Activity Patterns Of Older Adults Research Articles

Using multivariate partial least squares on fNIRS data to examine load-dependent brain-behaviour relationships in aging.

Researchers implementing non-invasive neuroimaging have reported distinct load-dependent brain activity patterns in older adults compared with younger adults. Although findings are mixed, these age-related patterns are often associated with compensatory mechanisms of cognitive decline even in the absence of direct comparisons between brain activity and cognitive performance. This study investigated the effects of cognitive load on brain-behavior relationships in younger and older adults using a data-driven, multivariate partial least squares (PLS) analysis of functional near-infrared spectroscopy (fNIRS) data. We measured bilateral prefrontal brain activity in 31 older and 27 younger adults while they performed single and dual 2-back tasks. Behavioral PLS analysis was used to determine relationships between performance metrics (reaction time and error rate) and brain oxygenation (HbO) and deoxygenation (HbR) patterns across groups and task loads. Results revealed significant age-group differences in brain-behavior relationships. In younger adults, increased brain activity (i.e., increased HbO and decreased HbR) was associated with faster reaction times and better accuracy in the single task, indicating sufficient neural capacity. Conversely, older adults showed a negative correlation between HbR and error rates in the single task; however, in the dual task, they demonstrated a positive relationship between HbO and performance, indicative of compensatory mechanisms under the higher cognitive load. Overall, older adults' showed relationships with either HbR or HbO, but not both, indicating that the robustness of the relationship between brain activity and behavior varies across task load conditions. Our PLS approach revealed distinct load-dependent brain activity between age groups, providing further insight into neurocognitive aging patterns, such as compensatory mechanisms, by emphasizing the variability and complexity of brain-behavior relationships. Our findings also highlight the importance of considering task complexity and cognitive demands in interpreting age-related brain activity patterns.

Daily activity patterns in older adults receiving initial support: the association between daily steps and sitting in bouts of at least 60 min

BackgroundAging has a significant impact on health, underlining the importance of maintaining physical function and reducing time spent sitting among older adults. To understand how to reduce prolonged sitting or increase physical activity, factors related to the daily living and observed daily activity patterns should be explored. This study aimed to investigate the association between daily steps, self-rated health, physical activity, sedentary behavior, motivation to exercise and fear of falling among older adults receiving initial support.MethodCross-sectional design with total population questionnaire data from adults aged ≥ 60 years (n = 917), living at home with initial support from municipal care in southern Sweden. The older adults were offered to participate in a follow-up study measuring daily activity patterns with accelerometers (n = 72). Linear regression was used to analyze associations between daily steps and possible predictors.ResultsThe linear model (\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ {R}^{2}= $$\\end{document}0.478) showed that sitting in unbroken bouts of > 60 min (β = -0.313, p < 0.05), walking independently outdoors (β = 0.301, p < 0.05), intending to increase physical activity (β = -0.294, p < 0.05), sex (β = 0.279, p < 0.05), relative autonomy index (β = 0.258, p < 0.05), fear of falling (β = -0.238, p < 0.05), and self-rated health (β = 0.213, p < 0.05) predicted daily steps.ConclusionThe model of predictors brings new understanding regarding daily steps among community-dwelling older adults. The association between sitting in bouts of > 60 min and daily steps is interesting as 35% of participants had a number of sitting bouts that on average, showed 30% less steps taken. Minimizing long sitting bouts and maintaining physical functioning to promote independence when walking outdoors can be tools for clinical practitioners devising interventions to break prolonged sitting among community-dwelling older adults. Future research should prioritize studying older adults’ outdoor walking independence, including its relation to walking with or without assistive devices and its impact on physical activity and sedentary behavior.

Distinct age-related brain activity patterns in the prefrontal cortex when increasing cognitive load: A functional near-infrared spectroscopy study

Researchers have long observed distinct brain activity patterns in older adults compared with younger adults that correlate with cognitive performance. Mainly, older adults tend to show over-recruitment of bilateral brain regions during lower task loads and improved performance interpreted as compensation, but not observed at higher loads. However, there are discrepancies about whether increases in activity are compensatory and whether older adults can show compensation at higher loads. Our aim was to examine age-related differences in prefrontal cortex (PFC) activity and cognitive performance using functional near-infrared spectroscopy (fNIRS) during single and dual N-back tasks. Twenty-seven young adults (18–27 years) and 31 older adults (64–84 yrs) took part in the study. We used a robust fNIRS data methodology consisting of channel and region of interest analyses. Results showed differences in performance between task load conditions and age-related differences in reaction times but no age-group effects for accuracy. Older adults exhibited more bilateral PFC activation compared with young adults across all tasks and showed increases in brain activity in high compared to low load conditions. Our findings further support previous reports showing that older adults use compensatory recruitment of additional brain regions in PFC to maintain cognitive performance but go against the notion that such compensation is not present at higher cognitive loads. Additionally, our results indicate that fNIRS is a sensitive tool that can characterize adaptive cortical changes in healthy aging.

