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1.
J Alzheimers Dis ; 74(2): 691-697, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32083587

RESUMO

BACKGROUND: Physicians are cautious to prescribe antihypertensive drugs in frail older adults because of the potential adverse effects, especially in those with cognitive complaints. Lifestyle aspects might provide safe targets to lower blood pressure in older adults. OBJECTIVE: Our goal was to evaluate the associations between activity patterns and blood pressure in memory clinic patients. METHODS: We used an observational cross-sectional study to measure activity patterns with the ActivPAL accelerometer, and simultaneous home blood pressure levels in memory clinic patients (age range 51-87 years old). Office blood pressure was assessed during routine clinical practice. RESULTS: 41 patients (mean age of 74.3 (7.7) years of age, 46% female) were included. Sedentary parameters were associated with higher mean home blood pressure, with the strongest correlation between more prolonged sitting bouts and higher SBP (r = 0.58, p < .0001). Physical activity parameters were negatively associated with mean home blood pressure. Adjusted regression estimates remained significant, showing, e.g., a 4.5 (95% CI = 1.6;7.4) mmHg increase in SBP for every hour of sitting per day and a -1.0 (95% CI = -1.8;-0.2) mmHg decrease in DBP for every additional 1000 steps per day. No strong correlations were found between any of the activity pattern variables and office blood pressure. CONCLUSION: Associations between activity pattern variables and blood pressure were only found with home blood pressure measurements, not with office measurements. Longitudinal evaluations of these associations are now needed to explore if reducing prolonged sedentary bouts and increasing step count indeed serve as safe targets to lower blood pressure.

2.
Sports Med ; 50(2): 403-413, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31529300

RESUMO

BACKGROUND: Besides physical activity as a target for dementia prevention, sedentary behaviour is hypothesized to be a potential target in its own right. The rising number of persons with dementia and lack of any effective treatment highlight the urgency to better understand these modifiable risk factors. Therefore, we aimed to investigate whether higher levels of sedentary behaviour are associated with reduced global cognitive functioning and slower cognitive decline in older persons without dementia. METHODS: We used five population cohorts from Greece, Australia, USA, Japan, and Singapore (HELIAD, PATH, SALSA, SGS, and SLAS2) from the Cohort Studies of Memory in an International Consortium. In a coordinated analysis, we assessed the relationship between sedentary behaviour and global cognitive function with the use of linear mixed growth model analysis (mean follow-up range of 2.0-8.1 years). RESULTS: Baseline datasets combined 10,450 older adults without dementia with a mean age range between cohorts of 66.7-75.1 years. After adjusting for multiple covariates, no cross-sectional association between sedentary behaviour and cognition was found in four studies. One association was detected where more sedentary behaviour was cross-sectionally linked to higher cognition levels (SLAS2, B = 0.118 (0.075; 0.160), P < 0.001). Longitudinally, there were no associations between baseline sedentary behaviour and cognitive decline (P > 0.05). CONCLUSIONS: Overall, these results do not suggest an association between total sedentary time and lower global cognition in older persons without dementia at baseline or over time. We hypothesize that specific types of sedentary behaviour may differentially influence cognition which should be investigated further. For now, it is, however, too early to establish undifferentiated sedentary time as a potential effective target for minimizing cognitive decline in older adults without dementia.

3.
PeerJ ; 7: e8140, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31799080

RESUMO

Background: This study sought to better understand the psychometric properties of the SARC-F, by examining the baseline and training-related relationships between the five SARC-F items and objective measures of muscle function. Each of the five items of the SARC-F are scored from 0 to 2, with total score of four or more indicative of likely sarcopenia. Methods: This manuscript describes a sub-study of a larger step-wedge, randomised controlled 24-week progressive resistance and balance training (PRBT) program trial for Australian community dwelling older adults accessing government supported aged care. Muscle function was assessed using handgrip strength, isometric knee extension, 5-time repeated chair stand and walking speed over 4 m. Associations within and between SARC-F categories and muscle function were assessed using multiple correspondence analysis (MCA) and multinomial regression, respectively. Results: Significant associations were identified at baseline between SARC-F total score and measures of lower-body muscle function (r =  - 0.62 to 0.57; p ≤ 0.002) in 245 older adults. MCA analysis indicated the first three dimensions of the SARC-F data explained 48.5% of the cumulative variance. The initial dimension represented overall sarcopenia diagnosis, Dimension 2 the ability to displace the body vertically, and Dimension 3 walking ability and falls status. The majority of the 168 older adults who completed the PRBT program reported no change in their SARC-F diagnosis or individual item scores (56.5-79.2%). However, significant associations were obtained between training-related changes in SARC-F total and item scores and changes in walking speed and chair stand test performance (r =  - 0.30 to 0.33; p < 0.001 and relative risk ratio = 0.40-2.24; p < 0.05, respectively). MCA analysis of the change score data indicated that the first two dimensions explained 32.2% of the cumulative variance, with these dimensions representing whether a change occurred and the direction of change, respectively. Discussion: The results advance our comprehension of the psychometric properties on the SARC-F, particularly its potential use in assessing changes in muscle function. Older adults' perception of their baseline and training-related changes in their function, as self-reported by the SARC-F, closely matched objectively measured muscle function tests. This is important as there may be a lack of concordance between self-reported and clinician-measured assessments of older adults' muscle function. However, the SARC-F has a relative lack of sensitivity to detecting training-related changes, even over a period of 24 weeks. Conclusions: Results of this study may provide clinicians and researchers a greater understanding of how they may use the SARC-F and its potential limitations. Future studies may wish to further examine the SARC-F's sensitivity of change, perhaps by adding a few additional items or an additional category of performance to each item.

