Adult Lifestyle Research Articles

Impact of a Discontinuous Training Program on Sedentary Behavior in Italian Type 2 Diabetes Older Patients: The Results of the TRIPL-A Randomized Controlled Trial.

Background: Physical activity is an important predictor of quality of life in older adults with type 2 diabetes (T2D). Unfortunately, most T2D adults adopt a sedentary lifestyle. The randomized, controlled TRIPL-A trial aims to verify the effect of a personalized, discontinuous exercise program on a sedentary lifestyle of T2D older adults. Methods: A total of 305 T2D patients (mean age ± SD: 68.8 ± 3.3 years) were divided into a control arm receiving only behavioral counseling and an intervention arm of an 18-month supervised discontinuous exercise program (ERS). The primary outcomes were the changes in sitting time (ST) and metabolic equivalent (MET) values, both evaluated by the International Physical Activity Questionnaire short form. A repeated measures ANOVA with Bonferroni correction for multiple comparisons was used to compare study outcomes. Results: The ST and MET differed significantly during the study compared to the control group (p = 0.028 and p = 0.004, respectively). In the intervention group, a decrease from baseline in ST at 6 months (p = 0.01) and an increase in MET values at 6 months (p = 0.01) up to 12 months (p < 0.01) were found. No significant differences were found for the other variables. Conclusions: Beneficial lifestyle changes were found within the first year of intervention. These results align with the theory of change.

Associations between regular physical exercise and physical, emotional, and cognitive health of older adults in China: an 8-year longitudinal study with propensity score matching.

The importance of healthy aging is growing in China as it has the largest number of older adults in the world and is one of the fastest-aging countries. This study aimed to examine the predictive value of regular physical exercise in relation to the physical, emotional, and cognitive health among samples of adults aged ≥60 years in China during an 8-year period. A total of 10,691 older adults were extracted from two waves of national data from the China Family Panel Studies in 2010 and 2018. To minimize the impact of selection bias on the findings, a longitudinal propensity score matching (LPSM) method was used to examine the relationships between regular physical exercise and emotional health (depression), between regular physical exercise and physical health (instrumental activities of daily living), and between regular physical exercise and cognitive health (cognitive ability) of older adults. After LPSM, 856 older adults were included in the study. In the regular physical exercise group, the average age of participants at baseline year was 65.67 years, with an average age of 65.90 years for 238 men and 65.45 years for 190 women, and in the non-physical exercise group, their average age at baseline year was 65.70 years, with an average age of 65.45 years for 253 men and 65.98 years for 175 women. LPSM indicated that regular physical exercise has been found to be effective in improving physical function and reducing depressive symptoms in old adults, even after controlling for background differences. However, the sensitivity analysis suggests that the positive association between regular physical exercise and cognitive function may not be sufficiently valid. The findings of this study indicate that engaging in long-term structured and repetitive physical exercise can have a significant positive effect on reducing depressive symptoms and improving the physical function of older adults. As a result, incorporating regular physical exercise into the lifestyle of older adults is recognized as an effective strategy for promoting healthy aging and reducing the strain on public health resources.

Sociocultural interactions and self-perception of health in older adults from an active participation centre: A qualitative study

IntroductionPromoting healthy ageing is a global priority. Active Participation Centres are potentially key in fostering psychosocial and emotional health, contributing to a fulfilling and active lifestyle for older adults. AimsThe study explores self-perceived health, perceptions of sociocultural participation, emotions that emerged when sociocultural participation, and preferences among older adults engaged in community socio-cultural activities from an Active Participation Centre. MethodsWe realised a hermeneutic study; interviews with nine older participants were conducted. Hermeneutic considerations were employed for data analysis. ResultsFindings reveal the centre's significance as a therapeutic space, positively influencing emotional well-being, fostering social connections, and offering diverse activity preferences. ConclusionThis study underscores the nuanced interplay between sociocultural engagement and self-perceived health, emphasising the need for holistic approaches to promote well-being among older adults attending Active Participation Centres.

