Waking Hours Research Articles

Detecting sleep and physical activity changes across the perinatal period using wearable technology

BackgroundPregnant women may not experience disruptions in sleep duration throughout the course of pregnancy, however, their sleep quality is dramatically impaired. Sleep quality deteriorates throughout pregnancy, reaching its lowest in the third trimester. The purpose of this study was to understand the change in sleep patterns across the perinatal period, as well as the impact of physical activity on sleep.MethodsA total of 18 physically active women trying to conceive wore a WHOOP strap (a fitness monitor) across the perinatal period. Daily behavior changes were tracked including time awake, hours in deep sleep, physical activity, and time in moderate to vigorous physical activity.ResultsWomen maintained overall physical activity levels during and after pregnancy and averaged 20.70 min of physical activity and 6.97 h of sleep per day. Total time in awake hours increased postpartum. Moderate-vigorous physical activity minutes improved deep sleep hours overall (Est. = 0.003 h, p < 0.0001) and during pregnancy (Est. = 0.00001 h, p = 0.0004). Similar effects were found for all activity minutes, although in post pregnancy the moderating impact of activity minutes no longer maintained significance (p = 0.09).\\.ConclusionsWearable technology, including fitness monitors such as WHOOP straps offer a convenient and less invasive way to track sleep and physical activity during the perinatal period. The findings of this study indicate a positive connection between sleep and engaging in moderate to vigorous activity and any activity throughout the perinatal period. These results may help inform clinical and practical recommendations for physical activity to improve sleep outcomes for pregnant women.

Getting up for brain health: Association of sedentary behavior breaks with cognition and mental health in children

Children spend most of their waking hours sedentary and reducing this behavior has been challenging. Interrupting prolonged episodes of sedentary behavior with active breaks can provide mental and cognitive health benefits. Considering the multifactorial nature of these health aspects, this study aimed to verify the role of body mass index (BMI), cardiorespiratory fitness (CRF), and moderate to vigorous physical activity (MVPA) in the relationship between the break in sedentary time with cognitive and mental health in children. This is a cross-sectional study with 129 children (62 boys), aged between 6 and 11 years (mean 8.73 ± 1.53) from a public school in southern Brazil. For the assessment of fluid intelligence, psychologists applied Raven’s Colored Progressive Matrices test. Mental health was measured using the Strengths and Difficulties Questionnaire. Sedentary breaks were measured using accelerometers, and CRF was determined using the 6-min walk test. Generalized linear regression analyses were used to verify associations of sedentary breaks with fluid intelligence and mental health, according to children’s BMI, CRF, and MVPA. All models were adjusted for sex, age, somatic maturation, and total time of accelerometer use. Our results indicated that sedentary breaks were associated with fluid intelligence in overweight/obese (β = 0.108; p = 0.021) and physically inactive children (β = 0.083; p = 0.010). Regarding mental health, no association was identified with sedentary breaks. In conclusion, sedentary breaks should be encouraged for the benefits of fluid intelligence, especially in children who do not meet physical activity recommendations and are overweight.

Using wearable technology to objectively investigate physical behaviour and determine health outcomes of a physical activity intervention in patients with psoriasis.

Sedentary behaviour has a detrimental effect on health independent of the amount of physical activity undertaken. Despite the association of cardiometabolic and psychosocial comorbidities with psoriasis, how physical behaviour influences health outcomes in patients with psoriasis is poorly understood. We hypothesized that objective measurement of physical behaviour, using wearable digital technology, would have utility in understanding the clinical impact of an exercise intervention designed in partnership with patients with psoriasis. Fourteen patients with psoriasis completed a 20-week study. During weeks 1-10, participants followed an incrementally progressive, exercise intervention, followed by independent activities during weeks 11-20. Accelerometers (GENEActiv Original) and pedometers recorded physical behaviour. Evaluation at week-0, -10, and -20 included assessment of psoriasis, cardiometabolic disease/risk, psychological health and functional capacity. Our intervention supported significantly increased physical activity, including moderate-vigorous physical activity (p=0.04) and step count (p=0.04). We also observed a significant association between physical activity and psoriasis area and severity index (PASI)-50 response (p=0.01) and psychosocial functioning (p=0.029) together with a significant negative correlation between step count and psoriasis severity (p=0.012). We observed no change in total waking hour sedentary behaviour. Objective measurement of physical behaviour, using wearable digital technologies, offers a mechanism to further understand the clinical impact of lifestyle behaviour interventions. Crucially, despite increased levels of physical activity, we observed no change in total waking hour sedentary time. Further investigation is required to establish how modification of physical behaviour could offer an adjuvant management strategy for patients with psoriasis.

