Disability and Patterns of Leisure Participation Across the Life Course.

OBJECTIVES: Patterns of healthy leisure are dependent upon age, but people with disabilities are particularly susceptible to passive and disengaged types of activities. This study evaluates how individuals with disabilities spend their time in passive, active, social, and isolated forms of leisure over the life course, and how these patterns vary by age. METHOD: I analyze nationally representative data from 70,165 respondents ages 15 and older in the 2008, 2010, and 2012-2016 American Time Use Survey. Linear regression models estimate the association between disability and leisure time, net of self-rated health and sociodemographic controls. Interactions between age and disability are also evaluated, as well as the robustness of results by sensory, cognitive, physical, and multiple disability status. RESULTS: People with disabilities report significantly more, and poorer quality, leisure than people without disabilities. This includes more than 2 hr more time in passive leisure as well as a disproportionate amount of isolated leisure spent at home, alone. These differences are not fully explained by health and sociodemographic controls. The isolated leisure time of people with disabilities is most different from people without disabilities in later life-whereas differences in total and passive leisure time, by disability status, are greatest in midlife. DISCUSSION: People with disabilities spend less time in health-promoting forms of leisure at all ages, but these patterns are unique across midlife and older age.

The Impact of Late-Life Disability Spectrum on Depressive Symptoms: A Fixed-Effects Analysis of Panel Data.

OBJECTIVES: This study examines the impact of a previously validated disability spectrum that accounts for compensatory strategies on depressive symptoms in older adults. METHODS: This study was a secondary data analysis of 2011 through 2018 surveys from the National Health and Aging Trends Study (N = 7,609). The disability spectrum was categorized using a 5-level hierarchical scheme: fully able, successful accommodation, reduced activity, difficulty, and assistance for 12 mobility, self-care, and household activities. The individual fixed-effects panel model was used to examine the impact of this disability spectrum on depressive symptoms. RESULTS: Depressive symptoms rose progressively with each successive category on the disability spectrum in descriptive analyses. In fixed-effects models, moving from "fully able" to "successful accommodation" was not associated with significant changes in depressive symptoms; this result held for all self-care and mobility activities. Moving from "fully able" to "reduced activity" was associated with a significant increase in depressive symptoms for 3 household activities (doing laundry, making hot meals, and shopping for groceries) but not for paying bills/banking or keeping track of medications. Going up 2 or more stages above "fully able" on the disability spectrum was associated with a significant increase in depressive symptoms across all 12 activities. DISCUSSION: While limitations in a range of daily activities have harmful effects on mental health, using compensatory strategies that do not erode one's perception of autonomy can help older adults cope with the psychological detriments of late-life disability.

Signs of altered psychomotor capacity and use of alcohol and other drugs among nightclub patrons who drive in the city of São Paulo, Brazil.

Objectives: To investigate the occurrence of signs of altered psychomotor capacity (SAPC) associated with the violation of the dry law at the exits of nightclubs in the city of São Paulo, Brazil.Methods: Data from drivers participating in the Balada com Ciência project were used. Alcohol dosages were measured with breathalyzer test. The use of other drugs was obtained by interviewees' self-report. SAPC (speech, walking, glazed eyes, and alcohol odor) were verified by the interviewers at the time of the interview and categorized as "no sign" or "at least one sign". All measurements were evaluated at the exit of the nightclubs. The population description considered the sample weighting. Logistic regression analysis evaluated the association between the occurrence of SAPC, alcohol and other drugs use, controlling for sociodemographic variables.Results: At nightclubs, the SAPC among drivers are about 8 times higher when the breath alcohol concentration is above 0.05 mg/L if compared with those who did not drink alcohol, and about 30 times higher when the alcohol concentration was ≥ 0.34 mg/L in exhaled air. This finding is not generally verified in the literature for those who report the use of drugs inside nightclubs, which is interesting, since 20.4% of the interviewed population reported using drugs in the places surveyed.Conclusion: This study suggests the potential of using the Perham (2007) physical test for alcohol intoxication in sobriety checkpoints at the exit of nightclubs. However, the verification of these signs is not enough for the identification of drug use by drivers.

