Do the dual-task "8-foot up and go" tests provide additional predictive value for early detection of cognitive decline in community-dwelling older women?

BACKGROUND: The 8-Foot Up and Go (8UG) test is a widely used mobility assessment. Some dual-task mobility assessments have been developed to help detect cognitive decline. AIMS: This study developed a dual-task version of 8UG test to investigate the dual-task 8UG performance and to evaluate the ability of dual-task 8UG test in detecting cognitive decline. METHODS: A total of 101 eligible community-dwelling women aged 60-74 years were grouped into the mild cognitive impairment group (MCI, n = 49) and the non-cognitive impairment group (NCI, n = 52). The 8UG tests under single-task (ST), manual dual-task (MT), and cognitive dual-task (CT) conditions were performed respectively. The dual-task cost (DTC) and the correct response rate (CRR) were calculated to quantify the dual-task interference. RESULTS: Participants spent more time in performing the 8UG test under dual-task conditions. No differences were observed between NCI and MCI groups for 8UG parameters under ST and MT conditions (p > 0.05). When executing CT, significant differences were found in the number of correct answers and CRR (p < 0.05). CRR showed the strongest ability to predict MCI with a cut-off point of 0.50 (71.2% sensitivity and 61.2% specificity). DISCUSSION: Both manual and cognitive dual-task were found to interfere with the 8UG performance. CRR with cutoff point of 0.50 could be a potential predictor of MCI in community-dwelling older women. CONCLUSIONS: The CRR of the cognitive dual-task 8UG test could be recommended as a potential predictor for the early detection of MCI in community-dwelling older women.

Correlates of Meeting the Muscle-Strengthening Exercise Guidelines in Children and Adolescent.

This study aimed to explore the potential correlates of muscle-strengthening exercise (MSE) in Chinese children and adolescents. A convenient sample (n = 3733) was recruited into this study. Self-reported questionnaires were used to collect information on sex, grade, ethnicity, residence, family composition, moderate to vigorous physical activity (MVPA), family income, parent's education level and MSE in children and adolescents as well as their parent(s). The prevalence of meeting the MSE guidelines was 62.1%. Children and adolescents who were in primary or middle school were more likely to meet the MSE guidelines ([primary school] OR = 2.33, 95% CI: 1.16-4.68; [middle school] OR = 4.62, 95% CI: 2.27-9.39). Children and adolescents with Han ethnicity had a higher likelihood to meet the MSE guidelines (OR = 1.97, 95% CI: 1.37-2.83). Children and adolescents meeting the MVPA recommendation were more likely to meet the MSE guidelines (OR = 5.41, 95% CI: 3.97-7.37). Relative to those who had a parent not meeting the MSE guidelines, those with either father or mother meeting the MSE guidelines were more likely to meet the MSE guidelines (OR = 1.32, 95% CI: 1.13-1.55). Our study may offer evidence for future MSE interventions in Chinese children and adolescents.

Is the Health Behavior in School-Aged Survey Questionnaire Reliable and Valid in Assessing Physical Activity and Sedentary Behavior in Young Populations? A Systematic Review.

Backgrounds: Using the self-reported questionnaire to assess the levels of physical activity (PA) and sedentary behavior (SB) has been a widely recognized method in public health and epidemiology research fields. The selected items of the Health Behavior in School-aged (HBSC) Survey Questionnaire have been used globally for measurements and assessments in PA and SB of children and adolescents. However, there are no comprehensive and critical reviews to assess the quality of studies on reliability and validity of selected items for PA and SB measurement and assessment derived from the HBSC. Thus, this review aimed to critically assess the quality of those studies and summary evidence for future recommendations. Methods: A systematic review protocol was used to search potentially eligible studies on assessing reliability and validity of PA and SB measures of the HBSC questionnaire. electronically academic databases were used. The information on the reliability and validity of the PA and SB measures were extracted and evaluated with well-recognized criteria or assessment tools. Results: After a literature search, six studies were included in this review. The reliability of PA measures of the HBSC questionnaire showed a moderate agreement while the reliability of SB measures showed a great variation across the different items in the different subgroups. The validity of the PA measures had acceptable performance, whereas no studies assess the validity of the SB measures. The included studies all had quality weaknesses on reliability or validity analysis. Conclusions: The PA and SB measures of the HBSC questionnaires were reliable in assessing PA and SB among adolescents. However, a little evidence showed that PA measures are partially valid in assessing PA, but no evidence confirmed the validity of SB measures. The included studies all had methodological weaknesses in examining the reliability and validity of the PA and SB measures, which should be addressed in the future. Further studies are encouraged to use a more standardized study design to examine the reliability and validity of the PA and SB measures in more young populations.