Efficacy of education outside the classroom to increase adolescent physical activity

Physical inactivity increases risks of cardiovascular disease, poor mental health, and morbidity. School-based physical activity (PA) promotion can reach children from differing backgrounds in a large proportion of their waking hours. Education outside the classroom (EOtC) is an PA-integrating pedagogical approach that aligns PA with the primary goals of schools and is therefore thought to present an acceptable, feasible, and efficacious model for school-based PA. This registered report used a cluster randomised wait list design to evaluate the efficacy of an EOtC intervention that aims to increase adolescents’ (ages 10–16 years) school-based (school week) and overall (full week) PA by providing a course on the pedagogical and didactic methods of EOtC to teachers across 30 Danish schools, and subsequently the teachers implementing EOtC in their classes > 5 h weekly over the course of one school year. Across 20 schools, 503 pupils aged 9–14 years were enrolled. The intervention group classes delivered a weekly mean of 238 (± 50) minutes of EOtC per-protocol and engaged in 20.4% moderate-to-vigorous school-based PA above the control group, however with no effect on overall PA. Enhancing effectiveness on overall PA, supplementing the intervention with additional PA activities, or adjusting its delivery and implementation is necessary.Protocol registration The stage 1 protocol for this Registered Report was accepted in principle on 22/08/22. The protocol, as accepted by the journal, can be found at: https://doi.org/10.17605/OSF.IO/NTM9K.

Hands-On Gardening in Childcare Centers to Advance Preschool-Age Children's Fruit and Vegetable Liking in Semi-Arid Climate Zone.

Hands-on gardening is linked with healthy eating behaviors, increased outdoor activities, and overall well-being, all contributing factors to preventing obesity. Although these positive associations are widely established for adults and school-aged children, little evidence can be found on how such relationships may extend to early childhood, especially in the preschool years (3-5 years). One recent study conducted in North Carolina (NC) showed that participating in hands-on gardening significantly increased preschoolers' accurate identification of fruits and vegetables (FV) and FV consumption compared to children who did not participate in hands-on gardening, but no association was found between participation in hands-on gardening and the children's liking (eating preferences) of FV. FV identification and liking during the early years may lead to lifelong healthy eating behaviors and preferences, making hands-on gardening a critical health intervention in early childhood environments, especially in childcare centers where a majority of the 13 million children in the United States between the ages of 0 and 5 spend most of their waking hours. This research aimed to investigate how hands-on gardening in childcare centers may impact preschoolers' (3-5 years old) FV knowledge (identification) and liking in a semi-arid climate zone with a high concentration of Hispanic families by conducting experimental research with eight childcare centers and one hundred forty-nine children (n = 149) in Lubbock County, located in West Texas. The findings showed changes in average liking scores are generally positive in the experimental group of children who participated in hands-on gardening (compared to the control non-gardening group), implying an improved liking. The findings indicate that the benefits of hands-on gardening in childcare centers for enhancing healthy eating preferences are evident even in a semi-arid climate zone, where high temperatures and limited rainfall present significant gardening challenges. This research underscores the importance of integrating hands-on gardening into childcare programs, highlighting its potential as an effective obesity prevention strategy not only within the US but also in other regions with similar environmental constraints.

The History and Impact of Prescribing Orthokeratology for Slowing Myopia Progression.

