Prospective study of physical activity and physical function in early old age

BACKGROUND: In the elderly, higher levels of physical function have consistently been associated with higher levels of physical activity. In this study, we test the hypothesis that physical activity earlier in the life course preserves high physical function over an extended period of time, before the onset of major age-related declines in physical function. METHODS: A cohort study with an average of 8.8 years of follow-up (1991-1993 to 2001). Logistic regression analyses were conducted adjusting for long-standing illness, baseline physical function, smoking, body mass index, and employment grade. Participants were 6398 London-based civil servants aged 39 to 63 years at baseline, 90% of whom were working. The main outcome measure was physical function measured by the Short Form (SF-36) General Health Survey. RESULTS: Relatively fit and healthy, mainly working, middle-aged men and women who were physically active at recommended levels, were more likely to report high physical function at follow-up, compared to their sedentary counterparts (odds ratio 1.63, 95% confidence interval 1.32-2.00). The association between initial level of physical activity and high physical function at follow-up remained after adjustment for baseline level of physical function and the presence of long-standing illness. CONCLUSIONS: Participation in a physically active lifestyle during mid-life appears to be critical to the maintenance of high physical function in those who are fit and well enough to work and do or do not report any long-standing illness.     

Snacking may improve physical function among older Americans

Background/Objectives

Snacking was reported to provide nutritional benefits among older adults, but the association between such dietary behavior and health outcomes has not been clearly established. The purpose of this study is to examine the associations between snacking and gait speed, a performance-based measure of physical function.

Design

Cross-sectional population-based survey.

Setting

The 1999–2002 National Health and Nutrition Examination Survey (NHANES).

Participants

A nationally representative sample of Americans aged 60 and older n = 2,333).

Measurements

Participants were classified by snacking frequency (0, 1, 2, 3, ≥4 snacks/d) and by the contribution of snacking to their daily energy intake (0 to <10%, 10% to <20%, 20% to <30%, ≥30%). Physical function was assessed by measurement of gait speed over 20 feet.

Results

After adjusting for age, gender, education, race/ethnicity, smoking status, and marital status, older adults who snacked four times or more daily had a faster gait speed (P = 0.033) than non-snackers. Snacking that contributed 20% to <30% (P = 0.017) of energy was associated with a faster gait speed than snacking that contributed 0 to <10% of energy. Similar associations were observed after further adjustment for potential confounders.

Conclusion

Both snacking frequency and percentage of energy from snacking are positively associated with gait speed among older adults. The benefits of snacking on older adults’ physical function may warrant their inclusion in this population’s diet.     

The relationship among physical activity, obesity, and physical function in community-dwelling older women

BACKGROUND: The relationship between obesity and physical function is not well understood. Physical activity may be a key factor impacting on the relationship between obesity and physical function. METHODS: Subjects included 171 community-dwelling women (mean age = 74.3, SD = 4.3) participating in a 14-year follow-up study to a walking intervention trial. Measures of obesity [body mass index (BMI)] and physical activity (Modified Paffenbarger Questionnaire) were collected in 1982, 1985, 1995, and 1999. Physical function was assessed in 1999 using the Functional Status Questionnaire (FSQ) and gait speed. RESULTS: Measures of obesity from 1982 to 1995 and measures of physical activity from 1982 to 1995 were related to physical function in 1999. However, hierarchical regression analysis to predict physical function in 1999 controlling for the presence of chronic conditions indicated that physical activity from 1982 to 1995, and not obesity from 1982 to 1995, was an independent predictor of physical function (FSQ: adjusted R2 = 0.09, F = 4.68, P < 0.001; gait speed: adjusted R2 = 18.0, F = 9.41, P < 0.0001. CONCLUSION: Physical activity appears to be as important if not more important than body weight in predicting future physical function.     

