Abstract P128: Walking May Be a Viable Alternative to Recreational Physical Activity for Promoting Physical and Mental Wellbeing Among the Elderly
Authors: Remigio-Baker Rosemay A , LaCroix Andrea , Carlson Jordan , Kerr Jacqueline , Allison Matthew A 
Published: July 2021

INTRODUCTION:
Physical activity (PA) is a well-established protective behavior consistently associated with reduced risk of CVD morbidity and mortality. In older populations, moderate or vigorous activities (MVPA) are less common perhaps because of physical limitations; walking has been shown to have similar associations as MVPA with CVD outcomes. MVPA has also been associated with positive physical and mental wellbeing. Little is known, however, about how walking activities influence quality of life measures including indicators of mental wellness.

HYPOTHESIS:
We hypothesized that greater MVPA and walking will be associated with higher levels of both physical and mental wellbeing.

METHODS:
We evaluated the cross-sectional relationships of MVPA and walking with physical and mental wellbeing among 2,402 San Diego participants in the Women’s Health Initiative using multinomial logistic regression. MVPA was the sum of moderate and vigorous activity in hours/week, each calculated as ([number of days/week in activity]*[number of minutes [min]/day in activity])/60. Walking was defined as ([number of days walking > 10 min without stopping/week]*[number of min/day in activity])/60. Responses for the number of days/week in an activity included rarely/never, once, 2-3, 4-6 or 7+. Responses for number of min/day in an activity included <20, 20-39, 40-59 or 60+. Measures of physical and mental components of SF-36 were assessed as tertiles, and odds ratios using the lower tertile as reference were estimated. Covariates included age, ethnicity, education, smoking status, and comorbidity (presence of diabetes, arthritis, myocardial infarction, cancer or hypertension).

RESULTS:
Walking was more prevalent than MVPA in this cohort (86% vs. 57%).

There was a 14% (CI=1.07, 1.21) greater likelihood of scoring in the middle vs lower tertile of physical wellbeing per hour increase in MVPA. This nearly doubled to 29% (CI=1.21, 1.36) when comparing upper to lower tertile (trend p <0.001). There was a 20% (CI=1.12, 1.27) greater likelihood of scoring in the middle vs lower tertile of physical wellbeing per hour increase in walking, an estimate which also increased when comparing upper to lower tertile (OR=1.36, CI=1.28, 1.45, trend p <0.001).
Per hour increase in MVPA was also associated with 8% (CI=1.02, 1.13) greater mental wellbeing comparing middle to lower tertile. The estimate was weaker and non-significant comparing upper to lower tertile (trend p=0.122). Per hour increase in walking was also associated with 11% (CI=1.05, 1.17) greater mental wellbeing comparing middle to lower tertile. Although the estimate was weaker comparing upper to lower tertile, significance remained (trend p=0.018).

CONCLUSION:
For an elderly population where physical limitations may preclude moderate or vigorous exercise, walking activities may provide an alternate means to improve both physical and mental wellbeing.