The interaction effect between physical and cultural leisure activities on the subsequent decline of instrumental ADL: the Fujiwara-kyo study.

BACKGROUND: Maintenance of instrumental activities of daily living (IADL) and social role (SR) is crucial to keep independent life because the decline in SR and IADL was a significant predictor of dependence in basic ADL in later. The independent effect of physical and cultural leisure activities and their effect modification on the IADL remains unknown. METHODS: We prospectively observed 3241 elderly with intact IADL at baseline for 5 years. Higher level functional capacity such as IADL and SR was assessed using the Tokyo Metropolitan Institute of Gerontology Index of competence (TMIG index). RESULTS: The mean age of the participants was 72.3 years (standard deviation 5.1), and 46.9% were male, and 90.9% of them received a follow-up assessment. Of the participants, 10.4% developed an IADL decline. Engagement in leisure physical activity was associated with a significantly lower risk of IADL decline (adjusted risk ratio, 0.73; 95% confidence interval [CI], 0.60 to 0.89), and cultural leisure activity was also associated with lower risk of IADL decline (adjusted risk ratio, 0.77; 95% CI, 0.63 to 0.95) independent of potential confounders. We also found significant and positive interaction between physical and cultural leisure activities at risk for IADL decline (P = 0.024) and SR decline (P = 0.004). CONCLUSIONS: We found an independent association of physical and cultural leisure activities with a lower risk for functional decline in IADL and SR with positive interaction. Combined engagement in physical and cultural activities may effectively prevent from IADL decline and SR decline.

Reclassified cognitive leisure activity and risk of cognitive impairment in Chinese older adults aged ≥80 years: A 16-year prospective cohort study.

AIM: There is accumulating evidence that participation in cognitive leisure activities might be related to a reduced risk of cognitive impairment. However, there is no consensus regarding the classification of cognitive leisure activities, and it cannot clearly define each activity and quantitatively evaluate the effect of it. In the present study, we propose a new classification method, and examine the relationship between reclassified cognitive leisure activities and cognitive function. METHODS: The analysis included 4830 participants of the Chinese Longitudinal Healthy Longevity Survey, who were aged >80 years and free of cognitive impairment at 1998. They were followed up six times. Six cognitive leisure activities were mainly grouped into intrapersonal and interpersonal cognitive leisure activity by categorical principal component analysis. Cox proportional hazards analysis was used to evaluate the relationship between reclassified cognitive leisure activities and the risk of cognitive impairment. RESULTS: After a median follow-up period of 16 years, 1763 participants suffered from cognitive impairment (Mini-Mental State Examination score <24). Reading newspapers or books, taking part in some social activities and sometimes playing cards or mahjong were associated with a decreased risk of cognitive impairment (P < 0.05 for all). In multivariable adjusted models, compared with those with lower intensities, the hazard ratios (95% confident intervals) of cognitive impairment were 0.86 (0.74-0.99) and 0.71 (0.60-0.83) for participants with high intensities of intrapersonal and interpersonal cognitive leisure activity, respectively. CONCLUSION: A high frequency of participation in intrapersonal and interpersonal cognitive leisure activities showed a lower risk of cognitive impairment among the oldest-old in China. Geriatr Gerontol Int 2019; 19: 1041-1047.

Limitation of the use of voice in teaching and leisure-time physical activity: Educatel Study, Brazil, 2015/2016. / Limitação do uso da voz na docência e a prática de atividade física no lazer: Estudo Educatel, Brasil, 2015/2016.

The study sought to identify the prevalence of voice-related problems teaching basic education teachers and to analyze their association with the practice of physical activity. We used data from a phone survey of a representative sample (n = 6,510) of Educatel Study carried out between October 2015 and March 2016. The main data of this study were self-referred voice-related problems teaching, leisure-time physical activity (defined according to its intensity, duration and frequency) and potential confounding variables. The data was analyzed using Poisson regression models with robust variance. Around one fifth of teachers (20.5%) reported having had voice-related problems teaching, while approximately one third reported sufficient leisure-time physical activity (≥ 150 minutes/week) (37.8%). Both recommended physical activity volume and five or more days of physical activity per week (regardless of total volume) were inversely associated with voice-related problems teaching, both in bivariate models and in models adjusted for confounding variables (sex, age and working hours). Basic Education teachers have a high prevalence of voice-related problems teaching. Sufficient leisure-time physical activity and exercising five or more days a week are potential protective factors for reducing this problem.

