Changes In Leisure-time Physical Activity Research Articles

The association of changes in leisure-time physical activity on depressive symptoms during Covid-19 in German adults: A longitudinal study

This longitudinal survey assessed preventive and curative antidepressant effects of at least 75 min/week of leisure-time physical activity (LTPA) at different timepoints of the Covid-19 pandemic. We further investigated if high self-regulation skills were associated with higher odds of initiating or maintaining LTPA during the pandemic. Data was collected online from 4253 participants (age: m = 33.65 years, SD = 0.79; 79 % female) during the first quarantine measures in Germany (T1), as well as 4 weeks (T2), and 8 months (T3) later. We performed linear mixed models with changes (T2-T1, T3-T1) in LTPA and baseline major depressive disorder (MDD) as predictors (main effects and interaction effect) and depressive symptoms (at T2, T3) as the primary outcome. We found significant interaction effects of baseline depression and change in LTPA on depressive symptoms at T2 and T3 (p < 0.001). For probable cases of MDD an increasing LTPA to ≥75 min/week (vs. no change, <75 min/week) was associated with less depressive symptoms at T2 and T3 (p = 0.003, d = 0.28). For absence of depression at baseline, remaining at ≥75 min/week of LTPA was associated with less depressive symptoms at T2 and T3 compared to remaining at <75 min/week (p = 0.006, d = 0.11) or decreasing LTPA to <75 min/week (p = 0.018, d = 0.11). Reporting high self-regulation at T1 was associated with higher odds of performing ≥75 min/week of LTPA at T2/T3 (OR = 1.74, p < 0.001). In general, studies report reduced LTPA during Covid-19. To benefit from the reported preventive and interventional effects, further interventions should focus on improving physical activity related self-regulation to identify and overcome barriers for LTPA.

How does change in leisure-time physical activity influence the growth trajectory of depressive symptoms in college students?

Objectives: This longitudinal study was designed to examine the growth trajectory of depressive symptoms among early-stage college students and how the development of vigorous, moderate, and light leisure-time physical activity (LTPA) was related to the growth trajectory. Participants: Four hundred and eighty-eight first- and second-year undergraduate students completed measures of depressive symptoms and LTPA at the beginning, middle, and end of a semester. Methods: Latent growth mixture modeling (LGMM) was conducted. Results: On average, students reported mild levels of depressive symptoms with significant variability at the semester start, but the symptoms elevated over time. LGMM identified two trajectories: low/gradual (75.8%) and high/increasing (24.2%). For both groups, neither vigorous nor moderate LTPA development predicted the growth trajectory of depressive symptoms. However, the change of light LTPA was negatively and significantly associated with the growth trajectory. Even when controlling for covariances, increased light LTPA still had a unique effect on buffering depressive symptoms. Conclusion: There is great potential in targeting comprehensive LTPA strategies to improve college students’ mental health and promote an active lifestyle.

Employment conditions and leisure-time physical activity among Korean workers: a longitudinal study (2009–2019)

BackgroundEmployment conditions may affect individuals’ leisure-time physical activity (LTPA). We aimed to examine the relationship between changes in working and employment conditions and LTPA among working-age populations in South Korea from 2009 to 2019.MethodsA cohort of 6,553 men and 5,124 women aged 19–64 years was analyzed using linear individual-level fixed-effects regressions to examine changes in working and employment conditions with changes in LTPA.ResultsReduced working hours, labor union membership, and part-time work were associated with increased LTPA for both sexes. Manual labor and self-reported precarious work were associated with reduced LTPA. The longitudinal relationship between employment conditions and LTPA was clear in men, but less apparent in women.ConclusionsChanges in working and employment conditions had longitudinal associations with changes in LTPA among working-age Koreans. Future research should examine changing employment conditions and their effect on LTPA, particularly among women and manual/precarious workers. These results could inform effective planning and interventions to increase LTPA.

Changes in occupational class differences in leisure-time physical activity and the contribution of retirement.

