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BackgroundSmartphones have great potential for monitoring physical activity. Although a previous laboratory-based study reported that smartphone apps were accurate for tracking step counts, little evidence on their accuracy in free-living conditions currently exists. ObjectiveWe aimed to investigate the accuracy of step counts measured using iPhone in the real world. MethodsWe recruited a convenience sample of 54 adults (mean age 31 [SD 10] years) who owned an iPhone and analyzed data collected in 2016 and 2017. Step count was simultaneously measured using a validated pedometer (Kenz Lifecorder) and the iPhone. Participants were asked to carry and use their own iPhones as they typically would while wearing a pedometer on the waist for 7 consecutive days during waking hours. To assess the agreement between the two measurements, we calculated Spearman correlation coefficients and prepared a Bland-Altman plot. ResultsThe mean step count measured using the iPhone was 9253 (3787) steps per day, significantly lower by 12% (1277/10,530) than that measured using the pedometer, 10,530 (3490) steps per day (P

Background: Physical activity (PA) surveillance, policy, and research efforts need to be periodically appraised to gain insight into national and global capacities for PA promotion. The aim of this paper was to assess the status and trends in PA surveillance, policy, and research in 164 countries. Methods: We used data from the Global Observatory for Physical Activity (GoPA!) 2015 and 2020 surveys. Comprehensive searches were performed for each country to determine the level of development of their PA surveillance, policy, and research, and the findings were verified by the GoPA! Country Contacts. Trends were analyzed based on the data available for both survey years. Results: The global 5-year progress in all 3 indicators was modest, with most countries either improving or staying at the same level. PA surveillance, policy, and research improved or remained at a high level in 48.1%, 40.6%, and 42.1% of the countries, respectively. PA surveillance, policy, and research scores decreased or remained at a low level in 8.3%, 15.8%, and 28.6% of the countries, respectively. The highest capacity for PA promotion was found in Europe, the lowest in Africa and low- and lower-middle-income countries. Although a large percentage of the world's population benefit from at least some PA policy, surveillance, and research efforts in their countries, 49.6 million people are without PA surveillance, 629.4 million people are without PA policy, and 108.7 million live in countries without any PA research output. A total of 6.3 billion people or 88.2% of the world's population live in countries where PA promotion capacity should be significantly improved. Conclusion: Despite PA is essential for health, there are large inequalities between countries and world regions in their capacity to promote PA. Coordinated efforts are needed to reduce the inequalities and improve the global capacity for PA promotion. [ABSTRACT FROM AUTHOR]

Objectives It is well known that low educational attainment is associated with cognitive function decline in older age. Childhood book availability may help to preserve cognitive function in older adults with low education. The study objective was to examine the association between childhood book availability and cognitive function among older adults with low educational attainment, and to investigate the mediating effect of the volume of reading-related brain regions (e.g. superior temporal cortex). Methods A cross-sectional study of community-dwelling older Japanese adults aged 65–84 years was conducted (n  = 474). Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Childhood book availability was assessed using a retrospective questionnaire. Brain region volume was measured using magnetic resonance imaging. Multivariate regression modeling and structural equation modeling were used for analysis. Results Both high educational attainment and childhood book availability were independently associated with high MMSE score. Stratification of educational level showed that childhood book availability was positively associated with MMSE score among participants with low educational attainment (coefficient = 1.48, 95% confidence interval [CI]: 0.31 to 2.66), but not among those with moderate or high educational attainment (coefficient = −0.01, 95% CI: −1.44 to 1.42 and −1.21, 95% CI: −3.85 to 1.42, respectively). Among participants with low educational attainment, left superior temporal cortex volume mediated the association between childhood book availability and MMSE score. Discussion The availability of books in childhood helps to preserve cognitive function in older adults with low education via left superior temporal cortex volume. Further research is needed to replicate these findings. [ABSTRACT FROM AUTHOR]

Background Low socioeconomic position (SEP) has been linked to an increased risk of dementia. However, little is known about the association between SEP trajectory and regional brain volumes related to dementia. Methods A random sample of community-dwelling older adults (n = 428, age = 73.1 ± 5.5) living in Tokamachi City (Niigata Prefecture, Japan) without medical histories of dementia, Parkinson's disease, and depression who underwent automated assessment of brain volumes on magnetic resonance imaging and responded to a self-administered questionnaire survey in 2017. We measured SEP in childhood (household SEP at age 15), young adulthood (education), mid-adulthood (the longest occupation), and late adulthood (current wealth), and further performed group-based trajectory analysis to identify lifetime trajectory patterns on SEP. Multivariate regression models were employed to investigate the association between SEP trajectories and 4 regional brain volumes related to the development of Alzheimer's disease (ie, entorhinal cortex, hippocampus, amygdala, and the parahippocampus), the most common type of dementia. Results We found 3 distinct SEP trajectories (stable middle class [68%], downward [23%], and upward [9%]). Compared to those who experienced stable middle class, older adults who experienced the upward SEP mobility had significantly larger hippocampus (β: 213.2, 95% confidence interval: 14.7, 411.8). On the other hand, older adults who experienced downward SEP mobility showed no significant differences in any of the 4 brain structural volumes. Conclusions Our findings indicate that upward life-course SEP mobility is associated with larger volumes of hippocampus in old age. SEP trajectory may offer us a useful lens to enhance our understanding of the etiology of dementia. [ABSTRACT FROM AUTHOR]

