Frequency of complications and the effects of pneumococcal vaccination in young children with acute respiratory tract infection

BackgroundAcute respiratory infection (ARI) is the most frequent reason for children being seen by doctors worldwide. We aimed to estimate the frequency of complications in children aged 6–23 months during ARI episode and to evaluate risk factors present on recruitment associated with complications after the universal implementation of pneumococcal vaccine (PCV10) in our region.MethodsThis prospective cohort enrolled children who had shown ARI for up to 7 days and who were subsequently followed up 14–21 days after, in Salvador, Brazil. Data on recruitment were registered. The vaccine card was personally checked. Complication was defined when hospitalization, pneumonia or acute otitis media (AOM) were informed during the follow-up visit. Pneumonia and AOM were diagnosed by a doctor. Multiple logistic regression analysis was performed.ResultsOf 576 children, 422 (73%) returned and 79 (19%; 95%CI: 15–23%) had complications. The mean interval between admission and follow-up was 23 ± 13 days. Pneumonia (n = 47; 11%), hospitalization (n = 28; 7%), and AOM (n = 17; 4%) were reported. Most of the patients presented one complication (n = 66; 84%) followed by two (n = 13; 16%). Report of fever (92% versus 79%; OR [95%CI]: 2.90 [1.18–7.14]), bird at home (24% versus 14%; OR [95%CI]: 2.13 [1.07–4.26]), ronchi (48% versus 36%; OR [95%CI]: 2.06 [1.16–3.67]) or crackles (17% versus 7%; OR [95%CI]: 2.36 [1.04–5.38]) on auscultation were directly associated with complications whereas PCV10 (59% versus 75%; OR [95%CI]: 0.46 [0.26–0.82]) was inversely associated. Bird at home (OR [95%CI]: 5.80 [1.73–19.38]) and ronchi (OR [95%CI]: 6.39 [1.96–20.85]) were associated with AOM; PCV10 was inversely associated with AOM (OR [95%CI]: 0.16 [0.05–0.52]). Crackles were associated with pneumonia (OR [95%CI]: 2.55 [1.01–6.40]).ConclusionsOne fifth of the children presented complications. PCV10 was independently associated with lower odds of development of AOM. Bird at home and ronchi are risk factors of otitis. Crackles are associated with pneumonia.     

Physical activity,screen time and self-rated health and mental health in Canadian adolescents

ObjectivePhysical activity (PA) and screen time (ST) are associated with self-rated health (SRH) in adults; however, SRH has been less studied among youth, and information about self-rated mental health (SRMH) is lacking. This study examined the associations of PA and ST with SRH and SRMH among adolescents.MethodsCross-sectional data from the 2011–2012 Canadian Community Health Survey included 7725 participants aged 12–17 years, representing 1,820,560 Canadian adolescents. Associations of self-reported PA and ST to SRH and SRMH were assessed, controlling for age, race/ethnicity, smoking, highest household education and weight status.ResultsExcellent/very good SRH was reported by 78% of active vs. 62% of inactive adolescents, and 77% of those meeting vs. 70% of those exceeding ST guidelines (both p < 0.001). Excellent/very good SRMH was reported by 81% of active vs. 76% of inactive adolescents, and 84% of those meeting vs. 78% of those exceeding ST guidelines (both p < 0.001). Inactive adolescents had twice higher odds of sub-optimal SRH, and inactive girls had 30% greater odds of sub-optimal SRMH. Adolescents exceeding 2 h/day ST had 30% greater odds of sub-optimal SRH, and 30–50% greater odds of sub-optimal SRMH.ConclusionPA and ST are independently associated with health perceptions among Canadian adolescents. Interventions should consider health perceptions in addition to biomedical outcomes.     

