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Background Exercise referral schemes (ERS) are an effective strategy for increasing physical activity (PA) in older adults. Behavioural self-management strategies (SMS) may augment the maintenance of PA and associated benefits in this population, resulting in preservation of the functional capacity and prevention of disability over the long-term. Aim The primary aim was to investigate the long-term (22-months) effects of ERS enhanced with SMS on functional capacity assessed by the Short Physical Performance Battery (SPPB) compared to ERS (primary comparison) and a control condition (CTRL). Secondarily, between-group effects after 4 and 16 months on the SPPB and self-reported disability outcomes were investigated. Methods 1360 physically inactive community-dwelling older adults ≥65 years from four European countries were randomized into (i) 16 weeks ERS enhanced with SMS (ERS-SMS), (ii) ERS alone and (iii) CTRL. In addition to SPPB, self-reported function and disability were assessed by the short-form late life function and disability index and with a six-item activity of daily living questionnaire. Results No long-term effects were found for the SPPB-score in ERS-SMS vs ERS (0.21 point, 95% CI [−0.04, 0.46]). Significant group × time effects were observed for the SPPB-score after 4 months in favour of ERS-SMS over CTRL (0.51 point, 95% CI [0.29, 0.73]) and ERS (0.46 point, 95% CI [0.24, 0.68]). Conclusion The study did demonstrate differences, in favour of ERS + SMS, but on SPPB these were small, and not sustained over time. The additional effect of SMS was inconsistent and uncertain. [ABSTRACT FROM AUTHOR]

Background Multiples of resting metabolic rate (RMR) are often used to classify physical activity intensity, a concept known as the metabolic equivalent of task (MET). However, the METs metrics may misclassify physical activity intensity in older adults because of age-related changes in RMR and maximal aerobic capacity (⁠ V ˙ O 2 max). This study aimed to (i) compare classifications of activity intensity by estimated (METsestimated) and measured (METsmeasured) METs and (ii) compare physical activity classified by absolute (METsmeasured) versus relative intensity (% V ˙ O 2 Reserve) in older adults. Methods Ninety-eight adults aged 75–90 years participated in the study. RMR and V ˙ O 2 during sitting, standing, daily activities, and 6-minute walking test were measured. V ˙ O 2 Reserve was defined as the difference between V ˙ O 2 max and RMR. Moderate and vigorous intensity was classified as 3 and 6 METs and 40% and 60% of V ˙ O 2 Reserve, respectively. Paired t tests and a confusion matrix were used to investigate aims 1 and 2, respectively. Results METsmeasured was 24% lower than the standard 1 MET of 3.5 mL O2·min−1·kg−1. METsestimated underestimated the intensity during daily and walking activities when compared to METsmeasured. Nevertheless, when comparing METsmeasured to percentages of V ˙ O 2 Reserve, a mismatch was shown for moderate intensity in 47%–67% of the participants during daily activities and 21% of the participants during self-selected gait speed. Conclusions Applying METsestimated for older adults leads to potential underestimation of physical activity intensity, suggesting that current classification metrics should be revised for older adults. V ˙ O 2 Reserve is a candidate metric for establishing precise physical activity intensity cut points for older adults. Clinical Trials Registration Number: NCT04821713 [ABSTRACT FROM AUTHOR]

The authors investigated the association between vision impairment and physical activity among older adults from low- and middle-income countries. Visual acuity was measured using the tumbling ElogMAR chart, and vision impairment was defined as visual acuity worse than 6/18 (0.48 logMAR) in the better seeing eye. Physical activity was assessed by the Global Physical Activity Questionnaire. Multivariable logistic regression and meta-analysis were conducted to assess associations. The sample included 34,129 individuals aged 50-114 years (mean [SD] age 62.4 [16.0] years; 47.9% male). After adjustment for confounders, near vision impairment was not significantly associated with low physical activity, but far vision impairment showed a significant association (odds ratio = 1.32; 95% confidence interval [1.17, 1.49], I² = 0.0%). Far vision impairment was dose-dependently associated with low physical activity (e.g., severe [<6/10] vs. no [≥6/12] far vision impairment; odds ratio = 1.80; 95% confidence interval [1.03, 3.15]). Interventions to address low levels of physical activity in the visually impaired in low- and middle-income countries should target those with far vision impairment. [ABSTRACT FROM AUTHOR]

Background: There is a scarcity of studies on the relationship between visual impairment (VI) and time spent in sedentary behavior (SB), especially from low- and middle-income countries (LMICs). Thus, we investigated the association of objectively and subjectively measured VI with SB in adults aged ≥18 years across 6 LMICs. Methods: Cross-sectional data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Objective and subjective visual acuity were measured. Information on self-reported SB was also collected. Multivariable multinomial logistic regression analysis was conducted to assess associations with time spent in SB as the outcome. Results: The sample consisted of 42,489 individuals (mean age = 43.8 [14.4] y; 50.1% females). Only severe objective VI (vs no VI) was significantly associated with ≥11 hours per day of SB (vs <4 h/d) (odds ratio = 4.50; 95% confidence interval, 1.57–12.92). Increasing severity of subjective VI was associated with greater odds for ≥8 hours per day of SB (vs <4 h/d) dose dependently. Conclusions: The present study identified an association of both objectively and subjectively measured VI with time spent in SB in adults residing in LMICs, with subjectively measured VI being a stronger predictor of time spent in SB. Targeted interventions to decrease SB especially in those who perceive themselves to have VI are needed in LMICs. [ABSTRACT FROM AUTHOR]

