Intensity Matters for Musculoskeletal Health: A Cross-Sectional Study on Movement Behaviors of Older Adults from High-Income Scottish and Low-Income South African Communities
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Body Composition
2.3. Sarcopenia and Bone Mineral Density Cut Points
2.4. Hand Grip Strength and Functional Fitness Tests
2.5. Movement Behaviors
2.6. Accelerometry Data Management
2.7. Sleep and Physical Activity Recommendations
2.8. Sleep Quality
2.9. Statistical Methods
3. Results
3.1. Participant Characteristics
3.2. Body Composition, Bone Mineral Density, and Functional Measures
3.3. Relationship between 24-h Time Use Composition and Musculoskeletal Health in South African and Scottish Older Adults
4. Discussion
Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Scottish Cohort (n = 150) | South African Cohort (n = 138) | p-Value |
---|---|---|---|
Age (years) | 69 (66–73) | 68 (64–71) | 0.085 |
Sex (n, %), Females | 117 (78) | 113 (82) | 0.463 |
Education (n, %) | <0.001 | ||
Less than secondary | 13 (9) | 72 (52) | |
Completed secondary | |||
Completed tertiary | 27 (18) | 65 (47) | |
Housing density | |||
110 (72) | 1 (1) | ||
0.3 (0.2–0.3) | 1 (0.6–1.4) | <0.001 | |
Smoking status (n, %) | 0.283 | ||
Never smoked | 94 (63) | 100 (73) | |
Previous smoker | 53 (35) | 22 (16) | |
Current smoker | 3 (2) | 16 (12) | |
Car owner (n, %) | 141 (94) | 17 (12) | <0.001 |
Civil status (n, %) | 0.228 | ||
Single | 30 (20) | 55 (40) | |
Married or living with a partner | 105 (70) | 25 (18) | |
Widowed | |||
15 (10) | 58 (42) | ||
Employed, yes (n, %) | 3 (2) | 0 | 0.095 |
Accelerometer total wear time (min/day) | 913 ± 46 | 878 ± 80 | <0.001 |
Total PA (min/week) | 324 ± 64 | 334 ± 96 | 0.112 |
SB (min/day) | 593 (546–638) | 539 (491–587) | <0.001 |
LPA (min/day) | 287 ± 55 | 318 ± 92 | 0.001 |
MVPA (min/day) | 27 (15–44) | 11 (3–21) | <0.001 |
Nocturnal TiB (min/night) | 513 ± 45 | 555 ± 75 | <0.001 |
SB (% daily wear time) | 41 (38–44) | 37 (34–41) | <0.001 |
LPA (% daily wear time) | 20 ± 4 | 22 ± 6 | 0.001 |
MVPA (% daily wear time) | 2 (1–3) | 1 (0.2–2) | <0.001 |
Nocturnal TiB (% daily wear time) | 36 ± 3 | 39 ± 5 | <0.001 |
MVPA (min/week) | 153 (88–265) | 64 (18–128) | <0.001 |
Meeting PA guidelines ≥150 min/week (n, %) | 77 (51) | 28 (20) | <0.001 |
Meeting sleep recommendations (n, %) | 41 (27) | 32 (23) | 0.498 |
Sleeping within the appropriate range (n, %) | 76 (51) | 36 (26) | <0.001 |
Sleeping too short (n, %) | 0 | 6 (4) | 0.011 |
Sleeping too long (n, %) | 33 (22) | 64 (45) | <0.001 |
