RESUMEN
BACKGROUND: Multidimensional frailty, including physical, psychological, and social components, is associated to disability, lower quality of life, increased healthcare utilization, and mortality. In order to prevent or delay frailty, more knowledge of its determinants is necessary; one of these determinants is lifestyle. The aim of this study is to determine the association between lifestyle factors smoking, alcohol use, nutrition, physical activity, and multidimensional frailty. METHODS: This cross-sectional study was conducted in two samples comprising in total 45,336 Dutch community-dwelling individuals aged 65 years or older. These samples completed a questionnaire including questions about smoking, alcohol use, physical activity, sociodemographic factors (both samples), and nutrition (one sample). Multidimensional frailty was assessed with the Tilburg Frailty Indicator (TFI). RESULTS: Higher alcohol consumption, physical activity, healthy nutrition, and less smoking were associated with less total, physical, psychological and social frailty after controlling for effects of other lifestyle factors and sociodemographic characteristics of the participants (age, gender, marital status, education, income). Effects of physical activity on total and physical frailty were up to considerable, whereas the effects of other lifestyle factors on frailty were small. CONCLUSIONS: The four lifestyle factors were not only associated with physical frailty but also with psychological and social frailty. The different associations of frailty domains with lifestyle factors emphasize the importance of assessing frailty broadly and thus to pay attention to the multidimensional nature of this concept. The findings offer healthcare professionals starting points for interventions with the purpose to prevent or delay the onset of frailty, so community-dwelling older people have the possibility to aging in place accompanied by a good quality of life.
Asunto(s)
Fragilidad , Vida Independiente , Anciano , Estudios Transversales , Anciano Frágil , Fragilidad/diagnóstico , Fragilidad/epidemiología , Evaluación Geriátrica , Humanos , Estilo de Vida , Calidad de Vida , Factores Sociodemográficos , Encuestas y CuestionariosRESUMEN
BACKGROUND: The aim of this study was to explore the predictive value of baseline characteristics in relation to changes in physical activity (PA) and sedentary behaviour among diabetic and pre-diabetic patients participating in a primary care based exercise intervention. We used a descriptive case series among diabetic and pre-diabetic patients (n = 119, 50.8% male, mean age 65.5 (SD = 7.8)). Measurements took place with questionnaires at baseline and two years after the start of the intervention. Predictor variables included demographic factors, Body Mass Index, baseline PA and sitting time, and baseline socio-cognitive profile. RESULTS: At follow-up, respondents spent more time being physically active than at baseline. For the total group, the average sitting time remained almost unchanged between the two measurements. Further exploration showed that respondents who had relatively high levels of PA at the start of the intervention, increased their total sitting time, while respondents with relatively low levels of PA at the start decreased their sitting time. The socio-cognitive profile did not predict behaviour change. The intervention appeared to be suitable for people with a low-education level, but the results should be interpreted in view of the limitations of the study such as the non-controlled design, self-reported outcomes and selective drop-out of participants. CONCLUSIONS: Interventions for this specific target group may need to put more emphasis on the prevention of increased sitting time. The finding that the socio-cognitive profile did not predict behaviour change may underline the proposition that decisions to initiate and maintain PA behaviour change are to a large extend non-linear events. Acknowledging the possible non-linearity of the relationship between socio-cognitive determinants and behaviour change will help our understanding of this complex and dynamic process.
Asunto(s)
Diabetes Mellitus/fisiopatología , Actividad Motora , Estado Prediabético/fisiopatología , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y CuestionariosRESUMEN
AIM: To examine factors explaining motivation among health care professionals to implement and continue a multidisciplinary primary care-based lifestyle intervention, called BeweegKuur, to support prevention and treatment of type 2 diabetes mellitus. METHODS: Questionnaire research with two measurements among Dutch general practitioners, practice nurses and physiotherapists participating in a pilot study. At baseline, professionals were generally preparing to start the implementation. At second measurement, all practices were implementing BeweegKuur. RESULTS: The results reveal a positive motivation among professionals to implement and continue the intervention. The motivation of practice nurses to continue implementation was lower compared with other professionals. Social support by colleagues, compatibility and perceived relative advantage of the intervention for the professionals were associates of the baseline motivation to implement it. High-baseline self-efficacy and profession (i.e. not being practice nurse) positively predicted the motivation to continue the intervention at second measurement. CONCLUSIONS: Professionals in our study can be characterized as innovators or early adopters, and inclusion of BeweegKuur in the basic health insurance package may persuade other adoption categories to implement the intervention. An intensified focus on skills building (e.g. motivational interviewing skills, general lifestyle counselling skills) is expected to contribute to sustained high-quality implementation of the intervention.
Asunto(s)
Diabetes Mellitus Tipo 2/terapia , Médicos Generales , Conductas Relacionadas con la Salud , Promoción de la Salud/organización & administración , Rol del Médico , Adulto , Consejo , Diabetes Mellitus Tipo 2/prevención & control , Femenino , Humanos , Estilo de Vida , Masculino , Análisis Multivariante , Relaciones Médico-Paciente , Atención Primaria de Salud/organización & administración , Apoyo Social , Encuestas y CuestionariosRESUMEN
This cross-sectional study examined the relationship between Body Mass Index (BMI), total sitting time and total physical activity time in a generally overweight or obese population of type 2 diabetics or pre-diabetics willing to participate in a lifestyle intervention [n = 221, 55.1% male, mean age (SD) 62.0 (9.9), mean BMI (SD) 31.4 (5.0)]. In addition, we aimed to identify demographic and psychosocial associates of the motivation to become more physically active. The measurement instrument was a self-report questionnaire. Results showed that total sitting time was more closely related to BMI than total physical activity time. Subjects with a higher weight status were more sedentary, but they were also more motivated to be physically active. On the other hand, their self-efficacy to be physically active was lower than subjects with a lower weight status. Lifestyle interventions to decrease the risk of obesity and type 2 diabetes should aim not only at increasing total physical activity time, but also at reducing the total sitting time. Despite generally high levels of motivation among these obese participants, intervention designers and intermediaries should be aware of their low level of self-efficacy towards being physically active.