Physical activity and the incidence of depression during the COVID-19 pandemic in Brazil: Findings from the PAMPA cohort

We examined the longitudinal association between physical activity (PA) and the incidence of self-reported diagnosed depression in adults in southern Brazil during the COVID-19 pandemic. Data from the PAMPA (Prospective Study About Mental and Physical Health) cohort was used. Data collection for baseline was carried out on June–July 2020, with two follow-up assessments taking place six months apart. An online, self-reported questionnaire assessed depression and PA. Depression was assessed by asking participants whether they were ever diagnosed with depression. We included 441 participants (women: 75.9%; mean age [SD]: 38.0 [13.5]) in southern Brazil. Over the follow-up, 21.8% (95% confidence interval [CI]: 18.1%–25.9%) were diagnosed with depression. Insufficiently active (<150 min per week of physical activity) (Incidence rate [IR]: 61.9; 95%CI: 39.5–102.4; p = 0.047) and active (≥150 min per week of physical activity) (IR: 50.4; 95%CI: 31.9–84.0; p = 0.015) participants had reduced IR of depression per 1000 persons-year at risk compared to inactive ones (0 min per week of physical activity) (IR: 99.9; 95%CI: 79.7–126.8). In the adjusted analyses, participants in the insufficient active (hazard ratio [HR]: 0.58; 95%CI: 0.34–0.98) and active (HR: 0.53; 95%CI: 0.31–0.93) group had a lower risk of developing depression than the inactive group. PA both at and out of home reduced the risk of incident depression (HR: 0.49; 95%CI: 0.25–0.98) compared to no physical activity. Endurance (HR: 0.52; 95%CI: 0.28–0.97) and endurance plus strengthening (HR: 0.40; 95%CI: 0.17–0.95) PA reduced the risk of incident depression compared to none. Being physically active during pandemic, regardless of the amount of PA practiced, reduced the incidence of depression in adults in southern Brazil.     

Active school transport and fast food intake: Are there racial and ethnic differences?

ObjectivesTo investigate whether active school transport was associated with fast food consumption, and to examine differences across racial/ethnic groups.MethodsAdolescent data (n = 3194) from the 2009 California Health Interview Survey were analyzed with logistic regression models to examine the association between active school transport (AST) and fast food intake across racial/ethnic groups.ResultsIn the overall sample, AST during 1–2 days in the past week was associated with greater likelihood of fast food intake (OR: 1.58; 95% CI: 1.03–2.43), compared with zero days of AST, controlling for demographic and other factors. The association between AST and fast food intake differed significantly by race/ethnicity (p < 0.01). Among Latino adolescents, greater frequency of AST was significantly associated with greater likelihood of fast food intake (1–2 days OR, 2.37, 95%CI: 1.05–5.35; 3–4 days OR, 2.78, 95% CI: 1.04–7.43; 5 days OR, 2.20, 95%CI: 1.23–3.93). Among White and Asian adolescents, there was a curvilinear pattern: relative to adolescents who reported zero days of AST, those who did AST 1–2 days/week had greater likelihood of fast food intake, but AST of 3–4 days and 5 days/week was associated respectively, with higher and lower likelihood of fast food intake among both groups.ConclusionsAST appears to be a risk factor for fast food intake, and may expose some ethnic groups more than others to increased opportunity to purchase and consume fast food. Programs and policies to promote AST among adolescents should incorporate efforts to encourage healthy eating and discourage concentration of fast food outlets near schools.     

Different social contexts of leisure-time physical activity: Does the association with depressive symptoms differ?

Our aim was to analyze the association between different social contexts of physical activity (PA) and depressive symptoms. Data from the Brazilian National Health Survey (PNS) (n = 59,722; ≥18 years) were used. The social context of leisure-time PA [classified according to the higher probability of being practiced in group (group PA) or individually (individual PA)] and total PA time were self-reported. Depressive symptoms were evaluated through the Patient Health Questionnaire-9. Chronological age, ethnicity, educational status, employment status, tobacco smoking, alcohol ingestion, and soft drink consumption were co-variables. Logistic regression models were applied for association analyses. Among men, individual and group PA were associated with lower depressive symptoms compared with the no PA group among men [Individual: OR:0.59 (95%CI:0.40 to 0.86); Group: OR:0.42 (95%CI:0.29 to 0.59)]. Sensitivity analysis revealed that men involved in group PA were 40% [OR:0.60 (95%CI:0.38 to 0.94)] less likely to present elevated depressive symptoms when compared with individual PA. In females, no differences in depressive symptoms were observed comparing individual PA [OR:0.89 (95%CI:0.71 to 1.11)] and group PA [OR:0.86 (95%CI:0.54 to 1.37)] with the no PA group. Activities that are more likely to be a group PA demonstrated a stronger association with low depressive symptoms among men, but not women.     