O objetivo do estudo foi identificar a prevalência de problemas na docência por causa da voz entre os professores da educação básica, e analisar sua associação com a prática de atividade física. Foram utilizados dados de inquérito por entrevista telefônica junto à amostra representativa (n = 6.510) de professores do Estudo Educatel, entre outubro de 2015 e março de 2016. As informações de interesse central deste estudo compreendem o relato do professor de problemas na docência por causa da voz, a prática de atividade física no lazer (definida por sua intensidade, duração e frequência) e potenciais variáveis de confundimento. A análise dos dados foi estudada por meio de modelos de regressão de Poisson com variância robusta. Cerca de um quinto dos professores (20,5%) relatou problemas na docência por causa da voz, enquanto aproximadamente um terço relatou a prática de atividade física suficiente no lazer (≥ 150 minutos/semana) (37,8%). Tanto a prática de volume recomendado de atividade física quanto a prática de atividade física em cinco ou mais dias por semana (independentemente do volume total) estiveram associadas de forma inversa a problemas na docência por causa da voz, tanto em modelos bivariados quanto naqueles ajustados por variáveis de confundimento (sexo, idade e jornada de trabalho). Professores da Educação Básica apresentam alta prevalência de problemas na docência por causa da voz. A prática suficiente de atividade física no lazer e a prática semanal por cinco ou mais dias despontam como fatores potenciais de proteção para a redução da prevalência deste problema.

El objetivo del estudio fue identificar la prevalencia de problemas en la docencia, debidos a la voz, entre profesores de educación básica y analizar su asociación con la práctica de actividad física. Se utilizaron datos de una encuesta por entrevista telefónica, junto a una muestra representativa (n = 6.510) de profesores de Estudio Educatel, entre octubre de 2015 y marzo de 2016. La información con mayor interés de este estudio incluye el relato de docentes con problemas en su profesión, debidos a la voz, la práctica de actividad física durante el tiempo de ocio (definida por su intensidad, duración y frecuencia) y las potenciales variables de confusión. El análisis de los datos se estudió mediante modelos de regresión de Poisson con variancia robusta. Cerca de un quinto de los profesores (20,5%) informó de problemas en la docencia, debidos a la voz, mientras aproximadamente un tercio informo sobre la práctica de actividad física suficiente durante el tiempo de ocio (≥ 150 minutos/semana) (37,8%). Tanto la práctica del volumen recomendado de actividad física, como la práctica de actividad física durante cinco o más días por semana (independiente del volumen total), se asociaron de forma inversa a problemas en la docencia debidos a la voz, tanto en modelos bivariados, como en aquellos ajustados por variables de confusión (sexo, edad y jornada de trabajo). Los profesores de Educación Básica presentan una alta prevalencia de problemas en la docencia debidos a la voz. La práctica suficiente de actividad física durante el ocio y la práctica semanal durante cinco o más días despuntan como factores potenciales de protección para la reducción de la prevalencia de este problema.

Limitação do uso da voz na docência e a prática de atividade física no lazer: Estudo Educatel, Brasil, 2015/2016 / Limitación del uso de la voz en la docencia y la práctica de actividad física durante el tiempo de ocio: Estudio Educatel, Brasil, 2015/2016 / Limitation of the use of voice in teaching and leisure-time physical activity: Educatel Study, Brazil, 2015/2016

