Health worry, physical activity participation, and walking difficulty among older adults: a mediation analysis

Do Worry and Brooding Predict Health Behaviors? A Daily Diary Investigation

BACKGROUND

Meta-analyses have reported associations between perseverative cognition (both worry and brooding) and increased engagement in health-risk behaviors, poorer sleep, and poorer physiological health outcomes.

METHOD

Using a daily diary design, this study investigated the within- and between-person relationships between state and trait perseverative cognition and health behaviors (eating behavior, physical activity, alcohol consumption, and sleep) both cross-sectionally and prospectively. Participants (n = 273, 93% students, M_age = 20.2, SD = 4.11, 93% female) completed morning and evening diaries across 7 consecutive days.

RESULTS

Multilevel modeling analyses revealed that, cross-sectionally, higher levels of state worry were associated with more time spent sitting and higher levels of state brooding predicted less daily walking.

CONCLUSION

Worry and brooding may represent useful intervention targets for improving inactivity and walking levels, respectively.

Light-Intensity Physical Activity and Cardiometabolic Risk Among Older Adults With Multiple Chronic Conditions

PURPOSE

To assess the relationship between light-intensity physical activity (LIPA) and cardiometabolic risk factors among middle-aged and older adults with multiple chronic conditions.

DESIGN

Cross-sectional design utilizing data from the Health and Retirement Study (2010, 2012).

SETTING

Laboratory- and survey-based testing of a nationally representative sample of community-dwelling middle aged and older adults.

PARTICIPANTS

Adults aged 50 years and older (N = 14 996).

MEASURES

Weighted metabolic equivalent of tasks was calculated using self-reported frequency of light, moderate, and vigorous physical activity. Cardiometabolic risk factors (systolic and diastolic blood pressure, glycosylated hemoglobin [HbA_1c], high-density lipoprotein cholesterol [HDL-C], total cholesterol, and non-HDL-C) were objectively measured. A multiple chronic condition index was based on 8 self-reported chronic conditions.

ANALYSIS

Weighted multivariate linear regression models.

RESULTS

Light-intensity physical activity was independently associated with favorable HDL-C (β = 1.25; 95% confidence interval [CI]: 0.46-2.05) and total cholesterol (β = 2.72; 95% CI: 0.53-4.90) after adjusting for relevant confounders. The HDL-C health benefit was apparent when stratified by number of chronic conditions, for individuals with 2 to 3 conditions (β = 1.73; 95% CI: 0.58-2.89). No significant associations were observed between LIPA and blood pressure, HbA_1c, or non-HDL-C.

CONCLUSIONS

Engaging in LIPA may be an important health promotion activity to manage HDL-C and total cholesterol. Additional longitudinal research is needed to determine the causal association between LIPA and cardiometabolic risk which can potentially inform physical activity guidelines targeting older adults with multiple chronic conditions.

Perseverative Cognition and Health Behaviors: A Systematic Review and Meta-Analysis

Recent developments in stress theory have emphasized the significance of perseverative cognition (worry and rumination) in furthering our understanding of stress-disease relationships. Substantial evidence has shown that perseverative cognition (PC) is associated with somatic outcomes and numerous physiological concomitants have been identified (i.e., cardiovascular, autonomic, and endocrine nervous system activity parameters). However, there has been no synthesis of the evidence regarding the association between PC and health behaviors. This is important given such behaviors may also directly and/or indirectly influence health and disease outcomes (triggered by PC). Therefore, the aim of the current review was to synthesize available studies that have explored the relationship between worry and rumination and health behaviors (health risk: behaviors which, if performed, would be detrimental to health; health promoting: behaviors which, if performed, would be beneficial for health). A systematic review and meta-analyses of the literature were conducted. Studies were included in the review if they reported the association between PC and health behavior. Studies identified in MEDLINE or PsycINFO (k = 7504) were screened, of which 19 studies met the eligibility criteria. Random-effects meta-analyses suggested increased PC was generally associated with increased health risk behaviors but not health promoting behaviors. Further analyses indicated that increases in rumination (r = 0.122), but not reflection (r = −0.080), or worry (r = 0.048) were associated with health risk behaviors. In conclusion, these results showed that increases in PC are associated with increases in health risk behaviors (substance use, alcohol consumption, unhealthy eating, and smoking) that are driven primarily through rumination. These findings provide partial support for our hypothesis that in Brosschot et al.'s (2006) original perseverative cognition hypothesis, there may be scope for additional routes to pathogenic disease via poorer health behaviors.

Evidence to Support Including Lifestyle Light-Intensity Recommendations in Physical Activity Guidelines for Older Adults

Purpose.

The purpose of this study was to examine the association of objectively measured lifestyle light-intensity physical activity (LLPA) and moderate-to-vigorous physical activity (MVPA) with various biological markers and chronic diseases among a nationally representative sample of U.S. older adults (65+ years).

Design.

A cross-sectional design was used for this study.

Setting.

Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2003–2006.

Subjects.

Subjects were 1,496 older U.S. adults.

Measures.

Participants wore an accelerometer for at least 4 days and completed questionnaires to assess sociodemographics and chronic disease information. Blood samples were taken to assess biological markers.

Analysis.

Adjusted Wald tests and Poisson regression were used to examine the association of LLPA and MVPA with biological markers and chronic disease.

Results.

Older adults engaging in ≥300 min/wk of LLPA had lower observed values for body mass index, waist circumference, C-reactive protein, and insulin resistance compared to those engaging in <300 min/wk of LLPA. Additionally, those engaging in <300 min/wk of LLPA had a rate 1.18 times greater for having chronic disease compared to those engaging in ≥300 min/wk of LLPA.