Association between physical education classes and physical activity among 187, 386 adolescents aged 13-17 years from 50 lowand middle-income countries

Abstract Objective: This study aimed to examine the association between physical education classes and PA among adolescents from 50 lowand middle-income countries (LMICs). Methods: A self-reported questionnaire from the Global School-based Student Survey (GSHS) was used to collect information on participation frequency of physical education classes and being physically active over the last week, as well as other control variables (e.g., sex, age, country, sedentary behavior). Multivariable logistic regression and a pooled meta-analysis were performed to explore the association and compared country-wise differences. Results: Included adolescents aged from 13 to 17 years (n = 187,386, %boys = 51.7; mean age = 14.6 years), the prevalence of sufficient PA (meeting the PA guidelines) was 14.9%. The prevalence of 5 days or more to engage in physical education classes was 16.5%. Compared with adolescents who had 0 days for physical education classes, higher participation frequency was more likely related to sufficient PA (OR: 1 day = 1.34, 2 days = 1.66, 3 days = 1.67, 4 days = 1.79, 5 days or more = 2.46), these findings were also observed in both sexes. A moderate inconsistency on the association across the included countries was found (I2 = 53%, p < 0.01), although the pooled OR was 1.50 (95% CI: 1.36-1.65). Conclusions: Participating in more physical education classes may be an effective approach to increase physical activity levels among adolescents in LMICs. However, promoting physical activity levels among adolescents in LMICs through physical education classes should consider more country-specific factors.

Association between physical education classes and physical activity among 187,386 adolescents aged 13-17 years from 50 low- and middle-income countries.

OBJECTIVE: This study aimed to examine the association between physical education classes and PA among adolescents from 50 low- and middle-income countries (LMICs). METHODS: A self-reported questionnaire from the Global School-based Student Survey (GSHS) was used to collect information on participation frequency of physical education classes and being physically active over the last week, as well as other control variables (e.g., sex, age, country, sedentary behavior). Multivariable logistic regression and a pooled meta-analysis were performed to explore the association and compared country-wise differences. RESULTS: Included adolescents aged from 13 to 17 years (n=187,386, %boys=51.7; mean age=14.6 years), the prevalence of sufficient PA (meeting the PA guidelines) was 14.9%. The prevalence of 5 days or more to engage in physical education classes was 16.5%. Compared with adolescents who had 0 days for physical education classes, higher participation frequency was more likely related to sufficient PA (OR: 1 day=1.34, 2 days=1.66, 3 days=1.67, 4 days=1.79, 5 days or more=2.46), these findings were also observed in both sexes. A moderate inconsistency on the association across the included countries was found (I2=53%, p<0.01), although the pooled OR was 1.50 (95% CI: 1.36-1.65). CONCLUSIONS: Participating in more physical education classes may be an effective approach to increase physical activity levels among adolescents in LMICs. However, promoting physical activity levels among adolescents in LMICs through physical education classes should consider more country-specific factors.

Meeting 24-h movement guidelines: Prevalence, correlates, and the relationships with overweight and obesity among Chinese children and adolescents.

