1445Physical activity and long-term mortality risk in Israeli older adults with and without cardiovascular disease

Abstract Background Physical activity (PA) is a known protective factor among both general population and cardiovascular disease (CVD) patients. Yet, only a few cohort studies assessed the role of PA among older adult populations, characterized by high CVD prevalence rates. Objectives To evaluate the association between PA levels and all-cause mortality among Israeli older adults, and to assess whether it differs by baseline CVD status. Methods Participants were drawn from the National Health and Nutrition Survey of Older Adults Aged 65+ (“Mabat-Zahav”), conducted by the Israel Center for Disease Control between July 2005 and December 2006. Clinical, behavioral, and psychosocial data were collected via interview at study entry; a detailed PA questionnaire was also administered, through which participants were classified as sufficiently-active, insufficiently-active, and inactive, according to the American College of Sports Medicine classification. Mortality data (last follow-up, December 2016) were obtained from the Israeli Ministry of Health. Inverse probability weighted Cox proportional hazards models, based on propensity score, were constructed to assess the adjusted association between PA categories and mortality. Results Of the 1799 participants (mean [SD] age, 74.6 [6.2] years; 647 [36%] with a history of CVD), 559 (31%) were sufficiently-active, 506 (28%) were insufficiently-active and 734 (41%) were inactive. During a mean follow-up period of 9.0 years, 684 participants (38%) died. PA and mortality demonstrated an inverse dose-response relationship in both CVD and non-CVD groups, with no CVD-by-PA interaction detected on multiplicative-scale (P=0.70) or additive-scale (P=0.58). Notably, inactive non-CVD subjects had comparable risk to CVD patients who were sufficiently active (Figure). Physical activity and mortality Conclusions In a nationally-based cohort of subjects aged 65 years and over, PA was inversely associated with mortality risk. CVD patients who preformed sufficient PA had a comparable mortality risk to inactive subjects free of CVD. These findings illustrate the importance of PA in the older adult population.

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Physical Activity and Long-Term Mortality Risk in Older Adults with and without Cardiovascular Disease: A Nationwide Cohort Study

Gerontology ◽

10.1159/000518169 ◽

2021 ◽

pp. 1-9

Author(s):

Or Shaked ◽

Gali Cohen ◽

Abigail Goshen ◽

Tal Shimony ◽

Tamar Shohat ◽

...

Keyword(s):

Physical Activity ◽

Cardiovascular Disease ◽

Older Adults ◽

Propensity Score ◽

Mortality Risk ◽

Mortality Data ◽

Cox Models ◽

Long Term Mortality

Aims: To evaluate the association between physical activity (PA) levels and mortality among older adults, to determine whether it differs according to cardiovascular disease (CVD) status, and to assess the optimal weekly duration of PA associated with subsequent survival. Methods: Participants (n = 1,799) were drawn from a national survey conducted from 2005 to 2006, constituting Israeli adults aged ≥65 years. Sociodemographic, clinical, behavioral, and psychosocial data were collected via interview at study entry. Based on a detailed PA questionnaire and according to published guidelines, participants were classified as sufficiently active, insufficiently active, and inactive. CVD status was self-reported. Mortality data (last follow-up, December 2016) were obtained from the Israeli Ministry of Health. Using Cox models, inverse probability weighted hazard ratios (HRs) for mortality, based on propensity score, were estimated for PA categories. Results: Among the participants at baseline (mean age, 74.6 years), 559 (31.1%) were sufficiently active, 506 (28.1%) were insufficiently active, and 734 (40.8%) were inactive. During follow-up (mean, 9.0 years), 684 participants (38.0%) died. PA was inversely associated with mortality, with propensity score-adjusted HRs (95% confidence intervals) of 0.84 (0.71–1.01) in insufficiently and 0.73 (0.61–0.88) in sufficiently active participants (ptrend < 0.001). No PA-by-CVD interaction was detected on multiplicative scale (p = 0.36) or additive scale (p = 0.58). A monotonic survival benefit was observed until ∼150 min of PA per week, beyond which no further gain was apparent. Conclusions: In a nationwide cohort of older adults, nearly 70% did not meet the guideline for PA. PA engagement was inversely associated with long-term mortality risk, similarly in individuals with and without CVD. A maximum survival advantage was achieved at around 150 min of exercise per week.

