Meeting Physical Activity Guidelines Research Articles

Mid- and Late-Life Leisure-Time Physical Activity and Global Brain Amyloid Burden: The Atherosclerosis Risk in Communities (ARIC)-PET Study.

Physical activity (PA) may slow the development of dementia by reducing the accumulation of amyloid. We tested the hypothesis that higher levels of leisure-time PA in mid- or late-life were associated with lower brain amyloid burden in late-life among 326 non-demented participants from the Atherosclerosis Risk in Communities Study of brain florbetapir positron emission tomography (ARIC-PET) ancillary. Self-reported PA was quantified using a past-year recall, interviewer-administered questionnaire in mid-life (1987-1989, aged 45-64 years) and late-life (2011-2013, aged 67-89 years). Continuous PA estimates were classified as 1) any leisure-time PA participation (yes/no); 2) meeting the 2018 United States' PA guidelines (yes/no); and 3) per 1 standard deviation (SD) higher metabolic equivalent of task (MET) minutes per week (MET·min·wk-1). A brain magnetic resonance imaging scan with Florbetapir PET was performed in late-life. Adjusted odds ratios (OR) of elevated amyloid burden, defined as a global cortical standardized uptake value ratio (>1.2), compared to no elevated amyloid burden were estimated according to PA measures. Among the 326 participants (mean age: 76 years, 42% male, 41% Black), 52% had elevated brain amyloid burden. Mid-life leisure-time PA did not show a statistically significant lower odds of elevated late-life amyloid burden (OR = 0.71, 95% CI: 0.43-1.18). A 1 SD (970 MET. min. wk-1) higher PA level in mid-life was also not significantly associated withelevated amyloid burden (OR = 0.89, 95% CI: 0.69-1.15). Similar estimates were observed for meeting versus not meeting PA guidelines in both mid- and late-life. Self-reported higher mid- and late-life leisure-time PA were not significantly associated with lower amyloid burden. Data show a trend of an association, which is, however, imprecise, suggesting replication in larger studies.

Does meeting physical activity recommendations ameliorate association between television viewing with cardiovascular disease risk? A cross-sectional, population-based analysis

ObjectivesAs a common form of sedentary behaviour, television viewing is associated with an increase in body mass index (BMI) as well as overall cardiovascular disease (CVD) risk. This study examined...

An international physical activity and public health research agenda to inform coronavirus disease-2019 policies and practices

An international physical activity and public health research agenda to inform coronavirus disease-2019 policies and practices

Associations of Neighborhood Factors and Activity Behaviors: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study.

Social and built environments may influence physical activity (PA). However, evidence for South Asian Americans (SAA), a group with low PA levels and high cardiometabolic risk, is lacking. We assessed the association between five neighborhood factors and PA behaviors in a community-based cohort of SAA. Data were from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study 2010-2013 (n = 906). Adjusted multivariable models stratified by sex regressing PA behaviors on neighborhood factors were run. Higher neighborhood social cohesion was associated with 17% more PA MET minutes/week in men (p < 0.01), but not in women. Having a park/playground near home was associated with meeting PA guidelines (odds ratio (95% CI): men: 3.14 (1.20-8.24); women: 3.67 (1.17-11.52). Neighborhood factors were associated with favorable PA behaviors in SAA. PA interventions for SAA that increase neighborhood social cohesion or focus on linking individuals with local resources may be effective.

Physical activity in people with epilepsy: A systematic review.

