Mirja Hirvensalo

Mobility difficulties and physical activity as predictors of mortality and loss of independence in the community-living older population.

OBJECTIVE: In older people, mobility impairments and physical inactivity are risk factors for further disability and death. We studied the interaction of physical activity and mobility impairment as a predictor of dependence and mortality.

Tracking of Physical Activity from Early Childhood through Youth into Adulthood

PURPOSE The aim of the study was to investigate the tracking of physical activity (PA) from preschool age to adulthood in six age cohorts of males and females. METHODS A random sample of 3596 boys and girls age 3-18 yr participated in the Cardiovascular Risks in Young Finns Study in 1980. The follow-up measurements were repeated in 1986, 1992, 2001, and 2007. The PA was measured by mothers report in 3- and 6-yr-olds and self-report in 9-yr-olds and older. Tracking of PA was analyzed using the Spearman rank-order correlation and a simplex model. RESULTS Mother-reported PA at age 3 and 6 yr significantly predicted self-reported PA in youth and in young adulthood, and there was a significant indirect effect of mother report on adult PA 2007 in males. Simplex models that fitted the data very well produced higher stability coefficients than the Spearman rank-order correlations showing moderate or high tracking. The tracking was higher in males than that in females. CONCLUSION This study has shown that physically active lifestyle starts to develop very early in childhood and that the stability of PA is moderate or high along the life course from youth to adulthood.

The continuity of physical activity – a retrospective and prospective study among older people

This study investigated the continuity of life‐span physical activity by examining the predictors of the maintenance of a high level of physical activity over 8 years among subjects aged 65–84 years at the baseline, in 1988, in Jyväskylä, Finland. Age, education, marital status and chronic conditions and past physical activity were studied at the baseline. In men and women, self‐reported competitive sport participation from as early as 10–19 years of age was a significant predictor for maintaining activity in old age. Also women’s participation in recreational sports at the age of 40–64 years predicted activity. We concluded that past physical activity is strongly connected to maintaining a high level of physical activity in old age regardless of chronic conditions that may develop.

Long-term Leisure-time Physical Activity and Serum Metabolome

Background— Long-term physical inactivity seems to cause many health problems. We studied whether persistent physical activity compared with inactivity has a global effect on serum metabolome toward reduced cardiometabolic disease risk. Methods and Results— Sixteen same-sex twin pairs (mean age, 60 years) were selected from a cohort of twin pairs on the basis of their >30-year discordance for physical activity. Persistently (≥5 years) active and inactive groups in 3 population-based cohorts (mean ages, 31–52 years) were also studied (1037 age- and sex-matched pairs). Serum metabolome was quantified by nuclear magnetic resonance spectroscopy. We used permutation analysis to estimate the significance of the multivariate effect combined across all metabolic measures; univariate effects were estimated by paired testing in twins and in matched pairs in the cohorts, and by meta-analysis over all substudies. Persistent physical activity was associated with the multivariate metabolic profile in the twins (P=0.003), and a similar pattern was observed in all 3 population cohorts with differing mean ages. Isoleucine, &agr;1-acid glycoprotein, and glucose were lower in the physically active than in the inactive individuals (P<0.001 in meta-analysis); serum fatty acid composition was shifted toward a less saturated profile; and lipoprotein subclasses were shifted toward lower very-low-density lipoprotein (P<0.001) and higher large and very large high-density lipoprotein (P<0.001) particle concentrations. The findings persisted after adjustment for body mass index. Conclusions— The numerous differences found between persistently physically active and inactive individuals in the circulating metabolome together indicate better metabolic health in the physically active than in inactive individuals.

The longitudinal effects of physical activity history on metabolic syndrome.

PURPOSE To examine the relationship of physical activity and its changes over a 9-yr follow-up to the prevalence of metabolic syndrome (MetS) in 2060 young adults (24-39 yr) enrolled in the Cardiovascular Risk in Young Finns Study. METHODS Leisure-time physical activity (LTPA) was assessed using a self-report questionnaire completed in connection with a medical examination at two consecutive measurements in 1992 and 2001. By summing the LTPA items, a physical activity index (PAI) was formed for both measurement points according to which the participants were divided into tracking groups: persistently active, increasingly active, decreasingly active, and persistently inactive. MetS in 2001 was defined by the guidelines of the European Group for the Study of Insulin Resistance (EGIR), the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III), and the International Diabetes Federation (IDF). A continuous metabolic risk score was also calculated by summing the z-scores for the metabolic risk factors. RESULTS There was a significant linear relationship between MetS and LTPA at baseline in men and at follow-up in both sexes according to all three definitions. Persistent physical activity during 9 yr was associated with a lower prevalence of MetS than persistent physical inactivity on all definitions (all P < 0.05). Similar results were found for increasingly active women (all P < 0.05). All of these associations remained significant after adjustment for potential confounders. In both men and women, the 9-yr change in LTPA was related to the metabolic risk score after adjustments for baseline LTPA, age, smoking, and education. CONCLUSIONS A physically active lifestyle across the lifespan may prevent or delay the onset of metabolic syndrome in young male and female adults.

