International Differences in Mortality at Older Ages Dimensions and Sources (2010) / Chapter Skim
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7 The Contribution of Physical Activity to Divergent Trends in Longevity--Andrew Steptoe and Anna Wikman
7 The Contribution of Physical Activity to Divergent Trends in Longevity--Andrew Steptoe and Anna Wikman
Pages 193-216
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From page 193... ...
Objective assessments using accelerometers or pedometers are being used more frequently, but they have yet to be applied to nationally representative samples in comparative studies. These factors conspire against definite conclusions at this point in time concerning the contribution of physical activity to differences in longevity across countries.
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From page 194... ...
BENEFITS OF PHYSICAL ACTIVITY AT OLDER AGES Regular physical activity is thought to be among the most important lifestyle factors for the maintenance of health and prevention of premature disease and mortality. Across developed regions of the world, inactivity ranks alongside tobacco, alcohol, and adiposity as a leading cause of reduced healthy life expectancy (Ezzati et al., 2003)
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From page 195... ...
. A recent longitudinal population study in Australia showed that physical activity was associated with a substantially reduced risk of falls over a 3-5 year period, independent of age, education, TABLE 7-1 Health Benefits of Regular Physical Activity for Older Adults How Physical Activity How Physical Activity How Physical Activity Can Can Improve Physical Can Improve Mental Be Beneficial at Older Ages in Functioning Functioning General • Improves • Enhances emotional • Helps maintain cardiorespiratory fitness well-being independence • Improves glucose • Provides relaxation and • Improves quality of life metabolism and insulin helps lower stress levels • Increases energy sensitivity • Helps maintain • Helps maintain social • Reduces blood pressure cognitive function and connectedness • Improves lipid profiles alertness • Reduces levels of • Helps reduce depression inflammatory markers • Enhances perceptions of • Induces growth factors coping ability • Improves balance • Improves sleep • Improves strength, flexibility and joint mobility (range of motion)
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From page 196... ...
. The Physical Activity Guidelines Advisory Committee concluded that there is a dose-response relationship with fracture risk, so greater physical activity results in greater risk reduction.
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From page 197... ...
(2004) Sedentary behavior is an independent risk factor for middle-aged and older men and women, with those reporting moderate activity having a 20 percent lower risk and those reporting higher activity having approximately a 30 percent lower risk than least active persons.
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From page 198... ...
SOURCE: Adapted from the 2008 Physical Activity Guidelines for Americans. at all -- is potentially relevant to international trends, since health problems associated with physical activity are likely to be most prominent among the sedentary population, not those who are moderately versus highly active.
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From page 199... ...
A number of standardized measures have been developed, such as the Paffenbarger Physical Activity Questionnaire and the Minnesota Leisure Time Physical Activity Questionnaire. Questionnaires designed specifically for older men and women have also been devised, including the Yale Physical Activity Survey for Older Adults, the Physical Activity Scale for the Elderly (PASE)
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From page 200... ...
Several types of measure are available, including doubly labeled water and heart rate monitoring, but the most useful objective method for population studies is motion sensing using accelerometers (Westerterp, 2009)
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From page 201... ...
Fox. Exercise, Nutrition, and Health Sciences, School of Applied and Community Health, Centre for Sport, Exercise & Health, University of Bristol, Tyndall Avenue, Bristol, BS8 1TP, UK.
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One recent study demonstrated that slow walking speed over 6 meters in older people was strongly associated with an increased risk of cardiovascular mortality (Dumurgier et al., 2009) ; those with a walking speed in the lower third of the distribution had about a threefold increased risk of cardiovascular death, but no increased risk of mortality from cancer or other causes of death.
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From page 203... ...
. The data collected using objective measures therefore shows marked differences from self-report in terms of the amount of activity achieved and very poor adherence to national recommendations.
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From page 204... ...
INTERNATIONAL DIFFERENCES IN PHYSICAL ACTIVITY Estimation of the contribution of physical activity to cross-national differences in longevity has to be based on robust estimates of activity in different countries. The previous sections of this chapter indicate that international comparisons are difficult to make.
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From page 205... ...
Table 7-4 summarizes data from a number of international studies of moderate or vigorous self-reported physical activity. The studies vary in the criterion adopted for assessing moderate or vigorous activity, as well as in the age range tested and sample size.
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, and the English Longitudinal Study of Ageing (ELSA)
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From page 207... ...
) Wave 2, English Longitudinal Study of Ageing (ELSA)
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From page 208... ...
) Wave 2, English Longitudinal Study of Ageing (ELSA)
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From page 209... ...
) Wave 2, English Longitudinal Study of Ageing (ELSA)
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From page 210... ...
In order to provide some external validation, a final set of analyses was carried out in which the aggregate estimates of physical activity and inactivity from HRS, ELSA, and SHARE were regressed onto life expectancy at age 50 20 15 Diabetes Preva lence % 10 5 0 0 5 10 15 20 25 Physical Inactivity % FIGURE 7-5 Scatterplot of the association between self-reported diabetes and the proportion of respondents in each country who are inactive. NOTE: Each point represents one Fig7-5.eps country.
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From page 211... ...
Countries with a higher proportion of vigorously or moderately active men age 50 or older had a greater life expectancy at age 50. The association was strongly influenced by results from the Czech Republic, which had the lowest life expectancy and relatively low prevalence of physically active men.
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From page 212... ...
It is plausible, therefore, that variations in physical activity and in sedentary behavior make a contribution to divergent trends in longevity across nations. Cross-national comparisons of objectively measured physical activity will greatly advance knowledge in this area, as will more sophisticated multivariate analyses of time trends in the activity of people in different countries.
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. Slow walking speed and cardiovascular death in well functioning older adults: Prospective cohort study.
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Cochrane Database of Systematic Reiews, CD003054. Physical Activity Guidelines Advisory Committee.
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. Undiagnosed diabetes: Data from the English Longitudinal Study of Ageing.
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From page 216... ...
. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study)
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