Age and Ageing

Morgan, Kevin

doi: 10.1093/ageing/27.suppl_3.3pmid: N/A

Morgan, Kevin

doi: 10.1093/ageing/27.suppl_3.5pmid: 10408677

Objectives: First, to describe the background and methodological approach to the assessment of customary physical activity health and psycho-social status used by the Nottingham Longitudinal Study of Activity and Ageing; second, to provide information on the sampling strategy and survey response rates for three waves of data collection; and, third, to provide information on the reliability and validity of the survey assessments.Design: Longitudinal study.Subjects: 1042 people originally aged 65 and over, randomly sampled from general practitioner lists in Nottingham, UK.Methods: A descriptive overview of response rates (%), instrument reliability (α coefficients) and intercorrelations among measured outcomes (correlation coefficients and principal components analysis).Main outcome measures: Questionnaire-assessed levels of physical activity; instrumental measurements of handgrip strength, weight, demi-span and shoulder flexibility; brief assessments of depression, social engagement, life-satisfaction and cognitive impairment.Results: The study achieved a baseline (TI) response rate of 80%, with re-interview rates of 88% and 73% for T2 (1989) and T3 (1993) surveys respectively. For both men and women, factor scores derived from first principal components extracted from Ti survey data showed significant (r≥0.4; P< 0.001) product moment correlations with instrumental measurements of handgrip strength and shoulder flexibility All the brief assessment measures showed satisfactory levels of reliability (α≥0.7)

Bassey, E. J.

doi: 10.1093/ageing/27.suppl_3.12pmid: 10408678

Objectives: First, to record, in a representative sample of older men and women, longitudinal changes in (i) maximal voluntary strength of the handgrip muscles, (ii) maximal range of movement in the shoulder joint and (iii) body weight and skeletal size; second, to explore associations between the changes in muscle strength and both customary physical activity and health outcomes.Design: Longitudinal analyses of survivors measured at baseline, and 4-year and 8-year follow-ups.Participants: 350 survivors of a random sample originally aged 65 and over.Results: Over 8 years average loss of body weight was slight but significant at about 2 kg (less than 5%). Loss of shoulder range was negligible, while loss of muscle strength was significant at about 40 N (less than 2% per year). Demispan remained stable across all three points of measurement. These mean values concealed substantial variation in the rate of loss of strength, which was twice as fast in the older groups, especially in the women. These losses could not be attributed to worsening health, although this was observed. All the respondents had at least two chronic health problems at the 8-year stage. For the changes in handgrip strength, reduced reported habitual use of the handgrip muscles and increased symptoms of anxiety and depression were significant independent covariates in addition to age and time (all P<0.0001).Conclusion: There are significant independent associations between the loss of muscle strength in old age and both decline in physical activity and increase in depression scores. This is strongly suggestive of causal links and confirms the need to encourage physical activity and control depression in order to maintain strength and function in old age.

Armstrong, Gillian K.; Morgan, Kevin

doi: 10.1093/ageing/27.suppl_3.17pmid: 10408679

Objectives: To describe stability and change in levels of customary physical activity assessed in recall-based questionnaire surveys of older people conducted in 1985, 1989 and 1993.Design: Longitudinal study.Subjects: 1042 people originally aged 65 and over randomly sampled from general practitioner lists in Nottingham, UK.Methods: Logistic and multiple regression analyses, intraclass correlation coefficients.Main outcome measures: Self-reported tune spent per day walking and shopping; self-reported time spent per week in other indoor, outdoor and leisure activities; frequency of performance of strength and flexibility activities.Results: Among survivors, activity levels at baseline tended to be higher than those of their non-surviving peers. Overall, 8-year change between 1985 and 1993 was characterized by progressively declining activity levels. Nevertheless, in both trajectories and stability profiles, differences did emerge among the seven activity categories studied. At least one in four respondents increased the time they spent walking, and approximately one in three respondents increased the time they spent shopping between 1985 and 1993.Conclusions: These findings suggest that, while some activity variables show levels of stability consistent with trait-like constructs, others are clearly more labile. While the present data cannot offer a definitive explanation for these differences, it seems reasonable that within each activity the influence of ability opportunity and need interact to determine levels of participation.

