Minnesota Leisure Time Physical Activity Research Articles

The Influence of Early Menopause on Baroreflex Sensitivity in Healthy Females

Introduction: The risks of hypertension (HTN) and cardiovascular disease (CVD) rise dramatically in females around the typical age of menopause (TM; menopause age ≥46yr). Early menopause (EM; menopause age <46yr) may substantially increase this risk. Attenuated baroreflex sensitivity (BRS) can be indicative of autonomic dysfunction and has been shown to be a marker of CVD risk. Thus, we aimed to investigate how EM would influence BRS. We hypothesized that females who experienced EM would exhibit attenuated BRS compared to females who experienced TM. Methods: 32 females completed two visits: Visit 1: informed consent, medical and health questionnaires to confirm eligibility, including the Minnesota Leisure Time Physical Activity Questionnaire to assess activity levels. Visit 2: Participants rested in a supine position for 10 min. Non-invasive beat-to-beat blood pressure (BP), heart rate (HR), and muscle sympathetic nerve activity (MSNA) were recorded. Blood was drawn to measure sex steroid levels. Cardiovagal (cBRS) and sympathetic (sBRS) BRS were calculated using the sequence method and Ensemble software, respectively. Both parametric and non-parametric methods were used for the statistical analysis. Results: Results are presented as mean ± SD. Participants in the TM (n=16; age: 63±3yrs, body-mass index (BMI): 25±4kg/m2) and EM (n=16; age: 62±4yrs, BMI: 26±4kg/m2) groups were matched for age and BMI. TM and EM had similar levels of estradiol (TM: 3.9±2; EM: 4.4±4pg/mL) and activity levels (TM: 299±177; EM: 208±147kcal/day), but significantly different menopause ages (TM: 51±3; EM: 43±2yrs; p<0.001). TM and EM had similar resting systolic BP (TM: 129±13; EM: 128±20mmHg), diastolic BP (TM: 79±10; EM: 82±14mmHg), HR (TM: 59±7bpm; EM: 62±9bpm), and MSNA (TM: 51±16; EM: 45±11bursts/100heartbeats), p>0.05 for all. Further, cBRS and sBRS were similar between TM (cBRSup: 9.7±3; cBRSdown: 12.3±7; cBRStotal: 12.3±7ms/mmHg; sBRS: -2.7±1bursts/100Hb/mmHg) and EM (cBRSup: 8.7±4; cBRSdown: 11±5; cBRStotal: 10.4±4ms/mmHg; sBRS: -2±1bursts/100Hb/mmHg; p>0.05 for all). Conclusion: Contrary to our hypothesis, these findings suggest that EM may not influence BRS. These findings indicate that completing menopause early may not disrupt autonomic baroreflex function, suggesting that other mechanisms need to be explored to better understand the increased CVD risk in postmenopausal females who complete menopause prematurely or early. This study was supported by a NIH 1 K01 AG064038-01A1 (MLKR), UMN Grant-in-Aid (MLKR), F32HL160012 (EL), and NIH National Center for Advancing Translational Sciences grant UL1TR002494. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Measuring Cardiorespiratory Fitness without Exercise Testing: The Development and Validation of a New Tool for Spanish Adults.

Background: Cardiorespiratory fitness (CRF) is an important component of overall physical fitness and is associated with numerous health benefits, including a reduced risk of heart disease, diabetes, and obesity. However, direct measurement of CRF is time-consuming and therefore not feasible for screening purposes. Methods: A maximal treadmill exercise test with the Bruce protocol was performed to estimate VO2max in 1047 Spanish men and women aged 17 to 62 years. Weight, height, and heart rate were measured. Leisure-time physical activity (LTPA) was recorded using the Minnesota Leisure Time Physical Activity Questionnaire. A multiple linear regression model was developed to predict exercise-based VO2max. The validity of the model was examined by correlation, concordance, Bland-Altman analysis, cross-validation, and construct validity analysis. Results: There was no significant difference between VO2max obtained by the Bruce protocol (43.56 mL/kg/min) or predicted by the equation (43.59 mL/kg/min), with R2 of 0.57, and a standard error of the estimate of 7.59 mL/kg/min. Pearson's product-moment correlation and Lin's concordance correlation between measured and predicted CRF values were 0.75 and 0.72, respectively. Bland-Altman analysis revealed a significant proportional bias of non-exercise eCRF, overestimating unfit and underestimating highly fit individuals. However, 64.3% of participants were correctly classified into CRF tertile categories, with an important 69.9% in the unfit category. Conclusions: The eCRF equation was associated with several cardiovascular risk factors in the anticipated directions, indicating good construct validity. In conclusion, the non-exercise eCRF showed a reasonable validity to estimate true VO2max, and it may be a useful tool for screening CRF.