Indicators of resilience and healthcare outcomes: findings from the 2010 health and retirement survey

Objective

To test the hypothesis that higher levels of resilience indicators are associated with lower overall healthcare utilization (HCU) as well as improvements in self-rated health (SRH), we analyzed a representative sample of 4562 adults 50–70 years old enrolled in the US 2010 health and retirement survey.

Methods

Multivariable logistic regression models estimated odds ratios (ORs) and 95 % confidence intervals (CIs) for high versus low resilience in relation to HCU and SRH improvements over 2 years. Resilience indicators included: cumulative lifetime adversity, social support, global mastery and domain-specific mastery. Cumulative lifetime adversity was defined as 0, 1–2, 3–4 or 5+ events. HCU included hospitalization (any vs. none) and physician visits (<20 vs. ≥20) over 2 years.

Findings

Hospitalization odds declined by 25 % (OR 0.75, 95 %CI 0.64–0.86), odds of ≥20 physician visits declined by 47 % (OR 0.53, 95 % CI 0.45–0.63) and the odds of SRH improvement increased by 49 % (OR 1.49, 95 % CI 1.17–1.88) for respondents with high versus low health mastery. Cumulative lifetime adversity manifested a dose-dependent positive relationship with HCU. Specifically, hospitalization odds was, respectively, 25, 80 and 142 % elevated for participants that reported 1–2, 3–4 and 5+ versus 0 lifetime adversities. High versus low global, financial and health mastery, respectively, predicted improved SRH, lower physician’s visits and hospitalizations.

Conclusion

In this sample of adults near or in retirement, resilience predicted lower HCU and improved SRH. Resilience is a dynamic state that can be enhanced in adults with positive impacts on subjective well-being and HCU.

     

Crush: A Randomized Trial to Evaluate the Impact of a Mobile Health App on Adolescent Sexual Health

PurposeMobile technology allows delivery of sexual and reproductive health (SRH) information directly to youth. We tested the efficacy of Crush, a mobile application aimed at improving sexual health by promoting the use of SRH services and contraception among female adolescents.MethodsWe recruited 1,210 women aged 14–18 years through social media advertising and randomized them into a Crush intervention group and a control group that received a wellness app. At 3 and 6 months post randomization, we compared changes from baseline in behaviors, attitudes, self-efficacy, perceived social norms, birth control knowledge, perceived control and use intentions, and SRH service utilization. Odds ratios were estimated with multivariable logistic regression and adjusted for baseline outcome, age, race/ethnicity, mother's education, and sexual experience.ResultsThere was no difference in accessing SRH services according to study group. Three months post baseline, Crush users had higher odds (p < .05) than control participants of reporting confidence in accessing SRH services (adjusted odds ratio [aOR] = 1.6, 95% confidence interval [CI]: 1.1–2.3) and of believing that it is a good thing to use birth control consistently (aOR = 2.3, 95% CI: 1.4–3.8). Six months after baseline, Crush users had higher odds than control participants of reporting they can control whether birth control is used every time they have sex (aOR = 1.8, 95% CI: 1.2–2.6) and perceiving they would get pregnant if they did not use birth control (aOR: 1.5, 95% CI: 1.1–2.2). Impacts on other behavioral constructs were also found.DiscussionCrush was associated with improvements in knowledge, attitudes, and self-efficacy related to key SRH behaviors and may be a strategy to deliver SRH education to adolescent women. Studies including larger numbers of sexually active adolescents are needed to demonstrate behavioral impacts.     

Longitudinal associations of subjectively-measured physical activity and screen time with cognitive development in young children

