Physical activity, inactivity and sleep during the Diabetes Remission Clinical Trial (DiRECT).

Aims: As sustained weight loss is vital for achieving remission of type 2 diabetes, we explored whether randomisation to weight loss plus maintenance in the DiRECT trial was associated with physical activity, inactivity or sleep.

Methods: Participants were randomised to either a dietary weight management programme or best-practice care. The weight management group were encouraged to increase daily physical activity to their sustainable maximum.

Movement as Medicine for Cardiovascular Disease Prevention: Pilot Feasibility Study of a Physical Activity Promotion Intervention for At-Risk Patients in Primary Care.

Background: Physical activity (PA) can reduce cardiovascular disease (CVD) risk factors, and although primary care settings offer a large reach to promote PA and reduce CVD risk, primary health care professionals may lack self-efficacy and tools to effectively promote PA in practice. Movement as Medicine for CVD Prevention is a suite of 2 theory-based, web-based behavioral interventions-one for health care professionals and one for patients-which may offer a pathway for promoting PA and reducing CVD risk in primary care.

Objective: This study aims to examine the feasibility and possible effects of Movement as Medicine for CVD Prevention.

The development, validation and application of remote blood sample collection in telehealth programmes.

Introduction: The ability to collect blood samples remotely without the involvement of healthcare professionals is a key element of future telehealth applications. We developed and validated the application of the Drawbridge OneDraw device for use at home for blood sample collection. The device was then applied in a large population-based remote monitoring study to assess changes in SARS-CoV-2 IgG antibody levels.

Curating a longitudinal research resource using linked primary care EHR data-a UK Biobank case study.

Primary care EHR data are often of clinical importance to cohort studies however they require careful handling. Challenges include determining the periods during which EHR data were collected. Participants are typically censored when they deregister from a medical practice, however, cohort studies wish to follow participants longitudinally including those that change practice.

Exploration of Sleep as a Specific Risk Factor for Poor Metabolic and Mental Health: A UK Biobank Study of 84,404 Participants.

Purpose: Short and long sleep durations have adverse effects on physical and mental health. However, most studies are based on self-reported sleep duration and health status. Therefore, this longitudinal study aims to investigate objectively measured sleep duration and subsequent primary health care records in older adults to investigate the impact of sleep duration and fragmentation on physical and mental health.

Using Wearable Activity Trackers to Predict Type 2 Diabetes: Machine Learning-Based Cross-sectional Study of the UK Biobank Accelerometer Cohort.

Background: Between 2013 and 2015, the UK Biobank collected accelerometer traces from 103,712 volunteers aged between 40 and 69 years using wrist-worn triaxial accelerometers for 1 week. This data set has been used in the past to verify that individuals with chronic diseases exhibit reduced activity levels compared with healthy populations. However, the data set is likely to be noisy, as the devices were allocated to participants without a set of inclusion criteria, and the traces reflect free-living conditions.

Objective sleep assessment in >80,000 UK mid-life adults: Associations with sociodemographic characteristics, physical activity and caffeine.

Study Objectives: Normal timing and duration of sleep is vital for all physical and mental health. However, many sleep-related studies depend on self-reported sleep measurements, which have limitations. This study aims to investigate the association of physical activity and sociodemographic characteristics including age, gender, coffee intake and social status with objective sleep measurements.

Analyzing walking speeds with ankle and wrist worn accelerometers in a cohort with myotonic dystrophy.

Accelerometers are accurate tools to assess movement and physical activity. However, interpreting standardly used outputs is not straightforward for populations with impaired mobility. The applicability of GENEActiv was explored in a group of 30 participants with myotonic dystrophy and compared to a group of 14 healthy-controls.

Cognitive behavioural therapy with optional graded exercise therapy in patients with severe fatigue with myotonic dystrophy type 1: a multicentre, single-blind, randomised trial.

Background: Myotonic dystrophy type 1 is the most common form of muscular dystrophy in adults and leads to severe fatigue, substantial physical functional impairment, and restricted social participation. In this study, we aimed to determine whether cognitive behavioural therapy optionally combined with graded exercise compared with standard care alone improved the health status of patients with myotonic dystrophy type 1.