Comparison of lifestyle, cognitive function, mental health, and quality of life between hospitalized older adults with COVID-19 and non-COVID-19 in South Korea: a cross-sectional study

BackgroundThe coronavirus disease (COVID-19) pandemic has greatly impacted older adults, resulting in many deaths. The impact of lifestyle and mental health on vulnerable groups, such as older adults, can be large and long lasting. Therefore, this study aimed to investigate the effects of COVID-19 confirmation on cognition, lifestyle, mental health, and quality of life in adults aged 55 years.MethodsThe sample consisted of 111 people in the COVID group and 189 people in the non-COVID group aged over 55 years in South Korea. An online survey was conducted between January and May 2022. Participants responded to the following assessment tools: Yonsei Lifestyle Profile, Prospective and Retrospective Memory (PRMQ), Subjective Memory Complaints Questionnaire (SMCQ), Visual Analogue Scale, Patient Health Questionnaire-9 (PHQ-9), Insomnia Severity Index (ISI), Fear of COVID-19 Scale (FCV-19 S), and the World Health Organization Quality of Life Scale abbreviated version (WHOQOL-BREF). Differences in lifestyle, cognition, depression, anxiety, and quality of life were compared between the two groups.ResultsThere were significant differences in physical activity, diet, the total score of the PRMQ, PM (a sub-score of the PRMQ), PHQ-9, Korean version of the ISI (ISI-K), and WHOQOL-BREF scores between the COVID and non-COVID groups. However, there were no significant differences in activity participation, Self-Rating Anxiety Scale (SAS), or FCV-19 S between groups.ConclusionsThe study confirms that COVID-19 negatively affects memory, physical activity, diet, quality of life, depression, and insomnia in the older adults. Therefore, this study implicated that prevention and intervention strategies required improving the memory, lifestyle, and mental health of older adults with COVID-19.Trial registrationThe study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board of Yonsei university in Korea (Registration number: 1041849-202112-SB-226-03, Date of registration: 01042022).

중고령자의 건강 라이프스타일에 반영된 가치체계에 따른 유형과 주관적 건강 및 종합적 행동 경향의 차이

Objective: To classify latent profiles of the value systems reflected in the healthy lifestyles of middle-aged and older adults using latent profile analysis (LPA) and analyze differences in related influencing factors, subjective health, and comprehensive behavioral tendencies. Methods: Yonsei Lifestyle Profile-Values, Self-Rated Health, and Yonsei Lifestyle Profile-ABCD data were collected from 300 middle-aged and older adults through an online research company. LPA was conducted on the collected lifestyle value system data. Multinomial logistic regression analysis was used to examine factors influencing the classified latent profiles, and one-way ANOVA was conducted to assess differences in the dependent variables between profiles. Results: Three latent profiles based on value system characteristics were identified: ‘Low Health Values System (Profile1),’ ‘High Health Values System (Profile2),’ and ‘Moderate Health Values System (Profile3).’ Educational attainment and age significantly influenced these latent profiles. Additionally, significant differences were observed in subjective health and overall behavioral tendencies among the profiles. Conclusion: Our findings suggest that middle-aged and older adults who prioritize health in their value systems are more likely to adopt healthier behaviors in their daily lives. This highlights the importance of considering value systems when designing intervention strategies and directions aimed at promoting healthy lifestyles from a health management perspective.

Remote Pilates Training Is Effective in Improving Physical Fitness in Healthy Women: A Randomized Controlled Study.

