General Practice Physical Activity Questionnaire Research Articles

Association of combined healthy lifestyle with general and abdominal obesity.

Data linking joint healthy lifestyle factors to general and abdominal obesity are scarce, in particular in the Middle East. The aim of this study was to examine the association of combined healthy lifestyle factors with general and abdominal obesity in a large population of Iranian adults. This cross-sectional study was done on 3,172 Iranian adults aged ≥18 years. We constructed healthy lifestyle score using information on dietary intakes, physical activity, smoking status, and psychological distress. To evaluate components of healthy lifestyle, we applied a validated 106-item semi-quantitative Food Frequency Questionnaire (FFQ), General Practice Physical Activity Questionnaire (GPPAQ), General Health Questionnaire (GHQ), and other pre-tested questionnaires. General obesity was defined as having a body mass index (BMI) ≥30 kg/m2 and abdominal obesity as a waist circumference (WC) of ≥102 cm in men and ≥88 cm in women. Mean age of participants was 36.54 ± 7.97 years. General and abdominal obesity were prevalent among 8.7% and 21.5% of study participants, respectively. Linear analysis showed a significant positive relationship between healthy lifestyle score and BMI among men (β: 0.30, 95% CI: 0.05, 0.54). However, no significant association was found between healthy lifestyle and abdominal obesity in men. Among women, one score increase in healthy lifestyle score was associated with a reduction of 0.65 cm in WC. In terms of individual components of healthy lifestyle, we found that low-distressed women had lower odds of abdominal obesity compared with high-distressed women. We found a significant inverse association between healthy lifestyle and WC among women. However, healthy lifestyle was positively associated with BMI among men.

Assessing the Effect of COVID-19 Lockdown on Perceived Barriers and Facilitators to Physical Activity Among Women in Southeast England

Background: The COVID-19 pandemic resulted in restricting daily physical activity (PA). Women’s PA levels have been disproportionately negatively affected by the pandemic, compared with men. It is important to determine how women’s PA has changed over the pandemic, and if new barriers to PA participation exist since the release of restrictions. Aims: To assess how women in southeast England changed their activity during the pandemic and postpandemic, including how barriers and facilitators to activity have changed. Methods: Three hundred and thirty females completed the first online questionnaire (during lockdown), and 139 completed the postlockdown questionnaire. Questionnaires were designed from the General Practice Physical Activity Questionnaire and International Physical Activity Questionnaire. Participants self-reported PA, and barriers and facilitators to exercise. Eighteen females then participated in online semistructured focus groups. Descriptive and inferential statistical analyses were used for questionnaire data, and focus group transcriptions were thematically analyzed. Results: Most females maintained PA levels throughout the pandemic. Significant barriers to activity were lack of access to equipment/space, limited time to exercise, limited access to social groups, and finances as well as legal restrictions, safety concerns, gender, and lack of childcare. Similarly, significant facilitators were identified during lockdown and postlockdown for access to equipment, finances, having more time to exercise, and exercising with a social group. Participants both expressed desires to return to prelockdown PA habits, but also maintain new ones that were created. Conclusion: It is evident that the pandemic affected and changed the barriers and facilitators to female PA participation. Governments and industries in the sector should focus on providing services that address these changing habits to improve activity levels in women.

