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Copyright of Revista Kronos is the property of Revista Kronos and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Copyright of Revista Kronos is the property of Revista Kronos and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Kronos is the property of Revista Kronos and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: This study aims to investigate the effects of a multimodal program using augmented reality on the functional fitness and physical activity of older adults living in the community., Method: Seventy-eight older adults living in the community participated in this study. Participants were divided into three groups: a control group that maintained their usual activities, and two experimental groups, one with multimodal training (EG1) and the other with multimodal training combined with augmented reality (EG2). Participants were assessed at baseline and post-intervention, after 12 weeks. Functional fitness was assessed using the Rikli and Jones Senior Fitness Test, handgrip strength, the functional reach test, and the Fullerton Advanced Balance Scale. Physical activity was measured using accelerometry., Results: In EG1, lower limb flexibility, agility, cardiorespiratory fitness, and balance improved significantly between baseline and the 12-week outcome ( p  ≤ 0.001 for all). In EG2, improvements were observed in upper and lower limb strength, lower limb flexibility, agility, cardiorespiratory fitness, handgrip strength, and balance ( p  < 0.05 for all). Sedentary behavior increased in EG1 after the intervention. The clinical effect sizes of the interventions were large for balance (ES = 1.19) in EG1 and for upper limb strength (ES = 1.24) in EG2, and medium for cardiorespiratory fitness (ES = 0.74), agility (ES = 0.50), and lower limb flexibility (ES = 0.65) in EG1, and lower limb strength (ES = 0.61) and cardiorespiratory fitness (ES = 0.79) in EG2., Conclusion: Both intervention programs led to improvements in several functional domains. However, the multimodal training combined with augmented reality program showed improvements across more domains, resulting in greater changes. Physical activity did not show significant improvements., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2025 Ferreira, Marmeleira, Del Pozo Cruz, Leite, Bernardino, Moradell and Raimundo.)

Study Objectives: To examine 1) multidimensional sleep profiles in pre-schoolers (3-6 years) across geocultural regions and 2) differences in sleep characteristics and family practices between Majority World regions (Pacific Islands, Sub-Saharan Africa, Eastern Europe, Northeast Asia, Southeast Asia, South Asia, the Middle East and North Africa, Latin America) and the Minority World (the Western world)., Methods: Participants were 3507 pre-schoolers from 37 countries. Nighttime sleep characteristics and nap duration (accelerometer: n=1950) and family practices (parental questionnaire) were measured. Mixed models were used to estimate the marginal means of sleep characteristics by region and examine the differences., Results: Geocultural region explained up to 30% of variance in sleep characteristics. A pattern of short nighttime sleep duration, low sleep efficiency, and long nap duration was observed in Eastern Europe, Northeast Asia, and Southeast Asia. The second pattern, with later sleep midpoints and greater night-to-night sleep variability, was observed in South Asia, the Middle East and North Africa, and Latin America. Compared to the Minority World, less optimal sleep characteristics were observed in several Majority World regions, with medium-to-large effect sizes (∣d∣=0.48-2.35). Several Majority World regions reported more frequent parental smartphone use during bedtime routines (Northeast Asia, Southeast Asia: 0.77-0.99 units) and were more likely to have electronic devices in children's bedroom (Eastern Europe, Latin America, South Asia: OR=5.97-16.57) and co-sleeping arrangement (Asia, Latin America: OR=7.05-49.86), compared to the Minority World., Conclusions: Pre-schoolers' sleep profiles and related family practices vary across geocultural regions, which should be considered in sleep health promotion initiatives and policies., (© The Author(s) 2024. Published by Oxford University Press on behalf of Sleep Research Society.)

Background: Our aim was to examine the prospective dose-response associations of American Heart Association's (AHA) LIFE's Essential 8 (LE8) score and number of cardiovascular health (CVH) factors with high score with all-cause and cardiovascular disease (CVD) related mortality., Methods: We pooled 6 consecutive waves of the National Health and Nutrition Examination Survey (NHANES) comprising rounds between 2007 and 2008 and 2017-2018. We calculated hazard ratios (HRs) and conducted restricted cubic splines models to assess the dose-response association of LE8 score and CVH factors with all-cause and CVD mortality., Results: Analyses included 23,531 adults aged 18 years and over (mean [SD] age, 43.6 [16.7] years; 11,979 [51%] female; 8960 [38.1%] non-Hispanic white individuals) with a median follow-up of 7.3 years (IQR 4.3-10.1), corresponding to 168,033 person-years. The dose-response analyses showed a significant inverse curvilinear trend for the association between LE8 score with all-cause and CVD mortality. The optimal risk reduction for all-cause mortality was found at 100 points of the LE8 Score (HR, 0.50; 95% CI, 0.27-0.93) compared to the reference (median LE8 score [62.5 points]). Moreover, the dose-response association between LE8 and CVD mortality also exhibited a significant inverse curvilinear association up to 90 points (HR, 0.41; 95% CI, 0.17-0.99). Optimal levels of LE8 score may be able to avert around 40% of the annual all-cause and CVD deaths among the US adult population., Conclusions: Best-case scenario of CVH may reduce around 40% of the all-cause and CVD annual mortality among adults in the United States., Competing Interests: Declaration of competing interest None., (Copyright © 2024. Published by Elsevier Inc.)

