Associations between dimensions of physical activity (intensity, frequency, duration, and volume) and frailty among middle-aged and older Chinese adults.

This study explored the association of physical activity (PA) from different dimensions including intensity, frequency, duration, and volume with possible sarcopenia (PSA), and established the PA cut-off value to identify PSA in middle-aged and older adults. The data in this study were from the China Health and Retirement Longitudinal Study in 2015. There were 7,957 adults aged over 45years in the analysis. PA was assessed using a modified version of the International Physical Activity Questionnaire Short Form. Muscle strength and physical performance were measured to define PSA. Results showed that men spending at least 3days each week, more than 10min each time on vigorous-intensity PA, or a minimum of 933 Mets on total PA each week had a lower risk of PSA. In women, spending at least 3days each week, more than 30min each time on moderate-intensity PA, or taking at least 6days each week, more than 120min each time on low-intensity PA, or a minimum of 933 Mets on total PA each week was associated with a lower risk of PSA. In older adults (≥ 65years), spending at least one day each week, more than 30min each time on vigorous-intensity PA, or taking a minimum of 933 Mets on total PA each week was linked with a decreased risk of PSA. However, no significant associations were found between any PA dimensions and PSA in middle-aged adults (45-64years). A receiver operating characteristic analysis showed that the PA cut-off value was 695 and 693 Mets each week for predicting PSA for men and women. The findings suggested that the intensity, frequency, duration, and weekly volume of PA is associated with the risk of PSA in middle-aged and older adults, and the association largely depends on sex and age. The PA cut-off value may be an early indication for a higher risk of sarcopenia.

To quantify the risk of heart diseases (HD) and determine the relationship between physical activity (PA) dimensions and HD among Chinese middle-aged and older individuals. Using data from the China Health and Retirement Longitudinal Study (CHARLS, 2018), 16,927 participants were included in this study. Multivariate logistic regression was performed to determine the association between HD risk and PA dimensions, including volume, intensity, frequency, and duration. Restricted cubic spline analysis was conducted to assess the dose-response relationship between PA and HD risk. Compared to the least active participants, a low risk of HD was significantly associated with a higher PA volume. With regards to frequency, a lower HD risk was associated with performing vigorous PA except for 3-5 days/week. The frequency and duration of light as well as moderate PA had no significant associations with HD risk after adjusted by using covariates. A non-linear association was also noted, with increased PA being associated with decreased HD risk, with steeper reductions in HD risk at low activity levels than at high activity levels. There was a non-linear association between PA and HD risk in participants in male and aged older than 65 years. An inverse non-linear dose-response association was detected between the total volume of PA and HD risk. As PA increased to 4,000 METs-min/week, HD risk in the overall population decreased by approximately 26%, while further increases in PA did not produce any further marked reduction in the risk. A vigorous intensity of PA was associated with a reduced risk of HD and is strongly recommended.

