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Ageing Research Reviews May 2021Engaging in physical activity (PA) and avoiding sedentary behavior (SB) are important for healthy ageing with benefits including the mitigation of disability and... (Meta-Analysis)
Meta-Analysis Review
The association of objectively measured physical activity and sedentary behavior with skeletal muscle strength and muscle power in older adults: A systematic review and meta-analysis.
BACKGROUND
Engaging in physical activity (PA) and avoiding sedentary behavior (SB) are important for healthy ageing with benefits including the mitigation of disability and mortality. Whether benefits extend to key determinants of disability and mortality, namely muscle strength and muscle power, is unclear.
AIMS
This systematic review aimed to describe the association of objective measures of PA and SB with measures of skeletal muscle strength and muscle power in community-dwelling older adults.
METHODS
Six databases were searched from their inception to June 21, 2020 for articles reporting associations between objectively measured PA and SB and upper body or lower body muscle strength or muscle power in community dwelling adults aged 60 years and older. An overview of associations was visualized by effect direction heat maps, standardized effect sizes were estimated with albatross plots and summarized in box plots. Articles reporting adjusted standardized regression coefficients (β) were included in meta-analyses.
RESULTS
A total of 112 articles were included representing 43,796 individuals (range: 21 to 3726 per article) with a mean or median age from 61.0 to 88.0 years (mean 56.4 % female). Higher PA measures and lower SB were associated with better upper body muscle strength (hand grip strength), upper body muscle power (arm curl), lower body muscle strength, and lower body muscle power (chair stand test). Median standardized effect sizes were consistently larger for measures of PA and SB with lower compared to upper body muscle strength and muscle power. The meta-analyses of adjusted β coefficients confirmed the associations between total PA (TPA), moderate-to-vigorous PA (MVPA) and light PA (LPA) with hand grip strength (β = 0.041, β = 0.057, and β = 0.070, respectively, all p ≤ 0.001), and TPA and MVPA with chair stand test (β = 0.199 and β = 0.211, respectively, all p ≤ 0.001).
CONCLUSIONS
Higher PA and lower SB are associated with greater skeletal muscle strength and muscle power, particularly with the chair stand test.
Topics: Aged; Aged, 80 and over; Exercise; Female; Hand Strength; Humans; Male; Middle Aged; Muscle Strength; Muscle, Skeletal; Sedentary Behavior
PubMed: 33607291
DOI: 10.1016/j.arr.2021.101266 -
BMJ (Clinical Research Ed.) Aug 2019To examine the dose-response associations between accelerometer assessed total physical activity, different intensities of physical activity, and sedentary time and all... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To examine the dose-response associations between accelerometer assessed total physical activity, different intensities of physical activity, and sedentary time and all cause mortality.
DESIGN
Systematic review and harmonised meta-analysis.
DATA SOURCES
PubMed, PsycINFO, Embase, Web of Science, Sport Discus from inception to 31 July 2018.
ELIGIBILITY CRITERIA
Prospective cohort studies assessing physical activity and sedentary time by accelerometry and associations with all cause mortality and reported effect estimates as hazard ratios, odds ratios, or relative risks with 95% confidence intervals.
DATA EXTRACTION AND ANALYSIS
Guidelines for meta-analyses and systematic reviews for observational studies and PRISMA guidelines were followed. Two authors independently screened the titles and abstracts. One author performed a full text review and another extracted the data. Two authors independently assessed the risk of bias. Individual level participant data were harmonised and analysed at study level. Data on physical activity were categorised by quarters at study level, and study specific associations with all cause mortality were analysed using Cox proportional hazards regression analyses. Study specific results were summarised using random effects meta-analysis.
MAIN OUTCOME MEASURE
All cause mortality.
RESULTS
39 studies were retrieved for full text review; 10 were eligible for inclusion, three were excluded owing to harmonisation challenges (eg, wrist placement of the accelerometer), and one study did not participate. Two additional studies with unpublished mortality data were also included. Thus, individual level data from eight studies (n=36 383; mean age 62.6 years; 72.8% women), with median follow-up of 5.8 years (range 3.0-14.5 years) and 2149 (5.9%) deaths were analysed. Any physical activity, regardless of intensity, was associated with lower risk of mortality, with a non-linear dose-response. Hazards ratios for mortality were 1.00 (referent) in the first quarter (least active), 0.48 (95% confidence interval 0.43 to 0.54) in the second quarter, 0.34 (0.26 to 0.45) in the third quarter, and 0.27 (0.23 to 0.32) in the fourth quarter (most active). Corresponding hazards ratios for light physical activity were 1.00, 0.60 (0.54 to 0.68), 0.44 (0.38 to 0.51), and 0.38 (0.28 to 0.51), and for moderate-to-vigorous physical activity were 1.00, 0.64 (0.55 to 0.74), 0.55 (0.40 to 0.74), and 0.52 (0.43 to 0.61). For sedentary time, hazards ratios were 1.00 (referent; least sedentary), 1.28 (1.09 to 1.51), 1.71 (1.36 to 2.15), and 2.63 (1.94 to 3.56).
