Household Physical Activity Research Articles

Household Activity in Relation to Functional Fitness in A Sample of Taiwanese Older Women

Physical inactivity is closely related to the age-induced decline in body function. While studies have shown the effects of physical activity (PA) in the improvement of physical functioning for older people, it is still unknown, however, the relationship between categories of physical activity and physical function, more specifically, functional fitness (FF), in the sample of female elderly. PURPOSE: To investigate the collective relationships between categories of PA and indicators of FF in a sample of Taiwanese older women. METHODS: One hundred seventy-nine older women(66.9 ± 8.4 yo) resided in Taipei/Taoyuan Areas were recruited in the study. The Physical Activity Scale for the Elderly (PASE) was used to collect the data for categories of PA including leisure, household, and occupational activity. The field-based Senior Fitness Test (SFT), namely body mass index (BMI), upper and lower body strength (30-s arm curl test and 30-s chair stand test), upper and lower body flexibility (back scratch test and chair sit-and-reach test), agility/dynamic balance (8-foot timed-up-and-go test), and aerobic endurance (2-minute walk-in-place), were conducted to measure the FF of the subjects. Canonical correlation was used to determine the multivariate association among categories of PA and parameters of FF. RESULTS: Only one significant canonical variate pair was derived from this analysis with RC=0.40 (p<.05). This canonical variate pair relates a higher structure coefficient on household activity (-.88) than leisure and occupational activity (-.50 and -.30 respectively) in the PA category variables, with strong correlations on lower body strength and aerobic endurance (-.70 and -.76 respectively) and moderate correlations on upper body strength, lower body flexibility and agility/dynamic balance (-.66, -.47 and -.48 respectively) in the FF parameter variables. CONCLUSIONS: Household physical activity relates more strongly than leisure and occupational activities to FF for older women in Taiwan. The surprising higher physical functioning benefit from activity of house chores for the Taiwanese female elderly, though may not be originally intended, may be gift from the traditional social role of women in the ethnic culture.

Sedentary behavior, physical activity, and concentrations of insulin among US adults

Time spent watching television has been linked to obesity, metabolic syndrome, and diabetes, all conditions characterized to some degree by hyperinsulinemia and insulin resistance. However, limited evidence relates screen time (watching television or using a computer) directly to concentrations of insulin. We examined the cross-sectional associations between time spent watching television or using a computer, physical activity, and serum concentrations of insulin using data from 2800 participants aged at least 20 years of the 2003-2006 National Health and Nutrition Examination Survey. The amount of time spent watching television and using a computer as well as physical activity was self-reported. The unadjusted geometric mean concentration of insulin increased from 6.2 μU/mL among participants who did not watch television to 10.0 μU/mL among those who watched television for 5 or more hours per day ( P = .001). After adjustment for age, sex, race or ethnicity, educational status, concentration of cotinine, alcohol intake, physical activity, waist circumference, and body mass index using multiple linear regression analysis, the log-transformed concentrations of insulin were significantly and positively associated with time spent watching television ( P = < .001). Reported time spent using a computer was significantly associated with log-transformed concentrations of insulin before but not after accounting for waist circumference and body mass index. Leisure-time physical activity but not transportation or household physical activity was significantly and inversely associated with log-transformed concentrations of insulin. Sedentary behavior, particularly the amount of time spent watching television, may be an important modifiable determinant of concentrations of insulin.

地域在住高齢者の余暇活動量，家庭内活動量，仕事関連活動量と身体機能との関連性

The study objective was to cross-sectionally examine the relationships among leisure-time, household, and occupational physical activity with physical functions in Japanese older adults. We randomly enrolled 189 community-dwelling older adults, aged 65 to 85 years, as subjects from the Basic Resident Register of Kasama City, Ibaraki prefecture. Physical activity was assessed by the Physical Activity Scale for the Elderly. Analysis of covariance was performed to determine the relationships between physical activity and physical functions, after adjustment for age and sex. Leisure-time physical activity significantly correlated with one-leg balance with eyes open, sit and reach, timed standing test from along sitting position on the floor, functional reach, 5-repetition sit-to-stand, timed up and go, 5-m habitual walk, choice stepping reaction time, and power in sit-to-stand tests. Household physical activity was significantly related to 5-repetition sit-to-stand and ability in sit-to-stand. Total (leisure-time plus household plus occupational) activity was significantly correlated with one-leg balance with eyes open, functional reach, and power in sit-to-stand tests. Post-hoc testing indicated that the levels of physical functions were higher in the subjects of the third tertile than in those of the first or second tertile. No difference was found in physical functions between the first and second tertile. Leisure-time physical activity was related to many physical functions. Household physical activity was also related to lower-extremity functions. Our data suggest that medium- or high-level physical activity may be necessary for older adults to maintain their physical functions.

