Daily sedentary time and physical activity as assessed by accelerometry and their correlates in older adults

Multimodal Factors Affect Longitudinal Changes in Dynamic Balance in Community-Dwelling Older Adults

Purpose

Dynamic balance, an important contributor to fall risk in older adults, involves maintaining the center of pressure while in locomotive states and is. Fall risk appraisal (FRA) is defined as assessing an older adult's awareness of their physiological and perceived fall risk. This longitudinal study aimed to evaluate how multimodal factors predict fluctuations in dynamic balance in community-dwelling low-income older adults, utilizing fear of falling (FoF), static balance, fall history, and moderate-to-vigorous physical activity (MVPA).

Patients and Methods

The longitudinal study included 140 community-dwelling, low-income older adults, with 124 women and 16 men. FoF was assessed using the Short Falls Efficacy Scale International (Short FES-I) and static balance using BTracks Balance Test (BBT). Both were utilized to define FRA Distance, an integrated quantification of physiological and perceived balance deficits. MVPA was assessed using accelerometers, fall history using self-report, and dynamic balance using the Timed Up and Go (TUG) test. The study was conducted at 4 timepoints at T1 (baseline), T2 (2 months), T3 (4 months), and T4 (6 months).

Results

Using mixed effects multilevel models, TUG scores were predicted by time, %MVPA, and FRA distance ratio. The effect of FRA distance ratio was primarily driven by FoF, and the effect of %MVPA varied by age. Additionally, while fall history did not show a predictive relationship with TUG scores, it did predict FRA distance.

Conclusion

Dynamic balance fluctuated over time and was influenced by multimodal factors, namely MVPA and FRA, which captured the interplay between static balance and FoF. Fall history did not directly predict dynamic balance but played a role in FRA, implicating the subjective effects of fall history. These findings demonstrate how physical activity, FRA, and their interactions can predict changes in dynamic balance. Future work can utilize the results to evaluate low-cost interventions for community-dwelling older adults.

Explanatory variables of objectively measured physical activity, sedentary behaviour and sleep in adults with type 1 diabetes: A systematic review

AIMS

This systematic review aimed to summarize knowledge on explanatory variables of PA, SB and sleep in adults with T1D to support the development of healthy lifestyle interventions.

METHODS

A systematic search of four databases (PubMed, Web of Science, Scopus and Embase) was performed. Only objective measurements of PA, SB and sleep were included and all explanatory variables were classified according to the socio-ecological model (i.e. intrapersonal, interpersonal, environmental and policy level). Risk of bias (ROB) (Joanna Briggs Institute appraisal checklists) and level of evidence (Evidence-Based Guideline Development) were assessed.

RESULTS

Twenty-one studies were included (66.7% low ROB). Most explanatory variables were situated at the intrapersonal level. A favourable body composition was associated with more time spent in total PA and moderate-to-vigorous PA (MVPA). Men with T1D spent more time in MVPA than women and a younger age was associated with increased MVPA. Barriers to PA were indeterminately associated with MVPA and HbA1c showed an indeterminate association with sleep. Explanatory variables of SB and light PA were not studied in at least two independent studies.

CONCLUSION

This review underscores the focus on the individual level to identify explanatory variables of movement behaviours in adults with T1D, despite the necessity for a socio-ecological approach to develop effective interventions. More evidence on psychological, interpersonal and environmental variables is needed as these are modifiable.

A comprehensive scoping review of intergenerational dance programmes for cohorts with a generational gap

INTRODUCTION

Loneliness and physical inactivity are issues that affect both young people and older adults. This can have negative health outcomes and well as high costs on health services. Physical activity can positively influence both physical and psychosocial health outcomes, however enjoyment is necessary for adherence. Combining exercise with arts-based activities can improve enjoyment for older adults and young people. Dance has been found to be a safe and enjoyable form of physical activity that can be equally or more effective than conventional exercise options. Intergenerational interventions can improve relationships between generations. The aim of this scoping review was to collate and map the available evidence for intergenerational dance.

METHODS

This scoping review followed the guidance outlined by the Joanna Briggs Institute. A systematic search of nine multidisciplinary databases and four repositories was conducted. Inclusion criteria were intergenerational dance or movement to music programmes. Exclusion criteria included dance movement therapy or groups with less than one generational gap. Data were extracted and summarised using narrative synthesis and research papers were appraised using the Mixed Methods Appraisal Tool.

RESULTS

The search identified eleven research studies, seven expert opinion/practice expertise and 13 sources from the grey literature. Dance classes were typically 11-12 weeks long. Genres varied with some programmes including co-creation through choreography. Experiences and social outcomes were the most assessed outcomes, with a lack of studies examining physical outcomes. Participants reported enjoying the programmes stating they felt proud for taking part and looked forward to sessions. The term intergenerational was not defined in any paper.

