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Time allocation to active domains, physical activity, and health indicators in older adults: cross-sectional results from the OUTDOOR ACTIVE study.

ABSTRACT: BACKGROUND:Physical activity (PA) is one of the key determinants of healthy ageing. Research showed that time allocation plays an important role in PA. Therefore, an understanding of the time use of older adults is crucial for developing PA programs. The aim of this study was to examine the associations of time allocation and objectively measured PA, and several health indicators in older adults. METHODS:In this cross-sectional study all 915 participants of the OUTDOOR ACTIVE study were included. The participants were 65 to 75?years old and resided in a subdistrict of Bremen, Germany (50.9% female). The active domains were derived from the SLOTH model (leisure activities, occupation, active transport, home-based activities). PA was objectively measured with accelerometers over seven consecutive days. Binary logistic regressions were used to test the associations of total PA and time spent in the domains with several health indicators (self-rated health, overweight, obesity, activities of daily living (ADL)). RESULTS:Participants over the age of 70?years were significantly less physically active than those under 70?years and women were significantly more physically active than men. Regardless of age and sex, most time was spent on home-based activities (women: 118.5?±?87.8?min/day; men: 80.2?±?69.4?min/day). Both PA and time spent on leisure activities were associated with a lower risk of bad self-rated health (0.36; 95%-CL: 0.20, 0.65 for PA; 0.93; 95%-CL: 0.87, 0.99 for leisure activities) and less limitations in ADL. PA and active transport seemed to lower the risk of overweight (0.39; 95%-CL: 0.25, 0.62 for PA; 0.80; 95%-CL: 0.69, 0.93 for active transport) and obesity (0.36; 95%-CL: 0.21, 0.60 for PA; 0.77; 95%-CL: 0.64, 0.92 for active transport). Having an occupation was associated with a lower risk of bad self-rated health (0.60; 95%-CL: 0.40, 0.92). CONCLUSIONS:The results of this study provide insights in the time allocation to active domains and total PA of older adults, as well as the associations with health indicators. These findings have important implications for the development of PA programs and guidelines. Future research should examine the associations further in longitudinal studies.

SUBMITTER: Stalling I

PROVIDER: S-EPMC7576691 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Time allocation to active domains, physical activity, and health indicators in older adults: cross-sectional results from the OUTDOOR ACTIVE study.

Stalling Imke I Albrecht Birte Marie BM Doerwald Friederike F Bammann Karin K

BMC public health 20201020 1

<h4>Background</h4>Physical activity (PA) is one of the key determinants of healthy ageing. Research showed that time allocation plays an important role in PA. Therefore, an understanding of the time use of older adults is crucial for developing PA programs. The aim of this study was to examine the associations of time allocation and objectively measured PA, and several health indicators in older adults.<h4>Methods</h4>In this cross-sectional study all 915 participants of the OUTDOOR ACTIVE stud ...[more]

PMID: 33081732

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Project description:BackgroundMaintaining good functional ability is a key component of healthy ageing and a basic requirement for carrying out activities of daily living, staying independent, and delaying admission to a nursing home. Even though women have a higher life expectancy and slower age-related muscle mass loss than men, they often show a higher prevalence of limitations in physical functioning. However, the reasons behind these sex differences are still unclear. Therefore, the aims of this study were to investigate sex differences among older adults regarding physical functioning and to study which factors are explaining these sex differences.MethodsCross-sectional data from participants of the OUTDOOR ACTIVE study residing in Bremen, Germany, aged 65 to 75 years, were included in the analyses. Physical functioning was assessed via a self-administered questionnaire using the SF-36 10-item Physical Functioning Scale. Social, lifestyle, and health-related factors were also assessed using the questionnaire. Physical activity was measured objectively using wrist-worn accelerometers over seven consecutive days. Descriptive analyses with absolute and relative frequencies, means and standard deviations, as well as T-tests and chi-square tests were carried out. To test for associations between sex, physical functioning, and several individual factors, linear regressions were performed.ResultsData of 2 141 participants (52.1% female) were included in the study. Women and men showed statistically significant differences in physical functioning, with men perceiving fewer limitations than women. On average, women had a physical functioning score of 81.4 ± 19.3 and men 86.7 ± 17.0. Linear regression showed a statistically significant negative association between physical functioning score and sex (β: -0.15, 95% CL: -0.19, -0.10). The association remained statistically significant when adding individual factors to the model. All factors together were only able to explain 51% of the physical functioning-sex association with health indicators and the presence of chronic diseases being the most influential factors.ConclusionsWe found sex differences in physical functioning, with older women having more limitations than older men. The results showed that health-related factors and chronic diseases played the biggest roles in the different physical functioning scores of women and men. These findings contribute to future longitudinal, more in-depth research.Trial registrationGerman Clinical Trials Register DRKS00015117 (Date of registration 17-07-2018).