PURPOSE The purpose of this investigation was to examine the pedometer accuracy in younger and older adults. METHODS Seventeen younger individuals (YI) and 28 elderly individuals wore a pedometer with a one-axial accelerometer (Life-Corder, LC) and an electrical pedometer (EC-200, YM) simultaneously for seven days on the left waist. The number of step was assessed by the two pedometers, and LC assessed the time spent in light, moderate and vigorous intensity physical activity. Elderly subjects were divided in one of two groups (active elderly: AE and inactive elderly: IE) according to the number of steps (=7500 steps/day). RESULTS Although AE took the higher number of steps and spent longer time in light intensity physical activity compared with YI (10736+/-3465 vs. 8866+/-1940 steps/day and 64+/-22 vs. 48+/-10 min/day, p<0.05), the time spent in moderate intensity physical activity did not differ significantly between two groups (32+/-18 vs. 35+/-12 min/day). In contrast, IE spent the same amount of time in light intensity physical activity (42+/-9 min/day) compared with YI (48+/-10 min/day), whereas the number of steps and the time spent in moderate intensity physical activity differed significantly (5402+/-1071 vs. 8866+/-1940 steps/day and 15+/-7 vs. 35+/-12 min/day, p<0.01). Furthermore, in IE, the relative time spent in light intensity physical activity (77+/-12%) was significantly longer than other two groups (p<0.01). The number of steps assessed by LC was significantly higher than the number of steps assessed by YM in overall subjects (8607+/-3197 steps/day vs. 7195+/-3144 steps/day, p<0.01), yet there was a strong relationship between the two measurements (r=0.962, p<0.01). The magnitude of the difference was significantly correlated with the relative time spent in light intensity (r=0.523, p<0.01) as well as the time spent in moderate intensity physical activity (r=−0.563, p<0.01). Consequently, in IE, the magnitude of difference (29+/-14%) was greater than in the other two groups (p<0.01), and the correlation between the two measurements was only modest (r=0.689, p<0.001). CONCLUSIONS The pedometer accuracy may decrease in elderly individuals due to greater length of time spent in light intensity physical activity and to the minimal time spent in moderate intensity physical activity. Therefore, elderly individuals should be encouraged to improve/maintain the daily physical activity levels based on the intensity of physical activity rather than on the number of steps.

Impact of physical activity intensity on longitudinal trajectories of cognitive function and depressive symptoms in middle-aged and older Chinese adults: Eight-year prospective study

Context: Persuasive evidence has shown the inverse associations between physical activity (PA) and the risk of stroke. However, few studies have investigated the associations between different dimensions (intensity, frequency, duration, volume) of PA and the risk of stroke. Objective: To investigate the associations between different dimensions of PA and the risk of stroke in total participants and subgroups. Method: This study included 6250 individuals aged 45 years old and above from the China Health and Retirement Longitudinal Study (CHARLS). PA was divided into vigorous PA (VPA), moderate PA (MPA), and light PA (LPA), and described in different dimensions (intensity, frequency, duration, volume). Stroke was defined on the basis of self-reported diagnosis and related treatments. Binary logistic regression models were established to assess the associations between different dimensions of PA and the risk of stroke in total participants and subgroups stratified by sex. Results: Individuals taking VPA with a frequency of 3–5 d/w, duration of ≥240 min/d, volume of ≥300 min/w had lower risks of strokes in total participants (Odds ratio (OR) = 0.32, 95% confidence interval (CI): 0.13, 0.75; OR = 0.60, 95% CI: 0.38, 0.94; OR = 0.68, 95% CI: 0.46, 0.99, respectively). However, significant associations of VPA with the risk of stroke in men were only observed in the duration of ≥240 min/d and volume of ≥300 min/w (OR = 0.53, 95% CI: 0.30, 0.93; OR = 0.61, 95% CI: 0.38, 0.99, respectively) whereas no significance in women. Compared with individuals taking no MPA, inverse significant associations between the risk of stroke and any level of frequency, duration and volume in MPA were observed in total sample (OR ranging from 0.16–0.40, all p < 0.05), whereas significant associations between the risk of stroke and MPA were found in men except the duration of 10–29 min/d and volume of 150–299 min/w (OR ranging from 0.26–0.35, all p < 0.05), and in women except the frequency of 1–2 d/w and duration of ≥240 min/d (OR ranging from 0.14–0.49, all p < 0.05). No significant associations could be observed in total participants and subgroups between LPA and the risk of stroke. Conclusion: This study revealed some significant associations between different dimensions of PA, especially MPA, and the risk of stroke. Furthermore, the difference of association was observed in the groups with different sex. Further prospective study is needed to determine deeper associations between PA and the risk of stroke.