Leisure time physical activity and exercise performance in active older people in rural areas-Comparison of the first and second COVID-19 related lockdown in Germany.

The closure of all sports facilities during the two lockdowns in Germany favoured a reduction of leisure time physical activity during the COVID-19 pandemic. The aim of this study was to compare leisure time physical activity during the 1st and 2nd lockdown and to examine exercise performance before and after resumption of exercise. Leisure time physical activity was measured by the Longitudinal Urban Cohort Ageing Study (LUCAS) functional ability index and energy expenditure in the Minnesota Leisure Time Physical Activity Questionnaire. Participants' exercise performance was extracted from a chip-controlled fitness circuit. Differences were tested for statistical significance using Friedman tests. 35 participants above 60 years were included from the Oldenburg area (20 women, 15 men, mean age and standard deviation 71±6 years). The decline in energy expenditure was higher during the 2nd lockdown (1st lockdown: Median -55.7 kcal.day-1, Q0.25-121.3 kcal.day-1, Q0.75 132.9 kcal.day-1; 2nd lockdown: Median -119.7 kcal.day-1, Q0.25-255.6 kcal.day-1, Q0.75-65.1 kcal.day-1; Friedman test: p<0.001, n = 35, W = 0.262). The time spent in the fitness circuit decreased from lockdown to lockdown as well as the number of participants exercising there. Intense activities were performed during the two lockdowns by only 7 and 3 participants, respectively, and were not resumed by two-thirds of the participants after the 2nd lockdown. During the 1st lockdown, exercise performance on resistance exercise devices increased in most of them, while it decreased by 1 to 7% during the 2nd lockdown. The lockdowns limited leisure time physical activity in older adults. This was more pronounced during the lockdown in winter 2020/2021, when participants engaged less in outdoor activities. Therefore, measures should be taken to maintain physical activity and muscle strength, especially during winter months, with a home-based training, if visiting gyms is not possible.

#4303 REDUCING FRAILTY IN HEMODIALYSIS PATIENTS THROUGH INTRADIALYTIC VIRTUAL REALITY EXERCISE INTERVENTION: THE REVID STUDY

Abstract Background and Aims People in hemodialysis experience fatigue, weakness, weight loss, exhaustion, and low physical activity - all criteria of the frail phenotype. Frailty is a critical issue in the hemodialysis population due to its link to negative health outcomes, but few studies have focused on frailty in this population, despite the knowledge that frailty can be reversed with early detection and treatment. Our group has previously shown that non-immersive virtual reality exercise during hemodialysis is a safe method to improve physical function and health-related quality of life. The aim of this study is to analyze the impact of an intradialysis non-immersive virtual reality exercise program on frailty in the hemodialysis population. Method A randomized trial (the REVID study) included two groups of patients, exercising at different times during the dialysis session. The present study includes participants from REVID study who, once the study finished, continued exercising at their preferred time during the hemodialysis treatment. All participants were evaluated using the five Fried frailty phenotype criteria: unintentional weight loss of more than 4.5 kg in the past year, exhaustion was assessed using two questions from the Center for Epidemiological Studies Depression (CES-D) scale, weakness was measured using a handgrip dynamometer, walking speed was assessed by timing the 4.6m distance covered at the participant's normal pace, and physical activity was measured using the short version of the Minnesota Leisure Time Physical Activity questionnaire. Each of the five criteria was scored as 0 (not frail-related) or 1 (frail-related). Participants were then stratified into three groups: a score of 0/5 for robust or not frail, a score of 1-2/5 for pre-frail, and a score of 3-5/5 for frail. After the frailty phenotype assessment, all participants performed an intradialytic exercise program consisting of a non-immersive virtual reality game (Treasure Hunting) adapted to the dialysis session. The game consists of catching treasures and avoiding bombs by moving the lower extremities, with a progressive duration of 15 to 45 minutes. Adherence to the exercise program was measured as a percentage (number of sessions attended divided by the number of sessions offered). All assessments and interventions were conducted at Hospital de Manises in Valencia, Spain from September to December 2022. Results The study included 12 subjects with a mean age of 71.8 (13.9) years, 9 of whom were male, median time in Hemodialysis 20 (11.3 - 56 interquartile range) months. Out of the 12 participants, 2 were classified as robust, 5 as pre-frail, and 5 as frail. A chi-square test showed a significant change in the frailty phenotype of the participants after the exercise intervention (15.400; P = 0.003). At the end of the program, 3 participants were classified as frail, 7 as pre-frail, and 2 as robust. 2 participants improved from being frail to pre-frail. Furthermore, five participants (four frail and one pre-frail) reduced the number of criteria associated with the frail phenotype. No worsening in the frailty phenotype was reported among the participants. The average adherence to the exercise program throughout the study was 54.4 (11.2) %. Conclusion This study suggests that an intradialytic exercise program consisting of a non-immersive virtual reality can be useful in mitigating and managing frailty in the hemodialysis population.

