scholarly journals The Predictive Performance of Objective Measures of Physical Activity Derived From Accelerometry Data for 5-Year All-Cause Mortality in Older Adults: National Health and Nutritional Examination Survey 2003–2006

2019 ◽  
Vol 75 (9) ◽  
pp. 1779-1785 ◽  
Author(s):  
Ekaterina Smirnova ◽  
Andrew Leroux ◽  
Quy Cao ◽  
Lucia Tabacu ◽  
Vadim Zipunnikov ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Logistic Regression ◽  
National Health ◽  
Predictive Performance ◽  
Wearable Technology ◽  
Living Environment ◽  
Activity Count ◽  
All Cause Mortality ◽  
Nutritional Examination Survey

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.

Combined Associations of Muscle-Strengthening Activities and Accelerometer-Assessed Physical Activity on Multimorbidity: Findings From NHANES

2016 ◽  
Vol 31 (4) ◽  
pp. 274-277 ◽  
Author(s):  
Scott J. Dankel ◽  
Jeremy P. Loenneke ◽  
Paul D. Loprinzi
Keyword(s):  
Physical Activity ◽  
Logistic Regression ◽  
Chronic Disease ◽  
Confidence Interval ◽  
National Health ◽  
Cost Effective ◽  
Muscle Strengthening ◽  
Recommended Guidelines ◽  
Nutritional Examination Survey

Purpose. Physical activity (PA) has previously been demonstrated to be inversely related with multimorbidity (having more than one chronic disease); however, it is unknown whether dual participation in both PA and muscle-strengthening activities (MSA) may further reduce the odds of being multimorbid. Therefore, the purpose of our study was to determine the association between multimorbidity and individuals meeting recommended guidelines for both PA and MSA. Design. Nonexperimental. Setting. The 2003–2006 National Health and Nutritional Examination Survey. Subjects. Four thousand five hundred eighty-seven adults aged ≥20 years. Measures. Accelerometry-measured PA, self-reported MSA, and multimorbidity. Analysis. Data were analyzed using multivariable linear and logistic regression. Results. The odds (95% confidence interval) of being multimorbid for those only meeting MSA guidelines, only meeting PA guidelines, and meeting both PA and MSA guidelines (vs. not meeting either), respectively, were .69 (.48, .98; p = .04), .55 (.44, .70; p < .01), and .38 (.27, .53; p < .01). Conclusion. Our findings demonstrate that individuals meeting recommended guidelines for both MSA and PA were less likely to be multimorbid than individuals participating in one or none of these exercise modalities. Determining effective ways to initiate and maintain concurrent adoption of MSA and PA is needed to provide a cost-effective behavioral alternative for reducing the prevalence of multimorbidity.

scholarly journals Postural Transitions during Activities of Daily Living Could Identify Frailty Status: Application of Wearable Technology to Identify Frailty during Unsupervised Condition

Gerontology ◽  
2017 ◽  
Vol 63 (5) ◽  
pp. 479-487 ◽  
Author(s):  
Saman Parvaneh ◽  
Jane Mohler ◽  
Nima Toosizadeh ◽  
Gurtej Singh Grewal ◽  
Bijan Najafi
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Logistic Regression ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Wearable Technology ◽  
Community Dwelling ◽  
Daily Physical Activity ◽  
Daily Number ◽  
Frailty Status

