Lung Function in Old Age and Physical Activity From Midlife to Old Age: Longitudinal Study With 24-30 Years' Follow-Up

The study investigated the role of physical activity, from midlife to older age, in relation to lung function in older age. In order to increase the understanding of the relationship between physical activity and lung function, the relationship between physical activity in midlife and physical activity in older age was also studied. Two Swedish studies based on nationally representative samples were used in this study, the Level of Living Survey, LNU, and the Swedish Panel Study of Living Conditions of the Oldest Old, SWEOLD. The participants were interviewed on three occasions; at the mean ages of 53 years, 61 years, and 81 years. The average follow-up time from the last to the first interview was 24-30 years. The results show that more physical activity in late midlife (mean age of 61 years) was associated with better lung function in older age. The association persists but attenuates when physical activity in older age was included in the analyses. There was also a strong association between physical activity in older age and better lung function in older age. Physical activity in late midlife had a positive association with physical activity in older age. This study shows the importance of physical activity in late midlife and in older ages to maintain good lung function in older ages. To invest in preventive actions in the form of physical activity are vital to be able to promote healthy aging, and should include the oldest old (76+).

Pain Persistence Is Associated With Increased Odds of MCI in Late Midlife and Early Older Adulthood

Twenty percent of older adults will experience persistent pain, the sensation of bodily harm lasting three or more months. Persistent pain doubles the risk of dementia, but we know less about the impact on earlier stages, such as mild cognitive impairment (MCI). As a step for clarification, this study leveraged data from the Vietnam Era Twin Study of Aging (VETSA) to understand how pain persistence relates to MCI in late midlife to early older adulthood. Participants (n=1,465, 100% male) were recruited across three waves at average ages 56, 62, and 68. At each wave, participants completed the SF-36 and were asked to rate their pain intensity from none (1) to very severe (6). Clinical pain was coded as pain intensity rated more than mild (>3/6). As a time-varying predictor, pain persistence was then calculated as a running frequency of the total waves reporting clinical pain. MCI diagnosis was based on Jak-Bondi criteria. Age, depressive symptoms, comorbidities, and opioid use were included as time-varying covariates. Age and education were included as time-invariant covariates. General estimating equations showed that pain persistence over two waves, reported in 35% of the sample, increased MCI odds by 57% (OR=1.57, 95%CI: 1.28 to 1.94). Pain persistence over three waves, reported in 17% of the sample, increased MCI odds by 98% (OR=1.98, 95%CI: 1.44 to 2.70). The findings emphasize the role of pain in earlier stages of dementia and the potential importance of pain management in offsetting cognitive decline.

BMI Change After Parent’s Death in Adulthood: Examining Age and Race Differences With Time-Varying Effects Modeling

Parental bereavement in adulthood is a stressful event that can have adverse health consequences for middle and older adults, including weight gain. Considering that the impact of bereavement is found to vary depending on the timing of death as well as across race/ethnicity, changes in weight after a parent’s passing may also be contingent on the timing of parent’s death and the bereaved individual’s race/ethnicity. Using Time-Varying Effects Modeling (TVEM), this study examined whether changes in BMI following a parent’s death differed across respondent’s age when their parent passed away. We also tested whether these age differences varied by race. Data came the Health and Retirement Study (HRS) Waves 1 – 13 and we selected respondents who experienced passing of either parent while participating in HRS. Analyses were run separately for mother’s death (n = 6,191) and father’s death (n = 3,301). Results showed significant racial/ethnic differences in BMI change following a mother’s death, particularly during late midlife to early late life. Specifically, non-Hispanic White and Black adults showed a greater increase in BMI compared to Hispanic adults. These race differences were consistent for father’s death as well, but to a lesser extent compared to mother’s death. Results suggest that White and Black adults who lost their parents between late midlife and early late life gained more weight compared to their Hispanic counterparts. This may be attributed to the racial/ethnic differences in health behaviors in response to parent’s death.

Choosing questions before methods in dementia research with competing events and causal goals

Several of the hypothesized or studied exposures that may affect dementia risk are known to increase the risk of death. This may explain counterintuitive results, where exposures that are known to be harmful for mortality risk sometimes seem protective for the risk of dementia. Authors have attempted to explain these counterintuitive results as biased, but the bias associated with a particular analytic method cannot be defined or assessed if the causal question is not explicitly specified. Indeed, we can consider several causal questions when competing events like death, which cannot be prevented by design, are present. Current dementia research guidelines have not explicitly considered what constitutes a meaningful causal question in this setting or, more generally, how this choice justifies and should drive particular analytic decisions. To contextualize current practices, we first perform a systematic review of the conduct and interpretation of longitudinal studies focused on dementia outcomes where death is a competing event. We then describe and demonstrate how to address different causal questions (referred here as "the total effect" and "the controlled direct effect") with traditional analytic approaches under explicit assumptions. Our application focuses on smoking cessation in late-midlife. To illustrate core concepts, we discuss this example both in terms of a hypothetical randomized trial and with an emulation of such a trial using observational data from the Rotterdam Study.