Project description:BACKGROUND:Meteorological conditions are potential determinants of physical activity (PA). A profound understanding of the determinants of PA behaviour is required for PA promotion. This study examined the association between accelerometer-assessed PA and meteorological conditions among older adults. METHODS:This cross-sectional study included data of 577 adults aged 65-75 years living in Bremen, Germany (52% female; 3278 days). PA was measured with accelerometers for seven consecutive days (10/15-08/16). A threshold of 240 lx was used to differentiate between outdoor physical activity (OPA) and indoor physical activity (IPA). Linear mixed models estimated the association between PA (daily accelerometer counts per minute (CPM)) and meteorological factors (temperature, cloud cover, wind, and no precipitation) derived by principal component analysis. RESULTS:The analyses showed associations between PA in CPM and the meteorological factors temperature (93.7; 95%-CL: 64.9, 122.5) and no precipitation (48.4; 95%-CL: 19.8, 77.0) in women and wind (-40.3; 95%-CL: -59.7, -20.8) and no precipitation (30.1; 95%-CL: 5.6, 54.6) in men. After distinguishing in OPA and IPA for a subsample of 128 participants (473 days), the sex differences were no longer present. OPA in CPM was associated with temperature (women: 174.5; 95%-CL: 81.3, 267.6; men: 183.3; 95%-CL: 81.2, 285.4), cloud cover (women: -153.0; 95%-CL: -200.3, -105.7; men: -123.2; 95%-CL: -174.7, -71.7), and wind (women: -118.6; 95%-CL: -189.6; -47.7; men: -96.9; 95%-CL: -177.0, -16.7). No association between OPA and no precipitation was found (women: 2.9; 95%-CL: -89.0, 94.8; men: -17.1; 95%-CL: -116.7, 82.4). CONCLUSIONS:The results of this study emphasize the importance of meteorological conditions as environmental determinants of PA among older adults. Meteorological conditions should be accounted for in the unbiased assessment of habitual PA and the development of PA promotion programs. Future research should focus on the associations of OPA and IPA with meteorological conditions in different climatic regions.

