Baseline Physical Activity Research Articles

Baseline Physical Activity Moderates Intracellular Lipid Deposition During Overfeeding

Baseline Physical Activity Moderates Intracellular Lipid Deposition During Overfeeding

LONGITUDINAL ASSOCIATIONS OF LONELINESS AND FRAILTY IN COMMUNITY DWELLING OLDER ADULTS

Abstract Loneliness is highly prevalent among older adults and is associated with poor health outcomes. This study examined longitudinal associations between loneliness and frailty and the influence of other objective and subjective social measures on these associations. We analyzed data from 1,3111 older adults without dementia at baseline from the Rush Memory and Aging Project (mean age 78.3 ±7.5 years, 72.5% female). Loneliness was assessed using the de Jong Gierveld Loneliness Scale. Frailty was defined using a 39-item cumulative deficit frailty index. Linear mixed effects models were used to examine the association of baseline loneliness and change in frailty over time adjusted for baseline age, gender, education, depressive symptoms, global cognition, social network, marital status, social support, and social, cognitive, and physical activity. Loneliness and frailty both increased significantly over a mean follow-up period of 4.6 years. Baseline loneliness was associated with an additional increase in frailty by 0.3 deficits per year compared to those who were not lonely (p< 0.001, CI 0.2, 0.5). The 0.3 increase in frailty per 1-point increase in loneliness equaled a 27% increase in frailty per year. Loneliness is associated with accelerated frailty and should be considered in the design of interventions to prevent frailty and promote healthy aging.

Relationship between Baseline Physical Activity and Generalized Anxiety Disorder and Major Depressive Disorder Treatment Outcomes.

Generalized anxiety disorder and major depressive disorder often benefit from medication and psychotherapy. Our aim was to determine whether a correlation exists between patient baseline physical activity and response to treatment. This was a retrospective study that included adult patients with anxiety and depression who received outpatient care for their conditions by providers in the Department of Psychiatry and Psychology of the Mayo Clinic in Jacksonville, Florida. Statistical analyses were used to analyze whether Rapid Assessment of Physical Activity scores as a measure of baseline exercise correlated to changes in Patient Health Questionnaire-9 (PHQ-9) scores or Generalized Anxiety Disorder-7-item scale (GAD-7) scores during treatment for anxiety or depression. Factors including age, sex, smoking status, and caffeine intake also were analyzed. When comparing change in GAD-7 or PHQ-9 scores from baseline to follow-up during treatment for anxiety or depression, there was no significant difference based on Rapid Assessment of Physical Activity scores. Caffeine intake had a direct correlation with PHQ-9 scores from baseline to 12 to 24 weeks but no correlation with GAD-7 scores. Overall, the amount of physical activity a patient participates in before anxiety or depression treatment does not appear to affect improvement outcomes. Caffeine intake may improve depression severity scores; however, further research is needed to assess whether this could be a part of future treatment plans.

Exercise Intensity Among Older Adults Participating From Home in Remotely Delivered EnhanceFitness.

We aimed to examine exercise intensity among older adults participating from home in remotely delivered EnhanceFitness (Tele-EF). Exercise intensity was assessed through Fitbit-measured heart rate and the Borg 10-point rating of perceived exertion over 1week of a 16-week exercise program. Outcomes included mean minutes spent at or above the heart rate reserve calculated threshold for moderate intensity and mean rating of perceived exertion. Pearson and Spearman rank correlations were used to examine associations between baseline characteristics with exercise intensity. During the 60-min classes, the 55 participants achieved moderate intensity for a mean of 21.0min (SD = 13.5) and had a mean rating of perceived exertion of 4.9 (SD = 1.2). There were no significant associations between baseline characteristics and exercise intensity. Older adults can achieve sustained moderate-intensity exercise during Tele-EF supervised classes. Baseline physical function, physical activity, and other health characteristics did not limit ability to exercise at a moderate intensity, though further investigation is warranted.