PurposeTo examine the longitudinal associations of subjectively-measured physical activity (PA) and screen time with multiple domains of cognitive development in a sample of young children.MethodsParticipants were 96 children (baseline age: 3.69 ± 0.78 years) and their parents from Edmonton, Canada in the Physical Activity and Cognition in Early Childhood (PACE) study. Different types of PA (organized, non-organized) and screen time (television viewing, video games) were measured using a parental questionnaire at baseline and at 6- and 12-month follow-ups. Total proxy-reported PA, total screen time, and meeting/not meeting the screen time recommendations (2–4 years: ≤1 h/d; 5 years: ≤2 h/d) of the Canadian 24-Hour Movement Guidelines were also calculated. Working memory (Nebraska Barnyard task) and inhibitory control (Fish-Shark Go/No-Go task) were assessed at the three time points. Intellectual ability, including language development, inductive reasoning, and perceptual speed, were assessed using the Woodcock-Johnson III test battery at 6- and 12-month follow-ups. Multilevel growth modeling was conducted.ResultsOrganized PA (B = 1.26; 95%CI: 0.19,2.33), non-organized PA (B = 0.89, 95%CI: 0.08, 1.71), and total proxy-reported PA (B = 1.03, 95%CI: 0.41,1.66) were positively associated with intellectual ability. In particular, positive associations in regard to language development and inductive reasoning were observed. As for screen time, most associations were not significant, except for positive associations of meeting the screen recommendation with intellectual ability (B = 3.19; 95%CI: 0.002,6.38) and language development (B = 4.32; 95%CI: 0.34,8.30).ConclusionFor young children, promoting PA participation in organized and non-organized activities, as well as meeting the screen time recommendations, appears important for cognitive development.     

Negative Physical Self-Concept Is Associated to Low Cardiorespiratory Fitness,Negative Lifestyle and Poor Mental Health in Chilean Schoolchildren

Background: Evidence suggests that physical self-concept (PSC) is linked to well-being in children and adolescents. Objective: The objective was to investigate the association of PSC with mental health (i.e., depression and body image), physical status (i.e., fitness and weight status) and lifestyle (physical activity (PA) patterns and nutritional level) in Chilean schoolchildren. Methods: A total of 617 schoolchildren (n = 271 girls and n = 346 boys) aged 10–14 years participated in this study. Self-concept, depression and body image dissatisfaction were determined by questionnaires. Physical fitness, PA, screen time (ST), Mediterranean diet (MD) adherence and anthropometric parameters were also included. Results: Poor PSC was linked to bad cardiorespiratory fitness (CRF) (<42 VO_2max) (OR 1.64; 95%CI 1.12–2.34; p = 0.01), severe body image dissatisfaction (OR 2.51, 95%CI 0.99–6.35; p = 0.05), ST of more than two hours a day (OR 2.1; 95%CI 1.41–3.12; p < 0.001), PA after school of no more than two hours per week (OR 1.52; 95%CI 1.08–2.13; p = 0.015) and depression (OR 1.80; 95%CI 1.1–2.92; p = 0.017). High nutritional level showed an association with general PSC and general self-concept (p < 0.05). Absence of body image dissatisfaction was related to general self-concept (p < 0.01) and physical condition dimensions (p < 0.05). Conclusions: PSC is associated with CRF, PA after school, ST and nutritional level. According to mental health variables, poor PSC is related to depression in Chilean schoolchildren. Therefore, promoting a healthy lifestyle among children should be a target of community- and school-based interventions to promote PSC.     

Physical activity,sedentary behaviour,and psychosocial well‐being among young South Korean children

Objective

To examine associations between television (TV) viewing, reading, physical activity (PA), and psychosocial well‐being among a representative sample of young South Korean children aged 0–5 years.

Methods

Findings are based on 1,774 children who participated in the Korea Children and Youth Survey. All measures were questionnaire‐derived. Psychosocial well‐being included social, interactive, and emotional skills (α = .7–.9), and the top quartile denoted high psychosocial well‐being. Multiple logistic regressions were performed to examine relationships after controlling for several confounders.

Results

Compared to children who participated in PA for <1 hr/week, those who participated in PA for 1‐ <3 hr/week were more likely to show high emotional skills (odds ratio [OR]: 1.40, 95% confidence interval [CI] [1.02, 1.93]), and those who participated ≥3 hr/week were more likely to show high social (OR: 2.01, 95% CI [1.45, 2.78]) and interactive skills (OR: 1.39, 95% CI [1.01, 1.92]). During weekdays, children who read 1– <3 hr/day and ≥3 hr/day, compared to <1 hr/day, were more likely to show high social (OR: 1.61, 95% CI [1.20, 2.16] and OR: 2.47, 95% CI [1.31, 4.67]) and emotional skills (OR: 1.57, 95% CI [1.16, 2.13] and OR: 2.58, 95% CI [1.34, 4.98]). In addition, children who read 1– <3 hr/day, compared to <1 hr/day, were more likely to show high interactive skills (OR: 1.44, 95% CI [1.08, 1.92]). Similar findings for reading on weekends were observed. TV viewing was not associated with social skills or interactive skills. TV viewing for 1– <3 hr/day, compared to <1 hr/day, was associated with increased odds of high emotional skills (OR: 1.71, 95% CI [1.28, 2.27] on weekdays; OR: 1.90, 95% CI [1.39, 2.61] on weekends).

