Physical function decline and the risk of elder self-neglect in a community-dwelling population.

PURPOSE: This longitudinal study examines the association between physical function decline and the risk of elder self-neglect in a community-dwelling population. DESIGN AND METHODS: Of the 5,570 participants in the Chicago Health Aging Project, 1,068 were reported to social services agency for suspected elder self-neglect from 1993 to 2005. The primary predictor was objectively assessed physical function using decline in physical performance testing. Secondary predictors were assessed using the decline in self-reported Katz, Nagi, and Rosow-Breslau scales. Outcome of interest was elder self-neglect. Logistic and linear regression models were used to assess these associations. RESULTS: After adjusting for confounding factors, every 1-point decline in physical performance testing was associated with increased risk of reported elder self-neglect (odds ratio [OR], 1.05, confidence interval [CI], 1.03-1.07, p < .001). Decline in Katz (OR, 1.05, CI, 1.00-1.10, p < .05) and decline in Rosow-Breslau (OR, 1.19, CI, 1.11-1.27, p < .001) were associated with increased risk of reported elder self-neglect. Decline in physical performance testing (standardized parameter estimate [PE]: 0.19, SE: 0.06, p = .002), Katz (PE: 0.65, SE: 0.14, p < .001), Nagi (PE: 0.48, SE: 0.14, p < .001), and Rosow-Breslau (PE: 0.57, SE: 0.21, p = .006) scales were associated with increased risk of greater self-neglect severity. IMPLICATIONS: Decline in physical function was associated with increased risk of reported elder self-neglect and greater self-neglect severity in this community-dwelling population.

Influence of demographic, physiologic, and psychosocial variables on adherence to a yearlong moderate-intensity exercise trial in postmenopausal women.

BACKGROUND: Few studies have examined the long-term adherence to a yearlong exercise intervention among postmenopausal women. We examined the patterns of adherence to a yearlong exercise intervention and the influence of demographic, physiologic, and psychosocial variables on patterns of adherence among 173 sedentary, overweight, postmenopausal women. METHODS: We collected demographic, physical activity (PA), physiologic, psychosocial, and medical history information at baseline and 12 months. The exercise prescription consisted of at least 45 min of moderate-intensity exercise 5 days/week for 12 months. We calculated several adherence variables. Associations between baseline variables and adherence levels were assessed in bivariate analyses and in multiple regression models. RESULTS: Women randomized to the exercise group (N = 87) participated in moderate-intensity sports or recreational PA on 3.7 +/- 1.4 days/week (79% of the prescribed 5 days/week) for 171 +/- 88 min/week (87% of the prescribed 225 min/week) over the yearlong trial period. Sixty-eight percent of the exercisers had a yearlong average PA level exceeding the national recommendation of 150 min/week. Being in the preparation stage vs. the contemplation stage of the transtheoretical model and a history of participating in any sports or recreational PA were significant predictors of adherence. CONCLUSIONS: Our findings provide important information for the design of future PA interventions and health promotion programs.

Effects of a moderate intensity exercise intervention on estrogen metabolism in postmenopausal women.

Physical activity has been associated with reduced breast cancer risk, potentially via hormonal pathways, and high urinary excretion of 2-hydroxyestrone (2-OH E(1)) relative to 16alpha-hydroxyestrone (16alpha-OH E(1)) also has been associated with reduced breast cancer risk. Studies suggest that body composition and exercise can influence estrogen metabolism. We determined the effects of a 12-month moderate intensity aerobic exercise intervention on urinary 2-OH E(1), 16alpha-OH E(1), and their ratio in overweight and obese, previously sedentary, postmenopausal women, ages 50-75 years. Women were randomized to a 12-month exercise intervention (n = 87) or stretching control group (n = 86); 170 completed the study. Urinary 2- and 16alpha-OH E(1) were measured in spot urines collected at baseline, 3, and 12 months. Body composition was measured at baseline and 12 months. Differences between exercisers and controls for excretion of estrogen metabolites were determined using general estimating equations. Further analyses assessed change in estrogen metabolites and their ratio by subgroups of change in body composition. Overall, there were no significant effects of the exercise intervention on 2-OH E(1), 16alpha-OH E(1), or their ratio (P > 0.05). There appeared to be an effect of change in intra-abdominal fat and adherence to the exercise intervention on change in the estrogen metabolites or their ratio. However, this did not reflect a potentially desirable change in estrogen metabolites associated with the exercise intervention. Thus, this 12-month moderate intensity exercise intervention did not significantly alter urinary excretion of 2-OH E(1), 16alpha-OH E(1), or their ratio in this population of women.