Joanna M Blodgett

University College London | UCL · Institute of Sport, Exercise and Health; Department of Targeted Intervention

Aims/hypothesis To examine the dose-response associations between device-measured physical activity types and posture (sitting and standing time) with cardiometabolic health. Methods An individual participant harmonised meta-analysis of 12,095 adults (mean age±SD= 54.5±9.6 years; Female=54.8%) from 6 cohorts with thigh-worn accelerometry. Associat...

Importance: Vigorous physical activity (VPA) is a time-efficient way to achieve recommended physical activity (PA) for cancer prevention, although structured longer bouts of VPA (via traditional exercise) are unappealing or inaccessible to many individuals. Objectives: To evaluate the dose-response association of device-measured daily vigorous i...

Background: Adolescence is a critical period filled with life changes. Early implementation of effective health promotion strategies could help alleviate the morbidity and mortality associated with inactivity. This study investigated whether adolescent participation in exercise and sport is associated with device-assessed physical activity (PA) le...

Background Accelerometer measures of physical behaviours (physical activity, sedentary behaviour and sleep) in observational studies offer detailed insight into associations with health and disease. Maximising recruitment and accelerometer wear, and minimising data loss remain key challenges. How varying methods used to collect accelerometer data i...

Background Movement behaviours (eg, sedentary behaviour (SB), moderate and vigorous physical activity (MVPA), light intensity physical activity (LIPA) and sleep) are linked to cognition, yet the relative importance of each component is unclear, and not yet explored with compositional methodologies. Objective To (i) assess the associations of diffe...

Background: Mental health and physical health are intrinsically linked, yet the mechanisms are not well understood. We investigated whether moderate-vigorous physical activity (MVPA) mediated the association between depression and physical function (PF) in midlife. Methods: Individuals from two UK birth cohorts born within one week in 1958 (n =...

Background It is hypothesised that lifelong physical activity behaviours are established in early life, however there is minimal, and contradictory, evidence examining prenatal and postnatal factors in relation to adulthood physical activity. We investigated associations between prospectively ascertained prenatal/postnatal factors and device-measur...

Background Obesity in adulthood is associated with reduced physical functioning (PF) at older ages. However, mechanisms underpinning this association are not well understood. We investigated whether and the extent to which C-reactive protein (CRP) mediates the association between early-adult obesity and mid-life PF. Methods We used data from 8495...

Background Studies exploring device-measured physical activity (PA) and cognition are lacking outside of older age, prior to prodromic cognitive decline. Further, existing studies in midlife do not account for the interdependence between the full spectrum of movement behaviours and primarily rely on self-reported PA measures. Limited evidence point...

Introduction The one-legged balance test is widely used as a fall risk screening tool in both clinical and research settings. Despite rising fall prevalence in midlife, there is little evidence examining balance and fall risk in those aged <65 years. This study investigated the longitudinal associations between one-legged balance and the number of...

IMPORTANCE Movement behaviours (e.g. sedentary behaviour (SB), moderate and vigorous physical activity (MVPA), light intensity physical activity (LIPA) and sleep) are linked to cognition, yet the relative importance of each component is unclear, and not yet explored with compositional methodologies. OBJECTIVE To examine how time spent in one behav...

Background: Balance ability underlies most physical movement across life, with particular importance for older adults. No study has investigated if balance ability is established in childhood nor if associations are independent of adult factors. We investigated associations between balance performance in early (age 10) and midlife (age 46), and wh...

Background: Frailty can be operationalised using the deficit accumulation approach, which considers health deficits across multiple domains. We aimed to develop, validate and compare three different frailty indices (FI) constructed from self-reported health measures (FI-Self Report), blood-based biomarkers (FI-Blood) and examination-based assessme...

Several step‐based daily targets have been widely circulated, but there is a lack of empirical population‐based evidence to support such guidance. We examined dose‐response associations between step count and classical CVD risk markers (glycated haemoglobin, high density lipoprotein cholesterol, triglycerides, C‐reactive protein) in 4,665 adults (a...

Introduction Obesity in adulthood is associated with reduced physical functioning (PF) at older ages. However, mechanisms underpinning this association are not well understood. We investigated whether and the extent to which C-reactive protein (CRP) mediates the association between early-adult obesity and mid-life PF. Methods We used data from 849...

Background The role of ambulance services is shifting, due in part to more intermediate, non-urgent patients who do not require direct emergency department conveyance, yet who cannot be safely left at home alone. Evidence surrounding the safety, effectiveness and efficiency of alternate care routes is not well known. Methods This scoping review so...

Objective The aim of this systematic review was to synthesise all published evidence on associations between one-legged balance performance and falls. Methods Medline, EMBASE, CINAHL and Web of Science were systematically searched (to January 2021) to identify peer-reviewed, English language journal articles examining the association between one-l...