Body mass index and physical function in older women

OBJECTIVE: We modified existing standardized measurement tools in the Physical Performance Test and tasks from the Frailty and Injuries: Cooperative Studies of Intervention Technique Study to evaluate physical function in older women. Our objectives were (1) to characterize physical function themes based on combinations of tasks (deriving factors or components) and (2) to quantify the correlation between derived factors and body mass index (BMI). RESEARCH METHODS AND PROCEDURES: Nutrition risk screens from enrollees in a Medicare-managed risk program served as the sampling frame. To obtain adequate representation for a range of BMI, a random sample was obtained of 90 women from the following BMI strata: BMI, 22 to <27 kg/m(2); BMI, 27 to <30 kg/m(2); and BMI, > or =30 kg/m(2). Subjects were asked to perform a series of 18 functional tasks during a home visit. RESULTS: The mean age was similar in the three BMI groups with an overall mean age of 71 +/- 4.9 years (SD). Factors characterized by lower-body function, upper-body function, coordination, and strength were responsible for 30%, 11%, 9%, and 9% of the variance in task scores, respectively. BMI, controlling for age, explained 5%, 14%, 3%, and 0% of the variation in these factors, respectively. Higher BMI is associated significantly with poorer upper- and lower-body function but is not associated significantly to strength or coordination. DISCUSSION: Higher BMI seems to differentially impede specific aspects of physical function, especially upper-body function, and to a lesser extent, lower-body function. BMI does not seem to be associated with levels of coordination or strength. Better understanding of how BMI impacts physical function will aid in the design of interventions to promote independent living in elderly, obese women.     

Impairment of physical and psychosocial function in recurrent syncope

Physical and psychosocial function have rarely been assessed in syncope. We used two valid and reliable measures of health status, the Sickness Impact Profile (SIP) and the Symptom Checklist 90 (SCL-90-R), to assess functional impairment in 62 patients with recurrent syncope seen in a syncope specialty clinic. Mean total SIP scores were markedly elevated at 17 (SD = 14), indicating a level of impairment similar to severe rheumatoid arthritis and chronic low back pain. SIP psychosocial scores were significantly greater than SIP physical scores (20 vs 11, p less than 0.0001). SCL-90-R scores were also high, comparable to those of psychiatric inpatients. Somatization, anxiety and depression dimensions of the SCL-90-R were particularly elevated. SCL-90-R subscale scores were highly correlated with SIP psychosocial scores (all r greater than 0.4, and p less than 0.001). Neither age nor number of comorbid diseases correlated with measures of psychosocial function, suggesting that syncope itself causes psychosocial impairment. Although this was a referral population, these data suggest that function can be seriously impaired by syncope, that the degree of impairment is similar to that reported in other chronic diseases, and that syncope leads to significantly greater psychosocial than physical impairment.     

The impact of stroke on psychological and physical function outcomes in people with long-term physical disability

BackgroundAn increased number of people who have a long-term physical disability (LTPD) are aging. Similar to older adults without previous disability, individuals with LTPD may experience age-related comorbidities secondary to aging. A leading cause of disability in the United States among older adults is stroke. Limited evidence supports that individuals with LTPD are at higher risk of a stroke compared to those without disability. Stroke may negatively impact physical, cognitive, and/or psychosocial function. For those who have lived longer with LTPD, the impact of stroke may differ.ObjectiveTo determine the impact of stroke on health outcomes in people with LTPD.MethodsThirty-three individuals with both LTPD and self-reported stroke were identified in a national purposive sample of adults reporting physical disability associated with LTPD (Group A). Group A was compared to an age matched sample of 33 individuals with the same conditions but no stroke (Group B). Group A participants were also compared to national norms based on age cohort from a national sample of 182 stroke survivors (Group C).ResultsAge range of all participants = 65–74 years. Combine sample among three groups = 248. Group A did not differ from Group B. However, Group A reported significantly higher pain interference (p < .001), fatigue (p = .003), and decreased physical function (p < .001) than Group C.ConclusionsThe study informs how the impact of acquiring another condition after living with a LTPD differs among a general stroke population and those who are living with LTPD.     

The development of a comorbidity index with physical function as the outcome

BACKGROUND AND OBJECTIVES: Physical function is an important measure of success of many medical and surgical interventions. Ability to adjust for comorbid disease is essential in health services research and epidemiologic studies. Current indices have primarily been developed with mortality as the outcome, and are not sensitive enough when the outcome is physical function. The objective of this study was to develop a self-administered Functional Comorbidity Index with physical function as the outcome. METHODS: The index was developed using two databases: a cross-sectional, simple random sample of 9,423 Canadian adults and a sample of 28,349 US adults seeking treatment for spine ailments. The primary outcome measure was the SF-36 physical function (PF) subscale. RESULTS: The Functional Comorbidity Index, an 18-item list of diagnoses, showed stronger association with physical function (model R(2) = 0.29) compared with the Charlson (model R(2) = 0.18), and Kaplan-Feinstein (model R(2) = 0.07) indices. The Functional Comorbidity Index correctly classified patients into high and low function, in 77% of cases. CONCLUSION: This new index contains diagnoses such as arthritis not found on indices used to predict mortality, and the FCI explained more variance in PF scores compared to indices designed to predict mortality.     