Gender difference in the effects of chronic diseases on daily physical activity patterns in older adults: analysis of objectively measured physical activity in NHATS 2021

PurposeMany chronic diseases have detrimental impact on the physical activity (PA) patterns of older adults. Often such diseases have different degrees of severity in males and females. Quantifying this gender difference would not only enhance our understanding of diseases but would also help design individual-specific PA interventions, thereby improving health outcomes for both genders. MethodsPA data for 747 participants from round 11 (2021) of the National Health and Aging Trends Study were analyzed. Multilevel functional regression models were used to study gender difference in the effects of chronic diseases on daily PA patterns while adjusting for confounders. ResultsFemales with dementia (or Alzheimer’s disease), hypertension, heart and lung disease had lower PA at different times of day compared to females without these diseases, whereas males with and without these diseases had comparable daily PA. Males with diabetes had higher midnight PA and lower noon PA compared to males without diabetes, while females’ PA with and without diabetes were similar. ConclusionsOur analysis demonstrates that although for most diseases, the daily PA patterns of individuals with the disease are negatively altered compared to healthy individuals, the extent of decline varies by gender and time of day. Designing personalized physical activity interventions considering gender and diurnal PA pattern can potentially improve quality of life across both genders.

The Relationship Between Pain Intensity and Pain-Related Activity Patterns in Older Adults with Chronic Musculoskeletal Pain: Mediating Roles of Pain Resilience and Pain Catastrophizing.

To explore the relationship between pain intensity, pain resilience, pain catastrophizing, and pain-related activity patterns in older adults with chronic musculoskeletal pain (CMP). A total of 220 elderly Chinese with chronic musculoskeletal pain were recruited from a tertiary general hospital. Participants completed several measures including a demographic questionnaire, Brief Pain Inventory (BPI), Pain Resilience Scale (PRS), Pain Catastrophizing Scale (PCS), and Patterns of Activity Measure-Pain (POAM-P). Moreover, Process version 3.5 plug-in SPSS26 was used to test the mediation effect between variables. The scores of POAM-P in older adults with CMP from high to low were: avoidance (27.39 ± 8.10), pacing (24.25 ± 9.48), and overdoing (16.65 ± 10.95). Mediation analysis revealed that pain resilience and pain catastrophizing mediated the relationship between pain intensity and pain-related activity patterns (avoidance and pacing) in older adults with CMP. These results provide evidence for the role of pain resilience and pain catastrophizing in the relationship between pain intensity and pain-related activity patterns. Interventions targeting these factors should be included in activity management programs for elderly CMP patients. It may be possible to reduce the negative impact of pain intensity on activity patterns by improving pain resilience and reducing pain catastrophizing.

Role of Environment on Physical Activity Patterns of Older Adults Living With HIV in New York City.

The purpose of this study was to survey the physical activity (PA) patterns of older adults with HIV and investigate the relationship between environmental factors and PA in this population. This study was a secondary data analysis from 100 adults, ages 50 years and older, living with HIV in New York City. Descriptive statistics assessed PA patterns. Linear regression assessed the association between environmental factors and time spent in PA. All participants had been living with HIV for 21 years on average, were on antiretroviral therapy, ranged in age from 50 to 71 years, and were 50% female. Participants performed at 75% of their functional capacity ( p < .0001), and females walked less than males ( p < .05). Traffic hazards were the sole environmental predictor of PA participation. Targeted interventions are needed to increase PA in this growing population. Interventions at the policy level should reduce traffic hazards to support PA.

