Physical activity and exercise among older adults - The Generation 100 study

SAMMENDRAG: De fleste land i verden vil fram mot år 2050 oppleve en demografisk endring, der andelen eldre personer vil øke sterkt. Denne demografiske endringen er forventet å øke helserelaterte kostnader, både fra et samfunnsøkonomisk perspektiv og for den enkelte. Fysisk aktivitet har vist seg å være en nøkkelfaktor for forebygging av livsstilsrelaterte sykdommer, men det er mindre forskning på fysisk aktivitet blant eldre enn i resten av befolkningen. I tillegg så finnes det få langvarige, randomiserte treningsstudier med friske eldre. Avhandlingen bygger på tre forskningsartikler. Artikkel 1 hadde som mål å beskrive design, metode og initiering av en randomisert kontrollert studie, Generasjon 100, som evaluerer effekten av langvarig trening på helse, levealder og fysisk aktivitetsnivå hos eldre. Artikkel 2 hadde som mål å beskrive det fysiske aktivitetsnivået blant eldre voksne, ved hjelp av både relative- og absolutte intensitetsgrenser for akselerometer. Artikkel 3 hadde som mål å øke kunnskapen om bakgrunnsfaktorer som er assosiert med akselerometer-målt fysisk aktivitet blant eldre. Generasjon 100 er beskrevet i detalj i artikkel 1. Den startet opp i år 2012 og vil pågå fram til 2018. Studien inkluderte 1567 personer i alderen 70-77 år, alle bosatt i Trondheim kommune. Deltakerne gjennomgikk undersøkelser, deriblant måling av fysisk aktivitetsnivå og kondisjon (maksimalt oksygenopptak). De fylte også ut spørreskjema. Undersøkelsene gjentas etter 1-, 3- og 5 år av studien. Deltakerne ble tilfeldig trukket ut til en kontrollgruppe eller til en gruppe som trener utholdenhet med enten moderat- eller høy intensitet, to ganger per uke. Resultatene fra artikkel 2 viste at aktivitetsnivået blant 1219 norske eldre var høyere enn i andre land, men svært likt som i en norsk nasjonal kartlegging fra 2008-2009. Kvinner hadde et høyere totalt aktivitetsnivå, og brukte mer tid i høyere relative intensiteter, sammenlignet med menn. Totalt aktivitetsnivå og tid i nær-maksimal intensitet avtok med økende alder. Eldre personer med god kondisjon var mer fysisk aktive enn de med lav- og middels kondisjon. Vi fant at relative intensitetsgrenser, justert for kjønn og kondisjon, resulterte i at en høyere andel (79 %) eldre oppfylte myndighetenes anbefalinger for fysisk aktivitet, sammenlignet med bruk av en tradisjonell absolutt intensitetsgrense (29 %). Resultatene fra artikkel 3 viste at 9 av 14 bakgrunnsfaktorer var med og forklarte 27 % av variansen i totalt aktivitetsnivå blant 850 eldre. Aktivitetsnivået var assosiert med demografiske, miljømessige og biologiske faktorer. Kondisjon, kjønn og årstid var faktorene som sterkest assosierte med totalt fysisk aktivitetsnivå. Studien er, så langt vi vet, den største studien av bakgrunnsfaktorer for fysisk aktivitet blant eldre som har kombinert akselerometermålinger og direkte målt maksimalt oksygenopptak

Are older adults physically active enough - a matter of assessment method? The generation 100 study

Introduction Physical activity (PA) is beneficial for general health. As a result, adults around the world are recommended to undertake regular PA of either absolute or relative intensity. Traditionally, adherence to PA recommendation is assessed by accelerometers that record absolute intensity thresholds. Since ageing often results in a decrease in cardiorespiratory fitness (CRF), older adults (aged > 65 years) might be more susceptible to not meeting the PA recommendation when measured in absolute terms. The aim of the present study was to compare the adherence to the PA recommendation using both absolute and relative thresholds. Additionally, we aimed to report the reference values for overall PA in a large sample of Norwegian older adults. Methods PA was assessed for 7 days using the Actigraph GT3X+ accelerometer in 1219 older adults (624 females) aged 70-77 years. Overall PA was measured as counts per minute (CPM) and steps. Absolute and relative moderate-to-vigorous PA (MVPA) thresholds were applied to quantify adherence to PA recommendation. The relative MVPA thresholds were developed specifically for the Generation 100 population sample. CRF was directly measured as peak oxygen uptake (VO2peak ). Results Proportions meeting PA recommendation were 29% and 71% when utilizing absolute and relative MVPA, respectively. More females met the relative PA recommendation compared to males. Overall PA was higher among the youngest age group. Older adults with medium-and high levels of CRF were more physically active, compared to those with the lowest levels of CRF. Conclusion This is the first study to compare adherence to PA recommendation, using absolute and relative intensity thresholds among older adults. The present study clearly illustrates the consequences of using different methodological approaches to surveillance of PA across age, gender and CRF in a population of older adults