Lungfunktion i hög ålder och dess samband med fysisk aktivitet från medelålder upp till hög ålder

Studien undersöker sambandet mellan lungfunktion i hög ålder och fysisk aktivitet från medel­ålder till hög ålder, samt sambandet mellan fysisk aktivitet i medelålder och i hög ålder. Vi använder data från Levnadsnivåundersökningen, LNU, och Undersökningen om äldre personers levnadsvillkor, SWEOLD. Deltagarna intervjuades i medelålder (genomsnitt 53 år), sen medelålder (genomsnitt 61 år) och hög ålder (genomsnitt 81 år), med en uppföljningstid på 24–30 år från medel­ålder till hög ålder. Mer fysisk aktivitet i sen medelålder har ett samband med bättre lungfunktion i hög ålder. Sambandet består men blir mindre starkt när fysisk aktivitet i hög ålder inkluderas i analysmodellen. Det finns ett starkt samband mellan fysisk aktivitet i hög ålder och bättre lungfunktion i hög ålder. Fysisk aktivitet i sen medelålder har ett positivt samband med fysisk aktivitet i hög ålder. Vår studie visar vikten av fysisk aktivitet även högt upp i åldrarna för att bibehålla god lungfunktion. Insatser som främjar fysisk aktivitet är av särskild vikt för att främja ett fortsatt hälsosamt åldrande, även för de allra äldsta. Lung function in older age and physical activity from midlife to older age – A longitudinal study with 24-30 years of follow-up The study investigated the role of physical activity, from midlife to older age, in lung function in older age. In order to increase the understanding of the relationship between physical activity and lung function, the relationship between physical activity in midlife and physical activity in older age was also studied. Two Swedish studies based on nationally representative samples were used in this study, the Level of living survey, LNU, and the Swedish panel study of living conditions of the oldest old, SWEOLD. The participants were interviewed on three occasions; at the mean ages of 53 years, 61 years, and 81 years. The average follow-up time from the last to the first interview was 24-30 years. The results show that more physical activity in late midlife (mean age of 61 years) was associated with better lung function in older age. The association persists but attenuates when physical activity in older age was included in the analyses. There was also a strong association between physical activity in older age and better lung function in older age. Physical activity in late midlife had a positive association with physical activity in older age. This study shows the importance of physical activity in late midlife and in older ages to maintain good lung function in older ages. To invest in preventive actions in the form of physical activity are vital to be able to promote healthy aging, and should include the oldest old (76+).

Effects of Exercise Dose and Detraining Duration on Mobility at Late Midlife: A Randomized Clinical Trial

Background: Office workers near retirement tend to be sedentary and can be prone to mobility limitations and diseases. We examined the dose effects of exergaming volume and duration of detraining on motor and cognitive function in office workers at late midlife to reduce sedentariness and mobility limitations. Methods: In an assessor-blinded randomized trial, 160 workers aged 55–65 years performed physically active video games in a nonimmersive form of virtual reality (exergaming) in small, supervised groups for 1 h, 1×, 2×, or 3×/week for 8 weeks followed by detraining for 8 and 16 weeks. Exergaming comprises high-intensity, full-body sensorimotor coordination, balance, endurance, and strengthening exercises. The primary outcome was the 6-minute walk test (6MWT), and secondary outcomes were body mass, self-reported physical activity, sleep quality, Berg Balance Scale, Short Physical Performance Battery, fast gait speed, dynamic balance, heart rate recovery after step test, and 6 cognitive tests. Results: The 3 groups were not different in any of the outcomes at baseline (all p > 0.05). The outcomes were stable and had acceptable reliability (intraclass correlation coefficients ≥0.334) over an 8-week control period. Training produced an inverted U-shaped dose response of no (1×), most (2×), and medium (3×/week) effects of exergaming volume in most motor and selected cognitive outcomes. The distance walked in the 6MWT (primary outcome) increased most (94 m, 19%, p < 0.05), medium (57 m, 12%, p < 0.05), and least (4 m, 1%) after exergaming 2×, 3×, or 0× (control) (all different p < 0.05). The highest responders tended to retain the exercise effects over 8 weeks of detraining, independent of training volume. This maintenance effect was less consistent after 16 weeks of detraining. Conclusion: Less was more during training and lasted longer after detraining. A medium dose volume of exergaming produced the largest clinically meaningful improvements in mobility and selected cognitive tests in 60-year-old office workers with mild mobility limitations and intact cognition.