Knowledge of Nutrition and Physical Activity Guidelines is Not Associated with Physical Function in Dutch Older Adults Attending a Healthy Ageing Public Engagement Event.

Evidence-based guidelines on nutrition and physical activity are used to increase knowledge in order to promote a healthy lifestyle. However, actual knowledge of guidelines is limited and whether it is associated with health outcomes is unclear. This inception cohort study aimed to investigate the association of knowledge of nutrition and physical activity guidelines with objective measures of physical function and physical activity in community-dwelling older adults attending a public engagement event in Amsterdam, The Netherlands. Knowledge of nutrition and physical activity according to Dutch guidelines was assessed using customized questionnaires. Gait speed and handgrip strength were proxies of physical function and the Minnesota Leisure Time Physical Activity Questionnaire was used to assess physical activity in minutes/week. Linear regression analysis, stratified by gender and adjusted for age, was used to study the association between continuous and categorical knowledge scores with outcomes. In 106 older adults (mean age=70.1 SD=6.6, years) who were highly educated, well-functioning, and generally healthy, there were distinct knowledge gaps in nutrition and physical activity which did not correlate with one another (R2=0.013, p=0.245). Knowledge of nutrition or physical activity guidelines was not associated with physical function or physical activity. However, before age-adjustment nutrition knowledge was positively associated with HGS in males (B= 0.64 (95% CI: 0.05, 1.22)) and having knowledge above the median was associated with faster gait speed in females (B=0.10 (95% CI: 0.01, 0.19)). Our findings may represent a ceiling effect of the impact knowledge has on physical function and activity in the this high performing and educated population and that there may be other determinants of behavior leading to health status such as attitude and perception to consider in future studies.

Transitions in frailty state 12months after kidney transplantation: a prospective cohort study.

Frailty is associated with several unfavorable outcomes after kidney transplantation (KTx). However, limited information is available regarding the transitions in frailty state and its components after KTx. This study aimed to evaluate the transitions in physical frailty phenotype and its components over a period of 12months after KTx. In this prospective single-center cohort study, we measured physical frailty phenotype (PFP) and its components at the time of admission for KTx and 12months after KTx.The evaluation includes five components: weakness (grip strengthanalysedby sex and body mass index quartiles), physical activity (kcals/week based on the Minnesota Leisure Time Physical Activity questionnaire), exhaustion (self-report using the Center for Epidemiological Studies Depression Scale), gait speed (time taken to walk 15 feet based on sex and height-specific cutoff), and unintentional weight loss (self-report of unintentional weight loss > 10 lbs in the last year). The exhaustion and physical activity components arevalidated inthe Brazilian population. Each component is scored as 0 or 1 according to its presence or absence, and aPFPscore of 3-5defines frailty, 2 isintermediate, and 0-1 is rated asnon-frail. We used the McNemar and Wilcoxon test to compare physical frailty phenotype and its components between the two periods. Among 87 patients included in the study, 16.1% were classified as frail, 20.7% as intermediately frail, and 63.2% as non-frail. Sixty-four patients were included in the analysis to evaluate transitions in frailty. At the time of admission for KTx, 15.6% of patients were defined asfrail compared to4.7% of patients at 12months after KTx (p = 0.023). Among the physical frailty phenotype components, the proportion of patients who scored in the weight loss category 12months after KTx was significantly lower than that at the time of KTx (6.3% vs 34.4%, p < 0.001). There was a 69.9% reduction in the prevalence of frail patients at the end of the 12-month follow-up after KTx. Among the components of frailty, weight loss showed a significant improvement.