CONCLUSIONS

Intergenerational dance is an emerging area of research. Many programmes run in communities but are not researched, therefore several gaps remain. More large-scale trials are needed around intergenerational dance. Definitions and descriptions of dance and intergenerational activity should be considered in future studies to ensure consistency.

Barriers and Facilitators to Physical Activity Among Older Adults in Residential Aged Care Facilities: A Mixed Methods Systematic Review Using the Social Ecological Model

OBJECTIVE

To ascertain the barriers and facilitators to physical activity (PA) for older adults in Residential Aged Care Facilities (RACFs), from the perspective of residents, staff, and family.

METHODS

A mixed-methods systematic review, underpinned by the Social Ecological Model (SEM). Five databases were searched from inception to May 2024. Data synthesis followed a convergent integrated approach, with relevant quantitative data 'qualitised' and synthesised with qualitative data using thematic synthesis.

RESULTS

This review included 67 studies (40 qualitative, 16 mixed-methods, and 11 quantitative). Thematic synthesis identified 51 key themes (27 facilitators and 24 barriers), spanning all levels of the SEM. Intrapersonal factors (e.g. poor general health) were the most commonly cited barriers (n = 53 studies), and interpersonal factors (e.g. social support) the most commonly reported facilitators (n = 55 studies) to PA in RACFs.

DISCUSSION

An interplay of multi-level factors must be addressed in the development and implementation of strategies to promote PA in RACFs.

Relationship between physical activity and abdominal obesity and metabolic markers in postmenopausal women

This study aimed to investigate the impact of physical activity indicators monitored by the POLAR accelerometer on body obesity indicators, metabolic syndrome parameters, and energy metabolism hormones in postmenopausal women. Was included 71 participants from this study program (68.8 ± 4.3 years). We divided participants into LPA and MVPA groups based on their level of moderate to vigorous physical activity per week; Physical activity levels over 7 days were assessed using a POLAR accelerometer, with daily step counts and sedentary time recorded. Measurements included waist circumference, visceral fat volume, body fat percentage, blood pressure, fasting blood glucose, triglyceride levels, HDL cholesterol, and energy metabolism hormone levels (leptin, resistin, adiponectin). The MVPA group displayed lower waist circumference, body fat percentage, abdominal fat, and BMI compared to the LPA group (p < 0.05). A significant negative correlation was observed between daily step count and obesity indicators, including waist circumference (r = -0.301), body fat percentage (r = -0.295), abdominal fat (r = -0.318), and BMI (r = -0.238). Conversely, sedentary time showed a positive correlation with obesity indicators such as waist circumference (r = 0.258), body fat percentage (r = 0.239), and abdominal fat (r = 0.244). Moreover, daily step count exhibited a significant negative correlation with leptin levels (r = -0.245), while sedentary time was positively correlated with the energy metabolic factor leptin (r = 0.279). Waist circumference demonstrated significant positive correlations with triglycerides, blood glucose, adiponectin, resistin, and leptin levels. Postmenopausal women who engage in at least 150 min of MVPA weekly show lower obesity indices. There is a significant correlation between physical activity levels and obesity indicators, which relate to metabolic syndrome and energy metabolism factors. Thus, increased physical activity may help prevent metabolic syndrome and cardiovascular diseases in this population.

Objectively Measured Physical Activity and Sedentary Behaviors Among Older Adults in Assisted Living Facilities: A Scoping Review

Older adults in assisted living facilities (ALF) are at risk for low physical activity (PA) and high sedentary behavior (SB), both of which place them at risk for negative health outcomes. The purpose of this scoping review was to synthesize evidence describing the volume of device-measured PA/SB, factors associated with PA/SB, and interventions designed to change PA/SB in older adults living in ALF. Twenty articles representing 15 unique studies were identified from eight electronic databases and grey literature. Residents in ALF spent 96-201 min/day in light PA (n = 2 studies), 1-9.74 min/day in moderate to vigorous PA (n = 2 studies), and 8.5-11.01 hr/day of SB during waking hours (n = 3 studies). Factors associated with PA included 16 personal factors (n = 6 articles), one social factor (n = 2 articles), and two environmental factors (n = 2 articles). Factors associated with SB included 14 personal factors (n = 4 articles) and one social factor (n = 1 article). No intervention successfully changed PA/SB.

Data Analytics in Physical Activity Studies With Accelerometers: Scoping Review

BACKGROUND

Monitoring free-living physical activity (PA) through wearable devices enables the real-time assessment of activity features associated with health outcomes and provision of treatment recommendations and adjustments. The conclusions of studies on PA and health depend crucially on reliable statistical analyses of digital data. Data analytics, however, are challenging due to the various metrics adopted for measuring PA, different aims of studies, and complex temporal variations within variables. The application, interpretation, and appropriateness of these analytical tools have yet to be summarized.

