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      Physical activity combined with sedentary behaviour in the risk of mortality in older adults

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          ABSTRACT

          OBJECTIVE

          To examine the effects of physical activity (PA) and sedentary behaviour (SB), in isolation and combination, on all-cause mortality in older adults.

          METHODS

          Prospective, population-based cohort study. The data were collected from first wave in 2015 and the follow-up continued until 2020. The sample consisted of 332 older adult people aged ≥ 60 years-old, out of which 59 died. The level of PA and SB was assessed by the International Physical Activity Questionnaire (IPAQ). The older adults were divided into PA categorized as sufficiently active and insufficiently active and into high and low SB. We built four combinations of PA and SB. Also, we used the Cox proportional hazards regression with a 95% confidence interval with hazard ratio estimate so as to verify the mortality risks between PA, SB, and the combinations of PA and SB.

          RESULTS

          Insufficiently active individuals had higher risks of mortality compared to sufficiently active people. We observed no associations between SB and mortality separately; however, when evaluated in a combined way, insufficiently active individuals and with a high SB time had a higher chance of mortality compared to active individuals with a low SB time.

          CONCLUSION

          Our isolated analyses demonstrate that complying with PA recommendations reduces the risk of mortality; however, no association was found between the time of PA exposure with the time of SB. When analysing the combination, being physically inactive and with a long time of SB showed higher mortality rates, with SB being an enhancer of this risk. The results of this study show the interdependence of SB for PA performed at moderate to vigorous intensity. The understanding of this interrelation must be considered in the formulation of public health guidelines.

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          Most cited references42

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          International physical activity questionnaire: 12-country reliability and validity.

          Physical inactivity is a global concern, but diverse physical activity measures in use prevent international comparisons. The International Physical Activity Questionnaire (IPAQ) was developed as an instrument for cross-national monitoring of physical activity and inactivity. Between 1997 and 1998, an International Consensus Group developed four long and four short forms of the IPAQ instruments (administered by telephone interview or self-administration, with two alternate reference periods, either the "last 7 d" or a "usual week" of recalled physical activity). During 2000, 14 centers from 12 countries collected reliability and/or validity data on at least two of the eight IPAQ instruments. Test-retest repeatability was assessed within the same week. Concurrent (inter-method) validity was assessed at the same administration, and criterion IPAQ validity was assessed against the CSA (now MTI) accelerometer. Spearman's correlation coefficients are reported, based on the total reported physical activity. Overall, the IPAQ questionnaires produced repeatable data (Spearman's rho clustered around 0.8), with comparable data from short and long forms. Criterion validity had a median rho of about 0.30, which was comparable to most other self-report validation studies. The "usual week" and "last 7 d" reference periods performed similarly, and the reliability of telephone administration was similar to the self-administered mode. The IPAQ instruments have acceptable measurement properties, at least as good as other established self-reports. Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings. The short IPAQ form "last 7 d recall" is recommended for national monitoring and the long form for research requiring more detailed assessment.
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            “Mini-mental state”

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              Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy.

              Strong evidence shows that physical inactivity increases the risk of many adverse health conditions, including major non-communicable diseases such as coronary heart disease, type 2 diabetes, and breast and colon cancers, and shortens life expectancy. Because much of the world's population is inactive, this link presents a major public health issue. We aimed to quantify the eff ect of physical inactivity on these major non-communicable diseases by estimating how much disease could be averted if inactive people were to become active and to estimate gain in life expectancy at the population level. For our analysis of burden of disease, we calculated population attributable fractions (PAFs) associated with physical inactivity using conservative assumptions for each of the major non-communicable diseases, by country, to estimate how much disease could be averted if physical inactivity were eliminated. We used life-table analysis to estimate gains in life expectancy of the population. Worldwide, we estimate that physical inactivity causes 6% (ranging from 3·2% in southeast Asia to 7·8% in the eastern Mediterranean region) of the burden of disease from coronary heart disease, 7% (3·9-9·6) of type 2 diabetes, 10% (5·6-14·1) of breast cancer, and 10% (5·7-13·8) of colon cancer. Inactivity causes 9% (range 5·1-12·5) of premature mortality, or more than 5·3 million of the 57 million deaths that occurred worldwide in 2008. If inactivity were not eliminated, but decreased instead by 10% or 25%, more than 533 000 and more than 1·3 million deaths, respectively, could be averted every year. We estimated that elimination of physical inactivity would increase the life expectancy of the world's population by 0·68 (range 0·41-0·95) years. Physical inactivity has a major health eff ect worldwide. Decrease in or removal of this unhealthy behaviour could improve health substantially. None.
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                Author and article information