This study aimed to systematically review studies focusing on levels of physical activity (PA) in people with epilepsy (PWE) compared with non-epilepsy controls, and identify factors associated with PA in PWE. Intervention studies were also reviewed to consider the effects of psychological interventions on levels of PA, and the effects of PA-based interventions on seizure activity, psychiatric comorbidity, and health-related quality of life (HRQoL). PRISMA guidelines were followed. Searches were conducted using PubMed, Cochrane Controlled Register of Trials, PsycINFO, and Embase. Forty-six studies met inclusion criteria, including case-control, cross-sectional, and intervention studies. Assessment measures included questionnaires, activity trackers, and measures of physiological fitness. Twelve of 22 (54.5%) case-control studies utilizing self-report questionnaire measures reported that PWE were performing lower levels of PA, less likely to be engaging in PA, or less likely to meet PA guidelines than controls. The remaining studies did not find a difference between PWE and controls. Eight of 12 (67%) case-control studies utilizing exercise/fitness tests reported that PWE performed significantly poorer than controls, whereas in two studies PWE performed better than controls. One of three studies investigating the relationship between PA and seizure frequency found that increased self-reported PA was associated with having fewer seizures, whereas two did not find a significant relationship. All seven cross-sectional studies that included measures of HRQoL and depression/anxiety found a positive relationship between levels of PA and HRQoL/reduced levels of depression and anxiety. All four studies that used PA-based interventions demonstrated improvements in levels of PA and increased HRQoL. Study quality was almost universally low. In conclusion, there is some evidence that PWE engage in less PA than peers, and that interventions can improve PA levels and HRQoL. However, there is a need for more robust study designs to better understand PA in individuals with epilepsy.

Lifestyle among long-term survivors of cancers in young adulthood

PurposeTo investigate lifestyle in a population-based sample of long-term (≥ 5 years since diagnosis) young adult cancer survivors (YACSs), and explore factors associated with not meeting the lifestyle guidelines for physical activity (PA), body mass index (BMI), and smoking.MethodsYACSs (n = 3558) diagnosed with breast cancer (BC), colorectal cancer (CRC), non-Hodgkin lymphoma (NHL), acute lymphoblastic leukemia (ALL), or localized malignant melanoma (MM) between the ages of 19 and 39 years and treated between 1985 and 2009 were invited to complete a mailed questionnaire. Survivors of localized MM treated with limited skin surgery served as a reference group for treatment burden.ResultsIn total, 1488 YACSs responded (42%), and 1056 YACSs were evaluable and included in the present study (74% females, average age at survey 49 years, average 15 years since diagnosis). Forty-four percent did not meet PA guidelines, 50% reported BMI ≥ 25 and 20% smoked, with no statistically significant differences across diagnostic groups. Male gender, education ≤ 13 years, comorbidity, lymphedema, pain, chronic fatigue, and depressive symptoms were associated with not meeting single and/or an increasing number of lifestyle guidelines.ConclusionA large proportion of long-term YACSs do not meet the lifestyle guidelines for PA, BMI, and/or smoking. Non-adherence to guidelines is associated with several late effects and/or comorbidities that should be considered when designing lifestyle interventions for YACSs.

The Association between Parents and Children Meeting Physical Activity Guidelines

PurposeTo examine the association between parents and children meeting physical activity (PA) guidelines, by gender, among 8–12 year old children with BMI ≥75th percentile Design and methodsThis was a secondary analysis of baseline data from a school-based healthy weight management intervention in Minnesota for 8–12 year old children. Survey data about PA participation were collected from 2014 through 2018. Analyses entailed descriptive statistics and multivariate logistic regression controlling for child age, race/ethnicity, BMIz, child's perception of parent support for activity, and number of sports played. ResultsChildren's (n = 132) mean age was 9.32 ± 0.89 years, 49% were female, 63% were members of racial/ethnic minority groups, and 33% met PA Guidelines (≥60 minutes daily). Parents' (n = 132) mean age was 39.11 ± 7.05 years, mean BMI of 30.90 ± 8.44, 94% were female, 42% were members of racial/ethnic minority groups, and 57% met PA Guidelines for Americans (≥150 minutes moderate or >75 minutes vigorous PA weekly). There was no association between parents and children meeting PA guidelines for the total sample (OR = 1.43, 95% CI = 0.63–3.24, p = 0.39) or girls (OR = 0.65, 95% CI = 0.18–2.33, p = 0.51). Boys whose parents met PA guidelines had 3.84 times greater odds of meeting PA guidelines (95% CI = 1.28–13.4, p = 0.04). ConclusionsPA interventions for boys may benefit from focus on parents' PA. Further research should investigate correlates of girls' PA. Practice implicationsPediatric nurses working with children to increase PA should encourage parents' PA. For parents of boys, this may increase the child's PA. Considered broadly, nurses should be aware of gender influences on children's engagement in PA.