OBJECTIVE

This research aimed to review studies that used analytical methods for analyzing PA monitored by accelerometers. Specifically, this review addressed three questions: (1) What metrics are used to describe an individual's free-living daily PA? (2) What are the current analytical tools for analyzing PA data, particularly under the aims of classification, association with health outcomes, and prediction of health events? and (3) What challenges exist in the analyses, and what recommendations for future research are suggested regarding the use of statistical methods in various research tasks?

METHODS

This scoping review was conducted following an existing framework to map research studies by exploring the information about PA. Three databases, PubMed, IEEE Xplore, and the ACM Digital Library, were searched in February 2024 to identify related publications. Eligible articles were classification, association, or prediction studies involving human PA monitored through wearable accelerometers.

RESULTS

After screening 1312 articles, 428 (32.62%) eligible studies were identified and categorized into at least 1 of the following 3 thematic categories: classification (75/428, 17.5%), association (342/428, 79.9%), and prediction (32/428, 7.5%). Most articles (414/428, 96.7%) derived PA variables from 3D acceleration, rather than 1D acceleration. All eligible articles (428/428, 100%) considered PA metrics represented in the time domain, while a small fraction (16/428, 3.7%) also considered PA metrics in the frequency domain. The number of studies evaluating the influence of PA on health conditions has increased greatly. Among the studies in our review, regression-type models were the most prevalent (373/428, 87.1%). The machine learning approach for classification research is also gaining popularity (32/75, 43%). In addition to summary statistics of PA, several recent studies used tools to incorporate PA trajectories and account for temporal patterns, including longitudinal data analysis with repeated PA measurements and functional data analysis with PA as a continuum for time-varying association (68/428, 15.9%).

CONCLUSIONS

Summary metrics can quickly provide descriptions of the strength, frequency, and duration of individuals' overall PA. When the distribution and profile of PA need to be evaluated or detected, considering PA metrics as longitudinal or functional data can provide detailed information and improve the understanding of the role PA plays in health. Depending on the research goal, appropriate analytical tools can ensure the reliability of the scientific findings.

Boosting enjoyment and social inclusion to increase physical activity and reduce sedentary behaviour among older adults: protocol for a feasibility study to test the JOIN4JOY approach in five European countries

INTRODUCTION

Programmes for older people aimed at increasing physical activity (PA) and reducing sedentary behaviour (SB) traditionally focus on achieving functional and health improvements. Focusing on enjoyment and social inclusion could strengthen adherence and help reach older people with social disadvantages. The aim of this study is to assess the feasibility and acceptability of the Join4Joy approach in PA programmes and its assessment tools.

METHODS AND ANALYSIS

A multicentric, pragmatic, pre-post feasibility study using mixed methods will be conducted. The intervention will consist of a PA programme boosting enjoyment and social inclusion, grounded on a co-creation process. Trainers will offer twelve, 1-hour weekly sessions of structured, supervised, group-based PA. Participants will be encouraged to increase activity in daily living. 144 older people will be recruited from the community and nursing homes in Spain, Denmark, Italy, Germany, and France. Additionally, participants and trainers will be invited to join virtual communities of practice to share their experiences across settings and countries. Qualitative procedures will be used to explore the acceptability of the design via interviews and focus groups with participants and trainers. Quantitative methods will be used to assess uptake, adherence, retention, reach, satisfaction, enjoyment (PACES questionnaire), physical function (e.g., Short Physical Performance Battery), quality of life (EQ-5D-5L scale), perceived improvement (Patient Global Impression of Improvement scale-I), activities of daily living (Barthel index) and SB and PA patterns (IPAQ and accelerometry). The degree and type of participation in virtual communities of practice will also be assessed. SPSS software will be used for the analysis of quantitative variables. Qualitative data will be analysed using reflective thematic analysis following Braun and Clarke (2006).

ETHICS AND DISSEMINATION

A favourable report by the Research Ethics Committee of UVic-UCC (282/2023) was obtained on 26 June 26th, 2023. Participation and withdrawal will be voluntary. Participants' (or their legal guardians', when necessary) written permission will be required. Results of the study will be disseminated through publication of scientific articles, presentations at sport and health-related professional conferences and congresses, as well as through social media and via the Join4Joy website.

STUDY REGISTRATION

ClinicalTrials.gov, NCT06100835.

The associations of weekend warrior and other physical activity patterns with the risk of all-cause and cardiovascular disease mortality in people with diabetes mellitus and chronic kidney disease: from NHANES 2007-2020

AIM

To investigate the associations of the weekend warrior and other physical activity (PA) patterns with all-cause, cardiovascular disease (CVD) mortality risk in people with diabetes mellitus (DM) and chronic kidney disease (CKD).