Background: Impairment of physical function is a major indicator of frailty. Functional performance tests have been shown to be useful for identification of frailty in older adults. However, these tests are often not translatable into unsupervised and remote monitoring of frailty status at home and/or community settings. Objective: In this study, we explored daily postural transition quantified using a chest-worn wearable technology to identify frailty in community-dwelling older adults. Methods: Spontaneous daily physical activity was monitored over 24 h in 120 community-dwelling elderly (age: 78 ± 8 years) using an unobtrusive wearable sensor (PAMSys™, BioSensics LLC, Watertown, MA, USA). Participants were classified as non-frail and pre-frail/frail using Fried's criteria. A validated software package was used to identify body postures and postural transition between each independent postural activity such as sit-to-stand, stand-to-sit, stand-to-walk, and walk-to-stand. The transition from walking to sitting was further classified as quick sitting and cautious sitting based on presence/absence of a standing posture pause between sitting and walking. A general linear model univariate test was used for between-group comparison. Pearson's correlation was used to determine the association between sensor-derived parameters and age. Logistic regression model was used to identify independent predictors of frailty. Results: According to Fried's criteria, 63% of participants were pre-frail/frail. The total number of postural transitions, stand-to-walk, and walk-to-stand were, respectively, 25.2, 30.2, and 30.6% lower in the pre-frail/frail group when compared to the non-frail group (p < 0.05, Cohen's d = 0.73-0.79). Furthermore, the ratio of cautious sitting was significantly higher by 6.2% in pre-frail/frail compared to non-frail (p = 0.025, Cohen's d = 0.22). Total number of postural transitions and the ratio of cautious sitting also showed significant negative and positive correlations with age, respectively (r = -0.51 and 0.29, p < 0.05). After applying a logistic regression model, among tested parameters, walk-to-stand (odds ratio [OR] = 0.997 p = 0.013), quick sitting (OR = 1.036, p = 0.05), and age (OR = 1.073, p = 0.016) were recognized as independent variables to identify frailty status. Conclusions: This study demonstrated that daily number of specific postural transitions such as walk-to-stand and quick sitting could be used for monitoring frailty status by unsupervised monitoring of daily physical activity. Further study is warranted to explore whether tracking the daily number of specific postural transitions is also sensitive to track change in the status of frailty over time.

scholarly journals Leisure-time physical activity among older adults in Brazil: results from the Brazilian National Health Survey – 2013

2021 ◽  
Author(s):  
Vítor Häfele ◽  
César Augusto Häfele ◽  
Jeferson Santos Jerônimo ◽  
Rodrigo Wiltgen Ferreira ◽  
Steve Anthony Maravillo ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
National Health ◽  
Health Survey ◽  
Leisure Time ◽  
Healthy Aging ◽  
Leisure Time Physical Activity ◽  
National Health Survey ◽  
Physical Activity Recommendations ◽  
Activity Recommendations

Introduction: Health behaviors are fundamental for healthy aging. In this sense, the practice of physical activity is one of the most beneficial factors for the health of individuals. Objective: To describe the prevalence of leisure-time physical activity among the older adults and analyze in terms of sociodemographic characteristics, national regions, Federative Units of Brazil, and types of physical activity practiced. Methods: Study utilizing data from the Brazilian National Health Survey - 2013. Leisure-time physical activity was analyzed with two distinct cutoff points: 1) Some physical activity - 10 or more minutes/week; 2) Meeting recommended 150 minutes/week of physical activity. Results: Nearly 21% of the older adults completed some physical activity, and 13.2% reached the physical activity recommendations. There was no difference in the prevalence of physical activity between men and women. Individuals aged 60-69 years and those with higher income were more active than their peers. As for the national regions, the North had the lowest prevalence of physically active older adults. Among all regions, walking was the most frequent form of physical activity practiced. Conclusion: The prevalence of older adults who practiced some physical activity and reached the physical activity recommendations was low, with walking being the most common form of physical activity. Older adults with higher age, low socioeconomic status and from the Northern Brazilian regions were the least active.

Heart Failure and Disability in Community-Dwelling Older Adults in the United States—1999 to 2018: Data From National Health and Nutrition Examination Survey

2021 ◽  
pp. 105477382110616
Author(s):  
Yaewon Seo ◽  
Jing Wang ◽  
Donelle Barnes ◽  
Surendra Barshikar
Keyword(s):  
Heart Failure ◽  
Older Adults ◽  
Logistic Regression ◽  
National Health ◽  
The United States ◽  
Community Dwelling ◽  
Nutrition Examination Survey ◽  
Mediating Effects ◽  
Health And Nutrition ◽  
Community Dwelling Older Adults

To examine the associations of heart failure (HF) with five domains of disability while controlling for covariates. Subjects with HF and aged ≥ 50 years were selected from the 1999 to 2018 National Health and Nutrition Examination Survey data. Five domains of disability were measured with 19 physical tasks. Logistic regression with adjustment for covariates was conducted. The prevalence of HF in 27,185 adults aged ≥ 50 years was 6.37%. After controlling for demographics and smoking, logistic regression showed that HF was associated with 2.8 to 3.4 times increased odds of all domains of disability compared to adults without HF, but with additional adjustments of covariates, the association was attenuated indicating the mediating effects of covariates. The future study may examine the mediating effects of covariates when intervening difficulties with lower extremity mobility and activities of daily living while considering in community-dwelling older adults with HF.

scholarly journals 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

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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