Association between leisure-time physical activity and health-related quality of life changes over time

Abstract

Objective

This study aimed to assess whether changes in leisure-time physical activity over 3 years are associated with changes in health-related quality of life.

Method

Among the adults enrolled in the Supplementation en VItamines et Minéraux Antioxidants study in France, 3891 completed the Modifiable Activity Questionnaire to assess leisure-time physical activity and the Medical Outcomes Study 36-item Short-Form to assess health-related quality of life in 1998 and 2001. Multivariate analyses involving logistic and linear regressions determined the association between changes in leisure-time physical activity and changes in health-related quality of life.

Results

Over 3 years, increased leisure-time physical activity was associated with high scores in health-related quality of life dimensions: physical functioning, mental health, vitality for both sexes as well as social functioning for women only. An increase of 1 h per week of leisure-time physical activity was associated with a 0.17- and 0.39-point increase in the vitality dimension in men and women, respectively. The mental component score was also increased in women increasing their leisure-time physical activity.

Conclusion

The long-term association between leisure-time physical activity and health-related quality of life changes is limited and has little clinical significance, especially for men and for the physical health-related quality of life dimensions. The long-term association needs to be further explored before formulating public health recommendations.

Introduction

Physical inactivity is estimated to contribute to at least 2 million deaths per year globally (World Health Organization, 2003) and is increasingly recognized as a serious public health concern. Indeed, regular physical activity has been associated with reduced risk of mortality and major chronic diseases such as type 2 diabetes (U.S. Department of Health and Human Services, 1996), cardiovascular disease (Forrest et al., 2001, Hu et al., 2001, McAuley et al., 2001, Sacco et al., 1998, Thompson et al., 2003), and certain cancers (Byers et al., 2002, Luoto et al., 2000, Slattery et al., 1997).

Observational studies (mainly cross-sectional) in the general population (Brown et al., 2003, Brown et al., 2004, Laforge et al., 1999) and in patients (Abell et al., 2005, Hulens et al., 2002) suggest that physical activity is associated with all health-related quality of life (HRQoL) dimensions. We conducted a cross-sectional study (Vuillemin et al., 2005) in the general population and obtained similar results.

The results of intervention studies are heterogenous. HRQoL has been shown to improve after exercise training programmes in the general population (Elley et al., 2003, Fisher and Li, 2004, Spirduso and Cronin, 2001) and in patients with breast cancer (Kolden et al., 2002), peripheral arterial occlusive disease (Tsai et al., 2002), or other chronic diseases (Joos et al., 2004, Stefanovic and Milojkovic, 2005, Stewart et al., 1994) but not in the study population of 2 other studies, one in a general population (Halbert et al., 2000) and the other in middle-aged cancer patients receiving or not receiving a personalized training program shortly after curative chemotherapy (Thorsen et al., 2005).

This review of the literature failed to evidence long-term results in the general population. Indeed, to date, only one study has examined the relation between long-term changes in leisure-time physical activity (LTPA) and HRQoL in this population. Wendel-Vos et al. (2004) have demonstrated that LTPA change over time is predominantly associated with improvement in the mental component of HRQoL, namely social functioning for both sexes and vitality, general health, mental health for men (Wendel-Vos et al., 2004). In this study, we also focus on LTPA because occupational physical activity and LTPA may have different effects: increase in LTPA is more likely to have a protective effect on HRQoL (physical functioning dimension) (Leino-Arjas et al., 2004), whereas higher physical load in the workplace, intensity and volume of physical tasks, is less likely to induce positive change (Ruzic et al., 2003). Thus, we aimed to assess whether changes in LTPA over 3 years are associated with changes in HRQoL, with the assumption of a positive association. Additionally, it was of secondary interest to examine the patterns of change in HRQoL in subjects reporting no LTPA over the 3-year period.