Physical Activity and Sedentary Behavior at the End of the Human Lifespan

Accelerometer-measured physical activity and sedentary behavior in nonagenarians: Associations with self-reported physical activity, anthropometric, sociodemographic, health and cognitive characteristics

BACKGROUND

Research on device-based physical activity in the oldest-old adults is scarce. We examined accelerometer-measured physical activity and sedentary behavior in nonagenarians. We also investigated how the accelerometer characteristics associate with nonagenarians' self-reported physical activity, anthropometric, sociodemographic, health and cognitive characteristics.

METHODS

Nonagenarians from a population-based cohort study (N = 38, mean age 91.2) used accelerometers during the waking hours for seven days. They also participated in a health survey and cognitive telephone interview. The Wald test and Pearson and polyserial correlations were used to analyze the data.

RESULTS

The participants' average day consisted of 2931 steps, 11 minutes of moderate-to-vigorous physical activity and 13.6 hours of sedentary time. Physical activity bouts less than 3 minutes per day and sedentary time bouts of 20-60 minutes per day were the most common. No sex differences were found. Many accelerometer-measured and self-reported physical activity characteristics correlated positively (correlations ≥0.34, p-values <0.05). The low levels of many accelerometer-measured physical activity characteristics associated with low education (correlations ≥0.25, p-values <0.05), dizziness (correlations ≤-0.42, p-values <0.01) and fear of falling (correlations ≤-0.45, p-values <0.01). Fear of falling was also associated with accelerometer-measured sedentary behavior characteristics (correlations -0.42 or ≥0.43).

CONCLUSIONS

Nonagenarians were mostly sedentary and low in physical activity, but individual variability existed. Accelerometer-measured and self-reported physical activity had a good consistency. Education, dizziness and fear of falling were consistently related to accelerometer-measured characteristics in nonagenarians.

Participation in youth sports influences sarcopenia parameters in older adults

Background

The degree of deterioration in sarcopenia parameters may be affected by a person's level of physical activity (PA) and sedentary behavior (SB). Our study focused on examining the PA and SB of active older adults including those with and without history of sports in youth.

Methods

Forty-four participants (20 men and 24 women, mean age of total sample 76.1 ± 5.2 years) were included in analysis of PA, SB habits and sarcopenia parameters, determined by skeletal muscle index, hand-grip strength, gait speed, Timed Up and Go tests (TUG). PA and SB were recorded with accelerometers. Our primary aim was to compare participants with (AH) or without a sport history in youth (NAH), in their sarcopenia parameters and PA and SB habits.

Results

When divided participants in two groups (AH and NAH) and adjusting for age, we have detected the differences for skeletal muscle index (p = 0.007) and hand-grip strength (p = 0.004) in favor of participants who were engaged in sports in youth. We did not find any differences in PA and SB habits between the AH and NAH groups. After adjusting for age, participants with a higher number of daily steps, longer moderate to vigorous physical activity (MVPA) bouts, a higher number of MVPA bouts in a day and higher overall MVPA engagement achieved better results in hand-grip strength and TUG. Participants with lower SB had better TUG and gait speed results.

Conclusions

Our findings suggest that engaging in sports activities in youth can make a difference with sarcopenia parameters. Although we found no differences in PA and SB habits between participants with AH and NAH, participants with an athlete history performed better results in sarcopenia parameters.

Physical Activity in Centenarians beyond Cut-Point-Based Accelerometer Metrics

This study described and compared physical activity (PA) characteristics at the end of the human lifespan using conventional cut-point-based versus cut-point-free accelerometer metrics. Eighteen institutionalized centenarians (101.5 ± 2.1 years, 72.2% female, 89% frail) wore the wrist GENEActiv accelerometer for 7 days. Conventional metrics, such as time spent in light-intensity PA (LiPA) and moderate-to-vigorous intensity PA (MVPA) were calculated according to published cut-points for adults and older adults. The following cut-point-free metrics were evaluated: average acceleration, intensity gradient and Mx metrics. Depending on the cut-point, centenarians accumulated a median of 15-132 min/day of LiPA and 3-15 min/day of MVPA. The average acceleration was 9.2 mg [Q1: 6.7 mg-Q3: 12.6 mg] and the intensity gradient was -3.19 [-3.34--3.12]. The distribution of Z-values revealed positive skew for MVPA, indicating a potential floor effect, whereas the skew magnitude was attenuated for cut-point-free metrics such as intensity gradient or M5. However, both cut-point-based and cut-point-free metrics were similarly positively associated with functional independence, cognitive and physical capacities. This is the first time that PA has been described in centenarians using cut-point-free metrics. Our results suggest that new analytical approaches could overcome cut-point limitations when studying the oldest-old. Future studies using these new cut-point-free PA metrics are warranted to provide more complete and comparable information across groups and populations.

Immersive Virtual Reality as a Novel Physical Therapy Approach for Nonagenarians: Usability and Effects on Balance Outcomes of a Game-Based Exercise Program

Physical exercise has been recognized as an important strategy in the promotion of healthy aging. Positive effects on older adults' motor ability are brought about by engaging their motor skills and promoting sensorimotor learning and cortical plasticity. These processes could be increased with the use of immersive virtual reality (IVR) technology, since the multisensory stimulation is greater. The aim of this study was to explore the usability and balance effects of an IVR exercise program in community-dwelling nonagenarian people. A sample of 12 women were allocated to an experimental group (EG n = 6; 91.67 ± 1.63 years) and a control group (CG n = 6; 90.83 ± 2.64 years). For 10 weeks, the EG used a commercial IVR exergame three times a week. All the sample completed the program without adverse effects (without Simulator Sickness Questionnaire symptoms). Post-gaming usability was good (System Usability Scale 78.33). The EG improved some balance parameters significantly (Tinetti test: balance (10.97 %; Sig = 0.017), gait (9.23%; Sig = 0.047) and total score (10.20%; Sig = 0.014) and maintained total TUG test times (-0.45%)). There were significant differences between groups (Tinetti test: balance (Sig = 0.004) and total score (Sig = 0.0032)). We successfully demonstrated that IVR training is feasible and is an effective and personalized method to enhance balance and to reduce the risk of falls in community-dwelling nonagenarian women.