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Physical Activity, Diabetes, and Heart Conditions Among Native Hawaiian and Other Pacific Islander Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.1298 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 403-404

Author(s):

Yeonjung (Jane) Lee ◽

Tyran Terada

Keyword(s):

Physical Activity ◽

Older Adults ◽

Older Adult ◽

Protective Factor ◽

Native Hawaiian ◽

Adult Population ◽

Pacific Islander ◽

The United States ◽

Activity Promotion ◽

Older Adult Population

Abstract The Native Hawaiian and Other Pacific Islander (NHOPI) older adult population remains understudied and are disproportionately affected by diabetes and heart conditions. Research has shown that participating in physical activity is a protective factor for many of the health conditions experienced by older adults. Yet, the link between physical activity, diabetes, and heart conditions among the NHOPI older adult population is limited. The purpose of this study is to identify the characteristics of NHOPI older adults and to explore the association between physical activity levels and diabetes/heart conditions. Methods and findings Using data from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (NHPI NHIS), which is considered to have a representative sample of NHOPI, the study explores the associations between physical activity and diabetes/heart conditions. A total of 1,045 older adults ages 50 years and older were included for analyses. Weighted multivariate analyses with multiple imputation techniques were used. The NHPI NHIS is the first federal survey focusing on the NHOPI population of the United States with rich information on health. Results and Implications Those with who were engaged in a sufficient physical activity had lower odds of having diabetes or heart conditions than their counterparts without physical activity while controlling for other sociodemographic characteristics. Findings highlight the importance of physical activity promotion intervention in preventing cardiovascular disease. Research and practice addressing health disparities and cardiovascular conditions should leverage efforts to provide culturally relevant physical activity types and resources to NHOPI older adults.

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Increased mortality risk in patients with primary and secondary adrenal insufficiency

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab096 ◽

2021 ◽

Author(s):

Kanchana Ngaosuwan ◽

Desmond G Johnston ◽

Ian F Godsland ◽

Jeremy Cox ◽

Azeem Majeed ◽

...

Keyword(s):

Cardiovascular Disease ◽

Adrenal Insufficiency ◽

Mortality Risk ◽

Reference Population ◽

Mortality Data ◽

Adrenal Crisis ◽

Malignant Neoplasms ◽

Geographical Differences ◽

All Cause Mortality

Abstract Context Mortality data in patients with adrenal insufficiency are inconsistent, possibly due to temporal and geographical differences between patients and their reference populations. Objective To compare mortality risk and causes of death in adrenal insufficiency with an individually-matched reference population. Design Retrospective cohort study. Setting UK general practitioner database (CPRD). Participants 6821 patients with adrenal insufficiency (primary, 2052; secondary, 3948) and 67564 individually-matched controls (primary, 20366; secondary, 39134). Main outcome measures All-cause and cause-specific mortality; hospital admission from adrenal crisis. Results With follow-up of 40799 and 406899 person-years for patients and controls respectively, the hazard ratio (HR; [95%CI]) for all-cause mortality was 1.68 [1.58 - 1.77]. HRs were greater in primary (1.83 [1.66 - 2.02]) than in secondary (1.52 [1.40 - 1.64]) disease; (HR; primary versus secondary disease, 1.16 [1.03 - 1.30]). The leading cause of death was cardiovascular disease (HR 1.54 [1.32-1.80]), along with malignant neoplasms and respiratory disease. Deaths from infection were also relatively high (HR 4.00 [2.15 - 7.46]). Adrenal crisis contributed to 10% of all deaths. In the first two years following diagnosis, the patients’ mortality rate and hospitalisation from adrenal crisis were higher than in later years. Conclusion Mortality was increased in adrenal insufficiency, especially primary, even with individual matching and was observed early in the disease course. Cardiovascular disease was the major cause but mortality from infection was also high. Adrenal crisis was a common contributor. Early education for prompt treatment of infections and avoidance of adrenal crisis hold potential to reduce mortality.

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Effects of a DVD-Delivered Exercise Intervention on Maintenance of Physical Activity in Older Adults

Journal of Physical Activity and Health ◽

10.1123/jpah.2015-0173 ◽

2016 ◽

Vol 13 (6) ◽

pp. 594-598 ◽

Cited By ~ 3

Author(s):

Jason Fanning ◽

Elizabeth A. Awick ◽

Thomas R. Wójcicki ◽

Neha Gothe ◽

Sarah Roberts ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Repeated Measures ◽