O objetivo do estudo foi identificar a prevalência de problemas na docência por causa da voz entre os professores da educação básica, e analisar sua associação com a prática de atividade física. Foram utilizados dados de inquérito por entrevista telefônica junto à amostra representativa (n = 6.510) de professores do Estudo Educatel, entre outubro de 2015 e março de 2016. As informações de interesse central deste estudo compreendem o relato do professor de problemas na docência por causa da voz, a prática de atividade física no lazer (definida por sua intensidade, duração e frequência) e potenciais variáveis de confundimento. A análise dos dados foi estudada por meio de modelos de regressão de Poisson com variância robusta. Cerca de um quinto dos professores (20,5%) relatou problemas na docência por causa da voz, enquanto aproximadamente um terço relatou a prática de atividade física suficiente no lazer (≥ 150 minutos/semana) (37,8%). Tanto a prática de volume recomendado de atividade física quanto a prática de atividade física em cinco ou mais dias por semana (independentemente do volume total) estiveram associadas de forma inversa a problemas na docência por causa da voz, tanto em modelos bivariados quanto naqueles ajustados por variáveis de confundimento (sexo, idade e jornada de trabalho). Professores da Educação Básica apresentam alta prevalência de problemas na docência por causa da voz. A prática suficiente de atividade física no lazer e a prática semanal por cinco ou mais dias despontam como fatores potenciais de proteção para a redução da prevalência deste problema.

El objetivo del estudio fue identificar la prevalencia de problemas en la docencia, debidos a la voz, entre profesores de educación básica y analizar su asociación con la práctica de actividad física. Se utilizaron datos de una encuesta por entrevista telefónica, junto a una muestra representativa (n = 6.510) de profesores de Estudio Educatel, entre octubre de 2015 y marzo de 2016. La información con mayor interés de este estudio incluye el relato de docentes con problemas en su profesión, debidos a la voz, la práctica de actividad física durante el tiempo de ocio (definida por su intensidad, duración y frecuencia) y las potenciales variables de confusión. El análisis de los datos se estudió mediante modelos de regresión de Poisson con variancia robusta. Cerca de un quinto de los profesores (20,5%) informó de problemas en la docencia, debidos a la voz, mientras aproximadamente un tercio informo sobre la práctica de actividad física suficiente durante el tiempo de ocio (≥ 150 minutos/semana) (37,8%). Tanto la práctica del volumen recomendado de actividad física, como la práctica de actividad física durante cinco o más días por semana (independiente del volumen total), se asociaron de forma inversa a problemas en la docencia debidos a la voz, tanto en modelos bivariados, como en aquellos ajustados por variables de confusión (sexo, edad y jornada de trabajo). Los profesores de Educación Básica presentan una alta prevalencia de problemas en la docencia debidos a la voz. La práctica suficiente de actividad física durante el ocio y la práctica semanal durante cinco o más días despuntan como factores potenciales de protección para la reducción de la prevalencia de este problema.

The study sought to identify the prevalence of voice-related problems teaching basic education teachers and to analyze their association with the practice of physical activity. We used data from a phone survey of a representative sample (n = 6,510) of Educatel Study carried out between October 2015 and March 2016. The main data of this study were self-referred voice-related problems teaching, leisure-time physical activity (defined according to its intensity, duration and frequency) and potential confounding variables. The data was analyzed using Poisson regression models with robust variance. Around one fifth of teachers (20.5%) reported having had voice-related problems teaching, while approximately one third reported sufficient leisure-time physical activity (≥ 150 minutes/week) (37.8%). Both recommended physical activity volume and five or more days of physical activity per week (regardless of total volume) were inversely associated with voice-related problems teaching, both in bivariate models and in models adjusted for confounding variables (sex, age and working hours). Basic Education teachers have a high prevalence of voice-related problems teaching. Sufficient leisure-time physical activity and exercising five or more days a week are potential protective factors for reducing this problem.

Diversity of indoor activities and economic development of neighborhoods.

