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Background Although clinical gait speed may indicate health and well-being in older adults, there is a lack of studies comparing clinical tests with ambulatory gait speed with regard to several health outcomes. Objective The objective of this study was to examine the associations of clinical gait speed, measured by the 2.44-m walk test and the ambulatory gait speed with several physical, mental, and cognitive health outcomes in older adults. Design A cross-sectional design was used. Methods The study population comprised 432 high-functioning, community-dwelling older adults (287 women) aged between 65 and 92 years. Clinical and ambulatory gait speeds were measured using the 2.44-m walk test and a portable gait analysis device, respectively. Multiple linear regressions were used to examine the association of clinical and ambulatory gait speeds with several health outcomes (body mass index, waist circumference, systolic and diastolic blood pressure, chronic conditions, self-rated health, exhaustion, upper- and lower-body strength, physical and mental health status, cognitive status, and self-rated cognitive status). Results The results showed that the average gait speed for clinical and ambulatory measures cannot be directly compared. Clinical gait speed was associated with 7 health outcomes, and the ambulatory gait speed was associated with 6 health outcomes. The significant associations between measures of gait speed and the health outcomes converged in 5 of the 13 health outcomes studied; however, the strength of associations was singly different between measures. Limitations The short monitoring time, the inability to distinguish between the ambulatory gait speed inside the home and outdoor gait speed, and the under-representative sample are limitations of the study. Conclusion The results indicated differences in the number and strength of associations between clinical and ambulatory gait speed. Both measures have construct validity because they have been associated with physical and health outcomes; however, they may have different predictive validity. Further research should be conducted to compare their predictive validity in longitudinal designs. [ABSTRACT FROM AUTHOR]

Background: Regular physical activity (PA) has been shown to protect against disability onset but, once the disability is present, it is unclear if PA might attenuate its harmful health consequences. Thus, we examined if mortality risk associated with physical disability can be offset by PA among older adults.Methods: We used data from a cohort of 3,752 individuals representative of the noninstitutionalized population aged 60 years and older in Spain. In 2000-2001, participants self-reported both PA levels (inactive, occasionally, monthly, weekly) and five physical disabilities (agility, mobility, global daily activities, instrumental activities of daily living, and self-care). Individuals were prospectively followed through 2014 to assess incident deaths.Results: The mean follow-up was 10.8 years, with a total of 1,727 deaths, 638 of them due to cardiovascular disease (CVD). All disability types were associated with higher total and CVD mortality. Being physically active (ie, doing any PA) was associated with a statistically significant 26%-37% and 35%-50% lower risk of total and CVD death, respectively, across types of disability. As compared with those being physically active and without disability, those who were inactive and had a disability showed the highest mortality risk from total (hazard ratios from 1.52 to 1.90 across disabilities, all p < .05) and from CVD (hazard ratios from 1.99 to 2.24 across disabilities, all p < .05). Total and CVD mortality risk was similar in physically active participants with disabilities and in inactive individuals without disability.Conclusions: In older adults, PA could attenuate the increased risk of mortality associated with physical disability. [ABSTRACT FROM AUTHOR]

INTRODUCTION: High cardiorespiratory fitness (CRF) is strongly associated with longer life among older adults. CRF can be assessed by exercise-based methods, which are not feasible in most clinical settings. Thus, nonexercise algorithms to estimate CRF have been developed, but whether they predict mortality in older adults is uncertain. METHODS: A cohort of 1470 men and 1460 women, representative of the Spanish population age ≥60 yr, was established in 2000/2001 and followed up prospectively through 2011. At baseline, nonexercise CRF was estimated with the sex-specific algorithms developed by Jackson et al. Analyses were performed with Cox regression and adjusted for the main confounders. RESULTS: During an average follow-up of 9.4 yr, 570 (38.8%) deaths occurred in men and 295 (20.2%) in women. Among men, no association was observed between nonexercise CRF and all-cause mortality. Compared with women in the lowest quartile of CRF, the hazard ratio (95% confidence interval) for all-cause death was 0.81 (0.62-1.06) in the second quartile, 0.68 (0.48-0.95) in the third quartile, and 0.56 (0.36-0.87) in the highest quartile (P for trend = 0.004). Results held regardless of age, body mass index, waist circumference, HR, subjective health, functional limitations, and disease status. CONCLUSIONS: Higher nonexercise CRF was related to lower risk of death in older women but not in men. Because previous research does not support clear sex-specific association, further research is required to assess whether nonexercise CRF predicts mortality in older adults or new algorithms should be developed for this population, with special attention to older men. [ABSTRACT FROM AUTHOR]