Exercise Intervention ◽

Adult Population ◽

Older Individuals ◽

Time Treatment ◽

Home Based ◽

Significant Patterns

Background:Previous research supports the efficacy of a 6-month DVD-delivered program for enhancing physical activity (PA) in older adults. In the current study, we examined the degree to which intervention-related increases in PA were maintained after a 6-month, no-contact follow-up.Methods:Follow-up assessments of PA via accelerometry and the Godin Leisure-Time Exercise Questionnaire (GLTEQ) were collected in a sample of older adults (N = 238). Repeated measures analyses of variance were conducted to examine changes in PA over the course of the follow-up period.Results:For accelerometer measured PA, there was a significant time × treatment × age group interaction, F1,203 =11.319, P = .001, η2 = .053, such that younger (≤70 years) intervention participants maintained high levels of PA across the follow-up period, while PA in older intervention and young control participants declined significantly. Rates of PA in older control participants remained low over the course of the follow-up period. Analyses of GLTEQ scores revealed similar, though less significant patterns.Conclusions:DVD-based exercise programs may be effective for maintaining PA in younger members of the older adult population; however, there remains a need to develop better strategies for promoting PA maintenance in older individuals when using home-based designs.

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Abstract P265: Trends In Cardiovascular Disease Risk Factors Among Older Adults (65+ Years) In New York City

Circulation ◽

10.1161/circ.141.suppl_1.p265 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Rienna Russo ◽

Yan Li ◽

Simona Kwon ◽

Chau Trinh-Shevrin ◽

Stella S Yi

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Older Adults ◽

New York ◽

New York City ◽

Older Adult ◽

York City ◽

Fruits And Vegetables ◽

Adult Population ◽

Older Adult Population

Introduction: There was a 19% increase in the older adult population ages 65 and older in New York City (NYC) between 2005 and 2015, which now comprises about 1.13 million people. Cardiovascular disease (CVD) is the leading cause of death among this older adult population. Dietary modification has been linked to improved CVD outcomes in older adults, demonstrating that prevention efforts are still effective in older age. Over the past decade, NYC has led numerous initiatives to improve dietary and physical activity behaviors. Little is known about the impact of these policies on CVD health and behavioral risk factors among older adults. Hypothesis: We anticipate that cardiovascular disease risk factors (fruit and vegetable intake; sugar-sweetened beverage (SSB) intake; exercise; diabetes; cholesterol; and hypertension) will have remained stagnant over an eight year period, from 2009 to 2017, as older adults remain a largely under-reached population. Methods: The New York City Community Health Survey (CHS) is an annual cross-sectional survey among NYC residents. A trend analysis was conducted using data from 2009 to 2017. Adults aged 65 years and older were included in the analysis (n= 20,771). Annual estimates of the percentage of persons with select CVD risk factors were calculated. Linear regression was used to measure changes over time; binary variables were scaled as 0 to 100 to represent percentages. Nonlinearity assessments were conducted and segmented regression models were used when appropriate. All analyses were conducted in SUDAAN v.11.0.3, using appropriate sample weights incorporating the complex survey design. Results: In 2017, over one-quarter (27.3%; 703/2,576) of older adults were diagnosed with diabetes, and almost two-thirds (64.8%; 1,664 /2,568) were diagnosed with hypertension. Only 10.4% (257/2,475) of older adults consumed 5 or more servings of fruits and vegetables and 17.3% (440/2,548) consumed at least one serving of SSB per day. From 2009-2017, there was an increase in the prevalence of diabetes among older adults (Average Percent Change [APC] 0.68; p<0.0001). There were decreases in the percentages of older adults consuming five or more servings of fruits and vegetables (APC -0.30; p=0.007) and one or more SSB across the years (APC -0.38; p=0.010). From 2010-2014, there was a decrease in the prevalence of older adults with high cholesterol (APC -1.06; p=0.047). There were no significant changes in hypertension or exercise rates over time. Conclusion: Decreases in SSB consumption and cholesterol indicate that some prevention efforts may have reached the older adult population. Despite these successes, more older adults suffer from diabetes and hypertension and fewer consume the recommended five servings of fruits and vegetables. In conclusion, more targeted policies and programs are needed to address CVD risks among older adults, as this population continues to grow.