BackgroundIt is known that insufficient physical activity is associated with the risk of hypertension, but the relationship to different physical activity dimensions within hypertension risk remains to be elucidated.ObjectiveThe objective of this study is to identify the association between physical activity intensity, frequency, duration, and volume with hypertension risk. Meanwhile, a dose-response experiment is conducted to determine the relationship between physical activity level and hypertension risk.MethodsData came from the 2018 China Health and Retirement Longitudinal Study (CHARLS, 2018), which included 14266 participants over the age of 45. Binary logistic regression models were established to assess the associations between different dimensions of physical activity and the risk of hypertension. Restricted cubic spline analysis was used to examine possible non-linear associations between physical activity volume and hypertension risk.ResultsFor frequency, lower hypertension risk was associated with performing vigorous physical activity 6–7d/w (OR 0.82, 95%CI 0.73–0.93) and moderate physical activity 6–7d/w (OR 0.89, 95%CI 0.80–0.99). No significant association between any light physical activity frequency and hypertension was observed before and after being adjusted. For the duration, lower hypertension risk was observed in performing vigorous physical activity ≥240 min/d (OR 0.85, 95%CI 0.75–0.97) and moderate physical activity ≥240 min/d (OR 0.83, 95%CI 0.71–0.97). For volume, the risks of hypertension in the participants who reported TPA in the 3th and 4th of quantiles were reduced by 18% (OR 0.82, 95%CI 0.72–0.95) and 22% (OR 0.78, 95%CI 0.68–0.91). A non-linear dose-response association between total physical activity and the risk of hypertension was shown among all of the participants (P non-linearity < 0.05).ConclusionHigher frequency and longer duration of vigorous physical activity or moderate physical activity were significantly associated with a lower risk of hypertension. Higher physical activity levels were associated with a lower risk of hypertension and there was an inverse non-linear dose-response relationship between weekly total physical activity and the risk of hypertension. These findings provide further proof that hypertension could be prevented through increased physical activity.

Intramyocellular lipid (IMCL) is influenced by physical exercise; however, whether the habitual level of physical activity affects resting IMCL content remains unclear. The purpose of this study was to determine the relationship between physical activity levels and resting IMCL content in young and older adults. In total, 15 nonobese young adults (21.0 ± 0.0years) and 15 older adults (70.7 ± 3.8years) were recruited. Time spent performing physical activities for 10days was assessed using a three-dimensional ambulatory accelerometer, and intensity was categorized as light [< 3.0 metabolic equivalents (METs)], moderate (3.0-6.0 METs), or vigorous (> 6.0 METs). Physical activity level was calculated as the product of METs and time spent performing physical activities (METh) at each intensity level. The IMCL content in the vastus lateralis was determined using 1H-magnetic resonance spectroscopy after overnight fasting. No significant differences in IMCL content were observed between young and older adults. Vigorous intensity physical activity (time and METh) was significantly lower in older than young adults (p < 0.01); this difference was not observed for light and moderate intensity physical activity. Light intensity physical activity (time and METh) was significantly and inversely correlated with IMCL content in young adults (r=- 0.59 and r=- 0.58; both p < 0.05), but not in older adults. These results suggest that daily light intensity physical activity reduces resting IMCL content in young adults, whereas no significant relationship was seen between daily physical activity and resting IMCL content in older adults.

