Physical activity as a protective factor for dementia and Alzheimer's disease : systematic review, meta-analysis and quality assessment of cohort and case-control studies

Objective Physical activity (PA) is associated with a decreased incidence of dementia, but much of the evidence comes from short follow-ups prone to reverse causation. This meta-analysis investigates the effect of study length on the association. Design A systematic review and meta-analysis. Pooled effect sizes, dose-response analysis and funnel plots were used to synthesise the results. Data sources CINAHL (last search 19 October 2021), PsycInfo, Scopus, PubMed, Web of Science (21 October 2021) and SPORTDiscus (26 October 2021). Eligibility criteria Studies of adults with a prospective follow-up of at least 1 year, a valid cognitive measure or cohort in mid-life at baseline and an estimate of the association between baseline PA and follow-up all-cause dementia, Alzheimer's disease or vascular dementia were included (n=58). Results PA was associated with a decreased risk of all-cause dementia (pooled relative risk 0.80, 95% CI 0.77 to 0.84, n=257 983), Alzheimer's disease (0.86, 95% CI 0.80 to 0.93, n=128 261) and vascular dementia (0.79, 95% CI 0.66 to 0.95, n=33 870), even in longer follow-ups (>= 20 years) for all-cause dementia and Alzheimer's disease. Neither baseline age, follow-up length nor study quality significantly moderated the associations. Dose-response meta-analyses revealed significant linear, spline and quadratic trends within estimates for all-cause dementia incidence, but only a significant spline trend for Alzheimer's disease. Funnel plots showed possible publication bias for all-cause dementia and Alzheimer's disease. Conclusion PA was associated with lower incidence of all-cause dementia and Alzheimer's disease, even in longer follow-ups, supporting PA as a modifiable protective lifestyle factor, even after reducing the effects of reverse causation.Peer reviewe

Predicting change in middle school students’ leisure‐time physical activity participation: A prospective test of the trans‐contextual model

© 2020 The Authors. Journal of Applied Social Psychology published by Wiley Periodicals LLC We applied the trans-contextual model (TCM) to examine the effects of middle school students’ perceived autonomy support from their physical education (PE) teachers on autonomous motivation toward PE in school and, critically, autonomous motivation toward, and actual participation in, leisure-time physical activity (PA). The research adopted a three-wave prospective design enabling the modeling of change in the TCM constructs over time. Middle school students (N=248) aged from 12 to 16years reported their perceived autonomy support, autonomous motivation in PE, autonomous motivation toward leisure-time PA, attitudes, subjective norms, perceived behavioral control (PBC), intentions for PA in leisure-time, and leisure-time PA participation. The psychological constructs and leisure-time PA were measured at baseline (T0) and at a first follow-up occasion (T1) 5weeks later. Another measure of PA was taken at a second follow-up occasion (T2) a further 5weeks later. A single-indicator structural equation model using residualized change scores revealed that perceived autonomy support predicted autonomous motivation in PE (β=.345), and autonomous motivation in PE predicted autonomous motivation for leisure-time PA (β=.484). Autonomous motivation toward leisure-time PA predicted attitudes (β=.425), subjective norms (β=.264), and PBC (β=.517). Autonomous motivation toward leisure-time PA (β=.376), attitude (β=.231), and subjective norms (β=.185) predicted intentions toward leisure-time PA, and intentions predicted PA (β=.198). Findings extend research on the TCM by demonstrating its efficacy in predicting change in middle school students’ autonomous motivation across PE and leisure-time contexts, and accounting for change in intentions toward, and actual participation in, leisure-time PA

Using physical education to promote out-of school physical activity in lower secondary school students – a randomized controlled trial protocol