4.
J Phys Act Health ; : 1-5, 2019 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-31810066

RESUMO

BACKGROUND: It is not always clear whether physical activity is causally related to health outcomes, or whether the associations are induced through confounding or other biases. Randomized controlled trials of physical activity are not feasible when outcomes of interest are rare or develop over many years. Thus, we need methods to improve causal inference in observational physical activity studies. METHODS: We outline a range of approaches that can improve causal inference in observational physical activity research, and also discuss the impact of measurement error on results and methods to minimize this. RESULTS: Key concepts and methods described include directed acyclic graphs, quantitative bias analysis, Mendelian randomization, and potential outcomes approaches which include propensity scores, g methods, and causal mediation. CONCLUSIONS: We provide a brief overview of some contemporary epidemiological methods that are beginning to be used in physical activity research. Adoption of these methods will help build a stronger body of evidence for the health benefits of physical activity.

5.
Artigo em Inglês | MEDLINE | ID: mdl-31783708

RESUMO

The development in research concerning sedentary behaviour has been rapid over the past two decades. This has led to the development of evidence and views that have become more advanced, diverse and, possibly, contentious. These include the effects of standing, the breaking up of prolonged sitting and the role of moderate-to-vigorous physical activity (MVPA) in the association between sedentary behaviour and health outcomes. The present aim is to report the views of experts (n = 21) brought together (one-day face-to-face meeting in 2018) to consider these issues and provide conclusions and recommendations for future work. Each topic was reviewed and presented by one expert followed by full group discussion, which was recorded, transcribed and analysed. The experts concluded that (a). standing may bring benefits that accrue from postural shifts. Prolonged (mainly static) standing and prolonged sitting are both bad for health; (b). 'the best posture is the next posture'. Regularly breaking up of sitting with postural shifts and movement is vital; (c). health effects of prolonged sitting are evident even after controlling for MVPA, but high levels of MVPA can attenuate the deleterious effects of prolonged sitting depending on the health outcome of interest. Expert discussion addressed measurement, messaging and future directions.

6.
Respir Med ; 154: 93-101, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31229944

RESUMO

BACKGROUND: Severe asthma and bronchiectasis are heterogeneous diseases that contribute to disability beyond the pulmonary system. The magnitude of the impact that these extrapulmonary features has on health-related quality of life (HRQoL) is unknown. METHODS: We analysed the cross-sectional relationships between HRQoL (St. George's Respiratory Questionnaire; SGRQ) and extrapulmonary characteristics, including physical activity (steps/day), anxiety and depression, isometric leg strength, systemic inflammation, and several comorbidities in adults with severe asthma (n = 70) and bronchiectasis (n = 61). RESULTS: Participants with severe asthma and bronchiectasis had similar SGRQ total scores (mean scores 43.7 and 37.8 for severe asthma and bronchiectasis; p > 0.05), and similar pulmonary and extrapulmonary characteristics. The associations between extrapulmonary variables and HRQoL did not differ according to diagnosis (all interactions p > 0.05). Greater anxiety and depressive symptoms, fewer steps/day and greater systemic inflammation were statistically associated with poorer HRQoL in both diseases (p < 0.05). Lower isometric leg strength in severe asthma, and greater Charlson Comorbidity Index in bronchiectasis were also associated with poorer HRQoL (p < 0.05). In the multivariable regression model performed in the combined disease groups, anxiety and depression, steps/day, systemic inflammation and isometric leg strength remained independently associated with HRQoL. Associations between extrapulmonary characteristics and SGRQ domains were stronger for the activity and impact domains, than symptoms. CONCLUSION: In severe asthma and bronchiectasis, extrapulmonary features including physical activity and leg strength have a significant impact on HRQoL, especially within the activity and impact domains. These features should be considered as part of the assessment of these conditions, and they may represent additional treatment targets to improve HRQoL.

