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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2010.02.028 Byline: Verity Cleland (a), Kylie Ball (a), Clare Hume (a), Anna Timperio (a), Abby C. King (b), David Crawford (a) Abstract: Women living in socioeconomically disadvantaged neighbourhoods are at heightened risk for physical inactivity, but little is known about the correlates of physical activity among this group. Using a social-ecological framework, this study aimed to determine the individual, social and neighbourhood environmental correlates of physical activity amongst women living in such neighbourhoods. During 2007-2008 women (n = 4108) aged 18-45 years randomly selected from urban and rural neighbourhoods of low socioeconomic status in Victoria, Australia completed the International Physical Activity Questionnaire (long). They reported on individual (self-efficacy, enjoyment, intentions, outcome expectancies, skills), social (childcare, social support from family and friends/colleagues, dog ownership) and neighbourhood environmental (neighbourhood cohesion, aesthetics, personal safety, 'walking environment') factors. Multinomial logistic regression was used to examine the odds of increasing categories of leisure time physical activity (LTPA) and transport-related physical activity (TRPA) for each individual, social and environmental factor. In partially adjusted analyses, all individual, social and environmental variables were positively associated with LTPA, while all individual factors, family and friend support and the walking environment were positively associated with TRPA. In fully adjusted multivariable models, all individual and social factors remained significantly associated with LTPA, while self-efficacy, enjoyment, intentions, social support, and neighbourhood 'walking environment' variables remained significantly associated with TRPA. In conclusion, individual and social factors were most important for LTPA, while individual, social and neighbourhood environmental factors were all associated with TRPA. Acknowledging the cross-sectional design, the findings highlight the importance of different levels of potential influence on physical activity in different domains, which should be considered when developing strategies to promote physical activity amongst women living in socioeconomically disadvantaged neighbourhoods. Author Affiliation: (a) Deakin University, School of Exercise and Nutrition Sciences, 221 Burwood Hwy, Burwood, Victoria 3125, Australia (b) School of Medicine, Stanford University, 259 Campus Drive, HRP Redwood Building, T221 Stanford, CA 94305-5405, USA

Background. Cognitive impairment is an important contributor to disability. Limited clinical trial evidence exists regarding the impact of physical exercise on cognitive function (CF). We report results of a pilot study to provide estimates of the relative impact of physical activity (PA) on l-year changes in cognitive outcomes and to characterize relationships between changes in mobility disability and changes in cognition in older adults at increased risk for disability. Methods. Sedentary persons (102) at increased risk for disability (aged 70-89 years) were randomized to moderate_intensity PA or health education. Participants were administered the Digit Symbol Substitution Test (DSST), Rey Auditory Verbal Learning Test (RAVLT), modified Stroop test, and Modified Mini-Mental State Examination at baseline and 1 year. Results. Group differences were not significant but improvements in cognitive scores were associated with improvements in physical function. Specifically, the DSST significantly correlated with change in the Short Physical Performance Battery score (r = .38, p = .0002), in chair stand score (r = .26, p = .012), in balance score (r = .21, p = .046), and in 400-m gait speed (r = .15, p = .147). Change recall on the RAVLT and in the Stroop test was also positively correlated with changes in chair stand and balance, respectively. Conclusions. These results provide further support for the benefits of exercise on CF in older adults. An adequately powered clinical trial of PA involving older adults at increased risk for cognitive disability is needed to expand the indications for prescribing exercise for prevention of decline in brain function. Key Words: Exercise--Cognition--Aging--Prevention--LIFE study.

