Corrigendum: Leisure sedentary time is associated with self-reported falls in middle-aged and older females and males: an analysis of the CLSA.

[This corrects the article DOI: 10.1093/ije/dyz173.].

Leisure Sedentary Time is Associated with Self-Reported Falls in Middle-aged and Older Females and Males: an Analysis of the CLSA.

Aim: The purpose of this analysis was to report the prevalence of falls and falls-related injuries among those reporting different volumes of weekly sedentary time, and to understand the association of sedentary time and falls, accounting for functional fitness. Methods: Baseline and first follow-up data from the Canadian Longitudinal Study on Aging (CSLA) were analyzed (n=22,942). Participants self-reported whether they had a fall in the past 12 months (at baseline) and whether they had an injury that was a result of a fall (follow-up). In-home interviews collected self-reported leisure sedentary time using the Physical Activity Scale for Elderly. Functional fitness was assessed using grip strength, timed-up-and-go, and chair rise tests during clinic visits. Results: The prevalence of falls was higher among those who reported higher sedentary time. For example, among males aged 65 and older who reported lower sedentary time (<1,080 min/week), the prevalence of falls in the past 12 months (at baseline) was 7.8% compared to 9.8% in those reporting higher sedentary time. The odds of reporting a fall (at baseline) was 21% higher in those who reported higher sedentary time (OR: 1.21; 95%CI: 1.11-1.33) in adjusted models. No associations were found between sedentary time and injuries due to a fall. Conclusions: Reporting high volumes of sedentary time may increase the risk of falls. Future research using device-based estimates of total sedentary time and breaks in sedentary time is needed to further elucidate this association.

Neighbourhood greenness moderates the association between physical activity and geriatric-relevant health outcomes: an analysis of the CLSA.

BACKGROUND: The purpose of this analysis was to evaluate the relationship between baseline physical activity levels of older adults and geriatric-relevant health outcomes at 3-year follow-up, and to determine whether baseline neighbourhood characteristics alter this association. METHODS: Data from the Canadian Longitudinal Study on Aging (CLSA) were used to assess geriatric-relevant outcomes of physical impairment, medication use, severity of daily pain, and depressive symptoms. Data from the Canadian Active Living Environments (Can-ALE) and the Normalized Difference Vegetative Index (NDVI) were used to determine neighbourhood walkability and greenness, respectively. The analytic sample included adults who were 65 years or older at baseline [Formula: see text]. Adjusted odds ratios and 95% confidence intervals for the base relationships were calculated using proportional odds logistic regression (physical impairment, pain, medication use), and linear regression (depressive symptoms). Moderation effects of environmental factors were assessed using greenness and walkability. RESULTS: The base relationships showed protective associations between each additional hour per week of total physical activity and physical impairment [Formula: see text] daily pain severity [Formula: see text] medication use [Formula: see text], and depressive symptoms [Formula: see text]. Additive moderation effects were seen when greenness was added to physical impairment [Formula: see text], daily pain severity [Formula: see text], and depressive symptoms [Formula: see text] but no moderation was seen with walkability. Sex differences were observed. For example, greenness moderation was found in severity of daily pain in males but not in females. CONCLUSION: Future research investigating geriatric-relevant health outcomes and physical activity should consider neighbourhood greenness as a potential moderator.

Short bouts of walking attenuates the response of IL-8 to prolonged sitting in healthy adults.