BackgroundLife satisfaction (LS) is part of a positive psychological feeling that protects individuals from a physical decline in old age. A healthy lifestyle, including physical activity (PA) and a healthy diet, such as the intake of fruits and vegetables (F&V), can lead to a better experience of LS in older adults. However, the association between PA and F&V intake habits when occurring together in older adults is still unclear for LS. The study aimed to investigate the combined association of PA and F&V intake on LS among a cohort of older Taiwanese adults.MethodsFive waves of population-based data gathered by the Taiwan Longitudinal Survey on Aging between 1999 and 2015 were analyzed. The year 1999 was set as the baseline, and the number of respondents was 4,440. The independent variables included the frequency, duration, and intensity of PA and the frequency of F&V intake. LS was assessed by using the Life Satisfaction Index. We performed generalized estimating equations (GEE) analysis with adjustment for covariates of health behaviors and health indicators.ResultsAfter adjusting for confounders, model 1 showed that moderate and high-PA levels significantly correlated with LS (odds ratio [OR] = 1.41, 95% CI = 1.12–1.79) and OR = 1.74, 95% CI = 1.50–2.02). Moreover, high-F&V intake significantly correlated with LS (OR = 2.07, 95% CI = 1.69–2.53). Regarding the combined association shown in model 2, compared with both the low PA and F&V intake group, there were significantly higher LS in the both-high-group (OR = 4.69, 95% CI = 3.49–6.31), only-high-F&V intake (OR = 2.87, 95% CI = 2.14–3.85), only-high-PA (OR = 2.48, 95% CI = 1.74–3.52).ConclusionsOur findings show the significant combined association of PA and F&V intake on LS among older adults. In addition, older adults who engaged in higher frequency, duration, and intensity of daily PA combined more than seven times a week of F&V intake had significantly higher LS than those who only engaged in low PA or only intake less F&V. Adopting multiple healthy behaviors in daily life is a safe and effective approach to promote LS among older adults.

Prospective study of physical activity and sleep in middle-aged and older adults.

Background: Aging increased the risks of cognitive impairment and depression. Then, these conditions can lead to poor quality of life by reducing one’s ability to perform activities of daily living. Recently, it is established that physical activity can decrease the cognitive decline and the risk of depression in older adults. Moreover, regular physical activity can improve physical and mental functions in populations of all ages. However, level and speed of cognitive decline occurs varies greatly among individual especially the difference between middle-aged and older adults. Objective: This study aimed to focus on the comparison of physical activity, cognitive function and depression between older and middle-aged adults, which has never been done before. Moreover, the associations of physical activity with cognitive impairment and depression were also investigated in older and middle-aged adults. The information in this study will provide an understanding regarding the design of physical activity program for different age groups. Methods: All participants were divided into two groups of 50 middle-aged adults and 50 older adults. The assessments of physical activity, cognitive function, and level of depression were conducted for all participants. Results: The total level of physical activity and cognitive function in older adults was decreased when compared with middle-aged ones. Moreover, each work and transportation domain of physical activity in older adults also was decreased when compared with that in middle-aged ones. However, the leisure domain of physical activity in older adults was increased via a decreasing depression level. In addition, the level of physical activity associated with both cognitive function and depression and depression alone in middle-aged and older adults, respectively. Conclusion: We suggested that total level of physical activity in older adults can increase via stimulating work and transportation activities in physical activity program. Moreover, the level of physical activity associated with both cognitive function and depression and depression alone in middle-aged and older adults, respectively.

This study investigates the impact of physical activity on cognitive function in Chinese middle-aged and older adult individuals, examining the relationship between different intensities of physical activity and cognitive function, as well as the effect of physical activity on various types of cognitive function. A total of 27,529 samples were selected from the China Health and Retirement Longitudinal Study (CHARLS) data from 2011 to 2018 for regression analysis. Multidimensional fixed effects estimation was used to validate the impact of physical activity on cognitive function in middle-aged and older adults, analyzing differences in the intensity of physical activity and types of cognitive function. The empirical results were further tested using methods such as propensity score matching (PSM). Additionally, this paper conducted heterogeneity analyses by gender, place of residence, presence of children, and marital status. Physical activity had a positive impact on cognitive function among middle-aged and older adults in China by improving their cardiovascular health, and this result held true regardless of gender, rural or urban residence, presence of children, or marital status. This conclusion was supported by both alternative explanatory variables and results from propensity score matching. Further research found that physical activity improves immediate memory and delayed recall among middle-aged and older adults. Moderate physical activity enhances the health of the older adult population, whereas excessive physical activity may impair cognitive function in middle-aged and older adults. Our study found that PA can effectively promote the improvement of cognitive function in middle-aged and older adults, with this conclusion still holding true in older populations. Such physical activity should be moderate, because vigorous physical activity may impair cognitive function in middle-aged and older people. The study conclusions play a significant role in promoting physical activity, delaying cognitive decline, achieving active aging, and reducing the burden of informal caregiving.