Evaluation of the influence of sleep on obesity indices among young adults

Background: Sleep is an indispensable physiological process. The recommended average sleep duration for young adults is about 7–9 h a day. Quality and duration of sleep have a considerable influence on several anthropometric measurements, in addition to the typical determinants, such as level of physical activity, dietary choices, and genetic predisposition. These days, obesity is a ubiquitous public health crisis and there has been a parallel rise in sleep deprivation. Several reviews have suggested an increased likelihood of obesity among short-sleepers. Aims and Objectives: This study aims to assess the quality and duration of sleep, physical activity, and obesity indices in young adults and evaluate the impact of sleep on the obesity indices. Materials and Methods: Three hundred young adults of both sexes aged between 18 and 25 years were selected and their anthropometric measurements such as height, weight, waist, and hip circumference were recorded. Obesity indices – waist/hip ratio (WHR), waist to height ratio, body mass index (BMI), abdominal volume index (AVI), and conicity index were calculated. Pittsburgh Sleep Quality Index (PSQI) and General Practice Physical Activity Questionnaire were used to assess the quality and duration of sleep as well as physical activity, respectively. Based on the PSQI index, they were categorized into – Group 1 with adequate sleep and Group 2 without adequate sleep. Independent Student’s t-test was employed; P < 0.05 was considered significant. Results: Analysis of anthropometric measurements showed a significant increase in weight (63.60 ± 16.52 kg vs. 60.26 ± 13.73 kg), waist circumference (79.52 ± 12.83 cm vs. 78.60 ± 10.27 cm), and AVI (13.07 ± 4.20 vs. 12.68 ± 3.30) in Group 2. BMI and WHR were increased in Group 2 but were not statistically significant. Physical activity was found to be more in Group 2 subjects. Conclusion: Quality of sleep has a role in obesity irrespective of physical activity.

Physical activity and health-related quality of life among adults living in Jeddah city Saudi Arabia.

Physical activity can improve health-related quality of life (HRQoL) in adults. However, the effect of physical activity on quality of life is unclear among the Saudi adult population. The study aimed to determine the association between physical activity and HRQoL in apparently healthy adults in Jeddah, Saudi Arabia. This cross-sectional study was conducted among visitors of shopping malls, walking tracks/fitness centres/gyms and governmental hospitals in Jeddah from March to September 2022. Physical activity was measured with the electronic template of the general practice physical activity questionnaire (GPPAQ), while the HRQoL was measured using the 36-Item Short Form Survey (SF-36) questionnaire. A multiple linear regression model investigated the relationship between physical activity and HRQoL. A total of 693 individuals participated in this study, with a mean age of 36 (±11). Individuals who fall in the active category of the physical activity level were mostly younger men (37% vs 21%), were non-smokers (30% vs 10%) and had no comorbid condition (29% vs 15%). After adjusting for covariates, men (adjusted β 4.43, 95% CI [1.44-7.41]) with higher physical activity levels (active-adjusted β 10.11, 95% CI [5.44-14.77]) had better scores on the physical component summary (PCS). Similarly, mental component summary (MCS) scores for men (adjusted β 6.51, 95% CI [3.40-9.63]) and physical activity levels (active-adjusted β 9.77, 95% CI [4.90-14.64]) were high. The article reinforces how physical activity contributes towards each dimension of HRQoL. Physical inactivity is a growing public health challenge in Saudi Arabia, affecting all age groups. Investing in innovative strategies and establishing targeted health education programs for academic institutions and communities are required to enhance healthy habits. Additionally, constructing more local sports facilities and concession packages, especially for the females at the gyms, can motivate individuals and promote physical activity.

Musculoskeletal pain, kinesiophobia, and quality of life in obese patients

Objectives: This study aims to examine musculoskeletal pain, kinesiophobia, and quality of life in individuals with normal body mass index and in individuals with obesity, and to determine the relationship between the variables. Methods: In the study; individuals aged between 20-65 years, with a body mass index of 30 kg/m2 and above (Group obesity) with obesity, and individuals with a range of 18.5-24.9 kg/m2 (Group normal) were included. General Practice Physical Activity Questionnaire, Orebro Musculoskeletal Screening Questionnaire, Short Form-12 Health Survey, and Kinesiophopia Causes Scale were applied to the participants for primary care. Results: When the descriptive characteristics of the individuals in the sample which were divided into two groups as the Group normal (n = 82; 22.6 ± 1.7 kg/m2) and Group obesity (n = 92; 33.0 ± 2.8 kg/m2 were analyzed; while a difference was determined in terms of sex, education level and presence of chronic disease (p ˂ 0.05), no difference was found in terms of age, marital status and regular drug use for the treatment of chronic disease (p ˃ 0.05). Although the activity level rates of Group obesity were lower according to the physical activity questionnaire classification for primary care, no statistically significant difference was found between the groups (p = 0.090). More musculoskeletal pain was found in the individuals of the obesity group (p = 0.003), the physical sub-dimension score of the general quality of life questionnaire was negatively affected (p = 0.014), and a difference in favor of phobia was determined in all domains of the kinesiophobia causes scale (p < 0.001). There was a weak positive correlation between body mass index and musculoskeletal pain, while a moderate positive correlation with kinesiophobia. Conclusions: Although physical activity level is similar to individuals with normal body mass index, musculoskeletal pain and kinesiophobia are higher in individuals with obesity, and their quality of life is negatively affected.