PURPOSE: Experimental studies have shown that prolonged sitting for 2-8 h can cause changes to vascular and metabolic markers; the response of pro-inflammatory cytokines is relatively unexplored. The purpose of this study is to determine the response of interleukin-8 (IL-8) to prolonged and interrupted sitting. METHODS: Healthy participants (n = 24, 21.1 years ± 2.2, 50% female) completed a prolonged sitting session (4 h) and an interrupted sitting session (4 h of sitting with 3 min of walking at 60%HRmax, every 30 min) in random order. Saliva and capillary plasma were collected at the beginning (T1) and at the end of each session (T2). RESULTS: Salivary concentrations of IL-8 increased during the prolonged (T1 median: 22.09 pg/mL, T2 median: 86.18 pg/mL; p = < 0.01, ES - 0.55) and interrupted (T1 median: 22.09 pg/mL, T2 median: 51.99 pg/mL; p = 0.021, ES - 0.34) sessions; however, the increase during interrupted sitting was lower (PS median: 134.4%, range: - 43.96 to 1115.69 and IS median: 50.8%, range: - 75.5 to 356.35; p = 0.011, ES - 0.53). In the sub-sample of males, salivary IL-8 did not increase in the interrupted session (T1 median: 22.09, range: 3.496-699.12, and T2 median: 24.96, range: 5.11-533.5, p = > 0.05, ES - 0.16). No significant findings were observed for IL-8 in the plasma. CONCLUSION: Prolonged sitting appears to increase concentrations of the pro-inflammatory cytokine IL-8 while interrupting this sitting with short bouts of walking blunts this response. Sex appears to moderate this relationship; however, there appears to be a large amount of individual variability.

Neighborhood greenness, but not walkability, is associated with self-rated measures of health in older adults: An analysis of the Canadian Longitudinal Study on Aging.

The purpose of this analysis was to determine whether older Canadians residing in neighborhoods characterized by denser greenness or higher walkability have better self-reported health outcomes at 3-year follow-up. Data on self-reported chronic diseases (composite score of 10 conditions) and self-rated measures of health (general health, mental health, and healthy aging) from the Canadian Longitudinal Study on Aging (CLSA) were used as outcomes. The CLSA database was linked with the Canadian Active Living Environments (Can-ALE), a measure of walkability, and Normalized Difference Vegetation Index (NDVI), a measure of greenness. The analytic sample consisted of adults aged 65 and older (n = 15339, age 72.9 ± 5.6, 50 % female). Crude and adjusted associations were assessed using Poisson regression and proportional odds regression modelling. The 4th quartile of greenness was associated with the chronic disease index and all three measures of self-rated health (general health, mental health, and healthy aging); living in a neighborhood with the highest greenness was associated with better health three years later when compared to those in the lowest quartile of greenness. After adjustment for covariates of age, sex, income, education, and physical activity levels, only the association for the 3rd quartile of greenness was significantly associated with general health (OR: 0.90, 95 %CI: 0.81-0.99) and mental health (OR: 0.88, 95 %CI: 0.79-0.97). Can-ALE was not associated with any of the outcomes assessed. Future research assessing perceived environmental walkability and geriatric relevant health outcomes rather than chronic disease may provide greater insight into our understanding of age-friendly environments.

Effects of high intensity interval training on cardiorespiratory fitness and salivary levels of IL-8, IL-1ra, and IP-10 in adults with asthma and non-asthma controls.

OBJECTIVE: The purpose of this study was to determine whether high intensity interval training (HIIT) would lead to improvements in 1) maximal VO2, VE, VE/VCO2, and VE/MVV, and/or 2) resting salivary concentrations of pro-inflammatory markers Interleukin (IL-8), interferon-gamma-inducible-protein (CXCL10/IP-10)) and anti-inflammatory marker IL-1 receptor antagonist (IL-1ra) in adults with well-controlled asthma compared to non-asthma controls. METHODS: Participants completed a maximal exercise test at the beginning (T1) and end (T2) of a 6-week HIIT intervention; saliva samples were obtained at the beginning and 30 min following the first (T1) and last (T2) exercise session. RESULTS: Adults with asthma (n = 20; age: 21.4 ± 2.4 years) and non-asthma controls (n = 12; age: 22.5 ± 3.4 years) completed the intervention. VO2max increased from T1 to T2 in both groups (asthma T1 32.9 ± 8, T2 38.6 ± 8.2 ml/kg/min; controls T1 34.5 ± 11.8, T2 38.9 ± 12.3 ml/kg/min). VEmax also increased in both groups (asthma T1 97.7, T2 110.8 units, p < 0.001, hp2 = <0.04; control T1 106.3, T2 118.1, p < 0.001, hp2 0.02). An increase in VE/VCO2 (F(1, 10)=22.11, p = 0.001) and VE/MVV (F(1, 10) = 111.30, p < 0.001) was observed in the control group; no differences were observed in the asthma group. No differences in IL-8 or IL-1ra were observed between groups. In the asthma group, resting salivary IP-10 concentrations significantly decreased from T1 (0.025 pg/ug protein) to T2 (0.015 pg/ug protein, p = 0.039, hp2 = 0.3 (moderate effect)). CONCLUSION: A 6-week HIIT intervention led to a similar increase in VO2max and VEmax in those with and without asthma, and a decrease in resting salivary IP-10 levels among adults with asthma.