Association of physical activity with vascular aging in a population with intermediate cardiovascular risk, analysis by sex: MARK study

BackgroundThe aim of this study was to analyze the association of physical activity and its intensity with arterial stiffness and vascular aging and differences by sex in a Spanish population with intermediate cardiovascular risk.MethodsCross-sectional study. A total of 2475 individuals aged 35–75 years participated in the study. Brachial–ankle pulse wave velocity (baPWV) was measured using a VaSera VS-1500® device. Based on the age and sex percentile presented by the participants, the latter were classified as follows: those with a percentile above 90 and presenting established cardiovascular disease were classified as early vascular aging (EVA); those with a percentile between 10 and 90 were classified as normal vascular aging (NVA) and those with a percentile below 10 were classified as healthy vascular aging (HVA). Physical activity was analyzed through the short version of the Minnesota Leisure Time Physical Activity Questionnaire (MLTPAQ).ResultsThe mean age of the participants was 61.34 ± 7.70 years, with 61.60% men. Of the total sample, 86% were sedentary (83% men vs 90% women). The total physical activity showed a negative association with baPWV (β = − 0.045; 95% CI − 0.080 to − 0.009). Intense physical activity showed a negative relationship with baPWV (β = − 0.084; 95% CI − 0.136 to − 0.032). The OR of the total physical activity and the intense physical activity carried out by the subjects classified as NVA with respect to those classified as HVA was OR = 0.946; (95% CI 0.898 to 0.997) and OR = 0.903; (95% CI 0.840 to 0.971), and of those classified as EVA it was OR = 0.916; (95% CI 0.852 to 0.986) and OR = 0.905; (95% CI 0.818 to 1.000). No association was found with moderate- or low-intensity physical activity.ConclusionsThe results of this study suggest that, when intense physical activity is performed, the probability of presenting vascular aging is lower. In the analysis by sex, this association is only observed in men.

Longitudinal association between cardiometabolic comorbidities and physical activity in middle aged and older adults living with HIV.

Cardiometabolic comorbidities have been associated with lower levels of physical activity (PA) among people living with HIV (PLWH). However, little is known about the longitudinal relationship between cardiometabolic comorbidities and PA participation. Therefore, the aim of this study was to determine the longitudinal association between cardiometabolic comorbidities and PA in PLWH. PLWH from New York City and with complete PA and cardiometabolic comorbidity data between December 2016 and October 2020 were included. PA was evaluated using energy expenditure from the Minnesota Leisure Time Physical Activity Questionnaire (MLTPAQ). Body composition was measured using body mass index (BMI) and different waist circumference measures. Diabetes and hyperlipidemia were determined by physician diagnosis. Hemoglobin A1c (HbA1c) was evaluated through blood samples. Linear mixed-effects models analyses were conducted to assess the longitudinal relationship between cardiometabolic comorbidities and PA. A total of 164 participants (mean age 59.6years; 48.2% females) were included. The mean follow-up period was 22.7months (SD=7.9). Higher BMI was associated with lower levels of PA in kcals/week (p<.05). An obese BMI was associated with lower levels of physical activity in kcals/week (p<.05). Higher mid-waist and umbilical circumference were associated with lower levels of PA in kcals/week (p<.05). Having hyperlipidemia was associated with lower levels of PA in kcals/week (p<.01). Having a diabetes diagnosis and elevated HbA1c were also associated with lower levels of PA in kcals/week (p<.05). Cardiometabolic comorbidities can have repercussions on PA participation among PLWH, which can in turn increase the risk of cardiovascular disease and mortality.

Abstract MP42: Physical Activity And Clinical Outcomes Among Older Adults With Atrial Fibrillation

Background: Current guidelines encourage adults with atrial fibrillation (AF) to engage in regular physical activity. However, little is known about the association between meeting the recommended level of regular physical activity and clinical outcomes among older adults with AF. Objective: To examine the association between meeting the recommended level of physical activity and clinical outcomes including mortality, stroke, and major bleeding. Methods: We used data collected from the Systemic Assessment of Geriatrics Elements (SAGE)-AF study which include patients with AF (≥65 years) and a CHA 2 DS 2 -VASc score ≥2. Participants were recruited from several clinics in Massachusetts and Georgia. We used the Minnesota Leisure Time Physical Activity questionnaire to examine if participants met the recommended level of physical activity (i.e. at least 500 metabolic equivalent task (MET)-minutes per week). A multivariable cox regression model was used to examine the association between meeting the recommended level of physical activity and our clinical outcomes while controlling for several potentially confounding variables. Results: A total of 1,244 participants (average age 75 years; 49% male; 85 % non-Hispanic White) were included in this study. Nearly one-half of participants engaged in regular physical activity. Meeting the recommended level of physical activity was associated with improved survival (adjusted HR (aHR) = 0.60, 95% CI = 0.38-0.96). However, engaging in regular physical activity was not significantly associated with reduced risk of stroke or major bleeding ( aHR = 1.37, 95% CI = 0.51-3.69; aHR = 0.86, 95% CI = 0.56-1.33, respectively ), although we may have lacked power for these associations, therefore, these results should be interpreted with caution. Conclusions: Meeting the recommended level of physical activity among older adults with AF significantly reduces the risk of mortality. Clinicians and health care providers should promote and encourage engagement in physical activity and tailor interventions to address barriers of engagement to improve patient survival.