Key Modifiable Factors in Community Participation Among Adults With Lower Limb Amputation.

The aim of the study is to identify factors that may predict community participation among adults with lower limb amputation. This study is a secondary analysis of a cross-sectional data set, including 126 community-dwelling adults, ≥1 yr after unilateral transfemoral- ( n = 44; mean age = 59 ± 14 yrs) or transtibial-level amputation ( n = 82; mean age = 59 ± 14 yrs) seen in an outpatient limb loss clinic. Participation was assessed with the Community Integration Questionnaire. Factors, that is, demographics, comorbidities, prosthesis use per the Houghton Scale, Socket Comfort Score, assistive device use, falls history, and activity level per General Practice Physical Activity Questionnaire were evaluated. Moreover, balance confidence per the Activities-Specific Balance Confidence Scale, mobility per the Locomotor Capabilities Index, fast and self-selected gait speed per 10-meter walk tests, and functional mobility via Timed Up and Go were also included. Community participation was correlated with several factors ( P ≤ 0.050). Stepwise regression of correlated factors found absence of peripheral neuropathy and greater self-reported physical activity, balance confidence, and prosthesis use, as the strongest correlates, collectively explaining 50.1% of the variance in community participation post-lower limb amputation. Findings identify key modifiable factors for consideration in future prospective research seeking to enhance community reintegration and participation among adults living with a unilateral transfemoral- or transtibial-level amputation.

Cultural influences on physical activity and exercise beliefs in patients with chronic kidney disease: ‘The Culture-CKD Study’—a qualitative study

ObjectivesThis study used a mixed-method approach to explore cultural and ethnic influences on the perception of, and decision to engage with or not to engage with, physical activity and exercise...

Physical activity among dental professionals during COVID-19 quarantine in Riyadh, Saudi Arabia

Background: To control the spread of COVID-19 infection, dental services were limited to only emergency treatments. This restriction impacted lifestyles and limited physical activity among dental professionals. This study aimed to investigate the effect of COVID-19 quarantine on the level of physical activity (LoPA) among dental professionals. Methods: A cross-sectional study was conducted among 211 participants from the dental profession in Riyadh city. Data were gathered from dental students, interns, general dentists, residents, and specialists through online and paper-based surveys. The assessment of physical activity was made using an adapted version of the General Practice Physical Activity Questionnaire to categorize participants in terms of physical activity level as Active, Moderately Active, Moderately Inactive, and Inactive. Results: Out of the 211 participants, 124 (58.8%) were males and 87 (41.2%) were females. Results presented that physical activity in 45.5% of the participants decreased during quarantine, whereas 40% had a similar score, and only 14% scored higher LoPA during quarantine. LoPA for most males (47%) did not change during quarantine, whereas most females (53%) had a decreased LoPA. Out of the 179 participants aged ≥40, 28 (15.6%) scored a higher LoPA. In the second age group (

Recreational Female Athletes Scored Higher on the Landing Error Scoring System-Real Time

Objective: There is no study examining the difference of LESS-RT (Landing Error Scoring System-real time) score according to gender. This study aimed to address this precise question. Methods: The study included recreational athletes aged 18-25 years who did not have a history of musculoskeletal injury in the last 6 months or surgery or fracture in the last 24 months, and who were classified as active according to the General Practice Physical Activity Questionnaire. Participants were evaluated using the LESS-RT. Jump-landing errors were evaluated in real-time by a sports medicine specialist. Results: The study included 55 healthy individuals (28 females, 27 males) with an average age of 21.8 ± 1.1 years. The two sexes were not significantly different in terms of age (p=0.572). For all participants, the mean LESS-RT score was 6.93 ± 1.99. Females scored significantly higher than males (7.61 ± 1.81 vs. 6.22 ± 1.97, p=0.009). However, the LESS-RT scores were not significantly correlated with anthropometric characteristics, such as age, height, body weight, or BMI, according to sex (p>0.05). Females scored higher on LESS-RT (i.e. poorer performance), (p= 0.007). Conclusion: Female athletes scored higher on LESS-RT. Athletes, especially females, should be assessed for biomechanical errors in jump-landing.

