There's More than Meets the Eye: Complex Associations of Daily Pain, Physical Symptoms, and Self-Efficacy with Activity in Middle and Older Adulthood

Associations Between Social Cognitive Determinants and Movement-Related Behaviors in Studies using Ecological Momentary Assessment Methods: A Systematic Review (Preprint)

BACKGROUND

The social cognitive framework is a long-standing framework within physical activity promotion literature to explain and predict movement-related behaviors. However, applications of the social cognitive framework to explain and predict movement-related behaviors have typically examined the relationships between determinants and behavior across macrotimescales (eg, weeks and months). There is more recent evidence suggesting that movement-related behaviors and their social cognitive determinants (eg, self-efficacy and intentions) change across microtimescales (eg, hours and days). Therefore, efforts have been devoted to examining the relationship between social cognitive determinants and movement-related behaviors across microtimescales. Ecological momentary assessment (EMA) is a growing methodology that can capture movement-related behaviors and social cognitive determinants as they change across microtimescales.

OBJECTIVE

The objective of this systematic review was to summarize evidence from EMA studies examining associations between social cognitive determinants and movement-related behaviors (ie, physical activity and sedentary behavior).

METHODS

Studies were included if they quantitatively tested such an association at the momentary or day level and excluded if they were an active intervention. Using keyword searches, articles were identified across the PubMed, SPORTDiscus, and PsycINFO databases. Articles were first assessed through abstract and title screening followed by full-text review. Each article was screened independently by 2 reviewers. For eligible articles, data regarding study design, associations between social cognitive determinants and movement-related behaviors, and study quality (ie, Methodological Quality Questionnaire and Checklist for Reporting Ecological Momentary Assessment Studies) were extracted. At least 4 articles were required to draw a conclusion regarding the overall associations between a social cognitive determinant and movement-related behavior. For the social cognitive determinants in which a conclusion regarding an overall association could be drawn, 60% of the articles needed to document a similar association (ie, positive, negative, or null) to conclude that the association existed in a particular direction.

RESULTS

A total of 24 articles including 1891 participants were eligible for the review. At the day level, intentions and self-efficacy were positively associated with physical activity. No other associations could be determined because of conflicting findings or the small number of studies investigating associations.

CONCLUSIONS

Future research would benefit from validating EMA assessments of social cognitive determinants and systematically investigating associations across different operationalizations of key constructs. Despite the only recent emergence of EMA to understand social cognitive determinants of movement-related behaviors, the findings indicate that daily intentions and self-efficacy play an important role in regulating physical activity in everyday life.

TRIAL REGISTRATION

PROSPERO CRD42022328500; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=328500.

Evaluating the Consistency of Subjective Activity Assessments and Their Relation to Cognition in Older Adults

(1) Background: Research examining whether activity engagement is related to cognitive functioning in older adults has been limited to using retrospective reports of activity which may be affected by biases. This study compared two measurements (estimated weekly versus reported daily), and whether these activity assessments were related to cognition in older adults; (2) Methods: Participants from US (n = 199) and Australian (n = 170) samples completed a weekly estimate of activity, followed by 7 consecutive days of daily reporting. Differences between weekly estimates and daily reports were found, such that estimations at the weekly level were lower than self-reported daily information. Multivariate multiple regression was used to determine whether total activity, activity domains and the discrepancy between assessment types (i.e., weekly/daily) predicted cognitive performance across three cognitive domains (fluid, verbal, memory); (3) Results: When activity assessments were totaled, neither predicted cognition; however, when activity was grouped by domain (cognitive, social, physical), different domains predicted different cognitive outcomes. Daily reported cognitive activity significantly predicted verbal performance (β = 1.63, p = 0.005), while weekly estimated social activity predicted memory performance (β = −1.81, p = 0.050). Further, while the magnitude of discrepancy in total activity did not significantly predict cognitive performance, domain specific differences did. Differences in physical activity reported across assessments predicted fluid performance (β = −1.16, p = 0.033); (4) Conclusions: The significant discrepancy between the measurement types shows that it is important to recognize potential biases in responding when conducting activity and cognition research.

Studying Within-Person Variation and Within-Person Couplings in Intensive Longitudinal Data: Lessons Learned and to Be Learned

Intensive longitudinal designs (e.g., experience sampling methods, daily diary studies, or ambulatory assessments) continue to gain importance in psychological aging research. Empirical research using these designs has greatly facilitated our understanding of short-term within-person processes and has started to approach the question how these processes shape long-term development across the life span. The aim of this viewpoint article is to point out four key issues in intensive longitudinal designs that in our opinion require more attention than they are currently given: (a) improvement in measurement reliability, (b) the necessity to investigate inter-individual differences in short-term dynamics, (c) considerations of the time scale across which dynamic effects unfold, and (d) targeting causality by incorporating experimental methods in intensive longitudinal designs. We illustrate these four key issues by referring to a prominent example of within-person dynamics in prior empirical research: the within-person coupling of stressor occurrence and well-being (stress reactivity).