This paper discusses the history and impact of orthokeratology on slowing the progression of myopia. It discusses the origins and evolution of orthokeratology from polymethymethaccrylate lenses worn during the day to its current prescribing of highly permeable, innovative reverse-geometry designs worn only while sleeping. Technological advances in corneal topography, lens design, lens materials, and manufacturing have facilitated growth of orthokeratology to a precise and predictable procedure. More recently, significant interest in orthokeratology has been stimulated by its efficacy in slowing axial elongation in myopic children. Safety of children wearing contact lenses while sleeping has been an ongoing concern. The potential of serious complications exists, but long-term studies and clinical experience have shown that risks of those events can be minimized with strict compliance with lens cleaning, disinfection, and hand hygiene. Because no correction is required during waking hours, patients using orthokeratology report higher vision-related quality of life, less activity restrictions, and more comfortable eyes compared with spectacles or contact lenses worn during the day. The future growth of orthokeratology will be fueled by the prescribing of orthokeratology as a modality to slow axial elongation and an alternative modality to spectacles, traditional contact lenses, and refractive surgery to correct refractive error.

Impact of Sedentary Behaviors on Blood Pressure and Cardiovascular Disease: An Umbrella Review of Systematic Reviews and Meta-Analyses.

Cardiovascular diseases (CVD) are among the leading causes of mortality in the western world, and high blood pressure is among the greatest risk factors for CVD. Given that most of a person's waking hours are spent in sedentary behaviors, understanding the cardiovascular impact of a sedentary lifestyle is imperative. Although limiting sedentary time is encouraged in public health messaging, individual reviews analyzing its impact on clinically relevant cardiovascular outcomes such as blood pressure and CVD exhibit conflicting results. We conducted an umbrella review of systematic reviews and meta-analyses synthesizing the effects of sedentary time/behaviors on blood pressure or CVD. To be included, studies had to be a systematic review and/or meta-analysis that studied the impact of sedentary time or a sedentary posture on blood pressure or CVD incidence/mortality. The review was preregistered in PROSPERO (CRD4202342568) and conducted in May 2023. The Joanna Briggs Institute and Risk of Bias in Systematic Reviews tools assessed study quality. PRISMA reporting was followed. Our umbrella review screened 2215 citations with 40 review studies meeting our inclusion criteria (n = 22 meta-analyses) that included 234 unique individual studies of 3,769,755 unique participants. The average study quality was high (9.2 ± 1.7 out of 11). A minority of studies (n = 7/20) supported that less sedentary time was associated with lower blood pressure, with reviews of interventional studies typically not observing a consistent effect (n = 9/12), whereas reviews of cross-sectional studies observed apositive effect (n = 5/7). When hypertension rates were used as the outcome, most (n = 3/4) studies observed a deleterious impact of sedentary time. For CVD incidence/mortality, less sedentary time or screen time was consistently associated with a lower CVD incidence/mortality (n = 17/23), with studies exhibiting a null effect generally including small sample sizes and being of a lower study quality. Total sedentary time and specific behaviors (i.e., television and screen time) exhibited similar findings. Based on a high quality of evidence and large sample size, existing systematic reviews and meta-analyses demonstrate the negative impact of sedentary behaviors on CVD incidence/mortality, with conflicting reports for blood pressure that vary based on the study design.

Designing affective workplace environments: The impact of typology, contour, ceiling and partition height on cognitive and aesthetic appraisal

Up to 90 % of our time is spent indoors, with 40 % of a full-time employee's waking hours spent at work, underscoring the critical importance of workplace environments in promoting health and well-being. While there is substantial knowledge about the impact of spatial design on environmental satisfaction and productivity, there is a gap in understanding its effect on employees' aesthetic and cognitive experiences. This study addresses these gaps by investigating how variations in typical workplace design elements—such as partition height, ceiling height, and contour shape—across three workplace typologies (Open plan, Cellular, and Bürolandschaft) influence both aesthetic (beauty, attention, pleasure) and cognitive (safety, distraction, interaction) appraisals. Thirty-six virtual models of workplace environments were generated using parametric modeling methods, and a total of 713 participants provided ratings and rankings for these dimensions. Our findings indicate that higher partitions are associated with greater perceived safety and reduced distractions, while curved contours are perceived as more aesthetically pleasing and enjoyable compared to angular designs. The Bürolandschaft typology significantly enhances perceived safety and interaction. Moreover, isovist analysis revealed that spatial features such as isovist compactness and circularity positively correlate with beauty, pleasure, and attention, while higher dispersion is linked to lower safety perceptions. These insights are crucial for designing affective workplace environments that balance openness and privacy, enhance safety, and support a science-informed approach to workplace design that promotes positive cognitive and aesthetic experiences.

