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Article ; Online: Correlates of life course physical activity in participants of the Baltimore longitudinal study of aging.

Moore, Ann Zenobia / Simonsick, Eleanor M / Landman, Bennett / Schrack, Jennifer / Wanigatunga, Amal A / Ferrucci, Luigi

Aging cell

2024 Volume 23, Issue 4, Page(s) e14078

Abstract: Physical activity is consistently associated with better health and longer life spans. However, the extent to which length and intensity of exercise across the life course impact health outcomes relative to current activity is undefined. Participants of ... ...

Abstract	Physical activity is consistently associated with better health and longer life spans. However, the extent to which length and intensity of exercise across the life course impact health outcomes relative to current activity is undefined. Participants of the Baltimore Longitudinal Study of Aging were asked to categorize their level of physical activity in each decade of life from adolescence to the current decade. In linear mixed effects models, self-reported past levels of physical activity were significantly associated with activity assessed at study visits in the corresponding decade of life either by questionnaire or accelerometry. A pattern of life course physical activity (LCPA) derived by ranking participants on reported activity intensity across multiple decades was consistent with the trajectories of activity estimated from standard physical activity questionnaires assessed at prior study visits. In multivariable linear regression models LCPA was associated with clinical characteristics, measures of body composition and indicators of physical performance independent of current physical activity. After adjustment for minutes of high intensity exercise, LCPA remained significantly associated with peak VO
MeSH term(s)	Humans ; Longitudinal Studies ; Baltimore ; Life Change Events ; Aging/physiology ; Exercise/physiology
Language	English
Publishing date	2024-01-16
Publishing country	England
Document type	Journal Article
ZDB-ID	2113083-8
ISSN	1474-9726 ; 1474-9718
ISSN (online)	1474-9726
ISSN	1474-9718
DOI	10.1111/acel.14078
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Article ; Online: Musculoskeletal Pain Characteristics and Objectively Measured Physical Activity in Older Adults.

Cai, Yurun / Liu, Fangyu / Wanigatunga, Amal A / Urbanek, Jacek K / Simonsick, Eleanor M / Ferrucci, Luigi / Schrack, Jennifer A

The journals of gerontology. Series A, Biological sciences and medical sciences

2024 Volume 79, Issue 4

Abstract: Background: Pain is associated with reports of restricted physical activity (PA), yet the association between musculoskeletal pain characteristics and objectively measured PA quantities and patterns in late life is not well understood.: Methods: A ... ...

Abstract	Background: Pain is associated with reports of restricted physical activity (PA), yet the association between musculoskeletal pain characteristics and objectively measured PA quantities and patterns in late life is not well understood. Methods: A total of 553 adults (mean age 75.8 ± 8.4 years, 54.4% women) in the Baltimore Longitudinal Study of Aging (BLSA) completed a health interview and subsequent 7-day wrist-worn ActiGraph assessment in the free-living environment between 2015 and 2020. Pain characteristics, including pain presence in 6x sites (ie, shoulders, hands/wrists, low back, hip, knees, and feet), pain laterality in each site, and pain distribution were assessed. PA metrics were summarized into total daily activity counts (TAC), activity fragmentation, active minutes/day, and diurnal patterns of activity. Linear regression models and mixed-effects models examined the association between pain characteristics and PA outcomes, adjusted for demographics and comorbidities. Results: Unilateral knee pain was associated with 184 070 fewer TAC (p = .039) and 36.2 fewer active minutes/day (p = .032) compared to those without knee pain. Older adults with shoulder pain or hand/wrist pain had more active minutes compared to those without pain (p < .05 for all). For diurnal patterns of activity, participants with knee pain had fewer activity counts during the afternoon (12:00 pm to 5:59 pm). Analyses stratified by sex showed that these associations were only significant among women. Conclusions: Our study highlights the importance of assessing pain laterality in addition to pain presence and suggests that pain interferes with multiple aspects of daily activity. Longitudinal studies are needed to assess the temporality of these findings.
MeSH term(s)	Humans ; Female ; Aged ; Aged, 80 and over ; Male ; Musculoskeletal Pain ; Longitudinal Studies ; Exercise ; Aging ; Lower Extremity ; Accelerometry
Language	English
Publishing date	2024-02-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	1223643-3
ISSN	1758-535X ; 1079-5006
ISSN (online)	1758-535X
ISSN	1079-5006
DOI	10.1093/gerona/glae039
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Article ; Online: Public transit stop density is associated with walking for exercise among a national sample of older adults.

