Physical activity trajectories during midlife and subsequent risk of physical functioning decline in late mid-life: The Study of Women's Health Across the Nation (SWAN)

Abstract

The purpose of this study was to examine the importance of midlife physical activity on physical functioning in later life. Data are from 1771 Study of Women’s Health Across the Nation (SWAN) participants, aged 42–52 (46.4 ± 2.7) years at baseline (1996–97). Latent class growth analysis was used to identify physical activity trajectory groups using reported sports and exercise index data collected at seven time-points from baseline to Visit 13 (2011–13); objective measures of physical functioning performance were collected at Visit 13. The sports and exercise index (henceforth: physical activity) is a measure of moderate to vigorous intensity physical activity during discretionary periods of the day. Multivariable linear regression analyses were used to model each continuous physical performance measure as a function of the physical activity trajectory class. Across midlife, five physical activity trajectory classes emerged, including: lowest (26.2% of participants), increasing (13.4%), decreasing (22.4%), middle (23.9%), and highest (14.1%) physical activity. After full adjustment, women included in the middle and highest physical activity groups demonstrated ≥5% better physical functioning performance than those who maintained low physical activity levels (all comparisons; p < 0.05). Statistically significant differences were also noted when physical activity trajectory groups were compared to the increasing physical activity group. Results from the current study support health promotion efforts targeting increased (or maintenance of) habitual physical activity in women during midlife to reduce future risk of functional limitations and disability. These findings have important public health and clinical relevance as future generations continue to transition into older adulthood.

Physical Activity Trajectories among Persons of Turkish Descent Living in Germany—A Cohort Study

“…While several studies showed that health-related factors like smoking or high BMI were associated with poor PA outcomes [ 21 , 47 , 48 , 49 , 50 ], the results of our study were not that concise. In our study, only overweight and obesity compared to normal weight subjects had decreased odds for being in the stable active trajectory, whereas smoking or having a cardiovascular risk factor were not associated with the PA trajectory.…”

“…Subsequent multivariable regression analyses revealed that being in the stable active trajectory was predicted by only one of the included socio-demographic factors, namely high education (more than 12 years compared to less than 10 years). This is partially in line with several other studies showing that male sex, lower age, high education, and/or a high household income were predictors for favorable PA trajectories (increasing or persistently active) [ 17 , 21 , 33 , 42 , 43 , 44 ].…”

“…Thus, for a more detailed description of PA over a longer time period and a better understanding of its complexity, prospective trajectories including two or more time points are proposed [ 16 , 17 ]. PA trajectories can then be used to predict future health and physical functioning and are therefore a good measure for PA [ 5 , 9 , 11 , 15 , 18 , 19 , 20 , 21 ]. In addition, the identification of associated factors for specific PA trajectories is important for tailoring prevention efforts.…”

Trajectories of physical activity from midlife to old age and associations with subsequent cardiovascular disease and all-cause mortality

“…Instead, the GBTM trajectories suggest that prior PA dictates PA in old age. This is consistent with some other GBTM studies using continuous measures of PA that have also identified trajectories that do not typically overlap during this life period 25 37 38. In contrast, a recent study among retired adults using retrospectively reported PA showed that trajectories are more changeable across the life course than suggested by the present findings 26.…”

Health cognitions mediate physical (in)activity and walking in midlife women

“…Recent research suggests their sedentary time is also increasing, compounding their risk [5] -daily leisure-time sitting of over 6 versus less than 3 h has been linked to ∼40% higher all-cause death rate, independent of PA [6]. To increase the odds of healthy ageing in this population, research is urgently needed to expand the limited evidence base on key factors to target in developing effective interventions which simultaneously target increased activity and reduced sitting across the menopausal transition [7].…”