Project description:ObjectivesTo describe the prevalence of different types of physical activities and to explore the association between engagement in these physical activities and performance in the physical fitness dimensions among older adults living in Bremen, Germany.DesignCross-sectional study.SettingTwelve subdistricts in Bremen, Germany.Participants1583 non-institutionalised adults aged 65-75 years residing in one of the 12 subdistricts in Bremen, Germany (53.1% female).Primary outcome measuresLevel of physical fitness in five dimensions: handgrip strength (hand dynamometry), lower muscle strength (30 s-chair stand test), aerobic endurance (2 min-step test), lower body flexibility (sit-and-reach test), and upper body flexibility (back scratch test); classified using normative values.ResultsIn this study population, home-based activities (housework, gardening) and activities for transport (walking, cycling) were performed by nearly all the participants, while leisure activities were less prevalent. Logistic regression revealed a positive association between being in or over norm in handgrip strength with cycling (OR: 1.56, 95% CI: 1.13 to 2.15), hiking/running (OR: 1.50, 95% CI: 1.05 to 2.16) and other sports (OR: 3.22, 95% CI: 1.37 to 7.56). Lower muscle strength was positively related to cycling (OR: 1.91, 95% CI: 1.37 to 2.65), gym training (OR: 1.62, 95% CI: 1.16 to 2.26) and dancing (OR: 2.15, 95% CI: 1.00 to 4.61). Aerobic endurance was positively associated with cycling (OR: 1.90, 95% CI: 1.37 to 2.65), gym training (OR: 1.68, 95% CI: 1.20 to 2.36), aerobics (OR: 1.64, 95% CI: 1.19 to 2.26), dancing (OR: 2.62, 95% CI: 1.10 to 6.22) and ball sports (OR: 2.07, 95% CI: 1.30 to 3.29). Apart from housework and upper body flexibility (OR: 0.39, 95% CI: 0.19 to 0.78), flexibility dimensions did not show any significant associations.ConclusionsWhile muscle strength dimensions and aerobic endurance were associated with several physical activities, flexibility dimensions were associated with none of the investigated activities apart from housework. Especially cycling and leisure activities (eg, hiking/ running, gym training, aerobics, dancing) showed great potential for sustaining and increasing physical fitness in older age.

Project description:BackgroundA key policy objective in most publicly financed health care systems is to allocate resources according to need. Many jurisdictions implement this policy objective through need-based allocation models. To date, no gold standard exists for selecting need indicators. In the absence of a gold standard, sensitivity of the choice of need indicators is of concern. The primary objective of this study was to assess the consistency and plausibility of estimates of per capita relative need for health services across Canadian provinces based on different need indicators.MethodsUsing the 2000/2001 Canadian Community Health Survey, we estimated relative per capita need for general practitioner, specialist, and hospital services by province using two approaches that incorporated a different set of need indicators: (1) demographics (age and sex), and (2) demographics, socioeconomic status, and health status. For both approaches, we first fitted regression models to estimate standard utilization of each of three types of health services by indicators of need. We defined the standard as average levels of utilization by needs indicators in the national sample. Subsequently, we estimated expected per capita utilization of each type of health services in each province. We compared these estimates of per capita relative need with premature mortality in each province to check their face validity.ResultsBoth approaches suggested that expected relative per capita need for three services vary across provinces. Different approaches, however, yielded different and inconsistent results. Moreover, provincial per capita relative need for the three health services did not always indicate the same direction of need suggested by premature mortality in each province. In particular, the two approaches suggested Newfoundland had less need than the Canadian average for all three services, but it had the highest premature mortality in Canada.ConclusionSubstantial differences in need for health care may exist across Canadian provinces, but the direction and magnitude of differences depend on the need indicators used. Allocations from models using survey data lacked face validity for some provinces. These results call for the need to better understand the biases that may result from the use of survey data for resource allocation.

Project description:BackgroundChildren participate in four main types of physical activity: organized sport, active travel, outdoor active play, and curriculum-based physical activity. The objective of this study was to develop a valid approach that can be used to concurrently measure time spent in each of these types of physical activity.MethodsTwo samples (sample 1: n = 50; sample 2: n = 83) of children aged 10-13 wore an accelerometer and a GPS watch continuously over 7 days. They also completed a log where they recorded the start and end times of organized sport sessions. Sample 1 also completed an outdoor time log where they recorded the times they went outdoors and a description of the outdoor activity. Sample 2 also completed a curriculum log where they recorded times they participated in physical activity (e.g., physical education) during class time.ResultsWe describe the development of a measurement approach that can be used to concurrently assess the time children spend participating in specific types of physical activity. The approach uses a combination of data from accelerometers, GPS, and activity logs and relies on merging and then processing these data using several manual (e.g., data checks and cleaning) and automated (e.g., algorithms) procedures. In the new measurement approach time spent in organized sport is estimated using the activity log. Time spent in active travel is estimated using an existing algorithm that uses GPS data. Time spent in outdoor active play is estimated using an algorithm (with a sensitivity and specificity of 85%) that was developed using data collected in sample 1 and which uses all of the data sources. Time spent in curriculum-based physical activity is estimated using an algorithm (with a sensitivity of 78% and specificity of 92%) that was developed using data collected in sample 2 and which uses accelerometer data collected during class time. There was evidence of excellent intra- and inter-rater reliability of the estimates for all of these types of physical activity when the manual steps were duplicated.ConclusionsThis novel measurement approach can be used to estimate the time that children participate in different types of physical activity.