Introduction: Previous studies suggest that the physical environment is associated with youth physical activity levels. Objective: The present study aimed at assessing the reliability and validity of an adapted version of the ALPHA environmental questionnaire (short version) to adults for application with Spanish youth. Methods: The reliability was evaluated in a sample (n = 190, 80 girls, 14.08 ± 1.38 years) using the Intraclass Correlation Coefficient (ICC) and Weighted kappa. In other sample (n = 140,61 girls, 13.03 ± 1.40 years) the validity was assessed using the Spearman correlation (rho) for its association with self-reported and objective (accelerometers) physical activity (PA). Results: The test-retest reliability showed ICC = 0.69 for the total questionnaire score, ranging from k = 0.42 to 0.77 for individual items. The total score showed significant correlations with PA reported by PACE questionnaire (rho = 0.18, p = 0.040), the Finnish Physical Activity Index (rho = 0.26, p = 0.002) and active commuting for girls (rho = 0.34, p = 0.010), as well as vigorous PA measured by accelerometry (rho = 0.18, p = 0.038). Discussion: The adapted version of the ALPHA environmental questionnaire has moderate to good reliability and acceptable validity to assess environmental factors that may influence PA in youth. [ABSTRACT FROM AUTHOR]

Aim: There is an emerging body of evidence on the potential effects of regular physical activity on academic performance. The aim of this study was to add to the debate, by examining the association between objectively measured physical activity and academic performance in a relatively large sample of children and adolescents. Methods: The Spanish UP & DOWN study is a 3-year longitudinal study designed to assess the impact, overtime, of physical activity and sedentary behaviours on health indicators. This present analysis was conducted with 1778 children and adolescents aged 6-18 years. Physical activity was objectively measured by accelerometry. Academic performance was assessed using school grades. Results: Physical activity was inversely associated with all academic performance indicators after adjustment for potential confounders, including neonatal variables, fatness and fitness (all p < 0.05). This association became nonsignificant among quartiles of physical activity. There were only slight differences in academic performance between the lowest and the second quartile of physical activity, compared to the highest quartile, with very small effect size (d < 0.20). Conclusion: Objectively measured physical activity may influence academic performance during both childhood and adolescence, but this association was negative and very weak. Longitudinal and intervention studies are necessary to further our understanding. [ABSTRACT FROM AUTHOR]

The aim of this report was to examine the associations between some characteristics (i.e., structure and number) of extracurricular physical activity (EPA) and cognitive performance in adolescents. A total of 1662 adolescents (880 girls; 13.0–18.5 years) from 5 Spanish cities (Granada, Madrid, Murcia, Santander and Zaragoza) were included in this study. Structure (organised and non-organised) and number of EPAs, and participation at vigorous intensity during EPA were self-reported. Cognitive performance (verbal, numeric and reasoning abilities, and an overall score) was measured with the “SRA-Test of Educational Ability”. Results showed that vigorous EPA was positively associated with all cognitive variables. Adolescents who practiced an organised EPA had higher scores in 3 of the 4 cognitive variables than those who practiced a non-organised EPA (allP < 0.05). Likewise, the group who participated in more than one EPA had higher cognitive performance in all variables than the group who participated in only one EPA (allP < 0.05). Regardless of potential confounder variables, including vigorous EPA, both structure and number of EPAs were each other independently associated with cognitive performance. Therefore, structure and number of EPAs may positively influence cognitive performance in adolescents. Participating in multiple, organised EPA may have benefits for cognitive performance. [ABSTRACT FROM AUTHOR]

The article evaluates the Assessing Levels of Physical Activity (ALPHA) health-related fitness test battery useful for monitoring health of children and adolescents.