Improving the capacity for physical activity interventions to maintain behavior change is a key public health concern and an important strategy for the health and independence of older adults. Ways of ensuring effective maintenance of physical activity levels in older adults are unclear. This study includes the objective measure of moderate-to-vigorous physical activity (MVPA); self-reported self-efficacy; and self-regulation at four timepoints (baseline, intervention completion at 4 months, 12-, and 18-month follow-up) from the SITLESS study, a clinical trial conducted with a cohort of community-dwelling older adults (≥65 years) from Denmark, Germany, Spain, and the United Kingdom. A cross-lagged analysis found that self-regulation and self-efficacy may be key determinants of MVPA behavior in community-dwelling older adults. More specifically, the use of behavioral support strategies represents an important correlate of MVPA behavior, and its association with MVPA may be mediated by self-regulation and self-efficacy in older adults in the short and long term. [ABSTRACT FROM AUTHOR]

Background: The proportion of the population aged 65 years or older is increasing. Typically, physical activity and health decline with age, which is why action to promote active ageing is a major public health priority, particularly due to health inequalities in older adults. The aim of this study is to assess the effectiveness and cost-effectiveness of the Walk with Me peer-led walking intervention for older adults. Methods: This study is a two-arm, assessor-blind, randomised controlled trial. The intervention is a 12-week peer-led walking intervention based on social cognitive theory. Participants in the control group will receive information on active ageing and healthy nutrition. The study will target 348 community-dwelling older adults, aged 60 years or over living in areas of socio-economic disadvantage communities. Trained peer mentors will deliver the intervention. The primary outcome will be a mean between-group change in moderate-to-vigorous physical activity at 12 months from baseline, measured using an Actigraph accelerometer. Secondary outcomes will include quality of life, mental wellbeing, blood pressure, BMI and waist circumference. An embedded process evaluation will involve focus groups and participant diaries. Discussion: Evidence-based, cost-effective interventions to promote physical activity in older adults living in socio-economically disadvantaged communities are needed to address health inequalities. [ABSTRACT FROM AUTHOR]

Social relationships are central to the health and well-being of older adults. Evidence exploring the association of physical activity (PA) with social isolation and loneliness is limited. This study uses a path analysis to investigate the longitudinal association between loneliness and social isolation with PA using the Irish Longitudinal Study on Ageing. Higher levels of social isolation measured using the Berkman–Syme Social Network Index were directly and indirectly associated with lower levels of walking, moderate PA, and vigorous PA over 6 years. Additionally, higher levels of walking were associated with lower levels of loneliness measured using a modified version of the University of California, Los Angeles loneliness scale over a 3-year period. Future interventions should target individuals who are more socially isolated and explore the effects of different types of PA on loneliness over time. [ABSTRACT FROM AUTHOR]

Research suggests that physical activity (PA) has many health benefits for an aging population. Evidence exploring the association between PA and vision is limited. This study includes the measures of self-reported PA (International Physical Activity Questionnaire) and self-rated vision at three points in time over a 6-year period used in the Irish Longitudinal study of Ageing, a cohort of community-dwelling older adults (50 years or older). A path analysis found that PA was indirectly associated with vision over 6 years controlling for age, sex, marital status, employment, education, depression (Centre for Epidemiologic Studies Depression Scale), self-reported general health, cardiovascular disease (e.g., heart attack), high blood pressure, diabetes, eye disease (e.g., glaucoma, diabetic eye disease, macular degeneration, cataract), and disabilities associated with activities of daily living. Further research is needed to fully understand the relationship over time and generalize the findings. [ABSTRACT FROM AUTHOR]

Research has found that social relationships are central to the health and well-being of an aging population. Evidence exploring the association between physical activity (PA) and sedentary behavior (SB) with social isolation and loneliness is limited. This study uses objectively measured PA and SB (ActiGraph®) and self-reported measures of loneliness (the De Jong Gierveld Loneliness Scale) and social engagement (the Lubben Social Network Scale) from the SITLESS study, a European-wide study of community-dwelling older adults. Social isolation was associated with SB where higher levels of SB were associated with an increase in the level of social isolation, controlling for age, sex, living arrangements, employment status, body mass index, educational background, marital status, and self-reported general health. In contrast, PA was not associated with social isolation, and neither SB nor PA was a statistically significant predictor of loneliness. SB may be linked to social isolation in older adults, but PA and SB are not necessarily linked to loneliness in older community-dwelling adults. [ABSTRACT FROM AUTHOR]

Exposure to aquatic environments (i.e., blue spaces) can lead to improved mental health and well-being. One meaningful way to spend time in blue spaces is through recreational angling, although limited scientific literature exists on this topic. The present study aims to examine the relationship between recreational angling and mental health and well-being in a sample of UK adult male anglers. A cross-sectional online survey asked questions about demographic characteristics, participation in recreational angling, physical activity levels, diagnosis of psychiatric disorders, and mental health and well-being. Relationships between angling status (i.e., how often and how long participants angled for) and mental health variables were determined using regression models adjusted for age. In total, 1752 participants completed the survey. The regression models found that those who took part in angling more regularly had reduced odds of having depression (p < 0.001), schizophrenia (p = 0.001), suicidal thoughts (p < 0.001), and deliberately self-harming (p = 0.012), in addition to having a higher mental well-being and lower symptoms of depression and anxiety compared to those taking part in angling less frequently. In general, the findings suggest that encouraging frequent participation in recreational angling could be a dual method strategy for promoting relaxation and positive mental health, as well as encouraging increased levels of physical activity in those with mental health issues. [ABSTRACT FROM AUTHOR]

