Association and Dose–Response Relationship of Self-Reported Physical Activity and Disability Among Adults ≥50 Years: National Health and Nutrition Examination Survey, 2011–2016

in Journal of Aging and Physical Activity
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Disability is a tremendous public health challenge. No study has assessed whether meeting U.S. Physical Activity guidelines is associated with disability in mobility tasks, activities of daily living, and social participation among U.S. older adults. Using 2011–2016 National Health and Nutrition Examination Survey data, this study examined this relationship among 8,309 individuals aged ≥50 years. Most participants (n = 4,272) did not achieve guidelines, and 2,912 participants were completely inactive. People who did not meet guidelines had higher odds of disability compared with those who did (adjusted odds ratio [AOR] = 1.80) in addition to difficulty with mobility tasks (AOR = 1.85), activities of daily living (AOR = 1.66), and social participation (AOR = 2.09). There was a dose–response effect for each level of activity (inactive, insufficient, and meeting and exceeding recommendations). Among adults aged ≥50 years, meeting the U.S. guidelines was associated with better social and physical functioning.

Delaney is with Rehabilitation Services, The George Washington University Hospital, Washington, DC, USA. Warren is with the Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ, USA. Kinslow is with Physical Therapy, Evolve Flagstaff, Flagstaff, AZ, USA. de Heer is with Health Sciences Department, Northern Arizona University, Flagstaff, AZ, USA. Ganley is with the Department of Physical Therapy and Athletic Training, Northern Arizona University—Phoenix Biomedical Campus, Phoenix, AZ, USA.

Delaney (md472@nau.edu) is corresponding author.
  • Bangsbo, J., Blackwell, J., Boraxbekk, C.-J., Caserotti, P., Dela, F., Evans, A.B., . . . Viña, J. (2019). Copenhagen consensus statement 2019: Physical activity and ageing. British Journal of Sports Medicine, 53(14), 856858. PubMed ID: 30792257 doi:10.1136/bjsports-2018-100451

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Boult, C., Kane, R.L., Louis, T.A., Boult, L., & McCaffrey, D. (1994). Chronic conditions that lead to functional limitation in the elderly. Journal of Gerontology, 49(1), M28M36. PubMed ID: 8282978 doi:10.1093/geronj/49.1.M28

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Centers for Disease Control and Prevention. (2013). National Center for Health Statistics (NCHS). National health and nutrition examination survey methods and analytic guidelines. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Retrieved from https://wwwn.cdc.gov/nchs/nhanes/analyticguidelines.aspx

    • Search Google Scholar
    • Export Citation
  • Centers for Disease Control and Prevention. (2018a, December 3). National Center for Health Statistics (NCHS). National health and nutrition examination survey data: 2011–2016. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/nchs/nhanes/index.htm

    • Search Google Scholar
    • Export Citation
  • Centers for Disease Control and Prevention. (2018b, December 3). National Center for Health Statistics (NCHS). National health and nutrition examination survey examination protocol: 2011–2016. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Retrieved from https://wwwn.cdc.gov/nchs/nhanes/continuousnhanes/Overview.aspx?BeginYear=2013

    • Search Google Scholar
    • Export Citation
  • Chen, H., & Guo, X. (2008). Obesity and functional disability among elder Americans. Journal of the American Geriatrics Society, 56(4), 689694. PubMed ID: 18266843 doi:10.1111/j.1532-5415.2007.01624.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Chodzko-Zajko, W., Proctor, D., Singh, M.F., Minson, C., Nigg, C., Salem, G., & Skinner, J. (2009). Exercise and physical activity for older adults. Medicine & Science in Sports & Exercise, 41(7), 15101530. PubMed ID: 19516148 doi:10.1249/MSS.0b013e3181a0c95c

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ciol, M.A., Rasch, E.K., Hoffman, J.M., Huynh, M., & Chan, L. (2014). Transitions in Mobility, ADLs, and IADLs among working-age Medicare beneficiaries. Disability and Health Journal, 7(2), 206215. PubMed ID: 24680050 doi:10.1016/j.dhjo.2013.10.007