Romeo J, Martinez-Gomez D, Diaz LE, Gómez-Martinez S, Marti A, Martin-Matillas M, Puertollano MA, Veiga OL, Martinez JA, Wärnberg J, Zapatera B, Garagorri JM, Morandé G, Campoy C, Moreno LA, Marcos A; EVASYON Study Group. Changes in cardiometabolic risk factors, appetite-controlling hormones and cytokines after a treatment program in overweight adolescents: preliminary findings from the EVASYON study Objective: We investigated the effects of the EVASYON program on body fatness, cardiometabolic risk factors, gut appetite-controlling hormones and serum levels of cytokines in adolescents with overweight or obesity (OW/OB). Methods: This study comprised 13 boys (10 obese) and 12 girls (8 obese), aged 13-16 years, from a Madrid Hospital. The EVASYON program was based on a calorie-restricted diet (10-40%), increased physical activity (at least 60 min/day 5 days a week), psychological therapy and nutritional education for 13 months. Anthropometric and blood pressure measurements were measured before and after intervention. Serum glucose, total cholesterol, high-density lipoprotein cholesterol, triglycerides, leptin, total peptide YY and insulin levels were determined before and after intervention. Serum levels of cytokines IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, and TNF-α were also assessed before and after intervention. Results: A decrease in body mass index (BMI), BMI z-score, skinfolds (triceps, biceps, subscapular, thigh, and calf), sum of six skinfolds and body circumferences (arm relaxed and flexed, waist, hip, and proximal thigh) values were observed after the intervention program (all p < 0.05). In addition, diastolic blood pressure also decreased (p < 0.05). A decrease in serum leptin levels (-48.4%, p < 0.001) was observed after intervention without changes in total peptide YY and insulin levels. Levels of IL-8, IL-10, and TNF-α also decreased (all p < 0.05) after the intervention program. Conclusions: These preliminary results evidence that the EVASYON program may improve body fat, leptin, and some pro-inflammatory cytokines in adolescents with OW/OB. [ABSTRACT FROM AUTHOR]

Background: The prevalence of overweight and obesity (OW/OB) among adolescents worldwide has increased since the 60 s. Spain has reached one of the highest OW/OB prevalence rates among adolescents from European countries. The aim of this methodological paper is to describe the design and evaluation in the EVASYON study (Development, implementation and evaluation of the efficacy of a therapeutic programme for adolescents with OW/OB: integral education on nutrition and physical activity). Methods/Design: The EVASYON was planned by a multidisciplinary team to treat OW/OB in Spanish adolescents. The EVASYON is a multi-centre study conducted in 5 hospitals in 5 Spanish cities (Granada, Madrid, Pamplona, Santander and Zaragoza) and two hundred and four OW/OB Spanish adolescents were recruited for this intervention. The treatment was implemented for approximately one-year follow-up. The adolescents were treated in groups of a maximum of 10 subjects; each group had 20 visits during the treatment period in two phases: intensive during the first 2 months (1st to 9th visits), and extensive during the last 11 months (10th to 20th visits). In order to assess the efficacy of the treatment, 8 dimensions were measured: diet; physical activity and fitness; eating behaviour; body composition; haematological profile; metabolic profile; minerals and vitamins; immuno-inflammatory markers. Moreover, genetic polymorphisms were also determined. Discussion: The treatment programme developed in the EVASYON study was designed as a national pilot study to be implemented as an effective treatment for adolescents with OW/OB into the Spanish Health Care Service. [ABSTRACT FROM AUTHOR]

