Dose–Response Association Between Accelerometer-Assessed Physical Activity and Incidence of Functional Disability in Older Japanese Adults: A 6-Year Prospective Study

Abstract Background It is unknown whether moderate-to-vigorous physical activity (MVPA) in bouts of <10 minutes protects against disability risks or if only 10 minutes bouts of MVPA is critical. Additionally, it is unclear whether light physical activity (LPA) or its accumulation patterns is associated with functional disability. Methods A total of 1,687 adults aged ≥65 years and without functional disability at baseline were followed up for 6 years. Functional disability was identified using the database of Japan’s Long-term Care Insurance System. Physical activity was measured using a tri-axial accelerometer secured to the waist. Results Functional disability was identified in 274 participants (16.2%). When examined as quartiles, higher levels of all MVPA measures were dose-dependently associated with lower risk of functional disability. Associations of MVPA in ≥10 and <10 minutes bouts remained significant in a mutually adjusted model. Neither total LPA nor LPA in bout of ≥10 minutes, but LPA in bouts of <10 minutes was associated with functional disability. Analyses using restricted cubic spline functions showed that associations of all MVPA measures and LPA in bouts of <10 minutes with functional disability were linear (p for nonlinear >.05). The hazard ratios (HRs; 95% confidence interval [CI]) for functional disability per 10 minutes increment of total MVPA and LPA in bout of <10 minutes were 0.86 (0.81–0.92) and 0.96 (0.93–0.99), respectively. Conclusions Higher MVPA, regardless accumulation patterns, or LPA in bouts of <10 minutes was associated with lower risk of functional disability in a linear dose–response manner in older adults.

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Combined effects of body mass index and unhealthy behaviors on disability in older Japanese adults: the Okayama study

PeerJ ◽

10.7717/peerj.8146 ◽

2019 ◽

Vol 7 ◽

pp. e8146

Author(s):

Yangyang Liu ◽

Toshiharu Mitsuhashi ◽

Michiyo Yamakawa ◽

Megumi Sasai ◽

Toshihide Tsuda ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Functional Disability ◽

Normal Weight ◽

Combined Effects ◽

Term Care ◽

Hazard Ratios ◽

Japanese Adults ◽

Cox Proportional Hazard Models ◽

Long Term Care Insurance

Background Body mass index (BMI) is a significant predictor of functional disability in older adults. However, when evaluated, the association between BMI and incident functional disability, considering behaviors only as covariates or not, may not be appropriate. The primary purpose of the study was to investigate the combined effects of BMI and unhealthy behaviors on the risk of incident functional disability. Methods This was a retrospective cohort study that took place in Okayama City, Japan. Data on BMI and unhealthy behaviors were obtained using the health check-up questionnaire. The certification of Long-Term Care Insurance was used to measure functional disability. Cox proportional hazard models were used; adjusted hazard ratios (HRs) with 95% confidence interval (CI) were calculated for incidence of functional disability across categories of BMI and number of unhealthy behaviors. Results The relationship between BMI and incident functional disability was U-shaped (HR = 1.18, 95% CI [1.11–1.25], among the underweight range; and 1.26 [1.19–1.34] among the obesity range), and its risk was significantly higher within the normal-to-overweight range of BMI values with co-occurring unhealthy behaviors (with normal weight range and one, 1.17 [1.01–1.21]; two, 1.29 [1.18–1.41]; and three or four unhealthy behaviors 1.38 [1.24–1.54]; as well as among overweight range and one, 1.16 [1.05–1.27]; two, 1.26 [1.15–1.38]; and three or four unhealthy behaviors, 1.47 [1.31–1.64]). In each BMI category, the risk of incident functional disability increased with increasing number of unhealthy behaviors (p < 0.05 for linear tread), with the highest risk (1.87 [1.58–2.20]) occurring in combination with at least three unhealthy behaviors with BMI ≥ 27.5, for both sexes (2.20 [1.64–2.92] in men and 1.66 [1.35–2.04] in women). Conclusion It is necessary to consider the combined effects of BMI and behaviors on incident functional disability. Furthermore, interventions targeting multiple behaviors should be considered as such interventions may offer greater benefits than simple interventions.