Life-course perspective for physical activity and sports participation

The purpose of this paper was to discuss physical activity and sports participation in a life-course framework, long-term tracking, determinants, and correlates of physical activity from childhood to old age, and present possible causal links and pathways for the continuity of physical activity. It seems that intensive participation in general in physical activity and sports, as well as participation at school age, are important predictors of adulthood participation. Especially, inactivity rather than activity tends to track from youth to adulthood. Socioeconomic status, place of residence, and personal upward social mobility are related to participation. If physical activity is at a low level in early adulthood, it does not easily become a part of life later on, particularly among blue-collar workers, women, and people with initially poor perceived health. Furthermore, in old age, earlier physical activity seems to be the key determinant along with gender. Repeated social reinforcement in the form of support for autonomy, competence, and relatedness is important especially in transition periods and life events such as secondary schooling, change in employment, and change in family structure. In contrast, retirement presented itself as a good chance of starting new leisure time activities. A life-course approach provides understanding on long-ranging developmental trajectories. According to these results in particular, the polarization of exercise to the active and inactive portions of the population is accumulated over time, and gender and social background features require special attention.

Unmet Physical Activity Need in Old Age

OBJECTIVES: To examine which individual and environmental factors correlate with unmet physical activity need in old age and predict development of unmet physical activity need (the feeling that ones level of physical activity is inadequate and thus distinct from the recommended amount of physical activity) over a 2‐year follow‐up.

Cross-sectional associations between physical activity and selected coronary heart disease risk factors in young adults. The Cardiovascular Risk in Young Finns Study.

Abstract Objective. Physical activity (PA) may reduce the risk of coronary heart disease (CHD) by inducing beneficial changes in several risk factors. We studied the associations between PA and a range of risk markers of CHD in young adults. Methods and results. We measured serum lipoproteins, oxidized LDL, adipokines, inflammatory markers, metabolic markers, and arginine metabolites in 2,268 individuals (age 24–39 y). Participants were asked frequency, duration, and intensity of PA in leisure time. In addition, commuting to work was assessed. In both sexes, PA was inversely associated with waist circumference (all P < 0.0001). After controlling for sex, age, and waist circumference, PA was directly associated with HDL-cholesterol and apolipoprotein A1, and inversely with heart rate, smoking, oxidized LDL, apolipoprotein B, insulin, glucose, C-reactive protein, leptin, L-arginine, and phospholipase A2 activity (all P < 0.05). Conclusion. These population-based data are consistent with the idea that the beneficial effects of PA on CHD risk are mediated by favorable influences on several risk factors, as judged by independent relations to markers of lipoprotein metabolism, glucose metabolism, and inflammation. These associations reflect beneficial effects on cardiovascular health in both sexes and may offer mechanistic insights for the inverse association between PA and CHD.

Customer‐oriented counseling for physical activity in older people: study protocol and selected baseline results of a randomized‐controlled trial (ISRCTN 07330512)

The objective of this study is to describe the rationale, design and selected baseline results of a 2‐year randomized‐controlled trial (RCT) on the effects of physical activity counseling in community‐living older people.

Long-term Effect of Physical Activity Counseling on Mobility Limitation Among Older People: A Randomized Controlled Study

BACKGROUND Physical activity counseling increases physical activity among older people, but its effectiveness on mobility, that is, maintaining the ability to move independently, is unknown. We studied the effect of physical activity counseling on mobility among older people and evaluated whether counseling-induced benefits persist after cessation of the intervention. METHODS In a 2-year, single-blinded, randomized controlled study, 632 sedentary participants aged 75-81 years were randomly assigned into the intervention (n = 318) or control (n = 314) group. The intervention group received a single individualized physical activity counseling session with a supportive telephone contact every 4 months for 2 years. The outcome measures-perceived difficulty in advanced (walking 2 km) and basic (walking 0.5 km) mobility-were gathered semiannually during the intervention and the 1.5-year postintervention follow-up. RESULTS The proportion of participants with difficulties in advanced mobility at the beginning and end of the intervention was 34% and 38%, respectively, in the intervention group. In the control group, the corresponding proportions were 32% and 45%. The treatment effect was significant at the 2-year follow-up (odds ratio [OR] 0.84, 95% confidence interval [CI]: 0.70-0.99; p = .04) and remained significant 1.5 years postintervention (OR 0.82, 95% CI: 0.68-0.99; p = .04). The effect on basic mobility postintervention was parallel but nonsignificant (OR 0.87, CI: 0.69-1.09; p = .22). CONCLUSIONS Among older people, a single individualized physical activity counseling session with a supportive phone contact every 4 months for 2 years had a positive effect on mobility, an important factor for maintaining independence in the community in old age.