METHODS

This study pooled the data from NHANES 2007-2020. Participants with DM and CKD were included. PA was assessed using a self-reported questionnaire. According to the characteristics of recreational activities, individuals were categorized as inactive (no activities), insufficiently active (total PA duration <  150 min/week), weekend warrior (total PA duration ≥  150 min/week for 1-2 sessions), and regularly active (total PA duration ≥  150 min/week for ≥  3 sessions). Weighted Cox regression models with adjusting sociodemographic, behavioral, and metabolic factors were performed to investigate the relationship of PA patterns with all-cause and CVD mortality risk. Stratification and interaction analyses were further performed.

RESULTS

Among 1702 participants (46.53% female; 64 ± 0.46 years old), 536 died (163 cardiovascular) during the follow-up of 68 (39-104) months. The hazard ratio (HR) of all-cause death was 0.618 (95% CI 0.406-0.942) for insufficiently active PA pattern, 0.338 (95% CI 0.116-0.988) for weekend warrior PA pattern, and 0.536 (95% CI 0.395-0.726) for regularly active PA pattern compared with inactive PA pattern. HR of CVD death was 0.545 (95% CI 0.250-1.189) for the PA pattern of insufficiently active, 0.165 (95% CI 0.020-1.343) for weekend warrior, and 0.393 (95% CI 0.218-0.710) for regularly active compared with the inactive PA pattern. The associations present no difference in subgroups. Moreover, there was no discernible difference between weekend warrior and regularly active PA patterns for all-cause and CVD deaths. The risk of death declined relatively quickly When exercise was initiated and to a total of 450 min or 4 times per week.

CONCLUSION

In a population of DM and CKD, the weekend warrior pattern was similar to regular activity to lower the risk of all-cause mortality, compared with inactivity. The weekend warrior pattern was recommended for people who only have time to exercise on the weekend. However, longer and larger sample cohort studies are needed to validate our findings.

Effect of E-PR-01 on non-specific low back pain in the adult population: A randomized, double-blind, placebo-controlled, parallel-group trial

BACKGROUND

Low back pain (LBP) has emerged as a major public health concern leading to significant work productivity loss and deterioration in the quality of life.

OBJECTIVE

A randomized, double-blind, placebo-controlled parallel-group clinical trial was conducted to investigate the effect of E-PR-01, a proprietary blend of Vitex negundo leaves and zingiber officinale rhizome, in individuals with LBP.

METHODS

Seventy-two individuals aged 18 to 60 years with LBP were randomized in a 1:1 ratio in either the E-PR-01 or placebo group. The participants were instructed to take 2 capsules/day of the study products in two divided doses for 30 days. The study outcomes were changes in functional activity, bending flexibility, pain intensity, work productivity, and sleep quality. The sustained effect of the study products was also evaluated on the pain and physical functioning for 7 days after stopping the product intake. The product's safety was evaluated by adverse events reporting throughout the study.

RESULTS

Compared to the placebo, the E-PR-01 demonstrated a statistically significant reduction in functional disability (mean RMQ score: -5.47 vs. -2.48), pain intensity (mean VAS score: -31.29 vs. -14.55) and improved bending flexibility (mean distance: -5.60 vs. -2.38 cm). In addition, a significant improvement in work productivity as well as sleep quality was also observed. In the E-PR-01 group, a statistically significant sustained effect was observed compared to the placebo for the pain intensity (p< 0.0005) and the functional activity (p< 0.0001) scores. No significant adverse event was reported in the study.

CONCLUSION

E-PR-01 significantly improved low back pain and bending flexibility in adults without adverse effects. Moreover, the effect of E-PR-01 lasted 7 days after stopping the intervention.

Longitudinal Changes in Moderate to Vigorous Physical Activity in Community-Dwelling Older Men and Women: A 2-Year Prospective Cohort Study in Japan

BACKGROUND

To examine longitudinal changes in accelerometer-measured moderate to vigorous physical activity (MVPA) and associated factors of changes in MVPA among community-dwelling older Japanese men and women over 2 years of follow-up.

METHODS

In total, 601 participants (72.2 [5.4] y, 40.6% men) were included. MVPA was assessed at baseline (2011) and follow-up (2013) using triaxial accelerometers. Sex-stratified multiple linear regression models were used to identify associated factors of changes in MVPA.

RESULTS

On average, a significant decrease in MVPA over 2 years was observed only in women (P < .001). Higher baseline MVPA levels and older age were significantly associated with a decrease in MVPA over 2 years in both men and women. Men who were currently drinking (vs no) and had faster maximum gait speed showed statistically significant increases in MVPA. Women who had very poor/poor economic status (vs fair/good) and were socially isolated (vs no) showed statistically significant increases in MVPA over 2 years, while those who had fear of falling (vs no) and poor/fair self-rated health (vs good/very good) showed statistically significant decreases in MVPA over 2 years.

