The Association Between Objectively Measured Physical Activity and Subsequent Health Care Utilization in Older Men.
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ABSTRACT:
SUBMITTER: Langsetmo L
PROVIDER: S-EPMC6521915 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundThe steep decline in physical activity (PA) among the oldest old is not well understood; there is little information about the patterns of change in PA and sedentary behaviour (SB) in older people. Longitudinal data on objectively measured PA data can give insights about how PA and SB change with age.MethodsMen age 70-90 yr, from a United Kingdom population-based cohort wore a GT3X accelerometer over the hip annually on up to three occasions (56%, 50%, and 51% response rates) spanning 2 yr. Multilevel models were used to estimate change in activity. Men were grouped according to achieving ≥150 min·wk of MVPA in bouts of ≥10 min (current guidelines) at two or three time points.ResultsA total of 1419 ambulatory men had ≥600 min wear time on ≥3 d at ≥2 time points. At baseline, men took 4806 steps per day and spent 72.5% of their day in SB, 23.1% in light PA, and 4.1% in moderate-to-vigorous PA (MVPA). Mean change per year was -341 steps, +1.1% SB, -0.7% light PA, and -0.4% MVPA each day (all P < 0.001). A total of 76.3% (n = 1083) never met guidelines ("stable low"), 7.9% (n = 112) consistently met guidelines ("stable high"), 8.2% (n = 116) stopped meeting guidelines by the last occasion ("decreasers"), and 4.9% (n = 69) started meeting guidelines by the last occasion ("increasers"). "Decreasers" spent 69.3% of each day in SB at baseline, which increased by 2% per year (P < 0.005), light activity remained at 23.3% (change, -0.2% per year; P = 0.4), and total MVPA decreased from 7.1% by -1.7% per year, (P < 0.001). The number of sedentary bouts >30 min increased from 5.1 by 0.1 per year (P = 0.02).ConclusionsAmong older adults, the steep decline in total PA occurred because of reductions in MVPA, while light PA is relatively spared and sedentary time and long sedentary bouts increase.
| S-EPMC4281510 | biostudies-literature
Project description:Backgroundkidney function declines in older adults and physical activity levels are low. We investigated whether higher levels of physical activity and lower levels of sedentary behaviour were associated with lower odds of low kidney function in older men.Methodscross-sectional study of 1,352 men from the British Regional Heart Study, mean (standard deviation) age 78.5 (4.6) year. Physical activity and sedentary behaviour were measured using Actigraph GT3X accelerometers. Kidney function was measured by estimated Glomerular filtration rate (eGFR) using the chronic kidney disease-EPI creatinine-cystatin equation. Associations between physical (in)activity and kidney function were investigated using regression models.Resultshigher levels of physical activity and lower levels of sedentary behaviour were associated with reduced odds ratios (ORs) for lower eGFR (<45 versus ?45 ml/min per 1.73 m2) after adjustment for covariates. Each additional 1,000 steps, 30 min of light physical activity and 10 min of moderate/vigorous physical activity per day were associated with a lower odds (95% confidence interval (CI)) of a low eGFR; OR 0.81 (0.73, 0.91), OR 0.87 (0.78, 0.97) and OR 0.84 (0.76, 0.92), respectively. Each additional 30 min of sedentary behaviour per day was associated with a higher odds of a low eGFR (1.16 95% CI 1.06, 1.27). Associations between moderate/vigorous physical activity and lower kidney function persisted after adjustment for light physical activity or sedentary behaviour.Conclusionphysical activity is associated with kidney function in older men and could be of public health importance in this group who are at increased risk of poor kidney function and low physical activity. More evidence is needed on whether the association is causal.
| S-EPMC5860422 | biostudies-literature
Project description:BACKGROUND:N-terminal pro-brain natriuretic peptide (NT-proBNP) and high sensitivity Troponin T (hsTnT) are markers of cardiac injury used in diagnosis of heart failure and myocardial infarction respectively, and associated with increased risk of cardiovascular disease. Since physical activity is protective against cardiovascular disease and heart failure, we investigated whether higher levels of physical activity, and less sedentary behaviour were associated with lower NT-proBNP and hsTnT. METHODS AND RESULTS:Cross sectional study of 1130 men, age 70-91years, from the British Regional Heart Study, measured in 2010-2012. Fasting blood samples were analysed for NT-proBNP and hsTnT. Physical activity and sedentary behaviour were measured using ActiGraph GT3X accelerometers. Relationships between activity and NT-proBNP or hsTnT were non-linear; biomarker levels were lower with higher total activity, steps, moderate/vigorous activity and light activity only at low to moderate levels of activity. For example, for each additional 10min of moderate/vigorous activity, NT-proBNP was lower by 35.7% (95% CI -47.9, -23.6) and hsTnT by 8.4% (95% CI -11.1, -5.6), in men who undertook <25 or 50min of moderate/vigorous activity per day respectively. Biomarker levels increased linearly with increasing sedentary behaviour, but not independently of moderate/vigorous activity. CONCLUSION:Associations between biomarkers and moderate/vigorous activity (and between hsTnT and light activity) were independent of sedentary behaviour, suggesting activity is driving the relationships. In these older men with concomitantly low levels of physical activity, activity may be more important in protecting against cardiac health deterioration in less active individuals, although reverse causality might be operating.