7.
Health Rep ; 30(3): 12-23, 2019 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-30892662

RESUMO

BACKGROUND: Sitting time and physical activity may be modifiable determinants of lung function. The purpose of this study was to assess the effect that replacing various movement behaviours has on lung function among individuals with and without obstructive lung disease. DATA AND METHODS: For analysis, data were used from participants of the Canadian Longitudinal Study on Aging, recruited between 2012 and 2015. Lung function was assessed using spirometry. A modified version of the Physical Activity Scale for the Elderly was used to assess sitting time and physical activity levels. Isotemporal substitution analysis was performed to analyze the effects of replacing 30 minutes per day of one movement behaviour with another, keeping the total time constant. Analyses were run separately for individuals with an obstructive lung disease (asthma, chronic obstructive pulmonary disease, or forced expiratory volume in 1 second [FEV1] ⟨ 5th percentile lower limit of normal; n=3,398), and healthy adults (n=14,707). RESULTS: When sitting time was replaced with 30 minutes per day of any type of physical activity or sleep, an increase in percent (%) of predicted FEV1 (i.e., ß=0.65, confidence interval [CI]: 0.43, 0.88 for replacing sitting time with strenuous or strengthening activity) was observed among healthy adults. Among adults with obstructive lung disease, replacing 30 minutes per day of sitting time or sleep duration with strenuous or strengthening activity was associated with an improvement in the percent of predicted FEV1 (i.e., ß=0.98, CI: 0.13, 1.82 for replacing sleep duration with strenuous or strengthening activity). DISCUSSION: Replacing sitting time with physical activity leads to significant improvements in lung function among adults with an obstructive lung disease, as well as among adults without a respiratory disease.


Assuntos
Exercício Físico/fisiologia , Volume Expiratório Forçado/fisiologia , Comportamento Sedentário , Idoso , Idoso de 80 Anos ou mais , Canadá , Feminino , Humanos , Estudos Longitudinais , Pneumopatias Obstrutivas/fisiopatologia , Masculino , Pessoa de Meia-Idade
8.
Respirology ; 24(4): 352-360, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30384396

RESUMO

BACKGROUND AND OBJECTIVE: Physical activity (PA) in obstructive airway diseases (OAD) is likely to be impaired but this has not been extensively studied outside of chronic obstructive pulmonary disease (COPD). We describe PA levels in severe asthma and bronchiectasis compared to moderate-severe COPD and to controls, and tested the cross-sectional associations of PA (steps/day) with shared disease characteristics in the OAD group. METHODS: Adults with OAD (severe asthma = 62, COPD = 67, bronchiectasis = 60) and controls (n = 63) underwent a multidimensional assessment, including device-measured PA levels. RESULTS: The OAD group included 189 participants (58.7% females), with median (interquartile range) age of 67 (58-72) years and mean forced expiratory volume in the first second (FEV1 ) % predicted of 69.4%. Demographic characteristics differed between groups. Compared to controls (52.4% females, aged 55 (34-64) years, median 7640 steps/day), those with severe asthma, bronchiectasis and COPD accumulated less steps/day: median difference of -2255, -2289, and -4782, respectively (P ≤ 0.001). Compared to COPD, severe asthma and bronchiectasis participants accumulated more steps/day: median difference of 2375 and 2341, respectively (P ≤ 0.001). No significant differences were found between the severe asthma and bronchiectasis group. Exercise capacity, FEV1 % predicted, dyspnoea and systemic inflammation differed between groups, but were each significantly associated with steps/day in OAD. In the multivariable model adjusted for all disease characteristics, exercise capacity and FEV1 % predicted remained significantly associated. CONCLUSION: PA impairment is common in OAD. The activity level was associated with shared characteristics of these diseases. Interventions to improve PA should be multifactorial and consider the level of impairment and the associated characteristics.