Conclusion

PA and reading primarily showed favourable associations with psychosocial well‐being, whereas TV viewing did not; thus, PA or reading may be a better option over TV viewing for optimal psychosocial well‐being among young South Korean children. These findings should be confirmed with stronger study designs.     

Effect of pneumococcal conjugate vaccine on prevalence of otitis media with effusion among children in Vietnam

PurposeOtitis media with effusion (OME) is common in young children and is associated with Streptococcus pneumoniae infection. We aimed to determine the impact of pneumococcal conjugate vaccine (PCV) introduction on the prevalence of OME and OME associated with vaccine-type (VT) or non-VT.MethodsPopulation-based cross-sectional surveys were conducted in pre- (2016) and post-PCV periods (2017, 2018, and 2019) at selected communes in Nha Trang, Vietnam. For each survey, we randomly selected 60 children aged 4–11 months and 60 aged 14–23 months from each commune. Nasopharyngeal sample collection and tympanic membrane examination by digital otoscope were performed. S. pneumoniae was detected and serotyped by lytA qPCR and microarray. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated using Firth’s logistic regression, stratified by age group.ResultsOver the four surveys, 2089 children had a bilateral ear examination. Compared to pre-PCV, the prevalence of OME reduced in 2018 (OR 0.51, 95 %CI 0.28–0.93) and in 2019 (OR 0.53, 95 %CI 0.29–0.97) among the <12-month-olds, but no significant reduction among the 12–23-month-olds. The prevalence of OME associated with VT pneumococcus decreased in 2018 and 2019 (2018: OR 0.14, 95 %CI 0.03–0.55; 2019: OR 0.20, 95 %CI 0.05–0.69 in the <12-months-olds, 2018: OR 0.05, 95 %CI 0.00–0.44, 2019: OR 0.41, 95 %CI 0.10–1.61 in the 12–23-months-olds). The prevalence of OME associated with non-VT pneumococcus increased in the 12–23-month-olds in 2017 (OR 3.09, 95 %CI 1.47–7.45) and returned to the pre-PCV level of prevalence in 2018 and 2019 (OR 0.94, 95 %CI 0.40–2.43 and 1.40, 95 %CI 0.63–3.49).ConclusionPCV10 introduction was associated with a reduction of OME prevalence in infants but not in older children.     

Where can they play? Outdoor spaces and physical activity among adolescents in U.S. urbanized areas

ObjectiveTo estimate behavior-specific effects of several objectively measured outdoor spaces on different types of moderate to vigorous physical activity (MVPA) in a large, diverse sample of U.S. adolescents.MethodsUsing data from Wave I (1994–1995) of the National Longitudinal Study of Adolescent Health (U.S., n = 10,359) and a linked geographic information system, we calculated percent greenspace coverage and distance to the nearest neighborhood and major parks. Using sex-stratified multivariable logistic regression, we modeled reported participation in wheel-based activities, active sports, exercise, and ≥ 5 MVPA bouts/week as a function of each outdoor space variable, controlling for individual- and neighborhood-level sociodemographics.ResultsAvailability of major or neighborhood parks was associated with higher participation in active sports and, in females, wheel-based activity and reporting ≥ 5 MVPA bouts/week [OR (95% CI): up to 1.71 (1.29, 2.27)]. Greater greenspace coverage was associated with reporting ≥ 5 MVPA bouts/week in males and females [OR (95% CI): up to 1.62 (1.10, 2.39) for 10.1 to 20% versus ≤ 10% greenspace] and exercise participation in females [OR (95% CI): up to 1.73 (1.21, 2.49)].ConclusionsProvision of outdoor spaces may promote different types of physical activities, with potentially greater benefits in female adolescents, who have particularly low physical activity levels.     

Physical activity inversely associated with the presence of depression among urban adolescents in regional China

Background  

An inverse relationship between physical activity (PA) and depression among adolescents has been reported in developed communities without consideration of sedentary behaviors (SB, including sitting for course study, viewing TV, and sleeping). We explored the association between recreational PA time (hr/wk) and depression after adjustment with SB and other possible confounders among Chinese adolescents.     