CONCLUSIONS

Our findings showed different associated factors of changes in MVPA by sex, suggesting the importance of accounting for sex differences in terms of developing specific intervention strategies for promoting MVPA among older men and women.

Sedentary patterns and cardiometabolic risk factors in Mexican children and adolescents: analysis of longitudinal data

BACKGROUND

Sedentary behavior is a modifiable risk factor for cardiometabolic health; however, the assessment of total sedentary time may not capture youth's highly active and interrupted activity patterns. This study examined the associations between sedentary activity patterns and cardiometabolic risk factors among Mexican youth, who have a disproportionate burden of metabolic diseases, using a repeated measure design out of a longitudinal data.

METHODS

570 subjects in the Early Life Exposure in Mexico to ENvironmental Toxicants (ELEMENT) birth cohort, who were followed up to three-time points during adolescence, were included. Bout duration, and frequency and percentages of waking time spent in specific intensities of activity, were quantified using ActiGraph wGT3X-BT wrist accelerometers. Self-reported questionnaires were used to query the usual duration of different sedentary behaviors. Outcomes were fasting lipid profile, markers for glucose homeostasis, anthropometry, and blood pressure. Associations were modeled using linear mixed-effects models, and isotemporal substitution approach was additionally used to assess the effect of replacing objectively assessed sedentary activity with other activity intensities, adjusting for potential confounders.

RESULTS

Each hour of self-reported screen-based time was positively associated with diastolic blood pressure (mm Hg) [β = 0.30, 95% confidence interval (95% CI) = 0.10, 0.51], and an hour of other sedentary time was associated with log serum glucose (mg/dL) [β = 0.01, 95% CI = 0.004, 0.017]. Substitution models showed that replacing 5% of sedentary time with moderate to vigorous physical activity (MVPA) was associated with lower waist circumference (cm) [β = - 1.35, 95% CI = - 1.91, - 0.79] and log serum triglycerides (mg/dL) [β = - 0.11, 95% CI = - 0.18, - 0.03]. Substituting one uninterrupted sedentary bout with light activity was associated with lower insulin (μIU/mL) [β = - 0.06, 95% CI = - 0.10, - 0.02].

CONCLUSIONS

Sedentary time was associated with cardiometabolic risk factors in Mexican youth in a context-specific manner. Replacing sedentary time with higher intensities was associated with improvements in some cardiometabolic markers.

Historical development of accelerometry measures and methods for physical activity and sedentary behavior research worldwide: A scoping review of observational studies of adults

This scoping review identified observational studies of adults that utilized accelerometry to assess physical activity and sedentary behavior. Key elements on accelerometry data collection were abstracted to describe current practices and completeness of reporting. We searched three databases (PubMed, Web of Science, and SPORTDiscus) on June 1, 2021 for articles published up to that date. We included studies of non-institutionalized adults with an analytic sample size of at least 500. The search returned 5686 unique records. After reviewing 1027 full-text publications, we identified and abstracted accelerometry characteristics on 155 unique observational studies (154 cross-sectional/cohort studies and 1 case control study). The countries with the highest number of studies included the United States, the United Kingdom, and Japan. Fewer studies were identified from the continent of Africa. Five of these studies were distributed donor studies, where participants connected their devices to an application and voluntarily shared data with researchers. Data collection occurred between 1999 to 2019. Most studies used one accelerometer (94.2%), but 8 studies (5.2%) used 2 accelerometers and 1 study (0.6%) used 4 accelerometers. Accelerometers were more commonly worn on the hip (48.4%) as compared to the wrist (22.3%), thigh (5.4%), other locations (14.9%), or not reported (9.0%). Overall, 12.7% of the accelerometers collected raw accelerations and 44.6% were worn for 24 hours/day throughout the collection period. The review identified 155 observational studies of adults that collected accelerometry, utilizing a wide range of accelerometer data processing methods. Researchers inconsistently reported key aspects of the process from collection to analysis, which needs addressing to support accurate comparisons across studies.