Objective: to examine if those adolescents who dislike physical education classes get better results on academic and cognitive performance than their peers.Methods: participants included 4 226 adolescents from the AVENA, AFINOS and UP&DOWN studies. Physical education enjoyment was assessed with a 7-point Likert scale. Cognitive performance in the AVENA study was assessed using the Spanish version of the SRA Test of Educational Ability. Academic performance in the AFINOS and UP&DOWN studies was assessed through Mathematics and Language grades and the average of both subjects.Results: in the AVENA study we found differences in verbal ability among girls who dislike physical education and their peers (P = 0.033). In the AFINOS study, boys who dislike physical education had higher scores in Language than their peers (P = 0.024). In the UP&DOWN study girls who disliked physical education had higher scores in Language and in the average of Language and Mathematics than their peers (P < 0.001).Conclusion: in the AVENA and AFINOS studies adolescents who disliked physical education had similar results in cognitive and academic performance than their peers, but in the UP&DOWN study girls who disliked physical education showed higher results in academic performance than their peers. [ABSTRACT FROM AUTHOR]

Background: Growth Differentiation Factor 15 (GDF-15) is a marker of inflammation and oxidative stress that has been associated with multiple age-related chronic diseases. Since lifestyle is key for preventing these adverse health outcomes, we examined the association between a Mediterranean lifestyle and GDF-15 serum concentrations in Spanish older adults., Methods: We used cross-sectional data from 2502 older adults participating in the Seniors ENRICA-2 cohort. Adherence to the Mediterranean lifestyle was assessed with the 27-item MEDLIFE index, divided into three blocks: 1) "Mediterranean food consumption, 2) Mediterranean dietary habits, 3) Physical activity, rest, social habits, and conviviality". Analyses of the association between the MEFLIFE index and GDF-15 concentrations were performed using multivariable linear regression models adjusting for the main potential confounders., Results: The MEDLIFE index was inversely associated with GDF-15. Compared with participants in the lowest quartile of the MEDLIFE score, GDF-15 mean percentage differences (95% CI) were -3.0% (-8.0, 2.3) for the second quartile, -8.7% (-13.0, -4.1) for the third quartile, and -10.1% (-15.0, -4.9) for the fourth quartile (p-trend<0.001). Block 3 of MEDLIFE, and particularly doing sufficient physical activity, adequate sleep duration, and participating in collective sports, was individually linked to lower concentrations of GDF-15. Results remained similar after excluding participants with cardiovascular disease, type 2 diabetes, or obesity., Conclusions: A Mediterranean lifestyle was associated with reduced levels of GDF-15, suggesting that a combination of multiple lifestyles may be an integral approach to reduce chronic inflammation and disease burden in older adults., Competing Interests: Declaration of competing interest Authors declare that they have no competing interests., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: To examine the association between cognitive frailty and long-term all-cause mortality and the stratified and combined associations of physical activity and cognitive frailty with long-term all-cause mortality in a population-based cohort of older adults from Spain., Patients and Methods: A representative cohort of 3677 noninstitutionalized individuals from Spain aged 60 years or older was recruited between April 17, 2000, and April 28, 2001, with follow-up through December 28, 2014. Information on self-reported physical activity and cognitive frailty status were collected at baseline. Analyses were performed with Cox regression after adjustment for confounders., Results: The median follow-up was 14 years (range, 0.03-14.25 years), corresponding to 40,447 person-years, with a total of 1634 deaths. The hazard ratio (HR) for all-cause mortality among participants with cognitive frailty compared with robust participants was 1.69 (95% CI, 1.43-2.01). Being active was associated with a mortality reduction of 36% (95% CI, 21%-47%) in cognitively frail individuals. Compared with those who were robust and active, participants with cognitive frailty who were inactive had the highest mortality risk (HR, 2.13; 95% CI, 1.73-2.61), which was equivalent to being 6.8 (95% CI, 5.33-7.99) years older., Conclusion: Cognitive frailty was more markedly associated with increased mortality in inactive older adults, and being active reduced the mortality risk among cognitively frail individuals by 36%. These novel results highlight that engaging in physical activity could improve survival among cognitively frail older adults., (Copyright © 2018 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.)