Supervised machine learning to predict smoking lapses from Ecological Momentary Assessments and sensor data: Implications for just-in-time adaptive intervention development.

Specific moments of lapse among smokers attempting to quit often lead to full relapse, which highlights a need for interventions that target lapses before they might occur, such as just-in-time adaptive interventions (JITAIs). To inform the decision points and tailoring variables of a lapse prevention JITAI, we trained and tested supervised machine learning algorithms that use Ecological Momentary Assessments (EMAs) and wearable sensor data of potential lapse triggers and lapse incidence. We aimed to identify a best-performing and feasible algorithm to take forwards in a JITAI. For 10 days, adult smokers attempting to quit were asked to complete 16 hourly EMAs/day assessing cravings, mood, activity, social context, physical context, and lapse incidence, and to wear a Fitbit Charge 4 during waking hours to passively collect data on steps and heart rate. A series of group-level supervised machine learning algorithms (e.g., Random Forest, XGBoost) were trained and tested, without and with the sensor data. Their ability to predict lapses for out-of-sample (i) observations and (ii) individuals were evaluated. Next, a series of individual-level and hybrid (i.e., group- and individual-level) algorithms were trained and tested. Participants (N = 38) responded to 6,124 EMAs (with 6.9% of responses reporting a lapse). Without sensor data, the best-performing group-level algorithm had an area under the receiver operating characteristic curve (AUC) of 0.899 (95% CI = 0.871-0.928). Its ability to classify lapses for out-of-sample individuals ranged from poor to excellent (AUCper person = 0.524-0.994; median AUC = 0.639). 15/38 participants had adequate data for individual-level algorithms to be constructed, with a median AUC of 0.855 (range: 0.451-1.000). Hybrid algorithms could be constructed for 25/38 participants, with a median AUC of 0.692 (range: 0.523 to 0.998). With sensor data, the best-performing group-level algorithm had an AUC of 0.952 (95% CI = 0.933-0.970). Its ability to classify lapses for out-of-sample individuals ranged from poor to excellent (AUCper person = 0.494-0.979; median AUC = 0.745). 11/30 participants had adequate data for individual-level algorithms to be constructed, with a median AUC of 0.983 (range: 0.549-1.000). Hybrid algorithms could be constructed for 20/30 participants, with a median AUC of 0.772 (range: 0.444 to 0.968). In conclusion, high-performing group-level lapse prediction algorithms without and with sensor data had variable performance when applied to out-of-sample individuals. Individual-level and hybrid algorithms could be constructed for a limited number of individuals but had improved performance, particularly when incorporating sensor data for participants with sufficient wear time. Feasibility constraints and the need to balance multiple success criteria in the JITAI development and implementation process are discussed.

Language environment and early language production in Slovenian infants: An exploratory study using daylong recordings.

Daylong recordings provide an ecologically valid option for analyzing language input, and have become a central method for studying child language development. However, the vast majority of this work has been conducted in North America. We harnessed a unique collection of daylong recordings from Slovenian infants (age: 16-30months, N=40, 18 girls), and focus our attention on manually annotated measures of parentese (infant-directed speech with a higher pitch, slower tempo, and exaggerated intonation), conversational turns, infant words, and word combinations. Measures from daylong recordings showed large variation, but were comparable to previous studies with North American samples. Infants heard almost twice as much speech and parentese from mothers compared to fathers, but there were no differences in language input to boys and girls. Positive associations were found between the social-interactional features of language input (parentese, turn-taking) and infants' concurrent language production. Measures of child speech from daylong recordings were positively correlated with measures obtained through the Slovenian MacArthur-Bates Communicative Development Inventory. These results support the notion that the social-interactional features of parental language input are the foundation of infants' language skills, even in an environment where infants spend much of their waking hours in childcare settings, as they do in Slovenia.