| S-EPMC5958950 | biostudies-literature
Project description:Data are sparse regarding the impacts of habitual physical activity (PA) and sedentary behavior on cardiovascular (CV) risk in older adults with mobility limitations. This study examined the baseline, cross-sectional association between CV risk and objectively measured PA among participants in the Lifestyle Interventions and Independence for Elders (LIFE) study. The relationship between accelerometry measures and predicted 10-year Hard Coronary Heart Disease (HCHD) risk was modeled by using linear regression, stratified according to CVD history. Participants (n=1170, 79±5 years) spent 642±111 min/day in sedentary behavior (ie, <100 accelerometry counts/min). They also spent 138±43 min/day engaging in PA registering 100 to 499 accelerometry counts/min and 54±37 min/day engaging in PA ≥500 counts/min. Each minute per day spent being sedentary was associated with increased HCHD risk among both those with (0.04%, 95% CI 0.02% to 0.05%) and those without (0.03%, 95% CI 0.02% to 0.03%) CVD. The time spent engaging in activities 100 to 499 as well as ≥500 counts/min was associated with decreased risk among both those with and without CVD (P<0.05). The mean number of counts per minute of daily PA was not significantly associated with HCHD risk in any model (P>0.05). However, a significant interaction was observed between sex and count frequency (P=0.036) for those without CVD, as counts per minute was related to HCHD risk in women (β=-0.94, -1.48 to -0.41; P<0.001) but not in men (β=-0.14, -0.59 to 0.88; P=0.704). Daily time spent being sedentary is positively associated with predicted 10-year HCHD risk among mobility-limited older adults. Duration, but not intensity (ie, mean counts/min), of daily PA is inversely associated with HCHD risk score in this population-although the association for intensity may be sex specific among persons without CVD. www.clinicaltrials.gov Unique identifier: NCT01072500.
| S-EPMC4345863 | biostudies-literature
Project description:Low physical activity (PA) and high levels of sedentary time (ST) are associated with higher cardiovascular disease (CVD) risk among older people. However, their independent contribution and importance of duration of PA and ST bouts remain unclear. We investigated associations between objectively measured PA, ST and non-invasive vascular measures, markers of CVD risk. Cross-sectional study of 1216 men from the British Regional Heart Study, mean age 78.5years, measured in 2010-2012. Carotid intima thickness (CIMT), distensibility coefficient (DC) and plaque presence were measured using ultrasound; pulse wave velocity (cfPWV) and augmentation index (AIx) using a Vicorder. PA and ST were measured using hip-worn ActiGraph GT3X accelerometers. After adjusting for covariates, each additional 1000 steps per day was associated with a 0.038m/s lower cfPWV (95% CI=-0.076, 0.0003), 0.095 10(-3) kPa(-1) higher DC (95% CI=0.006, 0.185), 0.26% lower AIx (95% CI=-0.40, -0.12) and a 0.005mm lower CIMT (95% CI=-0.008, -0.001). Moderate and vigorous PA (MVPA) was associated with lower AIx and CIMT, light PA (LPA) with lower cfPWV and CIMT and ST with higher cfPWV, AIx and CIMT and lower DC. LPA and ST were highly correlated (r=-0.62). The independence of MVPA and ST or MVPA and LPA was inconsistent across vascular measures. Bout lengths for both PA and ST were not associated with vascular measures. In our cross-sectional study of older men, all PA regardless of intensity or bout duration was beneficially associated with vascular measures, as was lower ST. LPA was particularly relevant for cfPWV and CIMT.