9.
Int J Behav Nutr Phys Act ; 15(1): 114, 2018 11 20.
Artigo em Inglês | MEDLINE | ID: mdl-30458790

RESUMO

BACKGROUND: High volumes of sitting time are associated with an elevated risk of type 2 diabetes and cardiovascular disease, and with adverse cardiometabolic risk profiles. However, previous studies have predominately evaluated only total sitting or television (TV) viewing time, limiting inferences about the specific cardiometabolic health impacts of sitting accumulated in different contexts. We examined associations of sitting time in four contexts with cardiometabolic risk biomarkers in Australian adults. METHODS: Participants (n = 3429; mean ± SD age 58 ± 10 years) were adults without clinically diagnosed diabetes or cardiovascular disease from the 2011-2012 Australian Diabetes, Obesity and Lifestyle (AusDiab) study. Multiple linear regressions examined associations of self-reported context-specific sitting time (occupational, transportation, TV-viewing and leisure-time computer use) with a clustered cardiometabolic risk score (CMR) and with individual cardiometabolic risk biomarkers (waist circumference, BMI, resting blood pressure, triglycerides, HDL- and LDL-cholesterol, and fasting and 2-h post-load plasma glucose). RESULTS: Higher CMR was significantly associated with greater TV-viewing and computer sitting time (b [95%CI] = 0.07 [0.04, 0.09] and 0.06 [0.03, 0.09]), and tended to be associated with higher occupational and transport sitting time (0.01 [- 0.01, 0.03] and 0.03 [- 0.00, 0.06]), after adjustment for potential confounders. Furthermore, keeping total sitting time constant, accruing sitting via TV-viewing and computer use was associated with significantly higher CMR (0.05 [0.02, 0.08] and 0.04 [0.01, 0.06]), accruing sitting in an occupational context was associated with significantly lower CMR (- 0.03 [- 0.05, - 0.01]), while no significant association was seen for transport sitting (0.00 [- 0.03, 0.04]). Results varied somewhat between the respective biomarkers; however, higher sitting time in each domain tended to be associated detrimentally with individual biomarkers except for fasting glucose (non-significant associations) and systolic blood pressure (a beneficial association was observed). Overall, associations were stronger for TV-viewing and computer use, and weaker for occupational sitting. CONCLUSIONS: Higher context-specific sitting times tended to be detrimentally associated, albeit modestly, with CMR and several cardiometabolic risk biomarkers. There was some evidence suggesting that the context in which people sit is relevant above and beyond total sitting time. Methodological issues notwithstanding, these findings may assist in identifying priorities for sitting-reduction initiatives, in order to achieve optimal cardiometabolic health benefits.


Assuntos
Biomarcadores/sangue , Doenças Cardiovasculares/epidemiologia , Síndrome Metabólica/epidemiologia , Comportamento Sedentário , Triglicerídeos/sangue , Adiposidade , Idoso , Austrália/epidemiologia , Glicemia/metabolismo , Pressão Sanguínea , Índice de Massa Corporal , Doenças Cardiovasculares/sangue , Colesterol/sangue , Feminino , Humanos , Atividades de Lazer , Estilo de Vida , Estudos Longitudinais , Masculino , Síndrome Metabólica/sangue , Pessoa de Meia-Idade , Fatores de Risco , Tamanho da Amostra , Postura Sentada , Fatores Socioeconômicos , Inquéritos e Questionários , Televisão , Fatores de Tempo , Circunferência da Cintura
10.
Artigo em Inglês | MEDLINE | ID: mdl-30487444

RESUMO

Physical activity, primarily comprised of walking in older adults, confers benefits for psychological health and mental well-being, functional status outcomes and social outcomes. In many communities, however, access to physical activity opportunities are limited, especially for older adults. This exploratory study engaged a small sample (N = 8) of adults aged 65 or older as citizen scientists to assess and then work to improve their communities. Using a uniquely designed mobile application (the Stanford Healthy Neighborhood Discovery Tool), participants recorded a total of 83 geocoded photos and audio narratives of physical environment features that served to help or hinder physical activity in and around their community center. In a facilitated process the citizen scientists then discussed, coded and synthesized their data. The citizen scientists then leveraged their findings to advocate with local decision-makers for specific community improvements to promote physical activity. These changes focused on: parks/playgrounds, footpaths, and traffic related safety/parking. Project results suggest that the Our Voice approach can be an effective strategy for the global goals of advancing rights and increasing self-determination among older adults.


Assuntos
Planejamento Ambiental , Meio Ambiente , Exercício Físico , Aplicativos Móveis , Características de Residência , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Relações Interpessoais , Masculino , Parques Recreativos
11.
Am J Public Health ; 108(11): 1478-1482, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30252516

RESUMO

Sitting has frequently been equated with smoking, with some sources even suggesting that smoking is safer than sitting. This commentary highlights how sitting and smoking are not comparable. The most recent meta-analysis of sedentary behavior and health outcomes reported a hazard ratio of 1.22 (95% confidence interval [CI] = 1.09, 1.41) for all-cause mortality. The relative risk (RR) of death from all causes among current smokers, compared with those who have never smoked, is 2.80 (95% CI = 2.72, 2.88) for men and 2.76 for women (95% CI = 2.69, 2.84). The risk is substantially higher for heavy smokers (> 40 cigarettes per day: RR = 4.08 [95% CI = 3.68, 4.52] for men, and 4.41 [95% CI = 3.70, 5.25] for women). These estimates correspond to absolute risk differences of more than 2000 excess deaths from any cause per 100 000 persons per year among the heaviest smokers compared with never smokers, versus 190 excess deaths per 100 000 persons per year when comparing people with the highest volume of sitting with the lowest. Conflicting or distorted information about health risks related to behavioral choices and environmental exposures can lead to confusion and public doubt with respect to health recommendations.