Physical activity and sleep among pregnant women

Sleep disturbances are common among pregnant women and safe treatments to improve sleep are needed. Generally, physical activity improves sleep, but studies are lacking on the associations of physical activity with sleep among pregnant women. Our aim was to investigate the cross-sectional association of various modes of physical activity and activity clusters with sleep quality and duration among 1259 pregnant women. Participants were recruited into the Pregnancy, Infection, and Nutrition Study from prenatal clinics at the University of North Carolina Hospitals. Women self-reported sleep quality and duration and physical activity in the past week. We used cluster analysis to create seven physical activity profiles and multivariable logistic regression analysis, with adjustments for age, race/ethnicity, education, marital status, parity, self-rated general health, anxiety and depressive symptoms. Women with higher levels of occupational physical activity were more likely to report either short or normal sleep duration than longer duration. Women with higher levels of indoor household physical activity were less likely to report normal sleep duration than shorter duration. Women in the recreational-indoor household activity cluster were less likely than women in the inactivity cluster to report normal sleep duration as compared with longer duration. Our data suggest weak associations of physical activity with sleep duration and quality in late pregnancy. Physical activity is recommended to pregnant women for health benefits, yet more research is needed to understand if physical activity should be recommended for improving sleep.

Health indicators of Native Hawaiian and Pacific Islanders in the United States.

This study aimed to describe health indicators and behaviors of Native Hawaiian and Pacific Islander (NHPI) adults and to compare findings to previous reports on US NHPI and the US population. A sample of N = 100 (56 M, 44 F) NHPI adults aged 40–59 years completed an anonymous questionnaire addressing education and household income, tobacco use, physical activity, fruit and vegetable (F&V) consumption, cancer screening and health status. Objective measures of height and weight were taken to calculate body mass index (BMI). The study sample consisted of 49% current smokers and the majority was not meeting guidelines for physical activity (80%) or F&V consumption (99%). Cancer screening rates ranged from 0 to 57% and were higher among females. Mean BMI was 33.9 ± 7.5 kg/m2 and 95% were overweight or obese. While 36.7% were hypertensive, only 11.1% were taking prescribed medication. Compared to both the general US population and available data for US NHPI, study participants reported higher prevalence of obesity and chronic conditions (hypertension, high cholesterol, diabetes, and angina/CHD) and lower levels of physical activity, F&V consumption and cancer screening rates. Study findings contribute to the limited knowledge regarding health behaviors of US NHPI. Comparisons to US data increase evidence of NHPI health disparities, while comparisons to previous NHPI studies emphasize the magnitude of unhealthy lifestyle behaviors and subsequent adverse health conditions for this particular sample. Further improvements to community outreach and recruitment strategies could successfully encourage high-risk individuals to participate in health promotion and behavior intervention studies to improve NHPI health behaviors.

Associations of multiple physical activity domains with mental well-being

Objective Physical activity (PA) has consistent associations with mental well-being, but studies have focused primarily on leisure-time activity, and there has been little attention to the roles of other activity domains (household, occupational and transport). We examined the dose–response relationships of PA dimensions (frequency, amount and volume) with mental well-being for all four PA domains. We also assessed the interaction effects of gender, age, body weight status, and PA domains. Method In 2003–2004, two surveys collected data on PA, socio-demographics, height and weight, perceived neighborhood attributes, barriers to PA, and physical and mental well-being from 2194 Australian adults. Generalized linear models with restricted cubic splines identified the dose–response relationships of PA domains with mental well-being; the interactive effects of PA domains, age, gender and weight status; and the confounding effects of poor mental or physical health as barriers to PA. Results Leisure-time PA was independently linearly related to mental well-being in most demographic groups. Stronger effects were observed for vigorous-intensity leisure-time PA. Poor health as a barrier to PA explained only a small portion of the relationships of PA with mental well-being. The magnitude and direction of the effects of household, occupational and transport PA depended on age, gender, weight status and/or participation in other PA domains. Conclusions Individual physical capacities and characteristics, and level of discretionary choice are likely determinants of the effects of PA on mental well-being. Strategies aimed at increasing PA for mental health benefits need to take these diverse and sometimes counterintuitive effects into account.

