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- 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.
- Sarcopenia and Physical Activity Predict Falls in Older Adults from Amazonas, BrazilPublication . Ihle, Andreas; Kliegel, Matthias; Jurema, Jefferson; Tinôco, Antonieta; Campos, Pedro; Marques, Adilson; Gouveia, Bruna; Gouveia, Élvio Rúbio; Miranda, Kessketlen Alvest. Introduction: Sarcopenia is a progressive and widespread skeletal muscle disorder involving loss of muscle mass and function, and is associated with several outcomes, including falls, functional decline, frailty, and mortality. Therefore, this study aimed: (1) to estimate the prevalence of sarcopenia, falls, and the risk of falls considering age, sex, and the level of physical activity (PA), and (2) to identify which of these predictors better explained the likelihood that participants present risk of fall. A total of 701 participants (433 women) with a mean age of 70.4±6.9. Sarcopenia was determined according to the most recent guidelines from the European Working Group (EWGSOP2). The prevalence of falls and the level of physical activity were assessed by questionnaires. The risk of falls was assessed using the Fullerton Advance Balance (FAB) scale. This study provides evidence that women (OR: 2.5, p<0.001), the oldest people (OR: 1.1 p<0.001), and people who had identified sarcopenia (OR: 2.9 p<0.001), and lower level of physical activity (OR: 2.9 p<0.001), were more likely to present the risk of falls. Implications for vulnerable aging are discussed.
- The effect of the ProBalance Programme on health-related quality of life of community-dwelling older adults: A randomised controlled trialPublication . Gouveia, Bruna R.; Gouveia, Élvio R.; Ihle, Andreas; Jardim, Helena G.; Martins, Maria M.; Freitas, Duarte L.; Kliegel, MatthiasBackground: Health-related quality of life (HRQoL) is an important health outcome in older adults. This study aimed toassess the efficacyoftheProBalance rehabilitation programmeon HRQoLofcommunity-dwelling older adults with balance impairments and to investigate whether effects differ between age groups and/or HRQoL components. Methods: A single-blind, randomised controlled trial included community-dwelling older adults, aged 65–85, with balance impairments. Participants (n = 52) were randomly allocated to an intervention group (IG) or a control group (CG). A rehabilitation programme included gait, balance, functional training, strengthening, flexibility, and 3D training. A group-based intervention was administered over a period of 12 weeks (90-min sessions, 2days per week). A wait-list control group was instructed to maintain their usual activities during the same period. Participants’ HRQoL was assessed using the SF-36 questionnaire. The time points for assessment were at zero (pre-test), 12 (post-test), and 24 weeks (follow up). Results: A trend for higher HRQoL in the IG compared to the CG and a significant interaction of group with time were found, with significantly higher increases in HRQoL from the pre-test to the post-test (and to follow-up) in the IG, compared to the CG. Results: were independent of age group (young-old vs. old-old) and HRQoL component (physical vs. mental). Conclusions: Present results suggest that the ProBalance programme had a beneficial effect on HRQoL of community-dwelling older adults, which held across young and old adults and not only comprised physical but also mental HRQoL.
- 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 Role of Cognitive Performance and Physical Functions in the Association between Age and Gait Speed: A Mediation StudyPublication . Nascimento, Marcelo de Maio; Gouveia, Élvio Rúbio; Gouveia, Bruna R.; Marques, Adilson; Marconcin, Priscila; França, Cíntia; Ihle, AndreasIntroduction: With vulnerable aging, gait speed (GS) undergoes progressive changes, becoming slower. In this process, cognitive performance (CP) and physical function (PF) both play an important role. This study aims (1) to investigate the association between CP and PF with GS and (2) to examine whether CP and PF mediate the association between age and GS in a large sample of Brazilian older adults. Methods: A cross-sectional study analyzed 697 individuals (mean age 70.35 ± 6.86 years) from the state of Amazonas. The CP was evaluated by the COGTEL test battery, PF by the Senior Fitness Test battery, and GS with the 50-foot Walk Test. Results: Older adults with a lower CP and PF had a 70% and 86% chance of slow GS, respectively. When CP and PF were placed simultaneously as mediators, the direct effect estimated by the model revealed a non-significant relationship between age and GS. Specifically, CP and PF mediated the association between age and GS, at approximately 12% and 98%, respectively. Conclusions: CP and PF show the potential to estimate GS performance among older adults. Moreover, CP and PF indicated a negative and direct association between age and slow GS, especially PF.
