ObjectivesWe examined the associations of history and duration in high occupational physical activity (OPA) with long-term total and cause-specific mortality.MethodsThe sample included 322 126 ...participants (135 254 women) from the National Institutes of Health–AARP Diet and Health Study, established in 1995–1996. History and duration in high OPA were reported by participants. All-cause, cardiovascular, cancer and other cause mortality records available through 31 December 2011.ResultsThe prevalence of high OPA was 52.1% in men and 16.1% in women. During 13.6 years (SD, 3.3) of follow-up, 73 563 participants (25 219 women) died. In age-adjusted models, the risk of death was higher among men (HR 1.14, 95% CI 1.12 to 1.16) and women (HR 1.22, 95% CI 1.18 to 1.26) with a history of high OPA. However, these associations were substantially attenuated in women (HR 1.04, 95% CI 1.00 to 1.07, an 81.8% attenuation) and eliminated in men (HR 1.02, 95% CI 0.99 to 1.04, 85.7% attenuation) after multivariable adjustments. Similar important attenuation results were found when examining duration in high OPA, as well as using cause-specific deaths as the outcomes. Educational attainment and smoking patterns were the main contributors in the excess mortality among people working in highly physically active jobs in both men and women.ConclusionParticipating in high OPA was not consistently associated with a higher mortality risk, after adjustments for education and smoking factors. Workers in high OPA should be aware that they might not be getting all well-known health benefits of being physically active if they are only very active at work.
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.
Objective To examine the independent and combined associations of the components of physical fitness with academic performance among youths. Study design This cross-sectional study included a total ...of 2038 youths (989 girls) aged 6-18 years. Cardiorespiratory capacity was measured using the 20-m shuttle run test. Motor ability was assessed with the 4 × 10-m shuttle run test of speed of movement, agility, and coordination. A muscular strength z -score was computed based on handgrip strength and standing long jump distance. Academic performance was assessed through school records using 4 indicators: Mathematics, Language, an average of Mathematics and Language, and grade point average score. Results Cardiorespiratory capacity and motor ability were independently associated with all academic variables in youth, even after adjustment for fitness and fatness indicators (all P ≤ .001), whereas muscular strength was not associated with academic performance independent of the other 2 physical fitness components. In addition, the combined adverse effects of low cardiorespiratory capacity and motor ability on academic performance were observed across the risk groups ( P for trend <.001). Conclusion Cardiorespiratory capacity and motor ability, both independently and combined, may have a beneficial influence on academic performance in youth.
The authors' aim in this cross-sectional study was to characterize levels of objectively measured physical activity and sedentary time in adolescents from 9 European countries. The study comprised ...2,200 European adolescents (1,184 girls) participating in the HELENA cross-sectional study (2006-2008). Physical activity was measured by accelerometry and was expressed as average intensity (counts/minute) and amount of time (minutes/day) spent engaging in moderate- to vigorous-intensity physical activity (MVPA). Time spent in sedentary behaviors was also objectively measured. Cardiorespiratory fitness was measured by means of the 20-m shuttle run test. Level of maternal education was reported by the adolescents. A higher proportion of boys (56.8% of boys vs. 27.5% of girls) met the physical activity recommendations of at least 60 minutes/day of MVPA. Adolescents spent most of the registered time in sedentary behaviors (9 hours/day, or 71% of the registered time). Both average intensity and MVPA were higher in adolescents with high cardiorespiratory fitness, and sedentary time was lower in the high-fitness group. There were no physical activity or sedentary time differences between maternal education categories. These data provide an objective measure of physical activity and amount of time spent in sedentary behaviors in a relatively large number of European adolescents.
Peripheral arterial disease (PAD) is associated with a high risk of cardiovascular events and death and is postulated to be a critical socioeconomic cost in the future. Extracellular vesicles (EVs) ...have emerged as potential candidates for new biomarker discovery related to their protein and nucleic acid cargo. In search of new prognostic and therapeutic targets in PAD, we determined the prothrombotic activity, the cellular origin and the transcriptomic profile of circulating EVs. This prospective study included control and PAD patients. Coagulation time (Procoag-PPL kit), EVs cellular origin and phosphatidylserine exposure were determined by flow cytometry in platelet-free plasma (n = 45 PAD). Transcriptomic profiles of medium/large EVs were generated using the MARS-Seq RNA-Seq protocol (n = 12/group). The serum concentration of the differentially expressed gene S100A9, in serum calprotectin (S100A8/A9), was validated by ELISA in control (n = 100) and PAD patients (n = 317). S100A9 was also determined in EVs and tissues of human atherosclerotic plaques (n = 3). Circulating EVs of PAD patients were mainly of platelet origin, predominantly Annexin V positive and were associated with the procoagulant activity of platelet-free plasma. Transcriptomic analysis of EVs identified 15 differentially expressed genes. Among them, serum calprotectin was elevated in PAD patients (p < 0.05) and associated with increased amputation risk before and after covariate adjustment (mean follow-up 3.6 years, p < 0.01). The combination of calprotectin with hs-CRP in the multivariate analysis further improved risk stratification (p < 0.01). Furthermore, S100A9 was also expressed in femoral plaque derived EVs and tissues. In summary, we found that PAD patients release EVs, mainly of platelet origin, highly positive for AnnexinV and rich in transcripts related to platelet biology and immune responses. Amputation risk prediction improved with calprotectin and was significantly higher when combined with hs-CRP. Our results suggest that EVs can be a promising component of liquid biopsy to identify the molecular signature of PAD patients.
To examine the stratified and joint associations of physical activity (PA) and the number of chronic conditions on long-term all-cause mortality.
