scholarly journals Changes in healthcare seeking and lifestyle in old aged individuals during COVID-19 lockdown in Germany: the population-based AugUR study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Caroline Brandl ◽  
Martina E. Zimmermann ◽  
Felix Günther ◽  
Alexander Dietl ◽  
Helmut Küchenhoff ◽  
...  

Abstract Background Containment measures in the COVID-19 pandemic protected individuals at high risk, particularly individuals at old age, but little is known about how these measures affected health-related behavior of old aged individuals. We aimed to investigate the impact of the spring 2020 lockdown in Germany on healthcare-seeking and health-related lifestyle in the old aged and to identify susceptible subgroups. Methods We conducted a follow-up survey among the pre-pandemically well-characterized participants of our AugUR cohort study, residents in/around Regensburg aged 70+ years and relatively mobile. A self-completion questionnaire on current behavior, perceived changes, and SARS-Cov-2 infection was mailed in May 2020, shortly before contact restrictions ended. Pre-pandemic lifestyle and medical conditions were derived from previous study center visits. Results Among 1850 survey participants (73–98 years; net-response 89%), 74% were at increased risk for severe COVID-19 according to medical conditions; four participants reported SARS-CoV-2 infection (0.2%). Participants reported changes in behavior: 29% refrained from medical appointments, 14% increased TV consumption, 26% reported less physical activity, but no systematic increase of smoking or alcohol consumption. When comparing during- and pre-lockdown reports of lifestyle within participant, we found the same pattern as for the reported perceived changes. Women and the more educated were more susceptible to changes. Worse QOL was perceived by 38%. Conclusions Our data suggest that the spring 2020 lockdown did not affect the lifestyle of a majority of the mobile old aged individuals, but the substantial proportions with decreased physical activity and healthcare-seeking are markers of collateral damage.

2009 ◽  
Vol 160 (5) ◽  
pp. 833-838 ◽  
Author(s):  
Johan Svartberg ◽  
Sigrid K Brækkan ◽  
Gail A Laughlin ◽  
John-Bjarne Hansen

ObjectivesLow testosterone levels in men have been associated with cardiovascular risk factors and atherosclerosis and lately also an increased risk of both cardiovascular disease (CVD) and all-cause mortality. As arterial CVDs and venous thromboembolism (VTE) have been shown to share common risk factors, the purpose of the present study was to determine the impact of endogenous sex hormone levels on the incidence of VTE in a cohort of men.DesignA prospective, population-based study.MethodsSex hormone measurements were available in 1350 men, aged 50–84, participating in the Tromsø study in 1994–1995. First, lifetime VTE-events during the follow-up were registered up to September 1 2007.ResultsThere were 63 incident VTE-events (4.5 per 1000 person-years) during a mean of 10.4 years of follow-up. Age was significantly associated with increased risk of VTE; men 70 years or older had a 2.5-fold higher risk of VTE (HR 2.47, 95% CI 1.19–5.12), compared with those between 50 and 60 years of age. In age-adjusted analyses, endogenous sex hormones levels were not associated with risk of VTE; for each s.d. increase, hazards ratios (95% CI) were 1.06 (0.83–1.35) for total testosterone, 1.02 (0.79–1.33) for free testosterone, and 1.27 (0.94–1.71) for ln-estradiol. In dichotomized analyses comparing men in the lowest total and free testosterone quartile with men in the higher quartiles, hypoandrogenemia was not associated with risk of VTE.ConclusionsIn this population-based study of middle-aged and older men, endogenous sex hormone levels were not associated with 10-year risk of VTE.


2018 ◽  
Vol 38 (4) ◽  
pp. 153-161 ◽  
Author(s):  
Guy Faulkner ◽  
Lira Yun ◽  
Mark S. Tremblay ◽  
John C. Spence

ParticipACTION is the Canadian physical activity communications and social marketing organization first launched in the fall of 1971 and then ceased operations in 2001. ParticipACTION was relaunched in 2007. Framed as a public health natural experiment, evidence was collected from a population-based survey of knowledge, awareness, understanding of physical activity, and physical activity levels among Canadians (individual level), and key informant surveys and interviews examining capacity, readiness and advocacy for physical activity promotion among physical activity organizations (organizational level). The purpose of this paper is to first provide an overview of some of the major initiatives undertaken by the ‘new’ ParticipACTION that may have contributed to any changes at these individual or organizational levels. Second, the paper sets the stage for the three empirical papers in this special series reporting follow-up results.