Heterogeneity in physical activity participation of older adults: A latent class analysis

Participation in leisure and transport-related physical activities is generally viewed as the main means of increasing overall physical activity levels of older adults. The success of any intervention strategy depends on how well the strategy fits older people's physical activity patterns. This study therefore examines heterogeneity in physical activity patterns of older adults and the relationships between these patterns and socio-demographic and neighborhood environmental characteristics. This is done using a latent class multinomial logit model based on one-week diary data collected on 363 Dalian Chinese older adults aged 60 and over in 2017. The results show that two segments of physical activity patterns of older adults can be identified: leisure physical activities oriented and both transport-related and leisure physical activities oriented. Age, physical limitation and having grandchildren in the household have an important influence on physical activity patterns of older people. However, there are no significant relationships between physical activity patterns and various environmental characteristics, except accessibility of local shops, condition of footpaths and safety from crime. The empirical findings have implications for the development of tailored interventions to maintain or promote physical activity of older adults.

Lifestyle changes and outcomes of older adults with mild cognitive impairment: A 4-year longitudinal study

Longitudinal studies have shown that mild cognitive impairment (MCI) reverts to normal cognition (NC). However, we could not find any reports on the examination of changes in lifestyle activity patterns in older adults diagnosed with MCI and their outcomes, in a longitudinal study. We determined the changes in lifestyle activity patterns among older adults with MCI. The participants in this study were 769 community-dwelling older adults aged ≥65 years with MCI at baseline. Four years later, participants were categorized into reverters, maintainers, and converters who reverted from MCI to NC, maintained MCI, and had global cognitive impairment or Alzheimer disease, respectively. We used latent class analysis to classify changes in instrumental activities of daily living, and in cognitive, social, and productive activities of the participants. Subsequently, a multinomial logistic regression analysis was performed with reversion status and class membership as the dependent and independent variables, respectively. The reversion rate of 769 participants was 33.3%. The reverters maintained multidomain lifestyle activities, converters discontinued multidomain lifestyle activities or were inactive, and maintainers maintained productive activities. According to the logistic regression analysis, the activity patterns of those who continued to engage in multidomain lifestyle activities and start activities, were more likely to help in reverting from MCI to NC (P < 0.05). Community-dwelling older adults with MCI who continued their multidomain lifestyle activities were more likely to revert to NC. Even if it does not revert to NC, continuing productive activities is important to maintaining MCI without converting.

Examining the When and How of Physical Activity Patterns in Older Adults: The Women’s Health Study

Using data from the Women’s Health Study (N = 17,708, mean age = 72 years), we investigated the relative importance of physical activity volume, intensity, frequency of sessions, and session duration. We calculated the mortality hazard ratio for varying patterns and combinations of physical activity intensities and sedentary behavior. In separate analyses, we compared participants who engaged in activity regularly throughout the week to those who focused on one or two days a week, and the relative importance of session frequency and duration. These characteristics of activity patterns and their impact on health may help design interventions and public policy.

Understanding User Behavior Through the Use of Unsupervised Anomaly Detection: Proof of Concept Using Internet of Things Smart Home Thermostat Data for Improving Public Health Surveillance.

BackgroundOne of the main concerns of public health surveillance is to preserve the physical and mental health of older adults while supporting their independence and privacy. On the other hand, to better assist those individuals with essential health care services in the event of an emergency, their regular activities should be monitored. Internet of Things (IoT) sensors may be employed to track the sequence of activities of individuals via ambient sensors, providing real-time insights on daily activity patterns and easy access to the data through the connected ecosystem. Previous surveys to identify the regular activity patterns of older adults were deficient in the limited number of participants, short period of activity tracking, and high reliance on predefined normal activity.ObjectiveThe objective of this study was to overcome the aforementioned challenges by performing a pilot study to evaluate the utilization of large-scale data from smart home thermostats that collect the motion status of individuals for every 5-minute interval over a long period of time.MethodsFrom a large-scale dataset, we selected a group of 30 households who met the inclusion criteria (having at least 8 sensors, being connected to the system for at least 355 days in 2018, and having up to 4 occupants). The indoor activity patterns were captured through motion sensors. We used the unsupervised, time-based, deep neural-network architecture long short-term memory-variational autoencoder to identify the regular activity pattern for each household on 2 time scales: annual and weekday. The results were validated using 2019 records. The area under the curve as well as loss in 2018 were compatible with the 2019 schedule. Daily abnormal behaviors were identified based on deviation from the regular activity model.ResultsThe utilization of this approach not only enabled us to identify the regular activity pattern for each household but also provided other insights by assessing sleep behavior using the sleep time and wake-up time. We could also compare the average time individuals spent at home for the different days of the week. From our study sample, there was a significant difference in the time individuals spent indoors during the weekend versus on weekdays.ConclusionsThis approach could enhance individual health monitoring as well as public health surveillance. It provides a potentially nonobtrusive tool to assist public health officials and governments in policy development and emergency personnel in the event of an emergency by measuring indoor behavior while preserving privacy and using existing commercially available thermostat equipment.