Epidemiology of Leisure, Transportation, Occupational, and Household Physical Activity: Prevalence and Associated Factors

To estimate the prevalence of and identify factors associated with physical activity in leisure, transportation, occupational, and household settings. This was a cross-sectional study aimed at investigating living and health conditions among the population of São Paulo, Brazil. Data on 1318 adults aged 18 to 65 years were used. To assess physical activity, the long version of the International Physical Activity Questionnaire was applied. Multivariate analysis was conducted using a hierarchical model. The greatest prevalence of insufficient activity related to transportation (91.7%), followed by leisure (77.5%), occupational (68.9%), and household settings (56.7%). The variables associated with insufficient levels of physical activity in leisure were female sex, older age, low education level, nonwhite skin color, smoking, and self-reported poor health; in occupational settings were female sex, white skin color, high education level, self-reported poor health, nonsmoking, and obesity; in transportation settings were female sex; and in household settings, with male sex, separated, or widowed status and high education level. Physical activity in transportation and leisure settings should be encouraged. This study will serve as a reference point in monitoring different types of physical activities and implementing public physical activity policies in developing countries.

Association between Different Domains of Physical Activity and Markers of Inflammation

Physical activity has recently been established as a potential modifier of the inflammatory process, suggesting that it mitigates inflammation and consequently reduces the incidence of several chronic diseases such as cardiovascular events. This study examined the association between different domains ofself-reported physical activity (work, transportation, household, and leisure time) and three inflammatory markers (fibrinogen, C-reactive protein (CRP), and interleukin 6 (IL-6)). Study subjects included 796 men and women aged 35-74 yr with complete data for the main study variables who participated in the 1989/1990 MONItoring trends and determinants in CArdiovascular disease (MONICA) Augsburg Survey. Data were collected using the MONICA Optional Study on Physical Activity (MOSPA) questionnaire, and activity levels were classified into low, moderate, and vigorous physical activities. Fibrinogen showed an inverse relationship with higher levels of work (Ptrend = 0.038), transportation (Ptrend = 0.025), leisure time (Ptrend = 0.013), and summary physical activity (Ptrend< 0.001). This relationship was still observed after adjusting for age and sex and further correction for body mass index, waist-to-hip ratio, smoking status, hypertension, diabetes, total-to-HDL cholesterol ratio, education, and self-reported limited physical activity due to health problems. IL-6 showed significant results for transportation (Ptrend = 0.031), leisure time (Ptrend = 0.016), and summary physical activity (Ptrend < 0.001), whereas CRP was inversely related with the summary activity (Ptrend = 0.003) in the fully adjusted model. No statistically significant inverse association between household physical activity and any of the investigated markers was found. We observed interactions between summary physical activity and smoking (fibrinogen: P = 0.003) as well as ex-smoking (CRP: P < 0.001; IL-6: P = 0.049). These data indicate that beyond leisure time, work and transportation physical activity may reduce inflammation.

Validation of reported physical activity for cholesterol control using two different physical activity instruments

The National Cholesterol Education Program recommends increasing physical activity to improve cholesterol levels and overall cardiovascular health. We examined whether US adults who reported increasing their physical activity to control or lower blood cholesterol following physician's advice or on their own efforts had higher levels of physical activity than those who reported that they did not. We used data from the National Health and Nutrition Examination Survey 2003-2004, which implemented two physical activity assessment instruments. The physical activity questionnaire (PAQ) assessed self-reported frequency, intensity, and duration of leisure-time, household, and transportation-related physical activity in the past month. Physical movement was objectively monitored using a waist accelerometer that assessed minute-by-minute intensity (counts of movement/minute) during waking time over a 7-day period. We adjusted our analysis for age, gender, race/ethnicity, educational attainment, and body mass index. Participants who reported increasing physical activity to control blood cholesterol had more PAQ-assessed physical activity and more accelerometer-assessed active days per week compared to those who did not. However, there were no significant differences in cholesterol levels between comparison groups. These findings suggest that self-report of exercising more to control or lower cholesterol levels among US adults might be valid.