Correlates of objectively measured physical activity among norwegian older adults: The Generation 100 Study

The aim of this study was to identify how demographics, physical activity (PA) history, and environmental and biological correlates are associated with objectively measured PA among older adults. PA was assessed objectively in 850 older adults (70–77 years, 48% females) using the ActiGraph GT3X+ activity monitor. Hierarchical multiple regression analysis was used to identify important PA correlates. The included correlates explained 27.0% of the variance in older adult’s PA. Cardiorespiratory fitness (CRF), gender, and season were the most important correlates, explaining 10.1%, 3.9%, and 2.7% of the variance, respectively. PA was positively associated with CRF, females were more physically active than males, and PA increased in warmer months compared with colder months. This is, to our knowledge, the largest study of PA correlates in older adults that has combined objectively measured PA and CRF. Our findings provide new knowledge about how different correlates are associated with PA

Do weather changes influence physical activity level among older adults? – The Generation 100 study

Introduction Understanding how individual and environmental factors impact physical activity (PA) level is important when building strategies to improve PA of older adults. No studies have examined how hour-to-hour weather changes influence PA in older adults or how the association between weather and PA eventually is related to cardiorespiratory fitness (CRF) measured as peak oxygen uptake. The aim of this study was therefore to examine how hour-to-hour changes in weather effects hour-to-hour PA in a cohort of Norwegian older adults across CRF levels, gender and seasons. Methods PA was assessed objectively in 1219 older adults (70–77 years, 51% females) using the Actigraph GT3X+ accelerometer, and quantified as counts·min-1 (CPM). Weather (Norwegian meteorological Institute) and CRF (MetaMax II) were measured objectively. Panel data analysis added a longitudinal dimension when 110.888 hours of weather- and PA data were analyzed. Results Older adults had a higher PA level in warmer (597 CPM) than colder months (556 CPM) (p<0.01). Fixed effects regression-models revealed that increasing temperatures (per hour) influenced PA positively in both colder and warmer months (all, p<0.01), with greater influence in fitter vs. less fit participants (p<0.01). In warmer months, increasing precipitation negatively influenced PA in both unfit females and unfit males (p<0.01). In colder months, increasing precipitation positively influenced PA for moderately fit to fit males (p<0.01), but not for females and unfit males. Conclusion To the best of our knowledge, this is the first study to examine the association between weather conditions and objectively-measured-PA among Norwegian older adults. Our findings demonstrates that unfit older adults will be less likely to participate in PA when the weather is unpleasant, compared to those highly fit. The data suggests that the impact of weather should not be ignored when planning public health strategies for increasing PA among older adults

Do weather changes influence physical activity level among older adults? - The Generation 100 study

Understanding how individual and environmental factors impact physical activity (PA) level is important when building strategies to improve PA of older adults. No studies have examined how hour-to-hour weather changes influence PA in older adults or how the association between weather and PA eventually is related to cardiorespiratory fitness (CRF) measured as peak oxygen uptake. The aim of this study was therefore to examine how hour-to-hour changes in weather effects hour-to-hour PA in a cohort of Norwegian older adults across CRF levels, gender and seasons.PA was assessed objectively in 1219 older adults (70-77 years, 51% females) using the Actigraph GT3X+ accelerometer, and quantified as counts·min-1 (CPM). Weather (Norwegian meteorological Institute) and CRF (MetaMax II) were measured objectively. Panel data analysis added a longitudinal dimension when 110.888 hours of weather- and PA data were analyzed.Older adults had a higher PA level in warmer (597 CPM) than colder months (556 CPM) (

Predictors of dropout in exercise trials in older adults: The Generation 100 Study

Purpose Dropout from exercise programs, both in the real world and in research, is a challenge, and more information on dropout predictors is needed for establishing strategies to increase the likelihood of maintaining participants in a prescribed exercise program. The aim of the present study was to determine the dropout rate and its predictors during a 3-yr exercise program in older adults. Methods In total, 1514 men and women (mean ± SD age = 72.4 ± 1.9 yr) were included in the present study. Participants were randomized to either a supervised exercise intervention or to follow national guidelines for physical activity (PA). Self-reported demographics (e.g., education), general health, morbidity (e.g., heart disease, memory loss, and psychological distress), smoking, and PA were examined at baseline. Cardiorespiratory fitness (CRF) and grip strength were directly measured at baseline. Dropout rate was evaluated after 1 and 3 yr. Multivariate logistic regression analysis was used to identify dropout predictors. Results The total dropout rate was 11.0% (n = 166) after 1 yr and 14.9% (n = 225) after 3 yr. Significant predictors of dropout after 1 yr were low education, low grip strength, lower cardiorespiratory fitness, low PA level, and randomization to supervised exercise. The same predictors of dropout were significant after 3 yr, with reduced memory status as an additional predictor. Conclusion This is the largest study to identify dropout predictors in a long-term exercise program in older adults. Our findings provide new and important knowledge about potential risk factors of dropout in long-term exercise programs in older adults