Occupational class differences in leisure-time physical activity (LTPA) are well recognized. Less is known about how these differences develop as individuals age, and how retirement is associated with this change. We investigated how occupational class differences in LTPA change in a cohort over a 15-17 years follow-up. We further examined, how the transition into mandatory or disability retirement contributed to the change in LTPA levels and occupational class differences. We used the data from the Helsinki Health Study surveying the aging City of Helsinki employees. In all, 8773 individuals were included in the analyses. We evaluated LTPA levels using weekly metabolic equivalent task (MET) hours and used generalized linear mixed effect models (GLMM) to estimate the development of LTPA levels. Commuting was included in the LTPA measure. Occupational class differences in LTPA emerged and widened during the follow-up. The physical activity levels decreased in the lower occupational class and slightly increased in the higher occupational class, resulting in a difference of 4.3 MET-hours at the end of follow-up, accounting for 50 min of brisk walking per week. The occupational class differences emerged during transition into mandatory retirement and persisted after this. Transition into disability retirement temporarily widened the occupational class differences in LTPA levels, but the differences diminished during the follow-up. Research on interventions to counteract the declining LTPA is needed to discover ways to prevent the widening of occupational health disparities during aging. The transition into old-age retirement could be an optimal period for focusing these interventions.

Leisure-time physical activity from adolescence to late middle age and its associations with the COVID-19 pandemic: A 45-year follow-up

ABSTRACT We aimed to investigate the association of self-reported leisure-time physical activity (LTPA) over a 45-years from adolescence to late middle age mediated by LTPA in early middle age. We also explored whether LTPA in adolescence and early middle age was associated with change in LTPA during the COVID-19 pandemic. We constructed a path model employing questionnaire data from three LTPA measurements (1976, 2001, 2021) including duplicated assessment for pre- and during COVID-19 in 2021. The direct and indirect associations between LTPA in adolescence, early middle and late middle age were investigated, as well as the impact of previous LTPA on change in late middle age LTPA due to the pandemic. The number of participants per assessment was: n = 2083; n = 1468 (71% of the original); n = 878 (42%) and n = 867 (42%), respectively. However, the number varied depending on the path examined. LTPA in adolescence was associated with LTPA in late middle age, although the association was not strong. LTPA decreased significantly during the pandemic. Earlier LTPA was associated with change in LTPA between before and during COVID-19 among males. This study is the first to demonstrate an association between adolescent and late middle age LTPA. However, the association across the 45-years was low.

Association Between Change in Leisure-Time Physical Activity During the Postretirement Period and Incident Stroke.

To investigate the association of change in leisure-time physical activity (LTPA) occurring during the postretirement period with incident stroke. The current study enrolled 12,644 retired workers from the Dongfeng-Tongji cohort from April to October 2013. The change in LTPA was categorized as follows, according to whether the LTPA time met the WHO recommended minimum (at least 150 minutes per week): (1) stayed inactive at both surveys; (2) stayed inactive at the 2008 survey but became active at the 2013 survey; (3) stayed active at the 2008 survey but became inactive at the 2013 survey; (4) stayed active at both surveys. We used multivariable-adjusted Cox proportional hazards regression models to examine the association between change in LTPA and the risk of incident stroke. During 70,437 person-years of follow-up, we documented 549 incident stroke cases, including 434 incident ischemic stroke cases and 115 incident hemorrhagic stroke (HS) cases. Compared with participants who stayed active at both the 2008 and 2013 surveys, those who were active at the 2008 survey but became inactive at the 2013 survey had significantly higher risks of incident total stroke (hazard ratio [HR] 1.30, 95% CI 1.03, 1.65) and HS (HR 2.34, 95% CI 1.51, 3.63). When stratified by body mass index (BMI) categories, a significant elevated risk of total stroke was seen among overweight participants who stayed active at the 2008 survey but became inactive at the 2013 survey (HR 1.65, 95% CI 1.20, 2.27). The risk of incident stroke decreased with increasing LTPA levels between the 2 surveys (HR of per 150 min/wk increase of LTPA: HR 0.97, 95% CI 0.94, 1.00). In addition, we found that compared with participants who maintained their BMI and stayed active at both the 2008 and 2013 surveys, those who were inactive at both points or who became inactive had higher risks of stroke (HR 2.13, 95% CI 1.09, 4.15; HR 1.50, 95% CI 1.07, 2.08, respectively). Among Chinese older adults, increasing LTPA levels during the postretirement period was associated with a lower risk of incident stroke. Retired individuals should be encouraged to participate in LTPA more frequently to lessen future risk of incident stroke.