Background Given the documented decline in levels of physical activity in early adolescence, promoting physical activity in young people is a priority for health promotion. School physical education (PE) is an important existing network in which participation in physical activity beyond school can be promoted to the captive young people. The objective of current article is to present the protocol for a PE teacher-delivered theory-based trial to promote secondary school students’ participation in physical activity out-of-school contexts. The intervention will be guided by the trans-contextual model explaining the processes by which PE teachers’ support for autonomous motivation in the classroom promotes students’ motivation to engage in out-of-school physical activity. We hypothesize that school students receiving the teacher-delivered intervention to promote autonomous motivation toward physical activity will exhibit greater participation in physical activities outside of school, relative to students receiving a control intervention. Methods The trial will adopt a waitlist-control design with cluster-randomization by school. PE teachers assigned to the intervention condition will receive a two-week, 12-h training program comprising basic information on how to promote out-of-school physical activity and theory-based training on strategies to promote students’ autonomous motivation toward physical activity. Teachers assigned to the waitlist control condition will receive an alternative training on how to monitor physical functional capacity in children with special needs. PE teachers (n = 29) from eleven schools will apply the intervention program to students (n = 502) in PE classes for one month. Physical activity participation, the primary outcome variable, and psychological mediators from the trans-contextual model will be measured at pre-trial, post-trial, and at one-, three- and six-months post-trial. We will also assess teachers’ autonomy-supportive techniques and behaviours by observation. Discussion The study will make a unique contribution to the literature by testing a theory-based intervention delivered by PE teachers to promote school students’ participation in out-of-school physical activity. Information will be useful for educators, community stakeholders and policy makers interested in developing programs to promote students’ out-of-school physical activity.Peer reviewe

Trait Self‐Control, Social Cognition Constructs, and Intentions : Correlational Evidence for Mediation and Moderation Effects in Diverse Health Behaviours

Background We examined effects of trait self‐control, constructs from social cognition theories, and intentions on health behaviours. Trait self‐control was expected to predict health behaviour indirectly through theory constructs and intentions. Trait self‐control was also predicted to moderate the intention–behaviour relationship. Methods Proposed effects were tested in six datasets for ten health‐related behaviours from studies adopting prospective designs. Participants (N = 3,249) completed measures of constructs from social cognition theories and self‐control at an initial time point and self‐reported their behaviour at follow‐up. Results Results revealed indirect effects of self‐control on behaviour through social cognition constructs and intentions for eight behaviours: eating fruit and vegetables, avoiding fast food, dietary restrictions, binge drinking, physical activity, walking, out‐of‐school physical activity, and pre‐drinking. Self‐control moderated the intention–behaviour relationship in four behaviours: dietary restriction, and alcohol‐related behaviours. Conclusions Mediation effects suggest that individuals with high self‐control are more likely to hold beliefs and intentions to participate in future health behaviour, and more likely to act. Moderation effects indicate that individuals with high self‐control are more likely to enact healthy intentions and inhibit unhealthy intentions, but findings were restricted to few behaviours. Training self‐control and managing contingencies that derail goal‐directed action may be effective intervention strategies.Peer reviewe

Testing a physical education-delivered autonomy supportive intervention to promote leisure-time physical activity in lower secondary school students : the PETALS trial

BackgroundInadequate physical activity in young people is associated with several physical and mental health concerns. Physical education (PE) is a potentially viable existing network for promoting physical activity in this population. However, little research has been conducted on whether PE teachers can influence students' engagement in leisure-time physical activity. The present study therefore examined the efficacy of an intervention aimed at increasing PE teachers' autonomy support on students' leisure-time physical activity (the PETALS trial). The intervention was guided by the trans-contextual model (TCM) explaining the processes by which PE teachers' provision of autonomy support during PE promotes students' motivation and engagement in physical activity in their leisure time.MethodsThe study adopted a cluster-randomized, waitlist control intervention design with randomization by school. Participants were PE teachers (N=29, 44.83%female; M age=42.83, SD=9.53yrs) and their lower secondary school students (N=502, 43.82%female; M age=14.52, SD=0.71yrs). We measured TCM constructs, including perceived autonomy support, autonomous motivation in PE and leisure time, beliefs and intentions towards leisure-time physical activity, and physical activity behavior at baseline, post-intervention, and at one-, three-, and six-months. Study hypotheses were tested through a series of ANOVAs and structural equation models using post-intervention and one-month follow-up data.ResultsWe found no changes in TCM constructs or physical activity behavior in either group at post-intervention or at 1 month. Path analyses supported two propositions of the TCM as change variables: perceived autonomy support had a significant effect on autonomous motivation in PE and autonomous motivation in PE had a significant effect on autonomous motivation in leisure time. Although we found a direct effect of autonomous motivation in leisure time on physical activity, we did not find support for the third premise of the TCM that autonomous motivation in leisure time indirectly affects physical activity through beliefs and intentions.ConclusionsCurrent findings did not support the efficacy of the PETALS intervention at changing physical activity behavior and TCM constructs. More research is required to determine whether the TCM predictive validity is supported when other model variables are manipulated through experimental and intervention studies.Trial registrationISRCTN, ISRCTN39374060. Registered 19 July 2018. Prospectively registered.Peer reviewe

