Physical behaviors, sarcopenia and adverse events in the Toledo study of healthy ageing

Abstract

Ageing population is a worldwide occurrence and this phenomenon poses substantial burden on individuals and healthcare systems. Life expectancy increases have not been accompanied by parallel healthspan expansions, which have led to higher rates of disability among a growing share of the population. Primary ageing, lifestyle factors and comorbidities interact to shape the functional trajectories along late-life. Healthy ageing refers to the maintenance of functional ability that guarantees wellbeing in older persons and is believed to occur in the absence of pathologies. In contrast, the presence of diseases and deleterious lifestyle factors might drive an accelerated ageing and premature disability. The loss of muscle mass and function, termed sarcopenia, has recently being proposed as a key factor leading to disability and adverse events in older adults. Physical exercise has been proposed as the best strategy for maintenance and development of functional ability. Nevertheless, few older adults partake in structured exercise regimes and the best dosage and intensity remains unclear in such a heterogeneous population. In this scenario, free-living physical activity and sedentary behaviour might constitute the differential factor determining functional ability trajectories. Recent availability of objective physical activity measures that allow better characterization of physical behaviours together with novel statistical methods have allowed to address open research questions regarding this relevant health determinant in older adults, such as the role of light physical activity and sedentary behaviour and the dynamic nature of physical activity on disability-related conditions and adverse outcomes. The current Ph.D. dissertation intends to add insight into the associations between physical activity and sedentary behaviour and healthy ageing, overcoming limitations identified in previous research, through two scientific works using data from the TSHA, an ongoing population-based study.