Background. This study sought to determine the 12-month effects of exercise increases on objective and subjective sleep quality in initially inactive older persons with mild to moderate sleep complaints. Methods. A nonclinical sample of underactive adults 55 years old or older (n = 66) with mild to moderate chronic sleep complaints were randomly assigned to a 12-month program of primarily moderate-intensity endurance exercise (n = 36) or a health education control program (n = 30). The main outcome measure was polysomnographic sleep recordings, with additional measures of subjective sleep quality, physical activity, and physical fitness. Directional hypotheses were tested. Results. Using intent-to-treat methods, at 12 months exercisers, relative to controls, spent significantly less time in polysomnographically measured Stage 1 sleep (between-arm difference = 2.3, 95% confidence interval [CI], 0.7-4.0; p = .003), spent more time in Stage 2 sleep (between-arm difference = 3.2, 95% CI, 0.6-5.7; p = .04), and had fewer awakenings during the first third of the sleep period (between-arm difference = 1.0, 95% CI, 0.39-1.55; p = .03). Exercisers also reported greater 12-month improvements relative to controls in Pittsburgh Sleep Quality Index (PSQI) sleep disturbance subscale score (p = .009), sleep diary-based minutes to fall asleep (p = .01), and feeling more rested in the morning (p = .02). Conclusions. Compared with general health education, a 12-month moderate-intensity exercise program that met current physical activity recommendations for older adults improved some objective and subjective dimensions of sleep to a modest degree. The results suggest additional areas for investigation in this understudied area. Key Words: Physical activity--Exercise--Sleep--Intervention--Older adult Polysomnography--Subjective sleep.

We examined the hypothesis that physical activity will have favorable effects on measures of self-efficacy for a 400-m walk and satisfaction with physical functioning in older adults 70+ years of age who have deficits in mobility. We randomized a total of 412 adults aged 70-89 years at elevated risk for mobility disability to either a physical activity or a successful aging educational control intervention for 12 months. Participants in the physical activity intervention had more favorable changes in both outcomes as a result of treatment than those in the successful aging intervention. Gender, age, and scores on a short physical performance battery did not moderate these effects. Physical activity is an effective means of intervening on self-efficacy and satisfaction with physical function in older adults with impaired lower extremity functioning. This is an important finding in light of the importance of these process variables in behavior change and quality of life. Key Words: Self-efficacy--Aging--Disability--Mobility--Quality of life.

Author(s): Tim Althoff [1]; Rok Sosi [1]; Jennifer L. Hicks [2]; Abby C. King [3, 4]; Scott L. Delp [2, 5]; Jure Leskovec (corresponding author) [1, 6] To be able [...]

An A to Z Weight Loss Study was conducted to examine the effects of four weight-loss diets, that is, Atkins, Zone, LEARN and Ornish, and gradations of carbohydrate intake on weight loss and related metabolic variables in overweight and obese premenopausal women. Results of the randomized trial revealed that the Atkins diet with the lowest carbohydrate content was most effective, indicating that a low-carbohydrate, high-protein, high-fat diet might be considered effective for weight loss.

Objectives. Translating efficacious interventions into practice within community settings is a major public health challenge. We evaluated the effects of 2 evidence-based physical activity interventions on self-reported physical activity and related outcomes in midlife and older adults. Methods. Four community-based organizations implemented Active Choices, a 6-month, telephone-based program, and 5 implemented Active Living Every Day, a 20-week, group-based program. Both programs emphasize behavioral skills necessary to become more physically active. Participants completed pretest and posttest surveys. Results. Participants (n = 838) were aged an average of 68.4 [+ or -] 9.4 years, 80.6% were women, and 64.1% were non-Hispanic White. Seventy-two percent returned posttest surveys. Intent-to-treat analyses found statistically significant increases in moderate-to-vigorous physical activity and total physical activity, decreases in depressive symptoms and stress, increases in satisfaction with body appearance and function, and decreases in body mass index. Conclusions. The first year of Active for Life demonstrated that Active Choices and Active Living Every Day, 2 evidence-based physical activity programs, can be successfully translated into community settings with diverse populations. Further, the magnitudes of change in outcomes were similar to those reported in the efficacy trials. (doi: 10.2105/AJPH.2005. 074690)

Response of patient subgroups like obese, unfit individuals among others to professional assistance and care is discussed.