2018 ◽  
Vol 43 (5) ◽  
pp. 453-459 ◽  
Author(s):  
Stephanie Truelove ◽  
Andrew M. Johnson ◽  
Leigh M. Vanderloo ◽  
Molly Driediger ◽  
Shauna M. Burke ◽  
...  

Being active offers many physical and emotional benefits contributing to a higher health-related quality of life (HRQoL); however, this relationship remains unexplored among preschoolers (aged 2.5–5 years). This study examined the impact of the Supporting Physical Activity in the Childcare Environment (SPACE), which was an intervention implemented using a cluster randomized controlled trial on preschoolers’ HRQoL. Childcare centres were randomly allocated to the experimental (n = 11) or control (n = 11) conditions, and preschoolers’ HRQoL was measured using the parent-report Pediatric Quality of Life Inventory 4.0 (3 subscales: physical, psychosocial, and total HRQoL) at baseline, post-intervention (i.e., week 8), and 6- and 12-month follow-up. A linear mixed-effects model was used to determine if preschoolers in the experimental condition displayed an increased HRQoL post-intervention and at follow-up compared with preschoolers in the control condition. Preschoolers (n = 234) with HRQoL data at baseline and one additional time-point were retained for analyses. Body mass index was not found to impact significantly on the intervention, and no statistically significant interaction effects were found for any of the 3 HRQoL variables. In conclusion, the SPACE intervention had no impact on preschoolers’ HRQoL. Given the scarcity of research in this population, additional exploration is necessary to better understand the potential impact of physical activity participation on preschoolers’ HRQoL.


2006 ◽  
Vol 24 (32) ◽  
pp. 5125-5131 ◽  
Author(s):  
Wendy Demark-Wahnefried ◽  
Bernardine M. Pinto ◽  
Ellen R. Gritz

Cancer survivors are at increased risk, not only for progressive and recurrent disease, but also other cancers, cardiovascular disease, diabetes, osteoporosis, and functional decline. Lifestyle interventions to improve dietary and physical activity behaviors, and smoking cessation, have the potential to improve the overall health and quality of life of this vulnerable population. Studies on overall health and physical function from 1966 and beyond regarding the impact of behavioral interventions that used randomized and controlled designs were identified through MEDLINE and PubMed searches. Published reports currently exist for 22 exercise interventions, 11 diet-related interventions (excluding those limited to dietary supplements or single nutrients), two diet and exercise interventions, and 10 behavioral-based smoking cessation interventions. Although many interventions have been successful in promoting behavioral change and have resulted in improvements in various health-related outcomes, more research is needed to determine the key components of interventions that are able to produce the greatest behavioral change and the most favorable health-related benefits. The oncology care provider can play a pivotal role in improving the long-term health of cancer survivors by (1) being aware of opportunities to encourage healthful behaviors (ie, smoking cessation, weight control, and increased physical activity); (2) vigilantly tracking long-term effects among cancer survivors and exploring whether they are amenable to intervention; (3) staying abreast of current health behavior guidelines for cancer survivors and existing resources for professional and patient education; and (4) supporting and contributing to efforts aimed at primary and tertiary prevention research.


2019 ◽  
Vol 26 (1) ◽  
pp. 114-124 ◽  
Author(s):  
Alvilde Maria Ossum ◽  
Øyvind Palm ◽  
Milada Cvancarova ◽  
Tomm Bernklev ◽  
Jørgen Jahnsen ◽  
...  

Ongoing joint pain and back pain were associated with reduced quality of life and fatigue in IBD patients after 20 years of disease, whereas spondyloarthritis without ongoing joint symptoms did not have a negative impact on these patient-reported outcomes.


2021 ◽  
Vol 12 ◽  
Author(s):  
Martina Svensson ◽  
Lena Brundin ◽  
Sophie Erhardt ◽  
Ulf Hållmarker ◽  
Stefan James ◽  
...  

