A recent study published in the Journal of Activity, Sedentary, and Sleep Behaviors described 24-hour behaviors and their relationship with mental well-being in older adults.
Study: To be well or not to be well: compositional associations of physical activity, sedentary behaviour and sleep with mental well-being in Flemish adults aged 55+ years. Image Credit: Kzenon/Shutterstock.com
Background
Aging is typically associated with a decline in physical/cognitive function and an increase in the prevalence of chronic disorders.
Life expectancy has increased from 74 to 78 among males and 81 to 84 among females over the past two decades in Europe, with only some of these excess years spent in good health. As such, the healthy life expectancy is 63.5 years for males and 64.5 for females in Europe.
Healthy life expectancy does not account for well-being, the positive state experienced by people/societies. Well-being is a daily life resource similar to health and is determined by economic, social, and environmental factors.
The relationship between well-being and age is often U-shaped, meaning the lowest levels of well-being are during mid-age, which increases with old age, even if health deteriorates.
A systematic review concluded that increased physical activity in older adults translated into better well-being. Prior studies on 24-hour behaviors and mental health in older populations mainly focused on anxiety and depression, with only a few studies assessing 24-hour patterns and mental well-being, which, nonetheless, report conflicting findings.
About the study
In the present study, researchers assessed 24-hour sedentary behavior (SB), sleep, and physical activity (PA) and whether they were associated with mental well-being.
Cross-sectional data were obtained from community dwellers aged 55 or older between July 2018 and July 2019. Demographic data were collected using a self-administered questionnaire.
Participants indicated if they had cancer, diabetes, arthritis, cardiovascular disease, metabolic disease, respiratory diseases, psychiatric/cognitive, or other illnesses. The 14-item Warwick-Edinburgh mental well-being scale (WEMWBS) was used to assess mental well-being.
SB, total sleep time (TST), and light-intensity (LPA) or moderate-to-vigorous intensity PA (MVPA) were estimated through accelerometry using a wrist-worn device.
Subjects were instructed to wear the device for six consecutive days and five nights, and data were processed using established algorithms. Participants with a minimum of four days of at least 10-hour wake wear time data were included for analysis. Linear regression examined associations between mental well-being and SB, LPA, MVPA, and TST.
Additionally, compositional isotemporal substitutions were performed to examine associations between reallocations of time (from one behavior to another) and well-being. The researchers mainly focused on 30-min reallocations from LPA to MVPA and SB to LPA, MVPA, or sleep time. They also explored other possible reallocations from five to 60 minutes at five-minute intervals.
Findings
The study included 410 participants for analysis, with an average age of 71.3. Most subjects (95%) were not professionally active anymore, 71% were females, and 77% were married or cohabitants. Around 54% of the participants had no chronic conditions.
Subjects spent almost 5.66 hours asleep, equating to 23.6% of their 24-hour period. Much wake time was spent sedentary (57%), with less time spent on LPA (10.7%) and MVPA (7.8%).
The researchers did not observe significant associations between mental well-being and time spent on these behaviors, albeit a positive association was observed between LPA and well-being in crude and partially-adjusted models. However, this was not significant in the fully-adjusted model.
Thirty-minute reallocations between behaviors were not significantly associated with changes in well-being.
Most reallocations did not have significant associations with changes in well-being. Some associations were significant when reallocations were longer than 30 minutes. The largest statistically significant differences in well-being were about two points in WEMWBS, indicating a relatively small change.
Conclusions
The study evaluated 24-hour behaviors and examined their associations with mental well-being. Additionally, the researchers investigated whether theoretical changes in well-being would occur by reallocating time between behaviors.
The findings revealed no significant associations between behaviors and well-being in the fully-adjusted model. Moreover, significant associations were not observed between well-being and up to 30-minute time reallocation (from one behavior to another).
Although significant changes were observed in well-being with more than 30-minute reallocations, they were not clinically relevant.
