Activity In Later Life Research Articles

Mediating effects of cognitive reserve on the relationship between frailty and cognition in older people without dementia.

This study aimed to explore the potential mediating effects of cognitive reserve on the association between frailty and cognition in the older people without dementia. We performed a cross-sectional analysis of data from 3122 community-dwelling older adults (≥ 65-years-old) without dementia of the Cognitive Function and Ageing Study in Wales. A 31-item frailty index was used to assess frailty. A cognitive lifestyle score was constructed to evaluate cognitive reserve, which includes participants' educational level, occupational attainment, and engagement in social and cognitive activities in later life. Linear regression and mediation modeling were used to investigate the relationship between frailty and cognition and the mediating effects of cognitive reserve as well as social and cognitive activities, an alterable component of cognitive reserve for older adults. Frailty was negatively associated with cognition. Cognitive reserve was a mediator of the association between frailty and global cognition (- 1.92; 95% CI: - 2.50, - 1.35), as well as individual cognitive domains, with indirect effects contributing to 13-59% of the total effects. Social and cognitive activities have smaller but similar mediating effects on these associations. Negative effect of frailty on cognition was partially mediated by a reduction in cognitive reserve. Our results support the possibility that enhancing cognitive reserve, especially engagement in social and cognitive activities may protect cognitive health against frailty.

The Role of Generativity in Later Life in the Case of Productive Activities: Does the Type of Active Aging Activity Matter?

Active aging has been associated with both personal and social benefits. However, active aging encompasses a broad range of activities, including self-oriented and community-oriented ones. The aim of this study was to explore to what extent generativity is a key factor in differentiating between both types of activity, and to contribute to the theoretical and methodological literature on generativity as a multidimensional concept relevant to later life participation in certain activities related to an active style of living. A sample of 549 older adults who engaged in two types of self-oriented activity (leisure activities and students of University of the Third Age programs) and two types of community-oriented activity (formal volunteering and political activism) participated in this study. Following a mixed-method strategy, we administered several qualitative and quantitative measures of generativity, including generative concern, generative goals, and perceived cultural demand. Our results showed that participants who engaged in self-oriented and community-oriented activities differed on all dimensions of generativity. Differences in generativity were particularly high regarding cultural demand and future generative goals, which were far more frequently mentioned by political activists and volunteers than by university of the third age students and those pursuing leisure activities. Overall, our findings suggest that generativity plays a role in older adults' participation in some (but not all) active aging activities in later life, and that our understanding of generativity in later life gains from a multidimensional assessment of the concept.

Prosocial activity in later life: are informal help and care associated with volunteering and charity?

Abstract Older adults' engagement in various prosocial activities is a salient question in present-day societies that aim to promote active ageing. However, there are only a few studies focusing on associations between several types of prosocial activities, and they have rarely considered help to relatives and friends separately. Moreover, there is lack of studies considering informal monetary help and charity donations when analysing multiple prosocial activities. Using population-based data of older Finns (N = 2,184), we examined whether providing informal help (i.e. practical help, financial support or personal care) to relatives and friends is associated with participation in volunteering and charity, respectively. Overall, 5 per cent of the participants provided all examined forms of informal help and volunteered, 16 per cent provided two types of help and volunteered, and 23 per cent provided one type of help and volunteered. In addition, 9 per cent of the participants provided all types of informal help and made charitable donations, 33 per cent provided two types of help and made charitable donations, and 54 per cent provided one type of help and made charitable donations. Practical help and care channelled outside the household were associated with an increased probability of volunteering, although they were not associated with the probability of making charitable donations. Practical help, financial support and personal care provided to friends were particularly important predictors of volunteering and charity. These results are discussed in the context of the role overload and role extension hypotheses.