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Deciphering the Role of Physical Activity in Stress Management During A Global Pandemic in Older Adult Populations: A Systematic Review Protocol

10.21203/rs.3.rs-59516/v1 ◽

2020 ◽

Author(s):

Ryan Churchill ◽

Indira Riadi ◽

Lucy Kervin ◽

Kelly Teo ◽

Theodore Cosco

Keyword(s):

Mental Health ◽

Physical Activity ◽

Systematic Review ◽

Older Adults ◽

Stress Management ◽

Older Adult ◽

Adult Population ◽

Activity Level ◽

Sufficient Evidence ◽

Physical Activity Interventions

Abstract Background: The world has changed dramatically since the beginning of 2020 due to COVID-19. As a result of the pandemic, many older adults are now experiencing an increased and unprecedented amount of psychological stress. Physical activity has been found to be an evidence-based means of combating stress among older adults to promote their quality of life. Studies have demonstrated that those who are physically active experience fewer issues in regard to their mental health, specifically depression and anxiety disorders. Engagement in physical activity may exert a protective influence over stress inducing events and subsequent mental health outcomes. Due to the fact that exercise is inexpensive, non-invasive, and effective even via incremental increases in activity level, physical activity interventions should be investigated as an important therapy for reducing stress for older adults during this current pandemic. Methods: Four electronic databases will be searched to identify all randomized control trials that involve physical activity as an intervention to address stress management in older adults 50 years of age or older. Only peer reviewed and published journal articles will be reviewed. All studies will be assessed for bias using Cochrane’s risk of bias tool. A random effects meta-analysis will be investigated if sufficient evidence of homogenous research exists and the heterogeneity of effect sizes will be tabulated. Discussion: This review will determine the effectiveness of various physical activity interventions for the treatment of stress among the older adult population. This knowledge will help inform care aides, clinicians, family members, and older adults themselves of the most effective physical activity interventions in dealing with stress which is relevant to the ongoing pandemic. Registration: PROSPERO CRD42020192546 Keywords: Stress management, physical activity, pandemic, intervention, older adults, systematic review

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Is Research on Aging and Physical Activity Really Increasing? A Bibliometric Analysis

Journal of Aging and Physical Activity ◽

10.1123/japa.7.2.182 ◽

1999 ◽

Vol 7 (2) ◽

pp. 182-195 ◽

Cited By ~ 8

Author(s):

Ronnie Lidor ◽

Uri Miller ◽

Arie Rotstein

Keyword(s):

Physical Activity ◽

Older Adults ◽

Bibliometric Analysis ◽

Older Adult ◽

Adult Population ◽

Is Research ◽

Depth Analysis ◽

Number Of Publications ◽

Older Adult Population

In light of the dramatic increase in the older adult population, we analyzed publications on aging and physical activity during the last 3 decades, based on (a) the ratio of the number of publications on aging to the total number of publications and the ratios of (b) the total number of publications on physical activity and aging and (c) the number of such publications in 6 selected journals to the number of publications on physical activity in general. Our findings indicate that few changes have occurred during the last 3 decades with regard to the volume of publication on aging and physical activity. Two conclusions can be reached: (a) The interest of researchers in exercise and sport sciences does not reflect that of society at large concerning older adults, and (b) an in-depth analysis should be conducted to study the periodicals that are published not only in the area of exercise and sport sciences but also in other related areas such as medicine, psychology, and health.

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Impact of physical activity on the risk of cardiovascular disease in middle-aged and older adults: EPIC Norfolk prospective population study

European Journal of Preventive Cardiology ◽

10.1177/2047487317737628 ◽

2017 ◽

Vol 25 (2) ◽

pp. 200-208 ◽

Cited By ~ 36

Author(s):

Sangeeta Lachman ◽

S Matthijs Boekholdt ◽

Robert N Luben ◽

Stephen J Sharp ◽

Soren Brage ◽

...

Keyword(s):

Physical Activity ◽

Cardiovascular Disease ◽

Older Adults ◽

Population Study ◽

Health Benefits ◽

Activity Levels ◽

Inverse Association ◽

Middle Aged ◽

Physical Activity Levels

Background There is broad consensus that regular physical activity yields major health benefits. However, current guidelines on physical activity are mainly aimed at middle-aged adults. It is unclear whether physical activity also translates into cardiovascular health benefits in older adults. Therefore, we aimed to compare the association between different levels of physical activity and the risk of cardiovascular disease (CVD) in elderly to middle-aged individuals. Methods We analysed data from the EPIC Norfolk prospective population study. Cox proportional hazards models were used to analyse the association between physical activity levels and time to CVD events in three age categories (<55, 55–65 and >65 years). Interaction between age categories and physical activity levels was assessed. Results Analyses were based on 24,502 study participants aged 39–79 years. A total of 5240 CVD events occurred during 412,954 person-years follow-up (median follow-up was 18.0 years). Among individuals aged over 65 years, hazard ratios for CVD were 0.86 (95% confidence interval (CI) 0.78–0.96), 0.87 (95% CI 0.77–0.99) and 0.88 (95% CI 0.77–1.02) in moderately inactive, moderately active and active people, respectively, compared to inactive people. Among people aged 55–65 and less than 55 years, the associations were directionally similar, but not statistically significant. The interaction term between physical activity levels and age categories was not significant ( P = 0.38). Conclusion The inverse association between physical activity and the risk of CVD was significant in elderly and comparable with middle-aged individuals. In addition, we observed that modest levels of physical activity confer benefits in terms of CVD risk, compared to being completely inactive.

