ABSTRACT
Background: Recreational physical activity (RPA) is associated with improved survival after breast cancer (BC) in average-risk women, but evidence is limited for women who are at increased familial risk because of a BC family history or BRCA1 and BRCA2 pathogenic variants (BRCA1/2 PVs). Methods: We estimated associations of RPA (self-reported average hours per week within 3 years of BC diagnosis) with all-cause mortality and second BC events (recurrence or new primary) after first invasive BC in women in the Prospective Family Study Cohort (n = 4610, diagnosed 1993-2011, aged 22-79 years at diagnosis). We fitted Cox proportional hazards regression models adjusted for age at diagnosis, demographics, and lifestyle factors. We tested for multiplicative interactions (Wald test statistic for cross-product terms) and additive interactions (relative excess risk due to interaction) by age at diagnosis, body mass index, estrogen receptor status, stage at diagnosis, BRCA1/2 PVs, and familial risk score estimated from multigenerational pedigree data. Statistical tests were 2-sided. Results: We observed 1212 deaths and 473 second BC events over a median follow-up from study enrollment of 11.0 and 10.5 years, respectively. After adjusting for covariates, RPA (any vs none) was associated with lower all-cause mortality of 16.1% (95% confidence interval [CI] = 2.4% to 27.9%) overall, 11.8% (95% CI = -3.6% to 24.9%) in women without BRCA1/2 PVs, and 47.5% (95% CI = 17.4% to 66.6%) in women with BRCA1/2 PVs (RPA*BRCA1/2 multiplicative interaction P = .005; relative excess risk due to interaction = 0.87, 95% CI = 0.01 to 1.74). RPA was not associated with risk of second BC events. Conclusion: Findings support that RPA is associated with lower all-cause mortality in women with BC, particularly in women with BRCA1/2 PVs.
Subject(s)
Breast Neoplasms/genetics , Breast Neoplasms/mortality , Exercise , Genetic Predisposition to Disease , Recreation Therapy , Adult , Age Factors , Aged , Cause of Death , Exercise/statistics & numerical data , Female , Follow-Up Studies , Genes, BRCA1 , Genes, BRCA2 , Humans , Middle Aged , Neoplasm Recurrence, Local/epidemiology , Neoplasm Recurrence, Local/genetics , Neoplasms, Second Primary/epidemiology , Neoplasms, Second Primary/genetics , Proportional Hazards Models , Recreation Therapy/statistics & numerical data , Time Factors , Young AdultABSTRACT
This study gathered previous research on the effects of therapeutic recreation programs for the elderly conducted in Korea in order to investigate the average effect size as well as the factors that influence the effect sizes. This study connoted findings of individual studies related to therapeutic recreation programs for the elderly from 2000 to 2018. A total of 15 papers were selected for meta-analysis. To analyze the data, a comprehensive meta-analysis 2.0 software program was used. Firstly, the overall mean effect size of the therapeutic recreation programs for the elderly was 0.644, and it was medium size. Secondly, for each dependent variable, the mean effect size on social emotional domain was 0.739, the mean effect size on physical domain was 0.548, and the mean effect size on cognitive domain was 0.485. Thirdly, major factors that influence the effect of therapeutic recreation programs for the elderly appeared to be the program period and hours per session. The results of this study prove that therapeutic recreation programs for the elderly can be an effective way to bring along a positive change, and show that the program period and hours per session are crucial factors in the design of therapeutic recreation programs for the elderly.
Subject(s)
Recreation Therapy , Aged , Female , Humans , Male , Recreation Therapy/standards , Recreation Therapy/statistics & numerical data , Republic of Korea , Treatment OutcomeABSTRACT
Cognitive decline impacts older adults, particularly their independence. The goal of this project was to increase understanding of how short-term, everyday lifestyle options, including physical activity, help an older adult sustain cognitive independence. Using a secondary analysis of lifestyle choices, we drew on a dataset of 4,620 community-dwelling elders in the US, assessed at baseline and one year later using 2 valid and reliable tools, the interRAI Community Health Assessment and the interRAI Wellness tool. Decline or no decline on the Cognitive Performance Scale was the dependent variable. We examined sustaining one's status on this measure over a one-year period in relation to key dimensions of wellness through intellectual, physical, emotional, social, and spiritual variables. Engaging in physical activity, formal exercise, and specific recreational activities had a favorable effect on short-term cognitive decline. Involvement with computers, crossword puzzles, handicrafts, and formal education courses also were protective factors. The physical and intellectual domains of wellness are prominent aspects in protection from cognitive decline. Inherent in these two domains are mutable factors suitable for targeted efforts to promote older adult health and well-being.