Physical activity delayed the onset of cognitive impairment in middle‐aged and older adults with diabetes ‐ Findings from the ELSA‐Brasil Study

AbstractBackgroundPhysical inactivity and diabetes are known risk factors for cognitive impairment. Yet, few studies in large samples of cognitively diverse populations have been reported to assess this joint effect on cognitive function. Therefore, this study aimed to characterize the joint association of baseline diabetes and physical activity with cognitive decline and the risk of cognitive impairment in middle‐aged and older adults.MethodsLongitudinal data of the Estudo Longitudinal da Saúde do Adulto (ELSA‐Brasil, Longitudinal Study on Adult’s Health), an occupational cohort of Brazilian adults aged 35‐74, were analyzed. A standardized questionnaire distinguished physically active (≥150 min/week) from inactive participants. Cognitive function was examined using standardized tests to assess memory, language, and executive function at baseline and during follow‐up visit. Global cognitive function summed all three aspects and was described as z‐score differences from the sample average over follow‐up. Linear mixed models, Cox proportional regression models, and Laplace regression models, adjusted for sociodemographic and behavioral variables, were used to assess the relationship of diabetes and physical activity with change in cognitive function over time.ResultsParticipants (n = 12,214; 55.5% women; age [SD]: 51.4 [8.8]) had median follow‐up of 8.2 (0.6) years. During follow‐up, those physically active at baseline showed a slower less than average global cognitive decline (z‐score difference 0.22; 95%CI: 0.19, 0.24) and those with diabetes greater than average decline (z‐score difference ‐0.22; 95%CI: ‐0.26 ‐0.19). In those with diabetes, active adults aged 80 or older showed global cognitive function (z‐score ‐0.80; 95%CI: ‐0.90, ‐0.69) similar to inactive adults aged 70 (z‐score ‐0.69; 95%CI: ‐0.74, ‐0.65). While inactive participants had an increased risk of incident cognitive impairment independent of diabetes status (no diabetes: HR: 1.31; 95%CI: 1.13, 1.53; diabetes: HR: 1.21; 95%CI: 1.02, 1.44), among active adults, diabetes was not associated with incident cognitive impairment (HR: 0.93, 95%CI: 0.69, 1.27) compared to active participants with no diabetes. In participants with diabetes, physical inactivity anticipated in 3.15 (95%CI: 1.60, 4.69) years the onset of cognitive impairment. Results remained consistent after multiple sensitivity analyses.ConclusionPhysical activity attenuated the impact of diabetes on cognitive function in middle‐aged and older adults.

Baseline and Six‐Month Actigraphy and Sleep‐monitoring Devices Help Differentiate Between Alzheimer’s Disease and Dementia with Lewy Bodies

AbstractBackgroundDementia with Lewy bodies (DLB) and Alzheimer’s disease (AD) are challenging to differentiate. Mobile health devices that measure motor and sleep domains between clinic visits may improve differential diagnosis.MethodParticipants with probable AD and probable DLB wore ActiGraph triaxial wGT3X‐BT actigraphy devices on their nondominant wrists for 2 weeks and multichannel Sleep ProfilerX8TM EEG devices on their foreheads for 2 consecutive nights.3 Actigraphy data were processed and scored using GGIR and activity counts in R. The Sleep Profiler characterizes abnormal slow‐wave sleep and non‐REM hypertonia (NRH).ResultAt baseline, participants with DLB (n = 9) had higher UPDRS scores and a higher likelihood of psychosis than participants with AD (n = 8; see Table 1). Using univariate Wilcoxon Rank‐Sum tests, we found that at baseline participants with DLB had lower daily activity counts, higher % time in NRH, and lower % time in REM sleep than participants with AD (unadjusted p‐values < 0.05; See Figure 1).In a recent 6‐month followup, activity levels were lower on average than baseline activity levels for both DLB (n = 5) and AD (n = 5). at 6‐months, the differences in % sleep in NRH increased between DLB participants (n = 5) and AD participants (n = 3) as average % NRH increase 6% in DLB and decreased 1% in AD (see Table 2). These 6‐month differences are not statistically significant, but data collection are ongoing.An exploration of methods for processing and scoring actigraphy data revealed that processing can result in wide range of findings. As a result, we have focused on actigraphy outcomes which are more suitable to older participants with dementia.ConclusionParticipants with DLB demonstrated lower baseline physical activity and higher rates of baseline sleep disturbances than participants with AD; sleep differences between DLB and AD appeared to increase over 6 months.Actigraphy and sleep‐monitoring devices are well tolerated in participants with dementia and they can reliably collect valid, useful activity and sleep data in between clinic visits.