Despite its positive impact on physical and mental well-being, adults may refrain from performing regular physical activity, due to inadequate time, accessibility, or funds. Yet remote platforms could overcome such obstacles and increase participation. This study evaluated the effectiveness of remote-synchronous group-Pilates classes compared to in-studio classes in healthy sedentary women. In a randomized controlled design, 40 women, aged 20-45, were assigned to a Zoom or studio group-Pilates training. The intervention included twice-weekly 45 min sessions over an eight-week period. Attendance (adherence) was recorded, and the participants completed physical motor tests (plank, curl-up, stork, push-up, and V-sit and reach), Profile of Mood State Surveys, and Nordic Musculoskeletal Pain Questionnaires. Evaluations were performed at baseline, mid-intervention (4 weeks), and post intervention (8 weeks). Adherence to training was high in the Zoom and studio groups (80% and 74%, respectively). Improvements in physical motor tests were seen in both groups following the Pilates interventions, thereby indicating the effectiveness of group-Pilates Zoom training. In conclusion, remote online physical activity such as Pilates offers a good alternative to in-studio trainings, as a means for improving physical fitness and promoting a healthy lifestyle in adults, by offering a more accessible and less timely alternative to in-studio physical activity programs.

Abstract P256: Rationale, Development, and Implementation of a Multidisciplinary Digital Lifestyle Health Education Program for Older Adults With Cardiovascular Disease and Osteoarthritis

Introduction: Cardiovascular disease (CVD) is the leading cause of death worldwide. Globally, osteoarthritis (OA) affects 654 million. In 2018, of the 1.2 million Australians who had CVD, half also had arthritis, with the most common form in Australia being OA. Ongoing pain and physical limitations from OA can affect lifestyle choices, contributing to the shared risk factor profile of CVD and OA (physical inactivity, overweight/obesity, poor diet, high medication use). This contributes further to the burden of both diseases including reduced 6-minute walk (6MW) performance, which is directly related to increased CVD mortality. This project outlines the rationale for and development of a multidisciplinary digital lifestyle health education program for the treatment and secondary prevention of CVD and its common comorbidity of OA. Methods: This study is a cross-sectional analysis of older adults in Sydney. Class was classified based on the Australian socioeconomic index for areas. Conditions were defined according to Australian national guidelines. Medical history, body mass index (BMI), waist measurement, muscle strength, and 6MW measurements were assessed. Differences between those with and without OA were determined via one-way analysis of variance. Simple linear regressions assessed potential relationships. Results: In a cohort of 532 adults; n=341 (64.1%) had diagnosed CVD; 48.4% of which had OA (mean age 66±12 years; 73.3% female). Socioeconomic index was deemed high. In the OA cohort mean BMI and waist were above healthy heart recommendations according to the World Health Organisation. There were no significant differences between those with OA and those without for cardiovascular risk factors of body weight, BMI, waist measurement, blood pressure, 6MW, or muscle strength. However, in those with CVD and OA, the relationship between age and 6MW was stronger and age accounted for more of the variance in performance (r=-0.44; r 2 =0.19; p&lt;0.001) than those without OA (r=-0.37; r 2 =0.17; p&lt;0.001), indicating a greater reduction in walking ability in those with OA as they get older. Conclusion: With 6MW performance being related to CVD mortality, interventions are needed to improve health and fitness in this cohort. International guidelines for CVD and OA recommend treatment should prioritise lifestyle changes, including a healthy diet, regular physical activity, and interventions that address all risk factors. Lifestyle LIFEMAP will assess the efficacy of a widely translatable multidisciplinary digital evidence-based 10-module lifestyle, food, exercise, medication, and park prescription education program for adults with the comorbidity of CVD and OA. We expect this program to improve knowledge, and healthy lifestyle choices, thereby improving physical activity and health outcomes in this highly vulnerable population.

Factors Influencing Healthy Lifestyle Among Older Adults: A Qualitative Study

ABSTRACT Healthy living is crucial in achieving active and successful aging. As the aging population is growing rapidly, improving healthy lifestyle behaviors is important. This study aimed to explore factors affecting a healthy lifestyle in older Iranian adults. We used content analyses as a study approach. We conducted in-depth individual semi-structured interviews and focus group discussions with open-ended questions between October 2020 and April 2021. Using purposive and snowball sampling techniques, participants were selected from community dwellings of Iranian older adults and experts from various health system levels. A qualitative thematic analysis approach was used for data analysis. Factors affecting a healthy lifestyle were categorized into five themes, including individual factors, cultural and religious factors, social factors, economic factors and policy factors, divided into 17 subthemes. Results highlighted the need for a holistic view of all dimensions of older adults’ lifestyles. Enhancing healthy lifestyles could have a greater impact than addressing multiple risk factors with costly strategies. Thus, health policies should strongly emphasize identified lifestyle factors that are contextually relevant.