The oscillatory mechanisms associated with syntactic binding in healthy ageing

Older adults frequently display differential patterns of brain activity compared to young adults in the same task, alongside widespread neuroanatomical changes. Differing functional activity patterns in older adults are commonly interpreted as being compensatory (e.g., Cabeza et al., 2002). We examined the oscillatory activity in the EEG during syntactic binding in young and older adults, as well as the relationship between oscillatory activity and behavioural performance on a syntactic judgement task within the older adults. 19 young and 41 older adults listened to two-word sentences that differentially load onto morpho-syntactic binding: correct syntactic binding (morpho-syntactically correct, e.g., “I dotch”); incorrect syntactic binding (morpho-syntactic agreement violation, e.g., “they dotches”) and no syntactic binding (minimizing morpho-syntactic binding, e.g., “dotches spuff”). Behavioural performance, assessed in a syntactic judgement task, was characterized by inter-individual variability especially in older adults, with accuracy ranging from 76 to 100% in young adults and 58–100% in older adults. Compared to young adults, older adults were slower, but not less accurate. Functional neural signatures for syntactic binding were assessed as the difference in oscillatory power between the correct and no syntactic binding condition. In older adults, syntactic binding was associated with a smaller increase in theta (4–7 Hz), alpha (8–12 Hz) and beta (15–20 Hz) power in a time window surrounding the second word. There was a significant difference between the older and young adults: in the alpha range, the condition difference seemed to be in the opposite direction for older versus young adults. Our findings thus suggest that the neural signature associated with syntactic binding in older adults is different from young adults. However, we found no evidence of a significant association between behavioural performance and the neural signatures of syntactic binding for older adults, which does not readily support the predictions of compensatory models of language and ageing.

Social-ecological correlates of older adults’ outdoor activity patterns

IntroductionAn understanding of outdoor activity patterns of older adults may help in the development of more tailored physical activity programs for enhancing higher physical activity levels and more effective environmental interventions. This study aimed to identify patterns of outdoor activity of older adults, and to examine their relationships with physical activity levels and correlates of these patterns. MethodsBased on data collected among 363 respondents aged 60 or older in Dalian, China, a two-step cluster analysis approach was adopted to identify outdoor activity patterns; one-way analysis of variance and chi-square tests were performed to examine differences in physical activity levels across activity patterns; and a multinomial logistic regression model was estimated to examine the socio-ecological correlates of each activity pattern. ResultsThe study identified five distinct activity patterns, namely: 1) utilitarian activity pattern; 2) low frequency/short duration leisure-time physical activity pattern; 3) sedentary activity pattern; 4) long duration leisure-time physical activity pattern; and 5) high frequency leisure-time physical activity pattern. The type of activity pattern was associated with older adults' physical activity levels. Older adults’ patterns of outdoor activity participation were associated with their age, gender, education level, physical ability and household type. In addition, neighborhood characteristics such as accessibility to local shops, safety from crime, social capital and social cohesion were also significantly associated with outdoor activity patterns. ConclusionsThe findings can help health professionals to develop tailored physical activity programs for older adults with certain socio-demographic characteristics and urban planners to design suitable environmental interventions supporting the habitual activity pattern of specific subgroups of older adults.

Effects of a Long-Term Physical Activity Program on Activity Patterns in Older Adults.

To examine the effect of a long-term structured physical activity (PA) intervention on accelerometer-derived metrics of activity pattern changes in mobility-impaired older adults. Participants were randomized to either a PA or health education (HE) program. The PA intervention included a walking regimen with strength, flexibility, and balance training. The HE program featured health-related discussions and a brief upper body stretching routine. Participants (n = 1341) wore a hip-worn accelerometer for ≥10 h·d for ≥3 d at baseline and again at 6, 12, and 24 months postrandomization. Total PA (TPA)-defined as movements registering 100+ counts per minute-was segmented into the following intensities: low-light PA (LLPA; 100-759 counts per minute), high light PA (HLPA; 760-1040 counts per minute), low moderate PA (LMPA; 1041-2019 counts per minute), and high moderate and greater PA (HMPA; 2020+ counts per minute). Patterns of activity were characterized as bouts (defined as the consecutive minutes within an intensity). Across groups, TPA decreased an average of 74 min·wk annually. The PA intervention attenuated this effect (PA = -68 vs HE: -112 min·wk, P = 0.002). This attenuation shifted TPA composition by increasing time in LLPA (10+ bouts increased 6 min·wk), HLPA (1+, 2+, 5+, and 10+ bouts increased 6, 3, 2, and 1 min·wk, respectively), LMPA (1+, 2+, 5+, and 10+ bouts increased: 19, 17,16, and 8 min·wk, respectively), and HMPA (1+, 2+, 5+, and 10+ bouts increased 23, 21, 17, and 14 min·wk, respectively). The PA intervention increased PA by shifting the composition of activity toward higher-intensity activity in longer-duration bouts. However, a long-term structured PA intervention did not completely eliminate overall declines in total daily activity experienced by mobility-impaired older adults.

