Po-Wen Ku

Physical Activity and Depressive Symptoms in Older Adults 11-Year Follow-Up

BACKGROUND Few studies have explored the reciprocal relationships between naturally occurring changes in physical activity and depressive symptoms in later life. PURPOSE This study examined the reciprocal associations between changes in physical activity and depressive symptoms in a population-based sample of Taiwanese older adults over an 11-year period. METHODS Analyses were based on nationally representative data from the Taiwans Health and Living Status of the Elderly Survey collected in 1996, 1999, 2003, and 2007. Data from the fixed cohort of 1160 participants aged ≥67 years in 1996 with 11 years of follow-up were studied. Depressive symptoms were assessed using the ten-item Chinese version of the Center for Epidemiologic Studies-Depression Scale. Physical activity was self-reported as the number of sessions per week. Latent growth modeling was used to examine the bidirectional associations between changes in physical activity and depressive symptoms when controlling for sociodemographic variables, lifestyle behaviors, and health status. Data analyses were completed in 2011. RESULTS With multivariate adjustment, initial levels of physical activity were negatively associated with changes in depressive symptoms (β=-0.34, p<0.05). In contrast, early depressive symptoms were not related to change in physical activity (β=-0.17, p>0.05). CONCLUSIONS Physical activity engagement in later life is associated with a lower risk of subsequent depressive symptoms, but the reverse association is not supported. The finding has underlying implications for future physical activity and mental health promotion in aged populations.

Relationships of leisure-time and non-leisure-time physical activity with depressive symptoms: a population-based study of Taiwanese older adults.

BackgroundLimited research has explored the relationship between non-leisure-time physical activity (NLTPA), including domestic and work-related physical activities, with depressive symptoms. This study was designed to elucidate independent associations between leisure-time physical activity (LTPA), NLTPA, and specific parameters of physical activity (frequency, duration and intensity) with depressive symptoms in older adults.MethodsA total of 2,727 persons aged ≥ 65 years participating in the 2005 Taiwan National Health Interview Survey were studied. Depressive symptoms were measured by the Center for Epidemiological Studies Depression Scale. Information regarding energy parameters for each type of LTPA and NLTPA during the past 2-week period was analyzed. After adjusting for socio-demographic variables, lifestyle behaviors and health status, multivariate logistic regression models were used to compute adjusted odds ratios (AOR) for LTPA and NLTPA for predicting depressive symptoms.ResultsLTPA but not NLTPA was significantly associated with depressive symptoms. Compared with participants expending 2000+ kcal/week through LTPA, the risk of experiencing depressive symptoms was significantly higher for those expending 1-999 kcal/week (AOR = 2.06, 95% CI: 1.25-3.39), and those who expending 0 kcal/week (AOR = 3.72, 95%CI: 2.28-6.06). Among the three parameters of LTPA (intensity, duration and frequency) examined, only intensity was independently associated with depressive symptoms.ConclusionsThese findings imply that exercise recommendations for older adults should emphasize the importance of higher intensity activity, rather than frequency or duration, for improved mental well-being. However, well-designed prospective cohort studies or intervention trials are needed to confirm these findings.

Fitness Change and Subsequent Academic Performance in Adolescents

BACKGROUND This study examined the association between fitness change and subsequent academic performance in Taiwanese schoolchildren from 7th grade to 9th grade. METHODS The 7th graders from 1 junior high school district participated in this study (N = 669). Academic performance was extracted from school records at the end of each grade. Cardiovascular (CV) fitness, sit-and-reach flexibility, bent-leg curl-ups, and height and weight for calculating body mass index (BMI) were assessed at the start of each grade. RESULTS The results showed that improvement in CV fitness, but not muscular endurance or flexibility, is significantly related to greater academic performance. A weak and nonsignificant academic-BMI relationship was seen. CONCLUSION CV fitness exhibits stronger longitudinal associations with academic performance than other forms of fitness or BMI for adolescents.

Effects of Acute Resistance Exercise on Late-Middle-Age Adults' Goal Planning.

PURPOSE We investigated the effects of an acute bout of resistance exercise on the planning component of executive function in late-middle-age adults. METHODS With a within-subjects design, 30 community-dwelling adults (mean age = 57.20 ± 2.93 yr, 16 females) experienced both resistance exercise and control treatment conditions. The exercise condition involved two sets of 10 repetitions of 70% of 10-repetition maximum of seven exercises, whereas the control condition consisted of reading. Planning was assessed before and immediately after each treatment via the Tower of London task. RESULTS Acute resistance exercise facilitated Tower of London performances in terms of less total move scores, more total correct scores, and a longer total initial time compared with control and baseline. CONCLUSIONS Our results expand the existing literature by demonstrating that resistance exercise has a positive effect on cognition and contributes to improved quality of planning, working memory, and inhibition aspects of executive function.