Background: The aim of this study was to determine the absolute and relative reliability of the Ruler Drop Test (RDT) for assessing dual-task, choice, and discrimination reaction time. In addition, the construct validity of the RDT is examined in comparison to the Deary-Liewald reaction time (DLRT)., Methods: Tests were administered by the same evaluator, one week apart. Intraclass Correlation Coefficient (ICC3.1) was used to measure relative reliability, and the standard error of measurement (SEM) and minimal detectable change (MDC95) were used to measure absolute reliability. Spearman correlation test was used to measure construct validity., Results: The results showed that the relative reliability was good for the choice ruler drop (ICC = 0.81), moderate for the dual-task ruler drop test (ICC = 0.70) and discrimination ruler drop test (ICC = 0.72), and good for simple ruler drop test. However, the simple ruler drop test had poor reliability (ICC = 0.57). The RDT shows construct validity compared to the DLRT., Conclusion: We conclude that the RDT is a suitable instrument for measuring dual-task, choice and discrimination reaction time. Future studies should explore the reliability of these measures in other populations., (© 2024. The Author(s).)

Competing Interests: The authors have no competing interests to declare.

Background: The optimal dose or type of physical activity to control glycosylated hemoglobin (HbA1c) in people with diabetes remains unknown. Current guidelines do not include consideration of baseline HbA1c for activity prescription., Purpose: To examine the dose-response relationship between physical activity and HbA1c (%) in individuals with type 2 diabetes., Data Sources: A systematic search was performed in Embase, MEDLINE, Scopus, CINAHL, SPORTDiscus, and Web of Science., Study Selection: We included trials that involved participants diagnosed with type 2 diabetes that included any type of physical activity as intervention., Data Extraction: Pre- and postintervention HbA1c data, population and interventions characteristics, and descriptive statistics were collected to calculate change scores for each study arm., Data Synthesis: We used Bayesian random-effects meta-analyses to summarize high-quality evidence from 126 studies (6,718 participants). The optimal physical activity dose was 1,100 MET min/week, resulting in HbA1c reductions, ranging from -1.02% to -0.66% in severe uncontrolled diabetes, from -0.64% to -0.49% in uncontrolled diabetes, from -0.47% to -0.40% in controlled diabetes, and from -0.38% to -0.24% in prediabetes., Limitations: The time required to achieve these HbA1c reductions could not be estimated due to the heterogeneity between interventions' duration and protocols and the interpersonal variability of this outcome., Conclusions: The result of this meta-analysis provide key information about the optimal weekly dose of physical activity for people with diabetes with consideration of baseline HbA1c level, and the effectiveness of different types of active interventions. These results enable clinicians to prescribe tailored physical activity programs for this population., (© 2024 by the American Diabetes Association.)

Objective: To identify the optimal dose and type of physical activity to improve functional capacity and reduce adverse events in acutely hospitalised older adults., Design: Systematic review and Bayesian model-based network meta-analysis., Data Sources: Four databases were searched from inception to 20 June 2022., Eligibility Criteria for Selecting Studies: Randomised controlled trials that assessed the effectiveness of a physical activity-based intervention on at least one functional outcome in people aged ≥50 years hospitalised due to an acute medical condition were included. Pooled effect estimates (ie, standardised mean differences for functional capacity and the ratio of means for adverse events) were calculated using random treatment effects network meta-analysis models., Results: Nineteen studies (3842 participants) met the inclusion criteria. Approximately 100 Metabolic Equivalents of Task per day (METs-min/day) (~40 min/day of light effort or ~25 min/day of moderate effort activities) was the minimal dose to improve the functional capacity of acute hospitalised older adults (standardised mean difference (SMD)=0.28, 95% credible interval (CrI) 0.01 to 0.55). The optimal dose was estimated at 159 METs-min/day (~70 min/day of light effort or ~40 min/day of moderate effort activities; SMD=0.41, 95% CrI 0.08 to 0.72). Ambulation was deemed the most efficient intervention, and the optimal dose was reached at 143 METs-min/day (~50 min/day of slow-paced walking; SMD=0.76, 95% CrI 0.35 to 1.16), showing a high evidential power (87.68%). The minimal effective ambulation dose was estimated at 74 METs-min/day (~25 min/day of slow-paced walking; SMD=0.25, 95% CrI 0.01 to 0.41). Physical activity interventions resulted in a decrease in the rate of adverse events compared with usual care at discharge (ratio of means=0.96, 95% CrI 0.95 to 0.97; median time 7 days)., Conclusions: This meta-analysis yielded low to moderate evidence supporting the use of in-hospital supervised physical activity programmes in acutely hospitalised older adults. As little as ~25 min/day of slow-paced walking is sufficient to improve functional capacity and minimise adverse events in this population., Trial Registration Number: PROSPERO CRD42021271999., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: No prior research has investigated how exposure to environmental tobacco smoke is related to the combination of 24-h movement behaviors among young populations thus far. The aim of this study was to examine the associations between exposure to secondhand smoke and the 24-h movement guidelines., Methods: This is a cross-sectional study using data from the last available wave of the Spanish National Health Survey [2017], a nationally representative survey of the Spanish children and adult population. The final sample included 4,378 (49.0% girls) Spanish young people aged 2-14 years., Results: A lower likelikood of meeting screen time (ST) and all three 24-h movement guidelines were found in those exposed to environmental tobacco smoke in unadjusted models. After adjusting for several covariates, meeting screen time [odds ratio (OR) =0.76; 95% confidence interval (CI), 0.59-0.97], sleep duration (OR =0.75; 95% CI, 0.58-0.96), and all three 24-h movement guidelines (OR =0.63; 95% CI, 0.44-0.91) reached significance after adjusting for potential confounders., Conclusions: Given the inverse associations found, environmental tobacco smoke exposure should be a relevant factor to consider when promoting 24-h behaviors in the young population. Avoiding exposure to tobacco smoke in the environment is essential, as it can potentially influence the 24-h movement behaviors of young people, and consequently, the health benefits associated with such behaviors., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tp.amegroups.com/article/view/10.21037/tp-23-93/coif). AGH serves as an unpaid editorial board member of Translational Pediatrics from August 2021 to July 2023. JFLG is a Margarita Salas Fellow (Universidad Pública de Navarra – 1225/2022). AGH is a Miguel Servet Fellow (Instituto de Salud Carlos III-FSE – CP18/0150). The other authors have no conflicts of interest to declare., (2023 Translational Pediatrics. All rights reserved.)