Twardzik, Erica / Falvey, Jason R / Clarke, Philippa J / Freedman, Vicki A / Schrack, Jennifer A

BMC geriatrics

2023 Volume 23, Issue 1, Page(s) 596

Abstract: Background: Walking is the primary and preferred mode of exercise for older adults. Walking to and from public transit stops may support older adults in achieving exercise goals. This study examined whether density of neighborhood public transit stops ... ...

Abstract	Background: Walking is the primary and preferred mode of exercise for older adults. Walking to and from public transit stops may support older adults in achieving exercise goals. This study examined whether density of neighborhood public transit stops was associated with walking for exercise among older adults. Methods: 2018 National Health and Aging Trends Study (NHATS) data were linked with the 2018 National Neighborhood Data Archive, which reported density of public transit stops (stops/mile Results: Among 4,836 respondents with complete data, 39.7% lived in a census tract with at least one neighborhood public transit stop and 8.5% were public transit users. The odds of walking for exercise were 32% higher (OR = 1.32; 95% confidence interval: 1.08, 1.61) among respondents living in a neighborhood with > 10 transit stops per mile compared to living in a neighborhood without any public transit stops documented. Self-reported public transit use mediated 24% of the association between density of neighborhood public transit stops and walking for exercise. Conclusions: Density of neighborhood public transit stops was associated with walking for exercise, with a substantial portion of the association mediated by self-reported public transit use. Increasing public transit stop availability within neighborhoods may contribute to active aging among older adults.
MeSH term(s)	Humans ; Aged ; Walking ; Exercise ; Aging ; Economic Status ; Healthy Aging
Language	English
Publishing date	2023-09-26
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2059865-8
ISSN	1471-2318 ; 1471-2318
ISSN (online)	1471-2318
ISSN	1471-2318
DOI	10.1186/s12877-023-04253-x
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Article ; Online: Assessment of Physical Activity in Adults Using Wrist Accelerometers.

Liu, Fangyu / Wanigatunga, Amal A / Schrack, Jennifer A

Epidemiologic reviews

2021 Volume 43, Issue 1, Page(s) 65–93

Abstract: The health benefits of physical activity (PA) have been widely recognized, yet traditional measures of PA, including questionnaires and category-based assessments of volume and intensity, provide only broad estimates of daily activities. Accelerometers ... ...

Abstract	The health benefits of physical activity (PA) have been widely recognized, yet traditional measures of PA, including questionnaires and category-based assessments of volume and intensity, provide only broad estimates of daily activities. Accelerometers have advanced epidemiologic research on PA by providing objective and continuous measurement of PA in free-living conditions. Wrist-worn accelerometers have become especially popular because of low participant burden. However, the validity and reliability of wrist-worn devices for adults have yet to be summarized. Moreover, accelerometer data provide rich information on how PA is accumulated throughout the day, but only a small portion of these rich data have been used by researchers. Last, new methodological developments are emerging that aim to overcome some of the limitations of accelerometers. In this review, we provide an overview of accelerometry research, with a special focus on wrist-worn accelerometers. We describe briefly how accelerometers work; summarize the validity and reliability of wrist-worn accelerometers; discuss the benefits of accelerometers, including measuring light-intensity PA; and discuss pattern metrics of daily PA recently introduced in the literature. A summary of large-scale cohort studies and randomized trials that implemented wrist-worn accelerometry is provided. We conclude the review by discussing new developments and directions of research using accelerometers, with a focus on wrist-worn accelerometers.
MeSH term(s)	Accelerometry ; Adult ; Exercise ; Humans ; Reproducibility of Results ; Wrist ; Wrist Joint
Language	English
Publishing date	2021-07-02
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	445346-3
ISSN	1478-6729 ; 0193-936X
ISSN (online)	1478-6729
ISSN	0193-936X
DOI	10.1093/epirev/mxab004
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Article ; Online: Hearing Loss and Physical Activity Among Older Adults in the United States.