Over the last few decades, public life has taken center stage in urban studies, but that is about to change. At times, indoor activities have been shown to matter more than what is publicly visible (they have been found to be more predictive of future crimes, for example). Until recently, however, data has not been available to study indoor activities at city scale. To that end, we propose a new methodology that relies on tagging information of geo-referenced pictures and unfolds in three main steps. First, we collected and classified a comprehensive set of activity-related words, creating the first dictionary of urban activities. Second, for both London and New York City, we collected geo-referenced Flickr tags and matched them with the words in the dictionary. This step produced both a systematic classification (our activity-related words were best classified in eleven categories) and two city-wide indoor activity maps which, when compared to open data of public amenities and sensory maps of smell and sound matched theoretical expectations. Third, we studied, for the first time, activities happening indoor in relation to neighborhood socio-economic conditions. We found the very same result for both London and New York City. In deprived areas, people focused on any of the activity types (leading to specialization), and it did not matter on which one they did so. By contrast, in well-to-do areas, people engaged not in one type of activity but in a variety of them (leading to diversification).

Typology of Nightclubs in São Paulo, Brazil: Alcohol and Illegal Drug Consumption, Sexual Behavior and Violence in the Venues.

BACKGROUND: Nightclubs are venues in which excessive alcohol use and illegal drug consumption occur in addition to other high-risk behaviors, such as violence and sexual risk behaviors. Environmental factors common in nightclubs and the personal characteristics of patrons might increase the risk of these events. To better understand the relationship between these factors, typologies were formulated that clustered nightclubs according to definite profiles to identify differences to be taken into consideration in preventive interventions. OBJECTIVES: The present study aim was to construct a typology of nightclubs in São Paulo, Brazil. METHODS: This typology was constructed using mixed methods research through the triangulation of several data sources as follows: 307 hours of ethnographic observation at 31 nightclubs, 8 focus group sessions with nightclub patrons (n = 34) and 30 semi-structured interviews with nightclub employees. Content analysis and qualitative typology were used. RESULTS: Four nightclub types were defined based on four analyzed thematic axes (Intoxicating, Violent, Dancing and Highly Sexualized nightclubs). Excessive alcohol use was detected in almost all of the investigated nightclubs, and drug use was observed in approximately one-third of them. Triangulation of the data revealed a relationship among environmental factors (especially alcohol sales strategies and promotion and the availability of areas for sex) and a more considerable presence of high-risk behaviors. CONCLUSIONS: The study shows that nightclubs are settings in which high-risk behaviors are potentiated by facilitating environmental factors as well as by the lack of laws restricting excessive alcohol use stimulated by the promotion strategies applied at these venues.

Ethnic and Gender Differences in Preferred Activities among Maori and non-Maori of Advanced age in New Zealand.

This study explored active aging for older Maori and non-Maori by examining their self-nominated important everyday activities. The project formed part of the first wave of a longitudinal cohort study of aging well in New Zealand. Maori aged 80 to 90 and non-Maori aged 85 were recruited. Of the 937 participants enrolled, 649 answered an open question about their three most important activities. Responses were coded under the World Health Organization's International Classification of Functioning, Disability and Health (ICF), Activities and Participation domains. Data were analyzed by ethnicity and gender for first in importance, and all important activities. Activity preferences for Maori featured gardening, reading, walking, cleaning the home, organized religious activities, sports, extended family relationships, and watching television. Gendered differences were evident with walking and fitness being of primary importance for Maori men, and gardening for Maori women. Somewhat similar, activity preferences for non-Maori featured gardening, reading, and sports. Again, gendered differences showed for non-Maori, with sports being of first importance to men, and reading to women. Factor analysis was used to examine the latent structural fit with the ICF and whether it differed for Maori and non-Maori. For Maori, leisure and household activities, spiritual activities and interpersonal interactions, and communicating with others and doing domestic activities were revealed as underlying structure; compared to self-care, sleep and singing, leisure and work, and domestic activities and learning for non-Maori. These findings reveal fundamental ethnic divergences in preferences for active aging with implications for enabling participation, support provision and community design.

Association of "Weekend Warrior" and Other Leisure Time Physical Activity Patterns With Risks for All-Cause, Cardiovascular Disease, and Cancer Mortality.