Background: Psychopathology and side effects of antipsychotic drugs contribute to worsening physical health and long-term disability, and increasing the risk of mortality in these patients. The efficacy of exercise on these factors is not fully understood, and this lack of knowledge may hamper the routine application of physical activity as part of the clinical care of schizophrenia., Aims: To determine the effect of exercise on psychopathology and other clinical markers in patients with schizophrenia. We also looked at several moderators., Method: MEDLINE, Web of Science, Scopus, CINAHL, SPORTDiscus, PsycINFO, and Cochrane Library databases were systematically searched from inception to October 2022. Randomized controlled trials of exercise interventions in patients 18-65 years old diagnosed with schizophrenia disorder were included. A multilevel random-effects meta-analysis was conducted to pool the data. Heterogeneity at each level of the meta-analysis was estimated via Cochran's Q , I 2 , and R 2 ., Results: Pooled effect estimates from 28 included studies (1,460 patients) showed that exercise is effective to improve schizophrenia psychopathology (Hedges' g  = 0.28, [95% CI 0.14, 0.42]). Exercise presented stronger effects in outpatients than inpatients. We also found exercise is effective to improve muscle strength and self-reported disability., Conclusions: Our meta-analysis demonstrated that exercise could be an important part in the management and treatment of schizophrenia. Considering the current evidence, aerobic and high-intensity interval training exercises may provide superior benefits over other modalities. However, more studies are warranted to determine the optimal type and dose of exercise to improve clinical outcomes in people with schizophrenia.

Introduction: This study aimed to explore the associations of activity fragmentation with frailty status and all-cause mortality in a representative US sample of people 50 years and over., Methods: This prospective study used data from the 2003-2006 waves of the National Health and Nutrition Examination Survey (NHANES). Participants 50 years or over were included in the study (n = 2,586). Frailty status was assessed using a valid modification of the Fried criteria. Linked data from the National Death Index registry were used to ascertain mortality. Physical activity fragmentation was measured by accelerometry. To calculate activity fragmentation, an active-to-sedentary transition probability was calculated as the number of physical activity bouts divided by the total sum of minutes spent in physical activity. Age, gender, ethnicity, education, mobility issues, drinking status, smoking status, BMI, and self-reported chronic diseases were reported in the NHANES study., Results: An increment of 1 SD in activity fragmentation was associated with an increased likelihood of frailty (odds ratio [95% confidence interval] = 1.36 [1.13-1.664]). Compared with participants in the high activity fragmentation/low physical activity category, participants in the low activity fragmentation/low physical activity and low activity fragmentation/high physical activity categories were associated with a lower likelihood of frailty. We found a nonlinear association between activity fragmentation and all-cause mortality. Compared with participants in the high activity fragmentation/low physical activity category, participants in the low activity fragmentation/low physical activity, low activity fragmentation/high physical activity, and high activity fragmentation/high physical activity categories were associated with a lower mortality risk. Participants with a low fragmented activity pattern may also overcome some of the detrimental effects associated with sedentary behavior., Conclusions: Our results suggest that a high fragmented physical activity pattern is associated with frailty and risk of mortality in adults and older adults. This association was independent of total volume of physical activity and time spent sedentary., (© 2022 S. Karger AG, Basel.)

Background: Evidence investigating associations between hospitalization and physical activity is scarce and limited to specific populations of older adults., Objective: The current study aimed to describe the impact of past hospitalization on current physical activity levels of a large representative sample of European older adults with accelerometry data., Methods: A representative sample of 856 European older adults aged 50 years and over was included in this study. Hospital admission and utilization (i.e., accumulated times and length of stay in hospital) in the last 12 months were self-reported retrospectively. Physical activity volume (mg) and distribution of intensity (intensity gradient) were assessed with thigh-worn accelerometers., Results: Multivariate linear regressions indicated that hospital admission (15% of the sample) was associated with reduced physical activity volume (-4.29 mg; 95% confidence interval (95% CI), -9.07 to 0.47) of participants. Each additional hospital admission was associated with lower volume (-2.29 mg; 95% CI, -4.65 to 0.06) and poorer distribution of intensity (-0.07; 95% CI, -0.11 to -0.04). Total length of stay was not associated with physical activity., Conclusions: This study suggests that hospital admission and the number of times admitted, but not accumulated length of stay, may curb physical activity levels of older adults. Public health strategies to promote successful aging should target post-hospitalization physical activity., (© 2022 S. Karger AG, Basel.)