Declines in Physical Activity among New Zealand Adults during the COVID-19 Pandemic: Longitudinal Analyses of Five Data Waves from Pre-Pandemic through April 2021.

Insights specific to the impact of the COVID-19 pandemic on physical activity participation in New Zealand (NZ) is limited. The purpose of this study was to examine longitudinal changes in leisure-time physical activity from pre-pandemic through April 2021. Demographic characteristics (age, gender, ethnicity, deprivation, disability status) and numerous indicators of leisure-time physical activity participation were assessed in a cohort of NZ adults (n = 1854, 54.6% women) over five waves (pre-pandemic, April 2020, June 2020, September 2020, and April 2021). Repeat measures were completed for: proportion participating in any physical activity; proportion meeting aerobic physical activity recommendations; physical activity duration; number of physical activities. There was a significant (p < 0.05) decline in mean physical activity duration and number of activities during the initial lockdown period in April 2020, but the proportion participating in any physical activity and the proportion meeting physical activity recommendations remained stable. However, all four physical activity participation indicators were significantly (p < 0.05) below pre-pandemic levels in all subsequent waves. Considerable and sustained declines in NZ adult leisure-time physical activity participation were evident over the first year of the pandemic. As of April 2021, physical activity participation showed limited signs of recovering to pre-pandemic levels.

Abstract MP29: Higher Levels Of Leisure Physical Activity In Mid-life And Attenuated Physical Function Declines In Late-life: The Atherosclerosis Risk In Communities Study

Introduction: Reduced physical functioning is a risk factor for many adverse outcomes for older adults, including risk of institutionalization and disability. Previous research indicates that leisure-time physical activity (LTPA) in mid-life predicts better physical function at a single timepoint in late-life, but more information is needed on the association between mid-life LTPA and trajectories of physical function in late-life. We hypothesized that higher levels of LTPA in mid-life are associated with attenuated physical function declines in late life. Methods: We studied 5,517 ARIC Study participants (Visit 5; mean age: 75.9 years; range: 67-91 years; 58% women; 21% Black participants) without Parkinson disease or prevalent stroke who completed the Short Physical Performance Battery (SPPB, a composite of gait speed, balance, and chair stands (lowest score 0, highest score 12). SPPB assessments were repeated at Visits 6 and 7 (median follow-up: 4.2 years). Engagement in LTPA was assessed using a modified Baecke Physical Activity Questionnaire in mid-life (Visit 1; mean age: 52 years; mean time between mid- and late-life exams: 23.7 years). Based on minutes/week of moderate-vigorous intensity LTPA participation, participants were classified into poor (0 min/week), intermediate (1-149), or ideal (≥150) LTPA levels, according to American Heart Association (AHA) physical activity recommendations. We also used the average total MET-mins/week and average moderate-vigorous intensity MET-min/week as continuous measures. Random-slope and random-intercept mixed models with an independent covariance structure tested the association between mid-life LTPA and SPPB score change in late-life, adjusted for age, sex, race-center, education, body mass index, smoking, diabetes, and hypertension. Results: SPPB scores declined an average of 2.19 points per 10 years (95% CI: -2.43, -1.96; p&lt;0.001) among older adults who had poor mid-life LTPA. In contrast, participants with intermediate or ideal mid-life LTPA levels declined 0.45 SPPB points less (95% CI: 0.11, 0.78; p&lt;0.001) and 0.65 SPPB points less (95% CI: 0.35, 0.95; p&lt;0.001), respectively, per 10 years compared to those with poor mid-life LTPA. In continuous analyses, each additional standard deviation higher total MET-min/week PA was associated with a 0.24 slower SPPB point decline per 10 years (0.13, 0.36; p&lt;0.001). Continuous results remained consistent when considering only moderate-vigorous intensity MET-min/week. Conclusions: Higher levels of self-reported LTPA at a single time point in mid-life were associated with mitigated physical function declines in SPPB in late-life, over two decades later. Additional research may consider the role of changes in LTPA across mid- and late-life and of other types of physical activity, as well as sedentary behaviors, in further understanding the association.