P08-14 The association of childhood commuting modes and physical activity in adult age

BackgroundPhysically active lifestyle prevents and contributes to managing non-communicable diseases. Childhood physical activities have shown to associate with physically active lifestyle in adulthood. More research on which childhood physical activity modes associate with physical activity in later life is still needed. Within the present study, we examined how physically active commuting to school in childhood contributed to overall physical activity in adulhood.MethodsThe participants (N = 3596) were from the population-based, longitudinal Cardiovascular Risks in Young Finns Study. Questionnaires were used in assessing subjects' childhood (1980) and adulthood (2001-2018) physical activity. ActiGraph accelerometers were also applied in the adulthood measurements (2018-2020). The results were analyzed using logistic and linear regression models. Participants' age, sex, parents' educational background, parents' income level, childhood living area, participants' educational background, adulthood income level, and adulthood living area were adjusted for in the models.ResultsBased on the preliminary examinations, childhood commuting was not associated with self-reported commuting to work (2001-2018) or accelerometer-measured overall physical activity (2018-2020) in adulthood (p>.05). Active commuting in childhood associated with increased self-reported leisure-time physical activity in the year 2001 (b=.38, p>.001), 2007 (b=.35, p>.001), and 2018 (b=.28, p=.012), but the association between childhood commuting and self-reported physical activity in the years 2001 and 2018 attenuated after adjusting for all covariates (p>.05).ConclusionsPhysically active commuting in childhood (1980) was associated with higher levels of self-reported leisure-time physical activity in adulthood (2001-2018). The associations attenuated after adjusting for covariates excluding the one between active commuting and leisure-time physical activity assessed in 2007. Physically active commuting can be regarded as recommendable with respect to the development of physically active lifestyle, if supportive evidence for the causality between childhood commuting and leisure-time physical activity in adult age can be found. Future research should also focus on assessing whether active commuting in childhood contributes to adulthood activities parallel to active commuting in childhood.

Bridging the Digital Divide: Childhood Social Relationships and Mobile Payment Use Among Chinese Middle-Aged and Older Adults.

This research accordingly examines the effect of childhood social relationships on the use of mobile payment and e-money among Chinese middle-aged and older adults from a life course perspective and tests the mediation role of social activities in such a path with the Karlson-Holm-Breen (KHB) method. The findings support that good childhood community relationships, peer relationships, and close relationships positively affect mobile payment and electronic money use when people enter middle and old age. These effects are significantly mediated by social activities in later life. The findings make marginal contributions to life course theory (LCT), with practical implications for individuals, commercial enterprises, governments, and societies in their efforts to facilitate a society that promotes the digital inclusion of middle-aged and older adults.

Reasons people refrain from sex in later life

There has been an increase in research on sexual activity in later life, yet far less is known about the actual perceptions and experiences of older adults who refrain from sexual activity. In the current study, a thematic analysis was conducted to identify patterns in semi-structured interviews with 47 older adults, aged 60-91. The analysis yielded seven themes that describe why older adults refrain from sex: 1) avoiding confronting sexual dysfunctions, 2) avoiding confronting the aging body, 3) avoiding performance anxiety, 4) being uninterested in sexual activity, 5) taking time to grieve the loss of a partner, 6) avoiding judgment, and 7) seeing sexuality as evolving and changing. Themes were organized according to the bio-psycho-social perspective and based on the axis of personal (self-focused) and interpersonal (partner-focused) motives. It is perfectly acceptable for people to refrain from sexual activity for their own reasons. However, if older adults want to remain sexually active, they should receive complete information about the many possibilities of treating different sexual problems in later life and about the many ways, beyond sexual penetration, one can enjoy sexual activity even in old age.

Factors affecting sexuality of elderly people and sexual dysfunctions

Introduction: Sexuality of elderly people is often an omitted topic. There isn’t a compact definition of sexuality of seniors. The available data shows that there are many factors influencing sexual activity in later life. There are also specific changes which contribute sexual dysfunctions. Purpose: The aim of present is to investigate what factors are related with decreased sexual activity of seniors, biological basis of sexual dysfunctions and how many elderly people it affects. Materials and methods: There were analyzed publications from 2007 to 2022 from PubMed and Google Scholar using phrases: older adults, elderly people, sexuality of elderly people, factors influencing sexuality, sexual dysfunctions. The state of knowledge: Almost half of people above 60 years old are sexually active. There are factors like low availability of partner, stereotypes, chronic diseases and treatments that contribute worse quality of sexual life. There are reports that communication between doctor and patient on the topic of sexuality is not sufficient, even more positive attitudes towards sexuality of seniors. Biological changes like lower hormone levels in women as well as in men contribute sexual dysfunctions. There are almost one in five women above 57 years old who feel pain during intercourse and there are about 43% of men above 65 with erectile problems. The awareness of sexual dysfunctions could make it easier to treat them. Conclusions: It is essential to pay attention to psychological, social, cultural and attitudes of health professionals towards sexuality of elderly people to diagnose sexual dysfunctions. Understanding biological basis of sexual dysfunction can facilitate matching appropriate treatment. Education can improve seniors’s quality of life and sexual functions.