Background: This study aims to investigate the acute effects of an augmented reality session and a cycle ergometer session compared to no exercise on the reaction times, cognitive flexibility, and verbal fluency of older adults., Methods: Each participant did a familiarization with cognitive tests and the following three sessions: cycle ergometer, no exercise (control group), and augmented reality exergame (Portable Exergame Platform for Elderly) sessions. The participants were randomized in a within-group design into one of six possible combinations. Each moment had a 30 min duration, and after the session, the participants performed a Trail Making Test, a verbal fluency test, and a Deary-Liewald reaction time task. The data were analyzed with a one-way ANOVA with a Bonferroni adjustment., Results: The analysis between the no exercise, cycle ergometer, and augmented reality sessions showed no significant differences in the cognitive measurements., Conclusions: One session of the cycle ergometer exercise or the augmented reality exergames does not acutely improve the reaction times, cognitive flexibility, or verbal fluency in the elderly.

Background and Purpose: Physical activity can delay the progression of self-care disability in older adults residing in living care facilities. Nonetheless, older adults residing in living care facilities spend most of their time sedentary and do not meet the physical activity recommendation, which may result in increasing self-care disability in this population group. In this study, we aimed to determine whether the association between sedentary time and self-care disability was moderated by moderate-to-vigorous physical activity (MVPA) in older adults residing in living care facilities., Methods: Sedentary time and MVPA were both measured with accelerometers. Self-care disability was assessed with the Barthel Index. A multivariate regression model was used to ascertain the effects of the interaction between sedentary time and MVPA on the self-care disability of participants. The Johnson-Neyman technique was then used to estimate the exact MVPA threshold at which the effect of sedentary time on self-care disability became nonsignificant., Results: We found a significant effect of sedentary time on self-care disability (standardized β=-1.66; 95% CI -1.77 to -1.54, P = .013). Results indicated that MVPA moderates the relationship between self-care disability status and sedentary time (standardized β= 1.14; 95% CI 1.13 to 1.14, P = .032). The Johnson-Neyman technique determined that 51 min/day of MVPA would offset the negative effects of sedentary time on self-care disability., Conclusions: Our results suggest physical therapists should focus on reducing sedentary time alongside physical activity to prevent the progression to dependency in octogenarians residing in living care facilities., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 APTA Geriatrics, An Academy of the American Physical Therapy Association.)

Objective: We aimed to examine the dose-response associations between the number of steps per day and all-cause mortality among adults with prediabetes and diabetes., Research Design and Methods: This prospective study used data from 1,194 U.S. adults with prediabetes and 493 with diabetes for whom accelerometer-derived steps per day could be retrieved. Mortality was ascertained through the National Death Index (February 25, 2019). Splines were used to assess the dose-response associations between steps per day and all-cause mortality., Results: Over ∼9 years of follow-up, 200 adults with prediabetes and 138 with diabetes died. Nonlinear associations akin to an L shape were observed. We estimated an optimal dose of ∼10,000 steps per day to reduce the risk of all-cause mortality for both individuals with prediabetes and those with diabetes., Conclusions: Accumulating more steps per day up to ∼10,000 steps per day may lower the risk of all-cause mortality of adults with prediabetes and diabetes., (© 2022 by the American Diabetes Association.)

Objectives: Fibromyalgia syndrome (FM) is a complex disease that is mainly characterised by chronic pain, fatigue, and sleep disturbances and may be precipitated or worsened by many stressors. The aim of this study was to examine the effects of respiratory muscle training (RMT) on respiratory efficiency and health-related quality of life (HRQoL) in women with FM., Methods: A total of 30 women with FM were included in the intention to treat analyses: 15 were assigned to the RMT group and 15 to the control group. The intervention consisted of 12 weeks of RMT. The primary outcome was the change in pulmonary function assessed by global body plethysmography at 12 weeks compared with baseline. Secondary outcomes included changes of scores in HRQoL assessed by the Short Form 36 Health Survey-Portuguese version., Results: The maximal inspiratory pressure (MIP) improved by 17.5% (p-value = .033), maximal expiratory pressure (MEP) improved 21.6% (p-value = 0.045) and maximum occlusion pressure (P0.1 max) increased 27.7% (p-value = 0.007). HRQoL improved in the dimensions of physical function, physical role, bodily pain and vitality (p-value <0.05)., Conclusions: RMT results in a significant improvement of respiratory efficiency and HRQoL after 12 weeks. RMT could be an effective therapy to enhance respiratory function and quality of life in women with FM.

Background: We investigated the associations of replacing sedentary behavior (SB) with physical activity of different intensities on the physical function of octogenarians living in long-term care facilities., Methods: This pooled study recruited 427 older adults aged 80 years and older (69.1% female; body mass index: 27.53). For 345 participants who provided valid data, we assessed device-measured time spent in SB, light-intensity physical activity (LIPA), and moderate to vigorous physical activity (MVPA). We assessed lower limb physical function, strength, mobility, and disability. We used compositional data analysis to investigate the associations of replacing SB with physical activity on the outcomes., Results: Reallocation of SB to LIPA and MVPA was associated with a higher number of 30-second Chair Stand cycles (LIPA: +0.21, MVPA: +1.81; P < .001), greater peak force (LIPA: +11.96 N, MVPA: +27.68 N; P < .001), peak power (LIPA: +35.82 W, MVPA: +92.73 W; P < .001), peak velocity (LIPA: +0.03 m/s, MVPA: +0.12 m/s; P < .001), higher levels of grip strength (LIPA: +0.68 kg, MVPA: +2.49 kg; P < .001), and less time in the Time Up and Go (LIPA: -7.63 s, MVPA: -12.43 s; P < .001)., Conclusions: Replacing SB with LIPA or MVPA is associated with physical function and disability of older adults living in long-term care facilities.