Project description:Background: Physical activity (PA) of higher intensity and longer duration mainly accumulates from older adults' out-of-home activities. Outdoor PA is influenced by environmental features; however, the day-to-day variability of PA and its associations with environmental features have not been widely studied. This study focused on the associations of environmental features with accelerometer-measured PA in older people on weekdays and weekend days. Methods: The study population comprised 167 community-dwelling older people aged 75-90 years. Accelerometers were worn on 7 consecutive days and a structured interview on physical functioning, health, and socioeconomic factors was administered. A geographic information system (GIS) was used to assess environmental features within a distance of 500 (number of land types, road network slope, intersection, and residential densities) or 1,000 m (habitat diversity within natural and green areas) from participants' homes. Accelerometer-based PA [number of PA bouts >10 min and minutes of moderate to vigorous physical activity (MVPA)] was analyzed for weekdays and weekend days separately. Associations between environmental features and PA were analyzed using linear regression models. Results: Participants accumulated on average 0.60 PA bouts and 34.2 MVPA minutes on weekdays and 0.50 PA bouts and 31.5 MVPA minutes on weekend days. Especially participants with low overall PA were less active at weekends. Habitat diversity in natural and green areas, intersection density, and residential density were positively associated with numbers of PA bouts and MVPA minutes on weekdays. Moreover, more diversity in natural and green areas was associated with more MVPA minutes on weekend days. A higher road network slope was negatively associated with the number of PA bouts throughout the week and with MVPA minutes on weekend days. Conclusions: Environmental features close to home, especially PA-supportive infrastructural features and services, were more strongly associated with weekday than weekend PA. This suggests that older people's out-of-home activities, typically conducted on weekdays, are related to service use. However, greater diversity of natural areas close to home seemed to motivate older adults to engage in higher MVPA throughout the week.

Project description:PurposeThe PRECEDE-PROCEED model (PPM) is a community-based participatory research (CBPR) framework for health promotion, yet the direct application of the PPM into practice is unclear. This paper describes how the PPM was adapted for the development and application of a pilot intervention study to promote outdoor physical activity (PA) in older adults (OUTDOOR ACTIVE). We illustrate the steps and adaptations we applied to put the PPM into practice and present the developed interventions.DesignThe PPM was adapted by incorporating a socio-ecological model. This ensured the design of any resultant intervention would explicitly address multi-level determinants of physical activity. The list of possible program components to select from for the design of an intervention was also extended.SettingBremen, Germany.ParticipantsParticipants in the intervention development were 924 noninstitutionalized older adults, aged 65-75 years (response: 25.2%), living in Bremen-Hemelingen, Germany. For implementation of the intervention and to ensure sustainability, several groups of stakeholders were involved throughout the process.MethodsA mixed method design was employed (e.g., focus groups, quantitative survey) to identify determinants. A round table and participatory workshops were held to involve the target group and community stakeholders in the design of an intervention using the adapted PPM model.ResultsA conceptual model was developed illustrating the integration of a socio-ecological model into the PPM. The model received ecological validity, as it was affirmed by community stakeholders as an appropriate method for designing a community-level PA intervention. Target goals to address PA determinants were selected by target group members. An intervention to meet the goals was developed and implemented with target group input.ConclusionThe adapted PPM is a promising starting point for developing multi-level interventions. Steps should be taken to ensure all social groups are participating in the process and all levels of determinants are addressed.

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Time allocation to active domains, physical activity, and health indicators in older adults: cross-sectional results from the OUTDOOR ACTIVE study.

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Time allocation to active domains, physical activity, and health indicators in older adults: cross-sectional results from the OUTDOOR ACTIVE study.

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