Is environment perception associated with change in leisure-time physical activity in Brazilian older adults? Results of EpiFloripa Idoso cohort study.

This study aims to analyze the association between perceived characteristics of the neighborhood environment and changes in leisure-time physical activity in Brazilian older adults. Longitudinal analysis was performed considering a population-based study carried out in 2009/2010 with follow-up in 2013/2014. Changes in leisure-time physical activity, obtained with the International Physical Activity Questionnaire during both waves, were associated with data of environment perception with the Neighborhood Environment Walkability Scale - Abbreviated (baseline only) performing multinomial logistic regression. In total, 1,162 older adults (65.2% women, mean age = 73.7 years) participated. Older adults who perceived flat streets, bicycle paths, and high flow of vehicles in the neighborhood were more likely to remain active in leisure time walking. Those who noticed the presence of flat streets also had a greater chance of becoming active than those who did not notice it. Older adults who perceived bicycle paths and sports events were more likely to maintain moderate and vigorous physical activity during leisure time. Furthermore, older adults who noticed parks and squares close to their residence were 0.49 times less likely to become insufficiently active. Brazilian older adults are more active in neighborhoods with more favorable attributes regarding leisure-time physical activity.

Individual level lifestyle changes during the COVID-19 pandemic – A Finnish population-based study

BackgroundThe COVID-19 pandemic containment measures may affect lifestyle. We aimed to examine the changes in key lifestyle factors based on the data from same individuals before (2017) and during (2020) the COVID-19 pandemic.MethodsThe study is based on the FinHealth 2017 Study representing the Finnish adult population, and its follow-up questionnaire conducted in autumn 2020. A total of 4814 individuals aged 25 and older at baseline answered the same questions on lifestyle in both years. Regular leisure-time physical activity (LPA), daily use of vegetables and/or fruits, experience of adequate sleep, daily use of nicotine products and high-risk use of alcohol, were dichotomized (yes/no) for the analysis. Weighted prevalence (no/favorable/unfavorable change) for three age groups (25-49, 50-69, 70+ years) was analyzed using multinomial logistic regression, sampling design and non-response acknowledged.ResultsIn general, the prevalence of total changes observed varied 6 − 27% between lifestyle factors. The changes were both unfavorable and favorable for health. About 14% (95% CI 11,17) and 12% (95% CI 9,16) of older women and men, respectively, had LPA in 2017 but not in 2020. Corresponding prevalence for favorable change in LPA were smaller, 6% (95% CI 4,8) in older women and 7% (95% CI 4,9) in men. In older women, the results concerning daily use of vegetables and fruits were parallel. In contrast, in older women the changes observed in the experience of adequate sleep were mainly favorable. In all age groups, high-risk use of alcohol slightly decreased especially in men but the changes in use of nicotine products were minor.ConclusionsThe results highlight unfavorable changes in LPA and vegetable consumption especially in older women during the COVID-19 pandemic. Part of the unfavorable changes may be explained by aging, but the pandemic containment measures may have accelerated them indicating the need for health promotion actions among the elderly.Key messages The lifestyle changes observed during COVID-19 pandemic were complex, varying by sex and age groups and being both favorable and unfavorable for health.Special attention should be given to promotion of physical activity in the elderly during and after the pandemic.