A hierarchy of correlates for objectively measured physical activity, sedentary time, and physical fitness in older adults: A CHAID analysis

The aging process reflects, in many cases, not only a decline in physical activity (PA) and physical fitness (PF), but also an increase in overall levels of sedentary time (ST). In order to hierarchically identify the most powerful correlates related to low and high levels of objectively assessed PA, ST, and PF during the late adulthood, a total of 2666 older adults were cross-sectionally evaluated. Multidimensional correlates were obtained through interview. Using chi-squared automatic detection analysis to identify the cluster of correlates with most impact on PA (<21.4 min/day), ST (≥8 h/day), and PF (<33.3th percentile), was found that the most likely subgroup to be physically inactive consisted of widowers not owning a computer and sport facilities in the neighbourhood (94.7%), while not being widowed, reporting to have a family that exercises and a computer at home (54.3%) represented the subgroup less likely to be inactive. Widowers without sidewalks in the neighbourhood were the most sedentary group (91.0%), while being a married woman and reporting to have space to exercise at home (40%) formed the most favourable group of correlates regarding ST. Men reporting a financial income <500€ and physical problems frequently formed the group with the lowest PF level (70.3%). In contrast, the less likely subgroup to have low levels of PF level consisted of having a financial income ≥1000€ and a computer at home (3.4%). Future interventions should target widowers with limited accessibility to computer and urban/sport-related infrastructures, as well as impaired older adults with low financial income.HighlightsChi-squared automatic interaction detection was used to identify and hierarchise correlates of objectively measured physical activity, sedentary time, and fitness.Widowers not having a computer at home and sport facilities in the neighbourhood were the most likely to be physically inactive, while not being widowed, having a family that exercises and a computer at home represented the subgroup less likely to be physically inactive.The most likely to be classified as sedentary were widowers without sidewalks in the neighbourhood, while the most favourable group of correlates regarding ST was formed by married women and reporting to have space to exercise at home.Individuals with a low financial income and physical problems comprised the population subgroup with the lowest PF levels, while having a medium-high financial income and a computer at home represented the less likely subgroup to have low levels of PF.

Start with reducing sedentary behavior: A stepwise approach to physical activity counseling in clinical practice

Recently, sedentary behavior recommendations have been included in the public health guidelines of multiple countries, pointing to new opportunities for prevention of chronic disease as well as a potential strategy for initiating long-term behavior change.

OBJECTIVE

To propose an evidence-informed approach to physical activity counseling that starts with a focus on reducing sedentary time.

METHODS

We put forward a case for addressing changes in sedentary behavior in clinical practice using a narrative review. We also propose a new approach for the assessment and counselling of patients with respect to movement behaviors.

RESULTS

There is evidence to support a stepwise approach to physical activity counseling that starts with targeting sedentary behavior, particularly in those who are highly sedentary, or those who have chronic disease, or physical impairments.

CONCLUSIONS

Our approach encourages clinicians to consider sedentary behavior counseling as a critical first step to physical activity counseling. For many patients, this initial step of reducing sedentary behavior could build a pathway to an active lifestyle.

PRACTICAL IMPLICATIONS

A shift from long periods of sedentary time to daily routines incorporating more light intensity physical activity could result in meaningful health improvements. Importantly, this approach may be more feasible for highly inactive patients.

Device-worn measures of sedentary time and physical activity in South Asian adults at high risk for type 2 diabetes in Metro-Vancouver, Canada

Background

South Asians have high incidence of chronic disease. Physical activity (PA) and sedentary time are modifiable risk factors for chronic disease but their assessment in South Asians has been primarily based on self-report. This study presents directly-measured PA and sedentary time in South Asian adults in Canada.

Methods

A subset of 100 South Asian participants from a larger study who were identified at being at a higher risk for type 2 diabetes wore Actical accelerometers for 7 days. Anthropometric measures were taken and socio-demographic factors including age, income, education level, years since immigration, presence of children under the age of 12 years in the household and employment status were self-reported.

Results

Ninety-one participants (mean age 65.6 years) provided valid accelerometer data. Participants accumulated mean 673.5 (95% CI: 656.6, 691.0) min/day sedentary time, 130.5 (95% CI: 117.3, 145.3) min/day light PA (LPA) and 2.3 (95% CI: 1.3, 4.2) min/day moderate-to-vigorous PA (MVPA). For sedentary time and LPA, sex and BMI explained 51% of variability. For MVPA, BMI, season of assessment and employment status explained 23% variability with those who were employed accumulating significantly higher mean min/day of MVPA compared to those who were unemployed; (5.8, 95% CI: 1.5, 21.7) vs (1.5, 95% CI: 5.3, 20.0) respectively.

Conclusion

High sedentary time, and low MVPA indicates the need to focus health promotion efforts on shifting sedentary time into LPA while trying to increase MVPA. Future studies need to be based on larger, representative samples of South Asians.