Physical activity, sedentary time and sleep and associations with mood states, shift work disorder and absenteeism among nurses: an analysis of the cross-sectional Champlain Nurses' Study.

BackgroundResearch has suggested ideal combinations of sleep, physical activity (PA) and sedentary time (ST) (i.e., optimal sleep/high PA/low ST) are associated with better overall health. Previous research has shown nurses spend more than half their day sedentary, do not generally meet PA guidelines and have difficulty obtaining adequate sleep. There has been no known work to examine how combinations of sleep, PA and ST relate to the work performance and mental health of nurses. Our objective was to assess the associations of sleep, PA and ST with absenteeism, mood states and shift work disorder (SWD) in a sample of Canadian nurses.MethodsA total of 342 nurses from the Champlain Nurses’ Study (mean age ± SD = 43 ± 12 years, 94% women) wore an ActiGraph GT3X accelerometer for ≥ 4 days for ≥ 10 h/day to derive time spent in moderate-to-vigorous intensity physical activity (MVPA) and ST and reported sleep time for ≥ 4 days using daily activity logs. Behavioural patterns were categorized into four groups for comparison based on opposing combinations of sleep, MVPA and ST (e.g., optimal sleep/high MVPA/low ST vs. non-optimal sleep/low MVPA/high ST). Self-reported absenteeism, mood states and SWD as measured by the Profile of Mood States (POMS) and Shift Work Disorder Screening questionnaires, respectively, were compared across combinations of high versus low MVPA and ST, and optimal vs. non-optimal sleep.ResultsNurses spent an average of 444 ± 11 min/day sedentary, 14 ± 15 min/day in bouts ≥ 10 minutes of MVPA (23% met PA guidelines) and reported an average of 8 h and 39 min ± 1 h 6 min of sleep/24-h. Significant associations between behaviour groups and the POMS score and its vigor subscale, as well as SWD were observed, however, none were observed for absenteeism. The healthiest behaviour group had a significantly lower mood disturbance compared to 2/3 unhealthy behaviours and greater vigor compared to 2/3 and 3/3 unhealthy behaviours. SWD trended toward being higher amongst the group with 2/3 unhealthy behaviours. Meeting PA guidelines was associated with significantly lower total mood disturbance versus not meeting guidelines (median [IQR] = 0.4 [4.5] vs. 1.3 [4.4], Z = − 2.294, df = 1, p = 0.022), as well as lower anger, higher vigor and lower fatigue. Low ST was associated with lower POMS total mood disturbance scores versus higher ST (0.6 [4.4] vs. 1.4 [4.3], Z = 2.028, df = 1, p = 0.043), as well as higher vigor and lower fatigue.ConclusionsIn this sample of hospital nurses, the combined effects of sleep, PA and ST are associated with total mood disturbance and SWD. Achieving the recommended levels in all three behaviours may be beneficial in decreasing total mood disturbance and minimizing the effects of SWD. Future work is needed to address the low PA and high ST levels of nurses and to better understand how these behaviours can be improved to optimize the mental health of the health workforce.

Neighborhood built and social environment and meeting physical activity recommendations among mid to older adults with joint pain.

Arthritis is a leading cause of disability in the United States, with the most efficacious treatments being physical activity (PA). Arthritis patients are less likely to meet PA recommendations and the neighborhood environment may play a role. This study examines the effect of neighborhood walkability and social cohesion on PA among arthritis patients in a sample of US adults. This cross-sectional study used 2015 National Health Interview Survey data. Eligible participants were age ≥45 years, had arthritis, recent leg-joint pain and complete data. Walkability was based on 6 questions regarding amenities and destinations that promote walking. Social cohesion was based on 4 validated questions. Meeting PA was defined as 150 min/week. Chi-squared testing and logistic regression determined associations between neighborhood environment and PA, including interaction between social cohesion and walkability. The final unweighted sample included 3,826 participants with mean age 64.6 years (SE = 0.26), 61.8% female and 78.1% non-Hispanic White. In adjusted, weighted analysis, not, slightly, and moderately-walkable neighborhoods all had lower odds of meeting PA recommendations verses highly-walkable neighborhood (OR = 0.61[95% CI 0.41–0.92], OR = 0.65[95% CI 0.50–0.85], OR = 0.75[95% CI 0.59–0.97], respectively). Social cohesion was independently associated with decreased odds of meeting PA guidelines (p = 0.003). No interaction with walkability was found (p = 0.405). Less than a highly-walkable neighborhood and lower social cohesion were independently associated with decreased odds of meeting PA recommendations among adults with arthritis and recent joint pain. Since walking is one of the most effective treatments for arthritis, clinicians should be sensitive to barriers patients may perceive to walking.