Effectiveness of Physical Activity and Finger Millet-Based Food Supplement on Biochemical Parameters and Bone Mineral Density among Premenopausal Women.

The effectiveness of physical activity and finger millet-based food supplement on biochemical parameters and bone mineral density (BMD) among premenopausal women were studied. Serum calcium, phosphorus, alkaline phosphatase, and BMD of 720 women (30–40 years) were analyzed. From them, 150 women with low BMD (t-score, −1 to −2.5) and low calcium (<9.0 mg/dL) were randomized to control and experimental groups, equally. The experimental group was given 5 days per week physical activity, for 3 months, and a diet supplement of finger millet-based sweet balls (ragi laddu), 3 days per week for 3 months. The above parameters were measured as the posttest. Physical activity was assessed by the General Practice Physical Activity Questionnaire. A 24 h recall assessment was carried out for the diet supplement, and self-reported activity checklist was maintained for physical activity. Among 720 women, 163 (22.6%) showed BMD, t-score < −1.0, and calcium <9.0 mg/dL (p < 0.001). The serum phosphorus and alkaline phosphatase were also low (p < 0.001). After the supplementation to the experimental group, all the biochemical parameters, BMD, and physical activity score showed significant improvement in the posttest (p < 0.001). This study showed significantly low BMD and calcium among premenopausal women. Physical activity and finger millet supplement improved the calcium level and BMD.

Personalized paths for physical activity: developing a person-centered quantitative function to determine a customized amount of exercise and enhancing individual commitment

BackgroundNon-Communicable Diseases (NCDs) are leading causes of mortality. These conditions are also known as chronic diseases of long duration and generally slow progression. Physical activity (PA) is a main factor to delay symptoms and consequences of NCDs. In last decades, reduced physical exercise has been observed across all ages. Despite educational campaigns aimed at modifying unhealthy habits, it is difficult to promote healthy lifestyles in general population. Poor interest, lack of motivation, as well as career and family commitments hinder people’s participation in regular PA programs. In this study we propose a theoretical person-centred approach to actively involve general population in enhancing their opportunity to perform PA based on personalized needs and targets.MethodsWe defined four profiles of baseline PA levels (inactive, moderately inactive, moderately active, and active people) by referring to Metabolic equivalents (METs) based on individual answers to General Practice Physical Activity Questionnaire (GPPAQ).ResultsBased on the answers to the GPPAQ and by computing the related METs for each profile of baseline exercise levels, we developed an innovative person-centered web-based algorithm/function for enhancing and measuring PA participation in community settings. This function can compute evidence-based standardized profiles of participants, personalized goals of PA being functional to the purpose of maintaining or gaining health benefits, as well as the type and duration of PA needed to reach these goals.ConclusionIt might be speculated that this approach would be a reliable method for increasing people’s self-efficacy and population adherence to recommended levels of PA. However, this theoretical proposal requires to be implemented in further research.