CONCLUSION
Higher levels of total physical activity, at any intensity, and less time spent sedentary, are associated with substantially reduced risk for premature mortality, with evidence of a non-linear dose-response pattern in middle aged and older adults.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42018091808.
Topics: Accelerometry; Aged; Exercise; Female; Humans; Male; Middle Aged; Mortality; Proportional Hazards Models; Prospective Studies; Risk Factors; Sedentary Behavior
PubMed: 31434697
DOI: 10.1136/bmj.l4570 -
The European Respiratory Journal Dec 2022Physical inactivity is common in asthma and is recognised as an important modifiable risk for poor clinical outcomes such as impaired asthma control and health-related... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Physical inactivity is common in asthma and is recognised as an important modifiable risk for poor clinical outcomes such as impaired asthma control and health-related quality of life (HRQoL). Despite evidence supporting the role of physical activity in reducing the risk of these outcomes, little is known about optimal interventions for increasing physical activity in those with severe disease. This systematic review and meta-analysis evaluates the effectiveness of interventions in increasing physical activity in severe asthma.
METHODS
MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, Embase, PubMed, Informit, SPORTDiscus and Cochrane databases were searched up to September 2021 for physical activity-based intervention studies that assessed physical activity outcomes ( steps per day, time spent undertaking physical activity) in adults with severe asthma. Data on asthma-related ( asthma control) and health-related outcomes ( HRQoL) were assessed as secondary outcomes. The revised Cochrane Risk of Bias tool was used to assess risk of bias. Random-effects meta-analyses synthesised data where possible.
RESULTS
Four randomised controlled trials (all 12 weeks in duration) including 176 adults with moderate-to-severe asthma were included. An increase in physical activity was reported with a moderate-vigorous intensity aerobic and resistance training intervention (steps per day and time spent undertaking physical activity), and an unsupervised pedometer-based intervention (steps per day). Meta-analyses showed that physical activity interventions had an overall positive effect on steps per day (mean difference (MD) 1588, 95% CI 399-2778; p0.009, I=23), asthma control (MD -0.65, 95% CI -0.95--0.35; p<0.0001, I=0%) and HRQoL (MD 0.56, 95% CI 0.10-1.01; p0.02, I=16%) compared to control.
CONCLUSION
While there is some evidence supporting the effectiveness of interventions in improving physical activity in adults with severe asthma, higher-quality, large-scale studies of longer duration are needed to determine the optimal intervention.
Topics: Adult; Humans; Quality of Life; Exercise; Sedentary Behavior; Asthma; Actigraphy
PubMed: 35896208
DOI: 10.1183/13993003.00546-2022 -
Journal of Medical Internet Research Nov 2019Wearable sleep monitors are of high interest to consumers and researchers because of their ability to provide estimation of sleep patterns in free-living conditions in a... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Wearable sleep monitors are of high interest to consumers and researchers because of their ability to provide estimation of sleep patterns in free-living conditions in a cost-efficient way.
OBJECTIVE
We conducted a systematic review of publications reporting on the performance of wristband Fitbit models in assessing sleep parameters and stages.
METHODS
In adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we comprehensively searched the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane, Embase, MEDLINE, PubMed, PsycINFO, and Web of Science databases using the keyword Fitbit to identify relevant publications meeting predefined inclusion and exclusion criteria.