Resting-state electroencephalography (EEG) microstates of healthy individuals following mild sleep deprivation

Mild sleep deprivation is widespread in many societies worldwide. Electroencephalography (EEG) microstate analysis provides information on spatial and temporal characteristics of resting brain network, serving as an indicator of neurophysiological activities at rest. This study seeks to investigate potential neural markers in EEG following mild sleep deprivation of a single night using EEG microstate analysis. Six-minute resting EEG was conducted on thirty healthy adults within 6 hours of waking in the morning and after at least 18 h of sleep deprivation. Translated and validated Malay language Karolinska Sleepiness Scale was used to assess the participants’ degree of sleepiness. Microstate characteristics analysis was conducted on the final 24 subjects based on four standard microstate maps. Microstate C shows a significant increase in mean duration, coverage and occurrence, while microstate D has significantly higher occurrence after sleep deprivation. This study demonstrates notable changes in resting state EEG microstates following mild sleep deprivation. Present findings deepen our understanding of the brain's spatiotemporal dynamics under this condition and suggest the potential utility of neural markers in this domain as components of composite markers for sleep deprivation.

Effects of orthodontic aligners on 24-hour masseter muscle activity: a multiple-day electromyographic study

ABSTRACT Objective This study aimed to assess the effects of aligners on masseter muscle activity by using an electromyographic device in the home environment. Methods The study was performed on healthy patients who required orthodontic treatment. Three different 24 h-EMG recording sessions were performed in different conditions: without aligners, with passive aligners, and with active aligners. The non-functional MMA work index (nfMMA-WI) and the non-functional MMA time index (nfMMA-TI) for both awake and sleep hours were assessed. ANOVA test was used to compare the average activity during the three recording conditions. Results On average, a total recording time of 204.7 ± 7.9 hours were provided for each patient. For most patients, ANOVA test showed an absence of significant differences between the recording sessions. Conclusions The impact of our results is not negligible: clinicians can find remarkable support to the hypothesis that the use of aligners affects the MMA only in a minority of subjects.

SPEctacle Correction for the TReatment of Amblyopia (SPECTRA): study protocol for a prospective non-randomised interventional trial in adults with anisometropic/mixed mechanism amblyopia

IntroductionAmblyopia is a neurodevelopmental vision disorder typically affecting one eye, resulting in compromised binocular function. While evidence-based treatments exist for children, there are no widely accepted treatments for adults. This...

ADULT PHYSICAL ACTIVITY, SEDENTARY BEHAVIOUR AND SLEEP QUALITY IN THE DIGITAL TRANSFORMATION ERA

The digital transformation era increases population health risks associated with lack of exercise, as well as emphasizes the role of an active lifestyle within sustainable socio-economic development. Digitalization is one of the main reasons for setting significant public health priorities: poor or insufficient sleep and physical inactivity. The aim of the research was to study the physical activity (PA), sedentary behaviour (SB) and sleep duration of the population measured by a tri-axial accelerometer. Methods: The study is based on the project “EUPASMOS”, where PA, SB, and sleep-time of the participants (n = 369) was measured 24/7 by a tri-axial accelerometer (UKK RM42, UKK Terveyspalvelut Oy, Tampere, Finland) for a week-long period. The participants mostly spent their waking hours in a sedentary state. The mean duration of sedentary behaviour was 7h 52min. The participants took an average of 9584 steps a day. They also engaged in light PA for 4h 15min, and moderate-to-vigorous PA for 1h 16min. The mean duration of sleep was 5h 46min. The results showed that the insufficient sleep and physical inactivity of the participants are serious health risks in the digital transformation era. Future research should focus on the effect that various components of physical activity (dose, mode, timing) have on sleep.

Changes in Accelerometer-measured Physical Activity and Sedentary Behavior From Before to After COVID-19 Outbreak in Workers.