Physical activity may prevent anxiety, but the importance of exercise intensity, sex-specific mechanisms, and duration of the effects remains largely unknown. We used an observational study design to follow 395,369 individuals for up to 21 years to investigate if participation in an ultralong-distance cross-country ski race (Vasaloppet, up to 90 km) was associated with a lower risk of developing anxiety. Skiers in the race and matched non-skiers from the general population were studied after participation in the race using the Swedish population and patient registries. Skiers (n = 197,685, median age 36 years, 38% women) had a significantly lower risk of developing anxiety during the follow-up compared to non-skiers (adjusted hazard ratio, HR 0.42). However, among women, higher physical performance (measured as the finishing time to complete the race, a proxy for higher exercise dose) was associated with an increased risk of anxiety compared to slower skiing women (HR 2.00). For men, the finishing time of the race did not significantly impact the risk of anxiety. Our results support the recommendations of engaging in physical activity to decrease the risk of anxiety in both men and women. The impact of physical performance level on the risk of anxiety requires further investigations among women.


2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Elizabeth W Regan ◽  
Reed Handlery ◽  
Sara Wilcox ◽  
Jill Stewart ◽  
Joseph L Pearson ◽  
...  

Purpose: Lack of physical activity after stroke results in increased risk of stroke recurrence and other health problems. While some survivors receive physical therapy (PT), it is often discontinued within a year. Cardiac Rehabilitation (CR) is a community exercise program for people with cardiac dysfunction; however, stroke is not a covered diagnosis despite high cardiovascular risk. CR for stroke survivors is an opportunity to bridge the gap between PT and community physical activity. The study evaluated the impact of CR participation on stroke survivors. Materials and Methods: A pilot study was completed at a phase 3 CR facility. Participants were screened for eligibility and entered the CR program (3 x per week for 12 weeks) with an aerobic fitness focus. Individual outcomes were taken pre- and post-program, and 6-months follow up. Program impact was measured by paired t-tests (24 participants) and repeated measures ANOVA (18 participants) for 6-month follow up. Results: Twenty-four participants completed the study. Participants were 79% (19/24) male with an average age of 62.2 years old (range 33.5 -81.5) with a time since stroke of 29.7 months (range 3-123). Most participants (20/24) were community ambulators at the start of the study (six-minute walk test (6MWT) > 288 m). Pre-Post Program: The six-minute walk test (6MWT) (endurance) improved by 62 ± 66 m (p<0.005). The five times sit to stand test (5xSS) (strength) improved by 3.8 ± 5.8 sec (P=0.004). The Stroke Impact Scale Mobility Subscale improved by 7.3% ± 11.8%, (p=0.006), the Activities of Daily Living Subscale improved by 6.2% ± 9.9%, (p=0.006) and the Memory Subscale by 6.4% ± 14.7%, (p=0.043). Fast Walking Speed, Self-Efficacy and Exercise Outcome Expectation Scales improved with statistical significance but lacked clinical significance. No other outcomes had statistically significant changes. Six-month Follow up: At 6-month follow up, 89.5% (16/18) of participants were still exercising at least once a week. The CR program elicited statistically significant participant improvements over time in the 6MWT (p=0.001) and 5xSS (p<0.001). Post-hoc analysis revealed a statistically significant improvement from pre-program to 6-month follow up in 6MWT distance (66.52 ± 53.73m, p=0.013), 5xSS (-3.44 ± 2.20s, p=0.003) but not post-program to 6 months follow up 6MWT (-5.2 ± 26.4m, p=1.00) and 5xSS (-0.24 ± 1.69s, p=1.00) demonstrating maintenance of gains, but no additional gains. Conclusions: CR elicited meaningful improvements for stroke survivors (exceeding minimal clinically important differences) in walking endurance, strength, perceived memory and perceived mobility with gains maintained for endurance and strength at 6-month follow up. CR enhances exercise habits and physical activity through structured exercise after discharge from PT and may improve community participation.


Author(s):  
David Bergman ◽  
Hamed Khalili ◽  
Bjorn Roelstraete ◽  
Jonas F Ludvigsson

