Combined associations of regular exercise and work-related moderate-to-vigorous physical activity with occupational stress responses: a cross-sectional study.

Objective: The association between work-related moderate-to-vigorous physical activity (MVPA) and higher levels of stress response is recognized, but whether this association is moderated by regular exercise remains unclear. This cross-sectional study investigated whether exercise-based physical activity (PA) associates with lower levels of stress responses moderated by work-related MVPA. Methods: The study participants comprised 863 workers from 35 small and medium-sized enterprises in Shimane prefecture, Japan, collected through convenient sampling from April 2021 to August 2022. The Brief Job Stress Questionnaire was used to assess stress responses. Work-related MVPA and exercise-based PA were measured using questionnaires. Multiple linear regression was used to analyze the combined variables of work-related MVPA and exercise-based PA. The reference group had no weekly exercise-based PA and >60 min of work-related MVPA. Results: When work-related MVPA exceeded 60 min/day, flexibility activity or walking for ≥5 days/week (B = -3.53, 95% CI = -5.96, -1.11; B = -2.53, 95% CI = -4.90, -0.16) and muscle-strengthening activity 1-3 times/week (B = -3.52, 95% CI = -6.91, -0.12) were significantly associated with lower psychological stress response. Flexibility activity (B = -1.74, 95% CI = -3.01, -0.46) showed a similar link with physical stress response. When work-related MVPA was below 60 min/day, flexibility activity (B = -3.23, 95% CI = -6.01, -0.44; B = -3.29, 95% CI = -5.94, -0.63) or walking (B = -4.03, 95% CI = -6.62, -1.45; B = -3.10, 95% CI = -5.76, -0.44) practice 1-4 times/week and ≥5 times/week was significantly associated with lower psychological stress response. Conclusion: Exercise-based PA greatly and consistently associates with a lower level of stress responses moderated by work-related MVPA.

Are middle-aged and older adult users of physical activity monitors more physically active and at a lower risk of locomotive syndrome? Cross-sectional Web-based Online Survey.

Background: Physical inactivity is a risk factor for locomotive syndromes and functional limitations in middle-aged and older adults. Therefore, strategies to promote physical activity should be considered. This study investigated whether users of physical activity monitors were more physically active and exhibited a lower risk of locomotive syndrome, compared with non-users. Methods: We analyzed data from 742 Japanese adults aged 60-79 years. The participants were surveyed for their use of physical activity monitors in their daily lives. We also assessed the prevalence of locomotive syndrome. Results: We observed significantly higher physical activity levels in users compared with non-users. Moreover, the use of a physical activity monitor was significantly associated with decreased odds of locomotive syndrome (adjusted odds ratio [aOR] = 0.48). Significantly lower risk of locomotive syndrome were observed in individuals who had used a monitor for >2 years (aOR = 0.42) or had set a personal step goal (aOR = 0.32). Conclusion: Physical activity monitoring may increase engagement in physical activity-associated behavior. Therefore, monitoring could serve as a useful tool to promote physical health in middle-aged and older adults.

Associations between information and communication technology use and frailty in community-dwelling old-old adults: results from the ILSA-J.

OBJECTIVES: Frailty is a significant cause of adverse health events including long-term care and hospitalization. Although information and communication technology (ICT) has become an integral part of modern life, it remains unclear whether ICT use is associated with frailty. DESIGN: A cross-sectional study (Integrated Longitudinal Studies on Aging in Japan, ILSA-J). SETTING AND PARTICIPANTS: Aged 75 and older data from the ILSA-J in 2017 (n = 2893). METHODS: ICT use was measured using the technology usage sub-items of the Japan Science and Technology Agency Index of Competence. Specifically, the use of mobile phones, ATMs, DVD players, and sending e-mails were rated as "yes" (able to do) or "no" (unable to do), with the first quintile (≤1 point) defined as ICT non-users. Frailty was assessed using the Japanese version of the Cardiovascular Health Study criteria based on the phenotype model (e.g., weight loss, slowness, weakness, exhaustion, and low activity). Further, multivariate logistic regression analysis analyzed its association with ICT use. Subgroup analyses were stratified according to gender, years of education, and living arrangements. RESULTS: Higher ICT use was not associated with frailty after adjusting for covariates (odds ratio [OR]: 0.53; 95%CI 0.39-0.73). Similar associations were found in the sub-groups of women (OR 0.45, 95%CI 0.30-0.66), <13 years of education (OR 0.48, 95%CI 0.34-0.67), living alone (OR 0.46, 95%CI 0.27-0.79), and living together (OR 0.57, 95%CI 0.38-0.85). No association existed between using ICT and frailty in the sub-groups of men and ≥13 years of education. CONCLUSIONS AND IMPLICATIONS: Higher ICT use is associated with the absence of frailty in individuals 75 years and older. Such benefits may be particularly pronounced in women, those with lower levels of education, and older adults living alone or with others.