Conclusion.

In this national sample of older U.S. adults, participation in at least 300 min/wk of LLPA was associated with more favorable health outcomes. Future experimental studies are warranted to confirm these findings.

The 2015 C. H. McCloy Lecture: Road Trip Toward More Inclusive Physical Activity: Maps, Mechanics, Detours, and Traveling Companions

This essay stems from the 35th annual C. H. McCloy Research Lecture at the 2015 SHAPE America National Convention & Expo in Seattle, WA. The lecture series has 2 main aims. First, it provides an annual forum for a contemporary scholar to delve deeply into her/his work and to share that work with her/his peers. Second, it is an enduring tribute to the pioneering work and influential career of Charles Henry McCloy (March 30, 1886-September 18, 1959), research professor emeritus at the University of Iowa. This essay is composed of 6 sections: a prologue, a biography of McCloy, my autobiography, the fundamental premises and overarching aims of my work, a summary of my research contributions aimed at promoting inclusive physical activity, and an epilogue. The entire article is built around the construct of maps, mechanics, detours, and traveling companions. Paradigm shifts and insights are unraveled as the work unfolds and becomes increasingly integrated. Rarely does a scholar have the chance to provide a narrative of this nature, and it is hoped that this essay will inspire others to discover their own scholarly pathways and to contextualize and reflect on their contributions for the greater good of the field of kinesiology and society.

Dose response association between physical activity and biological, demographic, and perceptions of health variables

BACKGROUND

Few population-based studies have examined the association between physical activity (PA) and cardiovascular disease risk factors, demographic variables, and perceptions of health status, and we do not have a clear understanding of the dose-response relationship among these variables.

METHODS

Data from the 2003-2006 National Health and Nutrition Examination Survey was used to examine the dose-response relationship between objectively measured PA and metabolic syndrome (and its individual cardiovascular disease risk factors), demographic variables, and perceptions of health. After exclusions, 5,538 participants 18 years or older were included in the present study, with 2,538 participants providing fasting glucose and 2,527 providing fasting triglyceride data. PA was categorized into deciles.

RESULTS

Overall, the health benefits showed a general pattern of increase with each increasing levels of PA. Of the ten PA classifications examined, participants in the highest moderate-to-vigorous physical activity (MVPA) category (at least 71 min/day) had the lowest odds of developing metabolic syndrome.

CONCLUSION

At a minimum, sedentary adults should strive to meet current PA guidelines (i.e., 150 min/week of MVPA), with additional positive benefits associated with engaging in three times this level of PA.

Role of self-efficacy (SE) and anxiety among pre-clinically disabled older adults when using compensatory strategies to complete daily tasks

Classic developmental theory suggests that aging is associated with using compensatory strategies to prolong independence. While compensatory strategies are typically considered positive adaptations, they also signify an early phase in the disablement process - commonly known as pre-clinical disability. To build a better understanding of psychological constructs related to these early signs of disability, we examined the contribution of SE and state anxiety on using compensatory strategies among pre-clinically disabled older adults. Compensatory strategies were observed during performance of daily activities in 257 pre-clinically disabled older adults (67.6 ± 7.04), and SE and state anxiety were evaluated prior to performing each task. In univariate models, lower SE and higher anxiety were associated with more compensation (Spearman correlations: 0.15-0.48, p<0.05). Multivariate logistic regression indicated that low SE [Odds Ratio (OR): 1.70; 95% Confidence Interval (CI): 1.40-2.08) and high anxiety (OR: 1.34; 95% CI: 1.10-1.63) were positively associated with using ≥6 compensatory strategies - a level signifying substantial compensation. When considered jointly with SE, the association with anxiety was reversed - higher anxiety demonstrated a lower likelihood of using compensation (OR: 0.70-0.73; 95% CI: 0.50-0.99). The addition of SE might remove the self-defeating cognitions characterizing anxiety allowing the remaining arousal component to appear beneficial. In conclusion, lower SE and higher anxiety are associated with using compensation to complete daily tasks among pre-clinically disabled older adults. Such psychological constructs may contribute to the use of compensatory strategies and represent future intervention targets to help reduce early signs of disability.

Relationship between beliefs, motivation, and worries about physical activity and physical activity participation in persons with rheumatoid arthritis

OBJECTIVE

To determine the relationship between beliefs, motivation, and worries about physical activity and physical activity participation in persons with rheumatoid arthritis (RA).

METHODS

A cross-sectional study used baseline data from 185 adults with RA enrolled in a randomized clinical trial assessing the effectiveness of an intervention to promote physical activity. Data included patients' self-reported beliefs that physical activity can be beneficial for their disease, motivation for physical activity participation, worries about physical activity participation, and average daily accelerometer counts of activity over a week's time. Body mass index (BMI), sex, age, race, and disease activity were measured as potential statistical moderators of physical activity.

RESULTS

Physical activity participation was greater for those with higher scores on scales measuring beliefs that physical activity is beneficial for their disease (P for trend = 0.032) and motivation for physical activity participation (P for trend = 0.007) when adjusted for age, sex, BMI, race, and disease activity. There was a positive but nonsignificant trend in physical activity participation in relation to worries.

CONCLUSION

Stronger beliefs that physical activity can be helpful for managing disease and increased motivation to engage in physical activity are related to higher levels of physical activity participation. These data provide a preliminary empirical rationale for why interventions targeting these concepts should lead to improved physical activity participation in adults with RA.