Cumulative Effects of Physical Activity, Dietary Variety, and Social Participation on Active Life Expectancy

Regular physical activity, dietary variety, and active social participation are modifiable and influential factors of adverse health outcomes. However, the cumulative effects of these behaviors are unknown. We examined these cumulative associations with active life loss in older adults. We analyzed 3-year longitudinal data from 7246 initially non-disabled residents aged 65-84 years from 18 districts of Ota City, Tokyo. Sufficiency of moderate- to vigorous-intensity physical activity (MVPA) of ≥150 minutes/week, dietary variety score (DVS) of ≥3, and social participation of ≥1 time/month were assessed using self-administered questionnaires. We operationally defined active life loss for individuals as being newly certified for long-term care insurance or death without prior certification. Multilevel survival analyses were applied to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). During an average follow-up of 2.9 years, the cumulative incidence of active life loss was 11.3% (817 individuals: 650 new certifications and 167 deaths without prior certification). Multivariate-adjusted HRs (95% CIs) for active life loss were 0.73 (0.58-0.92) in only MVPA of ≥150 minutes/week, 0.88 (0.67-1.15) in only DVS of ≥3, 0.75 (0.51-1.09) in only social participation of ≥1 time/month, 0.56 (0.45-0.70) in the group satisfying any two, and 0.52 (0.40-0.67) in the group satisfying all three behaviors, compared with a reference group that did not satisfy any of the behaviors. Sensitivity analysis that excluded active life losses during the first year showed similar results. The combination of regular physical activity, dietary variety, and social participation further enhances the effects on active life expectancy than individual practices.

Inequalities in Trends in Healthy and Disability-Free Life Expectancies: A Systematic Review

To update previous reviews, we searched Medline, Embase, Scopus and the Office for National Statistics (ONS) website for studies and reports published after 2016 that describe trends in healthy life expectancy, active life expectancy or disability-free life expectancy (DFLE) in the UK and other OECD high-income countries. We focus here on studies reporting inequalities by socioeconomic position (SEP) in these trends. There was mixed evidence of educational and area-level deprivation inequalities in trends in DFLE, with four studies indicating that educational inequalities were widening in European countries. No studies were identified that examined inequalities in disability-free life expectancy trends in the UK. All studies were based on cross-sectional data from multiple time points or longitudinal panel studies. We discuss the size of inequalities in DFLE between SEP groups and the limitations of previous studies.

Falling behind the Rest? China and the Gender Gap Index

China’s rank falling in the Global Gender Gap Index of the World Economic Forum has aroused the domestic scholar’s controversy. Based on the data provided by the Global Gender Gap Report, this article will describe the gender inequality in China by comparing its overall index scores and scores in the fields of economic participation and opportunity, education attainment, health and survival, and political empowerment with other countries, and then examining the reasons for China’s falling in rank through the score changes of sub-dimensions and indicators. Analysis of the data suggests that China has not kept up with the rate of improvement in the overall index, and in the four fields, compared to the original 112 countries, the upper-middle income countries, and the Asian and Pacific countries. Over the 13 years covered by the report, China’s score experienced a rapid improvement from 2006 to 2009 and a decline after 2013. China’s high sex ratio at birth, further expansion of gender inequality in active life expectancy, and an enlarged gender gap in secondary education caused China’s lagging overall score and ranking. In addition, the inclusion of measures such as secondary education enrollment, political empowerment, and other indicators also led to the backward ranking of China to some extent.

The Role of Underweight in Active Life Expectancy Among Older Adults in Japan

Objectives It is underweight, rather than overweight or obesity, that has been a pressing public health concern in Japan. This study examines the impact of being underweight on the health of older Japanese men and women, measured by active life expectancy at age 65. Following the Japanese government’s guideline, underweight in this study is defined using the body mass index (BMI) value of 20. Method Data came from five waves (1999–2009) of the Nihon University Japanese Longitudinal Study of Aging (NUJLSOA). We used the Interpolation of Markov Chain approach to estimate the number of years underweight (BMI < 20), normal weight (20 < BMI < 25), and overweight (25 < BMI) individuals were expected to live without difficulty in activities of daily living (ADLs) or instrumental ADLs. Results We found differences in life and health expectancies across the three weight categories. Underweight people were expected to live the shortest lives and spend the fewest years in an active state compared with normal and overweight individuals. Results remained unchanged even when accounting for educational attainment, smoking history, and a count of existing chronic conditions. Discussion Being underweight is associated with poor quality of life lived among Japanese older adults. This finding suggests the importance of maintaining proper weight and avoids nutritional risks at advanced ages.

Changing Impact of Obesity on Active Life Expectancy of Older Americans

Background The rise in the number and earlier age of onset of obese persons has raised critical concerns about consequences of obesity; however, recent evidence suggests that the impact of obesity on health outcomes may have changed. This study aims to assess the change of the impact of obesity on active life expectancy among Americans aged 70 years and older over almost two decades, 1993–1998 to 2010–2014. Methods For each period, we use three waves of data from the Health and Retirement Study to estimate age-specific transition probabilities between health states. The average number of years active and disabled is calculated with Interpolated Markov Chain software based on estimated transition probabilities. Results Overall obesity and severe obesity increased markedly over time yet active life expectancy expanded for all individuals and the increases are greater among the obese and women. Increases in total and active life expectancy occurred because of the changing association of obesity with disability and mortality. Conclusions Individuals at age 70 years in the later period in each weight group could expect to live a smaller proportion of remaining life with activities of daily living disability than those in the earlier period. High levels of obesity continue to have significant adverse effects on the quality of life. The increasing prevalence of severe obesity and the growing number of older persons may result in substantial additional health care needs and costs. Continued effort to improve cardiovascular health is required to control the burden of obesity in later life in an era of rising obesity.

Biological, Psychological, and Social Predictors of Longevity Among Utah Centenarians

Studies of longevity among centenarians examine biological, psychological, and social factors, yet few consider these components concurrently. This study explores such factors individually and collectively, as they are related to days lived past the age of 100 years. Data from 268 family members of centenarians identified in the State of Utah between 2008 and 2015 were used in negative binomial models predicting number of days lived among the centenarians. Findings suggested that sleep latency (biological), life satisfaction (psychological), and attachment closeness (social) were predictive factors of more days lived within individual models. When considered together, sleep latency and life satisfaction remained significant predictors of days lived. Although biological factors are commonly considered in relation to longevity, this study further indicates that psychological and social factors may play important roles in life expectancy. Further examination is needed to explore how these factors link additionally to active life expectancy.