Effects of social participation and physical activity on all-cause mortality among older adults in Norfolk, England: an investigation of the EPIC-Norfolk study

Abstract Background Declining physical activity (PA) is a hallmark of aging. Wearable technology provides reliable measures of the frequency, duration, intensity, and timing of PA. Accelerometry-derived measures of PA are compared with established predictors of 5-year all-cause mortality in older adults in terms of individual, relative, and combined predictive performance. Methods Participants aged between 50 and 85 years from the 2003–2006 National Health and Nutritional Examination Survey (NHANES, n = 2,978) wore a hip-worn accelerometer in the free-living environment for up to 7 days. A total of 33 predictors of 5-year all-cause mortality (number of events = 297), including 20 measures of objective PA, were compared using univariate and multivariate logistic regression. Results In univariate logistic regression, the total activity count was the best predictor of 5-year mortality (Area under the Curve (AUC) = 0.771) followed by age (AUC = 0.758). Overall, 9 of the top 10 predictors were objective PA measures (AUC from 0.771 to 0.692). In multivariate regression, the 10-fold cross-validated AUC was 0.798 for the model without objective PA variables (9 predictors) and 0.838 for the forward selection model with objective PA variables (13 predictors). The Net Reclassification Index was substantially improved by adding objective PA variables (p < .001). Conclusions Objective accelerometry-derived PA measures outperform traditional predictors of 5-year mortality, including age. This highlights the importance of wearable technology for providing reproducible, unbiased, and prognostic biomarkers of health.

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The Bidirectional Association Between Physical and Cognitive Function Among Chinese Older Adults: A Mediation Analysis

The International Journal of Aging and Human Development ◽

10.1177/0091415020940214 ◽

2020 ◽

pp. 009141502094021 ◽

Cited By ~ 1

Author(s):

Xiaohang Zhao ◽

Lei Jin ◽

Skylar Biyang Sun

Keyword(s):

Physical Activity ◽

Older Adults ◽

Cognitive Function ◽

Cognitive Decline ◽

Social Participation ◽

Cognitive Aging ◽

Reciprocal Relationship ◽

Vicious Cycle ◽

Chinese Older Adults ◽

Bidirectional Association

This study investigated the bidirectional association between physical and cognitive function in later life and examined the mechanisms underlying the interrelationship. We employed cross-lagged panel models to analyze a sample of 4232 unique participants aged 65 years and older from three waves of the Chinese Longitudinal Healthy Longevity Survey. Physical activity and social participation were tested as potential mediators between physical and cognitive function. Our findings revealed a reciprocal relationship between physical and cognitive function and a reciprocal relationship between physical and cognitive decline. Moreover, physical activity was confirmed to mediate the bidirectional association between physical and cognitive function, whereas social participation did not seem to be a mediator. A vicious cycle linking physical and cognitive decline may exist in Chinese older adults. However, leading a physically active lifestyle could be an effective intervention to slow physical and cognitive aging, thereby toning down the vicious cycle.

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Dose-response association of implantable device-measured physical activity with long-term cardiac death and all-cause mortality in patients at high risk of sudden cardiac death: a cohort study

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-020-01026-2 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Xiaoyao Li ◽

Shuang Zhao ◽

Keping Chen ◽

Wei Hua ◽

Yangang Su ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

High Risk ◽

Sudden Cardiac Death ◽

Dose Response ◽

Cardiac Death ◽

Cox Regression ◽

Cardiac Resynchronization ◽

All Cause Mortality

Abstract Background Cardiovascular implantable electronic devices (CIEDs) with physical activity (PA) recording function can continuously and automatically collect patients’ long-term PA data. The dose-response association of implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy defibrillator (CRTD)-measured PA with cardiovascular outcomes in patients at high risk of sudden cardiac death (SCD) was investigated. Methods In total, 822 patients fulfilling the inclusion criteria were included and divided into three groups according to baseline PA tertiles: tertile 1 (< 8.04%, n = 274), tertile 2 (8.04–13.24%, n = 274), and tertile 3 (> 13.24%, n = 274). The primary endpoint was cardiac death, the secondary endpoint was all-cause mortality. Results During a mean follow-up of 59.7 ± 22.4 months, cardiac death (18.6% vs 8.8% vs 5.5%, tertiles 1–3, P < 0.001) and all-cause mortality (39.4% vs 20.4% vs 9.9%, tertiles 1–3, P < 0.001) events decreased according to PA tertiles. Compared with patients younger than 60 years old, older patients had a lower average PA level (9.6% vs 12.8%, P < 0.001) but higher rates of cardiac death (13.2% vs 8.1%, P = 0.024) and all-cause mortality (28.4% vs 16.7%, P < 0.001) events. Adjusted multivariate Cox regression analyses showed that a higher tertile of PA was associated with a lower risk of cardiac death (hazard ratio (HR) 0.41, 95% confidence interval (CI): 0.25–0.68, tertile 2 vs tertile 1; HR 0.28, 95% CI: 0.15–0.51, tertile 3 vs tertile 1, Ptrend < 0.001). Similar results were observed for all-cause mortality. The dose-response curve showed an inverse non-linear pattern, and a significant reduction in endpoint risk was observed at the low-moderate PA level. The HR for cardiac death was reduced by half with 12.32% PA (177 min), and the HR for all-cause mortality was reduced by half with 11.92% PA (172 min). Subgroup analysis results indicated that older adults could benefit from PA and the range for achieving optimal benefits might be lower. Conclusions PA monitoring may aid in long-term management of patients at high risk of SCD. More PA will generate better survival benefits, but even low-moderate PA is already good especially for older adults, which is relatively easy to achieve.