Predictors of school students’ leisure-time physical activity : An extended trans-contextual model using Bayesian path analysis

The present study aimed to examine effects of motivational and social cognition constructs on children’s leisure-time physical activity participation alongside constructs representing implicit processes using an extended trans-contextual model. The study adopted a correlational prospective design. Secondary-school students (N = 502) completed self-report measures of perceived autonomy support from physical education (PE) teachers, autonomous motivation in PE and leisure-time contexts, and social cognition constructs (attitudes, subjective norms, perceived behavioral control), intentions, trait self-control, habits, and past behavior in a leisure-time physical activity context. Five weeks later, students (N = 298) self-reported their leisure-time physical activity participation. Bayesian path analyses supported two key premises of the model: perceived autonomy support was related to autonomous motivation in PE, and autonomous motivation in PE was related to autonomous motivation in leisure time. Indirect effects indicated that both forms of autonomous motivation were related to social cognition constructs and intentions. However, intention was not related to leisure-time physical activity participation, so model variables reflecting motivational processes did not account for substantive variance in physical activity participation. Self-control, attitudes, and past behavior were direct predictors of intentions and leisure-time physical activity participation. There were indirect effects of autonomous motivation in leisure time on intentions and physical activity participation mediated by self-control. Specifying informative priors for key model relations using Bayesian analysis yielded greater precision for some model effects. Findings raise some questions on the predictive validity of constructs from the original trans-contextual model in the current sample, but highlight the value of extending the model to incorporate additional constructs representing non-conscious processes.Peer reviewe

Predicting Adolescents’ Physical Activity Intentions : Testing an Integrated Social Cognition Model

Background: Few adolescents meet guideline levels of physical activity associated with good health, highlighting the need for intervention. Interventions promoting adolescents’ physical activity should be guided by research applying behavioral theory to identify potentially modifiable correlates and associated processes. We applied an integrated social cognition model to identify theory-based constructs and processes that relate to physical activity intentions in a secondary analysis of two samples of Finnish adolescents using a correlational design. Method: Participants in the first sample (n = 455) completed self-report measures of social cognition constructs from theory of planned behavior, habit, self-discipline, and past and current physical activities. Participants in the second sample (n = 3878) completed identical measures plus measures of socio-structural and socio-environmental factors. Participants from the first sample also wore accelerometers for 1 week. Hypothesized model effects were tested using variance-based structural equation modeling in data from the first sample and subsequently confirmed in a pre-registered analysis of data from the second sample. Results: Across both samples, habit, attitude, perceived behavioral control, and self-reported past behavior were associated with physical activity intention. Effects of self-reported past physical activity on intention were partially mediated by social cognition constructs. Effects of accelerometer-based physical activity were small by comparison. Effects of socio-structural and socio-environmental factors on intention in the second sample were partially mediated by the social cognition constructs. Conclusion: Results corroborate beliefs and habit as consistent correlates of adolescents’ physical activity intentions and provide preliminary evidence that social cognition constructs account for effects of socio-structural and socio-environmental factors on intentions.publishedVersionPeer reviewe

A web-based physical activity promotion intervention for inactive parent-child dyads: Protocol for a randomized controlled trial

