Physical activity trajectories, mortality, hospitalization, and disability in the Toledo Study of Healthy Aging

Sánchez Sánchez, Juan Luis; Izquierdo Redín, Mikel; Carnicero Carreño, José Antonio; García García, Francisco José; Rodríguez Mañas, Leocadio

Physical activity trajectories, mortality, hospitalization, and disability in the Toledo Study of Healthy Aging

dc.contributor.author	Sánchez Sánchez, Juan Luis
dc.contributor.author	Izquierdo Redín, Mikel
dc.contributor.author	Carnicero Carreño, José Antonio
dc.contributor.author	García García, Francisco José
dc.contributor.author	Rodríguez Mañas, Leocadio
dc.contributor.department	Ciencias de la Salud	es_ES
dc.contributor.department	Osasun Zientziak	eu
dc.date.accessioned	2020-07-06T08:41:25Z
dc.date.available	2020-07-06T08:41:25Z
dc.date.issued	2020
dc.description.abstract	Background: Physical activity (PA) is a recognized contributor to healthy aging. However, the majority of studies exploring its associations with adverse outcomes in cohorts of older adults use single-time PA estimates, which do not consider its dynamic nature. The aim of the present study is to explore the presence of different PA trajectories in the Toledo Study of Healthy Aging and their association with adverse outcomes. Our hypothesis is that prospectively maintaining or increasing PA is associated with a reduced risk of adverse outcomes. Methods: We used data from 1679 participants enrolled in the Toledo Study of Healthy Aging. Trajectories based on the Physical Activity Scale for the Elderly were identified using group-based trajectory modelling. Cox and logistic regression were used to investigate associations between PA trajectories and mortality and hospitalization, and incident and worsening disability, respectively. Mortality was ascertained by linkage to the Spanish National Death Index; disability was evaluated through the Katz Index; and hospitalization was defined as the first admission to Toledo Hospital. Models were adjusted by age, sex, smoking, Charlson Index, education, cognitive impairment, polypharmacy, and Katz Index at Wave 2. Results: We found four PA-decreasing and one PA-increasing trajectories: high PA-consistent (n = 566), moderate PA-mildly decreasing (n = 392), low PA-increasing (n = 237), moderate PA-consistent (n = 191), and low PA-decreasing (n = 293). Belonging to the high PA-consistent trajectory group was associated with reduced risks of mortality as compared with the low PA-decreasing group [hazard ratio (HR) 1.68; 95% confidence interval (CI) = 1.21–2.31] and hospitalization compared with the low PA-increasing and low PA-decreasing trajectory groups (HR 1.24; 95% CI = 1.004–1.54 and HR 1.25; 95% CI = 1.01–1.55, respectively) and with lower rates of incident [odds ratio (OR) 3.14; 95% CI = 1.59–6.19] and worsening disability (OR 2.16; 95% CI = 1.35–3.45) in relation to the low PA-decreasing trajectory group and at follow-up. Increasing PA during late life (low PA-increasing group) was associated with lower incident disability rates (OR 0.38; 95% CI = 0.19–0.82) compared with decreasing PA (low PA-decreasing group), despite similar baseline PA. Conclusions: Our results suggest that sustaining higher PA levels during aging might lead to healthy aging, characterized by a reduction in adverse outcomes. Our study supports the need for enhancing PA participation among older populations, with the goal of reducing personal and economic burden in a worldwide aging population.	en
dc.description.sponsorship	The present work was funded by grants from the Spanish Ministry of Economy, Industry and Competitiveness, cofinanced by the European Regional Development Funds (RD120001/0043) and the Centro de Investigación Biomédica en Red en Fragilidad y Envejecimiento Saludable (CB16/10/00464).	en
dc.format.extent	11 p.
dc.format.mimetype	application/pdf	en
dc.identifier.doi	10.1002/jcsm.12566
dc.identifier.issn	2190-5991
dc.identifier.uri	https://academica-e.unavarra.es/handle/2454/37346
dc.language.iso	eng	en
dc.publisher	Wiley	en
dc.relation.ispartof	Journal of Cachexia, Sarcopenia and Muscle (2020)	en
dc.relation.publisherversion	https://doi.org/10.1002/jcsm.12566
dc.rights	© 2020 The Authors. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.	en
dc.rights.accessRights	info:eu-repo/semantics/openAccess
dc.rights.uri	https://creativecommons.org/licenses/by/4.0/
dc.subject	Physical activity	en
dc.subject	Healthy aging	en
dc.subject	Trajectories	en
dc.subject	Adverse outcomes	en
dc.subject	Older adults	en
dc.subject	Mortality	en
dc.title	Physical activity trajectories, mortality, hospitalization, and disability in the Toledo Study of Healthy Aging	en
dc.type	info:eu-repo/semantics/article
dc.type.version	info:eu-repo/semantics/publishedVersion
dspace.entity.type	Publication
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