Development of a Questionnaire to Evaluate Older Adults' Total Sedentary Time and Sedentary Time With Cognitive Activity

This study aimed to develop a questionnaire for evaluating total sedentary time (ST) and ST with cognitive activity, and to examine the association between ST and cognitive function among Japanese older adults. The questionnaire to evaluate ST comprised 12 items regarding behavior in specific settings, including 8 items on ST with cognitive activity, in a usual week. Older adults aged ≥75 years who participated in a health check-up assessing cognitive function completed the developed questionnaire and subsequently wore an accelerometer and recorded a diary of ST with cognitive activity for a week as validity measures. Cognitive function was assessed with neuropsychological tests covering 4 domains: memory, attention, executive function, and processing speed. Fifty-two participants were included in the validity analysis. Spearman's correlation coefficient indicated fair-to-good agreement between the questionnaire-measured and the diary-measured time for ST with cognitive activity (r = 0.59, p < 0.001), but this was not the case for total ST. Bland-Altman plots showed that the questionnaire-measured total ST contained proportional bias (r = 0.51, p < 0.001). Multiple regression analysis (n = 49) showed longer questionnaire-measured ST with cognitive activity was significantly associated with better neuropsychological test scores (attention: β = -0.38, p = 0.025; executive function: β = -0.46, p = 0.003; and processing speed: β = 0.31, p = 0.041), while total ST was not associated with better cognitive performance. The developed questionnaire showed acceptable validity to measure ST with cognitive activity, which was found to be protectively associated with cognitive function.

Prevalence of Physical Activity and Sedentary Behavior Patterns in Generally Healthy European Adults Aged 70 Years and Older—Baseline Results From the DO-HEALTH Clinical Trial

Background

Physical activity (PA) is important for healthy aging and disease prevention whereas sedentary behavior (SB) accelerates health deterioration.

Aim

To investigate activity profiles regarding PA and SB among generally healthy European older adults.

Methods

Meeting PA recommendations was defined as ≥150 min/week of moderate and/or ≥75 min/week of vigorous PA. A cut-off of ≥5.5 h/day was used to define time spent with SB. We present prevalence of PA and SB overall and by sex, age, BMI, and country. We examined correlates with multivariate logistic regression models.

Results

Two thousand one hundred and fifty-five DO-HEALTH participants completed baseline information on activity profiles [mean age 74.9 years (SD 4.5), 61.8% women]. Overall, 62.2% met PA recommendations and overall, 37.1% spent ≥5.5 h/day with SB. Younger participants (70–74 years), men, and those with BMI <25 kg/m² met PA recommendations more often. Per country, prevalence of meeting PA recommendations were: Austria 74.4%, France 51.0%, Germany 65.6%, Portugal 46.5%, and Switzerland 66.7%. Regarding SB, prevalence did not differ in all subgroups. In multivariate logistic regression analyses, being male, younger age, lower MoCA scores, and higher SPPB score were associated with greater odds, whereas higher BMI, more years of education, higher GDS score, and residing in Portugal were associated with lower odds of meeting PA recommendations. High BMI and higher MoCA scores were associated with greater odds of high SB.

Conclusion

Individualized public health efforts may be warranted even in active older adults, as profiles were less favorable in subgroups of older age, female sex and higher BMI.

Factors associated with physical activity reduction in Swedish older adults during the first COVID-19 outbreak: a longitudinal population-based study

Background

Physical activity (PA) decreased during the COVID-19 pandemic, especially among older adults, potentially leading to adverse consequences for their health. However, factors associated with reductions of PA during the pandemic have not been examined in a population-based sample of older adults. Thus, the aim of this study was to explore the association of pre-pandemic physical, mental, social and lifestyle factors with reductions in PA in older adults during the first wave of COVID-19, and whether the associations differed by age and sex.

Methods

A population-based sample of 624 participants aged 65-99 years were identified from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) COVID19 Study. Information on pre-pandemic factors was collected through clinical examinations, interviews, and self-administered questionnaires in 2016-2019. Changes in light and intense PA during the first wave of the pandemic (May-September 2020) were self-reported. Data were analyzed using multiple logistic regression models, stratified by age (<70 vs. >80 years) and sex.

Results

There was an association between pre-pandemic levels of higher depressive symptom burden (Odds Ratio (OR): 2.6, 95% Confidence Interval (CI): 1.1-6.4, <70 years), and impaired balance (OR: 1.7, 95% CI: 1.0-2.8, >80 years old) with reductions in light-intensity PA. Furthermore, the presence of musculoskeletal disease (OR: 1.8, 95% CI: 1.1-2.9, <70 years; OR: 2.3, 95% CI: 1.2-4.4, men), moderate/high levels of neuroticism (OR: 1.6, 95% CI: 1.0-2.6, <70 years; OR: 2.2, 95% CI: 1.3-3.5, women), and poor levels of social support (OR: 2.2, 95% CI: 1.2-4.3, >80 years) were related to reductions in higher-intensity PA. Those who were current smokers (OR: 0.3, 95% CI: 0.1-0.8, <70 years; OR: 0.2, 95% CI: 0.06-0.7, women), or had impaired balance (OR: 0.4, 95% CI: 0.2-0.8, >80 years) were less likely to reduce their levels of higher-intensity PA.