Baseline and Six‐Month Actigraphy and Sleep‐monitoring Devices Help Differentiate Between Alzheimer’s Disease and Dementia with Lewy Bodies

AbstractBackgroundDementia with Lewy bodies (DLB) and Alzheimer’s disease (AD) are challenging to differentiate. Mobile health devices that measure motor and sleep domains between clinic visits may improve differential diagnosis.MethodParticipants with probable AD and probable DLB wore ActiGraph triaxial wGT3X‐BT actigraphy devices on their nondominant wrists for 2 weeks and multichannel Sleep ProfilerX8TM EEG devices on their foreheads for 2 consecutive nights.3 Actigraphy data were processed and scored using GGIR and activity counts in R. The Sleep Profiler characterizes abnormal slow‐wave sleep and non‐REM hypertonia (NRH).ResultAt baseline, participants with DLB (n = 9) had higher UPDRS scores and a higher likelihood of psychosis than participants with AD (n = 8; see Table 1). Using univariate Wilcoxon Rank‐Sum tests, we found that at baseline participants with DLB had lower daily activity counts, higher % time in NRH, and lower % time in REM sleep than participants with AD (unadjusted p‐values < 0.05; See Figure 1). In a recent 6‐month followup, activity levels were lower on average than baseline activity levels for both DLB (n = 5) and AD (n = 5). at 6‐months, the differences in % sleep in NRH increased between DLB participants (n = 5) and AD participants (n = 3) as average % NRH increase 6% in DLB and decreased 1% in AD (see Table 2). These 6‐month differences are not statistically significant, but data collection are ongoing. An exploration of methods for processing and scoring actigraphy data revealed that processing can result in wide range of findings. As a result, we have focused on actigraphy outcomes which are more suitable to older participants with dementia.ConclusionParticipants with DLB demonstrated lower baseline physical activity and higher rates of baseline sleep disturbances than participants with AD; sleep differences between DLB and AD appeared to increase over 6 months. Actigraphy and sleep‐monitoring devices are well tolerated in participants with dementia and they can reliably collect valid, useful activity and sleep data in between clinic visits.

Impact of social isolation during COVID-19 on anthropometric data, quality of life, baseline physical activity and aortic pulse wave parameters in children and adolescents in two independent samples

BackgroundThe social restrictions resulting from the COVID-19 pandemic had a great impact on the routine of children and adolescents, with important consequences such as sleep, eating, and psychological/psychiatric disorders. Even though there are no studies on the subject, it is possible that these changes in habit and routine have also affected arterial stiffness (AS) in this population, which is an important predictor of cardiovascular risk. This study aimed to assess possible changes in AS, anthropometry, and quality of life (QoL) resulting from the COVID-19 pandemic in children and adolescents.MethodsA controlled observational cross-sectional study was performed with 193 children and adolescents aged 9 to 19 years, allocated into two groups: before the pandemic (BPG) and one year after the pandemic (APG), matched by age and sex. Cardiovascular parameters were measured non-invasively by brachial artery oscillometry with a portable device. The main AS indices evaluated were the augmentation index (AIx) and pulse wave velocity (PWV) derived from the aortic pulse wave. QoL was assessed using the Paediatric Quality of Life Inventory version 4.0 (PedsQL 4.0).ResultsRegarding QoL, the APG showed a worsening in emotional (p = 0.002) and school-related (p = 0.010) aspects. There was no statistically significant difference for most anthropometric parameters, except for the hip circumference, which was higher in the APG group (p < 0.001). The main predictor of AS in the paediatric population, AIx@75, was shown to be increased in the APG group (p < 0.001). Other cardiovascular parameters were also different, such as peripheral (p = 0.002) and central (p = 0.003) diastolic blood pressure, stroke volume (p = 0.010), and total vascular resistance (p = 0.002), which were shown to be decreased in the APG group, while the heart rate was increased (p < 0.001).ConclusionsOur results show that routine changes resulting from the period of social isolation increased cardiovascular risk in children and adolescents, evident by the increase in AIx@75, which is considered to be an important marker of cardiovascular risk in the paediatric population.