Exercise patterns in older adults instructed to follow moderate- or high-intensity exercise protocol - the generation 100 study

Background: Making older adults exercise and keeping them in exercise programs is a major challenge. Understanding how older adults prefer to exercise may help developing tailored exercise programs and increase sustained exercise participation in ageing populations. We aimed to describe exercise patterns, including frequency, intensity, type, location and social setting of exercise, in older adults instructed to follow continuous moderate-intensity training (MCT) or high-intensity interval training (HIIT) over a one-year period.Methods: Frequency, intensity, type, location and social setting (alone vs. together with others) of exercise were assessed using exercise logs from 618 older adults (aged 70-77 years) randomized to MCT or HIIT. All participants completed exercise logs after each exercise session they performed during one year. Pearson Chi-square tests were run to assess the association between intensity, type, location and social setting of exercise with training group.Results: Both groups performed 2.2 +/- 1.3 exercise sessions per week during the year. Walking was the most common exercise type in both groups, but MCT had a higher proportion of walking sessions than HIIT (54.2% vs. 41.1%, p < 0.01). Compared to MCT, HIIT had a higher proportion of sessions with cycling (14.2% vs. 9.8%, p < 0.01), combined endurance and resistance training (10.3% vs. 7.5%, p < 0.01), jogging (6.5% vs. 3.2%, p < 0.01) and swimming (2.6% vs. 1.7%, p < 0.01). Outdoors was the most common exercise location in both training groups (67.8 and 59.1% of all sessions in MCT and HIIT, respectively). Compared to MCT, HIIT had a higher proportion of sessions at a gym (21.4% vs. 17.5%, p < 0.01) and sports facility (9.8% vs. 7.6%, p < 0.01). Both groups performed an equal amount of sessions alone and together with others, but women had a higher proportion of sessions together with others compared to men (56% vs. 44%, p < 0.01).Conclusion: This is the first study that has followed older adults instructed to perform MCT or HIIT over a one-year period, collected data from each exercise session they performed and provided important knowledge about their exercise patterns. This novel information may help researchers and clinicians to develop tailored exercise programs in an ageing population

Exercise patterns in older adults instructed to follow moderate- or high-intensity exercise protocol - the generation 100 study

Background Making older adults exercise and keeping them in exercise programs is a major challenge. Understanding how older adults prefer to exercise may help developing tailored exercise programs and increase sustained exercise participation in ageing populations. We aimed to describe exercise patterns, including frequency, intensity, type, location and social setting of exercise, in older adults instructed to follow continuous moderate-intensity training (MCT) or high-intensity interval training (HIIT) over a one-year period. Methods Frequency, intensity, type, location and social setting (alone vs. together with others) of exercise were assessed using exercise logs from 618 older adults (aged 70–77 years) randomized to MCT or HIIT. All participants completed exercise logs after each exercise session they performed during one year. Pearson Chi-square tests were run to assess the association between intensity, type, location and social setting of exercise with training group. Results Both groups performed 2.2 ± 1.3 exercise sessions per week during the year. Walking was the most common exercise type in both groups, but MCT had a higher proportion of walking sessions than HIIT (54.2% vs. 41.1%, p < 0.01). Compared to MCT, HIIT had a higher proportion of sessions with cycling (14.2% vs. 9.8%, p < 0.01), combined endurance and resistance training (10.3% vs. 7.5%, p < 0.01), jogging (6.5% vs. 3.2%, p < 0.01) and swimming (2.6% vs. 1.7%, p < 0.01). Outdoors was the most common exercise location in both training groups (67.8 and 59.1% of all sessions in MCT and HIIT, respectively). Compared to MCT, HIIT had a higher proportion of sessions at a gym (21.4% vs. 17.5%, p < 0.01) and sports facility (9.8% vs. 7.6%, p < 0.01). Both groups performed an equal amount of sessions alone and together with others, but women had a higher proportion of sessions together with others compared to men (56% vs. 44%, p < 0.01). Conclusion This is the first study that has followed older adults instructed to perform MCT or HIIT over a one-year period, collected data from each exercise session they performed and provided important knowledge about their exercise patterns. This novel information may help researchers and clinicians to develop tailored exercise programs in an ageing population

Overall physical activity, measured in CPM and steps.

<p>Overall physical activity, measured in CPM and steps.</p