Few studies have examined the impact of motherhood on successful participation in physical activity (PA) interventions. The current study focused on mothers ill the Increasing Motivation for Physical Activity or IMPACT study, which aimed to promote PA in sedentary, low-income, ethnically diverse women (74% Latina). The aim of this study was to determine whether certain maternal variables (e.g., number of children, number and intensity of maternal stressors) influenced successful participation in an 8-week, class-based, PA intervention. PA consisted of accumulating 30 minutes or more of moderate-intensity activities (e.g., walking) five or more days a week. Sixty-eight mothers (average age = 32 years) were assessed at baseline and 10 weeks. Paired comparison t-tests demonstrated a significant increase in PA-related energy expenditure from baseline to 10 weeks (p < 0.057. Furthermore, this increase in PA was significantly associated with a decrease in the number of maternal stressors reported over this time period (p < 0.01). Simultaneous regression analyses indicated that (1) having a higher number of maternal stressors at baseline was associated with lower class attendance (p [less than or equal to] 0.057 and (2) rating these maternal stressors (e.g., unable to control children's behavior) as being more stressful at baseline was associated with lower levels of PA at 10 weeks (p [less than or equal to] 0.01), independent of the number of children at home. These results suggest that the number and intensity of perceived maternal stressors may negatively impact attempts to become more physically active. Interventions should address such stressors. KEYWORDS. Physical activity, women, maternal stress, mothers, family

This report describes cross-sectional associations among physical activity, cardiorespiratory fitness, dietary habits, and cardiovascular disease (CVD) risk factors in a large sample (n = 810) of African Americans (n = 279) and non-African Americans (n = 531) with above-optimal blood pressure. Participants in PREMIER, a clinical trial for blood pressure control through lifestyle approaches, underwent baseline assessments to determine physical activity level, cardiorespiratory fitness category, dietary intake, and CVD risk factors. Mean levels of body mass index (BMI), total cholesterol, LDL cholesterol, HDL cholesterol, daily percent calories from fat and saturated fat, daily servings of fruits and vegetables, and daily fiber intake were examined across three physical activity levels and two fitness categories. Hypertension status was also assessed. Data were stratified by sex and ethnicity. For all participants, those in the low fitness category had higher BMI levels. Total cholesterol was lower in African American women in the high fitness category. Mean values of more than five daily servings of fruits and vegetables were reported by non-African American women and African American men in the high activity category. Higher intake of dietary fiber was found for non-African American women at the high activity level, with a similar trend observed for African American women. Future work examining these associations prospectively should include sufficient minority representation to enhance generalizability to all population groups and determine the beneficial effects from increased physical activity and improved cardiorespiratory fitness. KEY WORDS: physical activity; cardiorespiratory fitness; cardiovascular risk factors; African Americans.

Background. The study objective was to determine the health and quality-of-life effects of moderate-intensity exercise among older women family caregivers. Methods. This 12-month randomized controlled trial involved a volunteer sample of 100 women aged 49 to 82 years who were sedentary, free of cardiovascular disease, and caring for a relative with dementia. Participants were randomized to 12 months of home-based, telephone-supervised, moderate-intensity exercise training or to an attention-control (nutrition education) program. Exercise consisted of four 30- to 40-minute endurance exercise sessions (brisk walking) prescribed per week at 60% to 75% of heart rate reserve based on peak treadmill exercise heart rate. Main outcomes were stress-induced cardiovascular reactivity levels, rated sleep quality, and reported psychological distress. Results. Compared with nutrition participants (NU), exercise participants (EX) showed significant improvements in the following: total energy expenditure (baseline and post-test means [SD] for EX = 1.4 [1.9] and 2.2 [2.2] kcal/kg/day; for NU = 1.2 [1.7] and 1.2 [1.6] kcal/kg/day; p < .02); stress-induced blood pressure reactivity (baseline and post-test systolic blood pressure reactivity values for EX = 21.6 [12.3] and 12.4 [11.2] mm Hg; for NU = 17.9 [10.2] and 17.7 [13.8] mm Hg; p < .024); and sleep quality (p < .05). NU showed significant improvements in percentages of total calories from fats and saturated fats relative to EX (p values < .01). Both groups reported improvements in psychological distress. Conclusions. Family caregivers can benefit from initiating a regular moderate-intensity exercise program in terms of reductions in stress-induced cardiovascular reactivity and improvements in rated sleep quality.