BACKGROUND: Meeting 24-h movement guidelines by children and adolescents has been associated with improved indicators of health, although it has been under-studied in China. Hence, this study aimed to investigate the prevalence of meeting the 24-h movement guidelines, its correlates, and its relationships with body mass index in children and adolescents in China. METHODS: Cross-sectional data from the 2017 Youth Study in China of 114,072 children and adolescents (mean age = 13.75 years, 49.18% boys) were used. Meeting 24-h movement guidelines (≥60 min of daily moderate-to-vigorous physical activity, ≤2 h of daily leisure screen time, 9-11 h and 8-10 h nightly sleep duration for 6-13-year-olds and 14-17-year-olds, respectively) and height and weight of all participants were assessed. The prevalence of meeting the 24-h movement guidelines and World Health Organization weight status categories were determined. Generalized linear models were used to determine the correlates of meeting the 24-h movement guidelines and the relationships of meeting the 24-h movement guidelines with overweight (OW) and obesity (OB). RESULTS: Only 5.12% of Chinese children and adolescents met the 24-h movement guidelines, and 22.44% were classified as OW/OB. Older children and adolescents were less likely to meet the 24-h movement guidelines. Parental education level and family income were positively related to meeting the 24-h movement guidelines. Children and adolescents meeting the 24-h movement guidelines showed lower odds ratios for OW/OB. Compared with participants meeting the 24-h movement guidelines, boys in 4th-6th grades met none of the recommendations (OR = 1.22, 95%CI: 1.06-1.40), met the screen time recommendation only (OR = 1.13, 95%CI: 1.01-1.28), met the nightly sleep duration recommendation only (OR = 1.14, 95%CI: 1.03-1.28), and had significantly higher odds ratios for OW/OB. Similar trends were observed for girls in 4th-6th grades: meeting none of the guidelines (OR = 1.35, 95%CI: 1.14-1.59), meeting sleep duration guidelines only (OR = 1.23, 95%CI: 1.08-1.39), and meeting moderate-to-vigorous physical activity + nightly sleep duration guidelines (OR = 1.24, 95%CI: 1.01-1.54). For girls in 7th-9th grades, the following trend was observed: meeting none of the guidelines (OR = 1.30, 95%CI: 1.01-1.67). CONCLUSION: Very few Chinese children and adolescents met the 24-h movement guidelines. Age (negatively correlated), parental education level, and family income (both positively correlated) were correlates of meeting the 24-h movement guidelines. Children and adolescents meeting the 24-h movement guidelines were more likely to have lower risks for OW/OB, especially in the youngest age group (Grades 4-6); and girls in the middle age group (Grades 7-9) were also more likely to have lower risks for OW/OB. Further research studies should explore additional correlates and determinants for meeting the 24-h movement guidelines. Also, future studies should use longitudinal or interventional designs to determine the relationships between meeting the 24-h movement guidelines and OW/OB and other health indicators, while taking sex and age differences into account.

Associations between various kinds of parental support and physical activity among children and adolescents in Shanghai, China: gender and age differences.

BACKGROUND: The associations between various kinds of parental support and children and adolescents' physical activity (PA) are inconclusive. This study aimed 1) to examine the associations between various kinds of parental support and children and adolescents' moderate-to-vigorous physical activity (MVPA), and 2) to examine gender and age differences in the association between each specific kind of parental support and MVPA. METHODS: Using a multi-stage stratified and random cluster sampling method, 711 schools in Shanghai were selected (data were collected from October 2014 to February 2015). In total, 61,429 school-aged children (6-18 years old, 50.7% boys) and their parents were included. Self-reported questionnaires were used to measure sociodemographic characteristics, MVPA and various kinds of parental support, including parental encouragement (PAEN), parental involvement (PAIV), parental financial support (PAFS) and, parental modeling (PAMD). Descriptive statistics and Chi-square were used to report the level of MVPA and its difference across various kinds of parental support by gender groups. The logistic regression analysis was used to examine the associations between parental support and MVPA with odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Overall, 19.4% of children and adolescents accumulated MVPA at least 60 min/day. Boys were more physically active than girls (21.4% > 17.4%, p <  0.001). According to the observation of OR estimates, girls may be more susceptible to the influences from various kinds of parental support than boys (OR = 1.59, 1.61, 1.27 and 1.63, 95% CI: 1.19-1.73 among girls, and OR = 1.48, 1.60, 1.21, and 1.60, 95% CI: 1.14-1.69 among boys for PAEN, PAIV, PAFS and PAMD respectively). PAMD is the only one supportive kind that was positively associated with MVPA in both genders across all grades (OR = 1.29-2.98, 95% CI: 1.09-4.08 among boys; OR = 1.27-2.64, 95% CI: 1.10-4.10 among girls). CONCLUSIONS: Less than one fifth of children and adolescents accumulated 60 min MVPA per day. Various kinds of parental support have important effects on children and adolescents' MVPA, which varied by gender and grades. PAMD, in particular, should be emphasized more than PAEN, PAIV and PAFS in family-based interventions aiming at increasing PA in the future.