RESULTS
The search yielded 3085 candidate articles. After eliminating duplicates and in compliance with inclusion and exclusion criteria, 22 articles qualified for systematic review, with 8 providing quantitative data for meta-analysis. In reference to polysomnography (PSG), nonsleep-staging Fitbit models tended to overestimate total sleep time (TST; range from approximately 7 to 67 mins; effect size=-0.51, P<.001; heterogenicity: I=8.8%, P=.36) and sleep efficiency (SE; range from approximately 2% to 15%; effect size=-0.74, P<.001; heterogenicity: I=24.0%, P=.25), and underestimate wake after sleep onset (WASO; range from approximately 6 to 44 mins; effect size=0.60, P<.001; heterogenicity: I=0%, P=.92) and there was no significant difference in sleep onset latency (SOL; P=.37; heterogenicity: I=0%, P=.92). In reference to PSG, nonsleep-staging Fitbit models correctly identified sleep epochs with accuracy values between 0.81 and 0.91, sensitivity values between 0.87 and 0.99, and specificity values between 0.10 and 0.52. Recent-generation Fitbit models that collectively utilize heart rate variability and body movement to assess sleep stages performed better than early-generation nonsleep-staging ones that utilize only body movement. Sleep-staging Fitbit models, in comparison to PSG, showed no significant difference in measured values of WASO (P=.25; heterogenicity: I=0%, P=.92), TST (P=.29; heterogenicity: I=0%, P=.98), and SE (P=.19) but they underestimated SOL (P=.03; heterogenicity: I=0%, P=.66). Sleep-staging Fitbit models showed higher sensitivity (0.95-0.96) and specificity (0.58-0.69) values in detecting sleep epochs than nonsleep-staging models and those reported in the literature for regular wrist actigraphy.
CONCLUSIONS
Sleep-staging Fitbit models showed promising performance, especially in differentiating wake from sleep. However, although these models are a convenient and economical means for consumers to obtain gross estimates of sleep parameters and time spent in sleep stages, they are of limited specificity and are not a substitute for PSG.
Topics: Actigraphy; Female; Humans; Male; Sleep; Wrist
PubMed: 31778122
DOI: 10.2196/16273 -
Behavioural Brain Research Mar 2021Despite increasing evidence that physical activity (PA) contributes to brain health in older individuals, both at the level of brain structure and function, this...
Despite increasing evidence that physical activity (PA) contributes to brain health in older individuals, both at the level of brain structure and function, this relationship is not yet well established. To explore this potential association, a systematic literature search was performed using PubMed, Scopus, and Web of Science, adhering to PRISMA guidelines. A total of 32 studies met the eligibility criteria: 24 cross-sectional and 8 longitudinal. Results from structural Magnetic Resonance Imaging (MRI) showed that PA associated with larger brain volumes (less brain atrophy) specifically in brain regions vulnerable to dementia, comprising the hippocampus, temporal, and frontal regions. Furthermore, functional MRI (fMRI) showed greater task-relevant activity in brain areas recruited in executive function and memory tasks. However, the dose-response relationship is unclear due to the high variability in PA measures. Further research using objective measures is needed to better understand which PA type, intensity, frequency, and duration, has the greatest protective effect on brain health. Findings highlight the importance of PA in both cognitive decline and dementia prevention.
Topics: Aged; Aging; Brain; Cognitive Dysfunction; Dementia; Exercise; Humans
PubMed: 33359570
DOI: 10.1016/j.bbr.2020.113061 -
Journal of Medical Internet Research Aug 2019Among areas that have challenged the progress of dementia care has been the assessment of change in symptoms over time. Digital biomarkers are defined as objective,...
Current State of Digital Biomarker Technologies for Real-Life, Home-Based Monitoring of Cognitive Function for Mild Cognitive Impairment to Mild Alzheimer Disease and Implications for Clinical Care: Systematic Review.
BACKGROUND
Among areas that have challenged the progress of dementia care has been the assessment of change in symptoms over time. Digital biomarkers are defined as objective, quantifiable, physiological, and behavioral data that are collected and measured by means of digital devices, such as embedded environmental sensors or wearables. Digital biomarkers provide an alternative assessment approach, as they allow objective, ecologically valid, and long-term follow-up with continuous assessment. Despite the promise of a multitude of sensors and devices that can be applied, there are no agreed-upon standards for digital biomarkers, nor are there comprehensive evidence-based results for which digital biomarkers may be demonstrated to be most effective.
OBJECTIVE
In this review, we seek to answer the following questions: (1) What is the evidence for real-life, home-based use of technologies for early detection and follow-up of mild cognitive impairment (MCI) or dementia? And (2) What transformation might clinicians expect in their everyday practices?