Embodied navigation: the influence of lived experience on physical activity and sedentary behavior among older adults

ABSTRACT Purpose The impact of a sedentary lifestyle on health and well-being is well recognized. However, there is limited understanding of how a lifetime of physical activity and sedentary behaviour influences an active lifestyle in older adults. The aim of this study was to describe how lived experience of physical activity and sedentary behaviour impacts daily activities among older adults, from a life course perspective. Methods Qualitative content analysis was used; individual telephone interviews were conducted with fourteen older adults aged 71 to 92 years. The participants received initial support from community care and lived in ordinary housing in southern Sweden. Results The interviews yielded one theme, “Navigating with an embodied activity compass,” and two sub-themes: “Being guided by the past” and “Unveiling pathways through body awareness.” Conclusions Our study highlights how older adults’ lived experiences of physical activity, with their connections to body awareness and acceptance, impact daily physical activity. These findings offer new knowledge for clinical practitioners balancing recommendations of sedentary behaviour and physical activity, to promote healthy daily physical activity among older adults. Future research and policies should consider the lived experiences of older adults when addressing public health matters related to sedentary behaviour and physical activity.

Physical activity, mental health, support networks, lifestyle, and memory in older adults during the COVID-19 pandemic

IntroductionAt the beginning of the pandemic, it was suggested that lockdown and social distancing could affect the physical, emotional, and cognitive aspects of people, especially the elderly. ObjectiveTo determine the characteristics of physical activity, mental health, support networks, and lifestyle of the elderly in lockdown by COVID-19 and its relationship with memory functioning. Method100 healthy elderlies (age ≥60 years) participated and answered a set of online instruments that evaluated 6 variables: demographic data, physical activity, mental health, social support networks, lifestyle, and subjective memory. MoCA and Neuropsi tests were applied through a video call. The study was conducted between September 2021 and May 2022. ResultsParticipants reported being and having been physically active, the presence of trait and state anxiety was found in 100%, also a higher perception of support from the family network. Insomnia was found in 46% of the sample, increased consumption of stimulant beverages and tobacco, and adequate competence in handling information and communication media. The memory functioning of 97% of the participants was normal or high normal, with fair self-perception of memory functioning. Correlations were moderate between mental health and self-perceived memory. ConclusionsThe results suggest that having social support networks, good mental health, and staying physically and cognitively active favour memory function.

Sports Health in Older Age: Prevalence and Risk Factors - Systematic Review

Exercise prevalence in older adults often shows low levels, with a considerable portion of this demographic being physically inactive. Myriad studies have also depicted gender disparities in exercise prevalence, highlighting that men tend to engage in more physical activity compared to women. The primary objective of this research is to highlight sports health in older age, prevalence, and risk fac-tors through a systematic review. This research employs a systematic review method by searching reputable journal databases such as Science Direct and Pubmed. The inclusion criteria in this study were articles published in the last five years related to exercise in the elderly, addressing topics such as exercise prevalence, risk factors for exercise, physical activity participation, the health of the elderly, and barriers to exercise. The exclusion criteria in this study were articles published in non-reputable journals. The researchers selected and analyzed 16 articles meeting the inclusing criteria for this systematic review. For standard operations, this study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) assessment. The research findings reveal that within the first group, various risk factors significantly impede exercise in older adults, including chronic health conditions such as heart disease and diabetes. In addition, factors such as lack of knowledge about the benefits of exercise, fear of injury, and social isolation contributed to reduced participation in physical activity. Furthermore, the findings with-in the second group underscore the significance of information that various exercises through health sports activities to support body health in old age. The results of the third group show that some treatments of sports health therapy are suitable for the elderly. Understanding these multifaceted factors is paramount to design effective interventions to increase sports participation in the elderly. Therefore, the promotion of active and healthy lifestyles in older adults should consider the social, economic and health factors that influence individuals' decisions. This holistic approach can contribute to improving the quality of life and well-being of older adults, concurrently reducing the burden of age-related diseases. Keywords: active lifestyle, older age, physical activity, Sports Health