小学生身体活动久坐行为与身体姿态健康的关系

  目的  探究小学生身体活动(physical activity, PA)、久坐行为(sedentary behavior, SB)与身体姿态健康的关系,为该群体异常身体姿态预防、矫正提供参考。  方法  2020年9—12月,采用多阶段分层整群随机抽样法,抽取北京市朝阳区4所学校206名小学生为研究对象,采用Body-Style身体姿态测试仪、ActiGraph GT3X+三轴加速度计客观测量身体姿态、PA,采用儿童休闲活动调查问卷调查SB。  结果  小学生异常身体姿态检出率为76.70%;PA与高低肩、X/O型腿、骨盆前倾、脊柱侧弯、综合测评具有正向线性相关(β值分别为0.17,0.21,0.19,0.24,0.19,P值均 < 0.05);SB与高低肩、X/O型腿、骨盆前倾、脊柱侧弯、综合测评具有负向线性相关(β值分别为-0.24,-0.22,-0.36,-0.24,-0.27,P值均 < 0.05)。对PA、SB联合分析,在高PA、低SB(OR=2.12,95%CI=1.46~3.37,P < 0.05)和低PA、高SB两个极端组合时,身体姿态测评合格率获得优势分别为最高和最低;高PA、高SB(OR=1.85, 95%CI=1.38~2.86)与低SB、低PA (OR=1.71, 95%CI=1.41~2.74)比较,身体姿态测评合格率获得优势更高。  结论  对于小学生身体姿态健康,PA是独立促进因素,SB是独立危险因素,二者联合具有抵消或协同的交互效应。     

Total and domain‐specific sitting time among employees in desk‐based work settings in Australia

Objective: To describe the total and domain‐specific daily sitting time among a sample of Australian office‐based employees. Methods: In April 2010, paper‐based surveys were provided to desk‐based employees (n=801) in Victoria, Australia. Total daily and domain‐specific (work, leisure‐time and transport‐related) sitting time (minutes/day) were assessed by validated questionnaires. Differences in sitting time were examined across socio‐demographic (age, sex, occupational status) and lifestyle characteristics (physical activity levels, body mass index [BMI]) using multiple linear regression analyses. Results: The median (95% confidence interval [CI]) of total daily sitting time was 540 (531–557) minutes/day. Insufficiently active adults (median=578 minutes/day, [95%CI: 564–602]), younger adults aged 18–29 years (median=561 minutes/day, [95%CI: 540–577]) reported the highest total daily sitting times. Occupational sitting time accounted for almost 60% of total daily sitting time. In multivariate analyses, total daily sitting time was negatively associated with age (unstandardised regression coefficient [B]=?1.58, p<0.001) and overall physical activity (minutes/week) (B=?0.03, p<0.001) and positively associated with BMI (B=1.53, p=0.038). Conclusions: Desk‐based employees reported that more than half of their total daily sitting time was accrued in the work setting. Implications: Given the high contribution of occupational sitting to total daily sitting time among desk‐based employees, interventions should focus on the work setting.     

Physical Activity is Associated With Fewer Subjective Cognitive Complaints in 47 Low- and Middle-Income Countries

ObjectivesTo determine the association between physical activity (PA) and subjective cognitive complaints (SCCs), and the influential factors in this association.DesignCross-sectional study.Setting and ParticipantsCommunity-based data of the World Health Survey, which included 248,504 individuals from 47 low- and middle-income countries (LMICs), were analyzed [mean age = 38.6 (standard deviation 16.1) years; 50.7% female].MethodsPA was assessed with the International Physical Activity Questionnaire. Participants were grouped into those who meet (high PA) the 150 minutes of moderate-to-vigorous intensity PA per week recommendation, and those who do not (low PA). Two questions on subjective memory and learning complaints in the past 30 days were used (scales ranged from 1 to 5, with higher scores representing more severe SCC). Multivariable ordinal logistic regression and mediation analyses were performed.ResultsOverall, after adjusting for sociodemographic and a wide range of behavioral, psychological, and physical factors, low PA was associated with a higher risk for having more severe subjective memory complaints [odds ratio (OR) = 1.10, 95% confidence interval (CI) = 1.04-1.23] and learning complaints (OR = 1.18, 95% CI = 1.12-1.26). Significant associations were only observed among the middle-aged (45-64 years; learning complaints OR = 1.19, 95% CI = 1.06-1.33) and older populations (≥65 years; memory complaints OR = 1.31, 95% CI = 1.15-1.49, and learning complaints OR = 1.41, 95% CI = 1.24-1.60). Chronic physical conditions, sleep problems, depression, and anxiety explained between 7.7% and 29.4% of the PA-SCC association among those aged ≥45 years.Conclusions and ImplicationsLow PA was associated with increased odds for more severe SCCs in middle-aged and older adults in LMICs. Given the particularly rapid increase in dementia in LMICs, more longitudinal research is warranted from this setting to understand the utility of PA promotion in the prevention of cognitive impairment.     