The novel coronavirus disease 2019 (COVID-19) pandemic may have reduced opportunities for engaging in physical activity (PA) and increased sedentary behavior (SB) among workers. However, most previous studies used self-reported assessments. This study aimed to examine the changes in accelerometer-measured PA and SB from before to after COVID-19 outbreak among Japanese workers. This 1-year longitudinal study used data from the annual health check-ups of workers who lived in the Tokyo metropolitan area. Baseline and follow-up data were collected from June to November of 2019 and June to November of 2020, respectively. Participants were asked to wear the accelerometer on their hip during awake hours for at least 10 days in both the surveys. Before the analysis, considering the difference in wearing time, time spent in PA and SB were converted to the percentage of wearing time. To investigate the changes in PA or SB from before to during COVID-19 outbreak, paired t-tests were performed. Of the 757 eligible participants, 536 were included in the analysis (70.8%). Participants' mean age was 53.3 years, 69.6% were female, and most were full-time employees. Time spent in PA decreased, regardless of weekdays or weekends, although changes on the weekends were not significant. Conversely, time spent in SB increased on both weekdays and weekends in 2020. These changes corresponded to approximately 10 minutes per day decrease in PA and increase in SB. Objectively measured PA decreased and SB increased by approximately 10 minutes per day after the COVID-19 outbreak among Japanese workers.

0062 Memory for Text Meaning Is Maintained During 24 Hours of Continuous Wakefulness

0062 Memory for Text Meaning Is Maintained During 24 Hours of Continuous Wakefulness

Improving Students Access to Primary Health Care Through School-Based Health Centers.

More than 20 million children in the United States lack access to primary health care. Research shows that students with regular access to physical and mental health services have fewer absences, are more social, less likely to participate in risky behaviors, have improved focus and higher test scores. School-based health centers (SBHCs) can be an important, valuable and viable health care delivery option to meet the full-range of primary health care needs of students where they spend the majority of their wake hours, ie, in school. Children in rural and other underserved communities, as well as those underinsured, non-insured, economically challenged, underserved, and the most vulnerable among us are especially at risk. This paper discusses the history, value, and importance of SBHCs from myriad perspectives, including physical and emotional wellbeing, academic and social success, and the promotion of a positive transition to adulthood. In addition, the authors' experiences that resulted in building the first SBHC in the Mid-Hudson Valley Region of New York State are shared. These experiences form the foundation for creating an important roadmap for individuals and school leaders that are interested in bringing a SBHC to their school and district.

Characterization of circulating leptin-receptor levels following acute sleep restriction: A pilot study on healthy adult females

BackgroundInsufficient sleep adversely affects energy homeostasis by decreasing leptin levels. The underlying physiological mechanisms; however, remain unclear. Circulating leptin is well described to be regulated by its soluble receptor (sOB-R). Intriguingly, the impact of short sleep duration on sOB-R levels has never been characterized. AimIn this study, we investigated, for the first time, the variation of sOB-R levels and its temporal relationship with circulating leptin upon acute sleep restriction. MethodsFive adult females were maintained on an 8-hour sleep schedule (bedtime at 00:00) for 1 week before restricting their sleep to 4.5 h (bedtime at 03:30) on 2 consecutive nights. Balanced meals were scheduled to specific hours and sleep was objectively measured. Four-hour blood samples were regularly collected during waking hours between 08:00 and 00:00. ResultsSleep restriction resulted in lower leptin (20.9 ± 1.7 vs 25.7 ± 1.7 ng/ml) and higher sOB-R concentrations (24.4 ± 1.2 vs 19.8 ± 1.6 ng/ml). Neither the discordant temporal relationship nor the pattern of leptin and sOB-R were altered in response to sleep restriction. ConclusionOur results suggest that sleep restriction may modulate circulating leptin levels and possibly metabolism via upregulating its soluble receptor. This observation may have valuable therapeutic implications when considering sOB-R as a potential target during the management of metabolic disturbances.