Physical activity, cardiorespiratory fitness, and cardiovascular outcomes in individuals with atrial fibrillation: the HUNT study.

AimsAtrial fibrillation (AF) confers higher risk of mortality and morbidity, but the long-term impact of physical activity (PA) and cardiorespiratory fitness (CRF) on outcomes in AF patients is unknown. We, therefore, examined the prospective associations of PA and estimated CRF (eCRF) with all-cause mortality, cardiovascular disease (CVD) mortality, morbidity and stroke in individuals with AF.Methods and resultsWe followed 1117 AF patients from the HUNT3 study in 2006–08 until first occurrence of the outcomes or end of follow-up in November 2015. We used Cox proportional hazard regression to examine the prospective associations of self-reported PA and eCRF with the outcomes. Atrial fibrillation patients meeting PA guidelines had lower risk of all-cause [hazard ratio (HR) 0.55, 95% confidence interval (CI) 0.41–0.75] and CVD mortality (HR 0.54, 95% CI 0.34–0.86) compared with inactive patients. The respective HRs for CVD morbidity and stroke were 0.78 (95% CI 0.58–1.04) and 0.70 (95% CI 0.42–1.15). Each 1-metabolic equivalent task (MET) higher eCRF was associated with a lower risk of all-cause (HR 0.88, 95% CI 0.81–0.95), CVD mortality (HR 0.85, 95% CI 0.76–0.95), and morbidity (HR 0.88, 95% CI 0.82–0.95).ConclusionHigher PA and CRF are associated with lower long-term risk of CVD and all-cause mortality in individuals with AF. The findings support a role for regular PA and improved CRF in AF patients, in order to combat the elevated risk for mortality and morbidity.

Sleep and Exercise Behaviors Do Not Differ Based Upon Aerobic Capacity or Hand Grip Strength

Background: Despite the known benefits of physical activity (PA), most of the population in the United States fails to meet minimum recommended levels, and this lack of activity is believed to affect their health and well-being. Objective: The purpose of this study was to compare lifestyle behaviors of exercise and sleep in low, moderate, and high performers for maximal aerobic capacity (VO2max) and hand-grip strength (GS). Methods: Participants (n = 107, 19-62 years old) performed physical fitness assessments: estimated VO2max through submaximal cycle ergometry, and GS. Physical activity (PA) and sleep were assessed via self-reported questionnaires: physical activity as a vital sign (PAVS) and the Pittsburgh Sleep Quality Index (PSQI). Participants were categorized according to age and gender-specific normative values as low, medium, and high performer (LP, MP, and HP). Group characteristics were compared for each ranked variable using Kruskall-Wallis tests. Results: PAVS scores revealed 66.3% (n=68) of participants met minimum PA of 150 min/week (221.6 ± 177.8). According to VO2max performance groups, the LP group was taller, heavier, had higher diastolic blood pressure, and had a larger waist circumference than MP or HP (p =.000-.029), with moderate and high effect sizes. When categorized by relative GS, the LP group was heavier and had larger waist and hip circumferences than the HP group (p =.003-.011), all with high effect sizes. Conclusion: Despite high levels of self-report PA in this cohort, this did not translate to better cardiorespiratory fitness or muscular strength. Participants met PA guidelines but achieved suboptimal scores for VO2max and GS signifying elevated risk of mortality. The incongruity between PA levels and fitness classification suggest that lifestyle habits may not be a suitable surrogate for objective measurement of fitness.