Background The relation between socioeconomic position (SEP) and obesity measured by body mass index (BMI), a measure of weight for height, has been extensively reviewed in children, showing consistent associations between disadvantaged SEP and higher BMI in high-income countries (HICs) and lower BMI in middle-income countries (MICs). Fat mass (FM)...

Multiple systematic reviews have investigated the relation between socioeconomic position (SEP) and body mass index (BMI) throughout the life course. However, BMI does not capture quantity and distribution of fat and muscle, which are better indicators of obesity than BMI, and have been independently linked to adverse health outcomes. Less is known...

Background Cognitive integration of sensory input and motor output plays an important role in balance. Despite this, it is not clear if specific cognitive processes are associated with balance and how these associations change with age. We examined longitudinal associations of word memory, verbal fluency, search speed and reading ability with repea...

Background The Centre for Epidemiologic Studies Depression Scale (CES-D) is a commonly used psychometric scale of depression. A four-factor structure (depressed affect, positive affect, somatic symptoms, and interpersonal difficulties) was initially identified in an American sample aged 18 to 65. Despite emerging evidence, a latent structure has no...

Background: The collective five-year experience with the acute management of pelvic trauma at a busy South African trauma service is reviewed to compare the usefulness and applicability of current grading systems of pelvic trauma and to review the compliance with current guidelines regarding pelvic binder application during the acute phase of resu...

Reducing population levels of frailty is an important goal and preventing its development in mid-adulthood could be pivotal. There is limited evidence on associations between childhood socioeconomic position (SEP) and frailty. Using 1958 British birth cohort data (followed from 1958 to 2016; N=8711), we aimed to: (i) establish the utility of measur...

Reducing population levels of frailty is an important goal and preventing its development in mid-adulthood could be pivotal. There is limited evidence on associations between childhood socioeconomic position (SEP) and frailty. Using 1958 British birth cohort data (followed from 1958 to 2016; N=8711), we aimed to: (i) establish the utility of measur...

Background Age-related changes in cognitive and balance capabilities are well-established, as is their correlation with one another. Given limited evidence regarding the directionality of associations, we aimed to explore the direction and potential explanations of associations between word memory and one-legged balance performance in mid-later lif...

Background With an ageing population, the number of people with frailty is increasing. Despite this trend, the extent to which the severity and lethality of frailty have changed over time is not well understood. We aimed to investigate how frailty severity and lethality have changed over an 18-year period in the USA. Methods In this population-bas...

Balance ability is a crucial component of everyday life, underlying physical movement at all stages in life. Despite this, balance is an overlooked aspect of physical health and ageing, with minimal evidence of how factors throughout life are associated with balance ability. This PhD thesis used a life course approach to investigate how factors acr...

Reducing population levels of frailty is an important goal and preventing its development in mid-adulthood could be pivotal. Childhood socioeconomic position (SEP) is associated with a myriad of adult health outcomes but evidence is limited on associations with frailty. Using 1958 British birth cohort data (N=8711), we aimed to: (i) establish the u...

Background: UK Ambulance services are under pressure to safely stream appropriate patients away from the Emergency Department (ED). Even so, there has been little evaluation of patient outcomes. We investigated differences between patients who are conveyed directly to ED after calling 999 and those referred by an ambulance crew to a novel GP refer...

Background: Hanging is a common form of self-harm, and emergency care physicians will not infrequently be called upon to manage a survivor.Despite the relative frequency of the injury, there is a paucity of literature on the topic and the spectrum and incidence of associated injuries are poorly described. Objectives: To review experience with ma...

Introduction: Despite its associations with falls, disability, and mortality, balance is an under-recognized and frequently overlooked aspect of aging. Studies investigating associations between factors across life and balance are limited. Understanding the factors related to balance performance could help identify protective factors and appropria...

Background and Aims Selective nonoperative management of abdominal stab wound is well established, but its application in the setting of isolated omental evisceration remains controversial. The aim of the study is to establish the role of selective nonoperative management in the setting of isolated omental evisceration. Materials and Methods A ret...

Introduction Poor balance ability in mid and later life is associated with increased risk of adverse health outcomes. Understanding what factors across life contribute to balance ability in the ageing population is important in order to prevent, delay or minimise balance decline. Our aim was to identify socioeconomic indicators, health behaviours,...

Background Falls in older adults are a growing public health concern. Evidence shows that balance ability is associated with falls and may be a useful screening tool to identify high-risk individuals. However, research has primarily focused on individuals aged 65+. This evidence has used regression modeling, without assessing the diagnostic accurac...

Introduction: Discrepancy in outcomes between urban and rural trauma patients is well known. We reviewed our institutional experience with the management of gunshot wounds (GSWs) in the specific setting of car hijacking and focused on clinical outcome between rural and urban patients. Methods: A retrospective review was conducted at a major trau...