Predictors of Sexual Function and Performance in Young- and Middle-Old Women.

Background: Maintaining sexual life in older women might be perceived as a measure of healthy and successful aging. This study aimed to establish the prevalence of female sexual dysfunction (FSD) based on the DSM-5 criteria and predictors of sexual performance in older women. Methods: A total of 185 women between 55 and 79 years old were included in the study. Validated scales were used to assess sexual function (Changes in Sexual Function Questionnaire (CSFQ)), the propensity for sexual excitation/inhibition (Sexual Excitation/Sexual Inhibition Inventory for Women), and sexual anxiety/avoidance (Body Exposure during Sexual Activity Questionnaire (BESAQ)). Multiple regression was used to assess the factors affecting sexual function and the prevalence of FDS. Results: Sexual distress was diagnosed in 14.1% of women, and FSD in 16.2% (n = 53), whereas sexual problems (CSFQ) were diagnosed in 33.3% of women, and distressing sexual concerns in 35.1%. Women with a lower number of male sexual partners (β = −0.22), a better attitude toward sex (β = 0.25), higher importance of sex (β = 0.31), a higher level of sexual excitation (β = 0.34), and that were sexually active (β = 0.39) had better sexual function, as evaluated by CSFQ. Conclusions: Most older women remain sexually active. The diversity of sexual activity in later life should be affirmed to encourage women to be sexually active and to strengthen the response to sexual stimuli.

Likeability and perceived effectiveness of messages designed to encourage physical activity participation among older adults.

Older adults are significantly less likely than their younger counterparts to engage in physical activity. Comprehensive policies to support healthy ageing thus need to include components encouraging greater participation in physical activity in later life. This study tested potential messages for use in health communication campaigns aimed at increasing physical activity among older adults. Twelve written messages designed to encourage older adults to increase their levels of physical activity were rated by Australians aged 60-92years (n=369; 54% female) on the variables of likeability and perceived effectiveness. Ratings for all the tested messages were high across both outcome variables. The message Move more, live longer scored most favourably, with large majorities of participants liking this message (87%) and considering it effective (81%). Messages featuring rhyming or alliteration were rated significantly higher on both outcomes than messages without these attributes (all Ps<.001). Results provide insights into the types of messages that are likely to be accepted by older adults. Statements that use the phonological patterns of rhyming or alliteration are likely to be especially well received. SO WHAT?: Increasing participation in physical activity among older adults is critical to promoting the sustainability of health care systems and enhancing quality of life. The specific messaging attributes identified in the present study as being effective could be used by public health practitioners to inform their approach to physical activity messaging to older adults and incorporated into future health communication campaigns to increase their potential effectiveness with this target group.

Cognitive reserve over life course and 7-year trajectories of cognitive decline: results from China health and retirement longitudinal study

BackgroundCognitive reserve (CR) could partly explain the individual heterogeneity in cognitive decline. No study measured CR from a life course perspective and investigated the association between CR and trajectories of cognitive decline in older Chinese adults.MethodsData of 6795 Chinese adults aged 60+ from China Health and Retirement Longitudinal Study were used. Global cognition score (0–32) was assessed in all four waves. A life-course CR score was constructed using markers of childhood circumstance, education, highest occupational class, and leisure activities in later life. Latent growth curve modelling (LGCM) was applied to assess the association between CR and trajectories of cognitive decline.ResultsFor the life-course CR, factor loadings of markers in adulthood and later life were larger than that of markers in childhood. The life-course CR score (ranged between − 2.727 and 6.537, SD: 1.74) was higher in urban Chinese adults (0.75, SD: 1.90) than in rural Chinese adults (− 0.50, SD: 1.43). The unconditional LGCM results showed that urban older Chinese adults had better global cognition at baseline (intercept: 15.010, 95% CI: 14.783, 15.237) and a slower rate of cognitive decline per year (linear slope: -0.394, 95% CI: − 0.508, − 0.281) than their rural counterparts (intercept: 12.144, 95% CI: 11.960, 12.329; linear slope: -0.498, 95% CI: − 0.588, − 0.408). After controlling for all covariates, one-unit higher CR score was associated with 1.615 (95% CI: 1.521, 1.709) and 1.768 (95% CI: 1.659, 1.876) unit higher global cognition at baseline for urban and rural older Chinese adults, respectively. The slower rate of cognitive decline associated with higher CR was more evident in rural residents (slope: 0.083, 95% CI: 0.057, 0.108) than in their urban counterparts (0.054, 95% CI: 0.031, 0.077).ConclusionsCR was associated with better baseline cognition and slower cognitive decline in Chinese older adults. Although rural residents were disadvantaged in both CR and cognition, the protective effect of CR against cognitive decline was stronger for them than in those who live in urban area.