Importance: More research is required to clarify the association between physical activity and health in "weekend warriors" who perform all their exercise in 1 or 2 sessions per week. Objective: To investigate associations between the weekend warrior and other physical activity patterns and the risks for all-cause, cardiovascular disease (CVD), and cancer mortality. Design, Setting, and Participants: This pooled analysis of household-based surveillance studies included 11 cohorts of respondents to the Health Survey for England and Scottish Health Survey with prospective linkage to mortality records. Respondents 40 years or older were included in the analysis. Data were collected from 1994 to 2012 and analyzed in 2016. Exposures: Self-reported leisure time physical activity, with activity patterns defined as inactive (reporting no moderate- or vigorous-intensity activities), insufficiently active (reporting <150 min/wk in moderate-intensity and <75 min/wk in vigorous-intensity activities), weekend warrior (reporting ≥150 min/wk in moderate-intensity or ≥75 min/wk in vigorous-intensity activities from 1 or 2 sessions), and regularly active (reporting ≥150 min/wk in moderate-intensity or ≥75 min/wk in vigorous-intensity activities from ≥3 sessions). The insufficiently active participants were also characterized by physical activity frequency. Main Outcomes and Measures: All-cause, CVD, and cancer mortality ascertained from death certificates. Results: Among the 63 591 adult respondents (45.9% male; 44.1% female; mean [SD] age, 58.6 [11.9] years), 8802 deaths from all causes, 2780 deaths from CVD, and 2526 from cancer occurred during 561 159 person-years of follow-up. Compared with the inactive participants, the hazard ratio (HR) for all-cause mortality was 0.66 (95% CI, 0.62-0.72) in insufficiently active participants who reported 1 to 2 sessions per week, 0.70 (95% CI, 0.60-0.82) in weekend warrior participants, and 0.65 (95% CI, 0.58-0.73) in regularly active participants. Compared with the inactive participants, the HR for CVD mortality was 0.60 (95% CI, 0.52-0.69) in insufficiently active participants who reported 1 or 2 sessions per week, 0.60 (95% CI, 0.45-0.82) in weekend warrior participants, and 0.59 (95% CI, 0.48-0.73) in regularly active participants. Compared with the inactive participants, the HR for cancer mortality was 0.83 (95% CI, 0.73-0.94) in insufficiently active participants who reported 1 or 2 sessions per week, 0.82 (95% CI, 0.63-1.06) in weekend warrior participants, and 0.79 (95% CI, 0.66-0.94) in regularly active participants. Conclusions and Relevance: Weekend warrior and other leisure time physical activity patterns characterized by 1 or 2 sessions per week may be sufficient to reduce all-cause, CVD, and cancer mortality risks regardless of adherence to prevailing physical activity guidelines.

Developing a Semantic Model to Describe Physical Activity Data.

The importance of data in the social and behavioral domains to biomedical research is increasing, but ensuring the reusability of such data through standardization is not a trivial task. To start addressing this challenge, we developed a semantic model of the physical activity domain by reviewing 302 physical activity questions collected from standardized questionnaires and public data repositories. Our semantic model is comprised of activity keywords, qualifiers, response measures and context. We identified three types of contexts: active lifestyle, physical capacity, and environment. The majority (94%) of the 204 activity keywords extracted from the 302 questions were mapped to the UMLS Metathesaurus. Preliminary evaluation of our model with 309 additional activity questions showed that the majority of the questions were related to one of the three context categories. We also noted the need to expand context categories to incorporate the questions assessing psychological aspects of dealing with physical activities.

Leisure-activity participation to prevent later-life cognitive decline: a systematic review.