The effect of physical activity across the menstrual cycle on reproductive function

PurposeTo evaluate the association between physical activity (PA) across the menstrual cycle and reproductive function.MethodsThe BioCycle Study (2005–2007) followed 259 healthy premenopausal women not using hormonal contraceptives for up to two menstrual cycles (N = 509 cycles). Serum leptin, estradiol, progesterone, luteinizing hormone, follicle-stimulating hormone, and testosterone were measured five to eight times per cycle. Linear mixed models were used to estimate the effect of past-week PA (measured four times during each cycle) on hormone levels. Past-week PA was categorized into tertiles based on metabolic equivalent of task hours per week (cut-points were 15.3 and 35.7). Risk ratios for sporadic anovulation were estimated using generalized linear models. Analyses adjusted for habitual PA (assessed at baseline), body mass index, race, age, and perceived stress. Linear mixed models used inverse probability weights to control for concurrent reproductive hormones and caloric intake.ResultsHigh past-week PA was inversely associated with leptin (−6.6%; 95% confidence interval, −10.6 to −2.5) and luteal phase progesterone (−22.1%; −36.2 to −4.7) as compared with low past-week PA. High past-week PA was not significantly associated with sporadic anovulation (adjusted risk ratio, 1.5; 0.6 to 3.4).ConclusionsHigh levels of PA were modestly associated with changes in select hormones but not sporadic anovulation among moderate to highly active premenopausal women.     

学龄前儿童身体活动与执行功能的相关性研究

目的 了解学龄前儿童日常身体活动现状,进一步研究身体活动与执行功能之间的相关性。方法 2018年5-7月在北京地区抽取3家幼儿园,采用方便抽样方法抽取中班儿童201人,连续3 d佩戴加速度计ActiGraph GT9X,采用早期儿童执行功能测量工具包(Early Years Toolbox,EYT)进行工作记忆、抑制控制和转换三项执行功能测试,采用自编问卷调查受试儿童的屏幕时间。结果 学龄前儿童每日中高强度身体活动、总身体活动时间分别为(95.65±29.02)min、(204.58±46.91)min,男女之间每日轻度、中度、剧烈、中高强度以及总身体活动时间存在差异(U=2 593.00,2 136.00,2 440.00,t=4.09,3.68,P<0.05)。每日屏幕时间为(72.84±51.79) min,男女之间差异无统计学意义(P>0.05)。工作记忆、抑制控制、转换三项执行功能测试得分依次是2.40±0.80、0.76±0.16、14.08±3.49,男女之间差异无统计学意义(P>0.05)。身体活动与EYT测试得分相关性分析发现在4岁组儿童中针对转换的测试得分与每日高强度身体活动时间存在显著相关性(r=0.199,P=0.040)。进一步以屏幕时间、每日总身体活动时间,每日中高强度身体活动时间达标与否进行分组,未发现各组间EYT测试得分差异有统计学意义(P>0.05)。结论 学龄前儿童存在身体活动不足的状况,身体活动和执行功能之间存在相关性,且这种相关性与身体活动的强度有关。     

学龄前儿童身体活动与执行功能的相关性研究

目的 了解学龄前儿童日常身体活动现状,进一步研究身体活动与执行功能之间的相关性。方法 2018年5-7月在北京地区抽取3家幼儿园,采用方便抽样方法抽取中班儿童201人,连续3 d佩戴加速度计ActiGraph GT9X,采用早期儿童执行功能测量工具包(Early Years Toolbox,EYT)进行工作记忆、抑制控制和转换三项执行功能测试,采用自编问卷调查受试儿童的屏幕时间。结果 学龄前儿童每日中高强度身体活动、总身体活动时间分别为(95.65±29.02)min、(204.58±46.91)min,男女之间每日轻度、中度、剧烈、中高强度以及总身体活动时间存在差异(U=2 593.00,2 136.00,2 440.00,t=4.09,3.68,P<0.05)。每日屏幕时间为(72.84±51.79) min,男女之间差异无统计学意义(P>0.05)。工作记忆、抑制控制、转换三项执行功能测试得分依次是2.40±0.80、0.76±0.16、14.08±3.49,男女之间差异无统计学意义(P>0.05)。身体活动与EYT测试得分相关性分析发现在4岁组儿童中针对转换的测试得分与每日高强度身体活动时间存在显著相关性(r=0.199,P=0.040)。进一步以屏幕时间、每日总身体活动时间,每日中高强度身体活动时间达标与否进行分组,未发现各组间EYT测试得分差异有统计学意义(P>0.05)。结论 学龄前儿童存在身体活动不足的状况,身体活动和执行功能之间存在相关性,且这种相关性与身体活动的强度有关。     

Tea consumption and physical function in older adults: A cross-sectional study

Background

Tea consumption has been reported to be associated with lowered risk of cardiovascular disease, stroke and osteoporosis that cause functional disability, but its association with physical function has not been investigated directly.