Independent Association between Cognitive Frailty and Cardio-Ankle Vascular Index in Community-Dwelling Older Adults.

INTRODUCTION: Although arterial stiffness has been suggested to be associated with poor physical function and mild cognitive impairment (MCI), its association with cognitive frailty (CF), a comorbidity of both, is unclear. This study aims to examine the association between CF and arterial stiffness in community-dwelling older adults. METHODS: A cross-sectional analysis of 511 community-dwelling older adults aged 65 years or older (mean age 73.6 ± 6.2 years, 63.6% women), who participated in a community cohort study (Tarumizu Study, 2019), was conducted. Poor physical function was defined as either slowness (walking speed <1.0 m/s) or weakness (grip strength <28 kg for men and <18 kg for women). MCI was defined by the National Center for Geriatrics and Gerontology Functional Assessment Tool as a decline of at least 1.5 standard deviation from age- and education-adjusted baseline values in any one of the four cognitive domains (memory, attention, executive, and information processing). CF was defined as the combination of poor physical function and MCI. Arterial stiffness was measured using the Cardio-Ankle Vascular Index (CAVI), and the average of the left and right sides (mean CAVI) was used. RESULTS: Multinomial logistic regression analysis adjusted for covariates was performed with the four groups of robust, poor physical function, MCI, and CF as dependent variables and mean CAVI as an independent variable. Using the robust group as reference, the poor physical function and MCI groups showed no significant relationship with the mean CAVI. The mean CAVI was significantly higher in the CF group (odds ratio 1.62, 95% confidence interval: 1.14-2.29). CONCLUSION: A significant association was found between CF and the higher CAVI (progression of arterial stiffness). Careful observation and control of CAVI, which is also an indicator of arterial stiffness, may be a potential target for preventive interventions for CF.

Association between different types of physical activity and occupational stress in Japanese workers: a cross-sectional study.

This cross-sectional study investigated the association between different types of physical activity (PA) and occupational psychological and physical stress responses among workers in Japan. Stress responses were assessed using the Brief Job Stress Questionnaire. Work-related PA (time spent sitting, sitting bouts, standing, walking, engaging in heavy labor, and moderate-to-vigorous PA [MVPA]) and exercise-based PA (frequencies [times/wk] of flexibility and muscle-strengthening activity, and walking) were measured using a questionnaire. Multiple linear regression was performed to examine the association between each type of PA and stress responses. Participants who engaged in >108 min/d of work-related MVPA exhibited a statistically significant association with higher psychological stress responses when compared to those who engaged in 0-42 min/d of work-related MVPA. For exercise-based PA, participants who engaged in flexibility activity or walking five or more times/wk, or muscle-strengthening activity one to three times/wk, demonstrated significantly lower psychological stress responses compared to those who did not exercise. Participants who engaged in flexibility activity five or more times/wok demonstrated significantly lower physical stress responses compared to those who did not exercise. This study suggests that work-related MVPA is associated with higher psychological stress responses, while exercise-based PA is associated with lower psychological or physical stress responses.

Epidemiology and Reporting Characteristics of Systematic Reviews in Orthopedic Journals: A Meta-Epidemiological Study.