Start with reducing sedentary behavior: A stepwise approach to physical activity counseling in clinical practice.

Recently, sedentary behavior recommendations have been included in the public health guidelines of multiple countries, pointing to new opportunities for prevention of chronic disease as well as a potential strategy for initiating long-term behavior change. OBJECTIVE: To propose an evidence-informed approach to physical activity counseling that starts with a focus on reducing sedentary time. METHODS: We put forward a case for addressing changes in sedentary behavior in clinical practice using a narrative review. We also propose a new approach for the assessment and counselling of patients with respect to movement behaviors. RESULTS: There is evidence to support a stepwise approach to physical activity counseling that starts with targeting sedentary behavior, particularly in those who are highly sedentary, or those who have chronic disease, or physical impairments. CONCLUSIONS: Our approach encourages clinicians to consider sedentary behavior counseling as a critical first step to physical activity counseling. For many patients, this initial step of reducing sedentary behavior could build a pathway to an active lifestyle. PRACTICAL IMPLICATIONS: A shift from long periods of sedentary time to daily routines incorporating more light intensity physical activity could result in meaningful health improvements. Importantly, this approach may be more feasible for highly inactive patients.

Leisure sedentary time and physical activity are higher in neighbourhoods with denser greenness and better built environments: an analysis of the Canadian Longitudinal Study on Aging.

Associations of environmental variables with physical activity and sedentary time using data from the Canadian Longitudinal Study on Aging, and the Canadian Urban Environmental Health Research Consortium (Canadian Active Living Environments (Can-ALE) dataset, and Normalized Difference Vegetation Index (NDVI, greenness) dataset) were assessed. The main outcome variables were physical activity and sedentary time as measured by a modified version of the Physical Activity for Elderly Scale. The sample consisted of adults aged 45 and older (n = 36 580, mean age 62.6 ± 10.2, 51% female). Adjusted ordinal regression models consistently demonstrated that those residing in neighbourhoods in the highest Can-ALE category (most well-connected built environment) reported more physical activity and sedentary time. For example, males aged 75+ in the highest Can-ALE category had 2 times higher odds of reporting more physical activity (OR = 2.0, 95% CI = 1.1-3.5) and 1.8 times higher odds of reporting more sedentary time (OR = 1.8, 95% CI = 1.0-3.4). Neighbourhoods with higher greenness scores were also associated with higher odds of reporting more physical activity and sedentary time. It appears that an environment characterized by higher Can-ALE and higher greenness may facilitate physical activity, but it also facilitates more leisure sedentary time in older adults; research using device measured total sedentary time, and consideration of the types of sedentary activities being performed is needed. Novelty: Middle-aged and older adults living in neighbourhoods with higher Can-ALE scores and more greenness report more physical activity and leisure sedentary time Greenness is important for physical activity and sedentary time in middle-aged adults.

Active Aging and Public Health: Evidence, Implications, and Opportunities.