Prospective associations between leisure-time physical activity and cognitive performance among older adults across an 11-year period.

Background Few studies have explored the relations between naturally occurring changes in physical activity and cognitive performance in later life. This study examined prospective associations between changes in physical activity and cognitive performance in a population-based sample of Taiwanese older adults during an 11-year period. Methods Analyses were based on nationally representative data from the Taiwan Health and Living Status of the Elderly Survey collected in 1996, 1999, 2003, and 2007. Data from a fixed cohort of 1160 participants who were aged 67 years or older in 1996 and followed for 11 years were included. Cognitive performance (outcome) was assessed using 5 questions from the Short Portable Mental Status Questionnaire. Physical activity (exposure) was self-reported as number of sessions per week. The latent growth model was used to examine associations between changes in physical activity and cognitive performance after controlling for sociodemographic variables, lifestyle behaviors, and health status. Results With multivariate adjustment, higher initial levels of physical activity were significantly associated with better initial cognitive performance (standardized coefficient β = 0.17). A higher level of physical activity at baseline (1996) was significantly related to slower decline in cognitive performance, as compared with a lower level of activity (β = 0.22). The association between changes in physical activity and changes in cognitive performance was stronger (β = 0.36) than the previous 2 associations. The effect remained after excluding participants with cognitive decline before baseline. Conclusions Physical activity in later life is associated with slower age-related cognitive decline.

Prospective Associations Between Household-, Work-, and Leisure-Based Physical Activity and All-Cause Mortality Among Older Taiwanese Adults

Most studies on the health effects of leisure time physical activity have focused on mortality. There has been limited research regarding physical activity undertaken at work or around the home and mortality. This study assessed the associations between leisure, work, and household physical activity and subsequent all-cause mortality among older adults aged 65 years and older (n = 2133) in Taiwan, over 8 years. Physical activity was evaluated with the Physical Activity Scale for the Elderly. Cox proportional hazard models were used to estimate the association of physical activity with the risk of mortality. This study demonstrated that a low level of total physical activity is predictive of increased all-cause mortality in both men and women in an East Asian population. It also indicates that leisure- and household-related but not work-related activity are significant contributors to this relationship.

Objectively assessed physical activity and lower limb function and prospective associations with mortality and newly diagnosed disease in UK older adults: an OPAL four-year follow-up study

Background: objective measures of physical activity and function with a diverse cohort of UK adults in their 70s and 80s were used to investigate relative risk of all-cause mortality and diagnoses of new diseases over a 4-year period. Participants: two hundred and forty older adults were randomly recruited from 12 general practices in urban and suburban areas of a city in the United Kingdom. Follow-up included 213 of the baseline sample. Methods: socio-demographic variables, height and weight, and self-reported diagnosed diseases were recorded at baseline. Seven-day accelerometry was used to assess total physical activity, moderate-to-vigorous activity and sedentary time. A log recorded trips from home. Lower limb function was assessed using the Short Physical Performance Battery. Medical records were accessed on average 50 months post baseline, when new diseases and deaths were recorded. Analyses: ANOVAs were used to assess socio-demographic, physical activity and lower limb function group differences in diseases at baseline and new diseases during follow-up. Regression models were constructed to assess the prospective associations between physical activity and function with mortality and new disease. Results: for every 1,000 steps walked per day, the risk of mortality was 36% lower (hazard ratios 0.64, 95% confidence interval (CI) 0.44–0.91, P = 0.013). Low levels of moderate-to-vigorous physical activity (incident rate ratio (IRR) 1.67, 95% CI 1.04–2.68, P = 0.030) and low frequency of trips from home (IRR 1.41, 95% CI 0.98–2.05, P = 0.045) were associated with diagnoses of more new diseases. Conclusion: physical activity should be supported for adults in their 70s and 80s, as it is associated with reduced risk of mortality and new disease development.