Abstract 14087: Physical Activity is Associated With Monocytes and Monocyte Subsets in Low-Resourced Neighborhoods: Data From the Step It Up Physical Activity Intervention

Background: Physical activity (PA) reduces cardiovascular disease (CVD) risk; those living in lower-resourced neighborhoods have higher CVD risk in part due to limited PA access. Monocyte subsets (classical, intermediate, and non-classical) with their platelet aggregates (PlAgg) are key in CVD, but less is known about relationships between PA and monocytes. We investigated associations between PA and monocyte subsets with PlAgg in African American (AA) women at risk for CVD living in resource-limited Washington, DC areas. Methods: Participants were enrolled in Step It Up, a technology-enabled, community-engaged PA intervention. Baseline PA was measured as daily step counts using a FitBit Charge 2. Monocyte subsets and PlAgg were measured in fasting blood samples by flow cytometry. Multivariable linear regression was used to determine relationships between PA and monocytes adjusting for BMI and ASCVD 10-year risk score. We examined neighborhood deprivation index (NDI), a 2018 Census-tract based measure of neighborhood socioeconomic deprivation, as a moderator of associations between PA and monocytes. Results: The study cohort was a sample of AA women with overweight/obesity enrolled in Step It Up (N=106, age=57±12 y, BMI=34.8±6.3kg/m2). Higher baseline PA associated with monocyte subsets, but not overall monocyte presence (Table). Furthermore, higher baseline PA negatively associated with PlAgg on all monocytes. PA and monocyte subsets were most associated among those residing in higher deprivation neighborhoods (Table). Conclusion: Baseline PA was associated with monocyte subsets and lower monocyte-PlAgg formation among AA women living in lower-resourced conditions. Future work should examine the relationship between PA changes and changes in monocyte subsets in community engaged PA interventions like Step It Up, particularly among those residing in limited resource communities.

Abstract 17225: Association Between Moderate and Vigorous Physical Activity on Long-Term Heart Failure Risk: The Cooper Center Longitudinal Study

Introduction: Regular physical activity (PA) is associated with a lower risk of heart failure (HF). However, the relative contributions of moderate and vigorous intensity exercise on HF risk is still unclear. We characterized the association between moderate (MPA) and vigorous physical activity (VPA) on the long-term risk for HF. Methods: We included participants free from baseline coronary disease in the Cooper Center Longitudinal Study (CCLS) who were Medicare eligible at age 65 years. PA was measured from a self-report instrument that included duration (minutes/week) and intensity of exercise (METs), with moderate intensity as 3-6 METs and vigorous intensity as 6 METs. Incident HF was defined as a HF hospitalization event (primary diagnosis) from Medicare claims files. MPA and VPA were considered separately as continuous variables. The association between baseline PA and incident HF was evaluated by Cox proportional hazards models adjusted for standard HF risk factors. Results: Of 32,322 individuals (mean age 50.9, 74.2% men), the mean number of hours/week of MPA and VPA was 1.2 and 1.4, respectively. 56.42% reported zero MPA and 42.6% reported zero VPA. Higher levels of VPA, but not MPA, were associated with a lower burden of HF risk factors. After 275,373 person-years of follow-up, we observed 954 incident HF hospitalizations. MPA was not significantly associated with HF risk in either model. VPA was inversely associated with HF risk in age-adjusted models. After multivariable adjustment, VPA was not associated with HF risk (see table). Conclusions: Midlife VPA, but not MPA, was associated with a lower risk for HF. However, after additional adjustment for traditional HF risk factors, the association between higher VPA and HF risk was no longer significant. These findings suggest that the inverse association between midlife VPA and long-term HF risk may be mediated by a more favorable risk factor profile.

41 The Role of Physical Activity, Social Support and Genetic Risk in Age-Related Cognitive Decline Over Time: A UK Biobank Study