Systematic reviews (SRs) with complete reporting or rigorous methods can lead to less biased recommendations and decisions. A comprehensive analysis of the epidemiological and reporting characteristics of SRs in orthopedics is lacking. We evaluated 360 SRs, including 165 and 195 published in orthopedic journals in 2012 and 2022. According to the established reporting guidelines, we examined these SRs for key epidemiological characteristics, including focus areas, type of meta-analysis (MA), and reporting characteristics. Most SRs (71%) were therapy-related, with a significant proportion originating from authors in the USA, UK, and China. Pairwise MA was performed on half of the SRs. The proportion of protocol registrations improved by 2022 but remained low (33%). Despite a formal declaration of adherence to the reporting guidelines (68%), they were often not used and reported enough. Only 10% of the studies used full search strategies, including trial registries. Publication bias assessments, subgroup analyses, and sensitivity analyses were not even planned. The risk of bias assessment improved in 2022; however, the certainty of the evidence remained largely unassessed (8%). The use and reporting of standard methods in orthopedic SRs have remained suboptimal. Thus, authors, peer reviewers, journal editors, and readers should criticize the results more.

Efficacy of telerehabilitation for patients after hip fracture surgery: A systematic review and meta-analysis.

INTRODUCTION: This study aimed to determine the efficacy of telerehabilitation for patients after hip fracture surgery through a systematic review and meta-analysis. METHODS: Eight electronic databases were searched in August 2022. The primary outcomes were mobility outcomes, activities of daily living (ADL) outcomes, and all adverse events, whereas the secondary outcomes were pain, health-related quality of life, and fall efficacy scale score. RESULTS: Seven randomized controlled trials were eligible for this study. The evidence regarding the effect of telerehabilitation on mobility outcomes (standardized mean difference (SMD): 0.05, 95% confidence interval (CI): -0.39 to 0.48) and all adverse events (risk ratio: 1.14, 95% CI: 0.62 to 2.21) was very uncertain. A clinically irrelevant but significant mean difference (MD) in ADL outcomes was found (MD: 4.82, 95% CI: 2.63 to 7.01). Telerehabilitation may result in a slight increase in fall efficacy scale score (SMD: 0.26, 95% CI: -0.02 to 0.54) and little to no difference in pain (MD: -1.0, 95% CI: -18.31 to 16.31). CONCLUSIONS: The efficacy of telerehabilitation for patients after hip fracture surgery was uncertain with respect to the mobility outcomes, all adverse events, and pain, with no clinically meaningful differences in ADL outcomes. Telerehabilitation may be necessary to be considered for patients after hip fracture surgery to improve their confidence in their ability to perform daily activities without falling. Therefore, medical staff may consider telerehabilitation for hip fractures.

Ability to walk 10 m within the first week of stroke predicts independent outdoor walking and destination.

OBJECTIVES: We aimed to determine if achieving a 10-m walk target within the first week of stroke onset correlates with independent outdoor walking at discharge and discharge to home for patients with stroke. MATERIALS AND METHODS: This study included 226 patients transferred to the subacute rehabilitation hospital (SRH) between January 2018 and March 2021. Data obtained from hospital records included age, sex, stroke type, lesion side, body mass index, presence of acute treatment, length of days from onset to physical therapy intervention, National Institutes of Health Stroke Scale, length of hospital stay, Functional Independence Measure score, and the ability to complete the 10 m walk target within the first week of stroke onset. The primary outcomes were independent outdoor walking ability and discharge destination from the SRH. A logistic regression analysis was performed to determine if the 10 m walking ability correlated with the outdoor walking ability and discharge destination. RESULTS: Compared with the inability to walk 10 m, walking 10 m independently walking within the first week of stroke onset correlated with the ability to walk independently outdoors at discharge (odds ratio [OR]: 4.38, p = 0.003) and being discharged home (OR: 4.52, p = 0.002), whereas, walking 10 m with assistance was associated with being discharged home (OR: 3.09, p = 0.043). CONCLUSIONS: The ability to walk 10 m within the first week of stroke onset may be a helpful marker for prognosis.

Associations of fall history and fear of falling with multidimensional cognitive function in independent community-dwelling older adults: findings from ORANGE study.