METHODS
A systematic search was conducted in PubMed, Cochrane, and Scopus databases for papers published from inception to July 2018. We searched for studies examining the implementation of digital biomarker technologies for mild cognitive impairment or mild Alzheimer disease follow-up and detection in nonclinic, home-based settings. All studies that included the following were examined: community-dwelling older adults (aged 65 years or older); cognitively healthy participants or those presenting with cognitive decline, from subjective cognitive complaints to early Alzheimer disease; a focus on home-based evaluation for noninterventional follow-up; and remote diagnosis of cognitive deterioration.
RESULTS
An initial sample of 4811 English-language papers were retrieved. After screening and review, 26 studies were eligible for inclusion in the review. These studies ranged from 12 to 279 participants and lasted between 3 days to 3.6 years. Most common reasons for exclusion were as follows: inappropriate setting (eg, hospital setting), intervention (eg, drugs and rehabilitation), or population (eg, psychiatry and Parkinson disease). We summarized these studies into four groups, accounting for overlap and based on the proposed technological solutions, to extract relevant data: (1) data from dedicated embedded or passive sensors, (2) data from dedicated wearable sensors, (3) data from dedicated or purposive technological solutions (eg, games or surveys), and (4) data derived from use of nondedicated technological solutions (eg, computer mouse movements).
CONCLUSIONS
Few publications dealt with home-based, real-life evaluations. Most technologies were far removed from everyday life experiences and were not mature enough for use under nonoptimal or uncontrolled conditions. Evidence available from embedded passive sensors represents the most relatively mature research area, suggesting that some of these solutions could be proposed to larger populations in the coming decade. The clinical and research communities would benefit from increasing attention to these technologies going forward.
Topics: Accelerometry; Aged; Alzheimer Disease; Automobile Driving; Biomarkers; Cognition; Cognitive Dysfunction; Disease Progression; Early Diagnosis; Geographic Information Systems; Humans; Independent Living; Surveys and Questionnaires; Technology; Telemedicine; Wearable Electronic Devices
PubMed: 31471958
DOI: 10.2196/12785 -
Sleep Medicine Reviews Oct 2021Epidemiological and interventional research has highlighted sleep as a potentially modifiable risk factor associated with poor physical and mental health. Emerging... (Meta-Analysis)
Meta-Analysis Review
Epidemiological and interventional research has highlighted sleep as a potentially modifiable risk factor associated with poor physical and mental health. Emerging evidence from (behavioral) genetic research also shows that sleep characteristics are under strong genetic control. With this study we aimed to meta-analyze the literature in this area to quantify the heritability of sleep duration and sleep quality in the general population. We conducted a systematic literature search in five online databases on January 24th 2020. Two authors independently screened 5644 abstracts, and 160 complete articles for the inclusion criteria of twin studies from the general population reporting heritability statistics on sleep duration and/or quality, and written in English. We ultimately included 23 papers (19 independent samples: 45,328 twins between 6 mo and 88 y) for sleep duration, and 13 papers (10 independent samples: 39,020 twins between 16 and 95 y) for sleep quality. Collectively, we showed that 46% of the variability in sleep duration and 44% of the variability in sleep quality is genetically determined. The remaining variation in the sleep characteristics can mostly be attributed to the unique environment the twins experience, although the shared environment seemed to play a role for the variability of childhood sleep duration. Meta-analyzed heritability estimates for sleep duration, however, varied substantially with age (17% infancy, 20-52% childhood, 69% adolescence and 42-45% adulthood) and reporter (8% parent-report, 38-52% self-report). Heritability estimates for actigraphic and Polysomnography (PSG)-estimated sleep were based on few small samples, warranting more research. Our findings highlight the importance of considering genetic influences when aiming to understand the underlying mechanisms contributing to the trajectories of sleep patterns across the lifespan.