Methods: We did a multicentre, single-blind, randomised trial, at four neuromuscular referral centres with experience in treating patients with myotonic dystrophy type 1 located in Paris (France), Munich (Germany), Nijmegen (Netherlands), and Newcastle (UK).

Accelerometer-derived physical activity in those with cardio-metabolic disease compared to healthy adults: a UK Biobank study of 52,556 participants.

Aim: Cardio-metabolic disease and physical activity are closely related but large-scale objective studies which measure physical activity are lacking. Using the largest accelerometer cohort to date, we aimed to investigate whether there is an association between disease status and accelerometer variables after a 5-year follow-up.

Methods: 106,053 UK Biobank participants wore a wrist-worn GENEactiv monitor.

Electrochemical Detection of Plasma Immunoglobulin as a Biomarker for Alzheimer's Disease.

The clinical diagnosis and treatment of Alzheimer's disease (AD) represent a challenge to clinicians due to the variability of clinical symptomatology as well as the unavailability of reliable diagnostic tests. In this study, the development of a novel electrochemical assay and its potential to detect peripheral blood biomarkers to diagnose AD using plasma immunoglobulins is investigated. The immunosensor employs a gold electrode as the immobilizing substrate, albumin depleted plasma immunoglobulin as the biomarker, and polyclonal rabbit Anti-human immunoglobulin (against IgA, IgG, IgM) as the receptor for plasma conjugation.

Low physical activity, high television viewing and poor sleep duration cluster in overweight and obese adults; a cross-sectional study of 398,984 participants from the UK Biobank.

Background: An unhealthy lifestyle is one of the greatest contributors to obesity. A number of behaviours are linked with obesity, but are often measured separately. The UK Biobank cohort of >500,000 participants allows us to explore these behaviours simultaneously.

Measuring Habitual Physical Activity in Neuromuscular Disorders: A Systematic Review.

Background: Free-living or habitual physical activity (HPA) refers to someone's performance in his or her free-living environment. Neuromuscular disorders (NMD) manifest through HPA, and the observation of HPA can be used to identify clinical risks and to quantify outcomes in research. This review summarizes and analyses previous studies reporting the assessment of HPA in NMD, and may serve as the basis for evidence-based decision-making when considering assessing HPA in this population.

Toward a low-cost gait analysis system for clinical and free-living assessment.

Gait is an important clinical assessment tool since changes in gait may reflect changes in general health. Measurement of gait is a complex process which has been restricted to bespoke clinical facilities until recently. The use of inexpensive wearable technologies is an attractive alternative and offers the potential to assess gait in any environment.

Cross-sectional study of diet, physical activity, television viewing and sleep duration in 233,110 adults from the UK Biobank; the behavioural phenotype of cardiovascular disease and type 2 diabetes.

Objectives: Simultaneously define diet, physical activity, television (TV) viewing, and sleep duration across cardiometabolic disease groups, and investigate clustering of non-diet lifestyle behaviours.

Design: Cross-sectional observational study.

Setting: 22 UK Biobank assessment centres across the UK.

A Novel, Open Access Method to Assess Sleep Duration Using a Wrist-Worn Accelerometer.

Wrist-worn accelerometers are increasingly being used for the assessment of physical activity in population studies, but little is known about their value for sleep assessment. We developed a novel method of assessing sleep duration using data from 4,094 Whitehall II Study (United Kingdom, 2012-2013) participants aged 60-83 who wore the accelerometer for 9 consecutive days, filled in a sleep log and reported sleep duration via questionnaire. Our sleep detection algorithm defined (nocturnal) sleep as a period of sustained inactivity, itself detected as the absence of change in arm angle greater than 5 degrees for 5 minutes or more, during a period recorded as sleep by the participant in their sleep log.

A comparison of subjective and objective measures of physical activity from the Newcastle 85+ study.

Background: Little is known about physical activity (PA) in the very old, the fastest growing age group in the population. We aimed to examine the convergent validity of subjective and objective measures of PA in adults aged over 85 years.

Methods: A total of 484 participants aged 87-89 years recruited to the Newcastle 85+ study completed a purpose-designed physical activity questionnaire (PAQ), which categorised participants as mildly active, moderately active and very active.

