title: Dose-response relationships between physical activity, walking and health-related quality of life in mid-age and older women.
abstract: BACKGROUND
  Although physical activity is associated with health-related quality of life (HRQL), the nature of the dose-response relationship remains unclear.
  
  
  OBJECTIVE
  To examine the concurrent and prospective dose-response relationships between total physical activity (TPA) and (only) walking with HRQL in two age cohorts of women.
  
  
  METHODS
  Participants were 10 698 women born in 1946-1951 and 7646 born in 1921-1926, who completed three mailed surveys for the Australian Longitudinal Study on Women's Health. They reported weekly TPA minutes (sum of walking, moderate and vigorous minutes). HRQL was measured with the Medical Outcomes Study Short-Form 36 Health Status Survey (SF-36). Linear mixed models, adjusted for socio-demographic and health-related variables, were used to examine associations between TPA level (none, very low, low, intermediate, sufficient, high and very high) and SF-36 scores. For women who reported walking as their only physical activity, associations between walking and SF-36 scores were also examined.
  
  
  RESULTS
  Curvilinear trends were observed between TPA and walking with SF-36 scores. Concurrently, HRQL scores increased significantly with increasing TPA and walking, in both cohorts, with increases less marked above sufficient activity levels. Prospectively, associations were attenuated although significant and meaningful improvements in physical functioning and vitality were observed across most TPA and walking categories above the low category.
  
  
  CONCLUSIONS
  For women in their 50s-80s without clinical depression, greater amounts of TPA are associated with better current and future HRQL, particularly physical functioning and vitality. Even if walking is their only activity, women, particularly those in their 70s-80s, have better HRQL.
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland 4059, Australia. k.heesch@qut.edu.au
authors.forename: Kristiann C
authors.initials: KC
authors.lastname: Heesch
authors.forename: Jannique G Z
authors.initials: JG
authors.lastname: van Uffelen
authors.forename: Yolanda R
authors.initials: YR
authors.lastname: van Gellecum
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Brown
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D015992:Body Mass Index; D015331:Cohort Studies; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D004734:Energy Metabolism; D015444:Exercise / Q000502:physiology*; D005260:Female; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D016014:Linear Models; D008137:Longitudinal Studies; D008603:Mental Health; D008609:Mental Status Schedule; D008875:Middle Aged; D011594:Psychometrics; D011788:Quality of Life; D012111:Residence Characteristics; D012923:Social Class; D012959:Socioeconomic Factors; D016138:Walking / Q000502:physiology*; D016387:Women's Health