Editors' Note: Cognitive Activity and Onset Age of Incident Alzheimer Disease Dementia

In their prospective observational cohort study, Dr. Wilson et al. explored the relationship between cognitive activity and incident dementia among consecutive elderly patients from the Rush Memory and Aging Project. The investigators hypothesized that self-reported higher levels of cognitive activity such as reading would be associated with older age of dementia onset in patients with clinical Alzheimer disease (AD). Of the 1903 included patients, 457 (24%) developed possible or probable AD over a mean of 6.8 years (±4.6) of follow-up. In the primary analysis, higher cognitive activity was independently associated with later dementia onset in the accelerated failure time model (estimate 0.026, 95% CI 0.013–0.039). This relationship persisted in multiple other exploratory models, including a model that accounted for sex and educational level, a model which adjusted for early-life cognitive activity (which bore no independent association with dementia), and a model excluding patients with possible AD from outcome events. When the top 10th percentile of patients with high cognitive activity were compared with the bottom 10th percentile, patients in the top 10th percentile developed dementia at a mean of 5 years later (93.6 vs 88.6 years). Dr. Krauss suggests that the hypothesized direction of the association (more cognitive activity → delay in dementia diagnosis) may possibly be reversed and that the low level of cognitive activity in late life may be an early sign of dementia. In an attempt to disprove this alternative hypothesis, the investigators analyzed the relationship between cognitive activity with markers of AD at enrollment and found no association. The authors agree with Dr. Krauss that their study cannot fully disprove the reverse causality hypothesis; however, these data complement previous research that continues to build the argument for an important relationship between cognitive activity and the subsequent symptoms of dementia. In their prospective observational cohort study, Dr. Wilson et al. explored the relationship between cognitive activity and incident dementia among consecutive elderly patients from the Rush Memory and Aging Project. The investigators hypothesized that self-reported higher levels of cognitive activity such as reading would be associated with older age of dementia onset in patients with clinical Alzheimer disease (AD). Of the 1903 included patients, 457 (24%) developed possible or probable AD over a mean of 6.8 years (±4.6) of follow-up. In the primary analysis, higher cognitive activity was independently associated with later dementia onset in the accelerated failure time model (estimate 0.026, 95% CI 0.013–0.039). This relationship persisted in multiple other exploratory models, including a model that accounted for sex and educational level, a model which adjusted for early-life cognitive activity (which bore no independent association with dementia), and a model excluding patients with possible AD from outcome events. When the top 10th percentile of patients with high cognitive activity were compared with the bottom 10th percentile, patients in the top 10th percentile developed dementia at a mean of 5 years later (93.6 vs 88.6 years). Dr. Krauss suggests that the hypothesized direction of the association (more cognitive activity → delay in dementia diagnosis) may possibly be reversed and that the low level of cognitive activity in late life may be an early sign of dementia. In an attempt to disprove this alternative hypothesis, the investigators analyzed the relationship between cognitive activity with markers of AD at enrollment and found no association. The authors agree with Dr. Krauss that their study cannot fully disprove the reverse causality hypothesis; however, these data complement previous research that continues to build the argument for an important relationship between cognitive activity and the subsequent symptoms of dementia.

Visual Difficulty, Race and Ethnicity, and Activity Limitation Trajectories Among Older Adults in the United States: Findings From the National Health and Aging Trends Study.