Rest-Activity Patterns in Older Adults with Heart Failure and Healthy Older Adults.

The purpose of this investigation is to examine differences in rest-activity patterns and sleep characteristics in older adults with heart failure (HF) and healthy older adults. The sample included older adults with HF (n = 20) and a reference group of healthy older adults (n = 20). Traditional cosinor analysis was used to assess three parameters of rest-activity from wrist actigraphy data: amplitude (range of activity), mesor (mean activity), and acrophase (time of peak activity). Traditional sleep characteristics were also determined from actigraphy data: total sleep time (TST), sleep latency (SL), sleep efficiency (SE), and wake after sleep onset (WASO). The HF group demonstrated significantly lower mesor and amplitude than the reference group (p < .01). The HF group had significantly greater TST (p < .01), but the groups had similar SE, SL, and WASO. Despite similar sleep characteristics to healthy older adults, overall rest-activity patterns were significantly dampened in those with HF.

Locations that Support Social Activity Participation of the Aging Population.

Social activities are an important aspect of health and quality of life of the aging population. They are key elements in the prevention of loneliness. In order to create living environments that stimulate older adults to engage in social activities, more insight is needed in the social activity patterns of the aging population. This study therefore analyzes the heterogeneity in older adults’ preferences for different social activity location types and the relationship between these preferences and personal and mobility characteristics. This is done using a latent class multinomial logit model based on two-day diary data collected in 2014 in Noord-Limburg in the Netherlands among 213 respondents aged 65 or over. The results show that three latent classes can be identified among the respondents who recorded social activities in the diary: a group that mainly socializes at home, a group that mainly socializes at a community center and a group that is more likely to socialize at public ‘third’ places. The respondents who did not record any interactions during the two days, are considered as a separate segment. Relationships between segment membership and personal and mobility characteristics were tested using cross-tabulations with chi-square tests and analyses of variance. The results suggest that both personal and mobility characteristics play an important role in social activity patterns of older adults.

Sedentary Behavior and Physical Activity Patterns in Older Adults After Hip Fracture: A Call to Action.

To characterize patterns of sedentary behavior and physical activity in older adults recovering from hip fracture and to determine characteristics associated with activity. Community-dwelling, Canadian adults (65 years+) who sustained hip fracture wore an accelerometer at the waist for seven days and provided information on quality of life, falls self-efficacy, cognitive functioning, and mobility. There were 53 older adults (mean age [SD] 79.5 [7.8] years) enrolled in the study; 49 had valid data and demonstrated high levels of sedentary time (median [p10, p90] 591.3 [482.2, 707.2] minutes/day), low levels of light activity (186.6 [72.6, 293.7]), and MVPA (2 [0.1, 27.6]), as well as few daily steps (2467.7 [617.1, 6820.4]). Regression analyses showed that age, gender, gait speed, and time since fracture were associated with outcomes. Older adults have long periods of sedentary time with minimal activity. Results are a call to action to encourage people to sit less and move more.