By 2050, 20% of the world's population will be over the age of 65 years, with projections that 80% of older adults will be living in low- to middle-income countries. Physical inactivity and sedentary time are particularly high in older adults, presenting unique public health challenges. In this article, we first review evidence that points to multiple beneficial outcomes of active aging, including better physical function, cognitive function, mental health, social health, and sleep, and we suggest the need to shift the research focus from chronic disease outcomes to more relevantoutcomes that affect independence and quality of life. Second, we review the critical role of age-friendly environments in facilitating active aging equitably across different countries and cultures. Finally, we consider emerging opportunities related to social engagement and technology-enabled mobility that can facilitate active aging. In all these contexts, it is a priority to understand and address diversity within the global aging population.

Aerobic fitness is inversely associated with neurohemodynamic transduction and blood pressure variability in older adults.

Higher aerobic fitness is independently associated with better cardiovascular health in older adults. The transduction of muscle sympathetic nerve activity (MSNA) into mean arterial pressure (MAP) responses provides important insight regarding beat-by-beat neural circulatory control. Aerobic fitness is negatively associated with peak MAP responses to spontaneous MSNA in young males. Whether this relationship exists in older adults is known. We tested the hypothesis that aerobic fitness was inversely related to sympathetic neurohemodynamic transduction and blood pressure variability (BPV) in older adults. Relative peak oxygen consumption (V̇O2peak, indirect calorimetry) was assessed in 22 older adults (13 males, 65 ± 5 years, 36.3 ± 11.5 ml/kg/min). Peroneal MSNA (microneurography) and arterial pressure (finger photoplethysmography) were recorded during ≥ 10-min of rest. BPV was assessed using the average real variability index. MAP was tracked for 12 cardiac cycles following heartbeats associated with MSNA bursts (i.e., peak ΔMAP). Peak ΔMAP responses (0.9 ± 0.6 mmHg) were negatively associated (all, P < 0.04) with resting burst frequency (30 ± 11 bursts/min; R = -0.47) and burst incidence (54 ± 22 bursts/100 heartbeats; R = -0.51), but positively associated with BPV (ρ = 0.47). V̇O2peak was inversely related to the pressor responses to spontaneous bursts (R = -0.47, P = 0.03) and BPV (ρ = -0.54, P = 0.01), positively related to burst incidence (R = 0.42, P = 0.05), but unrelated to MSNA burst frequency (P = 0.20). The V̇O2peak-BPV relationship remained after controlling for burst frequency, peak ΔMAP, age, and sex. Lower V̇O2peak was associated with augmented neurohemodynamic transduction and BPV in older adults. These negative hemodynamic outcomes highlight the importance of higher aerobic fitness with ageing for optimal cardiovascular health.

Sit less and move more for cardiovascular health: emerging insights and opportunities.

Sedentary behaviour - put simply, too much sitting, as a distinct concept from too little exercise - is a novel determinant of cardiovascular risk. This definition provides a perspective that is complementary to the well-understood detrimental effects of physical inactivity. Sitting occupies the majority of the daily waking hours in most adults and has become even more pervasive owing to the COVID-19 pandemic. The potential for a broad cardiovascular health benefit exists through an integrated approach that involves 'sitting less and moving more'. In this Review, we first consider observational and experimental evidence on the adverse effects of prolonged, uninterrupted sitting and the evidence identifying the possible mechanisms underlying the associated risk. We summarize the results of randomized controlled trials demonstrating the feasibility of changing sedentary behaviour. We also highlight evidence on the deleterious synergies between sedentary behaviour and physical inactivity as the underpinnings of our case for addressing them jointly in mitigating cardiovascular risk. This integrated approach should not only reduce the specific risks of too much sitting but also have a positive effect on the total amount of physical activity, with the potential to more broadly benefit the health of individuals living with or at risk of developing cardiovascular disease.

Low volume high intensity interval training leads to improved asthma control in adults.