This article investigates whether the use of telephone or mail health counseling techniques influence older adults' exercise adherence.

This article examines the relationship between life change events and adherence to a home-based or class-based exercise program. Results indicate that participants who reported three or four life events within a six month period had significantly lower rates of program adherence regardless of exercise format.

The personal, environmental, and program-based barriers to physical activity in US middle-aged women are discussed. The barriers included American Indian ethnicity, less education, older age, and lack of energy. Approximately 62% of respondents rated exercise with a personal trainer as more appealing than exercise in an instructor-led group.

Background: Many American adults remain sedentary despite many known health benefits. Research on the determinants of physical activity have indicated that social support is one of the strongest correlates, but little is known about this relation in important subgroups of middle and older-aged women. Objective: The purpose of this study was to assess the association of physical activity-related social support on several measures of physical activity in a national sample of minority women. A unique aspect of these measures is the inclusion of vigorous household tasks and occupational physical activities. Methods: The US Women's Determinants Study was conducted in 1996-1997. The survey was a modified-random sample, telephone survey of 2912 Black, Hispanic, American Indian/Alaskan Native, and White women age 40 and older. A composite score of physical activity social support (PASS) was analyzed as the independent variable in logistic regression analyses. Four measures of physical activity levels served as the dependent variables. A separate analysis was done to distinguish PASS from friends versus PASS from relatives. The potential confounding effect of race/ethnicity, marital status, age, income and education were evaluated and adjusted in the models. Results: Hispanic women were more likely to have high PASS scores than the other racial/ethnic groups. Odds ratios indicate that subjects with high levels of PASS were significantly less likely to be sedentary than those with low support, even after adjusting for race ethnicity. While there were significant associations among levels of social support and physical activity, this was not true for the measure of 'regular exercise.' There was no significant difference between the contribution of 'friend' support versus 'family' support on all four measures on physical activity. Discussion: based on our results, enhancing social support may be an important aspect of interventions aimed at increasing physical activity in a population of sedentary women of various racial/ethnic backgrounds. Also, 'regular exercisers' in this population appear to be less reliant social support to maintain their behavior. Keywords: Physical activity; Social support; Minority; Women

Background. This study explored the prevalence of and factors associated with physician suggestions to exercise in a sample of older adults. Methods. We conducted telephone interviews of a random sample of members of two Medicare health maintenance organizations (HMOs) in Northern California. Participants were 893 community-dwelling older adults of whom 63% were women, 52% were married, and 12% were in a minority group. Mean years of education was 14.8 [+ or -] (2.6) and mean years of age was 74.9 [+ or -] (6.5). The associations between patient self-reports of ever receiving physician recommendations to exercise and the following categories of variables were assessed: demographics, health-related quality of life, medical conditions, health/risk behaviors, and health knowledge/interest/satisfaction. Results. The prevalence of older adults in this study ever receiving a physician suggestion to exercise was 48.2%. In a multivariate logistic regression model, being younger, sedentary, and having a higher body mass index were independently (p [less than or equal to] .05) and positively associated with increased reports of having ever received a physician's advice to exercise. Those who were pre-contemplators (not thinking about changing physical activity behavior), and those who reported greater frequency of endurance exercise were less likely to report receiving a physician recommendation exercise (p [less than or equal to] .05). Conclusions. Although physician advice appeared to be targeted to subgroups that could benefit, physician advice on exercise could be particularly increased for patients over 75 years of age, those currently not thinking about an increase in physical activity, and those currently active patients who may benefit from ongoing physician advice to promote maintenance.