Prevalence of sarcopenia in adult patients with ankylosing spondylitis

Ankylosing Spondylitis is a chronic, progressive inflammatory rheumatic disease that involves primarily the sacroiliac joints and the axial skeleton. Sarcopenia is characterized by progressive and generalized loss of skeletal muscle mass and strength with a risk of adverse outcomes such as physical disability and poor quality of life. The study aimed to assess the prevalence of sarcopenia in patients with ankylosing spondylitis. A case-control study was conducted at Rheumatology Unit from January 2019 to July 2019. The study population consisted of 50 Iraqi patients diagnosed with AS and 50 healthy control. Demographic data, physical activity using General Practice Physical Activity Questionnaire (GPPAQ), disease activity scores using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were recorded. Sarcopenia assessment was done by using a dual-energy x-ray absorptiometry scan for body composition analysis and measuring skeletal mass index (SMI). The maximal voluntary grip strength of the hand was measured with an electronic dynamometer. Physical function was assessed by a 4-meter usual gait speed test. The prevalence of presarcopenia was 6% in both studied groups, while sarcopenia was 10% in AS patients. The mean value of BMI is significantly lower in patients with sarcopenia than in those without (p=0.001). The vast majority of the sarcopenic group (80%) were physically inactive which was statistically significant compared with the non-sarcopenic group (p=0.033). No significant association of treatment with anti-TNF or its duration was found between sarcopenia and non-sarcopenia groups (p=0.377; p=0.187). Both LM and handgrip showed fair validity to differentiate between AS patients and controls. Patients with AS are at higher risk of developing early sarcopenia than in healthy controls. Lower BMI and longer disease duration increase the risk of sarcopenia, while differences in gender, smoking and the use of anti-TNF do not influence the risk. Physical activity may improve muscle strength and perhaps decrease the risk.

Perceptions of exercise benefits and barriers: the influence on physical activity behaviour in individuals undergoing haemodialysis and peritoneal dialysis

BackgroundDespite growing evidence about the benefits of physical activity and exercise in patients receiving dialysis, physical inactivity is highly prevalent. This may be due to uncertainty and lack of appropriate guidance about exercise, or driven by the relative barriers and benefits that patients perceive. Understanding these perceptions in dialysis patients may inform interventions aimed to increase exercise participation.MethodsPerceived benefits and barriers to exercise were measured by the ‘Dialysis Patient-perceived Exercise Benefits and Barriers Scale’ (DPEBBS). Self-reported physical activity status was assessed by the ‘General Practice Physical Activity Questionnaire’. Barriers and benefits to exercise were classed as binary variables (i.e. yes and no). Frequency analyses and chi-squared tests were conducted to compare the differences perceived by people on haemodialysis (HD) and peritoneal dialysis (PD). Binominal logistical regression was performed to determine which perceived barriers and benefits had the biggest impact on physical activity status.ResultsOne thousand twenty-two HD and 124 PD patients completed the DPEBBS. A greater proportion of HD than PD patients reported ‘reduces body pain’ (P = 0.013), ‘delays decline in body function’ (P = 0.01), and ‘improves quality of life’ (P = 0.033) as benefits of exercise. No differences in barriers were observed. Tiredness was the most reported barrier to exercise. Patients who perceived ‘other comorbidities’ (OR 3.389, P < 0.001) or ‘burden of family’ (OR 3.168, P < 0.001) as barriers were 3 times more likely to be inactive.ConclusionsDialysis patients perceive several barriers which may prevent them from engaging in physical activity. Addressing these barriers may be key to increasing participation in physical activity and exercise.Graphic abstract

Usability and experience testing to refine an online intervention to prevent weight gain in new kidney transplant recipients.

Weight gain in the first year following kidney transplantation increases the risk of adverse health outcomes. Currently, there is no recognized intervention available to prevent weight gain after kidney transplantation. An online kidney transplant-specific resource, entitled Exercise in Renal Transplant Online (ExeRTiOn), has been co-created by a multi-professional team, including patients, to assist with weight prevention. This study aimed to evaluate patient and health care professional usability and experience of the ExeRTiOn online resource. Qualitative study utilizing 'Think-Aloud' and semi-structured interviews. Participants (n=17) were purposively sampled to include new kidney transplant recipients (n=11) and transplant health care professionals (n=6). Kidney transplant recipient participants were from a spread of physical activity levels based on scores from the General Practice Physical Activity Questionnaire (GPPAQ). 'Think-Aloud' interviews assessed the usability of ExeRTiOn. Semi-structured interviews explored participants' experience of ExeRTiOn, weight gain, and physical activity. The data set were analysed thematically. Participant characteristics, including login data and self-reported body weight, were collected. Data analyses identified valued intervention content and usability aspects which were summarized by two themes. The first theme 'You need to know how to manage yourself' included subthemes: (1) the resource filled a guidance gap, (2) expert patient content resonated, and (3) the importance of goal setting and monitoring progress. The second theme 'room for improvement' included subthemes: (2) web support and (2) content and operational change suggestions. Results have allowed for identification of potential areas for resource refinement. This has facilitated iterative enhancement of ExeRTiOn in preparation for a randomized controlled feasibility trial.