Five Year Physical Activity Changes Among Older Men In The Mros Study

PURPOSE: To describe the change in self-reported physical activity (total, leisure, household, occupational) among men aged 65+ years over a 4-5 year follow-up period, and to identify socio-demographic and health factors that predict change in physical activity among older men. METHODS: This prospective cohort study enrolled ambulatory community dwelling men (n=5995), 65 yrs or older, at 6 US clinical centers. Using the Physical Activity Scale for the Elderly (PASE), the men self-reported the intensity, frequency, and duration of their leisure, paid and volunteer occupational, and household activities over the past 7 days. Only men with PASE data at baseline and visit 2 were analyzed (n=5161). Linear regression models were built to examine the associations between change in total and subscale PASE scores (outcomes) and socio-demographic and health conditions measured at baseline. RESULTS: The analytic cohort was 90% Caucasian, mean age 73.1 + 5.5 yrs, median of 3 health conditions, 3% smoked, and 13% lived alone at baseline. Mean follow-up was 4.5 years. Total, leisure, occupational, and household physical activity scores declined (-19.5 + 68.0, -3.0 + 37.5, -6.3 + 34.1, -10.2 + 44.3, respectively; p<0.01). On average, total PASE scores decreased with age; -16 + 72 for <70, -16 + 67 for 70-74, -21 + 67 for 75-79, and -30 + 61 for 80+ yr olds. Declines in total physical activity were primarily attributed to occupational changes in 65-70 yr olds and household changes in 70+ yr olds. Participants exhibited a greater decline in physical activity if they lived alone (b=-12.9, SD=2.9), smoked cigarettes (b=-8.8, SD=5.6), or reported poor or very poor health (b=-17.3, SD=8.6) at baseline. Change in PASE scores was negatively associated with number of self-reported health conditions (b=-1.9, SE=0.4, p<0.01); a greater decline in PASE change scores was observed for older men with more health conditions. Significant predictors of change in PASE scores after adjusting for baseline PASE scores were living alone, age, smoking, and overall health status (p<0.01 for all). CONCLUSIONS: All domains of physical activity declined with age especially among older men who reported health conditions, lived alone or smoked. Efforts are needed to identify interventions aimed to reverse the negative physical activity trends in older men.

Anthropometric Measurements, Physical Activity, and the Risk of Symptomatic Gallstone Disease in Chinese Women

Gallstone disease is more common among overweight individuals, particularly in women. We conducted a cross-sectional case-control study of Chinese women nested in the Shanghai Women's Health Study (SWHS) to evaluate the association of gallstone disease with body mass index (BMI), waist to hip ratio (WHR), and physical activity (PA). The study included 8,485 women with self-reported, physician-diagnosed, prevalent gallstone disease and 16,970 frequency-matched controls by birth year and age at gallstone diagnosis (4-year intervals). Information on height, weight history, waist and hip circumferences, physical activities, and other exposures was obtained by in-person interview. : Usual BMI (p trend < 0.001) and WHR (p trend < 0.001) were both related to a high prevalence of gallstone disease, and a significant interaction between BMI and WHR on gallstone risk was found (odds ratio [OR] = 3.82, 95%CI [95% confidence interval] 2.47-5.23 for those with both highest BMI and WHR relative to those with lowest BMI and WHR, p interaction = 0.03). Gallstone risk was positively associated with cumulative occupational sitting time (p trend = 0.01) and inversely associated with occupational cumulative energy expenditure (p trend = 0.03) as well as with household PA (p trend = 0.02). Our findings further support that overall and central excessive adiposity is an independent risk factor for gallstones in women. In addition, regardless of adiposity level, being physically active may ameliorate the risk of this disease.

Physical activity and the risk of breast cancer in BRCA1/2 mutation carriers in the Netherlands.