Assuntos
Comportamento Sedentário , Fumar/efeitos adversos , Feminino , Humanos , Masculino , Meios de Comunicação de Massa , Fatores de Risco
12.
BMC Public Health ; 18(1): 818, 2018 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-29970048

RESUMO

BACKGROUND: Physical activity has been shown to attenuate the age-associated decline in lung function; however, there is little research evaluating different movement behaviours as potential correlates of lung function. Modifiable determinants need to be identified, as the prevalence of chronic respiratory disease is on the rise. The purpose of this study was to investigate associations of self-reported movement behaviours (i.e., sitting time, walking, different intensities of physical activity, and strengthening activities), with lung function in middle-aged and older adults without a respiratory disease, according to their smoking history. METHODS: Data from participants of the Canadian Longitudinal Study on Aging were used for analysis (n = 16,839). Lung function was assessed using spirometry. A modified version of the Physical Activity Scale for the Elderly was used to assess sitting time and physical activity levels. Smoking status was classified as non-smoking, < 10 pack years smoking, and 10 or more pack years of smoking. The association between movement behaviours and lung function was assessed using hierarchical linear regression models with all covariates (age, sex, smoking status, body mass index, education, retirement status, and sleep duration) entered into block 1, and all movement behaviours entered into block 2. RESULTS: All movement behaviours were associated with Forced Expiratory Volume in 1 s (FEV1) and Forced Vital Capacity (FVC) % predicted in crude and adjusted models, regardless of smoking status. Sitting time was negatively associated with both FEV1%pred (ß: -0.094, CI: -0.140, - 0.047) and FVC%pred (ß: -0.087, CI: -0.128, -0.045) among those who never smoked, and strength activity was positively associated with both FEV1%pred (ß: 0.272, CI: 0.048, 0.496) and FVC%pred (ß: 0.253, CI: 0.063,0.442) among those who smoked < 10 pack years, as well as with FVC%pred among those who smoked 10 or more pack years (ß: 0.309, CI: 0.064, 0.554). CONCLUSIONS: This is the first study to assess the association of different movement behaviours with lung function among middle-aged and older adults without a respiratory disease. These findings indicate that movement behaviours are correlates of lung function, and that they may be modifiable determinants of the age-associated decline in lung function.


Assuntos
Envelhecimento/fisiologia , Exercício Físico/fisiologia , Testes de Função Respiratória , Fumar/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Canadá/epidemiologia , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Movimento , Prevalência , Fatores Sexuais , Fatores Socioeconômicos
13.
Am J Epidemiol ; 187(11): 2387-2396, 2018 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-29868880

RESUMO

Prolonged sitting time is associated with several health outcomes; limited evidence indicates associations with frailty. Our aims in this study were to identify patterns of sitting time over 12 years in middle-aged (ages 50-55 years) women and examine associations of these patterns with frailty in older age. We examined 5,462 women born in 1946-1951 from the Australian Longitudinal Study on Women's Health who provided information on sociodemographic attributes, daily sitting time, and frailty in 2001 and then again every 3 years until 2013. Frailty was assessed using the FRAIL (fatigue, resistance, ambulation, illness, loss of weight) scale (0 = healthy; 1-2 = prefrail; 3-5 = frail), and group-based trajectory analyses identified trajectories of sitting time. We identified 5 sitting-time trajectories: low (26.9%), medium (43.1%; referent), increasing (6.9%), decreasing (18.1%), and high (4.8%). In adjusted models, the likelihoods of being frail were statistically higher for women in the increasing (odds ratio (OR) = 1.29, 95% confidence interval (CI): 1.03, 1.61) and high (OR = 1.42, 95% CI: 1.10, 1.84) trajectories. In contrast, women in the low trajectory group were less likely to be frail (OR = 0.86, 95% CI: 0.75, 0.98), and there was no difference in the likelihood of frailty in the decreasing trajectory group. Our study suggests that patterns of sitting time over 12 years in middle-aged women predict frailty in older age.