Lifestyle Intervention for Promoting Physical Activity in Prostate Cancer Patients with Androgen Deprivation Therapy

Background and objective Despite the awareness of the important roles of physical activity (PA), the majority of cancer survivors fail to meet PA guidelines due to a lack of access to facilities or motivation. The purpose of this study is to examine the effectiveness of lifestyle intervention in prostate cancer (PC) patients receiving androgen deprivation therapy (ADT). Material and methods A total of 23 PC patients (aged 75.26 &plusmn; 6.9 years) receiving ADT at least 3 months were randomized into an intervention group (n=12) and a control group (n=11). The intervention group received lifestyle interven-tion in the form of education program. Levels of PA, body composition, physical function, disease-specific quality of life (QoL), and fatigue were assessed before and after the 12-week intervention. Results The intervention group showed improvements in the level of PA (step count: p=0.028, moderate to vig-orous PA: p=0.013) compared with the control group. Thigh circumference (p=0.002), physical function (grip strength: p=0.034; knee extensor: p=0.004, up and go: p=0.001; 2-min step: p=0.001), QoL (p&lt;0.001), and fatigue (p=0.001) were also improved compared with the control group. There were no adverse events during the lifestyle intervention period. Conclusion The 12-week lifestyle intervention program appears to be a promising strategy to increase the PA and mit-igate the side effects of ADT for PC patients.

Relationship between meeting physical activity guidelines and motor competence among low-income school youth

ObjectivesGlobal health guidelines suggest that youth should accumulate at least 60min of daily, moderate-to-vigorous-intensity physical activity (MVPA). The relationship between meeting physical activity (PA) guidelines and motor competence (MC) in youth is relatively unknown. This study assessed levels of MVPA and MC among socially vulnerable youth and determined if meeting the PA guidelines was associated with MC. DesignCross-sectional. MethodsA total of 1017 youths aged 3–14 years from three schools participated in the study. Participants wore accelerometers for seven consecutive days to assess PA. Motor competence was assessed using the Test of Gross Motor Development, 2nd Edition and the Körperkoordinationstest für Kinder. MVPA and MC were compared by sex and school levels (preschool, elementary school and middle school). Binary logistic regression models examined the predictive power of meeting PA guidelines and age on MC. ResultsThe prevalence of meeting PA guidelines declined across school levels among both girls (72% in preschool to 21% in middle school, p<0.001) and boys (84% in preschool to 57% in middle school, p<0.001). MC levels were low and also declined across age in both sexes (p<0.001). During preschool, age (older) was a consistent predictor of low MC, independently of meeting PA guidelines. ConclusionsExcept for adolescent boys, meeting PA guidelines was not associated with higher MC. Public health policies should focus on the quantity and quality of MVPA within schools and on alleviating the decline in PA and MC across childhood and adolescence, with special attention to girls and disadvantaged families.

A Narrative Review on the Potential of Red Beetroot as an Adjuvant Strategy to Counter Fatigue in Children with Cancer.

Cancer-related fatigue (CRF) is a debilitating adverse effect among children with cancer and a significant barrier to physical activity (PA) participation. PA interventions are effective at reducing fatigue and improving both quality of life (QOL) and functional outcomes in children with cancer. However, 50–70% of children with cancer do not meet PA guidelines. Thus, adjuvant methods are needed to increase PA participation. Given the growing interest in the use of beetroot juice to reduce exercise-induced fatigue, our narrative review evaluated the potential use of beetroot to improve PA participation to counter CRF and improve QOL. Our review of 249 articles showed a lack of published clinical trials of beetroot in children and adults with cancer. Trials of beetroot use had been conducted in a noncancer population (n = 198), and anticancer studies were primarily in the preclinical phase (n = 40). Although results are promising, with beetroot juice shown to counter exercise-induced fatigue in a variety of athletic and patient populations, its use to counter CRF in children with cancer is inconclusive. Pilot and feasibility studies are needed to examine the potential benefits of beetroot to counter CRF, increase PA participation, and improve QOL in children with cancer.

The Association of Physical Activity With Carotid Intima Media Thickening in a Healthy Older Population: Cooper Center Longitudinal Study.