To characterize the influence of visual difficulty on activity limitation trajectories in older U.S. adults and investigate whether this varied across racial/ethnic groups. We used data from 8,077 participants in the nationally representative National Health and Aging Trends Study from 2011 to 2019. Using mixed-effects regression models, we investigated the association of self-reported visual difficulty and race/ethnicity with activity limitation trajectories. Higher levels of visual difficulty and belonging to a minority racial/ethnic group were associated with greater mobility, self-care, and household activity limitations. Visual difficulty was associated with mobility and self-care activity limitation trajectories, and race/ethnicity was significantly associated with mobility and household activity limitation trajectories. Among those with the highest levels of visual difficulty, non-Hispanic Black participants experienced a faster rate of decline in self-care activities compared to non-Hispanic White participants. Promoting optimal aging for all requires an understanding of the factors that influence disparities in key outcomes. Our study provides evidence from a diverse national sample that visual difficulty appears to disproportionately affect activity limitation trajectories among older adults from minority racial/ethnic groups and particularly among non-Hispanic "Black individuals." Further research is needed to determine whether interventions to promote healthy vision may positively affect overall activity and independence and ameliorate disparities in late-life activity limitation trajectories.

Physical activity moderates the association between executive function and functional connectivity in older adults.

Recent evidence suggests that physical activity may influence the functional connectivity of the aging brain. The purpose of this study was to examine the influence of physical activity on the association between executive function and functional connectivity of key brain networks and graph theory metrics in community-dwelling older adults. Participants were 47 older adults (M = 73 years; SD = 5.92) who participated in neuropsychological testing, physical activity measurements, and magnetic resonance imaging (MRI). Seed-to-voxel moderation analyses and graph theory analyses were conducted. Physical activity was significantly positively associated with default mode network functional connectivity (DMN FC; Posterior Cingulate Gyrus, p-FDR = 0.005; Frontal Pole (L), p-FDR = 0.005; Posterior Cingulate Gyrus, p-FDR = 0.006; Superior Frontal Gyrus (L), p-FDR = 0.016) and dorsal attention network functional connectivity (DAN FC; Inferior Frontal Gyrus Pars Opercularis (R), p-FDR = 0.044). The interaction between physical activity and executive function on the DMN FC and DAN FC was analyzed. The interaction between executive function and physical activity was significantly associated with DMN FC. When this significant interaction was probed, the association between physical activity and DMN FC differed between levels of high and low executive function such that the association was only significant at levels of high executive function. These results suggest that greater physical activity in later life is associated with greater DMN and DAN FC and provides evidence for the importance of physical activity in cognitively healthy older adults.

Different Strokes for Different Folks? Examining a New Measure for Age-Relative Sexual Attitudes

Recent research suggests increasingly permissive attitudes towards sexual activity in later life. Harboring more conservative beliefs especially as one reaches older age, however, may translate into how one views and navigates sexual health changes. A sample of participants (N = 706; Mage = 52.72 years, SD = 9.57, range = 36-79; 60.8% male) was recruited through Amazon’s Mechanical Turk to complete a survey on sexual beliefs about age and aging. Participants completed two versions of the Relative Sexual Attitudes Scale (RASA), wherein they were prompted to consider either “someone their own age” or “an older person” in response to items assessing sexual attitudes. Multi-group confirmatory factor analysis was used to confirm the original five-factor structure, reduce the total items from 31 to 25, and establish measurement equivalence for the 36-54 year-old and 55+ year-old samples. Through a series of profile analyses investigating each subscale, scores did not significantly differ between the two prompts, although significant age-group differences were found with the 36-54 year-old age group reporting more open attitudes than the 55+ year-old age group across all subscales, except the traditional mores subscale. Sexual attitude subscale scores also differed by gender, engagement in partnered sexual activity, and whether one had spoken to a health professional about their sexual health in the past year. The findings support use of the RASA for adults 36 and older and highlight applications to understanding differences in sexual health into later life.