OBJECTIVE: Regularly engaging in aerobic exercise is associated with improved asthma control and quality of life in adults with mild to moderate severity asthma. Previous intervention research has primarily employed moderate intensity continuous aerobic exercise protocols. As such, the impact of high intensity interval training (HIIT) on asthma control is poorly understood. METHODS: A six-week, low volume HIIT intervention (3 times/week, 20 min bouts) was conducted in adults with asthma (n = 20). Asthma control was assessed using the Asthma Control Questionnaire-7 (ACQ-7). RESULTS: ACQ-7 improved from pre to post-intervention (pre: 0.8 ± 0.6; post: 0.5 ± 0.4, p = 0.02, Cohens d = 0.5). In total, 7/20 (35%) participants experienced clinically meaningful improvements in ACQ-7. CONCLUSION: A low-volume HIIT intervention led to statistically and clinically significant improvements in asthma control as well as improved exertional dyspnea and exercise enjoyment.

Chemopreventive activity of hydroethanolic Murraya koenigii leaves extract (HEMKLE) against chemically induced skin carcinogenesis in mice.

The present study aimed to examine the chemoprotective effect of Hydroethanolic Murraya koenigii leaves extract (HEMKLE) on murine skin carcinogenesis model. For the study, male LACA mice divided into four groups (n = 15 per group). Group I (Control), Group II (DMBA/TPA), Group III (HEMKLE), and Group IV (HEMKLE + DMBA/TPA). Skin tumors were induced in Group II (DMBA/TPA) and Group IV (HEMKLE + DMBA/TPA) by topical application of 7, 12 dimethylbenz[a]anthracene (DMBA) [500 nmol/100 µL of acetone, twice a week for two weeks] and 12-O-tetradecanoyl phorbol-13-acetate (TPA) [1.7 nmol/100 µL of acetone, twice a week for eighteen weeks] and HEMKLE (200 mg/kg b. w.) was administered orally (instilled by oral gavage). The chemoprotective response of HEMKLE was evident by inhibition in tumor incidence, mean tumor volume, mean tumor burden, total number of tumors, and tumor size in Group IV (HEMKLE + DMBA/TPA) when compared to Group II (DMBA/TPA). HEMKLE administration also decreased the reactive oxygen species (ROS) and lipid peroxidation (LPO) levels and increased the antioxidants enzyme activities in Group IV (HEMKLE + DMBA/TPA) when compared to Group II (DMBA/TPA) that suggests its antioxidant potential. HEMKLE administration also increased the mRNA and protein expression of caspase-9 and caspase-3 and decreased the mRNA and protein expression of Bcl-2 in Group IV (HEMKLE + DMBA/TPA) when compared to Group II (DMBA/TPA) that suggest its apoptosis-inducing effect on DMBA/TPA induced skin carcinogenesis.

Reducing Anxiety and Anxiety Sensitivity With High-Intensity Interval Training in Adults With Asthma.

BACKGROUND: Low- and moderate-intensity exercise training has been shown to be effective for reducing general anxiety and anxiety sensitivity among adults with asthma. Exercise frequency and intensity have been shown to play an integral role in reducing anxiety sensitivity; however, less is known about the impact of high-intensity interval training (HIIT) on anxiety in adults with asthma. METHODS: A 6-week HIIT intervention was conducted with adults with asthma. Participants completed HIIT (10% peak power output for 1 min, 90% peak power output for 1 min, repeated 10 times) 3 times per week on a cycle ergometer. Preintervention and postintervention assessments included the Anxiety Sensitivity Index-3 and the Body Sensations Questionnaire. RESULTS: Total Anxiety Sensitivity Index-3 (PRE: 17.9 [11.8]; POST 12.4 [13], P = .002, Cohen d = 0.4, n = 20) and Body Sensations Questionnaire (PRE: 2.4 [1.0]; POST: 2.0 [0.8], P = .007, Cohen d = 0.3) improved from preintervention to postintervention. CONCLUSION: A 6-week HIIT intervention leads to improved anxiety among adults with asthma. Future research should determine the impact of HIIT among adults with asthma with clinical anxiety.