Healthy Lifestyle and Cognition in Older Adults With Common Neuropathologies of Dementia

A healthy lifestyle is associated with better cognitive functioning in older adults, but whether this association is independent of the accumulation of dementia-related pathologies in the brain is uncertain. To determine the role of postmortem brain pathology, including β-amyloid load, phosphorylated tau tangles, cerebrovascular pathology, and other brain pathologies, in the association between lifestyle and cognition proximate to death. This cohort study used data from the Rush Memory and Aging Project, a longitudinal clinical-pathologic study with autopsy data from 1997 to 2022 and up to 24 years of follow-up. Participants included 754 deceased individuals with data on lifestyle factors, cognitive testing proximate to death, and a complete neuropathologic evaluation at the time of these analyses. Data were analyzed from January 2023 to June 2023. A healthy lifestyle score was developed based on self-reported factors, including noncurrent smoking, at least 150 minutes of physical activity per week, limiting alcohol consumption, a Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet score higher than 7.5, and a late-life cognitive activity score higher than 3.2. The lifestyle score ranges from 0 to 5, with higher scores reflecting a healthier lifestyle. The global cognitive score was derived from a battery of nineteen standardized tests. Brain pathology measures included β-amyloid load, phosphorylated tau tangles, global Alzheimer disease pathology, vascular brain pathologies, Lewy body, hippocampal sclerosis, and TAR DNA-binding protein 43. Of 586 included decedents, 415 (70.8%) were female, 171 (29.2%) were male, and the mean (SD) age at death was 90.9 (6.0) years. Higher lifestyle score was associated with better global cognitive functioning proximate to death. In the multivariable-adjusted model, a 1-point increase in lifestyle score was associated with 0.216 (SE = 0.036, P < .001) units higher in global cognitive scores. Neither the strength nor the significance of the association changed substantially when common dementia-related brain pathologies were included in the multivariable-adjusted models. The β estimate after controlling for the β-amyloid load was 0.191 (SE = 0.035; P < .001). A higher lifestyle score was associated with lower β-amyloid load in the brain (β = -0.120; SE = 0.041; P = .003), and 11.6% of the lifestyle-cognition association was estimated through β-amyloid load. This study found that in older adults, a healthy lifestyle may provide a cognitive reserve to maintain cognitive abilities independently of common neuropathologies of dementia.

Lifestyle and behavioural changes in older adults during the Covid-19 pandemic are associated with subjective cognitive complaints

Subjective cognitive complaints (SCC) is a self-reported experience of persistently impaired cognitive functions which could be the earliest red flag of neurocognitive disorders. The COVID-19 pandemic and related restriction measures changed the lifestyle and behaviour of older adults. The aim of this study was to assess the relation of these changes and SCC status in Hungary. This cross-sectional study analysed the data of 359 elderly Hungarians who filled out the WW-FINGERS-SARS-CoV2 survey. A quarter of the respondents (n:88) reported SCC in connection with the pandemic. We compared sociodemographic features, health status, lifestyle, and social life parameters between subjects with reported SCC and without. To eliminate the potential interrelation across group differences, stepwise logistic regression was applied. Participants with SCC showed the following characteristics, compared to individuals without: (1) they were older; (2) they were more likely to be women; (3) they had a higher number of chronic disorders; (4) showed more prominent impairment in physical mobility; (5) had worse sleep quality; (6) spent less time with family; and (7) used internet more frequently during the pandemic (all p’s < 0.001). Logistic regression highlighted that only two parameters were related to SCC status independently, the physical mobility (ability to walk 500 m without difficulties; OR = 1.186; p < 0.001; 95%CI = 1.101, 1.270) and changes in time spent with grandchildren (OR = 1.04; p = 0.015; 95%CI = 1.008, 1.073). Our study draws attention to the importance of physical mobility and quality time with family as key factors in the cognitive well-being of elderly people.