The purpose of this study was to examine the association between self-reported physical activity (PA) and mean common carotid artery intima-media thickness (CCA IMT) among older adults. The data are from 1,811 Cooper Center Longitudinal Study participants, who were aged ≥60years, with no history of cardiovascular disease. A medical history questionnaire was used to assess PA. Carotid ultrasound was performed to measure CCA IMT and the presence of plaque and stenosis. Logistic regression models were constructed to estimate the association between PA and CCA IMT after adjustment for covariates. The participants were aged 69.2 ± 5.9years, and the majority were male (73.3%) and White (96.7%). The odds ratio of abnormal thickening of CCA IMT was 0.72 (95% confidence interval [0.54, 0.96]) in physically active participants (≥500 metabolic equivalent·min/week) after adjustment for covariates. In the current study, meeting PA guidelines in older adulthood was associated with lower odds of abnormal thickening of CCA IMT.

Choice of Processing Method for Wrist-Worn Accelerometers Influences Interpretation of Free-Living Physical Activity Data in a Clinical Sample

Wrist-worn accelerometers are increasingly used to assess free-living physical activity (PA), but the implications of different processing methods are not well characterized. To advance research in this area it is important to better understand how choice of processing method influences estimates of free-living PA behavior. This study compared PA profiles resulting from processing wrist-worn data collected under free-living conditions using four different methods in a clinical sample of 160 women with chronic pain, a condition for which PA serves as a treatment. Participants wore monitors on their non-dominant wrist for 7 days and completed a self-report PA measure. Processing methods were Hildebrand linear, a modified nonlinear Hildebrand, Staudenmayer linear, and Staudenmayer random forest. Using each method, minutes per day in sedentary, light, and moderate-to-vigorous PA (MVPA) were estimated and individuals were classified as meeting PA guidelines based on their accumulated MVPA. Comparisons of outcomes among processing methods and with self-reported PA were made using repeated measures ANOVA, correlations, and kappa statistics. With few exceptions, estimated time at each intensity differed significantly across processing methods and with self-report (p &lt; .001). Correlations between methods ranged widely (ρrange = 0.09 to 1.00) and showed inconsistent agreement for classifying individuals as meeting PA guidelines (κrange: −0.02 to 0.90). Thus, choice of processing method significantly influenced conclusions regarding free-living PA. Researchers and clinicians should exercise caution when interpreting accelerometer activity data and comparing across existing studies using different processing methods when examining how PA influences clinical conditions.

Physical activity and health-related fitness in Asian adolescents: The Asia-fit study

ABSTRACTPurpose: The present study aimed to investigate and compare physical activity (PA) and health-related fitness in Asian adolescents, and to examine the associations between meeting PA guidelines and attaining fitness standards. Methods: A sample of 12,590 adolescents (Mage = 13.63 years, SD = 1.01) from eight Asian metropolitan cities completed measurements of PA, five field-based fitness tests, and covariates. The fitness test scores were further classified into Healthy Fitness Zone (HFZ) or Needs Improvement Zone (NIZ). Results: Findings showed that adolescents’ levels of PA and fitness components differed by cities. City differences were also found in proportions of meeting PA guidelines and achieving the HFZs of aerobic capacity, muscular fitness, and body composition. After controlling covariates, meeting PA guidelines positively associated with being in the HFZs of aerobic and muscular fitness, but the association was not significant with being in the body composition HFZ. Conclusion: There was a large variation in PA and health-related fitness in adolescents across the eight Asian cities. Asian adolescents achieving PA guidelines were more likely to be in the HFZ of aerobic and muscular fitness. Prospective follow-up studies are warranted to gain better insights into the relationships between objectively-measured PA and fitness.

Change patterns and determinants of physical activity differ between breast, prostate, and colorectal cancer patients.

