Longitudinal changes in physical function and physical activity in older adults

Abstract

Background physical function (PF) and physical activity (PA) both decline as adults age and have been linked to negative outcomes, including dementia, depression and cardiovascular diseases. Although declines in each are associated with numerous negative outcomes, the longitudinal relationship between these two measures is unclear. Objective to examine the dynamic, bidirectional associations between declines in PF and PA. Design prospective cohort. Setting the Monongahela–Youghiogheny Healthy Aging Team (MYHAT) study. Subjects about 1,404 men and women, 76.96 ± 7.2 years, 62.4% female and 95.2% white. Methods over nine annual assessment cycles, PF was evaluated via the timed Up-and-Go task and PA via a self-reported questionnaire. Piecewise latent growth models examined bidirectional associations between PA and PF to determine whether the initial values (intercept) or early slope (cycles 1–5) (in either PF or PA) predicted later slope (cycles 5–9) (in either PF or PA). Results initial PF significantly predicted early (standardised β= −0.10, P < 0.001) and later (standardised β= −0.09, P = 0.01) PA slopes. Initial PA significantly predicted later (standardised β = −0.09, P = 0.04) but not early PF slope. Associations were independent of baseline memory test scores, baseline cognitive status, later cognitive status and age. Early physical function slope neither predicts later PA slope nor did early PA slope predict later PF slope (both P values >0.10). Conclusions the relationship between PF and PA is bidirectional, with PF more consistently predicting declines of PA, both in the short- and long-term. Intervening on PF impairments may improve PA engagement, which could in turn promote PF and translate to beneficial effects on cognitive function, cardiovascular health and mood.

Longitudinal Sex‐Specific Physical Function Trends by Age, Race/Ethnicity, and Weight Status

“…To our knowledge, the present study is the first to examine longitudinal trends and the annual rate of change in physical function, and the prevalence of physical function status by sex, age, race/ethnicity, and weight status, among adults aged 65 years and older using an objective measure of physical function. Similar to previous studies, [15][16][17] this study found that physical function deteriorated steadily with increasing age in both males and females. However, direct comparison of results of previous studies and the present study is challenging as most prior studies were conducted outside the United States, [15][16][17] utilized a relatively homogeneous sample with respect to race/ethnicity (95% whites), 16 or employed different physical function measures.…”

“…However, direct comparison of results of previous studies and the present study is challenging as most prior studies were conducted outside the United States, [15][16][17] utilized a relatively homogeneous sample with respect to race/ethnicity (95% whites), 16 or employed different physical function measures. 16,17 Nonetheless, the findings of the present study indicate that physical function declines with age, regardless of race/ethnicity or weight status. While considering the minimally clinically important difference (≥0.3 points' difference for SPPB), 29 only respondents aged 75 years and older had a meaningful annual SPPB score rate of decline, which suggests aging is a more influential factor than race/ethnicity or weight status for physical function decline.…”

Body composition and changes in health-related quality of life in older age: a 10-year follow-up of the Helsinki Birth Cohort Study

“…On the other hand, it is also possible that an increased fat mass index is a consequence of decline in HRQoL. Older adults who have problems with functioning tend to be less physically active [51], which may, in turn, increase fat mass over time. Nevertheless, we found a prospective association between baseline fat mass index and change in HRQoL, which suggests that at least some of the association is explained by a link directed from fat mass to physical HRQoL.…”

Aging, physical activity, and diabetic complications related to loss of muscle strength in patients with type 2 diabetes

“…The associations between physical inactivity and type 2 diabetes is well known 21) . The relationship between PA and physical function (PF) is bidirectional, with PF more consistently predicting declines of PA 22) . In a sex-specific univariate analysis, KEF was significantly higher in patients who regularly exercised than in patients who did not regularly exercise 23 ) .…”