The Influence of Childhood Trauma on Multiple Unhealthy Lifestyle Behaviors in Adulthood

ABSTRACT Childhood trauma (CT) is associated with unhealthy lifestyle in adulthood. However, an in-depth exploration of how CT relates to multiple unhealthy lifestyle behaviors remains inconclusive. This study included 2968 adults from the Netherlands Study of Depression and Anxiety. We examined associations between retrospectively reported CT, its severity, and types with seven unhealthy lifestyle behaviors and a cumulative lifestyle index. Results showed that CT was positively associated with smoking, illicit drug use, social inactivity, sleep deprivation, and excessive weight gain (β = .040–.98, pFDR < .05); negatively associated with alcohol use (β = -.042, pFDR = .033), and most strongly associated with cumulative lifestyle index (β = .141, pFDR < .001). Severe CT history (multiple types or frequencies of trauma) showed the strongest effects. The largest effects with the cumulative lifestyle index were found for physical abuse (β = .159, pFDR < .001), while other CT subtypes (emotional neglect/abuse, sexual abuse) showed similar effects (β = .127–.157, pFDR < .001). Associations were partially explained by the presence of depressive/anxiety disorders, lower education, and higher numbers of chronic diseases. Individuals with CT, especially severe forms, show diverse and accumulated unhealthy lifestyle behaviors in adulthood and, thus, may benefit from lifestyle-based interventions.

THE RELATIONSHIP OF DIET INTERVENTIONS TO QUALITY OF LIFE IN ADULTS WITH INFLAMMATORY BOWEL DISEASE: A NARRATIVE REVIEW

Abstract BACKGROUND Inflammatory bowel disease (IBD) can negatively impact quality of life (QOL) due to symptoms associated with chronic inflammation within the gastrointestinal (GI) tract. Dietary changes may offer some symptom relief, thus increasing QOL; however, the optimal dietary pattern to improve symptoms in IBD is unknown. The purpose of this review was to investigate the association between various dietary interventions and QOL in adults with IBD. METHODS A search strategy was developed using PRISMA guidelines. EBSCOhost was used to simultaneously search eight databases using key terms including ‘inflammatory bowel disease’ or ‘IBD’ or ‘ulcerative colitis’ or ‘Crohn’s disease’ AND ‘dietary interventions’ or ‘dietary advice’ or’ dietary recommendations.’ Relevant publications were hand-searched to identify additional studies. Included studies reported a dietary pattern intervention with QOL as an outcome measure. Studies that did not include adults, a dietary intervention, or a QOL measure were excluded. RESULTS After reviewing abstracts of 1,054 studies identified in the initial search, 13 studies met the inclusion criteria. Among these studies, dietary interventions differed and included the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet (n=4), Immunoglobulin G (IgG) diet (n=2), Autoimmune Protocol Diet (AIP) (n=1), Dietary Modified Program (DMP) (n=1), Dietary Modified Framework (DMF) (n=1), Mediterranean diet (n=2), and a high fiber diet (n=2). QOL was measured using various validated questionnaires. Results were inconsistent across studies. Significant improvements in QOL were found using the AIP, DMP, Mediterranean diet, and a high fiber diet. Two of the four low FODMAP studies and one of the two IgG diet studies found significant improvements in QOL, whereas the other three did not. Additionally, the DMF did not significantly improve QOL. It should be noted that the reviewed studies were limited to small sample sizes, a lack of diversity among participants, and short durations. Only one study assessed changes after elimination and reintroduction of suspected trigger foods. A nutrition professional was involved with the dietary intervention in 12 of the 13 studies. CONCLUSION Overall, adults with IBD reported improved QOL using a variety of dietary approaches. These approaches aimed to reduce symptoms by reducing foods that may increase inflammation, adding specific foods known to reduce inflammation, or a combination of the two approaches. These dietary approaches are complex and may be difficult to implement. Thus, the Registered Dietitian is needed to tailor dietary approaches to meet the nutrient needs and accommodate the lifestyles of adults with IBD. Additionally, there is a need for additional studies with larger samples sizes, more diverse populations, and additional follow-up periods.

