RESUMO
PURPOSE: we investigate the temporal association between the rate of change in physical function and the rate of change in disability across four comparison groups: Those with and without diabetes who report >30 min of physical activity per day, and those who report <30 min of physical activity per day. METHODS: six waves of longitudinal data from the Hispanic Established Population for Epidemiologic Studies of the Elderly were utilised. At baseline, there were a total of 3,050 elder participants aged 65 years old or greater. The longitudinal rates of change in disability and physical function were compared by the diabetes status (ever versus none) and the physical activity status (less than or greater than or equal to 30 min per day). RESULTS: disability and physical function data were analysed using a latent growth curve modelling approach adjusted for relevant demographic/health-related covariates. There were statistically significant longitudinal declines in physical function and disability (P < 0.001) in all groups. Most notable, the physical activity status was an important moderator. Those with >30 min of activity demonstrated better baseline function and less disability as well as better temporal trajectories than those reporting <30 min of physical activity per day. Comparisons between diabetes statuses within the same physical activity groups showed worse disability trajectories among those with diabetes. CONCLUSIONS: a longitudinal decline in physical function and disability is moderated most notably by physical activity. The diabetes status further moderates decline in function and disability over time. Increased physical activity appears to be protective of disability in general and may lessen the influence of diabetes-related disability in older Mexican Americans, particularly at the end of life.
Assuntos
Diabetes Mellitus/fisiopatologia , Avaliação da Deficiência , Avaliação Geriátrica , Americanos Mexicanos , Atividade Motora/fisiologia , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Complicações do Diabetes/prevenção & controle , Progressão da Doença , Feminino , Humanos , Estudos Longitudinais , Masculino , Fatores de TempoRESUMO
Factors were examined that might explain reported ethnic differences in leisure time physical activity (LTPA) between Mexican Americans (MAs) and European Americans (EAs). Data were from a random sample of 749 community-dwelling MAs and EAs, aged 65 and older, who participated in the San Antonio Longitudinal Study of Aging (SALSA) baseline examination. Variables examined included LTPA measured as kilocalories of energy expended per week, contextual variables (age, sex, socioeconomic status (SES), acculturation/structural assimilation), psychosocial measures (self-esteem, mastery, perceived health control), lifestyle variables (fat avoidance, current alcohol drinker, years smoking, body mass index (BMI)), and presence of chronic diseases (diabetes mellitus, angina pectoris, myocardial infarction, stroke, hypertension, arthritis, chronic obstructive pulmonary disease, depression, mild cognitive impairment). Hierarchical multiple regression was used to examine potential mediators of the ethnic group-LTPA association. EAs expended almost 300 kcal/wk more energy than did MAs (1,287 kcal/wk vs 1,001 kcal/wk). SES and psychosocial (self-esteem), lifestyle (fat avoidance, smoking, BMI), and disease (depression) factors that vary by SES explained this ethnic difference. In MAs, structural assimilation, but not acculturation, was significantly associated with LTPA independent of SES. Self-esteem, BMI, and depression explained this association. Psychosocial resources, lifestyle behaviors, and depression explain differences in LTPA between older MAs and EAs. Interventions to increase LTPA in both ethnic groups should be targeted especially at women and persons who have low self-esteem, smoke, and are obese or depressed. In MAs, additional emphasis should be focused on those who are less structurally assimilated into the broader American society.