SELF-REPORTED PHYSICAL ACTIVITY OF ELDERLY RESIDENTS IN WESTERN SLOVENIAN NURSING HOMES: A QUESTIONNAIRE-BASED APPROACH

The number of older people (65+ years) in the European Union is expected to reach 130 million by 2050. Regular physical activity has considerable benefits for health and physical functioning in the elderly population. The aim of the study was to evaluate the amount and intensity of self-reported physical activity expressed as energy consumption in a sample of 131 older individuals (aged 83.8 ± 7.6 years, 69% women) living in nursing homes by using the Minnesota Leisure Time Physical Activity Questionnaire. 109 participants reported to perform leisure time physical activity. Only 7.6% of them fulfilled the criteria for low physical activity proposed by Fried et al. (2001). The median energy expenditure (168.5 (IRQ=128.6) kcal/day) also exceeded the cut-off points for low activity. 54% of the participants stated that they perform the so-called heavy physical activity determined in a questionnaire with an intensity code 6 kcal/min or above. The questionnaire-based findings regarding physical activity in nursing homes are in terms of frailty encouraging but they should be verified against a more objective method for physical activity evaluation such as the use of accelerometers.

Abstract P159: Factors Associated With Moderate Physical Activity Among Older Adults With Atrial Fibrillation: SAGE-AF Study

Objective: Guidelines encourage patients with atrial fibrillation (AF) to engage in moderate-intensity physical activity. We examined the sociodemographic, geriatric, and clinical factors associated with engagement in moderate-intensity physical activity among older adults with AF. Methods: Patients aged 65 years and older, diagnosed with AF, and having a CHA 2 DS 2 -VASc ≥ 2 were recruited from multiple clinics in Massachusetts and Georgia between 2015 and 2018. We utilized The Minnesota Leisure Time Physical Activity questionnaire to assess whether participants reported being engaged in moderate physical exercise. We examined the association between sociodemographic, clinical, geriatric elements and engaging in moderate-intensity physical activity using multiple logistic regression modelling. Results: The mean age of participants was 76 years and 52% were men. Approximately one-half (52%) of participants met the recommended levels of physical activity. Participants who were cognitively impaired (adjusted OR [aOR]=0.74; 95% CI= 0.56-0.97 ) , morbidly obese (aOR= 0.40; 95% CI= 0.22-0.72), socially isolated (aOR= 0.58; 95% CI= 0.40-0.84), and had a slow gait speed (aOR= 0.44; 95% CI= 0.32-0.60) were less likely, while those with higher AF related quality of life score (aOR=1.66; 95% CI=1.26-2.18) more likely, to engage in moderate physical activity. Conclusions: A considerable proportion of older adults with AF did not engage in moderate physical activity. Cognitive impairment, morbid obesity, social isolation, and slow gait speed were associated with not engaging in moderate exercise. Health care providers should identify patients with AF who are sedentary, promote engagement, and tailor interventions to address obstacles in engagement in physical activity.

Muscle Sympathetic Nerve Activity is Elevated in Females with Physical Menopause Symptoms