Abstract Abstract #505 Background: Physical activity reduces the risk of breast cancer in the general population by 20-40%. Suggested biological mechanisms include a reduction of adipose tissue and decreased lifetime exposure to estrogens. This is one of the first studies that investigates the association between physical activity and breast cancer risk in BRCA1/2 mutation carriers (carriers).&amp;#x2028; Patients and methods: We analyzed data from a nationwide retrospective cohort study (GEO-HEBON), including 1026 carriers, of which 465 had a history of breast cancer. We examined the association between breast cancer risk and average (METhr/wk) sports, walking/cycling, occupational, household, and total physical activity, lifetime and for age-periods below and above age 20, separately. All analyses were stratified for birth cohort and gene, clustered on family, and adjusted for confounders and other physical activity variables (when investigating separate components).&amp;#x2028; Preliminary results: For adulthood sports activity we found a risk reduction for active carriers (low: Hazard Ratio (HR) = 0.72; 95% CI = 0.54-0.96; medium: HR = 0.64; 95% CI = 0.46-0.90; high: HR = 0.71; 95% CI = 0.48-1.06) when compared to carriers who had never engaged in sports. No risk change was found for sports activity before age 20. For lifetime (mainly adulthood) household activity we found a risk reduction of 0.74 (95% CI = 0.57-0.96) for the second versus the lowest quartile but for higher quartiles HRs were not significantly decreased, and a similar pattern for occupational activity (0.53 (0.35-0.82)). We found neither an effect for walking/cycling activity nor for total physical activity.&amp;#x2028; Discussion: Our physical activity information was relatively extensive, and we used proxy-questionnaires to examine survival bias. Limitations include the retrospective character of the cohort and potential misclassification bias. In conclusion, these preliminary results suggest that physical activity may reduce the risk of breast cancer in carriers. The inverse associations were clearest for physical activity during adulthood. Time-dependent, weighted (for testing bias), and stratified (for example by menopausal status and Body Mass Index) analyses will be conducted. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 505.

Lifetime total physical activity and prostate cancer risk: a population-based case–control study in Sweden

The etiologic role of physical activity in prostate cancer development is unclear. We assessed the association between lifetime total physical activity and prostate cancer risk in a Swedish population-based case-control study comprising 1,449 incident prostate cancer cases and 1,118 unaffected population controls. Information regarding physical activity was obtained via a self-administered questionnaire assessing occupational, household, and recreational activity separately at various ages throughout an individual's lifetime. Clinical data (TNM-classification, Gleason sum and PSA) was obtained from linkage to the National Prostate Cancer Registry. Overall, we observed no association between lifetime total physical activity and prostate cancer risk (odds ratio [OR] = 1.04, 95% confidence interval [CI] = 0.77-1.41 for > or =49.7 vs. <41.9 metabolic equivalent-hours per day). There was a significantly increased risk of prostate cancer in the most active men compared with the least active men in household (OR = 1.44, 95% CI = 1.08-1.92) and recreational physical activity (OR = 1.56, 95% CI = 1.16-2.10). Comparing the most active with the least active men, total physical activity was not associated with either localized disease (OR = 0.95, 95% CI = 0.67-1.34) or advanced disease (OR = 1.19, 95% CI = 0.83-1.71). These findings do not support the hypothesis that physical activity uniformly protects against prostate cancer development.

Upper-Body Progressive Resistance Training Improves Strength and Household Physical Activity Performance in Women Attending Cardiac Rehabilitation