Objective:This study aimed to determine how modifiable risk factors, such as physical exercise and social support, and non-modifiable risk factors, such as genetic risk may affect cognitive function over time in older adults. As well, the study explored how changes in modifiable risk factors (i.e., increase in exercise) may affect cognitive function over time. This research question was shaped with the help of a patient partner team.Participants and Methods:The study used UK Biobank data, and patient partners were involved in shaping research questions/goals. The UK Biobank study had participants complete comprehensive baseline assessments (2006-2010), with subgroups also completing repeat assessments (2012-2013), imaging assessments (2014-ongoing) and/or repeat imaging assessments (2019-ongoing; i.e., 2-4 data points per participant). Age, sex, education, ethnicity, and apolipoprotein E (APOE) e4 status (at least one e4 allele present) data were collected at baseline. Employment, physical activity, social support, and recent depressive symptom data were collected across timepoints. A Fluid intelligence score was obtained at each timepoint via a series of thirteen 1-pt. reasoning tasks (range: 0-13). Participants who did not complete cognitive testing at baseline and at least one other time point, and those with neurological conditions or events (e.g., stroke, epilepsy, dementia) were excluded (final N=17,409).Multi-Level Modeling (with Maximum Likelihood) was utilized, with fluid intelligence as the primary outcome measure. We ran Model 1: fully unconditioned, Model 2: with time predictor in years (baseline= 0), and Model 3: with baseline physical activity, social support and APOE e-4 predictors and covariates (mean-centered as appropriate), time-varying physical activity and social support predictors, and interaction terms. Nonsignificant interaction terms were trimmed from Model 3 to facilitate interpretation.Results:Model 1 was significant (p&lt;.001) with an intraclass correlation (ICC) of 0.64, suggesting that 64% of the total variance in fluid intelligence in this sample is due to interindividual differences. Model 2 revealed that the average fluid intelligence score at baseline mean age (55.85) was 6.79 and significantly decreased with each year increase since baseline. Results from Model 3 (trimmed) revealed that being male, white, and having at least a university degree were associated with higher score at baseline, while being older and having more recent depressive symptoms were associated with lower scores. Higher social support quality was associated with higher scores while higher social support quantity was associated with lower scores at baseline; however, higher social support quantity at baseline was associated with less decline in scores over time. Surprisingly, having at least one e4 allele was associated with higher scores. Engaging in more moderate physical activity was associated with lower scores at baseline, however, individuals who increased the length of their moderate physical activity sessions over time showed higher timepoint-specific fluid intelligence scores. Additional significant interactions will be elaborated.Conclusions:Results suggest that increases in the length of moderate physical activity exercise sessions were associated with better cognitive function over time. Having better social support quality was also associated with better cognitive function, while higher social support quantity was associated with less cognitive decline over time. These findings suggest that positive lifestyle changes in older adulthood may slow cognitive decline.

Objective physical activity measures to predict hospitalizations among patients with cancer receiving chemoradiotherapy.

592 Background: There is an unmet need for measures that predict adverse events during cancer therapy. Previous studies have demonstrated feasibility and value of collecting physical activity (PA) data from cancer patients undergoing curative-intent chemoradiotherapy using a commercial fitness tracker. Here, we compare the predictive value of objective PA measures versus standard clinical information and assess whether additional PA measures beyond daily step count help predict hospitalization events during treatment. Methods: Cancer patients enrolled in NCT03115398 (2017-2020) wore a Garmin VivoFit continuously during chemoradiotherapy for a variety of solid tumors. ECOG performance status (PS) was assessed at baseline. PA measures tabulated for each day included total step count, peak 30-minute cadence (average step rate over the 30 most active minutes [not necessarily consecutive]), and sedentary time. Baseline PA measures were defined as mean values from up to 14 days prior to start of chemoradiotherapy. Cox regression models with time-dependent (3-day rolling averages of PA measures and recent EORTC QLQ-C30 quality of life [QoL] score) and time-fixed (baseline PA variables, age, sex, cancer diagnosis) covariates were used to identify predictors of hospitalization. The incremental predictive value of PA measures was assessed using logistic regression models and five-fold cross validation. Results: One hundred thirty-eight patients were included in the analysis. The most common cancer diagnoses were gastrointestinal cancer (29%) and head and neck cancer (28%). Twenty-four patients (17%) were hospitalized during chemoradiotherapy. Univariate Cox regression models identified baseline step count (hazard ratio [HR] = 0.85 per 1000 steps, 95% confidence interval [CI]: 0.74-0.98, p = 0.03) and baseline peak 30-minute cadence (HR = 0.86 per 10 steps/min, 95% CI: 0.74-0.99, p = 0.03) as the most significant prognostic predictors of hospitalization. Neither baseline PS nor baseline sedentary time were significant predictors of hospitalization risk. Including both baseline step count and peak 30-minute cadence in multivariable models did not improve predictive power. During treatment, peak 30-minute cadence was identified as the most powerful dynamic predictor of short-term hospitalization risk (HR = 0.83 per 10 steps/min, 95% CI: 0.75-0.92, p &lt; 0.001). Conclusions: This study examined the relationship between a suite of PA measures and risk of hospitalization during concurrent chemoradiotherapy. Our results suggest that before treatment, daily step count average can serve as a simple and effective metric for identifying high-risk patients. During treatment, measures of peak activity may have additional utility for identifying patients in need of enhanced supportive care.

Association of baseline physical activity participation with participant characteristics and outcomes following education and exercise-therapy in people with knee osteoarthritis: AGLA:D® Australia prospective cohort study.