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The Effect of Physical Activity and Cardiorespiratory Fitness on All-Cause Mortality in Hong Kong Chinese Older Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glx180 ◽

2017 ◽

Vol 73 (8) ◽

pp. 1132-1137 ◽

Cited By ~ 1

Author(s):

Zhihui Lu ◽

Jean Woo ◽

Timothy Kwok

Keyword(s):

Physical Activity ◽

Older Adults ◽

Hong Kong ◽

Cardiorespiratory Fitness ◽

Hong Kong Chinese ◽

Chinese Older Adults ◽

All Cause Mortality

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Physical Activity and the Effect of Multimorbidity on All-Cause Mortality in Older Adults

Mayo Clinic Proceedings ◽

10.1016/j.mayocp.2016.12.004 ◽

2017 ◽

Vol 92 (3) ◽

pp. 376-382 ◽

Cited By ~ 15

Author(s):

David Martinez-Gomez ◽

Pilar Guallar-Castillon ◽

Esther Garcia-Esquinas ◽

Stefania Bandinelli ◽

Fernando Rodríguez-Artalejo

Keyword(s):

Physical Activity ◽

Older Adults ◽

All Cause Mortality

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Impact of the Changes in the Frequency of Social Participation on All-Cause Mortality in Japanese Older Adults: A Nationwide Longitudinal Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19010270 ◽

2021 ◽

Vol 19 (1) ◽

pp. 270

Author(s):

Keiichi Shimatani ◽

Mayuko T. Komada ◽

Jun Sato

Keyword(s):

Older Adults ◽

Social Participation ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Risk Of Mortality ◽

All Cause Mortality ◽

Japanese Older Adults ◽

The Impact

Previous studies have shown that more frequent social participation was associated with a reduced risk of mortality. However, limited studies have explored the changes in the frequency of social participation in older adults. We investigated the impact of the changes in the frequency of social participation on all-cause mortality in Japanese older adults aged 60 years and older. The current study, conducted as a secondary analysis, was a retrospective cohort study using open available data. The participants were 2240 older adults (45.4% male and 54.6% female) sampled nationwide from Japan who responded to the interview survey. Changes in the frequency of social participation were categorized into four groups (none, initiated, decreased, and continued pattern) based on the responses in the baseline and last surveys. The Cox proportional-hazards model showed a decreased risk of all-cause mortality in decreased and continued patterns of social participation. Stratified analysis by sex showed a decreased risk of mortality in the continued pattern only among males. The results of the current study suggest that the initiation of social participation at an earlier phase of life transition, such as retirement, may be beneficial for individuals.

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Correlations of Subjective and Social Well-Being With Sedentary Behavior and Physical Activity in Older Adults—A Population-Based Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glab065 ◽

2021 ◽

Author(s):

Shuyun Chen ◽

Amaia Calderón-Larrañaga ◽

Marguerita Saadeh ◽

Ing-Mari Dohrn ◽

Anna-Karin Welmer

Keyword(s):

Physical Activity ◽

Social Support ◽

Older Adults ◽

Positive Affect ◽

Sedentary Behavior ◽

Social Participation ◽

Oldest Old ◽

Well Being ◽

Sitting Time ◽

National Study

Abstract Background Subjective and social well-being, avoiding sedentary behavior (SB), and engaging in physical activity (PA) are important factors for health in older adults, but the extent to which they are related to each other remains unclear. We aimed to investigate these correlations, and whether they differ by age. Method A cross-sectional study was carried out in 595 people aged 66 years and older, from the Swedish National study on Aging and Care in Kungsholmen. Subjective and social well-being (life satisfaction, positive and negative affect, social connections, social support, and social participation) were assessed through validated questionnaires and activPAL3 accelerometers provided information on SB and PA. Data were analyzed using multi-adjusted quantile regression models. Results Higher positive affect was significantly associated with less daily sitting time (β = −27.08, 95% confidence interval [CI]: −47.77, −6.39) and higher levels of light PA (LPA) (β = 40.67, 95% CI: 21.06, 60.28). Higher levels of social support and social participation were associated with less daily sitting time (β = −22.79, 95% CI: −39.97, −5.62; and β = −21.22, 95% CI: −39.99, −2.44) and more time in LPA (β = 23.86, 95% CI: 4.91, 42.81; and β = 25.37, 95% CI: 6.27, 44.47). Stratified analyses suggested that the associations of positive affect and social participation were strongest for individuals aged 80 years and older. Conclusions Our results suggest that older adults with higher levels of subjective and social well-being spend less time sitting and engage more in PA. This was especially evident among the oldest-old individuals. Future research should longitudinally investigate the directionality of these correlations.

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