Does sedentary time increase in older adults in the days following participation in intense exercise?

BACKGROUND: Older adults have the highest sedentary time across all age groups, and only a small portion is meeting the minimum recommendations for weekly physical activity. Little research to date has looked at how changes in one of these behaviours influences the other. AIM: To assess changes in 24-h movement behaviours (sedentary time, light intensity physical activity (LPA), moderate-vigorous PA (MVPA) and sleep) over three consecutive days, following acute bouts of exercise of varying intensity in older adults. METHODS: Participants (n = 28, 69.7 ± 6.5 years) completed a maximal exercise test and the following exercise protocols in random order: moderate continuous exercise (MOD), high-intensity interval exercise (HI) and sprint interval exercise (SPRT). A thigh-worn device (ActivPAL™) was used to measure movement behaviours at baseline and the 3 days following each exercise session. RESULTS: Repeated measures analysis of variance indicated that compared to baseline, participants decreased MVPA in the 3 days following all exercise sessions and decreased LPA following HI and SPRT (p < 0.05). Over half of the sample had clinically meaningful increases in sedentary time (30 min/day) in the days following exercise participation. DISCUSSION: Older adults who compensate for exercise participation by reducing physical activity and increasing sedentary time in subsequent days may require behavioural counseling to ensure that incidental and recreational physical activities are not reduced. CONCLUSION: It appears that older adults compensate for acute exercise by decreasing MVPA and LPA, and increasing sedentary time in the days following exercise. Future research is needed to determine whether compensation persists with regular engagement.

Recommendations for 24-Hour Movement Behaviours in Adults with Asthma: A Review of Current Guidelines.

Background: Many countries have clinical practice guidelines (CPG) for asthma that serve as an important resource for healthcare professionals and inform the development of policies and practices relevant to asthma care. The purpose of this scoping review was to search for CPGs related to asthma to determine what recommendations related to the 24-h movement behaviours are provided. Methods: We searched for the most recent CPGs published by a national authoritative body from 195 countries. Guidelines were reviewed for all movement behaviours; that is, physical activity, sedentary behaviour, and sleep. Results: In total, 82 documents were searched for eligibility and 19 were included in our review. Of these, only 10 CPGs provided information on physical activity; none provided recommendations consistent with the FITT principle, while seven recommended activity levels similar to the general population. None of the guidelines included information on sedentary behaviour. Nine guidelines included information on sleep: recommendations mostly focused on changes to medication to reduce disruptions in sleep. Conclusions: It is recommended that future work be conducted to create comprehensive movement behaviour guidelines accompanied with relevant precautions and strategies to ensure that adults with asthma are able to safely and effectively engage in movement behaviours throughout the day.

Perspectives on Active Transportation in a Mid-Sized Age-Friendly City: "You Stay Home".

BACKGROUND: Active transportation is an affordable and accessible form of transportation that facilitates the mobility of older adults in their communities. Age-friendly cities encourage and support physical activity and social participation among older adults; however, they often do not adequately address active transportation. Our goal was to identify and understand the constraints to active transportation that older adults experience in order to inform the development of viable solutions. METHODS: Focus group interviews were conducted with community dwelling older adults (n = 52) living in the City of Oshawa in Ontario, Canada; each focus group targeted a specific demographic to ensure a diverse range of perspectives were represented. Data were analyzed to identify themes; sub-group analyses were conducted to understand the experience of those from low socioeconomic status and culturally diverse groups. RESULTS: Themes pertaining to environmental, individual, and task constraints, as well as their interactions, were identified. Of particular novelty, seemingly non-modifiable constraints (e.g., weather and personal health) interacted with modifiable constraints (e.g., urban design). Culturally diverse and lower socioeconomic groups had more favorable perspectives of their neighborhoods. CONCLUSION: While constraints to active transportation interact to exacerbate one another, there is an opportunity to minimize or remove constraints by implementing age-friendly policies and practices.