Napoleone, Jenna Marie
(2021)
Cardiometabolic-Health Related Risk Factors and Physical Function with Aging: Targets for Lifestyle Intervention.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
This is the latest version of this item.
Abstract
Maintaining optimal physical function with age is critical for quality of life and health. Modifiable risk factors (e.g., cardiometabolic, lifestyle and behavioral) have shown to contribute to declining physical function in late-life adults, yet less is known about how earlier midlife risk factors impact mid- and late-life functional performance.This dissertation examined associations of (1) maintenance session attendance impact on weight loss (WL) success in a lifestyle intervention (DPP-GLB) in adults with prediabetes and/or metabolic syndrome (MetS; n=238; mean age=62 years; 76% women), (2) objective physical function changes among GLB Moves participants randomized to an intervention with physical activity (DPP-GLB) or sedentary behavior (GLB-SED) goals vs. 6-month control and 12-month pre-post (n=305; 79% women), and (3) changes in the number of components of MetS across midlife with objective physical performance in early late life women from the Study of Women’s Health Across the Nation (SWAN; n=1722; age 65.4±2.7 years; 26.9% Black, 10.1% Chinese, 9.8% Japanese, 5.5% Hispanic). Regression analyses were applied (1: logistic and multinomial; 2: mixed models; and 3: linear and latent class modeling). Attending maintenance sessions and meeting the 6-month WL goal was associated with meeting the 12-month 5% WL goal, with Medicare eligible adults being more successful (OR=3.03, 95%CI:1.58-5.81). DPP-GLB and GLB-SED were effective at improving function with clinically meaningful changes (GLB-DPP: +0.05±0.17, GLB-SED: +0.06±0.16 m/s faster gait; GLB-DPP: -0.17±2.7, GLB-SED: -0.55±2.2 secs faster chair stands); those with lower initial function improved more (+0.09 faster gait in DPP-GLB, +0.07 in GLB-SED). Midlife MetS groups (≥3 components) were related to worse early late life 40-ft walk (β:-0.08; 95% CI:-0.13, -0.03), gait speed (β:-0.09; 95% CI:-0.15, -0.02), SPPB (β:-0.79; 95% CI: -1.15, -0.44), and chair stands (β:0.69; 95% CI: 0.09, 1.28), but no difference in stair climb. This dissertation provides valuable information to Medicare-DPP providers and characterize clinical and behavioral modifiable risk factors for functional decline in mid-to-early late life, to tailor preventive strategies to compress years of morbidity related to the onset of disability in late-life. Thus, the goal is to help older adults maintain independence with aging and live longer, healthier lives by intervening earlier in midlife.
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Details
| Item Type: |
University of Pittsburgh ETD
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| Status: |
Unpublished |
| Creators/Authors: |
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| ETD Committee: |
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| Date: |
12 May 2021 |
| Date Type: |
Publication |
| Defense Date: |
21 April 2021 |
| Approval Date: |
12 May 2021 |
| Submission Date: |
29 April 2021 |
| Access Restriction: |
2 year -- Restrict access to University of Pittsburgh for a period of 2 years. |
| Number of Pages: |
183 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Epidemiology |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
older adults, physical function, lifestyle intervention |
| Date Deposited: |
12 May 2021 19:51 |
| Last Modified: |
12 May 2023 05:15 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/40989 |
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Cardiometabolic-Health Related Risk Factors and Physical Function with Aging: Targets for Lifestyle Intervention. (deposited 12 May 2021 19:51)
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