To investigate whether participants with knee osteoarthritis classified as 'more' or 'less' physically active at baseline differ in characteristics and/or outcomes at baseline and at 3 and 12 months following the commencement of an education and exercise-therapy program. Prospective cohort study using the GLA:D® Australia registry. The University of California, Los Angeles Physical Activity Scale (UCLA) participant data dichotomised as 'more' (≥7) or 'less' active (≤6). Groups were compared using chi-square (obesity [baseline only], comorbidity prevalence, medication consumption, fear of damage from physical activity); and linear mixed model regression (12-item Injury Osteoarthritis Outcome Score [KOOS-12], pain [visual analogue scale], health-related quality of life [QoL] [EQ-5D-5L]) statistics, adjusted for age, sex and baseline physical activity at 3 and 12 months. We included 1059 participants (70% female). At baseline, 267 (25%) were classified as 'more' active, increasing to 29% and 30% at 3 and 12 months, respectively. At baseline, compared to the 'less' active group, the 'more' active group had a lower proportion of participants who were obese ('more'=21% vs. 'less'=44%), had comorbidities (58% vs. 74%) and consumed medications (71% vs. 85%); lower pain intensity (37 vs. 47); and higher KOOS-12 (59 vs. 50), and health-related QoL (0.738 vs. 0.665) scores. When accounting for age, sex and baseline physical activity, improvements seen in knee-related burden and health-related QoL were not different between groups at 3 or 12 months. Compared to the 'less' active group, the proportion of participants not consuming medication remained higher in the 'more' active group at 3 ('more' 45% vs. 'less' 28%) and 12 months (43% vs. 32%). 'More' active people with knee osteoarthritis were less likely to be obese, had fewer comorbidities, lower medication consumption, knee-related burden and pain intensity, and higher health-related QoL than 'less' active participants at all timepoints.

Motivational Profile as a Predictor of Physical Activity Among US Adults During the Early Months of the COVID-19 Pandemic: A Daily Diary Study.

This study used a daily diary approach to examine associations between day-level physical activity (PA) behavior, PA-specific motivational profile, and days since the COVID-19 national emergency declaration during the early months (April-June 2020) of the pandemic. A total of 468 US adults (Mage = 34.8y, 79% female) participated in a 28-day smartphone-based daily diary study assessing PA. A baseline survey assessed PA and motivation for PA using the Behavioral Regulation in Exercise Questionnaire. Multilevel linear regression models examined the main effects and interactions of motivational profile and time (days since the US March 13, 2020, COVID-19 national emergency declaration) on daily PA minutes. Latent profile analysis identified 4 distinct motivational profiles for PA among this sample: profile 1: high amotivation (n = 100, 21%); profile 2: low controlled motivation (n = 55, 12%); profile 3: high external regulation (n = 47, 10%); and profile 4: moderate autonomous motivation (n = 266, 57%). After controlling for baseline PA, there were significant interactions between profile and time on daily PA (-0.21, P < .01). Profile 2 showed greater decreases in daily PA minutes over time than profile 1 (b = -0.29, P < .01). Profiles 3 and 4 did not indicate significant decreases in PA compared with profile 1 (b = 0.14, P = .31 and b = -0.16, P = .05, respectively). Contrary to previous research, individuals with lower controlled or moderate autonomous motivation demonstrated the largest decreases in PA over time, whereas individuals with higher amotivation or external regulation demonstrated smaller decreases over time. These findings suggest that external motivation may have provided short-term protection against declines in PA observed during early months of the COVID-19 pandemic.

Circulating Cell-Free Mitochondrial DNA and Depressive Symptoms Among Low-Active Adults Who Smoke.

Mitochondrial dysfunction is implicated in the pathophysiology of psychiatric disorders. Levels of circulating cell-free mitochondrial DNA (cf-mtDNA) are observed to be altered in depression. However, the few studies that have measured cf-mtDNA in depression have reported conflicting findings. This study examined cf-mtDNA and depressive symptoms in low-active adults who smoke. Participants were adults 18 to 65 years old ( N = 109; 76% female) with low baseline physical activity and depressive symptoms recruited for a smoking cessation study. Self-report measures assessed depression severity, positive and negative affect, and behavioral activation. Blood was collected and analyzed for cf-mtDNA. Relationships between depressive symptoms and cf-mtDNA were examined with correlations and linear regression. Levels of cf-mtDNA were associated with categorically defined depression (Center for Epidemiologic Studies Depression Scale score >15), lower positive affect, and decreased behavioral activation ( p < .05). Relationships remained significant after adjustment for age, sex, and nicotine dependence. In a linear regression model including all depressive symptom measures as predictors, Center for Epidemiologic Studies Depression Scale group and lower positive affect remained significant. This work suggests that mitochondrial changes are associated with depressive symptoms in low-active adults who smoke. Higher levels of cf-mtDNA in association with depression and with lower positive affect and decreased behavioral activation are consistent with a possible role for mitochondrial function in depressive symptoms.