Older adults who have trouble sleeping may benefit from a regular exercise program. Researchers randomly assigned 29 women and 14 men between the ages of 50 and 76 to moderate-intensity exercise or no exercise (the control group). The exercise consisted of brisk walking or low-impact aerobics 4 times a week for 30 or 40 minutes. After 16 weeks, those in the exercise group reported better quality sleep that lasted almost an hour longer and spent less time napping. They also fell asleep faster compared to their baseline value. Those in the control group experienced no change in sleep habits., Objective.--To determine the effects of moderate-intensity exercise training on self-rated (subjective) sleep quality among healthy, sedentary older adults reporting moderate sleep complaints. Design.--Randomized controlled trial of 16 weeks&apos; duration. Setting.--General community. Participants.--Volunteer sample of 29 women and 14 men (of 67 eligible subjects) aged 50 to 76 years who were sedentary, free of cardiovascular disease, and reported moderate sleep complaints. No participant was withdrawn for adverse effects. Intervention.--Randomized to 16 weeks of community-based, moderate-intensity exercise training or to a wait-listed control condition. Exercise consisted primarily of four 30- to 40-minute endurance training sessions (low-impact aerobics; brisk walking) prescribed per week at 60% to 75% of heart rate reserve based on peak treadmill exercise heart rate. Main Outcome Measure.--Pittsburgh Sleep Quality Index (PSQI). Results.--Compared with controls (c), subjects in the exercise training condition (E) showed significant improvement in the PSQI global sleep score at 16 weeks (baseline and posttest values in mean [SD] for C=8.93 [3.1] and 8.8 [2.6]; baseline and posttest values for E=8.7 [3.0] and 5.4 [2.8]; mean posttest difference between conditions=3.4; P Conclusions.--Older adults with moderate sleep complaints can improve self-rated sleep quality by initiating a regular moderate-intensity exercise program. JAMA. 1997;277:32-37

Adults should engage in 30 minutes daily of moderate-intensity physical activity, according to recommendations released by the Centers for Disease Control and Prevention (CDC) and the American College of Sports Medicine. A committee composed of members of the CDC and the American College of Sports Medicine reviewed available medical information and concluded that daily moderate-intensity physical activity significantly reduces the risk of death from certain diseases including coronary heart disease, high blood pressure and colon cancer. The committee's research indicates that short bursts of physical activity can be accumulated during the day to reach the 30-minute total. Thirty minutes of moderate-intensity exercise is the equivalent of a brisk two-mile walk. Other activities that may contribute to the total amount of exercise include gardening, housework and active playing with children., Objective. - To encourage increased participation in physical activity among Americans of all ages by issuing a public health recommendation on the types and amounts of physical activity needed for health promotion and disease prevention. Participants. - A planning committee of five scientists was established by the Centers for Disease Control and Prevention and the American College of Sports Medicine to organize a workshop. This committee selected 15 other workshop discussants on the basis of their research expertise in issues related to the health implications of physical activity. Several relevant professional or scientific organizations and federal agencies also were represented. Evidence. - The panel of experts reviewed the pertinent physiological, epidemiologic, and clinical evidence, including primary research articles and recent review articles. Consensus Process. - Major issues related to physical activity and health were outlined, and selected members of the expert panel drafted sections of the paper from this outline. A draft manuscript was prepared by the planning committee and circulated to the full panel in advance of the 2-day workshop. During the workshop, each section of the manuscript was reviewed by the expert panel. Primary attention was given to achieving group consensus concerning the recommended types and amounts of physical activity. A concise "public health message" was developed to express the recommendations of the panel. During the ensuing months, the consensus statement was further reviewed and revised and was formally endorsed by both the Centers for Disease Control and Prevention and the American College of Sports Medicine. Conclusion. - Every US adult should accumulate 30 minutes or more of moderate-intensity physical activity on most, preferably all, days of the week. (JAMA. 1995;273:402-407)

A comparison of the physical and mental strain experienced by five caregiving working women and five noncaregiving working women proves that caregivers experience psychological stress that may affect their health in future. While interacting with an ailing family member, caregivers show an increase in blood pressure levels, which can cause cardiovascular diseases. Working women who have to take care of an unwell family member are better prepared for interactions with their colleagues.