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Corrigendum to: Dose–Response Association Between Accelerometer-Assessed Physical Activity and Incidence of Functional Disability in Older Japanese Adults: A 6-Year Prospective Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa231 ◽

2020 ◽

Vol 76 (1) ◽

pp. 176-176

Author(s):

Tao Chen ◽

Takanori Honda ◽

Sanmei Chen ◽

Kenji Narazaki ◽

Shuzo Kumagai

Keyword(s):

Physical Activity ◽

Prospective Study ◽

Dose Response ◽

Functional Disability ◽

Japanese Adults

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Association between multimorbidity patterns and disability among older people covered by long-term care insurance in Shanghai, China

BMC Public Health ◽

10.1186/s12889-021-10463-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zijing Wang ◽

Wenjia Peng ◽

Mengying Li ◽

Xinghui Li ◽

Tingting Yang ◽

...

Keyword(s):

Older People ◽

Functional Disability ◽

Long Term Care ◽

Strong Association ◽

Binary Logistic Regression ◽

Term Care ◽

Logistic Regression Models ◽

Disease Pattern ◽

Long Term Care Insurance

Abstract Background Functional disability and multimorbidity are common among older people. However, little is known about the relationship between functional disability and different multimorbidity combinations. We aimed to identify multimorbidity patterns and explore the associations between these patterns and functional disability. Methods We investigated a multi-stage random sample of 1871 participants aged ≥60 years and covered by long-term care insurance in Shanghai, China. Multimorbidity was defined as the simultaneous presence of two or more chronic diseases in an individual. Participants completed scales to assess basic and instrumental activities of daily living (BADL and IADL, respectively). Multimorbidity patterns were identified via exploratory factor analysis. Binary logistic regression models were used to determine adjusted associations between functional disability and number and patterns of multimorbidity. Results Multimorbidity was present in 74.3% of participants. The prevalence of BADL disability was 50.7% and that of IADL disability was 90.7%. There was a strong association between multimorbidity and disability. We identified three multimorbidity patterns: musculoskeletal, cardio-metabolic, and mental-degenerative diseases. The cardio-metabolic disease pattern was associated with both BADL (OR 1.28, 95%CI 1.16–1.41) and IADL (OR 1.41, 95%CI 1.19–1.68) disability. The mental-degenerative disease pattern was associated with BADL disability (OR 1.55, 95%CI 1.40–1.72). Conclusions Multimorbidity and functional disability are highly prevalent among older people covered by long-term care insurance in Shanghai, and distinct multimorbidity patterns are differentially associated with functional disability. Appropriate long-term healthcare and prevention strategies for older people may help reduce multimorbidity, maintain functional ability, and improve health-related quality of life.

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Impact of oral self-care on incident functional disability in elderly Japanese: the Ohsaki Cohort 2006 study

BMJ Open ◽

10.1136/bmjopen-2017-017946 ◽

2017 ◽

Vol 7 (9) ◽

pp. e017946 ◽

Cited By ~ 6

Author(s):

Shino Bando ◽

Yasutake Tomata ◽

Jun Aida ◽

Kemmyo Sugiyama ◽

Yumi Sugawara ◽

...

Keyword(s):