Variables | Scottish Cohort (n = 150) | South African Cohort (n = 138) | p Value |
---|---|---|---|
Body composition | |||
Height (cm) | 164.7 ± 9.2 | 157.3 ± 7.2 | <0.001 |
Body mass (kg) | 69.0 (60.8–77.3) | 79.3 (66.8–93.2) | <0.001 |
BMI (kg/m2) | 25.7 (23.5–28.3) | 31.7 (27.8–38.3) | <0.001 |
Underweight (n, %) | 2 (1.4) | 1 (0.7) | |
Normal (n, %) | 57 (38.0) | 21 (15.2) | |
Overweight (n, %) | 69 (46.0) | 32 (23.2) | |
Obese (n, %) | 22 (14.6) | 84 (60.9) | |
Fat mass (kg) | 25.4 ± 8.9 | 34.8 ± 14.1 | <0.001 |
Fat mass (%) | 37.5 (31.6–41.3) | 47.2 (40.7–51.8) | <0.001 |
FFSTM (kg) | 40.1 (36.3–45.2) | 37.2 (33.4–42.3) | <0.001 |
ASM (kg) | 17.6 (19.5–27.5) | 17.3 (15–20.4) | 0.066 |
ASMBMI (kg/m2) | 0.7 (0.6–0.8) | 0.5 (0.5–0.6) | <0.001 |
Sarcopenia (n, %) | 3 (2.0) | 42 (30.4) | <0.001 |
Functional and sarcopenia measures | |||
Grip strength (kg) | 23.0 (19.5–27.5) | 20.1 (17.0–23.8) | <0.001 |
Grip strength (kg) men | 34.7 (30.0–39.5) | 23.8 (19.8–29.0) | <0.001 |
Grip strength (kg) women | |||
21.7 (18.5–24.8) | 19.6 (16.8–22.9) | 0.001 | |
Grip strengthBMI (kg/m2) | 0.9 (0.7–1.2) | 0.6 (0.5–0.8) | <0.001 |
Grip strengthBMI (kg/m2) men | 1.3 (1.2–1.5) | 1.0 (0.8–1.2) | <0.001 |
Grip strengthBMI (kg/m2) women | |||
0.9 (0.7–1.0) | 0.6 (0.5–0.7) | <0.001 | |
Gait speed (m/s) | 1.5 (1.4–1.7) | 1.6 (1.4–1.7) | 0.041 |
Bone mineral density | |||
Femoral neck BMD (g/cm2) | 0.854 ± 0.149 | 0.758 ± 0.161 | |
Total hip BMD (g/cm2) | 0.905 ± 0.150 | 0.896 ± 0.177 | |
Lumbar spine BMD (g/cm2) | 1.112 ± 0.208 | 0.940 ± 0.191 | |
Femoral neck BMDHEIGHT (g/cm2) | 0.515 | 0.482 | |
Total hip BMDHEIGHT (g/cm2) | 0.547 | 0.569 | |
Lumbar spine BMDHEIGHT (g/cm2) | 0.672 | 0.598 | |
Femoral neck T score | −1.3 (−1.7–0.6) | −0.8 (−1.8–0.1) | |
Total hip T score | −1.1 (−1.7–−0.4) | −0.3 (−1.3–0.7) | |
Lumbar spine T score | −0.1 (−0.9–−0.7) | −1.1 (−2.2–0.1) | |
Osteopenia (n, %) | 105 (70.0) | 54 (39.1) | |
Osteoporosis (n, %) | 16 (10.7) | 28 (20.3) |
Variables | Sleep | p Value | SB | p-Value | LPA | p-Value | MVPA | p-Value | Model R2 | Model p-Value |
---|---|---|---|---|---|---|---|---|---|---|
South African cohort | ||||||||||
Grip strengthBMI (kg/m2) | 0.114 | 0.310 | −0.147 | 0.123 | 0.020 | 0.745 | 0.013 | 0.435 | 0.110 | 0.001 |
ASMBMI (kg/m2) | 0.036 | 0.571 | −0.057 | 0.289 | 0.019 | 0.582 | 0.002 | 0.856 | 0.200 | <0.001 |
Log gait speed (m/s) | −0.035 | 0.399 | −0.010 | 0.768 | 0.019 | 0.380 | 0.026 | <0.001 | 0.349 | <0.001 |
Femoral neck BMD (g/cm2) | −0.064 | 0.415 | 0.023 | 0.725 | 0.021 | 0.612 | 0.020 | 0.087 | 0.070 | 0.021 |