| S-EPMC4976831 | biostudies-other
Project description:PurposeEmerging evidence suggests physical activity (PA) is associated with cognitive function. To overcome limitations of self-report PA measures, this study investigated the association of accelerometer-measured PA with incident cognitive impairment and longitudinal cognition among older adults.MethodsParticipants were recruited from the cohort study Reasons for Geographic and Racial Differences in Stroke in the United States. Accelerometers provided PA measures, including the percentage of total accelerometer wearing time spent in moderate-to-vigorous-intensity PA (MVPA%), light-intensity PA, and sedentary time for four to seven consecutive days at baseline. Cognitive impairment was defined by the Six-Item Screener. Letter fluency, animal fluency, word list learning, and Montreal Cognitive Assessment (orientation and recall) were conducted to assess executive function and memory.ResultsParticipants (N = 6452, 69.7 ± 8.5 yr, 55.3% women, 30.5% Black) with usable accelerometer and cognition measures spent extremely limited time in MVPA (1.5% ± 1.9% of accelerometer wearing time). During an average of 3 yr of follow-up, 346 cases of incident cognitive impairment were observed. After adjustments, participants in higher MVPA% quartiles had a lower risk of cognitive impairment (i.e., quartile 2: odds ratio = 0.64, 95% confidence interval = 0.48-0.84) and better maintenance in executive function (≥0.03 z-score units) and memory (≥0.12 z-score units) compared with quartile 1 (P < 0.05). Stratified analyses showed the same association among White adults, but higher MVPA% was associated with better maintenance of only memory among Black adults. No significance was found for light-intensity PA or sedentary time.ConclusionThere was a dose-response relationship between MVPA% and cognitive function in older adults, with higher levels associated with a 36% or lower risk of cognitive impairment and better maintenance of memory and executive function over time, particularly in White adults.
| S-EPMC5161659 | biostudies-literature
Project description:BackgroundMental health among young people in many countries, including Norway, seems to be deteriorating. Physical activity (PA) has been positively associated with mental health. However, methodological issues related to study design and measurement of PA and mental health outcomes currently limits our understanding of the relationship. The purpose of the present study is to explore the prospective relationship between objectively measured PA and mental health outcomes. More specifically, volume (total PA), intensity (moderate-to-vigorous PA [MVPA]) and sedentary behaviour (SED) were explored in relation to mental health problems (MHP) and mental wellbeing (MWB).MethodsData from 599 adolescents (54.4% female, mean age at baseline ±SD 13.3 ± 0.3 years) were collected annually during their 3 years (T1, T2 and T3) at lower secondary school. PA was measured using accelerometry. MWB was measured using the 'Warwick-Edinburgh Mental Wellbeing Scale' and MHP by the 'Strengths and Difficulties Questionnaire'. Multiple linear regression was performed to explore relationships between changes in PA/SED (between T1-T3) and MWB/MHP (at T3). The term 'movement categories' was used to refer to components on the movement continuum and includes volume (total PA), intensity (MVPA) and SED.ResultsAmong boys, any increase in SED was positively associated with MWB (β = 0.05, 95% CI: 0.01 to 0.10), whereas a small positive association between an increase in total PA (volume) and MWB was found among girls (β = 1.13, 95% CI: 0.05 to 2.21). There were no associations between changes in any movement categories [total PA (volume), MVPA, SED] and score on MHP at T3, neither for girls nor boys.ConclusionThis study provided no clear evidence of any association between change in volume or intensity of PA and MHP among an overall healthy adolescent study sample. There was, however, evidence of a relationship between increased SED and MWB among boys and increased volume of PA and MWB among girls. The relationship between movement categories and mental health may depend on the measurement used to assess both PA/SED and variables of mental health. Future research would be strengthened by researchers clarifying what construct of mental health is being used and measured.
| S-EPMC8594230 | biostudies-literature
Project description:ObjectiveThe aim of this study was to examine the associations between sedentary behavior and different intensities of physical activity with cardiometabolic risk, and to analyze the simultaneous effect of excess sedentary behavior and recommended levels of physical activity on cardiometabolic risk markers in older adults.MethodsWe conducted a population-based cross-sectional study on a sample of older adults (60+) living in Florianopolis, Brazil. The objectively measured predictors were sedentary time, light physical activity and moderate to vigorous physical activity, and the outcomes were markers of cardiometabolic risk. Data were considered valid when the participant had used the accelerometer for at least four days per week.ResultsThe sample included 425 older adults (59.8% women), with a mean age of 73.9 years (95%CI: 73.5-74.4). Sedentary behavior was associated with lower systolic blood pressure levels (? = -0.03; 95%CI: -0.05; -0.01) and lower HDL cholesterol (? = -0.02; 95%CI: -0.02; -0.01). Light physical activity was not associated with any cardiovascular risk markers after adjustment. Each minute spent in moderate to vigorous physical activity was associated with lower waist circumference (? = -0.15; 95%CI: -0.24; -0.05), systolic blood pressure (? = -0.18; 95%CI: -0.32; -0.04) and plasma glucose (? = -0.18; 95%CI: -0.33;-0.02), and with higher HDL cholesterol (? = 0.10; 95%CI: 0.01; 0.18). Moreover, physically inactive and sedentary individuals had a greater mean waist circumference and lower HDL cholesterol than physically active and non-sedentary subjects.ConclusionThe results suggest that moderate to vigorous physical activity have a positive impact on cardiometabolic risk markers in older adults. Light physical activity does not appear to have a beneficial effect on the cardiometabolic markers, and despite the benefits provided by the different intensities of physical activity, the simultaneous presence of sedentary behavior and low physical activity level was associated with poor cardiometabolic risk markers.