Longitudinal associations among physical activity and sitting with endocrine symptoms and quality of life in breast cancer survivors: A latent growth curve analysis.

Adjuvant endocrine therapy (AET) often causes debilitating endocrine symptoms that compromise quality of life (QOL) in women diagnosed with hormone receptor positive breast cancer (BC). We examined whether greater levels of physical activity (PA) or prolonged sitting were associated with reduced side effects or worse side effects of AET, respectively. We used parallel process latent growth curve models to examine longitudinal patterns in PA and sitting behaviors, and their association with endocrine symptoms and QOL over 3 years of follow-up in 554 female BC survivors undergoing AET. At baseline, women were a mean age of 59 years, mostly white (72%), with overweight/obesity (67%), and approximately 50% were within 1 year of diagnosis. Unconditional models showed significant increases in PA (p < 0.01) over time but no change in sitting. Endocrine symptoms, general and BC-specific QOL all significantly worsened over time (p < 0.01). Parallel process models showed no cross-sectional or longitudinal associations between PA and endocrine symptoms. Higher levels of baseline PA were associated with higher baseline QOL scores (p = 0.01) but changes in PA were not associated with changes in QOL. Conversely, more sitting at baseline was associated with worse endocrine symptoms, general and BC specific QOL (ps <0.01). At baseline, having better QOL scores was associated with increases in sitting (ps <0.01), while having worse endocrine symptoms was associated with a slower rate of increase in sitting (p < 0.01). Increases in sitting time were also associated with a slower rate of increase in endocrine symptoms (p = 0.017). Model fit statistics (x2, CFI, TLI, SRMR) were acceptable. Both PA and sitting behaviors are important for the management of symptoms and in maintaining QOL in BC survivors. Women with already high symptom burden do not increase sitting time further but having better general and BC specific QOL to begin with means a greater decline over time.

A systematic review and cluster analysis approach of 103 studies of high-intensity interval training on cardiorespiratory fitness.

This study aims to systematically review the systematic reviews and meta-analyses examining the effect of high-intensity interval training (HIIT) protocols on improving cardiorespiratory fitness (CRF) and to characterize the main patterns of HIIT modalities using clustering statistical procedures to examine their potential differences on improving CRF. Finally, we aimed to develop a comprehensive guideline for reporting HIIT protocols. A systematic review was conducted on PubMed and Web of Science from their inception to 31 October 2022 for systematic reviews and meta-analysis aimed at assessing the effect of HIIT on CRF in the entire study population. The Assessment of Multiple Systematic Reviews 2 tool was used to evaluate the risk of bias of each review. Additionally, a principal component analysis testing the data adequacy for the factor solution through the Kaiser-Meyer-Olkin procedure test was conducted. Once the number of factors was identified, in order to identify data patterns according to the main characteristics of the HIIT protocols, a two-step cluster analysis was conducted. Nineteen systematic reviews and/or meta-analyses comprising 103 studies were included. Clustering of systematic reviews and meta-analyses identified three HIIT modalities ('HIIT-normal mixed', 'HIIT-long running', and 'HIIT-short cycling') underlying the interventions across the included studies. Similar effectiveness in increasing CRF among the three HIIT modalities was observed. Subgroup analyses showed no significant differences in CRF by sex, weight status, study design, and baseline physical activity level (P > 0.05), but differences were observed by age group, and exercise intensity indicator was used in the HIIT programmes (P < 0.05). All three HIIT modalities produced significant improvements of CRF, although some modalities showed greater changes for some specific age groups or intensity indicators.

Factors associated with failure of cardiopulmonary function recovery after lung cancer surgery.