Assi, Sahar / Twardzik, Erica / Deal, Jennifer A / Martin Ginis, Kathleen / Palta, Priya / Schrack, Jennifer A / Reed, Nicholas S / Martinez-Amezcua, Pablo

The journals of gerontology. Series A, Biological sciences and medical sciences

2023 Volume 79, Issue 1

Abstract: Background: Hearing loss is associated with adverse health outcomes among older adults. Lower physical activity levels may partly explain these observations, yet the association between hearing loss, hearing aid use, and physical activity among older ... ...

Abstract	Background: Hearing loss is associated with adverse health outcomes among older adults. Lower physical activity levels may partly explain these observations, yet the association between hearing loss, hearing aid use, and physical activity among older adults is understudied. Methods: Cross-sectional analysis of National Health and Aging Trends Study (2021) participants. The better-hearing ear pure-tone average (BPTA) at speech frequencies (0.5-4 kHz) was modeled continuously (10-dB increments) and categorically (no: ≤25 dB, mild: 26-40 dB, moderate or greater: >40 dB hearing loss). Activity measures were wrist accelerometry-derived (Actigraph) total activity counts, daily active minutes, activity fragmentation (using active-to-sedentary transition probability), and self-reported participation in vigorous activities and walking for exercise in the last month. We used multivariable regression adjusted for sociodemographic and health covariates. Results: Among 504 participants excluding hearing aid users (mean age = 79 years, 57% female, 9% Black), 338 (67%) had hearing loss. Worse hearing (continuously and categorically) was associated with fewer counts and active minutes, more fragmented activity, and greater odds of not reporting recent vigorous activities. Among 472 participants with hearing loss including hearing aid users, nonusers (n = 338) had more fragmented activity and greater odds of not reporting walking for exercise compared to users. Conclusions: Older adults with hearing loss are less physically active. This may mediate the association between hearing loss and other adverse outcomes. Recognition of this potential association is essential for providers to better support older adults in maintaining an active lifestyle. Future research is warranted to understand the impact of hearing interventions.
MeSH term(s)	Humans ; Female ; United States/epidemiology ; Aged ; Male ; Cross-Sectional Studies ; Hearing Loss/epidemiology ; Exercise ; Hearing Tests ; Aging
Language	English
Publishing date	2023-08-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	1223643-3
ISSN	1758-535X ; 1079-5006
ISSN (online)	1758-535X
ISSN	1079-5006
DOI	10.1093/gerona/glad186
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Article ; Online: Perceived Fatigability, Fatigue, and Mortality in Mid-to-Late Life in the Baltimore Longitudinal Study of Aging.

Marino, Francesca R / Chen, Xiaomeng / Deal, Jennifer A / Simonsick, Eleanor M / Ferrucci, Luigi / Schrack, Jennifer A / Wanigatunga, Amal A

Medicine and science in sports and exercise

2023 Volume 56, Issue 2, Page(s) 307–314

Abstract: Introduction/purpose: Fatigue is an established prognostic indicator of mortality risk. It remains unknown whether fatigability anchored to a physical task is a more sensitive prognostic indicator and whether sensitivity differs by prevalent chronic ... ...

