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Christopher J. Dondzila, Keith P. Gennuso, Ann M. Swartz, Sergey Tarima, Elizabeth K. Lenz, Stephanie S. Stein, Randal J. Kohl and Scott J. Strath

The aim of this study was to examine the dose-response relationship between walking activity and physical function (PF) in community-dwelling older adults. Physical activity (PA, pedometry) and PF (self-report [SF-36] and 6-minute walk test [6MWT]) were assessed in 836 individuals. Accumulated PA was categorized into four groups (1 = ≤ 2,500; 2 = 2,501–5,000; 3 = 5,001–7,500; and 4 = ≥ 7,501 steps/day). Across individual groups 1–4, SF-36 scores increased from 66.9 ± 25.0% to 73.5 ± 23.2% to 78.8 ± 19.7% to 81.3 ± 20.6%, and 6MWT increased from 941.7 ± 265.4 ft to 1,154.1 ± 248.2 ft to 1,260.1 ± 226.3 ft to 1,294.0 ± 257.9 ft. Both SF-36 and 6MWT scores were statistically different across all groups, apart from groups 3 and 4. PA and ranks of groups were highly significant predictors (p < .0001) for both SF-36 and 6MWT. There was a positive dose-response relationship evident for both SF-36 and 6MWT with increasing levels of PA. Low levels of PA appear to be an important indicator of poor functionality in older adults.

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Zakkoyya H. Lewis, Kyriakos S. Markides, Kenneth J. Ottenbacher and Soham Al Snih

We investigated the relationship between physical activity and physical function on the risk of falls over time in a cohort of Mexican-American adults aged 75 and older from the Hispanic Established Population for the Epidemiologic Study of the Elderly (H-EPESE). Participants were divided into four groups according to their level of physical activity and physical function: low physical activity and low physical function (n = 453); low physical activity and high physical function (n = 54); high physical activity and low physical function (n = 307); and high physical activity and high physical function (n = 197). Using generalized linear equation estimation, we showed that participants with high physical activity and low physical function had a greater fall risk over time, followed by the high physical activity and high physical function group. Participants seldom took part in activities that improve physical function. To prevent falls, modifications to physical activity should be made for older Mexican Americans.

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Sarah Roberts, Elizabeth Awick, Jason T. Fanning, Diane Ehlers, Robert W. Motl and Edward McAuley

Previous evidence suggests physical activity interventions effectively produce short-term improvements in physical function for older adults. The present study examined whether improvements in physical function after a DVD-delivered exercise intervention were maintained 18 months postintervention. Older adults (n = 153) randomized to a 6-month DVD-delivered exercise intervention or an attentional control condition were contacted 18 months postintervention. Participants completed the Short Physical Performance Battery (SPPB) and measures of flexibility, strength, and functional limitations were taken. Analyses of variance were conducted to determine if improvements in physical function as a result of the intervention were maintained at follow-up. Improvements in the SPPB, F (1,125) = 3.70, p = .06, η2 = .03, and upper body strength, F (1,121) = 3.04, p = .08, η2 = .03 were maintained for the intervention condition. Home-based DVD exercise training interventions may hold promise for long-term maintenance of physical function in older adults.

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Carolyn J. Murrock and Christine Heifner Graor

This study documented the feasibility and immediate effects of a dance intervention two times per week for 12 weeks on depression, physical function, and disability in older, underserved adults. The one-group, pretest–posttest study had a convenience sample of 40 participants recruited from a federally subsidized apartment complex located in an economically depressed, inner-city neighborhood. Depression, physical function, and disability were measured at baseline and 12 weeks. Average age was 63 years (SD = 7.9), 92% were female, and 75% were African American. At baseline, participants reported increased depression (M = 20.0, SD = 12.4), decreased physical function (M = 56.6, SD = 10.9), and increased disability limitations (M = 65.7, SD = 14.9). At posttest, paired t tests showed that the dance intervention significantly decreased depression, t = 6.11, p < .001, and disability, t = −2.70, p = .014, and significantly increased physical function, t = -2.74, p = .013. The results indicate that the 12-week dance intervention may be an effective adjunct therapy to improve depression, disability, and physical function in underserved adults.

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Elizabeth Chmelo, Barbara Nicklas, Cralen Davis, Gary D. Miller, Claudine Legault and Stephen Messier

Purpose:

To assess correlates of physical activity, and to examine the relationship between physical activity and physical functioning, in 160 older (66 ± 6 years old), overweight/obese (mean body mass index = 33.5 ± 3.8 kg/m2), sedentary (less than 30 mins of activity, 3 days a week) individuals with knee osteoarthritis.

Methods:

Physical activity was measured with accelerometers and by self-report. Physical function was assessed by 6-min walk distance, knee strength, and the Short Physical Performance Battery. Pain and perceived function were measured by questionnaires. Pearson correlations and general linear models were used to analyze the relationships.

Results:

The mean number of steps taken per day was 6209 and the average PAEE was 237 ± 124 kcal/day. Participants engaged in 131 ± 39 minutes of light physical activity (LPA) and 10.6 ± 8.9 minutes of moderate-vigorous physical activity (MPA/VPA). Total steps/day, PAEE, and minutes of MPA/VPA were all negatively correlated with age. The 6-min walk distance and lower extremity function were better in those who had higher total steps/day, higher PAEE, higher minutes of MPA/VPA, and a higher PASE score.

Conclusions:

This study demonstrates that a population who has higher levels of spontaneous activity have better overall physical function than those who engage in less activity.

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John A. Batsis, Cassandra M. Germain, Elizabeth Vásquez, Alicia J. Zbehlik and Stephen J. Bartels

Objectives:

Physical activity reduces mobility impairments in elders. We examined the association of physical activity on risk of subjective and objective physical function in adults with and at risk for osteoarthritis (OA).