This study aimed to evaluate the longitudinal changes in cardiopulmonary function (CPF) and identify predictors of cardiopulmonary recovery failure after lung cancer surgery. Data was obtained from a prospective CATCH-LUNG cohort study, where patients were divided into two groups based on 6-min walk distance (6MWD) at baseline and 6 months after surgery. CPF recovery failure was defined as a participant whose 6MWD dropped over 50 m from baseline to 6 months after surgery. Patients with a baseline 6MWD less than 400 m were excluded. The analysis was investigated using mixed effects models, and the relative estimates for the predictors were expressed relative risk (RR) and 95% CI using a Poisson regression. Among 419 patients, 24.1% and 17.7% showed failure of CPF recovery at 6 months and 1 year after surgery, respectively. In the multivariable analysis, baseline step count [RR per 1000 steps lower = 1.05 (95% CI, 1.01-1.09)], baseline dyspnoea [RR per 10 points higher = 1.15(1.07-1.23)], decreased FEV1 % predicted from baseline to 2 weeks after surgery [RR per 10% lower = 1.30(1.10-1.53)] and decreased moderate-to-vigorous physical activity (MVPA) from baseline to 2 weeks [RR = 1.95(1.22, 3.11)] or persistent low MVPA at baseline and 2 weeks after surgery [RR = 1.63(1.04, 2.54)] were significant factors for loss of CPF. The inability to recover CPF at 6 months after surgery was linked to reduction of lung function and MVPA from baseline to 2 weeks as well as baseline physical activity (PA) and dyspnoea. These results imply that engagement of perioperative PA is necessary to facilitate recovery of CPF after lung cancer surgery.

Description of Baseline Nutrition and Physical Activity Knowledge and Behavior in Acute Stroke/TIA Patients Enrolled in the Health Education on Information Retention and Behavior Change in Stroke (HERBS) Pilot Trial.

Lifestyle modifications after stroke are associated with better risk factor control and lower mortality. The primary objective of this study was to describe the knowledge of American Heart Association (AHA) recommendations for diet and exercise in survivors of stroke and transient ischemic attack (TIA). The secondary objectives were to describe their diet and exercise behaviors, self-efficacy (SE), behavioral intent (BI), stage of change, and barriers to change. Data are described from participants enrolled in a prospective educational intervention in mild stroke/TIA survivors. A multiple-choice questionnaire ascertained knowledge of AHA recommendations for diet and exercise, nutrition and physical activity behavior, SE, BI, stage of change, and barriers to change. Twenty-eight stroke/TIA survivors, with a mean age of 61.7 ± 11.8 years, completed questionnaires during their acute hospitalization. Participants underestimated the recommended intake of fruits, vegetables, whole grains, and participation in aerobic exercise and overestimated the recommended intake of sugar and salt. SE demonstrated a significant positive association with combined behavior scores (rs = 0.36, p = 0.043). Greater knowledge of the AHA recommendations was not associated with healthier behavior, greater SE, higher BI, or more advanced stage of change. The gaps between AHA recommendations and stroke/TIA patient knowledge identifies an area for potential intervention in stroke prevention and recovery.

Physical activity in childhood and adolescence and future depressive symptoms: an 11-year prospective cohort study.

Physical activity (PA) can reduce young peoples' risk of depressive symptoms. Associations between PA and depressive symptoms are often investigated over timeframes spanning minutes to weeks. Less is known about whether childhood/adolescent PA can predict depressive symptoms in early adulthood. Using a nationally representative sample from Ireland, latent growth mixture modelling was performed to investigate the extent to which different PA trajectories existed from ages 9-17, whether gender, weight status, and socio-economic deprivation at age 9, predicted PA trajectories from ages 9-17, and whether trajectory class membership predicted depressive symptoms at age 20. A 4-class solution was the best fit to the data (AIC = 52 175.69; BIC = 52 302.69; ssaBIC = 52 245.49; entropy = 1.00). Classes were labelled according to their baseline PA and slope of their trajectory: 'High-Decreasers'; 'Moderate-Decreasers'; 'Moderate-Stable'; and 'Low-Increasers'. A negative linear association existed between activity trajectory and the likelihood class members were female, overweight or socioeconomically deprived at age 9. The most active class (High-Decreasers) were significantly less likely to report depressive symptoms at age 20 than other classes. Multiple PA trajectories exist throughout childhood and adolescence although differences in PA levels reduced over time. The most/least active children continued to be the most/least active throughout adolescence. Those most active were least at risk of depressive symptoms in early adulthood. Being female, overweight or experiencing deprivation at age 9 were all risk factors for inactivity throughout adolescence. Findings have implications for public health and PA promotion in young people.