Abstract	Introduction/purpose: Fatigue is an established prognostic indicator of mortality risk. It remains unknown whether fatigability anchored to a physical task is a more sensitive prognostic indicator and whether sensitivity differs by prevalent chronic conditions. Methods: A total of 1076 physically well-functioning participants 50 yr or older in the Baltimore Longitudinal Study of Aging self-reported fatigue (unusual tiredness or low energy) and had perceived fatigability assessed after a standardized treadmill walk. All-cause mortality was ascertained by proxy contact and National Death Index linkage. Cox proportional hazards models estimated associations of perceived fatigability and fatigue with all-cause mortality, adjusting for demographic and clinical covariates. Interactions by chronic conditions were also examined. Results: Each 1 SD higher in perceived fatigability, unusual tiredness, or low energy was associated with a higher relative hazard of all-cause mortality after covariate adjustment (fatigability: hazard ratio (HR), 1.18 (95% confidence interval (CI), 1.03-1.36); unusual tiredness: HR, 1.25 (95% CI, 1.08-1.44); low energy: HR, 1.27 (95% CI, 1.10-1.46)). Models had similar discrimination ( P > 0.14 for all). Perceived fatigability was associated with mortality risk among participants free of arthritis or osteoarthritis who otherwise appeared healthy (no arthritis: HR, 1.45 (95% CI, 1.15-1.84); arthritis: HR, 1.09 (95% CI, 0.92-1.30); P -interaction = 0.031). Unusual tiredness was associated with mortality among those with a history of diabetes (no diabetes: HR, 1.16 (95% CI, 0.97-1.38); diabetes: HR, 1.65 (95% CI, 1.22-2.23); P -interaction = 0.045) or pulmonary disease (no pulmonary disease: HR, 1.22 (95% CI, 1.05-1.43); pulmonary disease: HR, 2.15 (95% CI, 1.15-4.03); P -interaction = 0.034). Conclusions: Higher perceived fatigability and fatigue symptoms were similarly associated with higher all-cause mortality, but utility differed by chronic condition. Perceived fatigability might be useful for health screening and long-term mortality risk assessment for well-functioning adults. Alternatively, self-reported fatigue seems more disease-specific with regard to mortality risk.
MeSH term(s)	Humans ; Aging ; Arthritis/complications ; Baltimore/epidemiology ; Chronic Disease ; Diabetes Mellitus ; Fatigue/etiology ; Longitudinal Studies ; Lung Diseases/complications ; Middle Aged ; Aged
Language	English
Publishing date	2023-09-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	603994-7
ISSN	1530-0315 ; 0195-9131 ; 0025-7990
ISSN (online)	1530-0315
ISSN	0195-9131 ; 0025-7990
DOI	10.1249/MSS.0000000000003306
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Article: Associations of Physical Activity and Heart Rate Variability from a Two-Week ECG Monitor with Cognitive Function and Dementia: the ARIC Neurocognitive Study.

Marino, Francesca R / Wu, Hau-Tieng / Etzkorn, Lacey / Rooney, Mary R / Soliman, Elsayed Z / Deal, Jennifer A / Crainiceanu, Ciprian / Spira, Adam P / Wanigatunga, Amal A / Schrack, Jennifer A / Chen, Lin Yee

medRxiv : the preprint server for health sciences

2024

Abstract: Background: Low physical activity (PA) measured from accelerometers and low heart rate variability (HRV) measured from short-term ECG recordings are associated with worse cognitive function. Wearable long-term ECG monitors are now widely used. These ... ...

Abstract	Background: Low physical activity (PA) measured from accelerometers and low heart rate variability (HRV) measured from short-term ECG recordings are associated with worse cognitive function. Wearable long-term ECG monitors are now widely used. These monitors can provide long-term HRV data and, if embedded with an accelerometer, they can also provide PA data. Whether PA or HRV measured from long-term ECG monitors is associated with cognitive function among older adults is unknown. Methods: Free-living PA and HRV were measured simultaneously over 14-days using the Zio Results: Each 1-unit higher in total amount of PA was significantly associated with 0.30 higher global cognition factor scores (95% CI: 0.16-0.44), 0.38 higher executive function factor scores (95% CI: 0.22-0.53), and 62% lower odds of MCI (OR: 0.38, 95% CI: 0.22-0.67) or 75% lower odds of dementia (OR: 0.25, 95% CI: 0.08-0.74) versus unimpaired cognition. Neither HRV measure was significantly associated with cognitive function or dementia. Conclusions: PA derived from a 2-week ECG monitor with an embedded accelerometer was significantly associated with higher cognitive test performance and lower odds of MCI/dementia among older adults. By contrast, HRV indices measured over 2 weeks were not significantly associated with cognitive outcomes. More research is needed to define the role of wearable ECG monitors as a tool for digital phenotyping of dementia. Clinical perspective: What Is New?:
Language	English
Publishing date	2024-03-04
Publishing country	United States
Document type	Preprint
DOI	10.1101/2024.03.01.24303633
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Article ; Online: Fatigability: A Prognostic Indicator of Phenotypic Aging.