Introduction Multiple symptoms accompany menopause, including vasomotor symptoms (VMS), physical symptoms, psychosocial symptoms and sexual dysfunction. Previous studies show that experiencing VMS may increase the risks for hypertension and cardiovascular disease (CVD); however, it is unclear whether physical menopausal symptoms, such as weight gain, lack of energy, or reduced muscular strength, contribute to CVD risk. Furthermore, muscle sympathetic nerve activity (MSNA) is elevated with CVD, but the relationship between menopause symptoms and MSNA is unknown. Thus, the aim of our study was to determine if physical menopausal symptoms are correlated with MSNA in postmenopausal females. Methods Eight postmenopausal females (age 63±1yr; menopause age 53±2yr) attended two study visits. The first visit included written informed consent, completion of the Menopause-Specific Quality of Life (MENQOL) and Minnesota Leisure Time Physical Activity (MLTPAQ) Questionnaires, and blood draws to measure sex hormone levels. The MENQOL asks participants to rate how bothered they feel in four areas of symptoms: vasomotor (i.e., VMS), psychosocial, physical, and sexual. The absence of a symptom corresponds with a score of 1 point, whereas a present symptom is rated according to how bothersome it is and is scored from 2-8 points. The MLTPAQ estimates caloric expenditure based on reported habitual physical activity. The second visit was conducted in the morning after an overnight fast and abstinence of alcohol, caffeine and exercise for 12 hours and included measurements of continuous noninvasive BP, heart rate via a 3-lead electrocardiography (ADInstruments, Colorado Springs, CO) and MSNA of the peroneal nerve via microneurography during a 10-minute period of quiet rest. Results Total MENQOL scores ranged from 1.3-2.4 on a 1-8 scale; physical symptom scores ranged from 1.1 to 3.4; and VMS ranged from 1.0-1.7. Body mass index (BMI, kg/m2) was 24±2. Levels of estradiol, total estrogens, testosterone, total estrogens: testosterone ratio, and MLTPAQ were not different between the females. Average mean arterial pressure was (101±5mmHg) and MSNA burst frequency was 29 bursts/min). In addition, MSNA burst frequency correlated with the MENQOL scores for physical symptoms (r=0.73, p=0.04), but not other menopausal symptoms, including VMS (p>0.05), indicating that females with more severe physical symptoms had greater MSNA. Conclusion Although females with VMS have greater CVD risk than those without VMS, data from this small sample of females suggests that reported physical symptoms rather than VMS were elevated with resting MSNA and were strongly associated with MSNA. These findings suggest that females who experience physical menopause symptoms may demonstrate autonomic dysregulation which could contribute to CVD risk.

Factors Associated with Moderate Physical Activity Among Older Adults with Atrial Fibrillation.

Engaging patients with atrial fibrillation (AF) in moderate-intensity physical activity has been encouraged by published guidelines. We examined factors associated with engagement in moderate physical activity among older adults with AF. This was a retrospective study involving ninety patients with episodes of Afib with RVR duData are from the SAGE (Systematic Assessment of Geriatric Elements)-AF study. Older adults (≥ 65 years) with AF and a CHA2DS2-VASc ≥ 2 were recruited from several clinics in Massachusetts and Georgia between 2015 and 2018. The Minnesota Leisure Time Physical Activity questionnaire was used to assess whether participants engaged in moderate-intensity physical activity (i.e. at least 150 minutes of moderate exercise). Logistic regression was utilized to examine the sociodemographic and clinical characteristics and geriatric elements associated with engaging in moderate-intensity physical activity. Participants were on average 76 years old and 48% were women. Approximately one-half (52%) of study participants engaged in moderate-intensity physical activity. Morbid obesity (adjusted OR [aOR]=0.41, 90%CI=0.23-0.73), medical history of renal disease (aOR= aOR=0.68,90%CI= 0.48-0.96), slow gait speed (aOR=0.44, 90%CI=0.32-0.60), cognitive impairment (aOR=0.74, 90%CI=0.56-0.97), and social isolation (aOR=0.58, 90%CI= 0.40-0.84) were independently associated with a lower likelihood, while higher AF related quality of life score (aOR=1.64, 90%CI=1.25-2.16) a greater likelihood, of meeting recommended levels of moderate physical activity. Nearly one-half of older adults with NVAF did not engage in moderate-intensity exercise. Clinicians should identify older patients with NVAF who are less likely to engage in physical activity and develop tailored interventions to promote regular physical activity.