A hundred and ninety-four passive men and women between the ages 50 and 65 were subjected to strict exercise routine, differing in format, home or class-based, and intensity. Physical fitness depended more on the degree of participation in exercise regimens than on the kind of exercise. However, no change was seen in their psychological health.

Many population-based surveys have reported that the prevalence of poor sleep increases with age. Despite the uniformity of findings, if remains unclear to what extent age-related declines in overall physical health are related to those results. One approach to this problem has been to adjust for such confounding variables multivariately. Some prior studies using this approach have not shown the expected age-related increases in the prevalence of poor sleep. Another approach has been the study of sleep in carefully screened, healthy populations. The current study reports the prevalence of disturbed sleep in a prevalence of disturbed sleep in a population, ages 50-65, carefully screened for physical health as part of an ongoing study of exercise and cardiovascular function. The prevalance of self-reported trouble falling asleep every night or almost every night (1.1% M, 2.%), trouble awakening and returning back to sleep (4.4% M, 3.3% F), and use of hypnotic medication at least twice a week (1.% M, 2.6% F) were consistently lower than in nearly all previous population-based studies of individuals of comparable age. This implies that when overall physical health factors are taken into account a decline in sleep quality is not necessarily an inevitable component of aging per se. As has been shown in other studies, there were small but statistically significant relationships between self-reported depression and poor sleep. Despite the low prevalance of poor sleep, about a third of the population reported feeling not well-rested and/or not getting the sleep they required. The individuals in this study also reported obtaining significantly less sleep relative to normative data from 30 years ago. Taken as a whole, these data raise the possibility of secular trends for individuals to actively curtail the amount of sleep they desire or need.

Two questionnaire formats for assessing alcohol consumption in a community sample were compared. Subjects completed the Semi-Quantitative Food Frequency Questionnaire and a questionnaire specifically targeting alcohol use. Across all alcoholic beverages, subjects reported lower consumption on the alcohol questionnaire than on the food frequency questionnaire. The results suggest that food frequency questionnaires may provide a better means for enhancing self-report of alcohol use than questionnaires that target solely alcohol intake. (Am J Public Health. 1994;84' 294-296), The drinking habits of middle-aged and older adults might be more accurately measured when questions on alcohol consumption are included in a more general food-consumption questionnaire. A total of 237 adults between 50 and 65 years old completed two questionnaires. One questionnaire asked for information on food and alcohol consumption habits. The other contained only questions on alcohol consumption. The questions on alcohol consumption were taken directly from the food questionnaire. Participants were randomly assigned to take one questionnaire first and the second three days later. Fewer participants were classified as drinkers when the alcohol-only questionnaire was used. A lower frequency of alcohol intake was also found with the alcohol-only questionnaire.

The simultaneous impact of factors hypothesized as mediators of the relationship between a motivationally tailored intervention for physical activity and six-month physical activity behavior in 239 adults is studied. Findings revealed that all mediation criteria were fulfilled by the two intervention arms. The different psychosocial variables of physical activity behavior change are discussed.

The effectiveness of health educators and an automated computer system in delivering physical inactivity interventions by phone was investigated. The medical personnel and the computer system were found efficient in physical actvity advice delivery, as participants in both trials demonstrated improvements. Delivering advice on physical activity through phone as an alternative system is further evaluated.

The perceived social environmental factors of physical activity were analyzed by subjecting 474 men and 387 women to the Activity Counseling Trial. It was observed that female participants who lived in neigborhoods with low crime crates and no unattanded dogs conducted 50 to 70 more minutes of activity than their counterparts. The importance of environmental factors in physical activity is studied.

The roles of telephone and print media in fueling the physical activity of sedentary adults to prevent cardiovascular diseases, based on social cognitive theory, are presented.