                Journal
                Rev Saude Publica
                Rev Saude Publica
                rsp
                Revista de Saúde Pública
                Faculdade de Saúde Pública da Universidade de São Paulo
                0034-8910
                1518-8787
                13 October 2021
                2021
                : 55
                : 60
                Affiliations
                [I ] orgnameUniversidade Federal do Triângulo Mineiro orgdiv1Programa de Pós-Graduação em Educação Física Uberaba MG Brasil originalUniversidade Federal do Triângulo Mineiro. Programa de Pós-Graduação em Educação Física. Uberaba, Minas Gerais, MG, Brasil
                [II ] orgnameUniversidade Federal do Triângulo Mineiro orgdiv1Instituto de Ciências da Saúde orgdiv2Departamento de Ciências do Esporte Uberaba MG Brasil originalUniversidade Federal do Triângulo Mineiro. Instituto de Ciências da Saúde. Departamento de Ciências do Esporte. Uberaba, Minas Gerais, MG, Brasil
                [III ] orgnameUniversidade do Estado da Bahia orgdiv1Departamento de Educação Teixeira de Freitas BA Brasil originalUniversidade do Estado da Bahia. Departamento de Educação. Teixeira de Freitas, Bahia, BA, Brasil
                Author notes
                Correspondence: Jair Sindra Virtuoso Junior Universidade Federal do Triângulo Mineiro Programa de Pós-Graduação em Educação Física Avenida do Tutunas,490 -Tutunas 38061-500 Uberaba, MG, Brasil E-mail: jair.junior@ 123456uftm.edu.br

                Authors’ Contribution: Study design and planning: ST, DATS, JSVJ. Data collection, analysis and interpretation: LLG, RRS, ST, DATS, JSVJ. Manuscript drafting or review: LLG, RRS, ST, DATS, JSVJ. Approval of the final version: LLG, RRS, ST, DATS, JSVJ. Public responsibility for the content of the article: LLG, RRS, ST, DATS, JSVJ.

                Conflict of Interests: The authors declare no conflict of interest.

                Author information
                https://orcid.org/0000-0001-9296-0997
                https://orcid.org/0000-0003-0071-8111
                https://orcid.org/0000-0001-9421-1519
                https://orcid.org/0000-0002-7664-5468
                https://orcid.org/0000-0001-7602-1789
                Article
                00251
                10.11606/s1518-8787.2021055003461
                8522709
                34706037
                c239d4d7-b63b-4414-a239-675c68c65310

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 1 January 2021
                : 24 March 2021
                Page count
                Figures: 2, Tables: 2, Equations: 0, References: 36
                Funding
                Funded by: Conselho Nacional de Desenvolvimento Científico e Tecnológico
                Award ID: 14/2014
                Funded by: Conselho Nacional de Desenvolvimento Científico e Tecnológico
                Award ID: 448184/2014-1
                Funding: This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) and supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (MCTI/CNPQ/Universal 14/2014, grant number: 448184/2014-1).
                Categories
                Original Article

                aged,sedentary behavior,exercise,risk factors,mortality
                aged, sedentary behavior, exercise, risk factors, mortality

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