Different Strokes for Different Folks? Examining a New Measure for Age-Relative Sexual Attitudes

Fear of developing dementia is common and has been linked to delays in seeking medical attention (Arlt et al., 2008). We used data from 320 adults (M age = 39.7, SD = 12.3, range 20 – 70) to examine the ways in which objective knowledge and subjective experience with dementia influence positive attitudes toward persons with dementia. We further examined how these constructs related to fear of developing dementia. A path analysis showed the model fit the data well, X2 (DF = 1) = 0.74, p = .39; RMSEA < .001. Objective knowledge and subjective experience were significantly associated with higher allophilia. Allophilia and subjective experiences were associated with personal fear. However, allophilia decreased fear, whereas subjective experiences were associated with increased fear of developing dementia. To clarify these findings, we conducted a moderated regression in which age was examined as a moderator of the relation between allophilia and fear as well as the relation between subjective experience and fear. Significant results were obtained [F (5, 294) = 10.41, p < .001; R2 = .15]. Age moderated the effect of personal experience on fear. Stronger effects emerged for adults in their 20s compared to those in their 40s; similarly, age exerted a stronger effect for those in their 40s than for those in their 50s. Regarding age effects on the relation between allophilia and fear of dementia, for adults in their 20s and 40s, allophilia reduced fear of dementia. For adults in their 50s, allophilia was associated with higher fear.

Neighborhood environment and cognition in older adults: Exploring the mediating effect of physical activity

AbstractBackgroundEmerging evidence suggests neighborhood environment may shape both health behaviors and outcomes. Neighborhood environment could be particularly influential for community‐dwelling older adults who prefer to age in place. Recent studies report that neighborhood social and built environment characteristics significantly influence older adults’ cognition. However, the underlying mechanisms by which neighborhood environment affects cognition are not well understood. Regular physical activity in late life is associated with a lower risk for cognitive decline and may be affected by neighborhood amenities and resources. This study examined how the neighborhood social and built environment affects cognition in older adulthood and explored whether physical activity levels mediated these relationships.MethodThe cross‐sectional analyses included older adults from Wave 2 of the National Social Life, Health, and Aging Project (N = 3,196; mean age = 73.17, SD = 7.34; 52.6% female; median education = high school diploma; 77.3% Caucasian). We tested a structural equation model to examine associations among neighborhood social and built environment and cognition as measured by the Montreal Cognitive Assessment. Built environment was operationalized as a latent variable of living density, litter, noise, traffic, pollution, and conditions of respondents’ building and other buildings nearby. The social environment latent variable was constructed with social cohesion, social ties, and perceived neighborhood danger. We tested whether self‐reported frequency of rigorous physical activity mediated these environment‐cognition relationships.ResultThe results indicated (1) greater disadvantages in the neighborhood built environment were associated with worse cognition (est = ‐0.05, p &lt; .001) and with lower levels of physical activity (est = ‐0.03, p = .001); (2) greater advantages in the neighborhood social environment were associated with better cognition (est = 0.03, p &lt; .001) and higher levels of physical activity (est = 0.02, p &lt; .001); however, (3) physical activity levels were not significantly associated with cognition (est = ‐0.02, p = .17).ConclusionThese results highlight the influence of neighborhood environment on both physical activity and cognition in older adulthood. While physical activity was not an underlying mechanism by which environment influences cognition, future studies should test for mediation using objectively‐measured physical activity.

Abstract 11894: Leisure-Time Physical Activity in Late-Life is Associated With Risk of Heart Failure With Preserved and Reduced Ejection Fraction - The Atherosclerosis Risk in Communities Study

Introduction: Leisure-time physical activity (LTPA) is associated with lower heart failure (HF) risk. However, reported associations with incident HF with preserved (HFpEF) and reduced ejection fraction (HFrEF) differ and whether these associations persist into-late life is unclear. Methods: We evaluated 5017 participants in the Atherosclerosis Risk in Communities study who attended visit 5 (2011-2013) and did not have prior HF or significant valvular heart disease. LTPA was assessed by the Baecke questionnaire, summarized in metabolic equivalent (MET)-minutes/week, and related to incident HFpEF (EF ≥ 50%) and HFrEF (EF &lt; 50%) using multivariable Cox regression and restricted cubic splines. All models were adjusted for age, sex, race, center, and smoking status. Results: The mean age was 75.5 ± 5.0 years, 41% were male, 21% Black, and median LTPA was 624 [IQR 0-1270] MET-min/wk. Over a median follow-up of 7.2 years, 435 participants developed HF (208 HFpEF, 166 HFrEF, 61 unknown EF). Compared to those with low LTPA levels (1 st tertile; &lt;139 MET-min/wk), higher levels of LTPA (3 rd tertile; &gt;1053 MET-min/wk) were significantly associated with lower HF risk (HR 0.48 [95% CI 0.37-0.62]) after adjusting for age, sex, race, center, and smoking status. The 2 nd and 3 rd tertile remained associated with lower HFpEF risk (2 nd tertile: HR 0.69 [0.50-0.96]; 3 rd tertile: 0.43 [0.29-0.62]), and lower HFrEF risk (2 nd tertlle: HR 0.55 [0.37-0.81]; 3 rd tertile: 0.57 [0.39-0.85]) in the adjusted model. Restricted cubic splines demonstrated a graded response between higher levels of LTPA and incident HFpEF and HFrEF (Figure). With further adjustment for HF risk factors that may be considered mediators, the association of higher LTPA with lower risk of HFpEF was preserved while the association with HFrEF risk was attenuated. Conclusions: In older adults, higher levels of LTPA are associated with a lower risk of both incident HFpEF and HFrEF.