BackgroundPhysical activity (PA) plays an important role in the process of several chronic diseases. It may be also associated with the incidence of sarcopenia. This study aimed to determine the association of PA from different components including frequency, duration, intensity, and volume with the incidence of sarcopenia in middle-aged and older adults.MethodsThis study used data from the China Health and Retirement Longitudinal Study in 2011 and 2015. A total of 3,760 individuals aged ≥ 40 years were involved in this study. Sarcopenia was diagnosed using muscle mass, strength and physical performance according to the Asian Working Group for Sarcopenia. PA information including frequency, duration, intensity, and volume was obtained by a self-reported questionnaire. Logistic regression analysis was employed to examine the association between PA and the incidence of sarcopenia at 4-year follow-up.ResultsThe incidence of sarcopenia was 5.9% during the 4-year follow-up. Compared to sedentary individuals, those taking 1–2 days or more per week, or a minimum of 10 min each time on vigorous-intensity PA (VPA) had a lower incidence of sarcopenia. Adults spending 3 days or more each week, a minimum of 30 min each time, or 150 min or more per week on moderate-intensity PA (MPA) had a lower presence of sarcopenia than sedentary adults. Adults taking 3 days or more per week, at least 30 min each time, or 150 min or more each week on light-intensity PA (LPA) tended to have a lower incidence of sarcopenia than sedentary individuals. Sensitivity analyses confirmed the robustness of the findings after removing persons with hypertension, dyslipidemia, or diabetes.ConclusionsThese findings suggest that the frequency, duration, and volume of VPA or MPA are negatively associated with the presence of sarcopenia. Participation in LPA tends to have a lower incidence of sarcopenia in middle-aged and older adults.

BackgroundConsistent evidence suggested that physical activity (PA) may delay dementia onset. However, the dose‐response association between PA and dementia remains unclear. This study aimed to examine the association between the volume, duration, and intensity of PA and incident dementia among older adults across diverse geographic regions.MethodWe harmonized longitudinal data from nine community‐based cohorts in seven countries covering five continents in the Cohort Studies of Memory in an International Consortium (COSMIC). The frequency and duration of performing various PAs per week were collected through questionnaires. Each activity was assigned a metabolic equivalent value (MET). The volume of each PA (MET‐hours) was calculated as the MET multiplied by the hours spent performing the activity. The average PA intensity was calculated as the total volume divided by the total duration hours of PA. Incident dementia was diagnosed after a median of 5.4 years of follow‐up. To explore the dose‐response associations, participants who reported doing regular PA were categorized into subgroups with stratified levels of the volume, duration, or intensity of PA. Multivariate Cox regression models were used to estimate the hazard ratios (HRs) of incident dementia in each group with the lowest volume, duration, or intensity as the reference group. Age, sex, educational year, cohort, APOE, body mass index, smoking, hypertension, diabetes, stroke, and depression were adjusted as the confounders.ResultA total of 8849 participants (51921 person‐years of follow‐up) were included in our analysis. Compared to engaging in low‐intensity activities (2.3≤MET≤3), engaging in moderate to high‐intensity activities was associated with a lower risk of incident dementia (3.00&lt;MET≤4.00, adjusted HR=0.80, 95% CI=0.59‐1.08; MET&gt;4, adjusted HR=0.58, 95% CI=0.40‐0.84; p for trend=0.004) . There was no significant dose‐response relationship between the volume or duration of PA and the risk of incident dementia.ConclusionOur analysis demonstrated a dose‐response association between PA intensity (but not volume or duration) and dementia risk. This evidence could potentially enrich the current recommendations for the protective effect of PA on dementia onset. While waiting for additional evidence from randomized interventions, older adults may be encouraged to perform a higher intensity of PA to preserve cognition.

