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- Muscle strength and balance as mediators in the association between physical activity and health-related quality of life in community-dwelling older adultsPublication . Maio Nascimento, Marcelo de; Gouveia, Bruna R.; Gouveia, Élvio Rúbio; Campos, Pedro; Marques, Adilson; Ihle, AndreasLower extremity muscle strength (LEMS) and body balance (BB) are essential for older adults to maintain an upright posture and autonomously perform their basic activities of daily living. This study aimed to examine whether LEMS and BB mediate the relationship between physical activity (PA) and health-related quality of life (HRQoL) in a large sample of community-dwelling older adults. This is a cross-sectional study carried out with 802 individuals, 401 males and 401 females (69.8 ± 5.6 years), residents of the Autonomous Region of Madeira, Portugal. PA and HRQoL were assessed by the Baecke Questionnaire and e SF-36, respectively. LEMS was assessed by the Senior Fitness Test and BB by the Fullerton Advance Balance (FAB). The serial mediation pathway model pointed out that LEMS and BB partially mediated the association between PA and HRQoL in approximately 39.6% and 47%, respectively. The total variance in HRQoL explained by the entire model was 98%. Our findings may indicate the role that LEMS and BB play in the relationship between PA and HRQoL in the older population.
- The Mediating Role of Physical Activity and Physical Function in the Association between Body Mass Index and Health-Related Quality of Life: A Population-Based Study with Older AdultsPublication . Nascimento, Marcelo de Maio; Gouveia, Élvio Rúbio; Gouveia, Bruna R.; Marques, Adilson; Campos, Pedro; García-Mayor, Jesús; Przednowek, Krzysztof; Ihle, AndreasThis study aimed (1) to investigate the association between body mass index (BMI), physical activity (PA), and physical function (PF) with health-related quality of life (HRQoL), and (2) to examine in-depth whether PA and PF mediate the relationship between BMI and HRQoL in older adults. We investigated 802 individuals (mean age 69.8 ± 5.6 years), residents of the Autonomous Region of Madeira, Portugal. Harmol and PA were assessed using the SF-36 and Baecke questionnaires, respectively, and PF by the Senior Fitness Test. The prevalence of overweight was 71.3%, 26.5% for normal weight, and 2.1% for underweight. We verified a small correlation between age and sex with BMI, PA, PF, and medium borderline with HRQoL. After adjusting for covariates (i.e., sex, age, comorbidities), the multivariate regression analysis indicated a 93.1% chance of improvement in HRQoL for low BMI, while PA and PF revealed a chance of increasing HRQoL by 91.8% and 60.0%, respectively. According to the serial mediation pathway, PA and PF partially mediated the association between BMI and HRQoL by 32.3% and 81.5%, respectively. The total variance of the model was 90%. It was concluded that BMI can negatively affect HRQoL. On the other hand, PA and PF are able to increase HRQoL levels during the aging process.
- Differential Patterns in Motivations for Practicing Sport and Their Effects on Physical Activity Engagement across the LifespanPublication . Nascimento, Marcelo de Maio; Gouveia, Élvio Rúbio; Gouveia, Bruna R.; Marques, Adilson; França, Cíntia; Campos, Pedro Filipe Pereira; Martins, Francisco; García-Mayor, Jesús; Ihle, AndreasThis study aims to report what motivates individuals to be physically active, to determine whether motivating factors influence physical activity (PA) levels, and whether this differs across the lifespan. This is a cross-sectional study with 498 individuals: 117 adolescents, 306 adults, and 75 older adults. PA was assessed using Baecke’s questionnaire, and motivating factors for practicing sports were investigated using a scale with twelve questions. The factor analysis identified three motivating factors for sports practice: psychosocial, bodily, and well-being. The scale’s overall reliability and internal consistency indicated a Cronbach’s alpha of 0.885. The analysis of covariance (ANCOVA) adjusted for sex indicated the three factors as having a significant effect on PA (p < 0.050); however, only the well-being factor showed a significant interaction with age groups (p = 0.023, ηp 2 = 0.030). Subsequently, the effect of the well-being factor on PA scores in each age group was explored through regression analyses. Only older adults showed a significant association in the unadjusted [OR = 0.378, p = 0.001, R2 = 0.243] and the sex-adjusted analysis [OR = 0.377, p = 0.001, R2 = 0.288]. These results help us to better understand the underlying motivational reasons in different age groups for engaging in sports.