Purpose: To examine the separate and joint associations of physical activity and levels of physical, mental, and social health with long-term all-cause and cardiovascular disease (CVD) mortality in older adults., Methods: A cohort of 4008 individuals representative of the non-institutionalized population of Spain aged 60 years and older was analyzed. Information on physical activity was self-reported. Physical and mental health were assessed with the SF-36 questionnaire, and social health with a 4-item score on network structure and social engagement. Participants were categorized as being in a good, intermediate, or poor health according to tertiles of the score in each health dimension. Analyses were performed with Cox regression and adjusted for main confounders, including levels in the other two health dimensions., Results: Over a median follow-up of 14 years, a total of 1811 deaths occurred, 674 due to CVD. Hazard ratios (95% confidence interval) for all-cause mortality were 1.35 (1.18-1.55), 1.18 (1.02-1.36), and 1.37 (1.18-1.58) for poor vs. good physical, mental, and social health, respectively (all p trend < 0.001). Being physically active was associated with a 28% (15-39%), 31% (19-42%), and 19% (5-31%) lower all-cause mortality in participants with poor physical, mental, and social health, respectively. In each health dimension, physically active individuals with poor health showed a similar or lower all-cause mortality than those who had intermediate or good health but were physically inactive. Results for CVD mortality were similar to those for all-cause death., Conclusions: Physical activity might attenuate the excess all-cause and CVD mortality associated with poor physical, mental, and social health.

Objectives: To examine the separate and joint association between physical activity and frailty and long-term all-cause and cardiovascular disease (CVD) mortality in older adults., Design: Population-based prospective cohort study., Setting: Cohort representative of the noninstitutionalized Spanish population., Participants: Individuals aged 60 and older (N=3,896) in 2000-01., Measurements: Participants reported their physical activity using a validated instrument, and frailty was ascertained using the Fatigue, low Resistance, limitation in Ambulation, Illness and weight Loss (FRAIL) scale. Those with 0 frailty criteria were considered to be robust, with 1 or 2 criteria to be prefrail, and with 3 of more criteria to be frail. Participants were followed until 2014 to identify all-cause and CVD deaths. Associations were summarized using hazard ratios (HRs) and Cox regression after adjustment for main covariates., Results: During a median 14 years of follow-up, 1,801 total deaths occurred, 672 from CVD. Compared with being robust, the multivariate hazard ratio (95% confidence interval) for all-cause mortality was 1.29 (1.14-1.45) in prefrail individuals, and 2.16 (1.82-2.58) in frail individuals (p-trend <.001). Compared with being physically inactive, being physically active was associated with a statistically significant 18% (1-32%), 28% (16-39%) and 39% (17-55%) lower all-cause mortality among robust, prefrail, and frail individuals, respectively (all p <.001). Compared with participants who were robust and physically active, those who were frail and inactive showed the highest all-cause mortality 2.45 (95%CI: 1.95-3.06); however, the hazard ratio (95% confidence interval) for all-cause mortality in frail individuals who were physically active was comparable to that in pre-frail and inactive participants: 1.70 (1.32-2.19) and 1.56 (1.34-1.82), respectively. Mortality of prefrail active participants was similar to that of robust inactive participants. Results were similar for CVD mortality., Conclusion: Physical activity might partly compensate for the greater mortality risk associated with frailty in old age. J Am Geriatr Soc 66:2097-2103, 2018., (© 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.)

This work examines whether the increased all-cause and cardiovascular disease (CVD) mortality associated with polypharmacy could be offset by a healthy lifestyle. We included a prospective cohort of 3,925 individuals representative of the Spanish population aged ≥60 years, who were recruited in 2000-2001 and followed up through 2014. Polypharmacy was defined as treatment with ≥5 medications. The following lifestyle behaviors were considered healthy: not smoking, eating a healthy diet, being physically active, moderate alcohol consumption, low sitting time, and adequate sleep duration. Individuals were classified into three lifestyle categories s: unfavorable (0-2), intermediate (3-4) favorable (5-6). Over a median 13.8-y follow-up, 1,822 all-cause and 675 CVD deaths occurred. Among individuals with polypharmacy, intermediate and favorable lifestyles were associated with an all-cause mortality reduction (95% confidence interval [CI]) of 47% (34-58%) and 54% (37-66%), respectively; 37% (9-56%) and 60% (33-76%) for CVD death, respectively. The theoretical adjusted hazard ratio (95%CI) associated with replacing 1 medication with 1 healthy lifestyle behavior was 0.73 (0.66-0.81) for all-cause death and 0.69 (0.59-0.82) for CVD death. The theoretical adjusted hazard ratio (95%CI) for all-cause and CVD mortality associated with simply reducing 1 medication was 0.88 (0.83-0.94) and 0.83 (0.76-0.91), respectively. Hence, adherence to a healthy lifestyle behavior can reduce mortality risk associated with polypharmacy in older adults.