Schrack, Jennifer A / Simonsick, Eleanor M / Glynn, Nancy W

The journals of gerontology. Series A, Biological sciences and medical sciences

2020 Volume 75, Issue 9, Page(s) e63–e66

MeSH term(s)	Aging/physiology ; Fatigue/diagnosis ; Fatigue/etiology ; Humans ; Phenotype ; Prognosis ; Task Performance and Analysis
Language	English
Publishing date	2020-09-16
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1223643-3
ISSN	1758-535X ; 1079-5006
ISSN (online)	1758-535X
ISSN	1079-5006
DOI	10.1093/gerona/glaa185
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Article ; Online: Response to "Comment on: Fatigability: A Prognostic Indicator of Phenotypic Aging".

Glynn, Nancy W / Qiao, Yujia Susanna / Simonsick, Eleanor M / Schrack, Jennifer A

The journals of gerontology. Series A, Biological sciences and medical sciences

2021 Volume 76, Issue 8, Page(s) e161–e162

MeSH term(s)	Aging ; Fatigue ; Humans ; Prognosis
Language	English
Publishing date	2021-02-26
Publishing country	United States
Document type	Letter ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	1223643-3
ISSN	1758-535X ; 1079-5006
ISSN (online)	1758-535X
ISSN	1079-5006
DOI	10.1093/gerona/glab058
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Article ; Online: Impact of balance on the energetic cost of walking and gait speed.

Brown, Colleen / Simonsick, Eleanor / Schrack, Jennifer / Ferrucci, Luigi

Journal of the American Geriatrics Society

2023 Volume 71, Issue 11, Page(s) 3489–3497

Abstract: Background: Examine the relationship between balance test performance and the energetic cost of walking (ECW) and gait speed.: Methods: Cross-sectional and longitudinal analyses of data from the Baltimore Longitudinal Study of Aging. Men (48%) and ... ...

Abstract	Background: Examine the relationship between balance test performance and the energetic cost of walking (ECW) and gait speed. Methods: Cross-sectional and longitudinal analyses of data from the Baltimore Longitudinal Study of Aging. Men (48%) and women aged 60-96 years enrolled in the BLSA between 2007 and 2020 (n = 1132). Balance was assessed using narrow walk (NW) and progressive standing balance tests (SB). ECW measured during 2.5-min usual paced walk while participants wore a portable indirect calorimeter. Gait speed assessed over 6-m. Each test parameterized using validated methods. Statistical analysis to compare balance measures to ECW, and gait speed used generalized logistic regression models and adjustments for age, sex, race, height, weight, and comorbidities. Results: Cross-sectionally, mean ECW was higher and gait speed slower in persons who failed the NW than those who passed (0.189 vs. 0.164 mL/kg/m, p < 0.0001 and 0.96 vs. 1.15 m/s, p < 0.0001, respectively). Mean ECW was increasingly higher and gait speed slower over three progressively challenging SB tests (0.207 vs. 0.171 vs. 0.164 mL/kg/m, p < 0.0001 and 0.95 vs. 1.05 vs. 1.15 m/s, p < 0.0001). Over an average 2.4 years, those who declined in SB and NW had a higher ECW and slower gait speed than persons who maintained performance (SB: 0.18 vs. 0.160 mL/kg/m, p = 0.0003, and 1.00 vs. 1.13 m/s, p = <0.001; NW: 0.175 vs. 0.160 mL/kg/m, p = 0.002, and 1.04 vs. 1.14 m/s, p = 0.001). Persons who improved had lower ECW and faster gait speed than those who failed at both visits (SB: 0.169 vs. 0.240 mL/kg/m, p = 0.0002, and 0.99 vs. 0.94 m/s, p = 0.67, NW: 0.163 vs. 0.195 mL/kg/m, p = 0.0005, and 1.10 vs. 0.92 m/s, p < 0.001). Conclusion: Instability contributes to higher ECW and slower gait speed which suggests that rehabilitation efforts to improve balance may help maintain function further into older adulthood and delay mobility limitation.
MeSH term(s)	Male ; Humans ; Female ; Aged ; Walking Speed ; Gait ; Longitudinal Studies ; Cross-Sectional Studies ; Walking
Language	English
Publishing date	2023-08-02
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Intramural
ZDB-ID	80363-7
ISSN	1532-5415 ; 0002-8614
ISSN (online)	1532-5415
ISSN	0002-8614
DOI	10.1111/jgs.18521
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