Taking Up and Terminating Leisure-Time Physical Activity over the Life Course: The Role of Life Events in the Familial and Occupational Life Domains.

Leisure-time physical activity (LTPA) is associated with various health-promoting effects. However, little is known about the relationship between life events and changes in LTPA over the life course, especially when multiple life events occur simultaneously. Therefore, this study examines taking up and terminating LTPA associated with life events in the familial and occupational life domains over 16 years of 16–76-year-old Swiss inhabitants (n = 1857) in a retrospective longitudinal cohort design, using a validated telephone survey and multilevel discrete-time event-history analyses. The results show that taking up LTPA was more likely when ending a relationship and retiring and less likely when becoming a parent; terminating LTPA was more likely when ending a job, starting vocational training after 30 years, a relationship ended for men, and becoming a mother with increasing age. If experiencing multiple life events simultaneously, the greater the number of life events, the more likely persons aged 45–70 years were to take up LTPA and, conversely, the more likely persons aged 15–44 years to terminate LTPA. The relationship between life events and changes in LTPA over the life course was often age dependent, especially when experiencing multiple life events simultaneously. The findings should be considered when promoting LTPA.

Changes in leisure-time physical activity during the adult life span and relations to cardiovascular risk factors-Results from multiple Swedish studies.

To evaluate how self-reported leisure-time physical activity (PA) changes during the adult life span, and to study how PA is related to cardiovascular risk factors using longitudinal studies. Several Swedish population-based longitudinal studies were used in the present study (PIVUS, ULSAM, SHE, and SHM, ranging from hundreds to 30,000 participants) to represent information across the adult life span in both sexes. Also, two cross-sectional studies were used as comparison (EpiHealth, LifeGene). PA was assessed by questionnaires on a four or five-level scale. Taking results from several samples into account, an increase in PA from middle-age up to 70 years was found in males, but not in females. Following age 70, a decline in PA was seen. Young adults reported both a higher proportion of sedentary behavior and a higher proportion high PA than the elderly. Females generally reported a lower PA at all ages. PA was mainly associated with serum triglycerides and HDL-cholesterol, but also weaker relationships with fasting glucose, blood pressure and BMI were found. These relationships were generally less strong in elderly subjects. Using data from multiple longitudinal samples the development of PA over the adult life span could be described in detail and the relationships between PA and cardiovascular risk factors were portrayed. In general, a higher or increased physical activity over time was associated with a more beneficial cardiovascular risk factor profile, especially lipid levels.

The bidirectional associations between leisure time physical activity change and body mass index gain. The Tromsø Study 1974-2016.

To examine whether leisure time physical activity changes predict subsequent body mass index (BMI) changes, and conversely, whether BMI changes predict subsequent leisure time physical activity changes. This prospective cohort study included adults attending ≥3 consecutive Tromsø Study surveys (time: T1, T2, T3) during 1974-2016 (n = 10779). If participants attended >3 surveys, we used the three most recent surveys. We computed physical activity change (assessed by the Saltin-Grimby Physical Activity Level Scale) from T1 to T2, categorized as Persistently Inactive (n = 992), Persistently Active (n = 7314), Active to Inactive (n = 1167) and Inactive to Active (n = 1306). We computed BMI change from T2 to T3, which regressed on preceding physical activity changes using analyses of covariance. The reverse association (BMI change from T1 to T2 and physical activity change from T2 to T3; n = 4385) was assessed using multinomial regression. Average BMI increase was 0.86 kg/m2 (95% CI: 0.82-0.90) from T2 to T3. With adjustment for sex, birth year, education, smoking and BMI at T2, there was no association between physical activity change from T1 to T2 and BMI change from T2 to T3 (Persistently Inactive: 0.89 kg/m2 (95% CI: 0.77-1.00), Persistently Active: 0.85 kg/m2 (95% CI: 0.81-0.89), Active to Inactive: 0.90 kg/m2 (95% CI: 0.79-1.00), Inactive to Active 0.85 kg/m2 (95% CI: 0.75-0.95), p = 0.84). Conversely, increasing BMI was associated with Persistently Inactive (odds ratio (OR): 1.17, 95% CI: 1.08-1.27, p < 0.001) and changing from Active to Inactive (OR: 1.16, 95% CI: 1.07-1.25, p < 0.001) compared with being Persistently Active. We found no association between leisure time physical activity changes and subsequent BMI changes, whereas BMI change predicted subsequent physical activity change. These findings indicate that BMI change predicts subsequent physical activity change at population level and not vice versa.