Age-related changes in cognitive and balance abilities are well-established, as is their correlation with one another. There is, however, limited evidence regarding the directionality of associations and whether or not common biological processes may underlie their age-related declines. The main aim was to explore bidirectional associations between...

Positive advances in life expectancy, healthcare access and medical technology have been accompanied by an increased prevalence of chronic diseases and substantial population ageing. How this impacts changes in both frailty level and subsequent mortality in recent decades are not well understood. We aimed to investigate how these factors changed ov...

Background Falls in older adults precipitate hospitalisation, frailty and premature mortality and are a growing health concern. The standing balance test is a simple, cost effective tool used to screen for fall risk in adults aged 65+, however the association between standing balance and fall risk has not been examined in individuals younger than 6...

Background: Standardized frailty assessments are needed for early identification and treatment. We aimed to develop a frailty scale using visual images, the Pictorial Fit-Frail Scale (PFFS), and to examine its feasibility and content validity. Methods: In Phase 1, a multidisciplinary team identified domains for measurement, operationalized impai...

We sought to examine how much sedentary time needs to be replaced by light or moderate-vigorous physical activity in order to reduce frailty and protect against mortality. We built isotemporal substitution models to assess the theoretical effect of replacing sedentary behavior with an equal amount of light or moderate-vigorous activity on frailty a...

Objectives To test whether developmental factors are associated with grip strength trajectories between 53 and 69 years, and operate independently or on the same pathway/s as adult factors. Design British birth cohort study. Setting England, Scotland and Wales. Participants 3058 men and women. Main outcome measures Grip strength (kg) at ages 53...

Background This study set out to review a large series of trauma laparotomies from a single center and to compare those requiring damage control surgery (DCS) with those who did not, and then to interrogate a number of anatomic and physiologic scoring systems to see which best predicted the need for DCS. Methods All patients over the age of 15 yea...

Objective Early frailty may be captured by a frailty index (FI) based entirely on vital signs and laboratory tests. Our aim was to examine associations between a laboratory‐based FI (FI‐Lab) and adverse health outcomes, and investigate how this changed with age. Methods Up to 8988 individuals aged 20+ years from the 2003‐2004 and 2005‐2006 Nationa...

Objective: The Center for Epidemiologic Studies Depression Scale (CES-D) is a 20-item, self-report metric intended to measure depression. Despite being one of the most popular depression scales, the psychometric properties, specifically the underlying factor structure of the scale, have come under scrutiny. The latent structure of a scale is a key...

The original article [1] contained an error whereby Table 5 within the Appendix is presented incorrectly. This error has now been corrected and Table 5 is presented appropriately.

Background Cognitive processing plays a crucial role in the integration of sensory input and motor output that facilitates balance. However, whether balance ability in adulthood is influenced by cognitive pathways established in childhood is unclear, especially as no study has examined if these relationships change with age. We aimed to investigate...

Introduction: This study examines the nature of trauma laparotomies performed primarily by trainees and those performed under the direct supervision of a consultant. Materials and Methods: A retrospective review was undertaken at the Pietermaritzburg Metropolitan Trauma Service (PMTS), South Africa. All patients who underwent a trauma laparotomy we...

Background Car hijacking, known as “carjacking”, is a form of aggravated robbery of a vehicle from the driver frequently involving firearm and is common in South Africa. There is, however, little literature on the spectrum of injuries sustained by victims of car hijacking. The study aimed to describe the spectrum of gunshot wound-related (GSW) inju...

Emerging evidence suggests that appropriate nutritional care can mitigate frailty and its complications. We investigated the association between nutrition and frailty across the life course, including the effect of nutrition-related parameters on mortality in frail people. Participants aged ≥20 years with frailty and nutrition data (n=8,482) from t...

Background Nutritional status and individual nutrients have been associated with frailty in older adults. The extent to which these associations hold in younger people, by type of malnutrition or grades of frailty, is unclear. Our objectives were to (1) evaluate the relationship between individual nutrition-related parameters and frailty, (2) inves...

Background Balance ability from midlife has been consistently shown to predict future health outcomes including mortality, morbidity and falls risk. Evidence has identified socioeconomic, behavioural and anthropometric contributors to balance, however there is little evidence on the role of psychological factors. We aimed to examine the association...

Background Maintenance of muscle strength with age enables independent living for longer and may protect against chronic disease. Developmental and adult factors are associated with level of adult grip strength but evidence about their influence on its decline is sparse. We used longitudinal data to test whether birthweight, motor and cognitive dev...

Introduction The modern concept of damage control surgery (DCS) for trauma was first introduced less than three decades ago. This audit aims to describe the spectrum and outcome of patients requiring DCS, to benchmark our experience against that reported from other centres and countries and to distil the pertinent teaching lessons from this experie...