The purpose of this study was to examine the impact of moderate-intensity, progressive, upper-body resistance training (RT) on muscle strength and perceived performance of household physical activities (HPA) among women in cardiac rehabilitation. The 10-week, pretest-posttest, experiment randomized women to either usual care (UC) aerobic exercise or RT. Muscle strength for 5 upper-body RT exercises (chest press, shoulder press, biceps curl, lateral row, and triceps extension) was measured using the 1-Repetition Maximum Assessment. The RT group progressively increased weight lifted using 40%, 50%, and 60% of obtained 1-Repetition Maximum Assessment at 3-week intervals. Perceived performance of HPA was measured with the Kimble Household Activities Scale. The RT group (n = 16, mean age 64 +/- 11) significantly increased muscle strength in all 5 exercises in comparison with the UC group (n = 14, mean age 65 +/- 10) (chest press, 18% vs 11%; shoulder press, 24% vs 14%; biceps curl, 21% vs 12%; lateral row, 32% vs 9%; and triceps extension, 28% vs 20%, respectively). By study end, Household Activities Scale scores significantly increased (F = 13.878, P = .001) in the RT group (8.75 +/- 3.19 vs 11.25 +/- 2.14), whereas scores in the UC group decreased (8.60 +/- 3.11 vs 6.86 +/- 4.13). Progressive upper-body RT in women shows promise as an effective tool to increase muscle strength and improve the ability to perform HPA after a cardiac event. Beginning RT early after a cardiac event in a monitored cardiac rehabilitation environment can maximize the strengthening benefit.

Upper-Body Progressive Resistance Training Improves Strength and Household Physical Activity Performance in Women Attending Cardiac Rehabilitation

Upper-Body Progressive Resistance Training Improves Strength and Household Physical Activity Performance in Women Attending Cardiac Rehabilitation

Prevalence of the overactive bladder among Iranian women based on the International Continence Society definition: a population-based study

There is a continuing debate on the accurate prevalence estimates of overactive bladder (OAB) among different ethnicities and regions. The aims of our study were to determine the prevalence of OAB, associated risk factors, and the impact of OAB on the quality of life and sexual function of Iranian women. A total of 8748 women between 15 and 55 years of age enrolled in this cross-sectional study. The definition of the 2002 International Continence Society (ICS) was applied to assess the prevalence of OAB. All participants underwent a detailed history and physical examination that included an evaluation of quality of life, coping strategies and treatment-seeking behavior, laboratory tests, urinalysis and current or previous therapy. The degree of bother was quantified using s visual analog scale (VAS). The overall prevalence of OAB was found to be 18.2% and increased with age from 10.9% in adults aged 15-29 years to 26.2% in those aged >50 years old (test for trend, P = 0.001). A negative impact of OAB on sexual function was reported by 72.3% of the women. Frequency was the most commonly reported symptom (67% of women), followed by urgency (54%). Subjects with OAB had a higher prevalence of anxiety (28.2 vs. 8.8%; P = 0.001), depression (38.2 vs. 18.2%; P = 0.02) and tiredness (16.4 vs. 2.7%; P = 0.001), and they reported significant impairment in carrying out household chores (P = 0.01), physical activities (P = 0.01) and work-related activities (P = 0.01) as well as negative effects on education (P = 0.02), sleep (P = 0.001), relationships (P = 0.001) and annual income (P = 0.01). The prevalence of OAB in Iranian women is higher than that reported in many previous studies in developed and developing countries. Our results reveal that OAB is a highly prevalent condition among Iranian women and that is has a serious impact on quality of life and sexual function.

Lifestyle physical activity of older rural women.

The purpose of this study was to describe and examine the lifestyle physical activity behaviors (household, leisure, occupational) of older rural women. Background characteristics included demographics, environment, social support, and health. Intrapersonal characteristics included motivation and self-efficacy. The majority of the women's energy expenditure was in the household dimension. Social support was positively associated with household activities. A higher level of leisure physical activity was associated with living within the two small cities and reporting lower levels of health and lower motivation. This research highlights the importance of household physical activity and the contribution of social support for household physical activity, both of which may be important in developing interventions to promote physical activity in older rural women.

Indications of recall bias found in a retrospective study of physical activity and myocardial infarction

Objective To evaluate the presence of recall bias in retrospective studies of physical activity and myocardial infarction. Study Design and Setting In 2005, seventy-eight cases who had suffered from a myocardial infarction and 243 control subjects, who had previously participated in the Swedish WOLF (Work, Lipids, and Fibrinogen) study, were asked about their physical activity level during 1990–2005. The answers about recalled past leisure time, occupational, and household physical activity level were compared with physical activity level as reported at the baseline examination of the WOLF study in 1992–1998. Results The proportion who recalled the same activity level as originally reported ranged from 69% to 96% (cases) and 69% to 89% (controls), and the kappa values ranged from 0.30 to 0.91 (cases) and 0.46 to 0.59 (controls), with the exception of perceived physical workload in household work, which showed low agreement between the originally stated and later recalled activity levels. Some differences were found between cases and controls regarding recall of past occupational activity, indicating the presence of recall bias in this domain of physical activity. Conclusion We cannot preclude the existence of recall bias when using retrospectively recalled information about occupational physical activity in studies of physical activity and myocardial infarction.

