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      Cross-Sectional Association Between Types of Leisure Activities and Self-rated Health According to Gender and Work Status Among Older Japanese Adults

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          Abstract

          Background

          Participation in leisure activities (LA) is essential for successful aging. Our aim was to investigate the cross-sectional association of types of LA with self-rated health (SRH) by gender and work status.

          Methods

          The target population was all residents aged ≥65 years in a municipality ( n = 16,010; response rate, 62.5%). We analyzed 4,044 men and 4,617 women without disabilities. LA were categorized into 14 types. SRH was assessed through the SF-8. Excellent or very good SRH was defined as positive SRH. Covariates included age, marital status, education, subjective economic status, body mass index, chronic diseases, alcohol, smoking, walking time, depression, and cognitive functioning. Multiple logistic regressions were used to calculate the odds ratio (OR) and 95% confidence interval (CI) for positive SRH, with non-participation as the reference.

          Results

          After adjustment for covariates and mutual adjustment for other LA, participation in the following types of LA was positively associated with positive SRH: sports activities among working men (OR 1.46; 95% CI, 1.07–2.00), non-working men (OR 1.33; 95% CI, 1.04–1.69), and non-working women (OR 1.74; 95% CI, 1.41–2.15); cooking among non-working men (OR 1.65; 95% CI, 1.18–2.33) and non-working women (OR 1.28; 95% CI, 1.03–1.60); musical activities among working men (OR 1.44; 95% CI, 1.01–2.05) and non-working women (OR 1.59; 95% CI, 1.29–1.95); and technology usage only among working men (OR 1.41; 95% CI, 1.01–1.96). In contrast, TV watching was negatively associated with positive SRH among non-working women (OR 0.69; 95% CI, 0.56–0.85).

          Conclusions

          Our results suggest that encouraging older adults to participate in types of LA appropriate to their gender and work status might be a key to positive SRH.

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          Most cited references33

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          Successful aging.

          Substantial increases in the relative and absolute number of older persons in our society pose a challenge for biology, social and behavioral science, and medicine. Successful aging is multidimensional, encompassing the avoidance of disease and disability, the maintenance of high physical and cognitive function, and sustained engagement in social and productive activities. Research has identified factors predictive of success in these critical domains. The stage is set for intervention studies to enhance the proportion of our population aging successfully.
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            What determines Self-Rated Health (SRH)? A cross-sectional study of SF-36 health domains in the EPIC-Norfolk cohort.

            Self-Rated Health (SRH) as assessed by a single-item measure is an independent predictor of health outcomes. However, it remains uncertain which elements of the subjective health experience it most strongly captures. In view of its ability to predict outcomes, elucidation of what determines SRH is potentially important in the provision of services. This study aimed to determine the extent to which dimensions of physical, mental and social functioning are associated with SRH. We studied 20,853 men and women aged 39-79 years from a population-based cohort study (European Prospective Investigation of Cancer study) who had completed an SRH (Short Form (SF)-1) measure and SF-36 questionnaire. SF-36 subscales were used to quantify dimensions of health best predicting poor or fair SRH within a logistic regression model. In multivariate models adjusting for age, gender, social class, medical conditions and depression, all subscales of the SF-36 were independently associated with SRH, with the Physical Functioning subscale more strongly associated with poor or fair compared with excellent, very good or good health (OR 3.7 (95% CI 3.3 to 4.1)) than Mental Health (OR 1.4 (95% CI 1.2 to 1.5)) or Social Functioning subscales (OR 1.8 (95% CI 1.6 to 2.0)) for those below and above the median. This study confirms that physical functioning is more strongly associated with SRH than mental health and social functioning, even where the relative associations between each dimension and SRH may be expected to differ, such as in those with depression. It suggests that the way people take account of physical, mental and social dimensions of function when rating their health may be relatively stable across groups.
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              Is television viewing time a marker of a broader pattern of sedentary behavior?

              Television (TV) viewing time is associated with abnormal glucose metabolism, the metabolic syndrome, and risk of type 2 diabetes; associations are stronger and more consistent in women. One explanation of this difference may be that TV viewing is a marker of an overall pattern of sedentary behavior in women. We sought to examine associations of TV viewing time with other sedentary behaviors and with leisure-time physical activity in a large sample of Australian adults. Adults aged between 20 and 65 years (n = 2,046) completed a self-administered questionnaire on TV viewing, five other leisure-time sedentary behaviors, and leisure-time physical activity. Mean adjusted time spent in other sedentary behaviors and in physical activity was compared across TV-time categories previously shown to be associated with abnormal glucose metabolism. After adjustment for body mass index and socio-demographic variables, women's time spent watching TV was associated positively with time in other sedentary behaviors and negatively with leisure-time physical activity, but no such associations were observed in men. TV viewing time may be a robust marker of a sedentary lifestyle in women but not in men. Gender differences in the pattern of sedentary behaviors may explain at least in part the gender differences in the previously reported associations of TV viewing time with biological attributes related to type 2 diabetes.
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                Author and article information

                Journal
                J Epidemiol
                J Epidemiol
                JE
                Journal of Epidemiology
                Japan Epidemiological Association
                0917-5040
                1349-9092
                5 November 2019
                13 October 2018
                2019
                : 29
                : 11
                : 424-431
                Affiliations
                [01]Nara Prefectural Health Research Center, Nara Medical University, Nara, Japan
                Author notes
                Address for correspondence. Kimiko Tomioka, Nara Prefectural Health Research Center, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (e-mail: tkimiko@ 123456naramed-u.ac.jp ).
                Article
                JE20180108
                10.2188/jea.JE20180108
                6776474
                30318494
                1f8e4a9e-1570-443d-8284-5d1f12a6df87
                © 2018 Kimiko Tomioka et al.

                This is an open access article distributed under the terms of Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                Funding
                Funded by: JSPS KAKENHI
                Award ID: JP17K09209
                Categories
                Original Article
                Public Health

                gender difference,leisure activities,self-rated health,successful aging,work status

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