The magnitude and direction of the association between sedentary time, physical activity (PA) of various intensities and weight status remain unclear. PURPOSE:The purpose of this study was to examine the cross-sectional and longitudinal effects of replacing sedentary time with light PA, moderate PA or vigorous PA on BMI in a large representative sample of adults and older adults. METHODS: We conducted cross-sectional (n=5013) and longitudinal (n=1823) analyses in a prospective cohort study in which PA was measured objectively by accelerometry (ActiGraph GT1M and GT3X+) for 7 days at both baseline (year 2008/09) and after 5 years. Exposure variables were daily time spent sedentary (below 100 cpm), and daily minutes spent performing light (100-2019 cpm), moderate (2020-5999 cpm) and vigorous intensity PA (6000 cpm and up). Outcome variable was BMI (kg/m2) derived from self-reported height and weight. Isotemporal substitution modelling was performed to convey the effects of replacing sedentary time with active behaviours on participant`s BMI. RESULTS: The isotemporal substitution models showed that replacing 10 minutes/day of sedentary time with an equal amount of time of either moderate PA (B=-0.2 95% CI: -0.2 to -0.1) or vigorous intensity PA (B=-1.0; 95% CI: -1.2 to -0.7) were associated with estimated beneficial effects on BMI after adjustments for age and socio-economic status in both genders. For men, replacing sedentary time with light intensity PA also showed small but significant beneficial associations with BMI (B=-0.1; 95% CI: -0.17 to -0.03). There were no longitudinal associations when replacing sedentary time with any of the PA intensities, after adjusting for baseline BMI. CONCLUSIONS: Replacing sedentary time with active behaviours is associated with BMI in cross-sectional but not prospective analyses. This may suggest that substituting sedentary time with PA at one point in time may not predict gain in BMI over time.

BackgroundPrevious studies on physical activity (PA) and pelvic organ prolapse (POP) were largely limited to self-reported PA in athletes, soldiers, and women in postpartum. We aimed to investigate the association of accelerometer-measured PA and sedentary behavior with the risk of POP in middle-aged and elderly women.MethodsIn this prospective cohort derived from the UK Biobank, the intensity and duration of PA and sedentary behavior were measured with wrist-worn accelerometers over a 7-day period in 2013–2015 for 47,674 participants (aged 42.8–77.9 years) without pre-existing POP. Participants were followed up until the end of 2022, during which incident POP was ascertained mainly by the electronic health records. Multivariable-adjusted Cox proportional hazards models and restricted cubic splines were used to assess the associations of interest. Isotemporal substitution models were applied to test the effects of substituting a type of activity with equivalent duration of others.ResultsDuring a median follow-up of 8.0 years, 779 cases of POP were recorded. The duration of light-intensity PA (LPA) was positively whereas sedentary time was negatively associated with the risk of POP. Every additional 1 h/day of LPA elevated the risk of POP by 18% (95% confidence interval [CI], 10%–26%). In contrast, the risk decreased by 5% (95% CI, 0–8%) per 1 h/day increment in sedentary behavior. No associations were found between moderate-intensity PA (MPA) or vigorous-intensity PA (VPA) and POP, except that women who had a history of hysterectomy were more likely to develop POP when performing more VPA (53% higher risk for every additional 15 min/day). Substituting 1 h/day of LPA with equivalent sedentary time was associated with a 18% (95% CI, 11%–24%) lower risk of POP. The risk can also be reduced by 17% (95% CI, 7%–25%) through substituting 30 min/day of LPA with MPA.ConclusionsMore time spent in LPA or less sedentary time was linked to an elevated risk of POP in middle-aged and elderly women, while MPA or VPA was not. Substituting LPA with equivalent duration of sedentary behavior or MPA may lower the risk of POP.