Does digital technology make people healthier: the impact of digital use on the lifestyle of Chinese older adults

BackgroundWith the arrival of the era of large-scale production, sharing and application of data, digital use has gradually changed people’s daily entertainment, consumption, social interaction, learning and other behaviors in its efficient form. This paper mainly discusses whether this fast and convenient behavior leads Chinese older adults to adopt healthier lifestyles.MethodsUsing the most recent information from the Chinese Family Panel Studies (CFPS) in 2020, this paper conducted a descriptive statistical analysis on the basic situation of digital use and lifestyles among Chinese older adults and used a structural equation model to analyse the influence of frequency and types of digital use in a variety of different aspects of the real life of Chinese older adults.ResultsResearch revealed that the quality of life of Chinese older adults improved significantly as a result of their use of digital technology. The frequency of digital use (FDU) significantly improved Chinese older adults’ diet, sleep, exercise, smoking and drinking, and relieved their depression. The types of digital use (TDU) had a significant positive correlation with the lifestyle of Chinese older adults, especially in the influence of digital entertainment (DE), digital consumption (DC) and digital social interaction (DI) on the lifestyle of Chinese older adults.ConclusionsDigital use can improve the health of Chinese older adults by promoting a healthy lifestyle through various means. The findings of this study have a substantial positive impact on bridging the digital divide that Chinese older adults face, as well as fostering the integration of digital use into their healthy lifestyles.

Capabilities for Physical Activity in Older People: Development and Testing of a Measurement Tool

Based on Sen's capability approach, this study addresses the operationalization of capabilities for leading an active lifestyle. By assessing capabilities, processes of change can be mapped and the development of interventions to promote physical activity in different population groups, e. g., older adults, can be supported. However, no standardized German-language instrument for measuring physical activity-related capabilities is available to date. Building on an exploratory interview study (Sauter et al., 2019) that identified relevant physical activity-related capabilities in older adults, a standardized questionnaire with 41 items was designed. Two different question formulations were designed to query perceived capabilities for physical activity. The "think-aloud" method was conducted to validate the instrument. This involved recording all verbal comments made by participants while completing the questionnaire and conducting supplementary interviews for comprehensibility and applicability. The sample included 16 older adults (w=9, MW=66.3 years). Overall, respondents rated the instrument's usability and comprehensibility as good. For the questioning of perceived capabilities, the formulation "I have the possibility to..." was favored instead of "I perceive my personal opportunities as…". Difficulties in understanding and ambiguities were found in a few items. Thus, further changes were made to specify these questions with regard to unclear terms such as "walking paths". The questionnaire seems to be suitable to asses perceived capabilities for leading an active lifestyle in older adults. The final questionnaire is available in English and in German. Further research is needed to test the applicability of the instrument in other population groups and verify objectivity, reliability and validity.

Machine-learning model predicting quality of life using multifaceted lifestyles in middle-aged South Korean adults: a cross-sectional study