    • Crossref
    • Search Google Scholar
    • Export Citation
  • de Rekeneire, N., Resnick, H.E., Schwartz, A.V., Shorr, R.I., Kuller, L.H., Simonsick, E.M.& Harris, T.B. (2003). Diabetes is associated with subclinical functional limitation in nondisabled older individuals: The health, aging, and body composition study. Diabetes Care, 26(12), 32573263. doi:10.2337/diacare.26.12.3257

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Dunlop, D.D., Manheim, L.M., Sohn, M.-W., Liu, X., & Chang, R.W. (2002). Incidence of functional limitation in older adults: The impact of gender, race, and chronic conditions. Archives of Physical Medicine and Rehabilitation, 83(7), 964971. PubMed ID: 12098157 doi:10.1053/apmr.2002.32817

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ervin, R.B. (2006). Prevalence of functional limitations among adults 60 years of age and over: United States, 1999–2002. Advance Data from Vital and Health Statistics, 375, 18.

    • Search Google Scholar
    • Export Citation
  • Ettinger, W.H., Fried, L.P., Harris, T., Shemanski, L., Schulz, R., & Robbins, J. (1994). Self-reported causes of physical disability in older people: The cardiovascular health study. CHS Collaborative Research Group. Journal of the American Geriatrics Society, 42(10), 10351044. PubMed ID: 7930326 doi:10.1111/j.1532-5415.1994.tb06206.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Friedmann, J.M., Elasy, T., & Jensen, G.L. (2001). The relationship between body mass index and self-reported functional limitation among older adults: A Gender difference. Journal of the American Geriatrics Society, 49(4), 398403. PubMed ID: 11347782 doi:10.1046/j.1532-5415.2001.49082.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hairi, N.N., Bulgiba, A., Cumming, R.G., Naganathan, V., & Mudla, I. (2010). Prevalence and correlates of physical disability and functional limitation among community dwelling older people in rural Malaysia, a middle income country. BMC Public Health, 10, 492. PubMed ID: 20716377 doi:10.1186/1471-2458-10-492

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hirvensalo, M., Rantanen, T., & Heikkinen, E. (2000). Mobility difficulties and physical activity as predictors of mortality and loss of independence in the community-living older population. Journal of the American Geriatrics Society, 48(5), 493498. PubMed ID: 10811541 doi:10.1111/j.1532-5415.2000.tb04994.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Luppa, M., Luck, T., Weyerer, S., König, H.-H., Brähler, E., & Riedel-Heller, S.G. (2010). Prediction of institutionalization in the elderly. A systematic review. Age and Ageing, 39(1), 3138. PubMed ID: 19934075 doi:10.1093/ageing/afp202

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lynch, J.W., Kaplan, G.A., & Shema, S.J. (1997). Cumulative impact of sustained economic hardship on physical, cognitive, psychological, and social functioning. The New England Journal of Medicine, 337(26), 18891895. PubMed ID: 9407157 doi:10.1056/NEJM199712253372606

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Millán-Calenti, J.C., Tubío, J., Pita-Fernández, S., González-Abraldes, I., Lorenzo, T., Fernández-Arruty, T., & Maseda, A. (2010). Prevalence of functional disability in activities of daily living (ADL), instrumental activities of daily living (IADL) and associated factors, as predictors of morbidity and mortality. Archives of Gerontology and Geriatrics, 50(3), 306310. doi:10.1016/j.archger.2009.04.017

    • Crossref
    • Search Google Scholar
    • Export Citation
  • National Health and Nutrition Examination Survey 2015–2016: Physical Activity Data Documentation, Codebook, and Frequencies. (2018a, December 3). Retrieved from https://wwwn.cdc.gov/Nchs/Nhanes/2015-2016/PAQ_I.htm

    • Export Citation
  • National Health and Nutrition Examination Survey 2015–2016: Physical Functioning Data Documentation, Codebook, and Frequencies. (2018b, December 3). Retrieved from https://wwwn.cdc.gov/Nchs/Nhanes/2015-2016/PFQ_I.htm