Primary Outcome ◽

Functional Disability ◽

Self Care ◽

Community Dwelling ◽

Tooth Brushing ◽

Term Care ◽

Increased Risk ◽

Long Term Care Insurance ◽

Elderly Japanese

ObjectivesTo assess whether oral self-care (tooth brushing, regular dental visits and use of dentures) affects incident functional disability in elderly individuals with tooth loss.DesignA 5.7-year prospective cohort study.SettingOhsaki City, Japan.Participants12 370 community-dwelling individuals aged 65 years and older.Primary outcome measuresIncident functional disability (new long-term care insurance certification).ResultsThe 5.7-year incidence rate of disability was 18.8%. In comparison with participants who had ≥20 teeth, the HRs (95% CIs) for incident functional disability among participants who had 10–19 and 0–9 teeth were 1.15 (1.01–1.30) and 1.20 (1.07–1.34), respectively (p trend<0.05). However, the corresponding values for those who brushed their teeth ≥2 times per day were not significantly higher in the ‘10–19 teeth’ and ‘0–9 teeth’ groups (HRs (95% CI) 1.05 (0.91–1.21) for participants with 10–19 teeth, and 1.09 (0.96–1.23) for participants with 0–9 teeth), although HRs for those who brushed their teeth <2 times per day were significantly higher (HRs (95% CI) 1.32 (1.12–1.55) for participants with 10–19 teeth, and 1.33 (1.17–1.51) for participants with 0–9 teeth). Such a negating association was not observed for other forms of oral self-care.ConclusionsTooth brushing may partially negate the increased risk of incident functional disability associated with having fewer remaining teeth.

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Less screen time and more frequent vigorous physical activity is associated with lower risk of reporting negative mental health symptoms among Icelandic adolescents

PLoS ONE ◽

10.1371/journal.pone.0196286 ◽

2018 ◽

Vol 13 (4) ◽

pp. e0196286 ◽

Cited By ~ 17

Author(s):

Soffia M. Hrafnkelsdottir ◽

Robert J. Brychta ◽

Vaka Rognvaldsdottir ◽

Sunna Gestsdottir ◽

Kong Y. Chen ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Screen Time ◽

Lower Risk ◽

Vigorous Physical Activity ◽

Mental Health Symptoms ◽

Health Symptoms

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Functional disability with systematic trends and uncertainty: a comparison between China and the US

Annals of Actuarial Science ◽

10.1017/s1748499521000233 ◽

2021 ◽

pp. 1-30

Author(s):

Yu Fu ◽

Michael Sherris ◽

Mengyi Xu

Keyword(s):

Systematic Uncertainty ◽

Functional Disability ◽

Long Term Care ◽

The Elderly ◽

Aged Care ◽

Term Care ◽

Healthy Longevity ◽

The Us ◽

Long Term Care Insurance

Abstract China and the US are two contrasting countries in terms of functional disability and long-term care. China is experiencing declining family support for long-term care and developing private long-term care insurance. The US has a more developed public aged care system and private long-term care insurance market than China. Changes in the demand for long-term care are driven by the levels, trends and uncertainty in mortality and functional disability. To understand the future potential demand for long-term care, we compare mortality and functional disability experiences in China and the US, using a multi-state latent factor intensity model with time trends and systematic uncertainty in transition rates. We estimate the model with the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and the US Health and Retirement Study (HRS) data. The estimation results show that if trends continue, both countries will experience longevity improvement with morbidity compression and a declining proportion of the older population with functional disability. Although the elderly Chinese have a shorter estimated life expectancy, they are expected to spend a smaller proportion of their future lifetime functionally disabled than the elderly Americans. Systematic uncertainty is shown to be significant in future trends in disability rates and our model estimates higher uncertainty in trends for the Chinese elderly, especially for urban residents.

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Abstract P231: Physical Activity and Sedentary Behavior Trajectories During Pregnancy and Postpartum Blood Pressure

Circulation ◽

10.1161/circ.141.suppl_1.p231 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Abbi Lane-Cordova ◽