Methods:

Adults aged ≥ 60 years from the longitudinal Osteoarthritis Initiative, a prospective observational study of knee OA, were classified by sex-specific quartiles of Physical Activity Score for the Elderly scores. Using linear mixed models, we assessed 6-year data on self-reported health, gait speed, Late-Life Function and Disability Index (LLFDI) and chair stand.

Results:

Of 2252 subjects, mean age ranged from 66 to 70 years. Within each quartile, physical component (PCS) of the Short Form-12 and gait speed decreased from baseline to follow-up in both sexes (all P < .001), yet the overall changes across PASE quartiles between these 2 time points were no different (P = .40 and .69, males and females, respectively). Decline in PCS occurred in the younger age group, but rates of change between quartiles over time were no different in any outcomes in either sex. LLFDI scores declined in the 70+ age group. Adjusting for knee extensor strength reduced the strength of association.

Conclusions:

Higher physical activity is associated with maintained physical function and is mediated by muscle strength, highlighting the importance of encouraging physical activity in older adults with and at risk for OA.

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Edward W. Gregg, Andrea M. Kriska, Kathleen M. Fox and Jane A. Cauley

Self-rated health has been related to functional status, disability, and mortality in a variety of populations. This study examined whether self-rated health was related to physical activity levels independent of functional status in a population of older women. For this study, 9,704 women aged 65-99 rated their health on a scale ranging from excellent to very poor. Physical activity and functional status questionnaires and physical function tests were administered to evaluate levels of physical activity, strength, and function. Comparisons between women in three groups of self-rated health (good and excellent; fair; poor and very poor) indicated that higher self-rated health was strongly related to physical activity independent of physical strength, functional status, and co-morbidity. These findings suggest that physical activity is an important determinant of self-rated health in older women regardless of functional status.

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Anne O. Brady, Chad R. Straight and Ellen M. Evans

The aging process leads to adverse changes in body composition (increases in fat mass and decreases in skeletal muscle mass), declines in physical function (PF), and ultimately increased risk for disability and loss of independence. Specific components of body composition or muscle capacity (strength and power) may be useful in predicting PF; however, findings have been mixed regarding the most salient predictor of PF. The development of a conceptual model potentially aids in understanding the interrelated factors contributing to PF with the factors of interest being physical activity, body composition, and muscle capacity. This article also highlights sex differences in these domains. Finally, factors known to affect PF, such as sleep, depression, fatigue, and self-efficacy, are discussed. Development of a comprehensive conceptual model is needed to better characterize the most salient factors contributing to PF and to subsequently inform the development of interventions to reduce physical disability in older adults.

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Jenni Kulmala, Tiia Ngandu, Satu Pajala, Jenni Lehtisalo, Esko Levälahti, Riitta Antikainen, Tiina Laatikainen, Heikki Oksa, Markku Peltonen, Rainer Rauramaa, Hilkka Soininen, Timo Strandberg, Jaakko Tuomilehto and Miia Kivipelto

Background:

Physical activity (PA) has beneficial effects on older age physical functioning, but longitudinal studies with follow-ups extending up to decades are few. We investigated the association between leisure-time PA (LTPA) and occupational PA (OPA) from early to late adulthood in relation to later life performance-based physical functioning.

Methods:

The study involved 1260 people aged 60 to 79 years who took part in assessments of physical functioning (Short Physical Performance Battery [SPPB] test, 10-m maximal walking test, and grip strength test). Participants’ data on earlier life LTPA/OPA (age range 25 to 74 years) were received from the previous studies (average follow-up 13.4 years). Logistic, linear, and censored regression models were used to assess the associations between LTPA/OPA earlier in life and subsequent physical functioning.

Results:

A high level of LTPA earlier in life was associated with a lower risk of having difficulties on the SPPB test (odds ratio [OR]: 0.37; 95% confidence interval [CI], 0.24–0.58) and especially on the chair rise test (OR: 0.42; 95% CI, 0.27–0.64) in old age. Heavy manual work predicted difficulties on SPPB (OR: 1.91; 95% CI, 1.22–2.98) and the chair rise test (OR: 1.75; 95% CI, 1.14–2.69) and poorer walking speed (β = .10, P = .005).

Conclusions:

This study highlights the importance of LTPA on later life functioning, but also indicates the inverse effects that may be caused by heavy manual work.

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Osarhiemen A. Omwanghe, Devin S. Muntz, Soyang Kwon, Simone Montgomery, Opeyemi Kemiki, Lewis L. Hsu, Alexis A. Thompson and Robert I. Liem

Purpose:

Sickle cell disease (SCD) significantly affects physical functioning. We examined physical activity (PA) patterns in children with SCD versus a national sample and factors associated with PA and participation in physical education and organized sports.

Method:

One hundred children with SCD completed a 58-item survey with questions from the 2009–2010 National Health and Nutrition Examination Survey (NHANES) Physical Activity Questionnaire and others on physical education and sports, disease impact, and physical functioning.

Results:

Compared with NHANES participants, more children with SCD (67 vs 42%, p < .01) reported doing at least 10 min of moderate-to-vigorous intensity PA (MVPA)/week. Children with SCD also reported spending more days in MVPA (2.3 vs. 1.4 days/week, p < .01). However, fewer reported spending ³ 60 min/day in either vigorous PA (VPA) (24 vs. 43%, p = .01) or MVPA (17 vs 23%, p < .01). In addition, 90% and 48% of children with SCD participated in physical education and sports, respectively. Greater disease impact on PA and physical functioning were associated with lower participation.

Conclusion:

Children with SCD are active at moderate to vigorous intensity for shorter durations. Negative personal beliefs about disease impact and poor physical functioning represent barriers to PA in SCD.