This systematic review aimed to identify the physical/motor fitness tests for nursing home residents and to examine their psychometric properties. Electronic databases were searched for articles published between January 2005 and October 2021 using MeSh terms and relevant keywords. Of the total of 4196 studies identified, 3914 were excluded based on title, abstracts, or because they were duplicates. The remaining 282 studies were full-text analyzed, and 41 were excluded, resulting in 241 studies included in the review. The most common physical component assessed was muscle strength; 174 (72.2%) studies assessed this component. Balance (138 studies, 57.3%) and agility (102 studies, 42.3%) were the second and third components, respectively, most widely assessed. In this review, we also describe the most used assessment tests for each physical/motor component. Some potentially relevant components such as manual dexterity and proprioception have been little considered. There are few studies assessing the psychometric properties of the tests for nursing home residents, although the data show that, in general, they are reliable. This review provides valuable information to researchers and health-care professionals regarding the physical/motor tests used in nursing home residences, helping them select the screening tools that could most closely fit their study objectives.

Objective: To examine the dose-response relationship between overall and specific types of exercise with cognitive function in older adults., Design: Systematic Review and Bayesian Model-Based Network Meta-Analysis., Data Sources: Systematic search of MEDLINE, Web of Science, Scopus, PsycINFO and SPORTDiscus., Eligibility Criteria for Selecting Studies: Randomized controlled trials of exercise interventions in participants aged 50 years or over, and that reported on at least one global cognition outcome., Results: The search returned 1998 records, of which 44 studies (4793 participants; 102 different effect sizes) were included in this review with meta-analysis. There was a non-linear, dose-response association between overall exercise and cognition. We found no minimal threshold for the beneficial effect of exercise on cognition. The estimated minimal exercise dose associated with clinically relevant changes in cognition was 724 METs-min per week, and doses beyond 1200 METs-min per week provided less clear benefits. We also found that the dose-response association was exercise type dependent, and our results show that clinically important effects may occur at lower doses for many types of exercise. Our findings also highlighted the superior effects of resistance exercises over other modalities., Conclusions: If provided with the most potent modalities, older adults can get clinical meaningful benefits with lower doses than the WHO guidelines. Findings support the WHO recommendations to emphasise resistance training as a critical component of interventions for older adults., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Introduction: 24-hour movement behaviours (physical activity, sedentary behaviour and sleep) during the early years are associated with health and developmental outcomes, prompting the WHO to develop Global guidelines for physical activity, sedentary behaviour and sleep for children under 5 years of age. Prevalence data on 24-hour movement behaviours is lacking, particularly in low-income and middle-income countries (LMICs). This paper describes the development of the SUNRISE International Study of Movement Behaviours in the Early Years protocol, designed to address this gap., Methods and Analysis: SUNRISE is the first international cross-sectional study that aims to determine the proportion of 3- and 4-year-old children who meet the WHO Global guidelines. The study will assess if proportions differ by gender, urban/rural location and/or socioeconomic status. Executive function, motor skills and adiposity will be assessed and potential correlates of 24-hour movement behaviours examined. Pilot research from 24 countries (14 LMICs) informed the study design and protocol. Data are collected locally by research staff from partnering institutions who are trained throughout the research process. Piloting of all measures to determine protocol acceptability and feasibility was interrupted by COVID-19 but is nearing completion. At the time of publication 41 countries are participating in the SUNRISE study., Ethics and Dissemination: The SUNRISE protocol has received ethics approved from the University of Wollongong, Australia, and in each country by the applicable ethics committees. Approval is also sought from any relevant government departments or organisations. The results will inform global efforts to prevent childhood obesity and ensure young children reach their health and developmental potential. Findings on the correlates of movement behaviours can guide future interventions to improve the movement behaviours in culturally specific ways. Study findings will be disseminated via publications, conference presentations and may contribute to the development of local guidelines and public health interventions., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Previous studies examining unidirectional relationships between social isolation and physical functioning among older adults may be biased due to reverse causality. This study leveraged data from a US national sample of older adults and a novel estimation method to identify bidirectional associations between these 2 phenomena and their associated temporal dynamics., Methods: The analyses were based on 9 waves of panel data from a sample of adults aged 65 and older from the US National Health and Aging Trends Study (n = 12 427 individuals) and a cross-lagged panel model. Social isolation was measured using the Social Isolation Index (SII) and physical functioning through the Short Physical Performance Battery (SPPB)., Results: One SD increase in the SPPB was associated with a -0.013 SD decrease (95% confidence interval [CI]: -0.023 to -0.004) in the SII a year later, whereas 1 SD increase in the SII was associated with a larger -0.058 SD decrease (95% CI: -0.069 to -0.046) in the SPPB a year later. The SII→SPPB effect lasted for approximately 5 years, whereas the SPPB→SII lasted for approximately 3 years., Conclusions: This study confirmed the existence of statistically significant bidirectional associations between social isolation and physical functioning among older adults in the United States, net of reverse causation. Because the effect of social isolation dominates, the findings indicate that public health strategies to promote successful aging should prioritize interventions that enrich older adults' social networks. Furthermore, the effect time horizons yielded by the model point to the optimal timing for the re-delivery of interventions., (© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: Social isolation among older adults is associated with poor health and premature mortality, but its impact on physical functioning is not fully understood. Previous studies have typically relied on community samples, cross-sectional data, and suboptimal prospective designs. This study generates more robust evidence by investigating the longitudinal associations between social isolation and physical functioning in a large panel of older adults., Methods: Analyses were based on 9 waves of data (2011-2019) from a sample of adults aged ≥65 years from the U.S. National Health and Aging Trends Study (N=12,427 individuals; 54,860 person-year observations) and within-individual fixed-effect panel regression models. Analyses were conducted in 2020. Social isolation was measured using the Social Isolation Index, and physical functioning was measured through the Short Physical Performance Battery., Results: In fully adjusted fixed-effect regression models, each 1-unit increase in the Social Isolation Index resulted in an average decrease of 0.27 units in the Short Physical Performance Battery (95% CI= -0.31, -0.24). This relationship was moderated by age, with the Social Isolation Index bearing a significantly and substantially stronger influence on the Short Physical Performance Battery at older ages than at younger ages., Conclusions: This study confirms that social isolation is associated with deficits in physical functioning among older adults in the U.S. using more robust data and methods than earlier studies. These findings highlight the importance of incorporating strategies to reduce social isolation in policies aimed at promoting successful aging., (Copyright © 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Introduction: Subjective memory complaints (SMC) are often considered a clinical marker of mild cognitive impairment and dementia and could manifest as shortening of activity bouts throughout the day causing daily activity to accumulate in a more fragmented pattern. In the current study we explored the association between activity fragmentation and SMC in middle-aged and older adults., Methods: We used data from 3820 participants in the National Health and Nutrition Examination Survey (2003-2006) with valid accelerometer SMC data. The analyses were conducted in 2020. To calculate activity fragmentation, an active-to-sedentary transition probability was calculated as the number of physical activity bouts (i.e., consecutive minutes registering 100+ counts/min) divided by the total sum of minutes spent in physical activity. A multivariable ordinal logistic regression model was conducted to examine the association between activity fragmentation (scaled) and SMC (yes/no)., Results: Higher activity fragmentation was associated with an increased likelihood of self-reported SMC in the study population (Odd Ratio [95% Confidence Interval] = 1.335 [1.067, 1.669]; Average Marginal Effect [95%CI] = 0.029 [0.006, 0.052]; p-value = 0.021). This association was independent of total physical activity volume., Conclusions: The findings provide support that studying fragmented activity patterns can be useful in identifying those at risk for SMC, over and above total volume of physical activity. Future longitudinal studies are required to establish causality and the temporal order of the observed association. Nevertheless, activity fragmentation in middle-aged and older adults may reflect pre-clinical signs of future neurodegenerative processes indicating potential targets for modification through intervention., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: The restrictions associated with the 2020 COVID-19 pandemic has resulted in changes to young children's daily routines and habits. The impact on their participation in movement behaviours (physical activity, sedentary screen time and sleep) is unknown. This international longitudinal study compared young children's movement behaviours before and during the COVID-19 pandemic., Methods: Parents of children aged 3-5 years, from 14 countries (8 low- and middle-income countries, LMICs) completed surveys to assess changes in movement behaviours and how these changes were associated with the COVID-19 pandemic. Surveys were completed in the 12 months up to March 2020 and again between May and June 2020 (at the height of restrictions). Physical activity (PA), sedentary screen time (SST) and sleep were assessed via parent survey. At Time 2, COVID-19 factors including level of restriction, environmental conditions, and parental stress were measured. Compliance with the World Health Organizations (WHO) Global guidelines for PA (180 min/day [≥60 min moderate- vigorous PA]), SST (≤1 h/day) and sleep (10-13 h/day) for children under 5 years of age, was determined., Results: Nine hundred- forty-eight parents completed the survey at both time points. Children from LMICs were more likely to meet the PA (Adjusted Odds Ratio [AdjOR] = 2.0, 95%Confidence Interval [CI] 1.0,3.8) and SST (AdjOR = 2.2, 95%CI 1.2,3.9) guidelines than their high-income country (HIC) counterparts. Children who could go outside during COVID-19 were more likely to meet all WHO Global guidelines (AdjOR = 3.3, 95%CI 1.1,9.8) than those who were not. Children of parents with higher compared to lower stress were less likely to meet all three guidelines (AdjOR = 0.5, 95%CI 0.3,0.9)., Conclusion: PA and SST levels of children from LMICs have been less impacted by COVID-19 than in HICs. Ensuring children can access an outdoor space, and supporting parents' mental health are important prerequisites for enabling pre-schoolers to practice healthy movement behaviours and meet the Global guidelines.