Abstract Background and Aims The association between microscopic colitis [MC] and cancer risk is unclear. Large, population-based studies are lacking. Methods We conducted a nationwide cohort study of 11 758 patients with incident MC [diagnosed 1990–2016 in Sweden], 50 828 matched reference individuals, and 11 614 siblings to MC patients. Data were obtained through Sweden´s pathology departments and from the Swedish Cancer Register. Adjusted hazard ratios [aHRs] were calculated using Cox proportional hazards models. Results At the end of follow-up [mean: 6.7 years], 1239 [10.5%] of MC patients had received a cancer diagnosis, compared with 4815 [9.5%] of reference individuals (aHR 1.08 [95% confidence interval1.02–1.16]). The risk of cancer was highest during the first year of follow up. The absolute excess risks for cancer at 5, 10, and 20 years after MC diagnosis were + 1.0% (95% confidence interval [CI] 0.4%-1.6%), +1.5% [0.4%-2.6%], and + 3.7% [-2.3–9.6%], respectively, equivalent to one extra cancer event in every 55 individuals with MC followed for 10 years. MC was associated with an increased risk of lymphoma (aHR 1.43 [1.06–1.92]) and lung cancer (aHR 1.32 [1.04–1.68]) but with decreased risks of colorectal (aHR 0.52 [0.40–0.66]) and gastrointestinal cancers (aHR 0.72 [0.60–0.85]). We found no association with breast or bladder cancer. Using siblings as reference group to minimise the impact of shared genetic and early environmental factors, patients with MC were still at an increased risk of cancer (HR 1.20 [1.06–1.36]). Conclusions This nationwide cohort study demonstrated an 8% increased risk of cancer in MC patients. The risk was highest during the first year of follow-up.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Soonil Kwon ◽  
So-Ryoung Lee ◽  
Eue-Keun Choi ◽  
Kyung-Do Han ◽  
Seokhun Yang ◽  
...  

AbstractAlthough chronic kidney disease is known to increase the risk of atrial fibrillation (AF), the impact of the variability of renal function on the risk of incident AF is unknown. We aimed to evaluate the association between variability of renal function and the risk of developing AF among the general population. We evaluated a total of 3,551,249 adults who had three annual health check-ups provided by the National Health Insurance Service. The variability of renal function was defined as GFR-VIM, which is variability independent of the mean (VIM) of creatinine-based estimated glomerular filtration rate (eGFR). The study population was divided into four groups (Q1-4) based on the quartiles of GFR-VIM, and the risks of incident AF by each group were compared. During a mean of 3.2 ± 0.5 years follow-up, incident AF occurred in 15,008 (0.42%) subjects. The incidence rates of AF increased from Q1 to Q4 (0.98, 1.42, 1.27, and 1.63 per 1,000 person-years, respectively). Adjusting with multiple variables, Q4 showed an increased risk of incident AF compared to Q1 (hazard ratio (HR) 1.125, 95% confidence interval (CI) 1.071–1.181). Variability of serum creatinine or other definitions of variability showed consistent results. On subgroup analyses, Q4 in males or those with a decreasing trend of eGFR had significantly increased risks of incident AF compared to Q1 (HR 1.127, 95% CI 1.082–1.175; and HR 1.115, 95% CI 1.059–1.173, respectively). High variability of eGFR was associated with an increased risk of incident AF, particularly in males or those with decreasing trends of eGFR during follow-up.


2015 ◽  
Vol 21 (10) ◽  
pp. 861-867 ◽  
Author(s):  
Sara Llamas-Velasco ◽  
Israel Contador ◽  
Alberto Villarejo-Galende ◽  
David Lora-Pablos ◽  
Félix Bermejo-Pareja

AbstractThe aim of this study was to analyze whether physical activity (PA) is a protective factor for the incidence of dementia after 3 years of follow-up. The Neurological Disorders in Central Spain (NEDICES) is a prospective population-based survey of older adults (age 65 years and older) that comprised 5278 census-based participants at baseline (1994–1995). A broad questionnaire was used to assess participants’ sociodemographic characteristics, health status, and lifestyle. Subsequently, a modified version of Rosow-Breslau questionnaire was applied to classify individuals’ baseline PA into groups (i.e., sedentary, light, moderate, and high). Cox regression models adjusted for several covariates (age, sex, education, previous stroke, alcohol consumption, hypertension, health related variables) were carried out to estimate the association between the PA groups and risk of dementia at the 3-year follow-up (1997–1998). A total of 134 incident dementia cases were identified among 3105 individuals (56.6% female; mean age=73.15±6.26) after 3 years. Hazard ratios (HRs) of the light, moderate, and high PA groups (vs. sedentary group) were 0.40 (95% confidence interval {CI} [0.26, 0.62]; p<.001), 0.32 (95% CI [0.20, 0.54]; p<.001) and 0.23 (95% CI [0.13, 0.40]; p<.001), respectively. Even after controlling for covariates and the exclusion of doubtful dementia cases, HRs remained significant. However, a supplementary analysis showed that the dose-effect hypothesis did not reach statistical significance. PA is a protective factor of incident dementia in this population-based cohort. (JINS, 2015, 21, 861–867)


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