- Associations of Gait Speed, Cadence, Gait Stability Ratio, and Body Balance with Falls in Older AdultsPublication . Nascimento, Marcelo de Maio; Gouveia, Élvio Rúbio; Gouveia, Bruna R.; Marques, Adilson; Martins, Francisco; Przednowek, Krzysztof; França, Cíntia; Peralta, Miguel; Ihle, AndreasTo investigate the association between gait speed (GS), cadence (CAD), gait stability ratio (GSR), and body balance (BB) with falls in a large sample of older adults. The analysis included 619 individuals—305 men and 314 women (69.50 ± 5.62 years)—residing in the Autonomous Region of Madeira, Portugal. Mobility in GS, CAD, and GSR was assessed using the 50-foot walk test and BB by the Fullerton Advanced Balance scale. The frequency of falls was obtained by self-report. Linear regression analysis showed that higher performance in GS and BB was able to reduce the risk of falling by up to 0.34 and 0.44 times, respectively. An increase in the GSR value enhanced the risk of falling by up to 0.10 times. Multinomial analysis indicated that, in relation to the highest tertile (reference), older adults classified with GS and BB performance in the lowest tertile (lowest) had an increased chance (OR) of falling by up to 149.3% and 48.8%, respectively. Moreover, in relation to the highest tertile, the performance of the GSR classified in the lowest and medium tercile showed an increase in the chance of falling by up to 57.4% and 56.4%, respectively
- 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.
- Sex Differences in Falls: The Mediating Role of Gait Stability Ratio and Body Balance in Vulnerable Older AdultsPublication . Nascimento, Marcelo de Maio; Gouveia, Élvio Rúbio; Gouveia, Bruna R.; Marques, Adilson; França, Cíntia; Marconcin, Priscila; Freitas, Duarte L.; Ihle, AndreasThis study, conducted on a large sample of older adults at elevated fall risk (1), aimed to verify statistical differences in gait stability ratio (GSR) and body balance (BB) according to sex, (2) to examine and compare GSR and BB performance between older adult fallers and non-fallers, (3) to determine an association between GSR and BB according to the history of falls, and (4) to explore whether GSR and BB mediate the association between sex and falls. We included 619 individuals (69.8 ± 5.6 years) living in the Autonomous Region of Madeira, Portugal. The frequency of falls was obtained by self-report. BB was determined by the Fullerton Advanced Balance scale, while GSR was established by dividing cadence by gait speed and data collected during the 50-foot walk test. Males indicated a lower prevalence of falls in the last 12 months (23.6%), while females had a higher score (48.7%), as well as a lower balance performance (p < 0.001) and higher GSR scores (p < 0.001). Lower BB control (p < 0.001), as well as higher GSR, were more expressive for fallers (p < 0.001). We found a large, negative and significant correlation between GSR and BB for historical falls (r = −0.560; p < 0.001), and between male and female cohorts (r = −0.507; p < 0.001). The total effect of sex on falls mediated by GSR and BB was 16.4%. Consequently, GSR and BB mediated this association by approximately 74.0% and 22.5%, respectively
- Atividade física, aptidão e saúde em pessoas idosasPublication . Gouveia, E.; Ihle, A.; Gouveia, B.; Kliegel, M.; Marques, A.; Tinôco, A.; Freitas, D.O Envelhecimento saudável é caracterizado pelo desenvolvimento e manutenção da capacidade funcional que possibilita o bem-estar à pessoa idosa. Atualmente, a maioria das pessoas esperam viver além dos 60 anos. A forma como cada indivíduo pode beneficiar dos anos extra que dispõe depende muito de um fator chave: a sua Saúde. As Ciências do Desporto assumem um papel determinante na promoção do Envelhecimento Saudável porque, embora muitos mecanismos que determinam o envelhecimento não são controláveis, existe uma forte evidência de que o resultado do envelhecimento é afetado pela interação entre o contexto e os comportamentos do indivíduo ao longo da sua vida. Os objetivos do presente trabalho foram: (a) enquadrar a investigação desenvolvida no âmbito dos adultos-idosos, na estratégia global da Organização Mundial de Saúde para a promoção do envelhecimento saudável; (b) refletir sobre os resultados da investigação desenvolvida no contexto da Região Autónoma da Madeira, e (c) apresentar linhas futuras de investigação. Os resultados dos nossos estudos têm suportado que níveis de atividade física e aptidão funcional mais elevados estão associados a melhores performances na capacidade funcional, melhor auto percepção da qualidade de vida relacionada com a saúde, melhor saúde óssea, maior massa muscular, níveis superiores de colesterol das HDL e melhores desempenhos cognitivos. Em conclusão, os resultados dos nossos estudos, sublinham a necessidade de desenvolver políticas ao nível da comunidade, que incluam estratégias gerais para o aumento da atividade física e da capacidade funcional, com vista à manutenção e/ou melhoria da qualidade de vida nas pessoas idosas.