Background. Despite well-known benefits of physical activity for older adults, about two thirds are underactive. Community-based programs are needed to facilitate increased physical activity. We examine the effectiveness of CHAMPS II, an inclusive, choice-based physical activity promotion program to increase lifetime physical activity levels of seniors. CHAMPS guided participants to choose activities that took into account their health, preferences, and abilities. It offered information on ways for them to exercise safely, motivate themselves, overcome barriers, and develop a balanced exercise regimen. Methods. A 1-year randomized controlled trial was conducted with physically underactive seniors in a multispecialty group practice. Changes in self-reported physical activity by group were evaluated using ANCOVA, controlling for age and sex. Results. Of 173 randomized subjects, 164 (95%) completed the trial. Subjects were aged 65 to 90 years (M = 74, SD = 6); 66% were female. The intervention group increased estimated caloric expenditure by 487 calories/week in moderate (or greater) intensity activities (MET [is greater than or equal to] 3.0; p [is less than] .001) and by 687 calories/week in physical activities of any intensity (p [is less than] .001). Control group changes were negligible. Between-group analyses found that the changes were significantly different in both measures (p values [is less than] .05). Overweight persons especially benefited from this program. The program was as effective for women, older adults (75+), and those who did not set aside time to exercise at baseline. Conclusions. The program led to meaningful physical activity increases. Individually tailored programs to encourage lifestyle changes in seniors may be effective and applicable to health care and community settings.

Purpose: This study examined gender differences in cardiovascular responses to laboratory-based stress, as well as in ambulatory hemodynamic (i.e., blood pressure and heart rate) functioning among caregivers of persons with dementia. Design & Methods: Participants were 25 men and 25 women caregivers, matched on age, type of care recipient's dementia, and relationship to the care recipient. After cardiovascular reactivity to a laboratory-based caregiving stressor was assessed, the ambulatory hemodynamic functioning levels of caregivers were measured in caregivers' natural environments. Results: Female caregivers displayed greater systolic and diastolic blood pressure reactivity to a laboratory-based stress task (i.e., discussing caregiving difficulties) compared with male caregivers (p [is less than or equal to] .01). In contrast, no gender differences were found for ambulatory hemodynamic functioning when aggregated overall or when in the presence of the care recipient. Implications: Laboratory-based findings suggest that female caregivers experience greater blood pressure reactivity to caregiving-related stress than do male caregivers. However, these laboratory-based gender differences may not generalize to differences in hemodynamic functioning in caregivers' daily lives. Key Words: Stress, Blood pressure, Heart rate

Objectives. The present study examined, prospectively and within the context of stress experienced in the natural environment, whether situational control served as a mediator between perceived social support and caregiver's mood. Methods. Data came from baseline assessments of individuals participating in health promotion interventions for women caregivers. Participants were 49 female caregivers of dementia patients who monitored their own acute psychological states during the day. Results. Results revealed that although the occurrence of a situational stressor increased negative mood, greater perceived support reduced the detrimental impact of a stressor on negative mood. Moreover, path analyses revealed that changes in situational control partially mediated the relationship between perceived support and stress-induced negative mood changes. However, changes in control did not serve as a mediator in analyses focused on happiness. Discussion. Results suggest that caregivers with greater perceived support were less emotionally reactive to stress occurring in their natural environments because of, in part, sustained or increased situational control.

A self-favoring bias for physical activity (PA) was examined in a community-based sample of middle-aged and older adults (N = 3,211). Participants' actual level of PA relative to peers was compared with their perceived PA relative to peers. It was estimated that 38% were realistic, 46% self-favoring, and 16% other-favoring in their perceptions. Among participants whose actual PA level was similar to peers, increasing age was associated with a self-favoring bias. Among less and more physically active participants, however, age was not associated with this bias. Better self-rated health and being male were also associated with a self-favoring bias. These results suggest that a self-favoring bias for PA exists in a significant proportion of middle-aged and older adults, and it is more pronounced with increasing age, among those with better self-rated health, and among men.