Background: Low levels of physical activity are associated with numerous adverse health outcomes, yet sedentary lifestyles are common among both children and adults. Physical activity levels tend to decline steeply among children aged between 8 and 12 years, even though children's behavioral patterns are largely governed by familial structures. Similarly, parents' activity levels have been generally reported as lower than those of nonparents of comparable age. For this reason, family-based physical activity promotion interventions are a potentially valuable and relatively underresearched method for mitigating physical activity declines as children develop into adolescents and for increasing physical activity in parents. Objective: This study aims to assess the efficacy, feasibility, and acceptability of a novel theory-based web-based physical activity promotion intervention among parent-child dyads in Finland who do not meet physical activity recommendations at baseline. Methods: Participants (target N=254) will be recruited from the general population using a panel company and advertisements on social media and randomly assigned to either an immediate intervention group or a waitlist control group. The intervention consists of 4 web-based group workshops over the course of 10 weeks, web-based tasks and resources, and a social support chat group. Data on physical activity behavior and constructs from the integrated behavior change model will be collected through self-report surveys assessing physical activity, autonomy support, autonomous motivation, attitude, subjective norm, perceived behavioral control, intention, self-monitoring, habit, and accelerometer measurements at baseline, post intervention, and 3 months post intervention. Exit interviews with participants will assess the feasibility and acceptability of the intervention procedures. Results: This study will reveal whether the intervention changes leisure-time physical activity among intervention participants relative to the control group and will examine the intervention's effects on important theoretical predictors of physical activity. It will also yield data that can be used to refine intervention materials and inform further implementation. Trial recruitment commenced in September 2023, and data collection should be completed by December 2024. Conclusions: The planned intervention has potential implications for both theory and practice. Practically, the use of an entirely web-based intervention may have scalable future uses for improving physical activity in 2 key populations, while also potentially informing on the value of dyadic, family-based strategies for encouraging an active lifestyle as an alternative to strategies that target either parents or children independently. Further, by assessing change in psychological constructs alongside potential change in behavior, the intervention also allows for important tests of theory regarding which constructs are most linked to favorable behavior change outcomes

Lukemisen ja aritmetiikan sujuvuuden kehittyminen toisen koululuokan aikana

Tutkimuksessa tarkasteltiin lukemisen ja aritmetiikan sujuvuutta ja niiden kehitystä toisen koululuokan aikana kolmena ajankohtana (lukukauden alussa, keskellä ja lopussa). Lukemisen sujuvuuden kehitys oli edistyvää niin sujuvilla kuin sujumattomillakin lukijoilla. Sen sijaan yhteen- ja vähennyslaskutaidon sujuvuudessa ei tapahtunut juurikaan kehitystä sujumattomilla laskijoilla, toisin kuin sujuvilla laskijoilla, joiden kehitys oli edistyvää lukukauden aikana. Tulokset tukevat oletusta aritmetiikan taitojen kehityksen Matteusvaikutuksesta, eli siitä, että lähtötasoltaan aritmetiikassa sujumattomien kehitys jää jälkeen lähtötasoltaan sujuvien laskijoiden kehityksestä. Lukutaidon taso ei sen sijaan vaikuttanut sen kehitykseen toisella koululuokalla. Lukemisen ja aritmetiikan sujuvuuden vaihtelua luonnehti pääsääntöisesti yleinen tasoero – sujuvat lukijat olivat useimmiten myös sujuvia laskijoita ja sujumattomat lukijat sujumattomia laskijoita. Osalle lapsista lukemisen ja laskemisen sujuvuudelle oli kuitenkin luonteenomaista tasoerot niiden välillä. Tilastollisesti sujumaton lukeminen oli yhteydessä keskimääräistä sujumattomampaan aritmetiikkaan; samoin sujumattomuus aritmetiikassa oli yhteydessä keskimääräistä sujumattomampaan lukemiseen. Ero sujuvuuden taitojen kehityksessä lukemisessa ja aritmetiikassa taidoiltaan heikommilla saattaa heijastella eroja taitojen kognitiivisten edellytysten ja vaatimusten välillä. Toinen mahdollinen selitys taitoalueiden kehityksen eroille on, etteivät oppimisen ongelmat aritmetiikassa tule koulumaailmassa samalla tavoin huomioiduksi kuin oppimisen ongelmat lukemisessa. Aritmetiikan kuntouttamisen ja erityisopetuksen toimivista käytänteistä ei ole myöskään yhtä paljon tutkittua tietoa ja käytännön kokemusta kuin lukemisen kohdalla. Lukemisen sujuvuuden kehityksellä ja laskemisen sujuvuuden kehityksellä ei ollut eroja sukupuolten välillä. Sen sijaan tyttöjen taso oli keskimäärin poikia parempi luonnollisen kielen lukemista vaativissa tehtävissä, mutta ei merkityksettömien tavujen ja sanojen lukemisessa. Aritmetiikan sujuvuudessa ei ollut tasoeroja sukupuolten välillä