Assuntos
Fragilidade/epidemiologia , Comportamento Sedentário , Saúde da Mulher , Idoso , Austrália/epidemiologia , Doença Crônica/epidemiologia , Fadiga/epidemiologia , Feminino , Comportamentos Relacionados com a Saúde , Nível de Saúde , Humanos , Estilo de Vida , Estudos Longitudinais , Pessoa de Meia-Idade , Limitação da Mobilidade , Aptidão Física/fisiologia , Fatores Socioeconômicos
14.
BMC Pulm Med ; 18(1): 98, 2018 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-29879930

RESUMO

BACKGROUND: The purpose of the current study was to determine the association between sedentary time and physical activity with clinically relevant health outcomes among adults with impaired spirometry and those with or without self-reported obstructive lung disease (asthma or COPD). METHODS: Data from participants of the Canadian Longitudinal Study on Aging were used for analysis (n = 4156). Lung function was assessed using spirometry. Adults were said to have impaired spirometry if their Forced Expiratory Volume in 1 s was <5th percentile lower limit of normal (LLN). A modified version of the Physical Activity Scale for the Elderly was used to assess sitting time and physical activity levels. Healthcare use and quality of life outcomes were assessed using self report. RESULTS: Among those with asthma, participating in strengthening activities was associated with lower odds of reporting poor perceived health (OR = 0.65, CI: 0.53, 0.79), poor perceived mental-health (OR = 0.73, CI: 0.60, 0.88), unhealthy aging (OR = 0.68, CI: 0.56, 0.83), and reporting an emergency department visit in the past 12 months (OR = 0.76, CI: 0.60, 0.95). Among those with COPD, those who reported highest weekly sedentary time had higher odds of reporting poor perceived health (OR = 2.70, CI: 1.72, 4.24), poor perceived mental-health (OR = 1.99, CI: 1.29, 3.06), and unhealthy aging (OR = 3.04, CI: 1.96, 4.72). Among those below the LLN, sitting time (OR = 2.57, CI: 1.40, 4.72) and moderate intensity physical activity (OR = 0.23, CI: 0.09, 0.63) were associated with overnight hospital stays. CONCLUSIONS: Higher physical activity levels and lower sedentary time may be associated with lower healthcare use and better quality of life. This research may have implications related to the use of physical activity for improving health outcomes and quality of life among adults with obstructive lung disease or impaired spirometry.


Assuntos
Asma , Exercício Físico , Doença Pulmonar Obstrutiva Crônica , Qualidade de Vida , Comportamento Sedentário , Idoso , Asma/diagnóstico , Asma/epidemiologia , Asma/fisiopatologia , Asma/psicologia , Canadá/epidemiologia , Correlação de Dados , Exercício Físico/fisiologia , Exercício Físico/psicologia , Teste de Esforço/métodos , Teste de Esforço/estatística & dados numéricos , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Aptidão Física , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/psicologia , Espirometria/métodos , Espirometria/estatística & dados numéricos
15.
Lung Cancer ; 119: 78-84, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29656757

RESUMO

OBJECTIVES: No studies have examined objectively assessed physical activity, sedentary time, and patient-reported outcomes among lung cancer survivors. The objective of this study was to determine associations of objectively assessed moderate-to-vigorous intensity physical activity (MVPA) and sedentary time with health-related quality of life (HRQoL) and fatigue among lung cancer survivors. MATERIALS AND METHOD: Lung cancer survivors in Southern Alberta (N = 540) were invited to complete a mailed survey that assessed HRQoL [Functional Assessment of Cancer Therapy-Lung (FACT-L)], physical and functional well-being [Trial Outcome Index (TOI)], and fatigue [Fatigue Scale (FS)]. Physical activity and sedentary time data was collected using an Actigraph® GT3X+ accelerometer that was worn on the hip for seven consecutive days. Quantile regression was used to examine associations of HRQoL and fatigue with physical activity and sedentary time at the 25th, 50th, and 75th HRQoL and fatigue percentiles. RESULTS: A total of 127 lung cancer survivors participated for a 24% response rate (Mean age = 71 years; Mean time since diagnosis = 75 months). Total MVPA minutes was positively associated with fewer fatigue symptoms at the 25th percentile (ß = 0.16, p = 0.046). Total sedentary time was inversely associated with HRQoL at the 75th percentile (ß = -0.07, p = 0.014) and inversely associated with fatigue symptoms at the 50th percentile (ß = -0.04, p = 0.009). Total sedentary time was also inversely associated with physical and functional well-being scores at the 25th (ß = -0.07, p = 0.045), 50th (ß = -0.07, p = 0.004) and 75th (ß = -0.04, p = 0.035) percentiles. CONCLUSION: Across the HRQoL, fatigue, and physical and functional well-being distributions, sedentary time was inversely associated with HRQoL, fatigue, and physical and functional well-being in lung cancer survivors. Small associations were observed between MVPA and fatigue, but no associations emerged with HRQoL or physical and functional well-being.