We used data from a cohort of 3967 individuals ...representative of the noninstitutionalized population 60 years and older in Spain (2000/2001). Information on self-reported PA (inactive, occasionally, monthly, weekly) and 11 chronic conditions diagnosed by a physician and reported by the study participants were recorded. Associations are summarized using hazard ratios (HRs) and Cox regression, after adjustment for covariates.
At baseline, 43.2%, 37.5%, 14.4%, and 4.9% of participants had 0, 1, 2, and 3 or more chronic conditions, respectively. Mean follow-up was 8.9 years (median, 10.8 years; range, 0.02-11.28 years), with 1483 deaths. The HRs (95% CIs) for all-cause mortality in participants with 1, 2, and 3 or more chronic conditions compared with those with none were 1.26 (1.05-1.39), 1.78 (1.51-2.09), and 2.27 (1.79-2.86), respectively. Being physically active (ie, doing any PA) was associated with a mortality reduction (95% CI) of 30% (14%-43%), 33% (18%-45%), 35% (16%-50%), and 47% (18%-66%) in participants with 0, 1, 2, and 3 or more chronic conditions, respectively. Compared with those with 0 chronic conditions who were physically active, participants with 2 (HR=2.63; 95% CI, 2.09-3.31) and 3 or more (HR=3.26; 95% CI, 2.42-4.38) chronic conditions who were physically inactive had the highest mortality risk.
Physical activity is associated with a reduction in increased risk of death associated with multimorbidity (ie, coexistence of ≥2 chronic conditions) in older individuals.
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.
Objectives
To examine the associations between cumulative physical activity (PA) and its changes over 3 years and changes over 9 years of follow‐up in physical performance in older adults.
Design
...Longitudinal.
Setting
Community‐based.
Participants
Men and women aged 65 and older from the Invecchiare in Chianti study (N = 782).
Measurements
Physical performance was assessed at baseline and at 3‐, 6‐, and 9‐year follow‐up using the Short Physical Performance Battery (SPPB). PA was assessed through an interviewer‐administered questionnaire at baseline and 3‐year follow‐up. Analyses were adjusted for education, body mass index, smoking, alcohol intake, coronary heart disease, stroke, peripheral arterial disease, cancer, lung disease, lower extremity osteoarthritis, depression, and Mini‐Mental State Examination.
Results
Over 3 years of follow‐up, 27.8% of participants were inactive, 52.2% were minimally active, and 20.0% were active, and the PA of 37.2% decreased, there was no change in PA of 50.1% and the PA of 12.7% increased. After adjustment for potential covariates, being mostly active (−1.08, 95% confidence interval (CI) = −1.43 to −0.73) and minimally active (−1.33, 95% CI = −1.53 to −1.12) over 3 years of follow‐up was associated with less decline in SPPB score than being mostly inactive (−2.60, 95% CI = −2.92 to −2.27). When analyzing changes, increasing PA (−0.57, 95% CI = −1.01 to −0.12) was associated with less decline in SPPB score over 9 years than decreasing PA (−2.16, 95% CI = −2.42 to −1.89).
Conclusion
Maintaining or increasing PA levels may attenuate age‐associated physical performance decline.
The aim was to examine the bidirectional association between cardiorespiratory fitness (CRF) and fatness in a 2‐year longitudinal study conducted in young people. A total of 1082 children (512 ...females) and 727 adolescents (342 females) with complete data at baseline and follow‐up were included. CRF was determined by the 20‐m shuttle run test. Height and weight were measured, and body mass index and fat mass index (kg/m2) were calculated. Triceps and subscapular skinfolds were assessed to compute body fat percentage. Bidirectionality was tested by including CRF and each fatness index as exposures and outcomes, alternatively, in different regression models. CRF was prospectively associated with fatness index levels (ß from −0.186 to −0.528; P < .001), remaining significant in children after adjusting for baseline fatness indices. Fatness indices were prospectively associated with CRF (ß from −0.207 to −0.479; P < .001), with no substantial changes observed in children and female adolescents when baseline CRF was considered. Changes in CRF were prospectively associated with several fatness indices, regardless of body fatness at baseline (ß from −0.062 to −0.220; P < .05). Body fatness changes were associated with future CRF levels, independently of baseline CRF, especially in children of both sexes and male adolescents (ß from −0.079 to −0.260; P < .05). Overall, a bidirectional association was observed between CRF and fatness in children and adolescents. The attainment of optimal CRF and fatness levels in early ages should be promoted since it could result in favorable future fatness and CRF levels, respectively, which are two key determinants of health status.
We aimed to analyze the cross-sectional and longitudinal association of physical activity (PA) levels and PA patterns with metabolic syndrome score (MetS) in children and adolescents.
A total of 175 ...children (82 females) and 188 adolescents (95 females) were included. Objective PA levels and patterns were determined by accelerometry. MetS was computed from waist circumference, systolic blood pressure, triglycerides, high-density lipoprotein cholesterol, and glucose levels. Different linear regression models were implemented to examine the associations of PA with MetS.
Vigorous PA, moderate-vigorous PA, number of bouts per day in 10 min (N10), and total time in bouts per day in 10 min (T10) were negatively associated with MetS in male children and adolescents at cross-sectional level (β ranging from -0.005 to -0.164, all p < 0.05). Total time in bouts per day in 20 min in male children, and vigorous PA and N10 in female children were longitudinally and negatively associated with MetS (β ranging from -0.011 to -0.247, all p < 0.05).
Associations of PA and MetS were observed at cross-sectional level in males and longitudinally in female children. The associations in PA patterns were found when patterns were grouped into bouts of 10 min. Therefore, for future studies of PA with health markers in the pediatric population, it would be advisable to choose bouts of shorter duration.
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