Objective

We examined the association between tea consumption and performance in gait and balance, instrumental and basic activities of daily living (IADL and BADL) in a cross-sectional study of community-living older persons.

Method

Baseline data of 2398 adults aged ≥ 55 years in the Singapore Longitudinal Ageing Studies who completed self-reported current tea consumption, Performance Oriented Mobility Assessment (POMA) of gait and balance, and self reports of BADL and IADL were analyzed.

Results

In multivariate analyses controlling for age, gender, education, housing type, co-morbidities, hospitalization, arthritis and hip fracture, GDS depression score, MMSE cognitive score, body mass index, creatinine, serum albumin, haemoglobin, physical activities score and coffee consumption, tea consumption was positively associated with better balance (β=0.06, p<0.01), gait (β=0.01, p=0.02), IADL (β=0.03, p=0.01) and BADL (β=0.01, p=0.05). Strongly positive associations were observed for black/oolong tea in multivariate analyses, and for green tea consumption only in univariate analysis, whereas coffee consumption was not associated at all.

Conclusions

Tea consumption was associated with better physical functional performances in community-living older adults.     

中重度体力劳动工人肺通气功能正常值的研究

目的 研究中重度体力劳动工人肺通气功能的影响因素,建立正常值预计公式。方法 采用非条件logistic回归分析筛选肺通气功能的影响因素,然后采用逐步多元回归计算肺通气功能预计值方程式。结果 对肺通气功能有非常显著影响的因素为:年龄、性别、身高、体重(P<0.01),有显著影响的因素为接尘工龄和接尘种类(P<0.05),正常体力劳动工人肺通气功能预计值公式为:VC(m1)=25.229 6H 52.940 8W-24A-203 8.394 4;FVC(ml)=16.817 7H 35.289 6W-27A 457.454 7;FEVl(ml)=15.853 9H 33.267 2W 22A-454.387 1;MVV(L)=0.297 3H 0.624 0W-1.025A 70.276。结论所得肺通气功能预计值公式较好地控制了年龄、身高、体重对正常值的影响,应用性较强。     

Accelerometer assessment of physical activity and its association with physical function in older adults residing at assisted care facilities

Objectives

To describe levels of physical activity among older adults residing at assisted care facilities and their association with physical function.

Design

Cross-sectional analysis.

Setting

Assisted care facilities within the greater Boston, MA area.

Participants

Older adults aged 65 years and older (N = 65).

Measurements

Physical Activity Level (PAL) as defined by quartiles from accelerometry (counts and steps), Short Physical Performance Battery (SPPB) Score, gait speed, and handgrip strength.

Results

Participants in the most active accelerometry quartile engaged in 25 minutes/week of moderate to vigorous physical activity (MVPA) and walked 2,150 steps/day. These individuals had an SPPB score, 400 meter walk speed, and handgrip strength that was 3.7–3.9 points, 0.3–0.4 meters/second, and 4.5–5.1 kg greater respectively, than individuals in the lowest activity quartile, who engaged in less than 5 min/wk of MVPA or took fewer than 460 steps/day.

Conclusion

Despite engaging in physical activity levels far below current recommendations (150 min/week of MVPA or > 7000 steps/day), the most active older adults in this study exhibited clinically significant differences in physical function relative to their less active peers. While the direction of causality cannot be determined from this cross-sectional study, these findings suggest a strong association between PAL and physical function among older adults residing in an assisted care facility.

     

Water loss as a function of energy intake, physical activity and season

Although water is an important nutrient, there are no recommended intake values. Here, water intake, energy intake, physical activity and water loss was measured over 1 week in summer and in winter. Subjects were healthy volunteers, forty-two women and ten men, mean age of 29 (SD 7) years and mean BMI 21.8 (SD 2.2) kg/m2. Water intake was measured with a 7 d food and water record. Physical activity level (PAL) was observed as the ratio of total energy expenditure, as measured with doubly labelled water, to resting energy expenditure as measured in a respiration chamber. Water loss was measured with the deuterium elimination method. Water loss was highly reproducible and ranged from 0.20 to 0.35 l/MJ, independent of season and activity level, with higher values in women. Water loss was related to water and energy intake in summer (r 0.96, P<0.0001 and r 0.68, P<0.001, respectively) as well as in winter (r 0.98, P<0.0001 and r 0.63, P<0.01, respectively). Water loss was, for men, higher in subjects with a higher physical activity in summer (r 0.94, P<0.0001) and in winter (r 0.70, P<0.05). Normalizing water loss for differences in energy expenditure by expressing water loss in litres per MJ resulted in the same value for men in summer and winter. For women, physical activity-adjusted values of water loss were higher, especially in summer. In men, water turnover was determined by energy intake and physical activity, while seasonal effects appeared through energy expenditure. Women showed a higher water turnover that was unrelated to physical activity.     