Background: The current Japanese hypertension management guidelines (2019) recommend regular exercise for all patients with hypertension. However, limited evidence is available regarding the prevalence of exercise habits in these patients. Therefore, we examined the proportion of participants who met the recommendations on exercise in the Japanese hypertension management guidelines (2019) using a nationally representative sample. Methods: Participants aged ≥20 years from the Japanese National Health and Nutrition Examination Survey conducted from 2013 to 2018 were included. Participants with hypertension were defined as those with blood pressure level ≥140/90 mmHg or those who used antihypertensive drugs. Adherence to the guideline recommendations, stratified by gender, age category, blood pressure level, and medication status, was examined. Results: This study included 13,414 participants with hypertension (age 68.2 ± 11.7 years, 48.1% men). Among them, 31.8% of participants with hypertension (36.8% of men and 27.3% of women) met the guidelines. Regarding age, the 20–64 years age group had the lowest proportion of patients who met the guidelines (22.4%), followed by those in the 65–74 (37.7%) and ≥75 years age groups (34.5%). Adherence to the guidelines did not significantly differ according to blood pressure levels (<120/<80, 120–129/<80, 130–139/80–89, 140–159/90–99, and 160–179/100–109 mmHg) and presence of antihypertensive medications. Conclusion: One‐third of participants with hypertension engaged in exercise as recommended by the current hypertension management guidelines. Promotion of exercise therapy and monitoring exercise habits among participants with hypertension is warranted. [ABSTRACT FROM AUTHOR]

Background: Differences in accelerometer-measured sedentary behavior and different physical activity (PA) intensities between men and women have been poorly described. The authors examined gender differences in time-use activity composition and total volume of PA. Methods: A cross-sectional mail survey was conducted from 2013 to 2015 with a randomized sample of 6000 middle-aged (40–64 y) community-dwelling Japanese adults living in urban and regional cities. Participants wore Active style Pro HJA-350IT on their waist for 7 consecutive days. Gender differences in activity time use was examined using compositional data analysis to control for time spent in all activity measures. Results: In total, 757 participants (303 men, 52.3 [7.1] y) with valid data were included in the analysis. Women spent on average 12.6% less time in sedentary behavior and 23.4% more time in light-intensity PA than men, whereas no significant difference was found for moderate to vigorous PA. Women accumulated a significantly greater volume of PA than men (17.8 vs 15.0 metabolic equivalent of task h/d). Conclusions: Japanese middle-aged women showed higher levels of PA than men because they spent more time in light-intensity PA. Given the health benefits of light-intensity PA, evaluating only moderate to vigorous PA may lead to an underestimation of women's participation in PA. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the relationships of moderate-to-vigorous physical activity (MVPA) with all-cause and disease-specific mortality. We also investigated how the association between MVPA at leisure time (LT-MVPA) and health outcomes differs at different MVPA at work (WT-MVPA) levels. Methods: The 81,601 community-dwelling Japanese persons age 50–79 yr who responded to a questionnaire in 2000–2003 were followed until 2018. Cox proportional hazard model was used to examine the association of total MVPA with risks of all-cause, cancer, heart disease, stroke, and respiratory disease mortality. Then, we compared the mortality risk according to the tertile of LT-MVPA, stratified by the tertile of WT-MVPA. Results: During the 15.1 yr of average follow-up, 16,951 deaths were identified. Even total MVPA below the recommended volume (i.e., 0.1–1.49 MET·h·d−1) was associated with 11% to 24% reductions in all-cause (hazard ratio [HR], 0.89; 95% confidence interval [CI], 0.82–0.96) and heart disease mortality (HR, 0.76; 95% CI, 0.61–0.94), compared with no MVPA at all. The further reduced risks were seen in MVPA up to 10 MET·h·d−1. The inverse association between LT-MVPA and mortality risks was more evident at lower WT-MVPA, which was also inversely associated with the risks. Conclusions: Health benefits were observed at low levels of MVPA and up to 10 MET·h·d−1, although the fine threshold for excessive MVPA was not clear. LT-MVPA had distinct health benefits especially for persons with lower WT-MVPA. [ABSTRACT FROM AUTHOR]