Combined Healthy Lifestyle Is Inversely Associated with Upper Gastrointestinal Disorders among Iranian Adults

Objective: Although lifestyle-related factors have separately been examined in relation to functional gastrointestinal disorders (FGIDs), there is no epidemiological data on the combined association of lifestyle factors with these conditions. We aimed to examine how combinations of several lifestyle factors were associated with functional dyspepsia (FD), its symptoms, and gastroesophageal reflux disease (GERD) in a large group of Iranian adults. Design, Setting, and Subjects: In a cross-sectional study on 3,363 Iranian adults, we calculated the “healthy lifestyle score” for each participant by summing up the binary score given for 5 lifestyle factors, including dietary habits, dietary intakes, psychological distress, smoking, and physical activity. A dish-based 106-item semi-quantitative validated food frequency questionnaire, General Practice Physical Activity Questionnaire, General Health Questionnaire, and other pre-tested questionnaires were used to assess the components of healthy lifestyle score. To assess FGIDs, a validated Persian version of ROME III questionnaire was used. Results: After adjustment for potential confounders, we found that individuals with the highest score of healthy lifestyle had 79 and 74% lower odds of FD (OR: 0.21; 95% CI: 0.05–0.92) and GERD (OR: 0.26; 95% CI: 0.09–0.69), respectively, compared with those with the lowest score. They were also less likely to have early satiation (OR: 0.28; 95% CI: 0.11–0.73), postprandial fullness (OR: 0.22; 95% CI: 0.09–0.50), and epigastric pain (OR: 0.44; 95% CI: 0.21–0.92). In addition to the combined healthy lifestyle score, low levels of psychological distress, a healthy diet, healthy dietary habits, and nonsmoking were separately and protectively associated with FGIDs. Conclusion: We found that adherence to a healthy lifestyle was associated with lower odds of GERD, FD, and its symptoms in this group of Iranian adults, in a dose-response manner. Individual lifestyle-related factors were also associated with these conditions.

How do lifestyle choices affect the link between living alone and psychological distress in older age? Results from the AgeHeaPsyWel-HeaSeeB study

BackgroundSocial isolation is widespread and strongly associated with worsening health-related outcomes across the life-course. Despite this broad base of knowledge, there is a paucity of research on the interactive effect of lifestyle choices and living arrangements on later life psychological state particularly in low- and middle-income settings. The aim of this study is to examine the influence of living alone on psychological distress in older people and to explore the protective roles of social participation and physical activity participation.MethodsWe used cross-sectional data from the 2016—17 Aging, Health, Psychological Well-being and Health-seeking Behavior Study (AgeHeaPsyWel-HeaSeeB) involving a representative sample of 1200 adults aged 50+ years in Ghana. The study focused on a latent measure of Kessler Psychological Distress Scale (K10) and on the General Practice Physical Activity Questionnaire (GPPAQ). Ordinary Least Squares (OLS) regression models evaluated the interactive effects of living arrangements and lifestyle choices on the K10 score.ResultsLiving alone was independent predictor of psychological distress in the overall sample, among females, urban dwellers and all age groups. However, lifestyle choices of physical activity and social participation significantly moderated these associations. Moreover, in the stratified analysis, physical activity moderated the association for males, rural-dwellers and those 65+ years whilst social participation moderated the association for females, urban-dwellers and those 50–64 years.ConclusionsLifestyle choices i.e. social participation and physical activity, and demographic factors i.e. age, gender, and residential status strongly attenuate the positive association of living alone with the risk of psychological distress in older age. These findings may inform intervention initiatives targeted at improving mental health of chronically detached and isolated older people.