Bennett, Kate Mary

doi: 10.1093/ageing/27.suppl_3.24pmid: 10408680

Objectives: To describe gender differences in levels of, and longitudinal changes in, habitual physical activity among older people.Design: Longitudinal study.Participants: Sub-groups of survivors (with sample sizes dependent on the availability of complete datasets, ranging from 303–344) assessed on three occasions: 1985, 1989 and 1993 in Nottingham, UK. All were 65 years and over in 1985.Methods: Descriptive presentation (median and range values) of quantitative longitudinal data by gender across five activity categories assessed in a recall-based questionnaire.Main outcome measures: Participation in walking, shopping, indoor, outdoor and leisure activities.Results: While levels of indoor and outdoor activities were marked by decline for both sexes, gender differentials were maintained over the 8 years of the study, with women showing higher levels of activity participation indoors and men showing higher levels of activity participation outdoors. In levels of walking/shopping activity, however, there was evidence of gender differentials reducing over time.Conclusions: Within these cohorts of older people traditional gender roles continue to exert a strong influence on levels and types of habitual physical activity well into later life. In some areas of activity, however, temporal changes provide some evidence of gender convergence consistent with late-life transitions in marital status and dependency.

Bath, Peter A.; Morgan, Kevin

doi: 10.1093/ageing/27.suppl_3.29pmid: 10408681

Objectives: To explore associations between customary physical activity and three longitudinal outcomes: 12-year all-cause mortality, 12-year disease-specific mortality and 8-year change in general practitioner and personal social service use.Design: Longitudinal study.Subjects: 1042 people originally aged 65 and over randomly sampled from general practitioner lists in Nottingham, UK.Methods: Cox regression survival and logistic regression analyses.Main outcome measures: questionnaire-assessed levels of physical activity; 12-year mortality; reported health and personal social service contacts in month prior to interview.Results: On the basis of factor scores derived from the interview questionnaire, activity levels were graded as high, intermediate or low, with respondents grouped accordingly. Relative to the high activity group, 12-year mortality was significantly increased in both the intermediate [adjusted hazard ratio (HR) = 1.53; 95% confidence interval (CI)= 1.10–2.14; P< 0.05] and low (HR= 1.75; 95% CI= 1.24–2.48; P<0.005) activity groups for men, and in the low activity group (HR= 1.73; 95% CI= 1.28–2.33; P<0.001) for women. Lower levels of activity were also associated with an increased likelihood of using health and personal social services 8 years after the initial interview, and an increased risk among men of having respiratory disease recorded as the primary cause of death. All models were adjusted for age, health and smoking status and weight category as measured at baseline.Conclusions: The results are consistent with the conclusion that, among elderly people, health gain resulting from higher customary physical activity levels can promote a longer and more independent later life.

Morgan, Kevin; Bath, Peter A.

doi: 10.1093/ageing/27.suppl_3.35pmid: 10408682

Objectives: To assess longitudinal relationships between habitual levels of physical activity and indices of psychological wellbeing in older people.Design: Baseline assessment with 4- and 8-year follow-ups.Subjects: 1042 people originally aged 65 and over randomly sampled from general practitioner lists in Nottingham, UK.Methods: Logistic regression analysis of selected T1 (1985) and T2 (i989) variables, with depression at T2 as dependent; multiple regression analyses of selected T1, T2 and T3 (1993) variables, with life satisfaction at T2 (model 1) or T3 (model 2) as dependent.Main outcome measures: Questionnaire-assessed levels of physical activity; 14-item Symptoms of Anxiety and Depression scale; 13-item Life Satisfaction Index; health, demographic and social activity variables.Results: In the logistic regression model, depression at T2 was most strongly associated with depression [odds ratio (OR) = 7.13; 95% confidence interval (CI) = 3.25–15.64; P < 0.001] and lower physical health status (OR = 1.26 per unit change in score; 95% CI = 1.17–1.42; P <0.001) at T1. Lower levels of outdoor/leisure activities at T1 were also associated with some increased risk of depression 4 years later (OR = 0.92 per hour of activity; 95% CI = 0.85–0.99; P < 0.05). Similar predictive patterns emerged from the multiple regression analyses where, in both models, earlier levels of life satisfaction, social engagement and health accounted for most of the explained variance in life satisfaction (R2 = 0.42 for model 1; R2 = 0.35 for model 2). Again, however, earlier levels of physical activity (as walking and housework) did contribute significantly, although modestly, to longitudinal changes in morale.Conclusions: While the results provide some support for the conclusion that physical activity contributes independently to the promotion and maintenance of psychological wellbeing in later life, this contribution is, at best, extremely modest.