Urban greenery cushions the decrease in leisure-time physical activity during the COVID-19 pandemic: A natural experimental study

The coronavirus disease 2019 (COVID-19) pandemic and related social distancing measures have altered the daily lifestyles of people worldwide. Although studies on this disease are emerging rapidly, less is known about the impacts of COVID-19 and urban greenery on leisure-time physical activity, which is critical to maintain health for urban residents during the pandemic. In this study, we used a natural experimental research design to identify whether urban greenery cushions the decrease in leisure-time physical activity caused by the pandemic and related social distancing measures in a high-density city. The two-wave physical activity data (before and during the pandemic) were collected for urban residents in neighborhoods with high or low levels of greenery. The results of difference-in-differences model suggest that urban greenery mitigated the decrease in physical activity during the pandemic. People who lived in greener neighborhoods experienced a lesser decrease in the leisure-time physical activity level than those who lived in less green neighborhoods. Additionally, people who lived in greener neighborhoods experienced increased levels of physical activity related to visits to country parks during the pandemic. These findings suggest that urban green spaces play a significant role in shaping physical activity and providing a refuge for the public during crises. Our study is among the first to investigate the impact of urban greenery on pandemic-induced changes in leisure-time physical activity in densely populated Asian cities, and our findings shed light on the potential protective role of urban greenery on public health during the COVID-19 pandemic and beyond.

Physical Activity and Sitting Time From 16 to 24Weeks of Pregnancy to 12, 24, and 48Months Postpartum: Findings From the 2015 Pelotas (Brazil) Birth Cohort Study.

Physical activity levels decrease during pregnancy, and the time course of return to prepregnancy levels is unclear. This study aimed to describe changes in leisure-time physical activity (LTPA) and sitting time from 16 to 24weeks of pregnancy to 12, 24, and 48months postpartum in women with different education levels in Brazil. Data from 4000 mothers of children enrolled in the 2015 Pelotas (Brazil) Birth Cohort were analyzed. The women were interviewed between 16 and 24weeks of pregnancy and when their children were aged 12, 24, and 48months. The LTPA and sitting time were self-reported. Only 15.7% of the women reported any LTPA during pregnancy; this declined to 7.9% at 12months postpartum; it was 16.8% at 24months and 23.2% at 48months. On average, participants spent a mean (SD) of 6.4 (3.9), 4.2 (3.2), 4.3 (3.3), and 4.4 (3.3) hours per day sitting during pregnancy, and at 12, 24, and 48months after the birth, respectively. Both any LTPA and high sitting (8+ h/d) were consistently higher among women with higher education. After 24months postpartum, LTPA levels had returned to or exceeded pregnancy levels, but sitting time remained lower than during pregnancy.

Does A Free Ticket For Local Transport Increase Physical Activity?