BACKGROUND: Falls and fear of falling (FoF) inhibit healthy longevity and have been suggested to be associated with cognitive function. However, the domains of cognitive function that are associated with them remain controversial. It is speculated that clarifying this will help in the assessment of health status and interventions in the community. AIM: To analyse the associations between fall history and FoF and multidimensional cognitive function in independent community-dwelling older adults. METHODS: The data from 9759 (73.3 ± 5.4 years, 59.9% women) older individuals enrolled in the cross-sectional ORANGE study were analysed. Simple questions were used to assess fall history in the past year and current FoF. Assessments of multidimensional cognitive function were performed using the National Center for Geriatrics and Gerontology-Functional Assessment Tool (NCGG-FAT) to evaluate memory, attention, executive function, and processing speed. The independent associations of fall history and FoF with multidimensional cognitive function were assessed using multivariate linear regressions adjusted for potential confounding variables. RESULTS: A total of 18.3% and 35.4% of participants presented with fall history and FoF, respectively. Fall history (p = 0.008) and FoF (p = 0.002) were significantly associated with memory. FoF, but not fall history was associated with attention (p = 0.004), executive function (p < 0.01), and processing speed (p < 0.01). CONCLUSION: In independent community-dwelling older adults, fall history was associated only with the memory domain; in contrast, fear of falling was associated with multidimensional cognitive function. This study provides weak evidence suggesting the need to assess falls and FoF in all situations involving independent community-dwelling older adults.

Association of self-rated health with type and frequency of social interaction during the declaration of COVID-19 state of emergency among Japanese community-dwelling oldest-old adults.

AIM: To investigate whether the type and frequency of social interaction during the state of emergency due to coronavirus disease were associated with self-rated health (SRH) after the state of emergency. METHODS: Data from a cross-sectional study were collected for 889 oldest-old adults in Bibai City, Hokkaido, Japan. In total, 612 participants (mean age: 83.0 ± 4.3 years; women: 51.8%) were included in the analysis, taking biological sex into account. The self-reported questionnaire included questions about demographic variables, SRH (July 2020, after the emergency), and the type and frequency of social interaction (March 2020, during the state of emergency). RESULTS: There was no significant association between social interaction and SRH in men (P > 0.05). Women who had social interactions (both face-to-face and non-face-to-face) more than once a week during the state of emergency reported higher SRH after the emergency than those who did not (odds ratio 2.17, 95% confidence interval 1.07-4.41). CONCLUSIONS: Having both types of interaction more than once a week during the state of emergency was related to higher SRH after the emergency among oldest-old women. It is suggested that having opportunities for both types of interaction at least once a week would potentially be beneficial for high SRH in women, even in situations where the declaration of a state of emergency restricts face-to-face interaction. Geriatr Gerontol Int 2022; 22: 405-411.

Association of Sleep Quality Status With Worsening Low Back or Knee Pain During The COVID-19 State of Emergency Among Old-Old Adults.

BACKGROUND: Poor sleep quality has a negative effect on pain among older adults. During the coronavirus disease 2019 (COVID-19) state of emergency, lifestyle changes can cause psychologic stressors and lead to poor sleep quality. AIM: This study examined whether sleep quality status was associated with low back or knee pain changes during the COVID-19 state of emergency among community-dwelling Japanese old-old adults. DESIGN: Cross-sectional investigation. METHODS: In July 2020, during the COVID-19 epidemic, we conducted a postal survey for old-old adults aged ≥77 years and collected data on 597 participants. For those who had low back or knee pain at the time of the survey (in July), characteristics such as low back pain, knee pain, changes in pain status, and sleep quality status during the COVID-19 state of emergency (in March) were assessed. RESULTS: Data from 597 participants showed the prevalence of low back pain (50.6%) and knee pain (40.7%) in July. Of those with low back or knee pain, 374 had pain changes during the state of emergency, with 12.3% worsening. Of these, 23.9% had poor sleep quality in March compared to non-change (p = .008). In a multivariate logistic regression model adjusted for potential confounders, poor sleep quality was significantly associated with pain worsening (odds ratio 2.80, 95% confidence interval 1.26-6.22). CONCLUSIONS: During the COVID-19 state of emergency, poor sleep quality was associated with worsening low back or knee pain. This may indicate the need to pay attention to poor sleep quality to prevent the exacerbation of pain among old-old adults.

Physical Activity and Perceived Physical Fitness during the COVID-19 Epidemic: A Population of 40- to 69-Year-Olds in Japan.