The aim of this study was to determine the absolute and relative reliability and validity of two reaction time (RT) tests in older adults using long-term facility: the ruler drop test (RDT, a simple RT) and the Deary-Liewald RT task (DLRT, simple and four-choice RT). Participants (≥65 years old) using long-term facilities were distributed into a group without cognitive impairment (GWCI, n = 41), and a group with mild cognitive impairment (GCI, n = 32). The tests were administered one week apart, by the same evaluator. Relative reliability was measured by the Intraclass Correlation Coefficient (ICC3.1), absolute reliability by the standard error of measurement (SEM) and minimal detectable change (MDC95) and convergent validity by the Pearson correlation. The results showed that the relative reliability was good for the RDT (GWCI, ICC = 0.84; GCI, ICC = 0.80) and moderate for the Deary Liewald RT simple (DLRT-S) (GWCI, ICC = 0.61; GCI, ICC = 0.65). The relative reliability of the Deary Liewald RT choice (DLRT-C) was good (ICC = 0.89) for the GWCI and excellent (ICC = 0.93) for the GCI. However, the DLRT-C had low feasibility in the GCI, as most participants were unable to complete the test. Measurement precision was acceptable for the RDT and DLRT-C (GWCI) and for the DLRT-C (GCI). There were no significant associations between the RDT and DLRT scores. We conclude that the RDT could be more suitable than the DLRT-S for assessing simple RT in older adults. Future studies should explore if fewer than the four stimulus-response alternatives used in the DLRT-C could be more appropriate for assessing choice RT in older adults with cognitive impairment., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objectives. We investigated the association between physical fitness and cognitive status. Further, we examined whether physical fitness mediates the association between cognitive functioning and aging. Design. Cross-sectional study. Setting. Urban and rural Colombian older adults. Methods. 4416 participants from the SABE study were included in the current analysis. Physical fitness was assessed with the handgrip test and the usual gait speed test. Cognitive status was evaluated through the Folstein Mini-Mental State Examination. A parallel mediation path was used to test the possible mediator role of physical fitness between aging and cognitive functioning. Results. Older adults with lower handgrip strength (HGS) were more likely to have mild-cognitive status than older adults with healthy HGS (OR = 1.53, 95% CI = 1.15; 2.02). In addition, older adults with a slower gait speed were more likely to have mild cognitive impairment (OR = 2.05, 95% CI = 1.54; 2.78). Age had an inverse relationship with cognitive function (β = -0.110, 95% CI = -0.130; -0.100) and it was also inversely associated with HGS (β = -0.003, 95% CI = -0.005; -0.002) and gait speed (β = -0.010, 95% CI = -0.011; -0.009). The indirect effects, which indicate that the effect of age on cognitive function is transmitted through mediators, showed that both gait speed (β = -0.028, 95% CI = -0.036; -0.020) and HGS (β = -0.014, 95% CI = -0.024; -0.005) were independent mediators of the detrimental effect of aging on cognitive function. Conclusions. Physical fitness mediates the effects of aging on cognitive functioning. Our findings suggest that physical activity can be a key factor to prevent cognitive deterioration during aging process.