PURPOSE: Active commuting can contribute to reaching recommended levels of physical activity (PA), and might therefore play an important role in PA promotion at the population level. The purpose of the study was to assess the changes in PA behavior after the introduction of a free ticket for local transport in the Federal State of Hessia in Germany. METHODS: We conducted a retrospective online survey among the employees of Goethe University Frankfurt, Germany, and assessed employees’ commuting (good/bad weather) and leisure time PA prior to and after the introduction of the free ticket. Group differences were calculated with the Wilcoxon test and the Mann-Whitney-U test. Associations were tested with Pearson’s correlation coefficient. The level of significance was set at p≤0.05. RESULTS: The link to the online survey was sent to 7935 employees, 989 (12.46%) responded, and 706 datasets (59% female) could be analyzed. No gender differences were found in total commuting time. With the availability of the free ticket public transport use increased significantly (53% vs 62% and 65% vs 76%), and car use decreased (17% vs. 9% and 20% vs. 12% in good and bad weather respectively). Public transport use included significantly more active transport minutes than car use (14±7 and 12±7 vs 3±3 and 3±3 in good and bad weather respectively). No change in leisure time PA was found. Weak associations showed between transport mode and body-mass-index, but not with smoking status. CONCLUSIONS: In this study the introduction of free tickets for public transport led to changes in commuting behavior in favor of public transport, which implies increased active travel. It is reasonable to assume that such changes, if sustained, can bear public health relevance. Since Goethe University is located in a metropolitan area with an extensive public transport network around it, our results may not be generalizable for areas with less developed transit system.

Longitudinal associations of changes in physical activity and TV viewing with chronic musculoskeletal pain in Brazilian schoolteachers.

This study analyzed the longitudinal association of changes in leisure-time physical activity (LTPA) practice and television viewing (TV viewing) with chronic musculoskeletal pain (CMP). The data about LTPA, TV viewing, and CMP were obtained in 2012 and after 24 months through individual interviews with schoolteachers from elementary and secondary education public schools in a large city in the southern region of Brazil. The statistical analysis was performed using generalized estimating equation regression models adjusted for sex, age, body mass index and depression. A total of 527 schoolteachers were studied, among which 66.6% were women, and the median age was 42 years (interquartile range: 34 to 49). A total of 170 (32.3%) participants reported CMP at baseline and 130 (24.7%) at follow-up. Both LTPA and TV viewing were independently and significantly associated with CMP regardless of all adjustment variables. Concretely, increasing LTPA by 60 minutes/week was associated with a 6.2% lower likelihood of CMP, and increasing TV viewing by 30 minutes/day was associated with a 5.1% higher likelihood of having CMP among the participants. In summary, this study showed that LTPA and TV viewing have independent and opposite relationships with the longitudinal risk of CMP, which suggests that the potential benefits obtained from practicing more LTPA are insufficient to compensate for the potential detrimental effect of viewing TV for longer with respect to the CMP.

Abstract P377: Changes in Leisure-time Physical Activity and Risk of Ischemic and Hemorrhagic Stroke: The Atherosclerosis Risk in Communities Study

Introduction: Engagement in leisure-time physical activity (PA) levels recommended by the American Heart Association (AHA) is inversely associated with both ischemic and hemorrhagic stroke risk. PA levels fluctuate over the lifecourse, but the association between changes in PA from mid- to late-life and stroke risk is unknown. Hypothesis: Participants who maintained ideal levels of PA or increased their PA across 6 years will have lower ischemic and hemorrhagic stroke risk relative to those who had persistently poor PA. Methods: We included 11,658 participants of the Atherosclerosis Risk in Communities study without a history of CHD or stroke at visit 3 (1993-1995). Leisure-time PA was assessed using the modified Baecke questionnaire at visits 1 and 3 and categorized according to the AHA guidelines for PA (ideal, intermediate, or poor). All adjudicated definite and probable incident ischemic and hemorrhagic strokes between visit 3 and end of year 2013 were included. Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for ischemic and hemorrhagic stroke by categories of PA at visits 1 and 3. Those with poor PA at both visits were the referent group. We adjusted for age, sex, race/center, smoking, alcohol consumption, hypertension, diabetes mellitus, LDL, HDL, triglycerides, and body mass index. Results: During a median of 18.7 years of follow-up, 640 incident ischemic strokes and 76 hemorrhagic strokes occurred. In adjusted analyses, participants with ideal PA at both visits had a significantly lower ischemic stroke risk (HR=0.75 (0.59, 0.96)) but not significantly lower hemorrhagic stroke risk (HR=1.27 (0.65, 2.48)). Those whose PA levels increased from poor to ideal also had lower ischemic stroke risk (HR=0.74 (0.54, 1.03)) but not hemorrhagic stroke risk (HR=0.74 (0.28, 2.02)). Conclusion: Increasing PA between visit 1 and visit 3 was associated with lower ischemic stroke risk. Increasing PA may be an important component of stroke prevention.