Relationship between Fundamental Movement Skills and Physical Activity in Preschool-Aged Children: A Systematic Review.

Preschool-aged children are in a critical period of developing fundamental movement skills (FMS). FMS have a close link with physical activity (PA). This study aimed to systematically review the associations between FMS and PA in preschool-aged children. Searching Cochrane Library, Web of Science, PubMed, ScienceDirect, and EBSCO (including SPORTDiscus, ERIC, and Academic Search Premier) was utilized to conduct a systematic review of the available literature. Studies were included if they examined associations between FMS and PA among typically developing children aged 3-6 years, published between January 2000 and April 2020. A total of 26 studies met the inclusion criteria, including 24 cross-sectional studies and two cohort studies. There was a strong level of evidence to support low to moderate associations between moderate to vigorous physical activity and components of FMS, specifically, the total FMS (r = 0.11-0.48, R2 = 16%-19%) and object control skill (r = 0.16-0.46, ß = 0.28-0.49, R2 = 10.4%-16.9%). Similar associations were also found between the total physical activity and components of FMS, specifically, the total FMS (r = 0.10-0.45, R2 = 16%), locomotor skills (r = 0.14-0.46, R2 = 21.3%), and objective control skills (r = 0.16-0.44, ß = 0.47, R2 = 19.2%). There was strong evidence that there is no significant association between light physical activity and FMS, specifically, total FMS and locomotor skills. The associations, including "stability skills-PA" and "locomotor skills-moderate to vigorous PA", were uncertain due to insufficient evidence. Our findings provide strong evidence of associations between specific FMS components and a specific PA intensity. Future studies should consider using a longitudinal study design in order to explore the causal relationship between specific-intensity PA and the FMS subdomain.

Prevalence of Physical Activity and Sedentary Behavior among Chinese Children and Adolescents: Variations, Gaps, and Recommendations.

Physical-activity (PA) and sedentary-behavior (SB) assessment is of particular importance in the promotion of health in young people. However, there is no comprehensive overview of PA and SB from national surveys among Chinese children and adolescents. Following a literature search for Chinese national health surveys, 11 papers from six national surveys were found. Of the included studies, the majority applied self-reported questionnaires to estimate the prevalence of PA and SB. Owing to different definitions of the prevalence of PA and SB and various measures, a large variation in prevalence of PA and SB was observed. Such variations were attributable to methodological and practical issues. This study highlights the current gaps in estimating the national prevalence of PA and SB among Chinese children and adolescents, which should be addressed. To improve the quality of PA and SB surveillance, standardized measurement protocols to estimate the prevalence of PA and SB more accurately among Chinese children and adolescents are urgently required.

Co-existence of physical activity and sedentary behavior among children and adolescents in Shanghai, China: do gender and age matter?

BACKGROUND: There is limited evidence for the prevalence of the co-existence of physical activity (PA) and sedentary behavior (SED), and its correlates among children and adolescents. This study has two aims: 1) to investigate the prevalence of PA and SED, and their co-existence, and 2) to examine the associations between PA or SED, or both with gender and age among children and adolescents in Shanghai, China. METHODS: Using a cross-sectional study design (conducted from September to December 2014), 50,090 children and adolescents (10-18 years old, 50.4% boys) were included in this study. A self-reporting questionnaire was used to measure participants' sociodemographic characteristics, PA, and SED. Descriptive statistics were used to describe sample characteristics, the prevalence of PA and SED, and their co-existence. A Generalized Linear Model was conducted to explore the associations between the prevalence of PA and SED, and their co-existence with gender and age separately. RESULTS: Of the children and adolescents studied, only 18.4% met the guidelines for PA, 25.5% met the guidelines for SED, and 5.7% met the guidelines for both. Boys were more physically active (aOR = 1.43, 95% CI: 1.36-1.50), and girls were less sedentary (aOR = 1.29, 95%CI: 1.24-1.34). The prevalence of PA, SED, or both all declined as age increased (p < 0.001). Stratified analysis by gender revealed greater declining trends of meeting the PA or SED guidelines, or both in girls (all p < 0.005). CONCLUSION: Very few children and adolescents showed active lifestyles, and this was significantly related to age. Effective interventions aiming to promote PA and concurrently to limited SED among children and adolescents should be implemented as early as possible.