| S-EPMC6338374 | biostudies-literature
Project description:OBJECTIVES:Hyperkyphosis is associated with restricted pulmonary function and posture, potentially contributing to poor sleep. A previous study reported older women with hyperkyphosis had worse self-reported sleep quality, but it is less clear if this association exists in men. We examined the association between hyperkyphosis and subjective and objective sleep quality in a cohort of older men. DESIGN:Longitudinal analysis of data from large cohort of older men participating in the Osteoporotic Fractures in Men Study (MrOS). SETTING:Community. PARTICIPANTS:We studied 754 men participants in MrOS who had kyphosis measured during the 3rd clinic visit (2007-2009) and future subjective and objective sleep quality assessed between 2009-2012 (an average of 2.9 years later). INTERVENTION:N/A. MEASUREMENTS:To measure kyphosis, 1.7 cm thick wooden blocks were placed under the participant's head to achieve a neutral spine position while lying supine on a DXA table. We collected data on both subjective (Pittsburgh Sleep Quality Index [PSQI], and Epworth Sleepiness Scale [ESS]) and objective (wrist actigraphy: Total Sleep Time [TST], Wake After Sleep Onset [WASO], Sleep Efficiency [SE], Sleep Onset Latency [SOL]; and polysomnography: Apnea Hypopnea Index [AHI]) sleep measurements. Those who required >3 blocks were considered hyperkyphotic (n = 145 or 19.2%). RESULTS:In unadjusted and multivariable analyses, men with hyperkyphosis did not report having worse self-reported sleep characteristics based on PSQI and ESS. Similarly, there were no significant associations between hyperkyphosis and objective sleep measures. When examined as a continuous predictor (blocks ranging from 0-8), results were no different. CONCLUSIONS:Although we hypothesized that poor posture in those with hyperkyphosis would interfere with sleep, in this sample of older men, worse kyphosis was not associated with self-reported or objectively measured poor sleep quality.
| S-EPMC7012394 | biostudies-literature
Project description:Determine the association of poor multidimensional sleep health with health-care costs and utilization. We linked 1,459 community-dwelling women (mean age 83.6 years) participating in the Study of Osteoporotic Fractures Year 16 visit (2002-2004) with their Medicare claims. Five dimensions of sleep health (satisfaction, daytime sleepiness, timing, latency, and duration) were assessed by self-report. The number of impaired dimensions was expressed as a score (range 0-5). Total direct health-care costs and utilization were ascertained during the subsequent 36 months. Mean (SD) total health-care costs/year (2017 dollars) increased in a graded manner across the sleep health score ranging from $10,745 ($15,795) among women with no impairment to up to $15,332 ($22,810) in women with impairment in three to five dimensions (p = 0.01). After adjustment for age, race, and enrollment site, women with impairment in three to five dimensions vs. no impairment had greater mean total costs (cost ratio [CR] 1.34 [95% CI = 1.13 to 1.60]) and appeared to be at higher risk of hospitalization (odds ratio (OR) 1.31 [95% CI = 0.96 to 1.81]). After further accounting for number of medical conditions, functional limitations, and depressive symptoms, impairment in three to five sleep health dimensions was not associated with total costs (CR 1.02 [95% CI = 0.86 to 1.22]) or hospitalization (OR 0.91 [95% CI = 0.65 to 1.28]). Poor multidimensional sleep health was not related to outpatient costs or risk of skilled nursing facility stay. Older women with poor sleep health have higher subsequent total health-care costs largely attributable to their greater burden of medical conditions, functional limitations, and depressive symptoms.
| S-EPMC7017952 | biostudies-literature