The COVID-19 pandemic has caused an abrupt change in lifestyle for many people with restrictions, often leading to a decrease in physical activity (PA), and thus contributing to a negative perception of health status. The purpose of this study was to examine the effects of the COVID-19 epidemic on physical activity and perceived physical fitness in Japanese adults aged 40 to 69 years. Data were collected from an online survey conducted between October 19 and 28, 2020. The analytic sample consisted of 1989 Japanese adults (mean age, 50.1 ± 6.9 years; women, 38.9%) who were aged between 40 and 69 years and completed the online survey. Overall, the PA time per week decreased by 32.4% between October 2019 and April 2020. A decrease in PA time was recorded in October 2020; however, a decline of 15.5% was observed. Compared to individuals who did not perceive a decline in physical fitness, individuals who perceived declining physical fitness during the COVID-19 state of emergency demonstrated a greater decrease in PA time in April 2020 (-50.5%), and this trend continued into October 2020 (-25.0%). These findings may indicate that Japanese adults aged 40 to 69 years who perceived declining physical fitness experienced a greater decrease in physical activity.

Association of Health Literacy with the Implementation of Exercise during the Declaration of COVID-19 State of Emergency among Japanese Community-Dwelling Old-Old Adults.

Health literacy is important for promoting and maintaining good health in old-old adults. It may influence the implementation of exercise in the coronavirus disease epidemic. The present cross-sectional study investigated the association of each dimension of health literacy with the implementation of exercise during the declaration of a state of emergency due to coronavirus disease in community-dwelling old-old adults. We collected data from 483 community-dwelling old-old adults (52.8% women) aged between 77 and 99 years who participated in a mail survey. Participants were divided into exercise or nonexercise groups based on the implementation of exercise during the declaration of a state of emergency. Health literacy was assessed using a 14-item health literacy scale. There were 327 (67.7%) participants in the exercise group and 156 (32.3%) in the nonexercise group. A significantly higher score of health literacy was observed in the exercise group than in the nonexercise group (communicative health literacy score = 14.0 ± 3.6 vs. 12.7 ± 3.8, p = 0.001). In a multivariate logistic regression model adjusted for potential confounders, high communicative health literacy scores were significantly associated with the implementation of exercise during the declaration of a state of emergency (odds ratio = 1.88, 95% confidence interval = 1.20-2.93). Approximately two-thirds of community-dwelling old-old adults implement exercise during the declaration of a state of emergency. High communicative health literacy was associated with the implementation of exercise during this period.

Perceived declining physical and cognitive fitness during the COVID-19 state of emergency among community-dwelling Japanese old-old adults.

AIM: Perceived health status, including physical and cognitive fitness, will be negatively associated with future health conditions among old-old adults. The coronavirus disease 2019 (COVID-19) pandemic has caused sudden changes in lifestyle. Thus, this study examined the associations of participation in an exercise class before the COVID-19 pandemic and the exercise habits and disruption to the rhythms of daily life during the COVID-19 state of emergency with perceived declining physical and cognitive fitness among community-dwelling old-old adults. METHODS: In July 2020, we carried out a mail survey of community-dwelling old-old adults aged between 77 and 99 years in Bibai, Hokkaido, Japan, to determine their perceived declining physical and cognitive fitness during the COVID-19 state of emergency. RESULTS: Of the 774 responders, 339 (43.8%) participants reported a decline in physical fitness, whereas 259 (33.5%) perceived declining cognitive fitness during the COVID-19 state of emergency. In a multivariate logistic regression model adjusted for potential confounders, exercise habits during the COVID-19 state of emergency were significantly associated with a lower perception of declining physical fitness. Disruption to the rhythms of daily life during the COVID-19 state of emergency was significantly associated with a higher perception of declining physical and cognitive fitness. CONCLUSIONS: Approximately half and more than one-third of community-dwelling old-old adults perceived declining physical and cognitive fitness, respectively, during the COVID-19 state of emergency. During this period, exercise habits were positively correlated with perceived health status among old-old adults, whereas disruption to the rhythms of daily life was negatively correlated. Geriatr Gerontol Int 2021; 21: 364-369.