Dose-response effects of a Web-based physical activity program on body composition and metabolic health in inactive older adults: additional analyses of a randomized controlled trial.

Background: Low physical activity is a major risk factor for several age-related diseases. Recently, we showed in a randomized controlled trial that a 12-week Web-based intervention (Philips DirectLife) to increase physical activity was effective in increasing physical activity levels and metabolic health in an inactive population aged 60-70 years.

Objective: The goal of this paper was to assess how many participants successfully reached the physical activity level as targeted by the intervention and what the effects of the intervention on body composition and metabolic health in these successful individuals were to provide insight in the maximum attainable effect of the intervention.

Reactive oxygen species production and mitochondrial dysfunction in white blood cells are not valid biomarkers of ageing in the very old.

Reliable and valid biomarkers of ageing (BoA) are needed to understand mechanisms, test interventions and predict the timing of adverse health events associated with ageing. Since increased reactive oxygen species (ROS) production and mitochondrial dysfunction are consequences of cellular senescence and may contribute causally to the ageing of organisms, we focused on these parameters as candidate BoA. Superoxide levels, mitochondrial mass and mitochondrial membrane potential in human peripheral blood mononuclear cells (PBMCs) and subpopulations (lymphocytes and monocytes) were measured in participants from the Newcastle 85+ study, a population-based study of the very old (aged 85 years and older).

Effects of a web-based intervention on physical activity and metabolism in older adults: randomized controlled trial.

Background: Lack of physical activity leads to detrimental changes in body composition and metabolism, functional decline, and increased risk of disease in old age. The potential of Web-assisted interventions for increasing physical activity and improving metabolism in older individuals holds great promise but to our knowledge it has not been studied.

Objective: The goal of our study was to assess whether a Web-based intervention increases physical activity and improves metabolic health in inactive older adults.

Assessment of sleep and circadian rhythm disorders in the very old: the Newcastle 85+ Cohort Study.

Objectives: to examine the association between subjective and objective measures of sleep and wake and other health parameters in a cohort of the very old.

Design: a population-based cohort study.

Setting: primary care, North East England.

Frailty and the role of inflammation, immunosenescence and cellular ageing in the very old: cross-sectional findings from the Newcastle 85+ Study.

Age-related frailty is an increasing societal challenge with growing emphasis on identifying its underlying pathophysiology and prospects for intervention. We report findings from the first comprehensive study of frailty and biomarkers of inflammation, immunosenescence and cellular ageing in the very old. Using cross-sectional data from the Newcastle 85+ Study (n=845, aged 85), frailty was operationalized by the Fried and Rockwood models and biomarker associations explored using regression analysis.

Activity classification using the GENEA: optimum sampling frequency and number of axes.

Introduction: The GENEA shows high accuracy for classification of sedentary, household, walking, and running activities when sampling at 80 Hz on three axes. It is not known whether it is possible to decrease this sampling frequency and/or the number of axes without detriment to classification accuracy. The purpose of this study was to compare the classification rate of activities on the basis of data from a single axis, two axes, and three axes, with sampling rates ranging from 5 to 80 Hz.

Assessment of a large panel of candidate biomarkers of ageing in the Newcastle 85+ study.

Sensitive and specific biomarkers of ageing are needed to evaluate interventions to extend health span. However, there is growing evidence that information provided by candidate biomarkers may change with age itself. Little is yet known about the value of candidate biomarkers in those over 85 years, currently the fastest growing population sub-group in many countries.

Estimation of daily energy expenditure in pregnant and non-pregnant women using a wrist-worn tri-axial accelerometer.

Background: Few studies have compared the validity of objective measures of physical activity energy expenditure (PAEE) in pregnant and non-pregnant women. PAEE is commonly estimated with accelerometers attached to the hip or waist, but little is known about the validity and participant acceptability of wrist attachment. The objectives of the current study were to assess the validity of a simple summary measure derived from a wrist-worn accelerometer (GENEA, Unilever Discover, UK) to estimate PAEE in pregnant and non-pregnant women, and to evaluate participant acceptability.