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Association of disability with mortality in the Spanish adult non-institutionalised population

Journal of Epidemiology & Community Health ◽

10.1136/jech-2021-217421 ◽

2021 ◽

pp. jech-2021-217421

Author(s):

Javier Damián ◽

Alicia Padron-Monedero ◽

Javier Almazán-Isla ◽

Fernando J García López ◽

Jesús de Pedro-Cuesta ◽

...

Keyword(s):

Mortality Risk ◽

Adult Population ◽

Community Dwelling ◽

Mortality Data ◽

Standard Population ◽

All Cause Mortality ◽

Specific Mortality ◽

Nationally Representative ◽

Rate Ratios

BackgroundThere are scant studies focused on measuring the association between disability and all-cause mortality based on large representative national samples of the community-dwelling adult population; moreover, the number of such studies which also include cause-specific mortality is yet lower.MethodsLongitudinal cohort study that used baseline data from 162 381 adults who participated in a countrywide disability survey (2008). A nationally representative sample was selected and interviewed in their homes. We present data on people ≥18 years. Disability was considered as any substantial limitation found on a list of 44 life activities that have lasted or are expected to last more than 1 year and originate from an impairment. Cause-specific mortality data were obtained from the Spanish Statistical Office. Subjects contributed follow-up time from baseline interview until death or the censoring date (31 December 2017). We computed standardised rate ratios (SRRs), with age, sex, living with a partner and education level distribution of the total group as standard population.ResultsAdults with disability (11%) had an adjusted mortality rate more than twice as high as adults without disability (SRR 2.37, 95% CI 2.24 to 2.50). The increased mortality risk remained over the 10-year follow-up period. Mortality due to diseases of the nervous system (SRR 4.86, 95% CI 3.93 to 6.01), diseases of the musculoskeletal system (SRR 3.45, 95% CI 2.18 to 5.47), infectious diseases (SRR 3.38, 95% CI 2.27 to 5.01) and diabetes mellitus (SRR 3.56, 95% CI 2.71 to 4.68) was particularly high in those with disability.ConclusionsAll-cause mortality rates are markedly higher among adults with disability. Preventive measures and health promotion initiatives are needed to reduce mortality risk in this population. Special attention should be paid to disabled people with certain specific diseases.

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Association of Socioeconomic Status Measures With Physical Activity and Subsequent Frailty in Older Adults

10.21203/rs.3.rs-1056571/v1 ◽

2021 ◽

Author(s):

Mark Kheifets ◽

Abigail Goshen ◽

Uri Goldbourt ◽

Guy Witberg ◽

Alon Eisen ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Socioeconomic Status ◽

Leisure Time Physical Activity ◽

Strong Predictor ◽

Population Based ◽

Older Individuals ◽

Nutrition Survey ◽

Significant Public Health

Abstract Background: Despite increased recognition, frailty remains a significant public health challenge. Methods: Using a population-based cohort of older adults, this study examined the relationship between socioeconomic status (SES) factors, physical activity and frailty. The study included 1,799 participants (mean [SD], age 75[6]; 53% women) from the "National Health and Nutrition Survey of Older Adults Aged 65 and Over in Israel", conducted in 2005-2006. A follow-up interview was performed 12-14 years later in a subgroup of 601 subjects (mean [SD], age 84[4]; 56% women). Extensive data including self-reported leisure-time physical activity (LTPA) and SES measures were assessed at baseline. Frailty was measured at follow-up. Results: All SES measures were strongly and positively associated with LTPA (all p<0.001). Eighty-two participants (14%) were classified as frail at follow-up. After age and sex adjustment and accounting for attrition bias using inverse probability weighting, baseline LTPA (OR=2.77, 95% CI: 1.57-4.90, for inactivity; OR=1.41, 95% CI: 0.75-2.68, for insufficient activity, compared with sufficient activity, Ptrend<0.001) was inversely associated with incident frailty. The association persisted after further adjustment for SES and comorbidity. Conclusion: Among older individuals, multiple SES measures were positively associated with LTPA, which was a strong predictor of lower subsequent frailty risk.

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