OBJECTIVE: A systematic literature review was conducted to characterise the current state of knowledge concerning the definition, categorisation, and operationalisation of leisure activity in studies examining its possible role in preventing later-life cognitive decline. Following PRISMA guidelines for a systematic review, the study examined peer-reviewed empirical research publications focused on leisure activity, cognitive decline, and prevention. METHODS: Searches in the PubMed/Medline reSEARCH, CINHAL, Ovid MEDLINE, Embase, Web of Science, PsychoINFO, ERIC Proquest, the Cochrane library, and PsycARTICLES databases for the years 2000 to 2011 identified 52 publications for inclusion. RESULTS: The results are discussed and based on these findings are further interpreted using the Model of Human Occupation, which focuses on key factors identified in the review that are salient to associations between participation in leisure activities and prevention of dementia. CONCLUSIONS: While the findings support a growing consensus that participation in leisure activities might significantly contribute to prevention of dementia, it also identifies major hindrances to progress. Important limitations detected include a lack of theoretical underpinnings, and little consensus and standardisation in the measured key variables. The study reinforces the critical need to overcome these limitations to enable health care professionals (e.g. occupational therapists) to make evidence-based recommendations for increased participation in activities as a means of promoting health and preventing cognitive decline.

The relationship between nature-based tourism and autonomic nervous system function among older adults.

BACKGROUND: Nature-based tourism has recently become a topic of interest in health research. This study was aimed at examining relationships among nature-based tourism, stress, and the function of the autonomic nervous system (ANS). METHODS: Three hundred and twenty-two older adults living in Taichung City, Taiwan, were selected as participants. Data were collected by a face-to-face survey that included measures of the frequency of participation in domestic and international nature-based tourism and the stress and ANS function of these participants. The data were analyzed using a path analysis. RESULTS: The results demonstrated that the frequency of participation in domestic nature-based tourism directly contributed to ANS function and that it also indirectly contributed to ANS function through stress reduction. CONCLUSIONS: Domestic nature-based tourism can directly and indirectly contribute to ANS function among older adults. Increasing the frequency of participation in domestic nature-based tourism should be considered a critical element of health programs for older adults.

Leisure-time physical activity predicts complaints of snoring in women: a prospective cohort study over 10 years.

OBJECTIVE: We aimed to assess the impact of self-reported physical activity on incidence and remission of snoring complaints in women. METHODS: A population-based sample of 4851 women aged >20 years responded to questionnaires in years 2000 and 2010. Based on the responses, the women were categorized into low, medium, or high level of physical activity at baseline and at follow-up. RESULTS: The prevalence of habitual snoring complaints increased from 7.6% at baseline to 9.2% in 2010 (P<.0001). After adjusting for age, body mass index (BMI), waist and neck circumference, weight gain, smoking status, alcohol dependence, and snoring status at baseline, reported physical activity level at baseline had a protective effect on habitual snoring complaints at follow-up. The adjusted odds ratio (OR) (95% confidence intervals) for complaints of habitual snoring was 0.7 (0.5-0.9) for the reported medium physical activity level and 0.5 (0.4-0.8) for the high activity level. When subdividing the population by changes in reported physical activity level over the follow-up period, an increase in physical activity was followed by a decrease in the complaint of snoring. Similarly a high level of reported physical activity only had a protective effect on snoring in participants who remained at a high or medium level. CONCLUSIONS: A low level of self-reported physical activity is a risk factor for future habitual snoring complaints in women, independent of weight, weight gain, alcohol dependence, and smoking. Increased physical activity can modify the risk.

Longitudinal and cross-sectional associations of physical activity with triglyceride and HDLc levels in young male adults.

BACKGROUND: The purpose of this study was to evaluate cross-sectional and longitudinal associations between physical activity and triglyceride and HDLc levels in young male adults. METHODS: We used information about males belonging 1982 Pelotas Birth Cohort. Physical activity in 4 domains (leisure time, transportation, household, and occupation) was assessed by self-report in participants of the cohort at ages of 18 and 23 years. Subjects were active if reached the recommendation of 150 min/week of moderate to vigorous physical activity. At 23 years of age, blood sample was collected, and triglycerides and HDLc levels estimated. Multivariate linear and Poisson regression were used to adjust the estimates for confounders. RESULTS: Males who were inactive at 18 and active at 23 years had 41% lower risk (ß = 0.59; 95% confidence interval: 0.40; 0.89) for borderline-high triglycerides (≥ 150 mg/dL) as compared with those who were inactive at both follow-ups. No association was found between changes of physical activity and HDLc level. In cross-sectional analyses, greater HDLc levels were found in active subjects in 4 domains, whereas there was no difference in HDL levels according physical activity during leisure time. CONCLUSION: Becoming active from adolescence to early adulthood reduced the risk for high triglycerides. Current physical activity was associated with greater HDLc levels.