Aging research indicates that there is increased sedentary behaviour and insufficient physical activity levels across the older adult population. There is a growing body of evidence that suggests that pet ownership can have beneficial physical and mental health effects. Data were drawn from the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA). This questionnaire measured general social demographics such as gender, age, and marital status while also examining elements of physical activity, lifestyle factors (drinking status, smoking status), and education. Two items from the short form International Physical Activity Questionnaire recorded moderate and vigorous activity. Respondents were asked if they owned a pet (Yes/No). The results are based on a secondary data analysis. An ordinal logistic regression revealed that an increase in moderate activity days was associated with pet ownership with an odds ratio of 0.111 (95% CI, −0.036 to 0.337), Wald χ2 (1) 15.013, p < 0.001. An increase in vigorous activity days was associated with pet ownership with an odds ratio of 0.039 (95% CI, 0.004 to 0.342), Wald χ2 (1) 8.952, p = 0.003). Amongst older adults in Northern Ireland, those with a pet were more likely to engage in regular physical activity. This study was based on a small specific sample of the population and showed differences in physical activity levels between pet owners and non-pet owners. Additionally, the study showed that physical activity is extremely low among the older adult population, therefore further investigation is warranted on the reasons for these low levels. [ABSTRACT FROM AUTHOR]

Background: General practice is a highly sedentary occupation, with many GPs spending more than 10.5 hours sitting each workday. This excessive sedentary behaviour and lack of physical activity (PA) is potentially detrimental to the health of GPs, as well as their ability to counsel patients regarding sedentary behaviour and PA. There is a lack of prior research examining the perspectives of GPs regarding their sedentary behaviour and PA. Aim: To explore GPs' perspectives regarding their sedentary behaviour and PA. Design & setting: A qualitative interview study of GPs in Northern Ireland. Method: Semi-structured interviews were conducted with a purposive sample of 13 GPs who had previously taken part in a study to objectively measure their levels of sedentary behaviour and PA. Interview transcripts were analysed using deductive thematic analysis. The Theoretical Domains Framework (TDF) was used to facilitate identification of barriers and enablers affecting the ability of GPs to increase their PA. Results: Key themes were categorised within six theoretical domains (environmental context and resources, social professional role and identity, goals, social influences, knowledge, and intentions) with sub-themes within each domain. Conclusion: Most GPs are unhappy with their current levels of sedentary behaviour and PA, and are concerned with how this is affecting their health. Numerous barriers and facilitators were identified affecting the ability of GPs to increase their PA, including working environment, and personal and professional responsibilities, among others. Addressing these could improve the health of GPs and their ability to counsel patients regarding sedentary behaviour and PA. [ABSTRACT FROM AUTHOR]

In previous research, older adults reported they preferred enjoyable exercise programmes. The aim of this systematic review is to identify the components of enjoyable group-based physical activity interventions for older adults. Eleven electronic databases were searched in May 2021. Inclusion criteria were: Community-dwelling, ≥60 years of age, group-based physical activity, controlled intervention studies, designed to promote enjoyment, and included a measure of enjoyment or physical activity. Characteristics of the studies, intervention content, and enjoyment outcomes were extracted. Six studies, involving 1205 participants (Mean = 72.9 years old, 71.3% female, 67% European countries) were included. While enjoyment outcomes (n = 3) appeared to improve, there was wide heterogeneity in measurement tools, making it difficult to compare studies. Enjoyable group-based physical activity for older adults may consist of a supportive instructor and peers, creating a shared positive experience. Components included confidence building through competence, and courage experienced in the company of others. Within a physically supportive environment, older adults have the potential to generate social support to enjoy being physically active together. Future studies should include measures of enjoyment and device-based physical activity. Furthermore, a standardised definition of enjoyable physical activity for older adults is needed to inform the design of future interventions. [ABSTRACT FROM AUTHOR]

Background: Sedentary behaviour, which may have increased among GPs due to increasing use of telemedicine, is associated with many illnesses and increased all-cause mortality. Aim: To explore levels of sedentary behaviour among GPs and General Practice Specialty Trainees (GPSTs). Design & setting: Sequential, cross-sectional design (initial online sedentary behaviour questionnaire and subsequent thigh-worn accelerometer substudy) of GPs and GPSTs in Northern Ireland. Method: Self-reported questionnaire data were aggregated and compared with device-measured accelerometry data. Results: Data from 353 participants (17.7% of GPs and GPSTs in Northern Ireland) revealed doctors in general practice self-reported higher workday sedentary time (10.33 hours, SD 2.97) than those in secondary care (7.9 hours, SD 3.43 [mean difference {MD} 2.43 hours; P<0.001]). An active workstation (for example, sit-stand desk), was used by 5.6% of participants in general practice, while 86.0% of those without one would consider using one in future. Active workstation users self-reported lower workday sedentary time (7.88 hours, SD 3.2) than non-users (10.47 hours, SD 2.88 [MD -2.58 hours, P = 0.001]). Accelerometer substudy participants underestimated their workday sedentary time by 0.17 hours (95% confidence interval [CI] = -1.86 to 2.20; P = 0.865), and non-workday sedentary time by 2.67 hours (95% CI = 0.99 to 4.35; P = 0.003). Most GPs (80.7%) reported increased workday sitting time compared to prior to the COVID-19 pandemic, while 87.0% would prefer less workday sitting time. Conclusion: GPs have high levels of workday sedentary time, which may be detrimental to their health. It is imperative to develop methods to address sedentary behaviour among GPs on workdays, both for their own health and the health of their patients. [ABSTRACT FROM AUTHOR]

