (PA) on mental health did not account for the intrinsically compositional nature of the time spent in several ...behaviors. Thus, we examined the cross-sectional and prospective associations of device-measured compositional time in sleep, SB, light PA (LPA) and moderate-to-vigorous PA (MVPA) with depression symptoms, loneliness, happiness, and global mental health in older people (greater than or equai to 65 years). Data were taken from the Seniors-ENRICA-2 study, with assessments in 2015-2017 (wave 0) and 2018-2019 (wave 1). Time spent in sleep, SB, LPA and MVPA was assessed by wrist-worn accelerometers. Depression symptoms, loneliness, happiness, and global mental health were self-reported using validated questionnaires. Analyses were performed using a compositional data analysis (CoDA) paradigm and adjusted for potential confounders. In cross-sectional analyses at wave 0 (n = 2489), time-use composition as a whole was associated with depression and happiness (all p < 0.01). The time spent in MVPA relative to other behaviors was beneficially associated with depression (gamma = -0.397, p < 0.001), loneliness (gamma = -0.124, p = 0.017) and happiness (gamma = 0.243, p < 0.001). Hypothetically, replacing 30-min of Sleep, SB or LPA with MVPA was beneficially cross-sectionally related with depression (effect size ES ranged -0.326 to -0.246), loneliness (ES ranged -0.118 to -0.073), and happiness (ES ranged 0.152 to 0.172). In prospective analyses (n = 1679), MVPA relative to other behaviors at baseline, was associated with favorable changes in global mental health (gamma = 0.892, p = 0.049). We observed a beneficial prospective effect on global mental health when 30-min of sleep (ES = 0.521), SB (ES = 0.479) or LPA (ES = 0.755) were theoretically replaced for MVPA. MVPA was cross-sectionally related with reduced depression symptoms and loneliness and elevated level of happiness, and prospectively related with enhanced global mental health. Compositional isotemporal analyses showed that hypothetically replacing sleep, SB or LPA with MVPA could result in modest but significantly improvements on mental health indicators. Our findings add evidence to the emerging body of research on 24-h time-use and health using CoDA and suggest an integrated role of daily behaviors on mental health in older people.