The purpose of this study was to examine and compare pre- to post-diagnosis change patterns of physical activity (PA) among breast, prostate, and colorectal cancer patients. Moreover, the study aimed to investigate sociodemographic and medical determinants of post-diagnosis PA and to identify patient subgroups at increased risk of inactivity. A total of 912 cancer patients (457 breast, 241 prostate, 214 colorectal cancer) completed a questionnaire assessing their pre- and post-diagnosis PA behavior, and sociodemographic and medical variables. Age-adjusted regression and classification tree analyses were used to investigate PA determinants and detect subgroups that were most likely to meet or not meet PA guidelines. Across cancer types, we found that PA yet decreased from pre- to post-diagnosis, but that 54.1% of participants still reported to be meeting PA guidelines after the diagnosis. While post-diagnosis PA was strongly affected by previous PA behavior among individuals of all patient groups, other sociodemographic and medical determinants played different roles depending on cancer type. The results yielded that previously active, longer diagnosed patients with higher education levels were most likely to be meeting PA guidelines post-diagnosis, whereas specifically previously inactive prostate cancer patients had an increased likelihood of insufficient activity. An encouragingly high number of cancer patients indicated sufficient PA levels. For those having difficulties to maintain or adopt PA post-diagnosis, interventions should be tailored to the specific characteristics of each cancer type, as different factors are associated with PA for each patient group.

Meeting Physical Activity Guidelines by Walking in Older Adults From Three Middle-Income Countries: A Cross-Sectional Analysis From the International Mobility in Aging Study.

Physical activity (PA) among older adults is understudied in middle-income countries. The authors examined the associations of factors across levels of the social ecological model (individual, interpersonal, organizational, and community) with older adults meeting guidelines of 150min of moderate- to vigorous-intensity PA per week through walking in three middle-income countries: Albania (n = 387), Colombia (n = 404), and Brazil (n = 402). Using 2012 International Mobility in Aging Study data, multivariate logistic regression models identified the following significant associations with meeting PA guidelines through walking (a)individual level: depression (odds ratio [OR] = 0.62, 95% confidence interval, CI [0.45, 0.86]), being female (OR = 0.74, 95% CI [0.56, 0.998]), and high relative education (OR = 1.79, 95% CI [1.33, 2.41]) and (b)interpersonal level: high life partner (OR = 1.38, 95% CI [1.04, 1.83]) and friend social ties (OR = 1.39, 95% CI [1.05, 1.83]). While individual and interpersonal variables were associated with meeting PA guidelines, community-level social and environmental variables were not.

Impact of depression and anxiety on cancer patients' perceptions of lifestyle behaviors.

141 Background: Health behaviors including tobacco use, alcohol consumption, and physical activity (PA) can impact outcomes in cancer survivors. While the peri-diagnostic period can be a "teachable moment" for behavior change, patients may face barriers including mental health comorbidities. We have previously identified that patient perceptions of behaviors can influence behavior change. Here, we evaluated the impact of anxiety and depression on patient perceptions of these behaviors. Methods: Cancer patients from all disease sites were surveyed (2016-17) on their smoking, alcohol habits, and PA, and perceptions of the impact of these behaviors on fatigue, survival, and quality of life (QofL). Survey data were linked with same day Edmonton Symptom Assessment Symptom (ESAS) anxiety and depression scores. Logistic regression models evaluated the impact of anxiety and depression on patient perceptions. Results: Of 496, 53% were male; median age, 60 years. At diagnosis, 20% were current smokers, 47% were current drinkers, and 67% were not meeting PA guidelines. 30% screened positive for anxiety (ESAS anxiety &gt; 3) and 34% screened positive for depression (ESAS depression &gt; 2); mean [standard deviation] scores were 1.9 [2.3] for anxiety and 1.5 [2.2] for depression. Most current smokers (&gt; 80%) perceived smoking to negatively impact fatigue, survival and QofL. Smokers screening positive for anxiety were more likely to perceive smoking as harmful on survival (OR=9.09, 95% CI (1.15-100), P=0.04); greater ESAS anxiety scores were associated with perceiving smoking to worsen survival (OR=1.51 per point, 95% CI (1.04-2.17), P=0.03). While those less physically active at diagnosis (&gt; 65%) felt that PA improves fatigue, survival and QofL and half of current drinkers (45%-50%) felt that alcohol worsens outcomes, anxiety and depression were not found associated with perceptions (P &gt; 0.10). Conclusions: Among current smokers, greater anxiety scores and those screening positive for anxiety were more likely to perceive continued smoking as harmful to survival. Mental health comorbidities were not found to have an impact on patient perceptions of the effect of alcohol consumption and PA on fatigue, survival, and QofL.