P0956HOW DO MARKERS OF FRAILTY VARY ACROSS KIDNEY DISEASE TRAJECTORY? A MULTICENTRE CROSS-SECTIONAL STUDY OF 4736 PATIENTS

Abstract Background and Aims Frailty is a complex health state of increased vulnerability to stressors and is common in those with chronic kidney disease (CKD). Frailty is strongly associated with progressive renal impairment and independently linked with adverse outcomes in all stages of CKD such as disability, falls, hospitalisation, and mortality. How frailty varies across the disease trajectory is not well-defined, particularly in those with early stages of disease. Identifying those with CKD who may be at risk of becoming frail could inform the early intervention and understanding how frailty changes across the disease spectrum may aid better future management of these patients. Method This is a secondary analysis of data of n=4736 CKD patients (42% female, mean age 59.7 (SD: 16.3) years) from a prospective observational study of physical activity behaviours. A modified assessment of frailty (based on the Fried phenotype model) was conducted across each of the CKD stages ((n=262 CKD stage 1/2, n=678 CKD stage 3, n=610 CKD stage 4/5, n=1094 haemodialysis (HD), n=177 peritoneal dialysis (PD), n=1915 transplant (TX)). Markers of frailty were defined as (1) poor endurance (defined as a VO2 peak of &amp;lt;20ml/kg/min estimated from the Duke Activity Index Scale); (2) low physical activity level (classified as ‘insufficiently active’ using General Practice Physical Activity Questionnaire); and (3) slowness (self-reported slow walking pace (less than 3mph)). Participants were classified as ‘frail’ if ≥2 markers were present. Frequency analysis and chi-squared tests were conducted to identify and compare patients with ≥2 markers of frailty across the disease trajectory. Binominal logistical regression was performed to determine which factors were associated with being frail. Results Across the total cohort, the majority (56%) of patients exhibited ≥2 markers of frailty. The presence of frailty increased concurrently with disease decline (39% CKD stage 1/2, 58% CKD stage 3, 74% CKD stage 4/5, 76% HD, 66% PD, 39% TX). The prevalence of frailty was significantly higher in patients in CKD stage 3, CKD stage 4/5, HD and PD patients when compared to CKD stage 1/2 and TX patients (p&amp;lt;.001). Frailty was significantly higher in patients in CKD stage 4/5 and on HD compared to those in CKD stage 3 (p&amp;lt;.001). Patients who were female (OR = 1.42 [1.23 to 1.65] p&amp;lt;.001), older (OR= 1.05 [1.05 to 1.06] p &amp;lt;.001), and of non-white ethnicity (OR = 2.41 [2.00 to 2.90] p&amp;lt;.001) had an increased likelihood of being frail. Increased number of comorbidities (OR = 1.26 [1.18 to 1.34] p&amp;lt;.001) were associated with an increased likelihood of being frail (Figure 1). Conclusion The proportion of patients with ≥2 markers of frailty increased with disease progression until it reached a peak in HD with almost 8 out of 10 HD patients exhibiting frailty. Frailty prevalence was reduced in those with a renal TX. Over half of those in CKD stage 3 and three-quarters with CKD stage 4/5 had ≥2 markers of frailty present. Worryingly, markers of frailty were present early in the disease process with over 1/3 of patients with CKD stage 1/2 classified as frail by this modified phenotype model. Age, sex, ethnicity, and number of comorbidities were associated with the likelihood of being frail. It is important that healthcare providers actively attempt to identify patients at risk of frailty to ensure appropriate interventions addressing risk factors that may exacerbate the progression of frailty can be implemented.

The Prevalence of Depression and Anxiety and Their Lifestyle Determinants in a Large Sample of Iranian Adults: Results from a Population Based Cross-Sectional Study