THE INTENSITY OF PHYSICAL ACTIVITY AND THE HEALTH-RELATED BEHAVIOUR OF UNIVERSITY STUDENTS OF SELECTED MAJORS

The health of a society is conditioned by healthy lifestyle choices. A significant role in shaping health-related behaviour is played by university students, who should be leaders in the scope of health in the future. Our aim was to determine the intensity of physical activities and their relation with the intensity of health-related behaviours of university students of selected majors. Our research covered 372 students of physical education (292) and social sciences (108) from Poznań and Szczecin. We applied Minnesota Leisure Time Physical Activity Questionnaire (MLTPAQ) and Health Behaviour Inventory (HBI). The relations between the level of physical activity (PA) and the health behaviour of the students were determined by intra-group correlations (r). The value of p&lt;0.05 was adopted as statistically significant. Physical education (PE) and public health (PH) students showed higher levels of PA and health behaviour as compared to the students of social sciences (SS). The total activity metabolic index (AMI) indicated a lower level of PA among women, regardless of major. PA [4; 6) MET of tourism and recreation (T&amp;R) students was highly and positively correlated with preventive behaviours (PB) (r=0.69). PA &lt;4 MET of female T&amp;R students and male PE students positively correlated with correct eating habits (CEH). We found negative correlations between PA ≥6 MET of female PE students and male PH students [4-6) and ≥6 MET and health practices (HP), as well as PA [4-6 MET) of male PE students and positive mental attitude (PMA). Positive and negative correlations between free-time physical activity and health-related behaviours indicate the need for regular physical and health education of students. Physical activity, correct eating habits and preventive behaviour of students will increase their chances of promoting a healthy lifestyle in society.

Frailty and aging-associated syndromes in lung transplant candidates and recipients.

Many lung transplant candidates and recipients are older and frailer compared to previous eras. Older patients are at increased risk for pre- and posttransplant mortality, but this risk is not explained by numerical age alone. This manuscript represents the product of the American Society of Transplantation (AST) conference on frailty. Experts in the field reviewed the latest published research on assessment of elderly and frail lung transplant candidates. Physical frailty, often defined as slowness, weakness, low physical activity, shrinking, and exhaustion, and frailty evaluation is an important tool for evaluation of age-associated dysfunction. Another approach is assessment by cumulative deficits, and both types of frailty are common in lung transplant candidates. Frailty is associated with death or delisting before transplant, and may be associated with posttransplant mortality. Sarcopenia, cognitive dysfunction, depression, and nutrition are other important components for patient evaluation. Aging-associated inflammation, telomere dysfunction, and adaptive immune system senescence may also contribute to frailty. Developing tools for frailty assessment and interventions holds promise for improving patient outcomes before and after lung transplantation.

Prevalence of cognitive frailty and associations with other frailty domains in a Spanish community‐dwelling sample

AbstractBackgroundThe concept of cognitive frailty has been defined as the simultaneous presence of frailty and mild cognitive impairment in absence of dementia, although recent approaches has considered cognitive frailty as a distinct construct and has taken into account different domains of physical frailty (De Roeck et al., 2020). The aim of the present study is to analyze the prevalence of cognitive frailty in groups with different degrees of cognitive impairment.MethodA total of 285 community‐dwelling middle‐age and older adults, aged &gt;50 years, from Galicia and Valencia (northwest and southeast of Spain respectively) participated. Cognitive function was assessed using MoCA test, and cognitive complaints with the Spanish version of the Everyday Memory Questionnaire. Participants were classified as objective cognitively impaired, cognitively unimpaired, and cognitively unimpaired with subjective cognitive complaints. Physical frailty criteria included: a) unintentional weight loss or lack of appetite in the last three months; b) self‐reported exhaustion, measured with the General Health Questionnaire‐12 question about affective state; c) weakness, measured with a dynamometer to determine handgrip strength; d) slow walking speed, measured through a timed‐up and go task; and e) low physical activity, measured with the reduced Spanish version of the Minnesota Leisure Time Physical Activity Questionnaire (VREM). Participants were classified as robust if they met none of the criteria, pre‐frail if they met 1 or 2 criteria, and frail if they met 3 or more criteria, corrected by gender and age.ResultsThe prevalence of frailty was 2.5% in the cognitively unimpaired group, 12.2% in the group with cognitive complaints, and 9.6% in the group with objective cognitive impairment (chi‐square=18.37;p&lt;0.01) (Table 1). The co‐occurrence with physical frailty is more frequent with slow walking speed and, in the group with complaints, with self‐reported exhaustion.ConclusionThe prevalence of physical frailty was higher in both cognitive complaints and cognitive impairment groups, compared with the cognitively unimpaired group. The subjective cognitive complaints can play a relevant role in characterizing the relation between physical and cognitive impairments.