Melissa Jones ◽

Janet M Catov ◽

Bethany Barone Gibbs

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Sedentary Behavior ◽

Latent Class ◽

Vigorous Physical Activity ◽

Clinic Visit ◽

Singleton Pregnancy ◽

Group Assignment ◽

Pregnancy And Postpartum ◽

Adjusted Model

Background: Pregnancy influences longer-term vascular health for women. Moderate-vigorous physical activity (MVPA) and sedentary behavior (SED) have been associated with blood pressure (BP) in non-pregnant adults. Self-reported pregnancy MVPA has been associated with less risk of hypertension during pregnancy, but associations of MVPA and SED patterns during pregnancy and postpartum BP have not been investigated. Methods: MVPA and SED were measured objectively in women in each trimester of a singleton pregnancy using triaxial and positional accelerometers and defined using established cut points. Systolic and diastolic BP obtained at the 6-week postpartum clinic visit were abstracted from medical charts. Latent class trajectory modeling was used to assign women to one of three MVPA and SED trajectory groups: low, medium, and high. Kruskal-Wallis tests were used to evaluate differences in systolic and diastolic BP between trajectory groups and linear regression was used to test for associations of MVPA and SED trajectory group assignment with BP. Adjustment variables included age, race, and postpartum BMI. Results: Of the 101 women in the study, 23 were African American, mean age = 31±0.5 years and mean postpartum BMI = 27.6±0.7 kg/m 2 . Mean postpartum systolic and diastolic BP were 114±1 and 71±1 mmHg. Systolic BP was similar among MVPA and SED trajectory groups. Diastolic BP differed between MVPA (low: 76±2, medium: 70±1, high: 70±2 mmHg, p<0.05) and SED (low: 71±3, medium: 69±1, high: 74±1, p<0.05) trajectory groups. In adjusted analyses, SED, but not MVPA, trajectory assignment was significantly associated with postpartum diastolic BP, b=3.1, 95% CI: 0.6, 5.6, p<0.02. Compared to the low SED trajectory, assignment to the high SED trajectory was associated with 4.9 (95% CI: -0.2, 10.0) mmHg higher diastolic BP in the adjusted model. Conclusions: SED trajectory across three trimesters of pregnancy was associated with postpartum diastolic BP, even after accounting for biologic covariates and MVPA. Results suggest avoiding high SED during pregnancy might help improve diastolic BP after delivery.

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Bout Length-Specific Physical Activity and Adherence to Physical Activity Recommendations among Japanese Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16111991 ◽

2019 ◽

Vol 16 (11) ◽

pp. 1991 ◽

Cited By ~ 2

Author(s):

Masaki Machida ◽

Tomoko Takamiya ◽

Noritoshi Fukushima ◽

Yuko Odagiri ◽

Hiroyuki Kikuchi ◽

...

Keyword(s):

Physical Activity ◽

Vigorous Physical Activity ◽

Adult Population ◽

Japanese Adult ◽

Physical Activity Guidelines ◽

Bout Length ◽

Japanese Adults ◽

Valid Data ◽

Physical Activity Recommendations ◽

Activity Recommendations

We aimed to clarify the patterns of moderate to vigorous physical activity (MVPA) in the Japanese adult population, and the proportion of people meeting the recommendations of the Physical Activity Guidelines (PAG) for Americans, second edition (2nd PAG; ≥150 min/week of total MVPA including bouts of any length) and those meeting the previously recommended PAG (2008-PAG; of ≥150 min/week of total MVPA lasting 10 min or longer [long-bout MVPA]). A total of 204 adults (aged 18 to 64 years) from two workplaces were asked to wear an accelerometer. MVPA was classified by bout length, and the proportion of long-bout MVPA was clarified. The proportion of participants adhering to the 2008-PAG and the 2nd PAG recommendations was calculated. Valid data was obtained from 184 adults. Long-bout MVPA accounted for 13.4% of total MVPA. Our results showed that 12.5% of individuals performed MVPA as recommended by the 2008-PAG whereas 92.4% performed MVPA as recommended by the 2nd PAG. Our results, hence, showed that long-bout MVPA comprised only a small proportion of total MVPA, and the proportion of individuals who satisfied the criteria stated in the guidelines (≥150 min/week) significantly changed by whether or not bout length of MVPA was taken into account.

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P0912THE SERUM CREATININE TO CYSTATIN C RATIO AND CLINICAL OUTCOMES IN PATIENTS WITH NON-DIALYSIS CHRONIC KIDNEY DISEASE: THE KNOW-CKD COHORT

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0912 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Kyu-Beck Lee ◽

Young Youl Hyun ◽

Kook-Hwan Oh ◽

Curie Ahn

Keyword(s):