Wilderness as therapeutic landscape in later life: Towards an understanding of place-based mechanisms for wellbeing through nature-adventure activity

While there is considerable evidence that therapeutic landscapes have a positive impact on wellbeing, we know little about the mechanisms through which this impact occurs. In this paper we go some way toward addressing this gap. Drawing on in-depth interviews with 12 people aged between 52 and 75 years of age, who are engaged in nature-adventure activity in the UK, we focus on what they understand by ‘wilderness’; their experiences of nature-adventure in wilderness settings; and the impact of these experiences on their wellbeing. Moving beyond the largely behavioural focus of laboratory-based studies prevalent within environmental psychology, we highlight the importance of understanding the role of the contextual in the therapeutic relationship. That is, how relational, embodied, social, lifecourse and/or cultural factors that are constitutive of wilderness environments impact wellbeing for those engaged in nature-adventure activity in later life. In doing so, we map out a working model of the mechanisms that impact wellbeing within this context. Our data suggest that there is no one single mechanism, rather we need to think about a range of mechanisms, often operating across a series of spectra (active/passive; safety/risk; alone/socially etc) and importantly, each are connected to place. Hence, we suggest, that where that activity takes place is instrumental for wellbeing.

Television Viewing, Physical Activity, and Loneliness in Late Life.

Television viewing is the most common leisure activity in late life and may ease loneliness but encourage sedentary behavior. These associations may be particularly evident among older adults who live alone and who may lack other forms of companionship throughout the day. Adults aged 65+ (N = 257) participated, of whom 34% lived alone. Participants completed an initial interview followed by a 5- to 6-day data collection involving multimethods: (a) Electronically Activated Recorders (30 s every 7 min) provided audio recordings of television viewing, (b) Actical accelerometers objectively measured physical activity, and (c) ecological momentary assessments every 3 hr assessed social interactions. On average, older adults spent approximately 37% of their waking time (6.4 hr a day) watching television. Multilevel models revealed that television viewing occurred when participants were alone or with a spouse and was associated with a greater proportion of time sedentary, lower activity, and higher ratings of loneliness compared to when not watching television. Older adults who lived alone reported greater loneliness during 3-hr intervals when viewing television, but older adults who lived with others spent a greater proportion of time sedentary when viewing television. Findings are discussed with regard to different rationales and ways of watching television-as compensation for social isolation or as a passive leisure activity with a social partner. We discuss ideas for research on additional aspects of television viewing and screen time in late life.

Everyday learning in later life through engagement in physical activity

ABSTRACT Despite older adults’ developmental process along with its inextricable connection to health and physical activity issues and a unique learning desire in later life, limited evidence exists regarding the nature of learning that occurs when older adults engage in their practice of exercise. As engagement in personally satisfying physical activity becomes more meaningful in older adulthood as a means for healthy aging, understanding their practice of exercise and learning particular exercise-related skills is imperative. Thus, we examined older adults’ perceptions of aging and everyday learning experiences in the context of physical activity. Using grounded theory, specifically following the paradigm model, we identified the core category of ‘nature of learning in physical activity in later life’ and older adult exercisers’ learning process including assimilative, accommodative, and social aspects of learning. The findings suggested that physical literacy in older adulthood, self-directed learning about physical activity, reflective practice, and nostalgic learning should be taken into consideration when developing quality exercise programs and conducting future research.