BackgroundIn the context of population aging, advances in healthcare technology, and growing interest in healthy aging and higher quality of life (QOL), have gained central focus in public health, particularly among middle-aged adults.MethodsThis study presented an optimal prediction model for QOL among middle-aged South Korean adults (N = 4,048; aged 30–55 years) using a machine-learning technique. Community-based South Korean population data were sampled through multistage stratified cluster sampling. Twenty-one variables related to individual factors and various lifestyle patterns were surveyed. QOL was assessed using the Short Form Health Survey (SF-12) and categorized into total QOL, physical component score (PCS), and mental component score (MCS). Seven machine-learning algorithms were used to predict QOL: decision tree, Gaussian Naïve Bayes, k-nearest neighbor, logistic regression, extreme gradient boosting, random forest, and support vector machine. Data imbalance was resolved with the synthetic minority oversampling technique (SMOTE). Random forest was used to compare feature importance and visualize the importance of each variable.ResultsFor predicting QOL deterioration, the random forest method showed the highest performance. The random forest algorithm using SMOTE showed the highest area under the receiver operating characteristic (AUC) for total QOL (0.822), PCS (0.770), and MCS (0.786). Applying the data, SMOTE enhanced model performance by up to 0.111 AUC. Although feature importance differed across the three QOL indices, stress and sleep quality were identified as the most potent predictors of QOL. Random forest generated the most accurate prediction of QOL among middle-aged adults; the model showed that stress and sleep quality management were essential for improving QOL.ConclusionThe results highlighted the need to develop a health management program for middle-aged adults that enables multidisciplinary management of QOL.

Epidemiological distribution of mosaic loss of chromosome Y in adult men in 10 areas in China and its prospective association with lung cancer

Objective: To detect the prevalence of mosaic loss of chromosome Y in adult men in ten study areas in China, describe the epidemiological distribution of mosaic loss of chromosome Y (mLOY) carriers and assess its prospective association with lung cancer. Methods: Based on the data from baseline survey, genetic analysis and follow-up (as of December 31, 2018) from China Kadoorie Biobank, we used Mosaic Chromosomal Alterations pipeline to detect mLOY carriers in 10 areas in China and described the epidemiological characteristics of mLOY carriers in adult men, including age, area distribution, lifestyle and disease history. We used multivariate logistic regression model to identify the potential relevant factor of mLOY. Cox proportional hazard regression model was fitted to assess the prospective association of mLOY with lung cancer. Stratification analysis were conducted to evaluate the potential modification effects of smoking and age. We also conducted mediation analysis to assess the mediating effect of mLOY in the association between smoking and lung cancer. Results: A total of 42 859 adult men were included in our analysis, in whom 2 458 mLOY carriers were detected (5.7%). The detection rate increased with age (P<0.05). The detection rate was higher in urban area (7.3%±0.2%) than that in rural area (4.7%±0.1%). The results of logistic regression analysis indicated that smoking might be a risk factor for the detection of mLOY (OR=1.49, 95%CI:1.36-1.64). After follow-up for average 11.1 years, 1 041 lung cancer cases were observed. The prospective analysis showed that mLOY carriers had an increased risk for lung cancer by 24% compared with non-mLOY carriers (HR=1.24, 95%CI:1.01-1.52) and expanded mLOY carriers (mLOY cell proportion ≥10%) had an increased risk for lung cancer by 50% (HR=1.50, 95%CI:1.13-2.00). Stratification analysis showed no modification effects of smoking and age in the association between mLOY and lung cancer (interaction P>0.05). Mediation analysis showed that mLOY could be a mediating factor in the association between smoking and lung cancer, the estimated effect was 0.09 (0.01-0.17). Conclusions: There were significant differences in the detection rate of mLOY in adult men with different social-economic characteristics and lifestyles in ten areas in China. Besides, mLOY carriers, especially expanded mLOY carriers, had increased risk for lung cancer and mLOY might be a mediating factor in the association between smoking and lung cancer.

Middle-Range theory of the nursing diagnosis of sedentary lifestyle in young adults.

To construct a middle-range theory for the nursing diagnosis of Sedentary Lifestyle in young adults. A methodological study for the validation of a nursing diagnosis based on a Middle-Range Theory, carried out in six stages: definition of the approach; definition of theoretical-conceptual models; definition of main concepts; development of a pictorial scheme; construction of propositions; establishment of causal relationships and evidence for practice. The theory construction was operationalized through an integrative review and supported by Roy's adaptation model. Three essential attributes were identified; 10 antecedents; 7 clinical consequences; a pictogram, 9 propositions, and 11 causal relationships and evidence for practice. The middle-range theory for the nursing diagnosis of Sedentary Lifestyle in young adults was constructed, expanding the understanding of this phenomenon, to be applied in clinical practice by nurses.