Levels and patterns of physical activity and sedentary behavior in adults with and without visual impairment

BackgroundLimited data are available on objectively measured physical activity (PA) and sedentary behavior (SB) among adults with and without visual impairment (VI).ObjectiveTo compare PA and SB levels and patterns in adults with and without VI and to examine how these differ based on sex and day of the week.MethodsThirty-two participants with VI and 32 participants without VI participated in this cross-sectional study. PA and SB were assessed using GT3X ActiGraph accelerometers during waking hours for 7 days, and variables were examined in terms of disability group, sex, and day of the week. Nonparametric Mann–Whitney U test and Wilcoxon signed-rank test were used, and significance was set at p < 0.05.ResultsPA did not differ in terms of sex or day of the week in participants with VI. The PA of participants without VI was significantly higher for men than it was for women and was significantly higher during weekdays than on weekend days. Total sedentary time and the duration of SB breaks were significantly longer for female participants with VI than for those without VI. The number of sedentary bouts lasting ≥10 min during weekend days was significantly higher for participants with VI than for those without VI.ConclusionsMost adults with and without VI did not meet the recommended levels of daily PA and spend a large portion of the day being sedentary. Interventions to enhance PA and reduce sedentary time in adults with and without VI are required.     

Are Health Behaviors and Self-Rated Health Related to Cardiovascular Health and Functional Performance? Results from the Lookup 7+ Cross-Sectional Survey among Persons Aged 65+

Objectives

Cardiovascular health (CVH) and physical performance (PP) are key factors of successful ageing. This study investigated whether self-reported CVH behaviours and self-rated health (SRH) are related to ideal CVH and PP.

Design

Cross-sectional survey.

Setting

Public places in Italy (e.g. exhibitions, malls, health promotion campaigns), outside of conventional healthcare settings.

Participants

1415 community-living persons aged 65+ years (mean age 72.2 ± 5.4; 58.4% female).

Measurements

Three ideal CVH behaviors [regular physical activity (PA), healthy diet, no smoking] and SRH (1 excellent — 4 poor) were assessed through a brief questionnaire. Four ideal CVH factors [iBMI ≤ 25 kg/m2, untreated random total blood cholesterol ≤200 mg/dl, absence of diabetes (untreated random blood glucose ≤200 mg/dl), untreated blood pressure (iBP) <140/90mmHg] and two ideal PP factors [grip strength (iGrip), 5-repetition chair-stand test <10 seconds (iStand)] were measured.

Results

Adjusted for age and gender, regular PA was positively related to CVH factor score (β = 0.1; p = <.001), iBMI (OR = 1.8; 95% CI = 1.5-2.3), iBP (OR = 1.3; 95% CI = 1.1-1.6) and iStand (OR = 1.6; 95% CI = 1.3-2.1). Healthy diet was positively related to CVH factor score (β = 0.1; p = <.05) and iGrip (OR = 1.4; 95% CI = 1.1-1.8). Participants rating SRH as “good” (OR = 2.0; 95% CI = 1.1-3.9) and “not so good” (OR = 2.3; 95% CI = 1.2-4.5) met iDiabetes more often than those with poor SRH. Moreover, iStand (OR = 3.2; 95% CI = 1.6-6.6) and iGrip (OR = 4.2; 95% = CI 2.0-8.8) were more prevalent among participants with excellent SRH compared with those with poor SRH.

Conclusions

Physical activity, diet and self-rated health may provide quick and easy-to-assess metrics to identify persons aged 65+ years at risk of cardiovascular events and functional impairment, who could particularly benefit from engaging in health promotion programs.