Total hip BMD (g/cm2) | −0.020 | 0.807 | −0.012 | 0.863 | 0.001 | 0.974 | 0.031 | 0.011 | 0.099 | 0.003 |
Lumbar spine BMD (g/cm2) | −0.014 | 0.894 | −0.037 | 0.664 | 0.066 | 0.220 | −0.015 | 0.296 | 0.008 | 0.787 |
Scottish cohort | ||||||||||
Grip strengthBMI (kg/m2) | 0.065 | 0.688 | −0.116 | 0.377 | −0.045 | 0.644 | 0.097 | 0.001 | 0.122 | <0.001 |
ASMBMI (kg/m2) | −0.039 | 0.589 | −0.022 | 0.706 | 0.012 | 0.789 | 0.049 | <0.001 | 0.119 | <0.001 |
Gait speed (m/s) | 0.100 | 0.450 | −0.090 | 0.378 | −0.012 | 0.876 | 0.007 | 0.773 | 0.049 | 0.063 |
Log femoral neck BMD (g/cm2) | 0.132 | 0.071 | −0.116 | 0.051 | −0.038 | 0.393 | 0.022 | 0.105 | 0.067 | 0.018 |
Log hip total BMD (g/cm2) | −0.019 | 0.698 | −0.029 | 0.458 | 0.044 | 0.131 | 0.004 | 0.696 | 0.013 | 0.583 |
Log spine BMD (g/cm2) | −0.043 | 0.438 | 0.030 | 0.503 | 0.025 | 0.445 | −0.013 | 0.208 | 0.013 | 0.591 |
Variables | Sleep | p Value | SB | p-Value | LPA | p-Value | MVPA | p-Value |
---|---|---|---|---|---|---|---|---|
Model 1: additionally adjusted for grip strength | ||||||||
Femoral neck BMD (g/cm2) | −0.080 | 0.257 | 0.019 | 0.748 | 0.039 | 0.326 | 0.022 | 0.043 |
Hip total BMD (g/cm2) | −0.048 | 0.512 | 0.002 | 0.984 | 0.015 | 0.724 | 0.032 | 0.005 |
Spine BMD (g/cm2) | −0.025 | 0.778 | −0.029 | 0.707 | 0.064 | 0.205 | −0.010 | 0.442 |
Model 2: additionally adjusted for ASM | ||||||||
Femoral neck BMD (g/cm2) | −0.087 | 0.236 | 0.014 | 0.814 | 0.049 | 0.230 | 0.024 | 0.029 |
Hip total BMD (g/cm2) | −0.049 | 0.525 | −0.002 | 0.980 | 0.015 | 0.720 | 0.035 | 0.002 |
Spine BMD (g/cm2) | −0.036 | 0.709 | −0.038 | 0.629 | 0.081 | 0.125 | −0.008 | 0.565 |
Model 3: additionally adjusted for gait speed | ||||||||
Femoral neck BMD (g/cm2) | −0.078 | 0.277 | 0.014 | 0.815 | 0.042 | 0.292 | 0.021 | 0.064 |
Hip total BMD (g/cm2) | −0.039 | 0.596 | −0.005 | 0.933 | 0.005 | 0.707 | 0.029 | 0.017 |
Spine BMD (g/cm2) | −0.022 | 0.815 | −0.038 | 0.627 | 0.070 | 0.176 | −0.011 | 0.464 |
Model 4: additionally adjusted for grip strength + ASM + gait speed | ||||||||
Femoral neck BMD (g/cm2) | −0.086 | 0.244 | 0.021 | 0.725 | 0.043 | 0.301 | 0.022 | 0.056 |
Hip total BMD (g/cm2) | −0.041 | 0.590 | 0.007 | 0.913 | 0.004 | 0.922 | 0.030 | 0.013 |
Spine BMD (g/cm2) | −0.039 | 0.497 | −0.026 | 0.740 | 0.070 | 0.190 | −0.011 | 0.452 |
Variables | Sleep | p-Value | SB | p-Value | LPA | p-Value | MVPA | p-Value |
---|---|---|---|---|---|---|---|---|
Model 1: additionally adjusted for grip strength | ||||||||
Log femoral neck BMD (g/cm2) | 0.113 | 0.056 | −0.113 | 0.044 | −0.045 | 0.287 | 0.025 | 0.067 |