We aimed to compare all-cause mortality risk across clusters of adults ≥50 years of age (n = 1,035) with common lifestyle behaviors patterns, enrolled in the US National Health and Nutrition Examination Survey (2005-2006). Log-ratio coordinates of 24-hour movement pattern and z scores of diet quality were used as input into a model-based clustering analysis. A Cox regression model was fitted to ascertain the all-cause mortality risk associated with each cluster. Participants were clustered into 4 groups: 1) a group characterized by a better physical activity profile and longer sleep duration coupled with an average diet quality (cluster 1); 2) a group with the poorest activity profile and shortest sleep but also the best diet quality (cluster 2); 3) another group featuring lower levels of activity of either intensity and higher levels of sedentary behavior and also a poor diet quality score (cluster 3); and 4) a group with an average diet quality and the best activity profile in the sample (cluster 4). A combination of a poorer diet and activity profile increased the prospective risk of all-cause mortality. Our findings emphasize the importance of considering the combination of diet quality and 24-hour movement patterns when developing interventions to reduce the risk of premature mortality., (© The Author(s) 2020. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Aims: Evaluate the validity and reliability of the data from the Wii balance board (WBB), against a force platform (FP) in patients with type 2 diabetes mellitus (T2DM)., Methods: Forty-three adults with T2DM (age 62.1 ± 12.1 yrs) in the validity trial and 27 (age 63.5 ± 10.8 yrs) in the reliability study, were tested. Total COP area (mm) and range of antero-posterior (AP) and medio-lateral (ML) COP excursion were collected simultaneously on a FP and a WBB., Results: Mean CoP sway path values were similar in all conditions in the FP when compared with the WBB. Regression model shows that WBB is able to explain most of the variation in CoP sway path data of the FP (between 42 and 72%) for all testing conditions, indicating that the WBB has good concurrent validity. Test-retest reliability for WBB was excellent, except for the COP sway area in the 'eyes open' condition (ICC = 0.55). Both conditions showed modest to excellent reliability in the AP (0.73-0.90) and the ML (0.77-0.91) directions., Conclusion: The WBB has been shown to be a valid and reliable method to quantify the COP displacement during different balance tests in older adults with T2DM., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Excess central adiposity accelerates the decline of muscle strength in older people. Additionally, hyperglycemia, independent of associated comorbidities, is related to the loss of muscle mass and strength, and contributes to functional impairment in older adults. We studied the mediation effect of glucose levels, in the relationship between abdominal obesity and relative handgrip strength (HGS). A total of 1571 participants (60.0% women, mean age 69.1 ± 7.0 years) from 86 municipalities were selected following a multistage area probability sampling design. Measurements included demographic and anthropometric/adiposity markers (weight, height, body mass index, and waist circumference). HGS was measured using a digital dynamometer for three sets and the mean value was recorded. The values were normalized to body weight (relative HGS). Fasting glucose was analyzed by enzymatic colorimetric methods. Mediation analyses were performed to identify associations between the independent variable (abdominal obesity) and outcomes (relative HGS), as well as to determine whether fasting glucose levels mediated the relationship between excess adiposity and relative HGS. A total of 1239 (78.8%) had abdominal obesity. Abdominal obesity had a negative effect on fasting glucose (β = 9.04, 95%CI = 5.87 to 12.21); while fasting glucose to relative HGS was inversely related (β = -0.003, 95%CI = -0.005 to -0.001), p < 0.001. The direct effect of abdominal obesity on relative HGS was statistically significant (β = -0.069, 95%CI = -0.082 to -0.057), p < 0.001. Lastly, fasting glucose levels mediates the detrimental effect of abdominal obesity on relative HGS (indirect effect β = -0.002, 95%CI = -0.004 to -0.001), p < 0.001. Our results suggest that the glucose level could worsen the association between abdominal obesity status and lower HGS. Thus, it is plausible to consider fasting glucose levels when assessing older adults with excess adiposity and/or suspected loss of muscle mass.

