The interaction effect between physical and cultural leisure activities on the subsequent decline of instrumental ADL: the Fujiwara-kyo study

BACKGROUND@#Maintenance of instrumental activities of daily living (IADL) and social role (SR) is crucial to keep independent life because the decline in SR and IADL was a significant predictor of dependence in basic ADL in later. The independent effect of physical and cultural leisure activities and their effect modification on the IADL remains unknown.@*METHODS@#We prospectively observed 3241 elderly with intact IADL at baseline for 5 years. Higher level functional capacity such as IADL and SR was assessed using the Tokyo Metropolitan Institute of Gerontology Index of competence (TMIG index).@*RESULTS@#The mean age of the participants was 72.3 years (standard deviation 5.1), and 46.9% were male, and 90.9% of them received a follow-up assessment. Of the participants, 10.4% developed an IADL decline. Engagement in leisure physical activity was associated with a significantly lower risk of IADL decline (adjusted risk ratio, 0.73; 95% confidence interval [CI], 0.60 to 0.89), and cultural leisure activity was also associated with lower risk of IADL decline (adjusted risk ratio, 0.77; 95% CI, 0.63 to 0.95) independent of potential confounders. We also found significant and positive interaction between physical and cultural leisure activities at risk for IADL decline (P = 0.024) and SR decline (P = 0.004).@*CONCLUSIONS@#We found an independent association of physical and cultural leisure activities with a lower risk for functional decline in IADL and SR with positive interaction. Combined engagement in physical and cultural activities may effectively prevent from IADL decline and SR decline.

Prática de atividade física no lazer entre idosos nas capitais brasileiras e no Distrito Federal: 2009 a 2017 / Practice of leisure physical activity among elderly people in the Brazilian capitals and Federal District: 2009 to 2017

Introdução: O aumento da importância das doenças crônicas não transmissíveis (DCNT) no perfil de saúde da população acarretou em demanda pela vigilância de seus fatores de risco e proteção. A população idosa vem experienciando uma grande expansão nas últimas décadas e sua vulnerabilidade majorada para as DCNT a classifica como alvo prioritário para essa vigilância. Objetivo: Analisar a tendência temporal da prática de atividade física no lazer entre a população idosa nas capitais brasileiras e no Distrito Federal, entre 2009 e 2017. Métodos: Dados do Vigitel coletados entre 2009 e 2017 (n= 129.967 idosos) (≥60 anos) foram utilizados. Informações acerca da intensidade, frequência semanal (dias/semana) e duração habitual (minutos/episódio) da prática de atividade física de lazer foram utilizados para a identificação do percentual de idosos, atendendo às recomendações atuais de prática (≥150min/semana). Essas informações foram estimadas para cada ano, para o conjunto completo da população e segundo estratos sociodemográficos e de saúde. Modelos de regressão Prais-Winsten foram usados para a análise da variação temporal. Resultados: A porcentagem dos idosos que referiu prática de atividade física nos 90 dias que antecederam a entrevista aumentou de 37,2% para 43,0% no período entre 2009 e 2017 (0,70 pontos percentuais (pp)/ano). A maioria dos idosos que já praticava atividade física relatou como opção atividade de intensidade moderada (93,9% em 2017). A porcentagem de idosos referindo não praticar atividade física ao menos um dia por semana diminuiu (de 64,2% para 59,4%, -0,73 pp/ano), com aumento nas faixas de prática entre 1 e 4 dias/semana. A duração habitual (minutos/episódio) da prática também aumentou, de 48,1% para 58,2% (0,62pp/ano), com a porcentagem de prática em 60 minutos ou mais por episódio. Com isso, a porcentagem de idosos atingindo nível recomendado de prática (≥150min/semana) aumentou de 23,2% para 25,8% (0,30 pp/ano), com maiores aumentos observados naqueles com idade entre 60 a 69 anos (0,39pp/ano), com escolaridade entre 0 e 8 anos de estudo (0,22pp/ano) e residentes nas capitais da região Norte (0,99pp/ano). De forma geral, maiores aumentos foram observados nos estratos com menor nível de prática no início do período estudado. Conclusão: A prática de atividade física evoluiu de forma favorável, com aumento da porcentagem de idosos atendendo às recomendações de prática.(AU)

Introduction: The increased importance of noncommunicable chronic diseases (NCDs) in the health profile of the population led to a demand for the surveillance of their risk factors and protection. The elderly population has been experiencing great expansion in recent decades and their increased vulnerability to NCDs classifies it as a priority target for this surveillance. Objective: To analyze the temporal tendency of leisure time physical activity among the elderly population in the Brazilian capitals and Federal District between 2009 and 2017. Methods: Vigitel data collected between 2009 and 2017 (n=129,967 elderly) (≥60 years) were used. Information related to the intensity, weekly frequency (days/week) and habitual duration (minutes/episode) of leisure physical activity practice were used to identify the percentage of elderly attending to the current recommendations of the practice (≥150min/week). This information was estimated for each year, for the entire population and according to socio-demographic and health strata. Prais-Winsten regression were used for temporal variation analysis. Results: The percentage of the elderly referring the physical activity practice in the 90 days before the interview increased from 37.2% to 43.0% in the period between 2009 and 2017 (0,70 percentage points (pp)/year). The majority of the elderly opted for moderate intensity activity (93.9% in 2017). The percentage of elderly individuals who reported not practicing physical activity at least one day per week decreased (from 64.2% to 59.4%, -0.73pp/year), with an increase in the practice ranges between 1 and 4 days/week. The usual duration of the practice also increased, with the percentage of practice in 60 minutes or more per episode, increasing from 48.1% to 58.2% (0.62pp/year). As a result, the percentage of elderly people reaching the recommended volume of leisure physical activity practice increased from 23.2% to 25.8% (0.30pp/year) with higher increases observed in those aged 60-69 years (0.39pp / year), with education between 0 and 8 years of study (0.22pp/year) and residents in the capitals of the North region (0.99pp /year).. In general, higher increases were observed in strata with lower level of practice at the beginning of the studied period. Conclusion: The practice of physical activity evolved favorably, with an increase in the percentage of elderly attending to the practice recommendations.(AU)