Assuntos
Sobreviventes de Câncer , Exercício Físico , Fadiga , Neoplasias Pulmonares/epidemiologia , Comportamento Sedentário , Idoso , Idoso de 80 Anos ou mais , Alberta/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Inquéritos e Questionários
16.
J Phys Act Health ; 15(6): 411-416, 2018 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-29570005

RESUMO

BACKGROUND: Physical activity confers many health benefits to older adults, and adopting activity into daily life routines may lead to better uptake. The purpose of this study was to test the effect of a lifestyle intervention to increase daily physical activity in older women through utilitarian walking and use of public transportation. METHODS: In total, 25 inactive women with mean age (SD) of 64.1 (4.6) years participated in this pilot randomized controlled trial [intervention (n = 13) and control (n = 12)]. Seven-day travel diaries (trips per week) and the International Physical Activity Questionnaire (minutes per week) were collected at baseline, 3, and 6 months. RESULTS: At 3 months, intervention participants reported 9 walking trips per week and 643.5 minutes per week of active transportation, whereas control participants reported 4 walking trips per week and 49.5 minutes per week of active transportation. Adjusting for baseline values, there were significant group differences favoring Everyday Activity Supports You for walking trips per week [4.6 (0.5 to 9.4); P = .04] and active transportation minutes per week [692.2 (36.1 to 1323.5); P = .05]. At 6 months, significant group differences were observed in walking trips per week [6.1 (1.9 to 11.4); P = .03] favoring the intervention (9 vs 2 trips per week). CONCLUSION: Given these promising findings, the next step is to test Everyday Activity Supports You model's effectiveness to promote physical activity in older women within a larger study.


Assuntos
Estilo de Vida , Prevenção Primária/métodos , Transportes/estatística & dados numéricos , Viagem/estatística & dados numéricos , Caminhada/fisiologia , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Projetos Piloto , Inquéritos e Questionários
17.
J Allergy Clin Immunol Pract ; 6(6): 1968-1981.e2, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29510231

RESUMO

BACKGROUND: Physical inactivity and high sedentary time are associated with adverse health outcomes in several diseases. However, their impact in asthma is less clear. OBJECTIVE: We aimed to synthesize the literature characterizing physical activity and sedentary time in adults with asthma, to estimate activity levels using meta-analysis, and to evaluate associations between physical activity and sedentary time and the clinical and physiological characteristics of asthma. METHODS: Articles written in English and addressing the measurement of physical activity or sedentary time in adults ≥18 years old with asthma were identified using 4 electronic databases. Meta-analysis was used to estimate steps/day in applicable studies. RESULTS: There were 42 studies that met the inclusion criteria. Physical activity in asthma was lower compared with controls. The pooled mean (95% confidence interval) steps/day for people with asthma was 8390 (7361, 9419). Physical activity tended to be lower in females compared with males, and in older people with asthma compared with their younger counterparts. Higher levels of physical activity were associated with better measures of lung function, disease control, health status, and health care use. Measures of sedentary time were scarce, and indicated a similar engagement in this behavior between participants with asthma and controls. High sedentary time was associated with higher health care use, and poorer lung function, asthma control, and exercise capacity. CONCLUSIONS: People with asthma engage in lower levels of physical activity compared with controls. Higher levels of physical activity may positively impact on asthma clinical outcomes. Sedentary time should be more widely assessed.


Assuntos
Asma/epidemiologia , Exercício Físico , Comportamento Sedentário , Asma/fisiopatologia , Humanos
18.
J Gerontol A Biol Sci Med Sci ; 73(12): 1675-1681, 2018 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-29408975

RESUMO

Background: There is limited evidence on the directionality of the associations of sitting time with physical function. This study examined the longitudinal associations of sitting time with changes in physical function, and physical function with changes in sitting time. Methos: Data from 10,027 retirees in the Social, Economic, and Environmental Factor (SEEF) population-based cohort were collected in 2006-20008 and in 2010-2011. Daily sitting time was assessed by a single-item question. Physical function was measured with the Medical Outcomes Study Physical Functioning Scale (range 0-100) with participants categorized as: no; minor; moderate; or severe limitation. General linear regression models, adjusted for covariates, were used to assess associations of sitting time with physical function for all participants and in subgroups according to sex, and categories of body mass index, physical activity, and physical function limitations. Results: Each hour of baseline sitting was associated with declines in physical function for women (0.20 units [95% confidence interval {CI} 0.04-0.37]) and those with severe functional limitations (0.65 units [95% CI 0.20-1.12]). Each unit of baseline physical function was associated with declines in sitting time for all participants (0.009 hours/day [95% CI 0.005-0.013]) and for all subgroups. Conclusions: There was limited evidence of a bidirectional association of sitting time with physical function except in women and people with severe functional limitations. Health promotion efforts are needed to address the impact of poor physical function on increases in sitting time which result in further functional declines for these subgroups of the population.