Self-assessed physical function levels of women with fibromyalgia: a national survey

OBJECTIVE: We sought to determine the self-reported physical function level of women with fibromyalgia (FM). METHODS: We performed a secondary analysis using data from an Internet-based survey posted on the National Fibromyalgia Association website. Data used for this study included women (n = 1,735) aged 31-78 years who reported being diagnosed with FM. RESULTS: More than 25% of women reported having difficulty taking care of personal needs and bathing, and >60% reported difficulty doing light household tasks, going up/down 1 flight of stairs, walking (1/2) mile, and lifting or carrying 10 lbs. More than 90% of women reported having difficulty doing heavy household tasks, lifting or carrying 25 lbs, and doing strenuous activities. Women with lower functional ability reported higher levels of fatigue, pain, spasticity, depression, restless legs, balance problems, dizziness, fear of falling, and bladder problems. CONCLUSIONS: The average woman in this sample reported having less functional ability related to activities of daily living and instrumental activities of daily living than the average community-dwelling woman in her 80s. Several symptoms/conditions were found to be associated with functional limitation in women with FM. Targeting these-singly or in clusters-may potentially be important in terms of future interventions.     

Minimal important change in physical function in trauma patients: a study using the short musculoskeletal function assessment

Quality of Life Research - The Short Musculoskeletal Function Assessment (SMFA) questionnaire can be used to evaluate physical functioning in patients with traumatic injuries. It is not known what...     

Association of dietary variety with body composition and physical function in community-dwelling elderly Japanese

Objectives

To examine the associations of dietary variety with body composition and physical function in community-dwelling elderly Japanese

Design

Cross-sectional study.

Setting

Community-based.

Participants

A total of 1184 community-dwelling elderly adults aged 65 and over.

Measurements

Dietary variety was assessed with a food frequency questionnaire (maximum, 10 points) that encompassed the 10 main food components of Japanese meals (meat, fish/shellfish, eggs, milk, soybean products, green/yellow vegetables, potatoes, fruit, seaweed, and fats/oils). Body composition was determined by multifrequency bioelectrical impedance analysis. Physical function was assessed by measuring grip strength and usual walking speed. Multiple linear regression analysis was used to examine the associations of dietary variety with body composition and physical function.

Results

After adjusting for potential confounders, higher dietary variety scores were independently associated with higher lean mass (β (SE): 0.176 (0.049), p<0.001) and appendicular lean mass (β (SE): 0.114 (0.027), p<0.001) but not with body fat mass. Elders with a higher dietary variety score had greater grip strength and faster usual walking speed (β (SE): 0.204 (0.071), p=0.004, and β (SE): 0.008 (0.003), p=0.012, respectively).

Conclusion

Greater dietary variety was significantly associated with greater lean mass and better physical function in Japanese elders. The causal relationship warrants investigation in a prospective study.

     

山东省中小学生体育煅炼对体质状况的影响

目的 分析体育锻炼对山东省中小学生体质状况的影响,探讨学生体质下降的原因,为采取相应干预措施提供依据.方法 以2010年山东省学生体质健康调研小学四年级以上的29 762名中小学生为研究对象进行问卷调查,了解学生每天参加体育锻炼的情况.将研究对象按每天平均锻炼时间＞1 h和＜1h分为两组,比较两组青少年体能素质及近视率和超重、肥胖率的差异.结果 每天平均锻炼＞1h组学生的肺功能、爆发力素质、耐力素质和柔韧素质优于每天锻炼＜1h组.每天平均锻炼＞1h组青少年的标准化超重和肥胖率为23.61％(男)、13.61％(女),标准化近视患病率为63.68％(男)、70.56％(女);每天锻炼＜1h组的标准化超重和肥胖率为27.31％(男)、14.87％(女),标准化近视患病率为66.13％(男)、72.23％(女).结论 每天锻炼1h对中小学生体质有促进作用,应减轻学生的学习负担,保证足够的体育锻炼时间.