Accelerometer-assessed light physical activity is protective of future cognitive ability: A longitudinal study among community dwelling older adults

Objective: Physical activity (PA), especially moderate‐to‐vigorous intensity, could protect older adults from cognitive impairment. However, most literature is based on self‐reported PA which is limited by recall bias. Light PA is popular among older adults, but a paucity of objective longitudinal data has considered the relationship between light PA and cognitive ability. We examined if a higher level of objectively measured light PA, independent of moderate‐to‐vigorous physical activity (MVPA), was prospectively associated with better cognitive ability in older adults. Methods: A longitudinal study over 22.12 (± 1.46) months including 274 community‐dwelling older adults across 14 regions in Taiwan was undertaken. Cognitive ability was obtained using a Chinese version of the Ascertain Dementia 8‐item Questionnaire (AD8) and light PA and MVPA captured by 7 days accelerometer positioned on waist. Multivariable negative binomial regression adjusted for confounders were undertaken. Results: 274 participants (74.52 years, 45.6% male) attended the follow‐up (96.1%). Higher light PA, independent from MVPA, was associated with a reduced rate of decline in cognitive ability (rate ratio 0.75 [0.60–0.92]). MVPA, was also associated with a reduced decline in cognitive ability (rate ratio 0.85 [0.75–0.95]). Light PA was protective of cognitive ability in sensitivity analyses removing participants with activities of daily living difficulties, depressive symptoms and cognitive impairment at baseline. Conclusion: Our data suggest that light PA may offer a protective influence of future cognitive ability in community dwelling older adults. The promotion of light PA may be a valuable means to maintain cognitive ability in older age. HighlightA paucity of studies have considered objective longitudinal PA and future cognitive ability decline in older adults.Our data suggests that higher LPA, independent of MVPA, is associated with a reduced risk of future cognitive decline.This is the first longitudinal paper to investigate light intensity PA and cognitive decline in older adults.This extends the existing evidence for the benefits of PA for preventing cognitive deterioration in later life.

Relationship Between Objectively Measured Sedentary Behavior and Cognitive Performance in Patients With Schizophrenia Vs Controls.

Objective Sedentary behavior (SB) is associated with poor cognitive performance in the general population. Although people with schizophrenia are highly sedentary and experience marked cognitive impairments, no study has investigated the relationship between SB and cognition in people with schizophrenia. Methods A total of 199 inpatients with schizophrenia (mean [SD] age 44.0 [9.9] years, 61.3% male, mean [SD] illness duration 23.8 [6.5]) and 60 age and sex matched controls were recruited. Sedentary behavior and physical activity (PA) were captured for 7 consecutive days with an accelerometer. Cognitive performance was assessed using the Vienna Test System, and the Grooved Pegboard Test. Multivariate regression analyses adjusting for important confounders including positive and negative symptoms, illness duration, medication, and PA were conducted. Results The 199 patients with schizophrenia engaged in significantly more SB vs controls (581.1 (SD 127.6) vs 336.4 (SD 107.9) min per day, P < .001) and performed worse in all cognitive performance measures (all P < .001). Compared to patients with high levels of SB (n = 89), patients with lower levels of SB (n = 110) had significantly (P < .05) better motor reaction time and cognitive processing. In the fully adjusted multivariate analysis, SB was independently associated with slower motor reaction time (β = .162, P < .05) but not other cognitive outcomes. Lower levels of PA were independently associated with worse attention and processing speed (P < .05). Conclusion Our data suggest that higher levels of sedentary behavior and physical inactivity are independently associated with worse performance across several cognitive domains. Interventions targeting reductions in SB and increased PA should be explored.

A Longitudinal Study of Childhood Obesity, Weight Status Change, and Subsequent Academic Performance in Taiwanese Children.

BACKGROUND This study examined the association among childhood obesity, weight status change, and subsequent academic performance at 6-year follow-up. METHODS First-grade students from one elementary school district in Taichung City, Taiwan were followed for 6 years (N = 409). Academic performance was extracted from the school records at the end of each grade. Weight and height were measured at the beginning of each grade. A weight change variable was created based on each childs weight status difference at grades 1 and 6. A multivariate linear regression model for predicting academic performance at grade 6 was developed with adjustment for individual characteristics and family factors. A latent growth curve (LGC) showed the association between changes in body mass index (BMI) and in academic performance across a 6-year period. RESULTS BMI in children increased significantly across 6 years. The rate of increase in BMI over 6 years was higher for children with higher baseline BMIs than it was for children with lower baseline BMIs. However, BMI changes were not significantly associated with changes of academic performance. CONCLUSION There was no significant relationship between initial obesity or change in weight status and subsequent academic performance. It appears that either being or becoming overweight/obese did not impact academic achievement for these Taiwanese children.