Assuntos
Exercício Físico/fisiologia , Qualidade de Vida , Aposentadoria/estatística & dados numéricos , Comportamento Sedentário , Postura Sentada , Fatores Etários , Idoso , Austrália , Estudos de Coortes , Bases de Dados Factuais , Avaliação da Deficiência , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Fatores Sexuais , Fatores de Tempo
19.
J Sci Med Sport ; 21(6): 604-608, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29102460

RESUMO

OBJECTIVES: The aim was to examine the associations between level of physical activity (PA) and non-hospital medical costs, and between physical activity and hospitalisations in older women from 1999 to 2013. DESIGN: Longitudinal observational study. METHODS: Data were collected from participants in the Australian Longitudinal Study on Women's Health, who completed surveys in 1999 (aged 73-78 years), 2002, 2005, 2008 and 2011. Annual cost data (from the Medicare Benefits Schedule) were available for 1999-2013 and hospital admissions data were available for 2002-2010. Costs were expressed in 2013 Australian dollars (AUD). Prospective associations between self-reported physical activity (categorised as inactive, low, moderate or high) and costs/admissions were examined using quantile regression (for costs) and logistic regression fitted with generalised estimating equations (for hospitalisation). RESULTS: Median annual costs were AUD122 (95% confidence interval [CI]=199, 45), AUD284 (CI=363, 204) and AUD316 (CI=385, 247) lower in low, moderate and highly active women, respectively, than in those who were inactive [AUD1890 (interquartile range=1107-3296)]. Odds of hospitalisation were also lower in the low (odds ratio [OR]=0.88, CI=0.80-0.96), moderate (OR=0.77, CI=0.70-0.85) and highly active (OR=0.78, CI=0.71-0.85) women, than in the inactive group. CONCLUSIONS: In inactive older Australian women, a small increase in physical activity may be sufficient to obtain substantial cost savings for the health system and to reduce hospital admissions.


Assuntos
Exercício Físico , Custos de Cuidados de Saúde , Hospitalização/estatística & dados numéricos , Idoso , Austrália , Feminino , Humanos , Modelos Logísticos , Estudos Longitudinais , Saúde da Mulher
20.
J Am Med Dir Assoc ; 19(1): 65-69, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28927946

RESUMO

OBJECTIVE: To assess the validity and responsiveness of the FRAIL scale in middle-aged women, who are a group at high risk of developing frailty. DESIGN: Longitudinal cohort study from 1998 to 2013. SETTING: Australia. PARTICIPANTS: 10,412 women born in 1946-1951 from the Australian Longitudinal Study on Women's Health (ALSWH). MEASUREMENTS: Frailty was measured by the 5-item FRAIL scale and assessed every 3 years from 1998 to 2013. Face validity was examined by assessing relationships with age. Spearman correlation quantified the relation of each item of the FRAIL scale with the scale's total score. Adjusted logistic regression models assessed the construct validity of frailty in 1998 predicting depression (10-item Center for Epidemiologic Studies Depression Scale Short Form) and disability (needing help with daily tasks) in 2013. Mortality was recorded from 1998 up to December 31, 2014. Survival analysis was done using Cox proportional hazards models. Finally, responsiveness was examined by measuring the relationship between changes in self-rated health and changes in FRAIL score between 2 subsequent surveys. RESULTS: Frailty increased with age such that 5.8% of women were frail at age 50 and 11.3% at age 66. Each component of the FRAIL scale was correlated with the total FRAIL score (rho = 0.13-0.82, all P < .001). Compared to being healthy, women who were frail in 1998 had an increased likelihood [odds ratio (95% confidence interval [CI])] of being depressed [2.77 (2.12, 3.63)] or disabled [6.87 (4.84, 9.77)] in 2013 with a hazard ratio (95% CI) for death of 2.01 (1.40, 2.87). Having a deficit in each of the 5 items in 1998 also increased the likelihood of being depressed or disabled in 2013. Changes in self-rated health were associated with total FRAIL score changes. CONCLUSION: The FRAIL scale is valid for use in longitudinal studies of middle-aged women. Studying trajectories of frailty from the middle-age to older-age population may yield insights into risk factors for poorer health in this population.


Assuntos
Atividades Cotidianas , Envelhecimento/fisiologia , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Saúde da Mulher , Idoso , Idoso de 80 Anos ou mais , Austrália , Feminino , Idoso Fragilizado , Avaliação Geriátrica/métodos , Humanos , Modelos Logísticos , Estudos Longitudinais , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Medição de Risco , Índice de Gravidade de Doença , Análise de Sobrevida
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