Neighborhood environment and physical activity among older adults: do the relationships differ by driving status?

Some attributes of neighborhood environments are associated with physical activity among older adults. This study examined whether the associations were moderated by driving status. Older adults from neighborhoods differing in walkability and income completed written surveys and wore accelerometers (N = 880, mean age = 75 years, 56% women). Neighborhood environments were measured by geographic information systems and validated questionnaires. Driving status was defined on the basis of a driver's license, car ownership, and feeling comfortable to drive. Outcome variables included accelerometer-based physical activity and self-reported transport and leisure walking. Multilevel generalized linear regression was used. There was no significant Neighborhood Attribute × Driving Status interaction with objective physical activity or reported transport walking. For leisure walking, almost all environmental attributes were positive and significant among driving older adults but not among nondriving older adults (five significant interactions at p < .05). The findings suggest that driving status is likely to moderate the association between neighborhood environments and older adults' leisure walking.

Patterns and determinants of leisure participation of youth and adults with developmental disabilities.

BACKGROUND: People with developmental disabilities are at high risk for a limited participation in leisure activities. The aim of this study was to investigate the participation in, preference for and interest in leisure activities of young and adults with developmental disabilities, and to examine the factors associated with leisure activity. METHODS: A cross-sectional design was used with a convenience sample of 237 people aged 17 to 65, living in the community. Leisure participation was assessed with the Spanish version of Leisure Assessment Inventory. Percentages were calculated by types of activity, and repeated measures anovas were used to analyse the differences between types of activities, and mixed anovas to analyse the factors that explain differences in leisure activity participation, preference and interest. RESULTS: Leisure social activities and recreation activities at home were mostly solitary and passive in nature and were identified as those being most commonly engaged in. Respondents expressed preference for more social and physical activity, and they were interested in trying out a large number of physical activities. Age and type of schooling determine participation in leisure activity. The results underscore the differences in leisure activity participation, preference and interest depending on the severity of the disability. CONCLUSIONS: The findings reveal interesting patterns of participation in leisure activities from the viewpoint of youngsters and adults with developmental disabilities. Leisure participation among people with developmental disabilities is likely to be more affected by environmental factors than by personal factors.

Association between physical activity and risk of stroke subtypes: the atherosclerosis risk in communities study.

BACKGROUND: The relationship between stroke subtypes and physical activity is unclear. METHODS: Using data from 13,069 men and women aged 45-64 years who participated in the Atherosclerosis Risk in Communities Study, physical activity was assessed by self-report using the Baecke questionnaire at baseline (1987-1989). The American Heart Association's ideal cardiovascular health guidelines served as a basis for the calculation of three physical activity categories: poor, intermediate, and ideal. Stroke and its subtypes were ascertained from physician review of medical records. Multivariable adjusted hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox regression models. RESULTS: During a median follow-up of 18.8 years, a total of 648 incident ischemic strokes occurred. Significant inverse associations were found between physical activity categories and total, total ischemic, and nonlacunar stroke in adjusted models (age, sex, race-center, education, cigarette-years). Compared with poor physical activity, the adjusted HR (95% CI) for ideal physical activity were 0.78 (0.62-0.97) for total, 0.76 (0.59-0.96) for total ischemic, 0.85 (0.51-1.40) for lacunar, 0.77 (0.47-1.27) for cardioembolic, and 0.71 (0.51-0.99) for nonlacunar stroke. Additional adjustments for waist-to-hip ratio, systolic blood pressure, antihypertensive medication, diabetes, left ventricular hypertrophy and laboratory parameters attenuated the HR. Further sex- and race-specific analyses revealed that the association was predominantly observed among males and among African-Americans. CONCLUSION: These data suggest a tendency toward a reduced risk of total, total ischemic, and nonlacunar stroke with higher levels of physical activity.