Background. Although inactivity is an important contributor to impaired functioning and disability with age, little is known concerning how improvements in physical functioning and well-being in older adults vary with the type of physical activity undertaken. Methods. One hundred three adults age 65 years and older, recruited via population-based methods, were randomized to 12 months of community-based, moderate-intensity endurance and strengthening exercises (Fit & Firm) or stretching and flexibility exercises (Stretch & Flex). A combination of class- and home-based exercise formats was used. Measured and self-rated physical performance along with perceived functioning and well-being were assessed pre- and postintervention. Results. Fit & Firm subjects showed greater 12-month improvements in both measured and self-rated endurance and strength compared to Stretch & Flex subjects. Stretch & Flex subjects reported greater improvements in bodily pain, and Stretch & Flex men evidenced greater improvements in flexibility relative to Fit & Firm subjects. Although overall exercise adherence was high in both exercise conditions (approximately 80%), subjects in both conditions showed better adherence to the home- versus class-based portions of their exercise prescriptions. Conclusions. Community-based programs focusing on moderate-intensity endurance and strengthening exercises or flexibility exercises can be delivered through a combination of formats that result in improvement in important functional and well-being outcomes. This represents one of the first studies to report significant improvements in an important quality of life outcome--bodily pain--with a regular regimen of stretching and flexibility exercises in a community-based sample of older adults.

Objectives. This study describes the patterns of physical activity among minority women by using a variety of definitions and determines sociodemographic and behavioral correlates of physical activity in this population. Methods. A cross-sectional study was conducted in 1996 and 1997 among US women 40 years and older (n = 2912) of the following racial/ethnic groups: African American, American Indian/Alaskan Native, Hispanic, and White. Results. Physical activity was lowest among African Americans and American Indians/Alaskan Natives (adjusted odds ratios [ORs] for no leisure-time activity were 1.35 [95% confidence interval (CI) = 1.08, 1.68] and 1.65 [95% CI = 1.33, 2.06], respectively). A much higher proportion of women were classified as being physically active when occupational activity rather than more traditional assessments of leisure activity were used to determine level of physical activity. On the basis of a composite definition of physical activity, 72% of respondents reported being physically active. Women living in rural regions (OR = 1.33; 95% CI = 1.12, 1.58) were more likely than urban inhabitants to be completely inactive during leisure time. Conclusions. Minority women are among the least active subgroups in American society, although not all groups are less active than White women when all domains of physical activity are taken into account. (Am J Public Health. 2000;90:264-270)

Despite decades of physical activity research and interventions conducted on men, very little is known about the patterns of physical activity among US women. Rates from several national surveys show much lower rates of physical activity for women than for men. Among women, rates may vary by socioeconomic status. Studies relating physical activity and experience with heart disease, cancer, osteoporosis, and mental health are discussed. Interventions in the workplace and the community may increase the level of physical activity among US women. A history of not participating in exercise and lack of time for this activity appear to be important constraints for many women. The Surgeon General's Report on physical activity sanctioned future research on specific groups, such as women. Applied research coupled with community and workplace policies that support women's efforts to be more physically active may decrease the rates of some chronic diseases in this population. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworth.com]

The article discusses the vital role that physical activity and social engagement play in improving and maintaining the functional health of an aging population. National initiatives, if properly executed and promoted as well as integrated with primary care can improve the longevity of individuals as well as provide quality care with cost effective means.

Providing care to a family member with dementia has significant psychological and physical consequences. Sleep quality is likely affected by caregiving, yet this domain has received surprisingly little empirical study. In this study, sleep complaints were examined in 90 older women who were family caregivers of adults with dementia. Caregivers reported more sleep complaints than similarly aged healthy adults on all seven components of the Pittsburgh Sleep Quality Index, and a similar level of sleep complaints to those of sleep-impaired women and depressives on 6 and 4 components, respectively. Sleep medication was used by 38% of caregivers in the past month. The most common sleep complaints that occurred at least weekly were waking up in the night or early morning (84%), bathroom needs (83%), and sleep onset difficulties (41%). Sixty percent of the sample reporting nighttime care recipient disruptions stated that these disruptions occurred 3 or more times per week. Caregiver relationship and care recipient diagnosis were unrelated to sleep complaints. Lower levels of education, less internalized anger, care recipient disruptions, and psychological distress were related to poorer overall sleep quality. Sleep complaints are a common yet understudied problem in family caregivers.