- Physical Activity Dimensions Differentially Predict Physical and Mental Components of Health-Related Quality of Life: Evidence from a Sport for All StudyPublication . Ihle, Andreas; Gouveia, Bruna R.; Gouveia, Élvio R.; Cheval, Boris; Nascimento, Marcelo de Maio; Conceição, Lúcia; Marconcin, Priscila; Peralta, Miguel; Ferrari, Gerson; Oliveira, Duarte; Kliegel, MatthiasThe present cross-sectional study aimed to investigate the relationship between different dimen sions of physical activity (PA) (i.e., work, sport, leisure) and health-related quality of life (HRQoL) (i.e., overall, physical component, mental component) in an adult lifespan sample of 381 active individuals (age range: 18–88 years; 38.8% men), while controlling for important covariates in terms of sex, age, education, and health profile regarding medical history. HRQoL was assessed using the 12-item Short-Form Health Survey (SF-12). Usual (i.e., previous 12 months) PA was assessed during face-to-face interviews using the Baecke questionnaire. Hierarchical regression analyses showed in Step 1 that the three PA dimensions work, sport, and leisure (entered simultaneously) together predicted 8%, 10%, and 4% of the variance in SF-12 total score, SF-12 physical component, and SF-12 mental component, respectively. In the final model, adjusting for sex, age, education, and health profile regarding medical history, sport emerged as the only PA dimension predicting SF-12 total score and the SF-12 physical component. In conclusion, health-policy targets at the community level should include the promotion of lifelong engagement in PA, especially sport, to allow the sustainability of HRQoL across the lifespan of our society.
- The Role of Physical Function in the Association between Physical Activity and Gait Speed in Older Adults: A Mediation AnalysisPublication . Nascimento, Marcelo de Maio; Gouveia, Élvio Rúbio; Marques, Adilson; Gouveia, Bruna R.; Marconcin, Priscila; França, Cíntia; Ihle, AndreasAdequate levels of physical function (PF) are essential for vulnerable older adults to perform their daily tasks safely and remain autonomous. Our objective was to explore the mediating role of PF in the relationship between physical activity (PA) and gait speed (GS) in a large sample of older adults from the north of Brazil. This is a cross-sectional study that analyzed 697 older adults (mean age 70.35 ± 6.86 years) who participated in the project “Health, Lifestyle, and Physical Fitness in Older Adults in Amazonas” (SEVAAI). PA was assessed using the Baecke Questionnaire, PF using the Senior Fitness Test, and GS using the 50-foot Walk Test. Mediation pathways were analyzed to test the possible mediating role of PF between specific PA domains (PA-total score, PA-housework, PA-sport, PA-leisure) and GS. Regarding PA-total, the analysis showed that high-performance GS was partially mediated in approximately 19% by better PF performance. Moreover, the PF could partially mediate the association between PA-sport and PA-leisure with GS, at levels of approximately 9% and 46%, respectively. An inverse relationship was observed between PA-housework (sedentary lifestyle) and GS. This association was partially mediated to an extent of approximately 9% by better PF performance. We conclude that PF plays a crucial role in mediating the association between PA and GS among vulnerable older adults.
- The Relation of Having Experienced a Fall in the Past to Lower Cognitive Functioning in Old Age Is Mediated via Less Physical Activity Engagement as Cognitive Reserve ContributorPublication . Ihle, Andreas; Gouveia, Élvio R.; Gouveia, Bruna R.; Marques, Adilson; Marconcin, Priscila; Nascimento, Marcelo de Maio; Haas, Maximilian; Jurema, Jefferson; Tinôco, Maria A.; Kliegel, MatthiasSimple Summary: Experiencing a fall in old age represents a critical life event affecting physical and cognitive health and the ability to engage in physical activities and exercise. This is crucial since physical activity engagement contributes to the accumulation of the so-called cognitive reserve relevant for maintaining cognitive health at old age. The goal of our study was to investigate whether the relationship between having experienced a fall and lower cognitive functioning can be explained by hampered physical activity engagement. Confirming this idea, our findings demonstrated that experiencing a fall at an older age hinders sufficient physical activity engagement and thereby impedes cognitive reserve accumulation, resulting in lower cognitive functioning outcomes. Consequently, our study suggests that at old age, the prevention of falls and related accidents is not only crucial to avoid injuries and preserve physical health, but it is also essential for maintaining one’s ability to engage in physical activities and exercises and, consequently, for preserving cognitive health in later life. Abstract: Physical activity and exercise contribute to the accumulation of cognitive reserve, which is instrumental for preserving cognitive health in old age. In a large sample of 701 older adults (mean age = 70.36 years), we investigated whether the relationship between having experienced a fall in the past and lower performance in cognitive functioning was mediated via less physical activity engagement as a cognitive reserve contributor. General cognition was assessed using the mini-mental state examination (MMSE), long-term memory using a word-pair delayed recall test and working memory using a backward digit-span test. In face-to-face interviews, individuals reported information on falls during the past 12 months and their habitual physical activity engagement. Our analyses demonstrated that the relationship between having experienced a fall in the past and lower performance in the cognitive functioning measures was partly mediated (by 16.3% for general cognition, 30.6% for ong-term memory, and 33.1% for working memory, respectively) via less physical activity engagement. In conclusion, we suggest as a core bio-psychological mechanism that experiencing a fall at an older age is a critical life event that hinders sufficient physical activity engagement and thereby impedes cognitive reserve build-up, resulting in lower cognitive functioning outcomes.