Log hip total BMD (g/cm2) | −0.030 | 0.519 | −0.019 | 0.602 | 0.042 | 0.137 | 0.007 | 0.430 |
Log spine BMD (g/cm2) | −0.038 | 0.485 | 0.033 | 0.449 | 0.017 | 0.603 | −0.012 | 0.237 |
Model 2: additionally adjusted for ASM | ||||||||
Log femoral neck BMD (g/cm2) | 0.133 | 0.056 | −0.108 | 0.053 | −0.046 | 0.275 | 0.022 | 0.108 |
Log hip total BMD (g/cm2) | −0.030 | 0.512 | −0.017 | 0.656 | 0.042 | 0.141 | 0.005 | 0.573 |
Log spine BMD (g/cm2) | −0.038 | 0.486 | 0.033 | 0.454 | 0.017 | 0.603 | −0.012 | 0.250 |
Model 3: additionally adjusted for gait speed | ||||||||
Log femoral neck BMD(g/cm2) | 0.130 | 0.061 | −0.109 | 0.051 | −0.044 | 0.295 | 0.023 | 0.085 |
Log hip total BMD (g/cm2) | −0.031 | 0.509 | −0.018 | 0.620 | 0.043 | 0.131 | 0.006 | 0.481 |
Log spine BMD (g/cm2) | −0.007 | 0.492 | 0.033 | 0.461 | 0.017 | 0.606 | −0.002 | 0.247 |
Model 4: additionally adjusted for grip strength + ASM + gait speed | ||||||||
Log femoral neck BMD (g/cm2) | 0.134 | 0.054 | −0.008 | 0.053 | −0.009 | 0.252 | 0.023 | 0.094 |
Log hip total BMD (g/cm2) | −0.028 | 0.546 | −0.018 | 0.635 | 0.040 | 0.162 | 0.006 | 0.519 |
Log spine BMD (g/cm2) | −0.376 | 0.490 | 0.032 | 0.461 | 0.018 | 0.601 | −0.012 | 0.251 |
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Pina, I.; Mendham, A.E.; Tomaz, S.A.; Goedecke, J.H.; Micklesfield, L.K.; Brooks, N.E.; Gallagher, I.J.; Crockett, R.; Dudchenko, P.; Hunter, A.M. Intensity Matters for Musculoskeletal Health: A Cross-Sectional Study on Movement Behaviors of Older Adults from High-Income Scottish and Low-Income South African Communities. Int. J. Environ. Res. Public Health 2021, 18, 4310. https://doi.org/10.3390/ijerph18084310
Pina I, Mendham AE, Tomaz SA, Goedecke JH, Micklesfield LK, Brooks NE, Gallagher IJ, Crockett R, Dudchenko P, Hunter AM. Intensity Matters for Musculoskeletal Health: A Cross-Sectional Study on Movement Behaviors of Older Adults from High-Income Scottish and Low-Income South African Communities. International Journal of Environmental Research and Public Health. 2021; 18(8):4310. https://doi.org/10.3390/ijerph18084310
Chicago/Turabian StylePina, Ilaria, Amy E. Mendham, Simone A. Tomaz, Julia H. Goedecke, Lisa K. Micklesfield, Naomi E. Brooks, Iain J. Gallagher, Rachel Crockett, Paul Dudchenko, and Angus M. Hunter. 2021. "Intensity Matters for Musculoskeletal Health: A Cross-Sectional Study on Movement Behaviors of Older Adults from High-Income Scottish and Low-Income South African Communities" International Journal of Environmental Research and Public Health 18, no. 8: 4310. https://doi.org/10.3390/ijerph18084310