Background This study details the within-trial economic evaluation and long-term economic model of SITLESS, a multi-country, three-armed randomized controlled trial comparing a combined intervention of exercise referral schemes (ERS) enhanced by self-management strategies (SMS) against ERS alone and usual care (UC). Methods A cost-utility analysis, conducted from the base-case perspective of the National Health Service and personal and social services, estimated the incremental cost per incremental quality-adjusted life year (QALY) and years in full capability (YFC). A secondary analysis combined the costs with a broad set of outcomes within a cost-consequence framework, from a societal perspective. A Markov-type decision-analytic model was developed to project short-term changes in physical activity to long-term outcomes and costs, over a 5- and 15-year time horizon. Results The results of the within-trial analysis show that SMS+ERS is highly likely to be cost-effective compared to ERS alone (ICER €4270/QALY), but not compared to UC. Participants allocated to the SMS+ERS group also showed an improvement in YFC compared to ERS alone and UC. The long-term analysis revealed that SMS+ERS is likely to be a cost-effective option compared to ERS and UC over a 5-year, but not with a 15-year horizon, being then dominated by ERS alone. Conclusion This research provides new evidence that SMS is a cost-effective add-on to ERS strategies. This economic evaluation informs the case for further, cost-effective, refinement of lifestyle change programmes targeted to older adults, with the aim of ultimately reducing the impact of non-communicable diseases in this population. [ABSTRACT FROM AUTHOR]

Currently, there is limited research reporting the symptoms of long COVID among athletes, and the recommendations for athletes returning to competition/training who have experienced long COVID symptoms. Therefore, the aim of this systematic review is to synthesise the recommendations for returning athletes who have experienced long COVID symptoms. The protocol was registered in PROSPERO under CRD42021265939. Two authors searched the electronic databases PubMed, Embase, Scopus, the Cochrane Library, Web of Science, CINAHL, PsycINFO, and SPORTDiscus from August 2019-July 2021. Search terms included words related to "long COVID", "athlete" and "return". Data extraction was completed for each study by two independent investigators for: (1) first author name; (2) year of publication; (3) journal; (4) Definition of athlete (i.e. elite or non-elite) (5) Recommendations reported. A total of 220 records were found. Following title and abstract screening, 61 studies were eligible for full text screening. Overall, no studies, commentaries, editorials or reviews provided specific recommendations for "long COVID" defined as COVID-19 signs and symptoms lasting for over 4 weeks as a result of COVID-19 infection. In addition, we found no studies which reported symptoms of athletes suffering from long COVID. Despite the lack of evidence, we did find eight separate professional recommendations for managing "long-term effects" and "ongoing" or "prolonged" symptoms and COVID-19 complications among athletes. Practitioners should be aware of both mental and physical symptoms of long COVID, and additional considerations may be required for athletes who have undergone intensive care. The present review provides a list of recommendations based on existing literature that may be followed and implemented for returning athletes. Further research, including longitudinal research of athletes who have tested positive for COVID-19, is required to develop evidenced-based guidelines for athletes with ongoing COVID-19 symptoms. Prior to returning to play after COVID-19 infection, a thorough medical history, physical and psychological examination should be conducted by a medical professional. Athletes should continue to monitor and record their own physical and psychological markers of health. [ABSTRACT FROM AUTHOR]

Physical inactivity is a global pandemic. The COVID-19 crisis has altered global patterns of physical activity in ways that were unimaginable before the outbreak. Enforced restrictions on mobility and the mass closure of indoor fitness centres has highlighted the limitations of many urban areas for enabling physical activity and reinforced inequalities in physical activity opportunities across cities. However, unprecedented reductions in mobility and increases in localised physical activity provide unique insight on opportunities for urban health promotion. COVID-19 responses can, therefore, encourage new perspectives in urban planning and inspire novel future strategies to design more sustainable, healthier and equitable cities. [ABSTRACT FROM AUTHOR]

Background: There are currently no studies on visual impairment and sarcopenia. We investigated the cross-sectional association between objectively measured far vision impairment and sarcopenia in a nationally representative sample of older adults aged 65 years and over from six low- and middle-income countries (LMICs). Methods: Cross-sectional, community-based data from the study on global ageing and adult health (SAGE) were analyzed. Far vision acuity was measured using the tumbling E LogMAR chart and classified as: no vision impairment (6/12 or better); mild vision impairment (6/18 or better but worse than 6/12); moderate vision impairment (6/60 or better but worse than 6/18); severe vision impairment (worse than 6/60). Sarcopenia was defined as having low skeletal muscle mass and either a slow gait speed or a weak handgrip strength. Associations were assessed with multivariable logistic regression. Results: Fourteen thousand five hundred and eighty five individuals aged ≥ 65 years were included in the analysis [mean (SD) age 72.6 (11.5) years; 54.1% females]. After adjustment for multiple potential confounders, compared to those with no vision impairment, the OR (95% CI) for sarcopenia in those with mild, moderate, and severe vision impairment were 1.10 (0.87–1.40), 1.69 (1.25–2.27), and 3.38 (1.69–6.77), respectively. The estimates for females and males were similar. Conclusions: The odds for sarcopenia increased with increasing severity of far vision impairment among older people in LMICs. The mere co-occurrence of these conditions is concerning, and it may be prudent to implement interventions to address/prevent sarcopenia in those with far vision impairment through the promotion of physical activity and appropriate nutrition. [ABSTRACT FROM AUTHOR]