The aim of this study was to quantify the effect of whole-body vibration on balance, functional mobility, gait, functional performance, and quality of life in institutionalized older people. Eight databases were systematically reviewed, as recommended by the Cochrane Collaboration. This systematic review was designed to answer the acronym set by the participants, interventions, comparators, and outcomes (PICO)-model. Ten randomized controlled trials were included in the meta-analysis. The analysis of the mean differences (MDs) of the functional mobility assessed with Time Up and Go test was MD = -2.49 s (95% confidence interval, CI, [-4.37, -0.61]; I2 = 68%). In 279 participants from five studies, the overall MD = 0.49 (95% CI [-0.13, 1.11]; I2 = 23%) for gait, and MD = 0.96 (95% CI [-0.45, 2.37]; I2 = 85%) for balance, which represents the total Tinetti score, MD = 1.59 (95% CI [-0.52, 3.70]; I2 = 82%). In summary, whole-body vibration could have benefits on functional mobility in institutionalized older people.

Background: Evidence supporting the individual associations of sedentary behaviours with depression symptoms commonly ignores the inherent co-dependency between physical activity, sedentary behaviours and sleep in a given 24-hour period. Data analysis based on compositional methods effectively deals with this issue., Aim: To investigate the association between sedentary behaviour and depression symptoms synergistically using compositional analysis methods., Methods: Participants were a representative sample of 3233 US adults and older adults from the 2005-2006 cycle of the NHANES with valid 24-hour lifestyle behaviours data (i.e., accelerometer-derived physical activity and sedentary behaviour and self-reported sleep) and available self-reported depression symptoms (PHQ-9). The association between sedentary behaviour and depression symptoms scoring was investigated using a compositional zero-inflated Poisson regression analysis. Subsequently, the model estimates were used to evaluate the effects on depression symptoms of replacing time spent in sitting activities with physical activity of different intensities and sleep., Limitations: The current study is limited by its cross-sectional design. Also, sleep time was self-reported, which could bias our estimations., Results: Increased sedentary behaviour relative to other behaviours was statistically significantly associated with increased depression symptoms (p < 0.001). Reallocating 60 min time from sedentary behaviours to moderate-to-vigorous physical activity (MVPA) and sleep was associated with small reductions in depression symptoms., Conclusions: A synergistic compositional analysis of accelerometer data uncovered a detrimental association between sedentary behaviour and depression symptoms. These results add to evidence from previous studies. The observed association seems to be principally driven by corresponding reductions in MVPA and sleep duration., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objectives: Bioavailability of supplements with coenzyme Q10 (CoQ 10 ) in humans seems to depend on the excipients of formulations and on physiological characteristics of the individuals. The aim of this study was to determine which factors presented in CoQ 10 supplements affect the different response to CoQ 10 in humans., Methods: We tested seven different supplement formulations containing 100 mg of CoQ 10 in 14 young, healthy individuals. Bioavailability was measured as area under the curve of plasma CoQ 10 levels over 48 h after ingestion of a single dose. Measurements were repeated in the same group of 14 volunteers in a double-blind crossover design with a minimum of 4 wk washout between intakes., Results: Bioavailability of the formulations showed large differences that were statistically significant. The two best absorbable formulations were soft-gel capsules containing ubiquinone (oxidized CoQ 10 ) or ubiquinol (reduced CoQ 10 ). The matrix used to dissolve CoQ 10 and the proportion and addition of preservatives such as vitamin C affected the bioavailability of CoQ 10 . Although control measurements documented that all formulations contained 100 mg of either CoQ 10 or ubiquinol, some of the participants showed high and others lower capacity to reach high increase of CoQ 10 in blood, indicating the participation of individual unknown physiological factors., Conclusion: This study highlights the importance of individually adapted selection of best formulations to reach the highest bioavailability of CoQ 10 in humans., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

This study aimed to compare the effect of high-intensity interval training (HIIT) with additional whole-body vibration (WBV) on body composition and lipid profile in obese/overweight adults on a hypocaloric diet. Forty adults were randomly assigned to (a) HIIT and vibration and hypocaloric diet (HIITWBV, n = 13), (b) HIIT and diet (HIIT, n = 14), and (c) diet only (control [CON], n = 13). High-intensity interval training WBV participants trained 3 times per week for 8 weeks (6 sets × 1 minute of HIIT, cycling at 90% heart rate peak followed by 1 minute of interset vibration, at a frequency of 18 Hz increasing until 25 Hz with a peak-to-peak displacement of 4 mm. Training volume increased 1 set every 2 weeks until 10 sets). The HIIT group performed HIIT training followed by 2 minutes of passive recovery, while the CON continued with their daily activities combined with calorie restriction. Body composition (body fat and fat-free mass) and biochemical indices (glucose, total cholesterol, high-density lipoprotein cholesterol, and triglycerides) were determined. Following 8 weeks, body fat was significantly reduced by 7.5% and both triglycerides and total cholesterol decreased in the HIITWBV group only (-16.5% and -11.7% respectively). This study suggests that HIIT in combination with WBV and a hypocaloric diet can improve overall lipid profile in overweight/obese individuals., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.