Injurious Falls Are Associated with Lower Household but Higher Recreational Physical Activities in Community-Dwelling Older Male Veterans

Background: Physical activity (PA) and exercise have numerous beneficial effects in older adults. The effect of sustaining an injury from a fall on subsequent PA levels has received little research attention, even though about a quarter of older adults who fall sustain a serious injury. Even less is known about the effect of injurious falls on different PA categorizations. Objective: To examine the role of injurious falls on subsequent household and recreational PA levels in older community-dwelling males who were all Canadian veterans of World War II and the Korean War. Methods: Data from a fall risk-factor modification trial were used for the present study. Falls and related injuries were ascertained prospectively using fall calendars. A brief, valid and reliable PA interview for older adults (Phone-FITT) measured household and recreational PA approximately 1 year later. Covariates were measured as part of the screening questionnaire administered at the start of the study. Multiple linearregression models were computed using household and recreational PA as dependent variables. Results: The present study included 200 males with a mean age 81 years (SD = 3.8). Half of the participants fell at least once and about one third reported at least one injury resulting from a fall. Multivariable analyses indicated that household PA scores were 3.1 points lower (95% CI = –5.8 to –0.3, p = 0.03) and recreational PA scores were 3.4 points higher (95% CI = 0.1 to 6.7, p = 0.04) among persons who had one or more falls leading to injury compared to those who did not fall or had one or more falls without injury. Analyses were adjusted for age, baseline PA, self-rated health, foot problems, balance problems, inability to stand without using armrests, vision and memory. Conclusion: Categorization of PA type (household vs. recreational) suggests distinct differences in PA response following an injurious fall. Use of an overall PA measure would obscure this finding. Following further research, the results from this study may help in the design of preventive strategies to maximize physical activity in those who have sustained an injurious fall.

The shape of health to come: prospective study of the determinants of 30-year health trajectories in the Alameda County Study

Considerable evidence now exists indicating that incidence and progression of disease and disability are associated with socio-economic, behavioural, demographic and psychosocial factors. The emerging life course perspective suggests that these factors might be associated with not just the incidence of disease and death, but also trajectories of health over decades. Prospective study of a representative, population-based cohort studied on four occasions over 30 years. Trajectories of health over this period, combining self-rated health and date of death, were related to behavioural, psychosocial and socio-economic risk factors. Trajectories of health were associated with behavioural, socioeconomic, and psychosocial risk factors, the strongest predictors being household income and physical activity. Those with an income 1 SD above the mean were approximately 25% more likely to die having previously consistently reported excellent health (Men: relative risk (RR) = 1.27, 95% CI = 1.10-1.46; Women: RR = 1.25, 95% CI = 1.06-1.47), were more likely to remain 'Alive in Excellent Health' (Men: RR = 1.35, 95% CI = 1.21-1.51; Women: RR = 1.30, 95% CI = 1.19-1.43) and were less likely to have shown an 'Unremitting Decline' (Men: RR = 0.72, 95% CI = 0.49-1.05; Women: RR = 0.71, 95% CI = 0.48-1.04). Those with low physical activity were approximately 50% less likely to die having consistently reported excellent health (Men: RR = 0.54, 95% CI = 0.39-0.76; Women: RR = 0.48, 95% CI = 0.33-0.71), and were five-times more likely to show an 'Unremitting Decline' (Men: RR = 5.05, 95% CI = 1.75-14.56; Women: RR = 5.00, 95% CI = 1.48-16.92). They were also less likely to be 'Alive in Excellent Health' (Men: RR = 0.41, 95% CI = 0.29-0.57; Women: RR = 0.44, 95% CI = 0.33-0.57). The burden of illness associated with behavioural, socio-economic and psychosocial risk factors extends beyond shortening of life to poorer trajectories of health over decades.