Background This is the first study analyzing levels of physical activity in a sample of quarantined adults with chronic conditions. The aim of this study was to compare moderate- and vigorous-intensity physical activity levels in Spanish adults with chronic conditions before and during coronavirus disease 2019 (COVID-19) quarantine. Methods A cross-sectional online survey was administered during the COVID-19 quarantine in Spain. A total of 163 participants with chronic conditions (113 females and 47 males; age range 18–64 years) completed the survey. A total of 26 chronic conditions were included. Participants self-reported average minutes/day of moderate and vigorous physical activity before and during quarantine. Differences in moderate- and vigorous-intensity physical activity levels before and during COVID-19 quarantine (overall, by gender, by age, by number of chronic conditions and by each chronic condition) were assessed by Wilcoxon-signed rank test. Results During COVID-19 quarantine, there was a significant decrease of moderate-intensity physical activity in Spanish people with chronic conditions (in both males and females, in those aged 18–24, 25–34, 35–44 and 55–64 years, in those with multimorbidity, in those with one/two chronic condition/s, and in those diagnosed with asthma/hypercholesterolaemia/chronic skin disease/haemorrhoids). Also, there was a significant decrease of vigorous-intensity physical activity in Spanish males with chronic conditions and in those with multimorbidity. Conclusions These results should be considered to develop effective strategies of physical activity promotion targeting these specific groups when new quarantine or restriction measures are implemented, in order to avoid new significant decreases of physical activity in these vulnerable populations. [ABSTRACT FROM AUTHOR]

Summary: Background: Data on the association between obesogenic behaviours and bullying victimization among adolescents are scarce from low‐ and middle‐income countries. Objectives: To assess the associations between obesogenic behaviours and bullying victimization in 54 low‐ and middle‐income countries. Methods: Cross‐sectional data from the global school‐based student health survey were analyzed. Data on bullying victimization and obesogenic behaviours were collected. The association between bullying victimization and the different types of obesogenic behaviour (anxiety‐induced insomnia, fast‐food consumption, carbonated soft‐drink consumption, no physical activity and sedentary behaviour) were assessed by country‐wise multivariable logistic regression analysis adjusting for age, sex, food insecurity and obesity with obesogenic behaviours being the outcome. Result: The sample consisted of 153 929 students aged 12 to 15 years [mean (SD) age 13.8 (1.0) years; 49.3% girls]. Overall, bullying victimization (vs no bullying victimization) was significantly associated with greater odds for all types of obesogenic behaviour with the exception of physical activity, which showed an inverse association. Specifically, the ORs (95% CIs) were: anxiety‐induced sleep problems 2.65 (2.43‐2.88); fast‐food consumption 1.36 (1.27‐1.44); carbonated soft‐drink consumption 1.14 (1.08‐1.21); no physical activity 0.84 (0.79‐0.89); and sedentary behaviour 1.34 (1.25‐1.43). Conclusion: In this large representative sample of adolescents from low‐ and middle‐income countries, bullying victimization was found to be associated with several, but not all, obesogenic behaviours. [ABSTRACT FROM AUTHOR]

The study aim was to explore associations between sedentary behavior (SB) bouts and physical function in 1360 community‐dwelling older adults (≥65 years old). SB was measured using an ActiGraph wGT3X + accelerometer for seven consecutive days at the dominant hip and processed accordingly. Various SB bout lengths were assessed including: 1‐ to 9‐minutes; 10‐ to 29‐minutes; 30‐ to 59‐minutes; and ≥60‐minutes, as well as maximum time spent in a SB bout. Total SB time was adjusted for within the SB bout variables used (percentage SB time in the SB bout length and number of SB bouts per total SB hour). Physical function was assessed using the 2‐minute walk test (2MWT), 5‐times sit‐to‐stand (chair stand) test, and unipedal stance test (UST). Hierarchical linear regression models were utilized. Covariates such as moderate‐vigorous physical activity (MVPA), demographic and health characteristics were controlled for. Lower percentage time spent in ≥60‐minute SB bouts was significantly (P <.05) associated with longer 2MWT distance while lower numbers of ≥60‐minute SB bouts were associated with longer 2MWT distance, shorter chair stand time and longer UST time. There were mixed associations with physical function for 10‐ to 29‐minute SB bouts. In a large cohort of European older adults, prolonged SB bouts lasting ≥60‐minutes appear to be associated with reduced physical function after controlling for MVPA and numerous other important covariates. Besides reducing SB levels, these findings suggest there is a need to regularly interrupt prolonged SB to improve physical function in older adults. [ABSTRACT FROM AUTHOR]

Introduction: Regular moderate‐to‐vigorous physical activity (MVPA) is associated with improved mental health, but the evidence for the effect of reducing sedentary behavior (SB) or increasing light PA (LPA) in older adults is lacking. Using isotemporal substitution (IS) models, the aim of this paper was to investigate the effect of substituting SB with LPA or MVPA on associations with mental health in older adults. Methods: Data from 1360 older adults (mean age 75.18 years) in four countries were utilized. PA and SB was measured using ActiGraph wGT3X‐BT + accelerometers worn for 7 days. Self‐rated mental health was measured using the Hospital and Anxiety Depression Scale (HADS). IS models estimated cross‐sectional associations when 30 minutes of one behavior was substituted with another. Models were adjusted for age, sex, marital status, and educational attainment. Results: Substituting 30 minutes of SB with LPA (β −.37; 95% CI −0.42, −0.32) or MVPA (β −.14; 95% CI −0.21, −0.07) and substituting LPA with MVPA (β −.11; 95% CI −0.18, −0.04) were associated with improvements in anxiety. However, substituting 30 minutes of SB with LPA (β.55; 95% CI 0.49, 0.62) was associated with increased depression. Conclusion: Replacing 30 minutes of SB with LPA or MVPA was associated with improved anxiety symptoms in older adults. Greater benefits were observed when shifting SB and LPA to MVPA. [ABSTRACT FROM AUTHOR]