Introduction: The spectrum of injury associated with anterior abdominal stab wounds (SWs) is well established. The literature in the specific setting of isolated omental evisceration is limited. Materials and methods: We reviewed our experience of 244 consecutive patients with established indications for laparotomy over an eight year period at a...

Maintenance of muscle strength is important for healthy ageing, protecting against chronic disease and enabling independent living. We tested whether developmental factors were associated with grip strength trajectories between 53 and 69 years, and operated independently or on the same pathway/s as adult factors, in 3058 participants from a British...

Background Balance impairments and subsequent increased risk of falling are a growing concern in older populations, yet there is little research examining contributing factors from early life. We aimed to examine associations of neurodevelopmental markers with standing balance measured on three occasions in later life. Methods The MRC National Sur...

Background Fear of falling is common in older people and is associated with activity restriction and subsequent functional decline. A study of older Italians found that those with lower mastery (ie, the sense of control individuals feel over their own lives) had greater fear of falling than those with higher mastery. This association was independen...

Background An innovative policy developed and implemented by a UK Ambulance Service allows paramedics to refer patients to the GP Acute Visiting Service scheme. Initial evidence suggests that using this alternate route of care can decrease hospital admission rates, increase bed availability, decrease wait time in A and Es and provide substantial sa...

A frailty index (FI) based entirely on common clinical and laboratory tests might offer scientific advantages in understanding ageing and pragmatic advantages in screening. Our main objective was to compare an FI based on common laboratory tests with an FI based on self-reported data; we additionally investigated if the combination of subclinical d...

Background Physical performance indicators, such as standing balance, grip strength and walking speed, are increasingly being used as markers of healthy ageing. This is based on growing evidence that poor performance on these tests is associated with adverse health outcomes including falls, disability, hospitalisation and mortality. Individual vari...

Background: Sedentary behaviours are associated with adverse health outcomes in middle-aged and older adults, even among those who exercise. We examined whether the degree of frailty affects the association between sedentary behaviours and higher risk of mortality. Methods: In this prospective cohort study, we used data from 3141 community-dwell...

Purpose With the increasing demand on ambulance services, paramedics are tasked to arrange as much out of hospital care as possible, to develop integrated systems of care and work with hundreds of different providers –all in the 15 minutes allocated for assessment. A UK ambulance trust is navigating and leading much of this work as one of the firs...

This abstract is being presented as a short talk in the scientific program. A full abstract is printed in the Proffered Abstracts section (PR14) of the Conference Proceedings. Citation Format: Artitaya Lophatananon, Kawthar Alajmi, Emma Thorpe, John Hughes, Joanna Blodgett, Bernadette Fisher, Simon Rogers, Erika K. Waters, Kenneth R. Muir. Developm...

Exposure to modifiable lifestyle and environmental risk factors accounts for approximately 40% of all cancers in the UK. Therefore, primary prevention is of growing importance and an effective and engaging strategy that encourages long-term adoption of healthy lifestyle behaviours is required. Several multivariable risk prediction models have been...

Although many common diseases occur mostly in old age, the impact of ageing itself on disease risk and expression often goes unevaluated. To consider the impact of ageing requires some useful means of measuring variability in health in animals of the same age. In humans, this variability has been quantified by counting age-related health deficits i...

An innovative policy implemented by a UK Ambulance Service allows paramedics to refer patients to a GP Acute Visiting Service scheme. Initial evidence suggests that this alternate route of care can decrease hospital admission rates, decrease A&E waiting time and provide substantial savings for the NHS. However, there are many unrecognised barriers...

Identifying and responding to frailty should begin in primary care where health professionals can consider both the medical and social context of their patients. The purpose of this study was to examine the feasibility of first measuring and then mitigating frailty in community-dwelling older adults. Fifty-one community-dwelling people (82.0±7 year...

Background: abnormal laboratory test results accumulate with age and can be common in people with few clinically detectable health deficits. A frailty index (FI) based entirely on common physiological and laboratory tests (FI-Lab) might offer pragmatic and scientific advantages compared with a clinical FI (FI-Clin). Objectives: to compare the FI-La...

The two most commonly employed frailty measures are the frailty phenotype and the frailty index. We compared them to examine whether they demonstrated common characteristics of frailty scales, and to examine their association with adverse health measures including disability, self-reported health, and healthcare utilization. The study examined adul...

(1) To examine how sedentary behaviour and moderate-vigorous (MVPA) are each experienced during the day across different levels of frailty; (2) estimate and compare the extent to which high levels of sedentary behaviour and low levels of MVPA are associated with increased frailty and self-reported health, disability and healthcare utilization. Comm...

As the mean life expectancy of the population continues to increase, the challenge for individuals is to remain healthy and fit throughout their life span. This review examines the relationships between moderate-vigorous physical activity and sedentary behaviour in relation to the fitness-frailty continuum. The association between increased physica...