Active and healthy ageing: the role of physical activity ... · Active and healthy ageing: the role...
Transcript of Active and healthy ageing: the role of physical activity ... · Active and healthy ageing: the role...
Active and healthy ageing: the role of physicalactivity and sedentary behaviour
Prof Dr jannique van Uffelen
KU Leuven – University of Leuven
Department of Movement Sciences
Physical Activity, Sports and Health Research Group
Sallis JF et al. Behavioral epidemiology: a systematic framework to classify phases of research on health promotion and disease prevention.
Ann Behav Med. 2000;22(4):294-8.
Setting the scene: behavioural epidemiology
1. Establish links
between behaviour
and health
2. Develop Methods
to measure
behaviour
3. Identify factors
that influence
behaviour
4. Evaluate
interventions
5. Translate into
practice
There are more than 30 supercentenariansin the world
http://www.grg.org/SC/WorldSCRankingsList.html
The oldest – still living - person in the worldwas born in the 19th century
https://en.wikipedia.org/wiki/List_of_the_oldest_living_people
https://en.wikipedia.org/wiki/List_of_the_verified_oldest_people
Healthy ageing
“ The process of developing and maintaining the
functional ability that enables wellbeing in
older age ”
Intrinsic capacity
mental and physical capacities that a person can draw on
Environments
Physical and social environment
WHO. World Report on Ageing and Health. 2015.
WHO. World Report on Ageing and Health.2015.
WHO. Active ageing: a policy framework. 2002
0
5
10
15
20
25
F - Europe M - Europe F - Belgium M - Belgium
Healthy life yrs at age 65 Life expectancy at age 65
https://ec.europa.eu/eurostat/
Being sedentary is the same as not beingphysically active
Definitions
• Physical activity → Bodily movement, produced by the contraction of skeletal muscles, that substantially increases energy expenditure
• Exercise→ Planned structured, repetitive and purposeful, resulting in improvement/maintenance of one or more components of physical fitness
• Sedentary behaviour→ Any waking activity characterized by an energy expenditure ≤ 1.5 metabolic equivalents and a sitting or reclining posture
Caspersen CJ et al. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research.
Public Health Rep. 1985;100(2):126-31.
http://www.sedentarybehaviour.org/
Every day activities
Serious exercise!
Lack of PA is in the top five leading mortality risks in the world
WHO. Global health risks - Mortality and burden of disease attributable to selected major risks. 2009.
Disease prevention / risk reduction
↓ all cause + CVD mortality
↓ CVD (incl CAD, stroke)
↓ diabetes
↓ cancer
↓ dementia
↓ risk of falls + related injuries
↓ hypertension
↓ adverse blood lipid profile
↓ weight (re)gain
Psychological
↑ QoL
↑ sleep
↓ anxiety
↓ depression
Functional status
↑ bone health
↑ physical function
↑ cognition
Regular
PA
Social
↑ confidence, mastery, self esteem
↑ social interaction
↑ community engagement
↓ isolation
↓ depressionBauman A et al. Updating the Evidence for Physical Activity: Summative Reviews of the Epidemiological
Evidence, Prevalence, and Interventions to Promote "Active Aging". Gerontologist. 2016 Apr;56 :S268-80
U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition.
Washington, DC: U.S. Department of Health and Human Services; 2018..
Bangsbo et al. The Copenhagen consensus conference. Physical activity and ageing. Br J Sports Med 2018
Increasing levels of
PA is one of the most
important steps older
adults can take to
improve and maintain
their physical, social
and mental health,
and quality of life.
https://movement-pills.nowwemove.com/
U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition.
Washington, DC: U.S. Department of Health and Human Services; 2018.
Aerobic activity
BalanceMuscle
strengthening
U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans,
2nd edition. Washington, DC: U.S. Department of Health and Human Services; 2018.
GUIDELINES BELGIUM / adults
www.gezondleven.be/themas/beweging-sedentair-gedrag/bewegingsdriehoek
52,656
72,8
19,216,9
11,7
28,2 27,1
15,5
0
10
20
30
40
50
60
70
80
55-64 yrs 65-74 yrs 75+ yrs
PE
RC
EN
TA
GE
Health Enhancing PA
0
1-149
150+
Majority of older adults do no PA
https://ec.europa.eu/eurostat
Many factors influence behaviour - SEM
Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJ, Martin BW. Correlates of physical activity: Why are some people physically active and others not?