Background: Sedentary behavior (SB) and physical activity (PA) are important determinants of health in older adults. This study aimed to describe the composition of accelerometer-measured SB and PA in older adults, to explore self-reported context-specific SB, and to assess sociodemographic and functional correlates of engaging in higher levels of SB in participants of a multicenter study including four European countries.Method: One thousand three hundred and sixty community-dwelling older adults from the SITLESS study (61.8% women; 75.3 ± 6.3 years) completed a self-reported SB questionnaire and wore an ActiGraph accelerometer for 7 days. Accelerometer-determined compositional descriptive statistics were calculated. A fixed-effects regression analysis was conducted to assess the sociodemographic (country, age, sex, civil status, education, and medications) and functional (body mass index and gait speed) correlates.Results: Older adults spent 78.8% of waking time in SB, 18.6% in light-intensity PA, and 2.6% in moderate-to-vigorous PA. Accelerometry showed that women engaged in more light-intensity PA and walking and men engaged in higher amounts of moderate-to-vigorous PA. Watching television and reading accounted for 47.2% of waking time. Older age, being a man, single, taking more medications, being obese and overweight, and having a slower gait speed were statistically significant correlates of more sedentary time.Conclusions: The high amount of SB of our participants justifies the need to develop and evaluate interventions to reduce sitting time. A clinically relevant change in gait speed can decrease almost 0.45 percentage points of sedentary time. The distribution of context-specific sedentary activities by country and sex showed minor differences, albeit worth noting. [ABSTRACT FROM AUTHOR]

The aim of the present study was to assess the association between levels of physical activity (PA) and the presence of cataracts in people aged 15–69 years residing in Spain. Cross-sectional data from the Spanish National Health Survey 2017 were analysed (n = 17,777 ≥ 15 years; 52% females; self-weighting sample). The International Physical Activity Questionnaire (IPAQ) short form was used to measure PA. Total PA MET-minutes/week were calculated, and participants were divided into two categories: 1) Less than 600 MET-minutes/week. 2) At least 600 MET-minutes/week, equivalent to meeting current PA recommendations. Cataracts were self-reported in response to the question "Have you ever been diagnosed with cataracts?". Multivariable logistic regression was used to assess associations overall and by age groups (15–49, 50–64, and 65–69 years; 15–49 and 50–69 years). Covariates included in the analysis were sex, education, BMI (Body Mass Index), multimorbidity, smoking, and alcohol consumption. The overall prevalence of cataract was 3.7%, and the overall prevalence of participating in less than 600 MET-minutes/week of PA was 30.2%. In the adjusted overall analysis, less than 600 MET-minutes/week of PA was associated with significantly higher odds for cataract: OR = 1.324 (95% CI = 1.116–1.571). Age-stratified analyses showed that the association between PA and cataract was significant only in the age groups of 65–69 years and 50–69 years. A significant association between PA and cataract was observed in people aged 15–69 years residing in Spain. Considering the impact on health and quality of life due to reduced PA in people with cataract, at least 600 MET-minutes/week activity should be promoted. [ABSTRACT FROM AUTHOR]

Accurately measuring older adults' physical activity (PA) and sedentary behavior (SB) using accelerometers is essential, as both are important markers of health. This study aimed to highlight how steps taken during data processing may affect key hip-based accelerometry outcomes in older adults, using a selection of baseline accelerometry data (n = 658) from the SITLESS study. Different analytical parameters tested included wear-time algorithms, use of low-frequency extension (LFE) filter, epoch length, and minimum and maximum daily wear-time thresholds. These were compared against vertical axis counts per minute (CPM), vector magnitude (VM) CPM, SB, light PA, moderate-to-vigorous PA, step counts, and wear-time percentage. Differences in settings across the analytical parameters were assessed using paired sample t-tests and repeated measures ANOVAs using Bonferroni correction. Using the "Choi" versus "Troiano" wear-time algorithm resulted in a higher percentage wear-time. Most SB and PA outcomes were significantly different across wear-time algorithms (p < .001). This was similar when using the LFE filter versus normal filter (p < .001). Using 10-second epoch length increased daily SB time (between +75.7 and +79.2 minutes) compared to 60-second. Most SB and PA outcomes significantly changed comparing minimum-wear-time thresholds of 360, 480, 600, and 720 minutes per day (p < .001). Applying a log-diary with a ≥1140-minute threshold had a significant impact on vertical axis CPM, VM CPM, SB, and light PA outcomes (p < .001). This study demonstrates the potential variability in the number of participants being included in studies and reported SB and PA levels when processing older adults' accelerometry data dependent on the analytical procedures utilized. [ABSTRACT FROM AUTHOR]