Objective: To examine the independent and combined associations of the components of physical fitness with academic performance among youths., Study Design: This cross-sectional study included a total of 2038 youths (989 girls) aged 6-18 years. Cardiorespiratory capacity was measured using the 20-m shuttle run test. Motor ability was assessed with the 4×10-m shuttle run test of speed of movement, agility, and coordination. A muscular strength z-score was computed based on handgrip strength and standing long jump distance. Academic performance was assessed through school records using 4 indicators: Mathematics, Language, an average of Mathematics and Language, and grade point average score., Results: Cardiorespiratory capacity and motor ability were independently associated with all academic variables in youth, even after adjustment for fitness and fatness indicators (all P≤.001), whereas muscular strength was not associated with academic performance independent of the other 2 physical fitness components. In addition, the combined adverse effects of low cardiorespiratory capacity and motor ability on academic performance were observed across the risk groups (P for trend<.001)., Conclusion: Cardiorespiratory capacity and motor ability, both independently and combined, may have a beneficial influence on academic performance in youth., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Background: Physical activity is necessary for bone mass development in adolescence. There are few studies quantifying the associations between physical activity and bone mass in adolescents., Purpose: To assess the relationship between moderate-to-vigorous physical activity (MVPA) and vigorous physical activity (VPA) and bone mass in adolescents., Methods: Bone mass was measured by dual-energy X-ray absorptiometry and physical activity by accelerometers in 380 healthy Spanish adolescents (189 boys, aged 12.5-17.5 years) from the HELENA-CSS (2006-2007). Subjects were classified according to the recommended amount of MVPA (<60 minutes or ≥60 minutes of MVPA/day). Receiver operating characteristic curve analysis was applied to calculate the relationship between physical activity and bone mass., Results: Less than 41 and 45 minutes of MVPA/day are associated with reduced bone mass at the trochanter and femoral neck. More than 78 minutes of MVPA/day is associated with increased bone mineral density (BMD) at the femoral neck. Regarding VPA, more than 28 minutes/day for the hip and intertrochanter and more than 32 minutes/day for the femoral neck are associated with increased BMD., Conclusions: The recommended amount of physical activity (minutes/day) seems insufficient to guarantee increased bone mass. With some minutes of VPA/day, bone adaptations could be obtained at different bone sites., (Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Excessive television (TV) viewing might play an important role in the development of cardiovascular disease (CVD). The aim of this study was to examine the independent associations between TV viewing and CVD risk factors in adolescents., Methods: A sample of 425 adolescents, aged 13- to 18.5-year-old, was included in this study. Body mass index (BMI), waist circumference (WC), glucose, total cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, apolipoprotein (apo) A-1, apo B-100, and lipoprotein(a) levels were determined. A composite CVD risk score was computed based on age-, sex-, sexual maturation- and race-standardized triglycerides, HDL-cholesterol, LDL-cholesterol and glucose. TV viewing was self-reported., Results: Two hundred and twenty-five adolescents (53%) who spent >3 hrs/day watching TV were considered as the "high TV viewing" group. Ninety-nine adolescents (23%) from the total sample were classified as overweight according to International age- and sex-specific BMI values. The high TV viewing group had significantly less favorable values of HDL-cholesterol, glucose, apo A1 and CVD score, independent of age, sex, sexual maturation, race and weight status. There was a significant interaction effect of TV viewing x weight status (P = 0.002) on WC, and the negative influence of TV viewing on WC persisted in the overweight group (P = 0.031) but was attenuated in non-overweight adolescents (P > 0.05)., Conclusion: Excessive TV viewing seems to be related to an unfavorable CVD risk factors profile in adolescence. Reducing TV viewing in overweight adolescents might be beneficial to decrease abdominal body fat.