- Estimation of engagement in moderate-to-vigorous physical activity from direct observation: a proposal for school physical educationPublication . Gouveia, Élvio R.; Gouveia, Bruna R.; Marques, Adilson; Lopes, Hélder; Rodrigues, Ana; Quintal, Tomás; Pestana, Marcelo; Peralta, Miguel; Kliegel, Matthias; Ihle, AndreasThis study aimed to test an observational momentary time sampling tool to estimate in class moderate-to-vigorous physical activity (MVPA), in terms of validity, reliability and agreement between observational momentary time sampling and accelerometry, and to develop a regression equation to estimate MVPA from observational momentary time sampling. The sample comprised 78 pupils (38 girls), mean age 14.0 ± 1.1 years. Measurements were taken in three similar Physical Education classes, on three different days. To monitor MVPA, we applied the observational momen tary time sampling method. Students wore an ActiGraph GT3X+ accelerometer. Reliabilities were determined by the intraclass correlations, the agreement between methods was analyzed using the Bland–Altman method, and a multiple regression analysis was performed to estimate the equation. The observational momentary time sampling showed good reliability across time (0.59 < r < 0.72, p < 0.001). It was significantly correlated with accelerometry (r = 0.51, p < 0.001). The MVPA assessed via accelerometer could be predicted from the following equation: Y = 44.3 + 0.47·(MVPA observa tional momentary time sampling method) + 8.0·(sex; with 0 = girls and 1 = boys). This observational momentary time sampling method is a stable and reliable tool to estimate MVPA. A regression equation using the score of observational momentary time sampling and sex can be used to better estimate the real MVPA.
- Exploring Mediation Effects of Gait Speed, Body Balance, and Falls in the Relationship between Physical Activity and Health-Related Quality of Life in Vulnerable Older AdultsPublication . Nascimento, Marcelo de Maio; Gouveia, Élvio Rúbio; Gouveia, Bruna R.; Marques, Adilson; França, Cíntia; Freitas, Duarte L.; Campos, Pedro; Ihle, AndreasThe present study aimed to examine whether gait speed (GS), body balance (BB), and falls mediated the relationship between physical activity (PA) and health-related quality of life (HRQoL) in community-dwelling older adults. This is a cross-sectional study that included 305 men and 314 women (69.5 ± 5.6 years), residing in the Autonomous Region of Madeira, Portugal. HRQoL and PA were assessed using the SF-36 and Baecke Questionnaires, respectively. While BB was obtained by the Fullerton Advance Balance (FAB) scale, GS by the 50-foot (15 m) walk test, and the frequency of falls was obtained by self-report. According to the analyses, when GS and BB were placed concomitantly as mediators, the direct effect revealed by the model revealed a non-significant relationship between PA and falls. Thus, in the context of falls, GS and BB partially mediated the association between PA and HRQoL in approximately 29.7%, 56%, and 49.2%, respectively. The total HRQoL model explained a variance of 36.4%. The results can help to understand the role that GS, BB, and falls play in the relationship between PA and HRQoL of the vulnerable older adult population.
- Balance and mobility relationships in older adults: A representative population-based cross-sectional study in Madeira, PortugalPublication . Gouveia, Élvio R.; Gouveia, Bruna R.; Ihle, Andreas; Kliegel, Matthias; Marques, Adilson; Freitas, Duarte L.Background: Balance and mobility impairments are important modifiable risk factors associated with falls in older people. Purpose: To investigate how different functional fitness components relate to balance and mobility, after controlling for age, sex, body mass index (BMI), and different physical activity (PA) domains. Methods: This representative cross-sectional study included 802 individuals, 401 males and 401 females (69.8 ± 5.6 years) from Madeira, Portugal. The Fullerton Advance Balance (FAB) scale was used to assess balance. Mobility in terms of gait velocity, cadence, stride length, and gait stability ratio (GSR) were assessed using the 50-foot Walk test. PA was assessed through a face-to-face interview using the Baecke questionnaire, and functional fitness was assessed with Senior Fitness tests (strength, flexibility, and aerobic endurance). Results: Balance and mobility were negatively associated with age and BMI, and positively related to PA and functional fitness. Moreover, male presented better performance in balance and mobility. Hierarchical multiple regression analyses showed that functional fitness explained the highest amount of variance in balance and all mobility parameters(over andaboveage,sex,BMI,and PA).Specifically, entering functional fitnesscomponents significantly increased explained variance in FAB (+19%), gait velocity (+25%), cadence (+15%), stride length (+9%), and GSR (+ 31%). In these models, aerobic endurance consistently had the strongest contribution. Conclusion: Strength, flexibility, and especially aerobic endurance, over and above non-modifiable variables like age and sex, are crucial for maintaining or improving balance and mobility and, thereby, prevent falls in older people.