Change in physical activity and health-related quality of life in old age-A 10-year follow-up study.

The aim of the study was to examine the association between change in leisure-time physical activity (LTPA) and change in health-related quality of life (HRQoL) and symptoms of depression during a 10-year follow-up. This prospective study included 1036 men and women (mean age at baseline=61.2years) from the Helsinki Birth Cohort Study. Leisure-time physical activity was measured with a questionnaire, HRQoL with SF36 and depression symptoms with Beck's depression inventory (BDI). The association between the change in LTPA and change in HRQoL and BDI were investigated with sex-stratified general linear models adjusted for age, smoking, educational attainment, comorbidity score, and baseline value of outcomes. One standard deviation (SD) increase in LTPA was associated with increase in physical summary component of HRQoL in women (B=0.7 unit, 95% CI=0.1-1.3, P=0.032) and in men (B=0.8 unit, 95% CI=0.2-1.5, P=0.014). In women, the 1SD increase in LTPA was also associated with an increase in mental summary component score (B=1.0, 95% CI=0.3-1.7, P=0.005) and a reduction in depressive symptoms (B=-0.7, 95% CI=-1.1 to -0.2, P=0.003). In conclusion, increase in the volume of LTPA over a 10-year period in late adulthood was associated with improved HRQoL in both men and women, and also diminished depressive symptoms in women. The findings support the promotion of physical activity in later years to enhance HRQoL and mental well-being.

Change in Physical Activity and Cardiac Structure over 10 Years: The Multi-Ethnic Study of Atherosclerosis.

Physical activity (PA) is inversely associated with risk of heart failure and cardiovascular disease (CVD), whereas increased left ventricular (LV) mass and mass to volume (m:v) ratio are unfavorable CVD risk factors. We assessed whether changes in leisure time PA were associated with longitudinal changes in cardiac structure in a community-based population. We included 2779 Multi-Ethnic Study of Atherosclerosis participants, free of baseline CVD, who had available data on PA and cardiac magnetic resonance imaging at examinations 1 (2000-2002) and 5 (2010-2012). Physical activity was measured by a Typical Week PA Survey and converted to MET-minutes per week of moderate+vigorous activity. We used linear mixed effect models to estimate the associations of baseline and change in PA with baseline and change in cardiac structure, adjusting for CVD risk factors and body size. At baseline, the mean age was 59 yr, 53% were women, and 58% of nonwhite race/ethnicity. During average 10-yr follow-up, and after accounting for baseline PA levels, the highest quintiles of PA increase were significantly associated with increases in LV mass (2.3 g; 95% confidence interval [CI], 0.4-4.2), LV end-diastolic volume (4.7 mL; 95% CI, 2.4-7.0), and stroke volume (3.3 mL; 95% CI, 1.6-5.1), but lower M:V ratio (-2.9; 95% CI, -5.0 to -0.8) compared with the lowest quintiles. Increasing exercise PA was associated with increases in LV diameter and reductions in M:V ratio, whereas occupational PA was associated with increases in m:v ratio. Increasing PA over 10 yr was also associated with greater risk of eccentric dilated LV hypertrophy at examination 5. After accounting for baseline PA, greater positive changes in leisure-time PA levels were associated with a more eccentric-type of LV remodeling pattern over 10 yr. The clinical implications of such findings remain to be determined.