Same old, same old? Age differences in the diversity of daily life

Some research suggests that compared with younger adults, older adults have more homogeneous, less diverse daily life experiences because everyday situations and activities become increasingly stable and routine. However, strong empirical tests of this assumption are scarce. In two complementary studies, we examined whether older age is associated with less diversity in daily life experiences (e.g., regarding social interaction partners, activities, and places across and within days) and, if so, to what extent health limitations account for these age differences. In Study 1, we used daily diaries to investigate diversity across days among younger (N = 246; Mage = 21.8 years, SD = 2.5) and older adults (N = 119; Mage = 67.7 years, SD = 5.3). In Study 2, we investigated diversity within days employing experience sampling methods over three weeks in an adult life span sample (N = 365; range = 14-88 years). Results showed that across and within days, the daily lives of older adults were less diverse regarding their social interaction partners. Yet, older adults reported more diversity in activities within days and across days in the afternoons, whereas younger adults reported less diverse activities partly due to working or studying more often. Age differences remained statistically significant when controlling for health limitations. We conclude that age differences in the diversity of daily life are nuanced, depending on the domain and the level of analysis. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Perceived ease of activity (but not strategy use) mediates the relationship between self-efficacy and activity engagement in midlife and older adults

Objectives: Activity participation is associated with a range of positive outcomes in older adults but tends to decline with age. Understanding protective factors is important to facilitate activity in later life. Social cognitive theory suggests that having high self-efficacy may promote activity because individuals with higher self-efficacy perceived their activities to be easier and use adaptive strategies to overcome barriers to activity. Despite considerable research linking self-efficacy and activity, limited research has examined the proposed mechanisms behind this association. This study therefore examined whether perceived ease of activity and use of adaptive strategies account for the association between self-efficacy and activity. Method: Participants were 412 adults aged 50-93 years who completed a cross-sectional survey. Structural equation modelling was used to examine whether the effects of self-efficacy on activity were mediated by perceived ease of activity and use of adaptive strategies. Results: Perceived ease of activity mediated the positive associations between self-efficacy and social (0.04 [0.02, 0.07]) and physical activity (0.16 [0.08, 0.25]), but not mental activity (0.01 [0.000, 0.03]). For physical activity, this effect was stronger for adults aged 70+ years than those aged 50-69 years (older a₂*b₂ - younger a₂*b₂ 0.13 [0.04, 0.24]). Use of adaptive strategies was not a significant mediator in any model. Conclusion: This study suggests that self-efficacy may influence older adults' perception of activities and, in turn, the activities they choose to participate in. This has potential implications for the development of interventions aimed at promoting activity engagement in later life.

Hard Tissue Augmentation of Aged Bone by Means of a Tin-Free PLLA-PCL Co-Polymer Exhibiting in vivo Anergy and Long-Term Structural Stability

BACKGROUND

Due to aging, tissue regeneration gradually declines. Contemporary strategies to promote tissue-specific regeneration, in particular in elderly patients, often include synthetic material apt for implantation primarily aiming at upholding body functions and regaining appropriate anatomical and functional integrity.

OBJECTIVE

Biomaterials suitable for complex reconstruction surgical procedures have to exert high physicochemical stability and biocompatibility.

METHOD

A polymer made of poly-L-lactic acid and poly-ε-caprolactone was synthesized by means of a novel tin-free catalytic process. The material was tested in a bioreactor-assisted perfusion culture and implanted in a sheep model for lateral augmentation of the mandible. Histological and volumetric evaluation was performed 3 and 6 months post-implantation.

RESULTS

After synthesis the material could be further refined by cryogrinding and sintering, thus yielding differently porous scaffolds that exhibited a firm and stable appearance. In perfusion culture, no disintegration was observed for extended periods of up to 7 weeks, while mesenchymal stromal cells readily attached to the material, steadily proliferated, and deposited extracellular calcium. The material was tested in vivo together with autologous bone marrow-derived stromal cells. Up to 6 months post-implantation, the material hardly changed in shape with composition also refraining from foreign body reactions.

CONCLUSION

Given the long-term shape stability in vivo, featuring imperceptible degradation and little scarring as well as exerting good compatibility to cells and surrounding tissues, this novel biomaterial is suitable as a space filler in large anatomical defects.