Physical activity, dietary habits and sleep quality before and during COVID-19 lockdown: A longitudinal study

The COVID-19 pandemic has forced the health public authorities to impose a lockdown as an epidemiological containment strategy. This study aimed to provide information regarding the impact of the mandatory confinement on the physical activity, eating disorders risk, sleep quality and well-being on a Spanish sample. An online survey that included the Minnesota Leisure Time Physical Activity Questionnaire, the Eating Attitude Test-26, and Pittsburgh Sleep Quality Index was administered two days after the state of alarm was stablished in Spain and five days after such measures began to be eased. Out of the 693 people who answered the first questionnaire, 161 completed the second one. These participants spent a total of 48 days locked at home, a period during which a significant worsening in all the variables assessed except for the risk of developing eating disorders, was observed: weight (kg), 67.3 ± 14.8 vs 67.7 ± 15.1, p = 0.012; physical activity (MET minutes per week), 8515.7 ± 10260.0 vs 5053.5 ± 5502.0, p < 0.001; sleep problems (total score), 6.2 ± 3.5 vs 7.2 ± 3.9, p < 0.001; self-perceived well-being (score), 4 (3–4) vs 3 (3–4), p < 0.001. The confinement had a significant differential effect on physically active participants, who experienced a significant decline (p < 0.05) on their physical activity levels, quality of sleep and well-being; whereas physically inactive participants did not experience significant changes. Findings from this longitudinal study indicate that a lockdown period due to COVID-19 had a negative impact on the physical activity levels, sleep quality and well-being in a group of physically active Spanish adults. Public health authorities should be aware that people who usually lead an active lifestyle, might be particularly susceptible to such disruptions.

GCKR rs780094 Polymorphism as A Genetic Variant Involved in Physical Exercise.

Exercise performance is influenced by genetics. However, there is a lack of knowledge about the role played by genetic variability in the frequency of physical exercise practice. The objective was to identify genetic variants that modulate the commitment of people to perform physical exercise and to detect those subjects with a lower frequency practice. A total of 451 subjects were genotyped for 64 genetic variants related to inflammation, circadian rhythms, vascular function as well as energy, lipid and carbohydrate metabolism. Physical exercise frequency question and a Minnesota Leisure Time Physical Activity Questionnaire (MLTPAQ) were used to qualitatively and quantitatively measure the average amount of physical exercise. Dietary intake and energy expenditure due to physical activity were also studied. Differences between genotypes were analyzed using linear and logistic models adjusted for Bonferroni. A significant association between GCKR rs780094 and the times the individuals performed physical exercise was observed (p = 0.004). The carriers of the minor allele showed a greater frequency of physical exercise in comparison to the major homozygous genotype carriers (OR: 1.86, 95% CI: 1.36–2.56). The analysis of the GCKR rs780094 variant suggests a possible association with the subjects that present lower frequency of physical exercise. Nevertheless, future studies are needed to confirm these findings.

Epidemiological Aspects of Low Back Pain.

Low back pain (LBP) is a major health problem, particularly in the contemporary societies of highly developed countries. This study seeks to define the influence of basic demographic and social factors, such as gender, body mass, physical activity, and the type of work, on the occurrence of lumbosacral spine pain in the early and middle-late adulthood. The study was based on a self-reported survey, using the revised Oswestry Low Back Pain Disability Questionnaire to evaluate pain symptoms, and managing everyday tasks. Physical activity was evaluated on the Minnesota Leisure Time Physical Activity Questionnaire. We found that patients in the early adulthood had a significantly lower level of disability. The older patients had a greater low back pain and motion, sleeping, and social life problems. Neither did gender nor the type of work, leisure time physical activity, or body mass appreciably affect the level of disability due to low back pain in both younger and older patient groups. We conclude that, all else unchanged from the epidemiological standpoint, wear and tear of the spine structure naturally progressing with age seems a major determinant of the appearance of low back pain.

Factors associated with falls in older adults with cataracts.

The aim of the present study was to evaluate factors associated with falls in community-dwelling older adults diagnosed with cataracts. An analytical, cross-sectional study was conducted with a sample of community-dwelling older adults residing in the Federal District of Brazil. Interviews and assessment tools were administered, such as the Timed Up and Go test, Short Physical Performance Battery (SPPB), Biodex Balance System, Katz Index, Lawton Scale, Minnesota Leisure Time Physical Activity Questionnaire and Mini Mental State Examination. Statistical analysis involved binary logistic regression. One hundred forty-two older adults (85 with cataracts) participated in the study (mean age: 69.39 ± 5.67 years). Falls were associated with the female sex (OR: 4.45) and sub-maximum score on the SPPB (OR: 3.53) among patients with cataracts, whereas multimorbidity (OR: 5.10) was the risk factor risk for older adults without cataracts. The data suggest different risk factors for falls among older adults diagnosed with cataracts.