Lancet. 2012;380:258-271.
Starting PA at older age does not result in health benefits
• n= 3,454
• Followed for 8 yrs (2002/2003 – 2010/2011)
• 63.7 ± 8.9 years at baseline
• PA = self reported, based on frequency vig, mod, light. • Inactive = no mod/vig on weekly basis• Moderate = at least 1/wk mod• Vigorous = at least 1/wk vig
• Which group had the best health 8 years later?
Hamer M, et al. Taking up physical activity in later life and healthy ageing: the English longitudinal study of ageing. Br J Sports Med 2014;48:239–243
* Adjusted for age, sex, and components of healthy ageing.
Hamer M, et al. Br J Sports Med 2014;48:239–243
1
0,9
0,6
1
0,8
0,7
1
0,7
0,5
1
0,6
0,4
0
0,2
0,4
0,6
0,8
1
1,2
Inactive Moderate activity Vigorous activity
Cognitive impairment
Chronic disease
Depressive symptoms
Physical functionOdds r
atio*
1
2,4
3,4
7,7
0
1
2
3
4
5
6
7
8
9
Remainedinactive
Became inactive Became active Remained active
Od
ds r
atio
*
* Adjusted for age, sex, marital status, wealth, smoking, alcohol intake.
Hamer M, et al. Br J Sports Med 2014;48:239–243
1
2,4
3,4
7,7
0
1
2
3
4
5
6
7
8
9
Remainedinactive
Became inactive Became active Remained active
4.4% 10.2% 12.4% 24.3%
Od
ds r
atio
*
* Adjusted for age, sex, marital status, wealth, smoking, alcohol intake.
Hamer M, et al. Br J Sports Med 2014;48:239–243
Older adults have to meet the PA guidelines for health benefits
• n= 7,646 women, born 1921-1926
• Surveys 2002, 2005, 2008
• 76-81 years at baseline
• PA = self reporte minutes of walking, moderate and vigorous PA in last week
• MET.min/week
• 7 categories
• Dose response association of PA and walking with QoL?
Heesch KC, van Uffelen et al. Dose-response relationships between physical activity, walking and health-related quality of life in mid-age and older
women. Journal of Epidemiology & Community Health. 201:66;670-677.
SF
-36
Ph
ysic
al
co
mp
on
en
tscale
(β
)
Concurrent
Prospective
●: Total PA○: Walking
SF
-36 P
hysic
al
fun
cti
on
ing
(β
)
Concurrent
Prospective
●: Total PA○: Walking
SF
-36 M
en
tal co
mp
on
en
t scale
(β
)
Concurrent
Prospective
●: Total PA○: Walking
SF
-36 V
itali
ty (β
) Concurrent
Prospective
●: Total PA○: Walking
In women in their 80s:
• Strong concurrent relationships→ physical and mental HRQoL
• Moderate-strong prospective relationships → physical HRQoL
• Most HRQoL gain with participation in up to sufficient levels
• Similar benefits for walking as for total leisure time PA
Health is the most important motivator for PA as people age
• People in their 60s • Health related factors more important than social factors• Gender differences:
• Shift towards social factors as people age
• Habit! Enjoyment!
What motivates older people to do PA?
Health Health/looks Social
improving appearance, losing weight spending time with others, meeting
friends
Van Uffelen et al. Gender differences in physical activity motivators and context preferences: a population-based study in people in their sixties.
BMC Public Health. 2017 Jul 4;17(1):624. doi: 10.1186/s12889-017-4540-0
Zubala A et al. Promotion of physical activity interventions for community dwelling older adults: A systematic review of reviews. PLoS One. 2017:
10;12(7):e0180902.
Take home messages
• PA has health benefits up to high age, even at levels below PA guidelines
• Benefits can be obtained from a simple activity like walking
• There is a need for multilevel interventions, targeting personal, interpersonal, environmental and policy factors, to encourage people to remain or become active as they age
• Doing something is better than doing
nothing
• You are never too old to start
• Have fun!
Thank you
KU Leuven
Department of Movement Sciences
Physical Activity, Sports and Health
Research Group