Abstract P274: Beyond MVPA: Machine Learning Insights Into Activity Patterns and Cardiometabolic Health in the National Health and Nutrition Examination Survey (NHANES) 2003-2004

Physical activity (PA) and sedentary behavior (SB) volumes and patterns may be useful in identifying individuals who are at elevated cardiometabolic risk. Identifying individuals at risk will facilitate early interventions for prevention of cardiovascular diseases. The objective of this project is to identify important free-living physical activity patterns to classify cardiometabolic markers including insulin, plasma glucose, and triglyceride. Methods: We used cross-sectional NHANES 2003-2004 accelerometer, blood exam and demographic data. We included adults age ≥18 years who wore a hip-worn ActiGraph 7164 during waking hours for at least 4 days of 10 hours/day of wear time. We included PA and SB predictors including minutes per day (min/d) in sedentary time (0-99 counts per minute, cpm), light intensity PA (100-759 cpm), Lifestyle PA (760-2019 cpm), moderate to vigorous PA (MVPA, ≥2019 cpm), number of breaks in SB, and number of 30-min and 60-min SB, 10-min MVPA bouts etc. The cut points for cardiovascular disease risk were defined based on literature as: fasting serum insulin ≤ 5 μU/mL, plasma glucose ≤ 100 mg/dL and triglyceride &lt; 150 mg/dL. Three random forest (RF) classification models were developed for each cardiometabolic marker using age, body-mass-index, general health, and PA variables as predictors. Models were trained and tested using a 60% training - 40% testing split. We tuned the hyperparameters (final selection: number of trees = 500 and variables = 3) to find the model with the highest testing accuracy based on the out-of-bag error. The importance of each predictor was measured and ranked by the mean decrease in GINI index. Results: The three datasets include insulin (n = 2810, age=34 ±23, 50% females), glucose (n = 1852, age = 49±20, 51% females) and triglyceride (n = 3180, age=36 ±24, 50% females). For insulin model, the PA variables with largest mean decrease in GINI index were SB time, light intensity PA, MVPA, and SB bouts of 30-min. Similarly, time spent in Lifestyle PA, light intensity PA, number of SB breaks and SB bouts of 30-min were the most important variables for abnormal fasting glucose prediction. The number of sedentary breaks, light intensity PA, SB time and SB bouts of 30-min were the most important PA predictors for risk of high triglyceride. Both BMI and age were important demographic variables for prediction of increased risk in each model. The prediction accuracy and precision are as following: Insulin(73%; 76%), Plasma Glucose(68%; 58%), and Triglyceride(64%; 46%). Conclusion: Cardiometabolic markers using free-living PA has the potential to provide insights for classifying the risk for cardiovascular disease based on given physiological marker cut-off points. The time spent lower intensity PA patterns and the number of sedentary breaks, and 30-minutes bouts are important predictors for identifying individuals who may have increased cardiometabolic risk.

SEDENTARY BEHAVIORS AND COGNITION: DOES THE TYPE OF BEHAVIOR MATTER?

Abstract Older adults spend 80% of their waking hours performing sedentary behaviors (SBs) that are either mentally active (e.g., using computers, socializing, and completing hobbies) or passive (e.g., television viewing and resting). Cross-sectional studies report an association between passive SB participation and cognitive impairments. However, longitudinal impact of baseline SB participation on cognition is unclear. We addressed this gap by using the National Health and Aging Trends Study (NHATS) dataset to run competing risks proportional hazards models. In our models, participants were identified as having an event (i.e., outcome) if their cognition scores dropped ≤ 1.5 standard deviations (SD) below the mean during follow-up (rounds 7-11, years 2017-2021). Competing risks included moving to long-term care facilities or dying. Our analyses included 1,574 community-dwelling older adults (mean age 84, SD = 7.1) who completed the sedentary module included in round 6 (year 2016) and had intact orientation, recall, and executive function at baseline. The majority of participants were female (55%) and non-Hispanic white (78%), and reported good or excellent health (80%). We identified that participating in active SBs had a protective effect on orientation, recall, and executive function (subdistribution hazard ratios [SHR]= 0.28-0.46, p&amp;lt; 0.001-0.02). Activities that had significant protective effects across all models included using computers (SHR =0.15-0.46, p=&amp;lt; 0.001-0.001) and socializing (SHR=0.27-0.52, p= &amp;lt; 0.001-0.05). Passive SBs did not have significant SHRs. Our identified protective effects highlight the potential of preventing cognitive impairments through active SB programs. Intervention studies are needed to develop program protocols and identify effectiveness of active SB programs.