Step Activity Patterns in Older Adults with High Fall Risk

Falls have been related to decreased levels of self-reported physical activity. One recent study also associated decreased step activity in older men with a history of recurrent falls. Physical activity as measured by instrumented step activity monitors instead of subjective measures has not been fully investigated in older adults with a high fall risk. PURPOSE: To determine if step activity patterns are different between older adults who are at high fall risk compared to their healthy counterparts. METHODS: Nineteen older adults (aged >= 65 years) were categorized as healthy (OA; n = 10; seven females) and those at high fall risk (FA; n = 9; six females) based on the American Geriatrics Society guidelines. Step activity was assessed for seven days using a StepWatch Activity Monitor (SAM). The SAM was worn on the ankle and set to record the number of strides taken every 10s. The recorded data from SAM was further processed to obtain the following dependent variables: total number of steps, number of bouts, average bout duration, average number of steps per bout and % of time inactive. A bout was defined as the number of 10-second intervals for which the stride count changed from 0 (indicating inactivity) to > 0 (indicating activity). All the dependent variables were taken as an average of data from accurate data collection days. Accuracy was defined as having more than 201 steps per day. An independent samples t-test was used to compare OA and FA groups. RESULTS: See Table 1. CONCLUSIONS: In spite of maintaining similar overall activity level as compared to their healthy counterparts, older adults at high fall risk seemed to perform shorter and lesser periods of activities per day. A study with larger sample size is warranted.Table 1: Means (SE) of dependent variables taken as an average of data from accurate data collection days

Non-exercise physical activity and survival: English longitudinal study of ageing.

The activity patterns of older adults include more light/mild-intensity or "non-exercise" activity and less moderate- to vigorous-intensity activity. The health benefits of this type of activity pattern remain unclear. To examine dose-response associations between physical activity and survival using time-varying analysis to understand the importance of "non-exercise" activity for survival in older adults. Participants (N=10,426) were drawn from The English Longitudinal Study of Ageing, a representative sample of men and women aged ≥50 years living in England. Participant data were linked with death records from the National Health Service registries from 2002 to 2011. Analyses were conducted in 2013. Cox proportional hazards models were used to estimate the risk of death according to time-varying estimates of physical activity. Over an average follow-up of 7.8 years (median follow-up, 8.5 years), there were 1,896 deaths. In models adjusted for comorbidities, psychosocial factors, smoking, and obesity, there was a dose-response association between time-varying physical activity and mortality, with the greatest survival benefit in vigorously active participants. However, participating in mild ("non-exercise")-intensity physical activity was also associated with a lower risk of all-cause mortality (hazard ratio [HR]=0.76, 95% CI=0.69, 0.83); cardiovascular mortality (HR=0.74, 95% CI=0.64, 0.85); and death by other causes (HR=0.67, 95% CI=0.58, 0.78). Time-varying models produced stronger, more robust estimates than models using a single measurement of physical activity at baseline. Older adults gain health benefits from participating in regular "non-exercise" physical activity, although the greatest benefits are observed for more vigorous activity.

Physical Activity and Sedentary Behavior in Older Adults With Intellectual Disabilities: A Comparative Study

The purpose of this study was to examine the physical activity patterns of older adults with intellectual disabilities (ID) in comparison with younger adults with ID and older adults without ID. A sample of 109 participants was included in the study. Sophisticated data reduction, time stamped technology, and multiple objective measures (i.e., pedometers and accelerometers) were used to determine physical activity intensities and walking patterns of participants. Results indicate that older adults with ID are performing less physical activity than comparison groups. A small proportion of older adults with ID (6%) met national physical activity recommendations of 150 min of moderate or 75 min of vigorous physical activity in bouts greater than ten minutes across the week (USDHHS, 2008). Sedentary behavior was also an observable factor in this study. These findings demonstrate the need for health promotion efforts for adults with ID across the lifespan.

Relationship between perceived stress and dietary and activity patterns in older adults participating in the Boston Puerto Rican Health Study

Previous research supports a relationship between psychological stress and chronic disease in Puerto Rican adults living in the Boston, Massachusetts area. Stress may affect health by influencing dietary and physical activity patterns. Therefore, perceived stress and two hypothesized mediators of stress-related food intake, insulin and cortisol, were examined for possible associations with dietary and activity patterns in >1300 Puerto Ricans (aged 45–75 years; 70% women) living in the Boston, Massachusetts area. Data were analyzed using multiple linear regression and ANCOVA. Greater perceived stress was associated with lower fruit, vegetable, and protein intake, greater consumption of salty snacks, and lower participation in physical activity. Stress was associated with higher intake of sweets, particularly in those with type 2 diabetes. Cortisol and stress were positively associated in those without diabetes. Cortisol was associated with higher intake of saturated fat and, in those with diabetes, sweet foods. Independent of diabetes, perceived stress was associated with higher circulating insulin and BMI. Our findings support a link between stress, cortisol, and dietary and activity patterns in this population. For high-sugar foods, this relationship may be particularly important in those with type 2 diabetes. Longitudinal research to determine causal pathways for these identified associations is warranted.