Background: Globally, populations are ageing. Typically, physical activity levels decline and health worsens as we age; however, estimates of the impact of physical inactivity for population health often fail to specifically focus on older adults. Methods: Multiple databases were searched for systematic reviews and/or meta‐analyses of longitudinal observational studies, investigating the relationship between physical activity and any physical or mental health outcome in adults aged ≥60 years. Quality of included reviews was assessed using AMSTAR. Results: Twenty‐four systematic reviews and meta‐analyses were included. The majority of reviews were of moderate or high methodological quality. Physically active older adults (≥60 years) are at a reduced risk of all‐cause and cardiovascular mortality, breast and prostate cancer, fractures, recurrent falls, ADL disability and functional limitation and cognitive decline, dementia, Alzheimer's disease, and depression. They also experience healthier ageing trajectories, better quality of life and improved cognitive functioning. Conclusion: This review of reviews provides a comprehensive and systematic overview of epidemiological evidence from previously conducted research to assess the associations of physical activity with physical and mental health outcomes in older adults. [ABSTRACT FROM AUTHOR]

Physical inactivity, an unhealthy diet, smoking, and alcohol consumption are key determinants of morbidity and mortality. These health behaviours often begin at a young age and track into adulthood, emphasising a need for interventions in children and young people. Previous research has demonstrated the potential effectiveness of behavioural incentive (BI) interventions in adults. However, little is known about their effectiveness in children and adolescents. Eight bibliographic databases were searched. Eligibility criteria included controlled trials using behavioural incentives (rewards provided contingent on successful performance of the target behaviour) as an intervention component for health behaviour change in children and adolescents. Intervention effects (standardised mean differences or odds ratios) were calculated and pooled by health behaviour, using a random effects model. Twenty-two studies were included (of n = 8392 identified), 19 of which were eligible for meta-analysis: physical activity (n = 8); healthier eating (n = 3); and smoking (n = 8). There was strong evidence that behavioural incentives may encourage healthier eating behaviours, some evidence that behavioural incentives were effective for encouraging physical activity behaviour, and limited evidence to support the use of behavioural incentives for smoking cessation and prevention in adolescents. Findings suggest that behavioural incentives may encourage uptake and initiation of healthy eating and physical activity in young people. However, this is a limited evidence base and a wide range of incentive designs have yet to be explored. Future research should further investigate the acceptability of these intervention approaches for young people. [ABSTRACT FROM AUTHOR]

Background: Older adults are the fastest growing segment of the world's population. Recent evidence indicates that excessive sitting time is harmful to health, independent of meeting the recommended moderate to vigorous physical activity (PA) guidelines. The SITLESS project aims to determine whether exercise referral schemes (ERS) can be enhanced by self-management strategies (SMSs) to reduce sedentary behaviour (SB), increase PA and improve health, quality of life and function in the long term, as well as psychosocial outcomes in community-dwelling older European citizens from four countries, within a three-armed pragmatic randomised controlled trial, compared with ERS alone and also with general recommendations about PA.Methods: A total of 1338 older adults will be included in this study, recruited from four European countries through different existing primary prevention pathways. Participants will be randomly allocated into an ERS of 16 weeks (32 sessions, 45-60 min per session), ERS enhanced by seven sessions of SMSs and four telephone prompts, or a control group. Outcomes will be assessed at baseline, month 4 (end of ERS intervention), month 16 (12 months post intervention) and month 22 (18 months post intervention). Primary outcomes will include measures of SB (time spent sedentary) and PA (counts per minute). Secondary outcomes will include muscle and physical function, health economics' related outcomes, anthropometry, quality of life, social networks, anxiety and depressive symptoms, disability, fear of falling, executive function and fatigue. A process evaluation will be conducted throughout the trial. The full analysis set will follow an intention-to-treat principle and will include all randomised participants for whom a baseline assessment is conducted. The study hypothesis will be tested with mixed linear models with repeated measures, to assess changes in the main outcomes (SB and PA) over time (baseline to month 22) and between study arms.Discussion: The findings of this study may help inform the design and implementation of more effective interventions to reduce SB and increase PA levels, and hence improve long-term health outcomes in the older adult population. SITLESS aims to support policy-makers in deciding how or whether ERS should be further implemented or restructured in order to increase its adherence, impact and cost-effectiveness.Trial Registration: ClinicalTrials.gov, NCT02629666 . Registered 19 November 2015. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the relationship between knowledge of the current UK physical activity (PA) guidelines and amount of daily PA using a sample population of 11-16 year olds in Northern Ireland.Methods: Cross-sectional survey data from the 2010 and 2013 Young Persons' Behaviour and Attitudes Survey of 10,790 young people provided information on PA, knowledge of guidelines and socio-demographic characteristics. Multinomial logistic regression was used to investigate the associations between knowledge and amount of daily PA.Results: Results from 2013 showed 67.0% of respondents were aware of PA guidelines with 15.4% reporting meeting them. Males were more likely to meet PA guidelines than females (OR 3.36, 95% CI 2.47, 4.59). Males who were active for 60 min or more, 7 days per week were less likely to be aware of guidelines (OR = 1.51, 95% CI 1.02, 2.24). For females, knowledge of PA guidelines had no significant association with amount of daily PA (OR = 1.74, 95% CI 0.99, 3.07). Those who did not enjoy being active were less likely to meet the guidelines (OR = 0.05, 95% CI 0.02, 0.12).Conclusions: Knowledge did not appear to be an important predictor of PA in young people. Consequently, threshold based messaging containing recommended minimum PA guideline information may not be appropriate for this age group. Re-branding PA promotion to include the use of humour may offer a new direction for public health messaging based around fun and enjoyment. [ABSTRACT FROM AUTHOR]