    • Export Citation
  • Nelson, M.E., Rejeski, W.J., Blair, S.N., Duncan, P.W., Judge, J.O., King, A.C., . . . Castaneda-Sceppa, C. (2007). Physical activity and public health in older adults: Recommendation from the American College of Sports Medicine and the American Heart Association. Medicine and Science in Sports and Exercise, 39(8), 14351445. PubMed ID: 17762378 doi:10.1249/mss.0b013e3180616aa2

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Offices of Disease Prevention and Health Promotion. (n.d.). Moderate to severe functional limitations, older adults, 2007 and 2011: Healthy People 2020. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/national-snapshot/moderate-to-severe-functional-limitations-older-adults-2007

    • Search Google Scholar
    • Export Citation
  • Office of Disease Prevention and Health Promotion. (2008a). Chapter 2—2008 Physical Activity Guidelines—health.gov. Retrieved from https://health.gov/paguidelines/2008/chapter2.aspx

    • Search Google Scholar
    • Export Citation
  • Office of Disease Prevention and Health Promotion. (2008b). Physical Activity Guidelines for Americans. Retrieved from https://health.gov/paguidelines/2008/

    • Search Google Scholar
    • Export Citation
  • Older Adults: Healthy People 2020. (2018, December 3). Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/Older-Adults/objectives#4980

    • Export Citation
  • Paterson, D.H., & Warburton, D.E. (2010). Physical activity and functional limitations in older adults: A systematic review related to Canada’s physical activity guidelines. International Journal of Behavioral Nutrition and Physical Activity, 7, 38. PubMed ID: 20459782 doi:10.1186/1479-5868-7-38

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Physical Activity: Healthy People 2020. (2018, December 3). Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/physical-activity/objectives

    • Export Citation
  • Spiteri, K., Broom, D., Bekhet, A.H., de Caro, J.X., Laventure, B., & Grafton, K. (2019). Barriers and motivators of physical activity participation in middle-aged and older-adults—A systematic review. Journal of Aging and Physical Activity, 180. doi:10.1123/japa.2018-0343

    • Search Google Scholar
    • Export Citation
  • Steeves, J.A., Shiroma, E.J., Conger, S.A., Van Domelen, D., & Harris, T.B. (2019). Physical activity patterns and multimorbidity burden of older adults with different levels of functional status: NHANES 2003–2006. Disability and Health Journal, 12(3), 495502. PubMed ID: 30871954 doi:10.1016/j.dhjo.2019.02.005

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Tak, E., Kuiper, R., Chorus, A., & Hopman-Rock, M. (2013). Prevention of onset and progression of basic ADL disability by physical activity in community dwelling older adults: A meta-analysis. Ageing Research Reviews, 12(1), 329338. PubMed ID: 23063488 doi:10.1016/j.arr.2012.10.001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • US Department of Health and Human Services. (2018). Physical activity guidelines for Americans (2nd ed.). Washington, DC: U.S. Department of Health and Human Services. [PDF file]. Retrieved from https://health.gov/paguidelines/second-edition/pdf/Physical_Activity_Guidelines_2nd_edition.pdf

    • Search Google Scholar
    • Export Citation
  • Ward, B.W., Clarke, T.C., Nugent, C.N., & Schiller, J.S. (2016). Early release of selected estimates based on data from the 2015 National Health Interview Survey. National Health Interview Survey Early Release Program, 54.

    • Search Google Scholar
    • Export Citation
  • World Health Organization. (2002). Towards a common language for functioning, disability and health, ICF. [PDF file]. Retrieved from https://www.who.int/classifications/icf/icfbeginnersguide.pdf?ua=1

    • Search Google Scholar
    • Export Citation
  • World Health Organization. (2019). Physical Activity. Retrieved from http://www.who.int/dietphysicalactivity/pa/en/

  • Zimmer, Z., & House, J. (2003). Education, income, and functional limitation transitions among American adults: Contrasting onset and progression. International Journal of Epidemiology, 32(6), 10891097. PubMed ID: 14681281 doi:10.1093/ije/dyg254

    • Crossref
    • Search Google Scholar
    • Export Citation
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