Physical Activity ◽

Chronic Kidney Disease ◽

Standard Deviation ◽

Kidney Disease ◽

Serum Creatinine ◽

Cystatin C ◽

Early Stage ◽

Vigorous Physical Activity ◽

Elderly Age ◽

Hazard Ratios

Abstract Background and Aims Muscle wasting leads to poor outcomes in patient with chronic kidney disease (CKD). The serum creatinine to cystatin C (Cr/CysC) ratio has been reported as marker for muscle mass and may predict outcomes in chronic diseases. We hypothesized that the Cr/CysC ratio would be a predictor of outcomes in CKD. Method We investigated a total of 2142 patients (male 61%, aged 54±12 year) with CKD followed for a median of 3.74 years. We assessed the factors associated with Cr/CysC ratio and the relationship between Cr/CysC ratio and outcomes of end-stage renal disease (ESRD), cardiovascular event (CVE), and mortality. Results The Cr/CysC ratio significantly correlated with age (r=-0.18), estimated glomerular filtration rate (eGFR) (r=-0.21), serum albumin (r=0.11), 24-hour urine creatinine (r=0.38), and moderate to vigorous physical activity time (r=0.07). After adjusting for age, sex, eGFR, and log urine albumin creatinine ratio (model 1), the hazard ratios for ESRD, CVE, and mortality were 0.96 (95% CI, 0.86-1.07), 0.78 (95% CI, 0.61-0.99), and 0.72 (95% CI, 0.53-0.97) per 1 standard deviation Cr/CysC increase (0.21), respectively. After full adjustment for model 1 variables plus lifestyle factors, laboratory factors, and comorbidities (model 2), the hazard ratios for ESRD, CVE, and mortality were 0.99 (95% CI, 0.88-1.10), 0.84 (95% CI, 0.65-1.07), and 0.75 (95% CI, 0.55-0.99) per 1 standard deviation Cr/CysC increase (0.24), respectively. In subgroup of the elderly (age>65 year) and early stage CKD (eGFR>60 ml/min/1.73m2), the hazard ratios for CVE were significantly lower in patients with high Cr/CysC ratio. Conclusion Cr/CysC ratio correlates with muscle biomarkers and physical activity. A higher Cr/CysC ratio is associated with low CVE and mortality, but not ESRD in CKD.

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Citrus consumption and incident dementia in elderly Japanese: the Ohsaki Cohort 2006 Study

British Journal Of Nutrition ◽

10.1017/s000711451700109x ◽

2017 ◽

Vol 117 (8) ◽

pp. 1174-1180 ◽

Cited By ~ 7

Author(s):

Shu Zhang ◽

Yasutake Tomata ◽

Kemmyo Sugiyama ◽

Yumi Sugawara ◽

Ichiro Tsuji

Keyword(s):

Cox Model ◽

Baseline Survey ◽

Inverse Association ◽

Term Care ◽

Hazard Ratios ◽

Incident Dementia ◽

Biological Studies ◽

Long Term Care Insurance ◽

Elderly Japanese

AbstractAlthough some experimental biological studies have indicated that citrus may have preventive effects against cognitive impairment, no cohort study has yet examined the relationship between citrus consumption and incident dementia. In a baseline survey, we collected data on daily citrus intake (categorised as ≤2, 3–4 times/week or almost every day) and consumption of other foods using a FFQ, and used a self-reported questionnaire to collect data on other covariates. Data on incident dementia were retrieved from the Japanese Long-term Care Insurance database. A multivariate-adjusted Cox model was used to estimate the hazard ratios (HR) and 95 % CI for incident dementia according to citrus consumption. Among 13 373 participants, the 5·7-year incidence of dementia was 8·6 %. In comparison with participants who consumed citrus ≤2 times/week, the multivariate-adjusted HR for incident dementia among those did so 3–4 times/week and almost every day was 0·92 (95 % CI 0·80, 1·07) and 0·86 (95 % CI 0·73, 1·01), respectively (Ptrend=0·065). The inverse association persisted after excluding participants whose dementia events had occurred in the first 2 years of follow-up. The multivariate HR was 1·00 (reference) for ≤2 times/week, 0·82 (95 % CI 0·69, 0·98) for 3–4 times/week and 0·77 (95 % CI 0·64, 0·93) for almost every day (Ptrend=0·006). The present findings suggest that frequent citrus consumption was associated with a lower risk of incident dementia, even after adjustment for possible confounding factors.

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