Topics: Actigraphy; Adolescent; Adult; Humans; Polysomnography; Self Report; Sleep; Sleep Wake Disorders
PubMed: 33636423
DOI: 10.1016/j.smrv.2021.101448 -
Sleep Medicine Reviews Dec 2021Even though tobacco-induced sleep disturbances (TISDs) have been reported in previous studies, the present article is the first meta-analysis quantitatively assessing... (Meta-Analysis)
Meta-Analysis Review
Even though tobacco-induced sleep disturbances (TISDs) have been reported in previous studies, the present article is the first meta-analysis quantitatively assessing the impact of tobacco on sleep parameters. We conducted a systematic review and meta-analysis of the studies comparing objective (i.e. polysomnography and actigraphy) and/or subjective sleep parameters in chronic tobacco smokers without comorbidities versus healthy controls. Studies were retrieved using PubMed, PsycINFO, and Web of Science. Differences are expressed as standardized mean deviations (SMD) and their 95% confidence intervals (95%CI). Fourteen studies were finally included into the review, among which ten were suitable for meta-analysis. Compared to healthy controls, chronic tobacco users displayed increased N1 percentage (SMD = 0.65, 95%CI: 0.22 to 1.07), N2 percentage (SMD = 1.45, 95%CI: 0.26 to 2.63), wake time after sleep onset (SMD = 6.37, 95%CI: 2.48 to 10.26), and decreased slow-wave sleep (SMD = -2.00, 95%CI: -3.30 to -0.70). Objective TISDs preferentially occurred during the first part of the night. Regarding subjective parameters, only the Pittsburgh Sleep Quality Index (PSQI) total score could be analyzed, with no significant between-groups difference (SMD = 0.53, 95%CI: -0.18 to 1.23). Smoking status should be carefully assessed in sleep medicine, while TISDs should be regularly explored in chronic tobacco users.
Topics: Actigraphy; Humans; Polysomnography; Sleep; Sleep Wake Disorders; Nicotiana
PubMed: 34597890
DOI: 10.1016/j.smrv.2021.101544 -
Journal of Physical Activity & Health Dec 2023Recent statistical approaches have allowed consideration of the integrated relationships between sedentary behavior (SB) and physical activity (PA) with different health... (Review)
Review
BACKGROUND
Recent statistical approaches have allowed consideration of the integrated relationships between sedentary behavior (SB) and physical activity (PA) with different health outcomes. The present paper aimed to systematically review the literature and synthesize evidence about associations between hypothetical reallocations from SB to different PA intensities and cardiovascular risk factors in youth.
METHODS
A systematic search of 8 databases was performed. Observational studies with a population of children and/or adolescents and based on statistical analysis that investigated the associations between time reallocations from SB to PA and cardiovascular risk factors were included.
RESULTS
Twenty-eight studies met the inclusion criteria. Level of evidence (derived from cross-sectional studies) indicated that the reallocation from SB to moderate to vigorous PA was beneficially associated with adiposity, cardiorespiratory fitness, and cardiometabolic biomarkers in youth. Reallocation from SB to light PA was not associated with the analyzed outcomes. Associations derived from longitudinal studies were mostly inconclusive.
CONCLUSION
Cardiovascular risk factors could be improved by increasing moderate to vigorous PA at the expense of time spent in SB in pediatric populations. Prospective studies or studies investigating the effects of reallocating sedentary bouts to PA are needed.
Topics: Humans; Adolescent; Child; Exercise; Cardiovascular Diseases; Sedentary Behavior; Cross-Sectional Studies; Prospective Studies; Risk Factors; Heart Disease Risk Factors; Accelerometry
PubMed: 37704195
DOI: 10.1123/jpah.2022-0471 -
Psychiatry Research Oct 2023Sleep disturbances are often linked to attention-deficit/hyperactivity disorder (ADHD). Consistent findings document that children and adolescents with ADHD report more... (Meta-Analysis)
Meta-Analysis Review
Sleep disturbances are often linked to attention-deficit/hyperactivity disorder (ADHD). Consistent findings document that children and adolescents with ADHD report more sleep problems than their typically developing (TD) peers across subjective sleep domains. However, few differences between these groups were observed in objectively measured sleep parameters, such as polysomnography (PSG) and actigraphy. This study synthesized empirical studies to identify objectively measured sleep continuity differences between children and adolescents with ADHD and TD. We included observational research and baseline data from intervention studies between 5- to 18-year-old individuals with ADHD and their TD peers at five databases from inception and September 2022. This systematic review and meta-analysis of 45 articles, including 1622 children and adolescents with ADHD and 2013 TD, found that compared with TD, children and adolescents with ADHD have higher sleep latency and moderately decreased sleep efficiency measured by actigraphy. Polysomnography-measured differences between ADHD and TD were not significant. Medication status and comorbid psychiatric status significantly moderated the group differences in sleep efficiency between ADHD and TD. Also, the group differences in sleep latency between ADHD and TD were moderated by actigraphy recorded nights. These findings highlight the importance of reducing disparities in sleep parameters among children and adolescents with and without ADHD.
Topics: Humans; Child; Adolescent; Child, Preschool; Attention Deficit Disorder with Hyperactivity; Sleep; Polysomnography; Actigraphy; Sleep Latency; Sleep Wake Disorders
PubMed: 37657199
DOI: 10.1016/j.psychres.2023.115447