Objectives. To examine the impact of environmental restructuring on attendees at a physical activity conference when provided with standing tables and given point-of-decision prompts (PODPs; e.g., health messages). Methods. This randomized controlled trial took place at the Health-Enhancing Physical Activity Europe 2016 conference in Belfast, United Kingdom, September 2016. We randomly allocated 14 oral sessions to either the intervention group (standing tables + PODPs; n = 7) or the control group (PODPs only; n = 7). Conference volunteers discreetly recorded the number of attendees standing and sitting and estimated the number of women and attendees aged 40 years or older. Results. There was a significant difference (P = .04) in the proportion of attendees standing during the intervention (mean = 16.8%; SD = 9.5%) than during control sessions (mean = 6.0%; SD = 5.8%). There was no differential response between gender and age groups in the proportion standing during intervention sessions (P > .05). Conclusions. Providing standing tables may be a feasible and effective strategy to reduce sitting at physical activity conferences. [ABSTRACT FROM AUTHOR]

A correction is presented to the article "Food insecurity and physical multimorbidity among adults aged ≥ 50 years from six low‑ and middle‑income countries" which appeared in the January 11, 2023 issue.

BACKGROUND: The transtheoretical model has been successful in promoting health behavior change in general and clinical populations. However, there is little knowledge about the application of the transtheoretical model to explain physical activity behavior in individuals with non-cystic fibrosis bronchiectasis. The aim was to examine patterns of (1) physical activity and (2) mediators of behavior change (self-efficacy, decisional balance, and processes of change) across stages of change in individuals with non-cystic fibrosis bronchiectasis. METHODS: Fifty-five subjects with non-cystic fibrosis bronchiectasis (mean age ± SD = 63 ± 10 y) had physical activity assessed over 7 d using an accelerometer. Each component of the transtheoretical model was assessed using validated questionnaires. Subjects were divided into groups depending on stage of change: Group 1 (pre-contemplation and contemplation; n = 10), Group 2 (preparation; n = 20), and Group 3 (action and maintenance; n = 25). Statistical analyses included one-way analysis of variance and Tukey-Kramer post hoc tests. RESULTS: Physical activity variables were significantly (P < .05) higher in Group 3 (action and maintenance) compared with Group 2 (preparation) and Group 1 (pre-contemplation and contemplation). For self-efficacy, there were no significant differences between groups for mean scores (P = .14). Decisional balance cons (barriers to being physically active) were significantly lower in Group 3 versus Group 2 (P = .032). For processes of change, substituting alternatives (substituting inactive options for active options) was significantly higher in Group 3 versus Group 1 (P = .01), and enlisting social support (seeking out social support to increase and maintain physical activity) was significantly lower in Group 3 versus Group 2 (P = .038). CONCLUSIONS: The pattern of physical activity across stages of change is consistent with the theoretical predictions of the transtheoretical model. Constructs of the transtheoretical model that appear to be important at different stages of change include decisional balance cons, substituting alternatives, and enlisting social support. This study provides support to explore transtheoretical model-based physical activity interventions in individuals with non-cystic fibrosis bronchiectasis. [ABSTRACT FROM AUTHOR]

Background: The impact of bronchiectasis on sedentary behaviour and physical activity is unknown. It is important to explore this to identify the need for physical activity interventions and how to tailor interventions to this patient population. We aimed to explore the patterns and correlates of sedentary behaviour and physical activity in bronchiectasis. Methods: Physical activity was assessed in 63 patients with bronchiectasis using an ActiGraph GT3X+ accelerometer over seven days. Patients completed: questionnaires on health-related quality-of-life and attitudes to physical activity (questions based on an adaption of the transtheoretical model (TTM) of behaviour change); spirometry; and the modified shuttle test (MST). Multiple linear regression analysis using forward selection based on likelihood ratio statistics explored the correlates of sedentary behaviour and physical activity dimensions. Between-group analysis using independent sample t-tests were used to explore differences for selected variables. Results: Fifty-five patients had complete datasets. Average daily time, mean(standard deviation) spent in sedentary behaviour was 634(77)mins, light-lifestyle physical activity was 207(63)mins and moderate-vigorous physical activity (MVPA) was 25(20)mins. Only 11% of patients met recommended guidelines. Forced expiratory volume in one-second percentage predicted (FEV1% predicted) and disease severity were not correlates of sedentary behaviour or physical activity. For sedentary behaviour, decisional balance 'pros' score was the only correlate. Performance on the MST was the strongest correlate of physical activity. In addition to the MST, there were other important correlate variables for MVPA accumulated in ≥10-minute bouts (QOL-B Social Functioning) and for activity energy expenditure (Body Mass Index and QOL-B Respiratory Symptoms). Conclusions: Patients with bronchiectasis demonstrated a largely inactive lifestyle and few met the recommended physical activity guidelines. Exercise capacity was the strongest correlate of physical activity, and dimensions of the QOL-B were also important. FEV1% predicted and disease severity were not correlates of sedentary behaviour or physical activity. The inclusion of a range of physical activity dimensions could facilitate in-depth exploration of patterns of physical activity. This study demonstrates the need for interventions targeted at reducing sedentary behaviour and increasing physical activity, and provides information to tailor interventions to the bronchiectasis population. [ABSTRACT FROM AUTHOR]

We investigated whether “hidden” (or unobserved) social networks were evident in a 2011 physical activity behavior change intervention in Belfast, Northern Ireland. Results showed evidence of unobserved social networks in the intervention and illustrated how the network evolved over short periods and affected behavior. Behavior change interventions should account for the interaction among participants (i.e., social networks) and how such interactions affect intervention outcome. [ABSTRACT FROM AUTHOR]