Abstract Association of lifestyle-related factors and mental health has been less studied in Middle Eastern countries. This study aimed to examine the prevalence of two common mental health problems, i.e., depression and anxiety, and their lifestyle determinants in a large sample of Iranian population. This study was conducted within the framework of SEPAHAN population based cross-sectional study (N=4763(. The General Practice Physical Activity Questionnaire (GPPAQ) was used to assess physical activity and the Iranian-validated version of Hospital Anxiety and Depression Scale (HADS) was applied to screen for anxiety and depression. Logistic regression was used as the main statistical method for data analysis by SPSS version 16.0. A P-value &lt;0.05 was considered to be statistically significant. The risk of anxiety and depression was 2.5 (OR=2.56,95% CI: 1.97-3.33) and 2.21(1.83-2.67) times higher in women than men, respectively. With every one-year increase in the age, the risk of anxiety decreased by 2% (OR=0.98,95% CI:0.97-0.99). Individuals with higher education had 56% lower risk of anxiety (OR=0.44,95% CI: 0.36-0.55) and 46% depression (OR=0.54,95% CI: 0.46-0.64) than the undergraduate group, and the risk of depression in the inactive (less than one hour of activity per week) group was 27% higher than the active group (OR=1.27,95% CI: 1.06-1.51). The risk of anxiety in the non-smoker group was 65% (OR=0.35,95% CI: 0.20-0.59) and depression was 64% lower than among smokers (OR=0.34,95% CI:0.22-0.53). In the ex-smoker group, the risk of anxiety was 60% (OR=0.40,95% CI:0.19-0.85) and depression was 59% lower than for the smoker group (OR=0.41,95% CI: 0.24-0.73). This current study’s results demonstrated significant associations between unhealthy lifestyle factors and increased risk of anxiety and depression. Hence, special attention must be paid to preventive intervention programmes aiming to enhance healthy lifestyle among at-risk populations.

Prevalence and correlates of physical activity across kidney disease stages: an observational multicentre study.

People with chronic kidney disease (CKD) report high levels of physical inactivity, a major modifiable risk factor for morbidity and mortality. Understanding the biological, psychosocial and demographic causes of physical activity behaviour is essential for the development and improvement of potential health interventions and promotional initiatives. This study investigated the prevalence of physical inactivity and determined individual correlates of this behaviour in a large sample of patients across the spectrum of kidney disease. A total of 5656 people across all stages of CKD (1-2, 3, 4-5, haemodialysis, peritoneal dialysis and renal transplant recipients) were recruited from 17 sites in England from July 2012 to October 2018. Physical activity was evaluated using the General Practice Physical Activity Questionnaire. Self-reported cardiorespiratory fitness, self-efficacy and stage of change were also assessed. Binominal generalized linear mutually adjusted models were conducted to explore the associations between physical activity and correlate variables. This cross-sectional observational multi-centre study was registered retrospectively as ISRCTN87066351 (October 2015). The prevalence of physical activity (6-34%) was low and worsened with disease progression. Being older, female and having a greater number of comorbidities were associated with greater odds of being physically inactive. Higher haemoglobin, cardiorespiratory fitness and self-efficacy levels were associated with increased odds of being active. Neither ethnicity nor smoking history had any effect on physical activity. Levels of physical inactivity are high across all stages of CKD. The identification of stage-specific correlates of physical activity may help to prioritize factors in target groups of kidney patients and improve the development and improvement of public health interventions.

Hubungan Antara Tingkat Aktivitas Fisik dengan Fungsi Kognitif Pada Lanjut Usia

Along with the aging process, all systems of the body dealing with changes or gradual deterioration functions, one of which was a decrease in physical activity. A decrease in physical activity in the elderly was one of the causes of cognitive impairment. Decline in cognitive function in the elderly is the biggest cause of the inability to perform normal daily activities. The purpose of the study was to know the correlation between the level of physical activity and cognitive function in the elderly in Pucangan Village Kartasura SubDistrict. This research was cross sectional design. The population were in this study are listed on the elderly Posyandu Pucangan Village Kartasura Sub-District aged &gt;60 years and include in inclusion criteria. The total sample in this study were 95 respondents. Sampling technique used is nonprobability sampling technique with proportional sampling method. The instrument used to measure the level of physical activity is GPPAQ (General Practice Physical Activity Questionnaire) and for cognitive function using the MMSE (Mini Mental State Examination). Analys of the data used was Chi Square test. Results of univariate known that elderly people who have high levels of physical activity inactive (35.8%) and active as much (21.1%). The percentage of elderly who have normal cognitive function as many (29.5%) and those with severe cognitive disorders amounted to (43.2%). The result of bivariate analysis there was no relationship between the level of physical activity and cognitive function in which showed the value of p value = 0.010 (p&gt; 0.05) means that Ho was &#x0D; rejected. The conclusions of this study shows there is a relationship between the level of physical activity and cognitive function in the elderly in Pucangan Village Kartasura Sub-District.