Conclusions

For future pandemics or waves of COVID-19, development of strategies is warranted for older individuals with psychiatric- or physical illness/dysfunction, as well as those with poor social support to counteract reductions in physical activities.

Supplementary Information

The online version contains supplementary material available at 10.1186/s11556-022-00287-z.

Use of daily posture and activity tracking to assess sedentary behavior, toss-and-turns, and sleep duration of independently living Thai seniors

This study examines the postures and activities of elders using activity-monitoring device or diary booklet. The research focuses on using the tracked data to assess sedentary behaviors, toss-and-turns, and sleep duration. Fifty seniors participated in the study for 14 days to obtain anecdotal evidence: half of them wore Sookjai, a motion-tracking device; the other half recorded their activities manually via a diary. The results show that they spent most of their time in the sit/stand posture; they tossed and turned during naps and sleep. Both groups showed a similar pattern of activities: the higher level of sedentary behavior is related to a longer sleep duration. Sedentary behavior and naps increased the number of toss-and-turns at night; toss-and-turns did not affect sleep duration. These independent living adults rated themselves healthy regardless of the extent of their sedentary behaviors or tossing and turning. Although the device did not meet all expectations, the seniors did indicate a positive intention to use wearables.

A recurrent neural network architecture to model physical activity energy expenditure in older people

Through the quantification of physical activity energy expenditure (PAEE), health care monitoring has the potential to stimulate vital and healthy ageing, inducing behavioural changes in older people and linking these to personal health gains. To be able to measure PAEE in a health care perspective, methods from wearable accelerometers have been developed, however, mainly targeted towards younger people. Since elderly subjects differ in energy requirements and range of physical activities, the current models may not be suitable for estimating PAEE among the elderly. Furthermore, currently available methods seem to be either simple but non-generalizable or require elaborate (manual) feature construction steps. Because past activities influence present PAEE, we propose a modeling approach known for its ability to model sequential data, the recurrent neural network (RNN). To train the RNN for an elderly population, we used the growing old together validation (GOTOV) dataset with 34 healthy participants of 60 years and older (mean 65 years old), performing 16 different activities. We used accelerometers placed on wrist and ankle, and measurements of energy counts by means of indirect calorimetry. After optimization, we propose an architecture consisting of an RNN with 3 GRU layers and a feedforward network combining both accelerometer and participant-level data. Our efforts included switching mean to standard deviation for down-sampling the input data and combining temporal and static data (person-specific details such as age, weight, BMI). The resulting architecture produces accurate PAEE estimations while decreasing training input and time by a factor of 10. Subsequently, compared to the state-of-the-art, it is capable to integrate longer activity data which lead to more accurate estimations of low intensity activities EE. It can thus be employed to investigate associations of PAEE with vitality parameters of older people related to metabolic and cognitive health and mental well-being.

Association with Temperature Variability and Physical Activity, Sedentary Behavior, and Sleep in a Free-Living Population

The present study examines the temperature variability in physical activity (PA), sedentary behavior (SB), and sleep in a free-living population. A representative sample of 1235 adults (ages 21–70) from Iowa, U.S.A., wore a SenseWear Mini Armband (SWA) for a randomly assigned day. Koppen’s weather climate classification was used to precisely classify the temperature: cold (−13 to 32 °F), cool (32 to 50 °F), mild (50 to 64 °F), warm (64 to 73 °F), and hot (73 to 95 °F). The main effect of three-way ANOVA (age × gender × temperature) had differences for SB and sleep, with older adults having higher levels than younger adults (p < 0.05). However, moderate to vigorous PA (MVPA) did not vary systematically by age or gender, and contrary to expectations, the main effect of the weather was not significant for MVPA (p > 0.05). Participants spent more time participating in PA at cold than at hot temperatures. The results clarify the impact of temperature on shaping PA and SB patterns in adults. The variable impacts and differential patterns by age suggest that weather should be considered when interpreting differences in PA patterns in research or surveillance applications.

Breaking Sedentary Time Predicts Future Frailty in Inactive Older Adults: A Cross-Lagged Panel Model

BACKGROUND

Cross-sectional evidence exists on the beneficial effects of breaks in sedentary time (BST) on frailty in older adults. Nonetheless, the longitudinal nature of these associations is unknown. This study aimed to investigate the direction and temporal order of the association between accelerometer-derived BST and frailty over time in older adults.

METHODS

This longitudinal study analyzed a total of 186 older adults aged 67-90 (76.7 ± 3.9 years; 52.7% females) from the Toledo Study for Healthy Aging over a 4-year period. Number of daily BST was measured by accelerometry. Frailty was assessed with the Frailty Trait Scale. Multiple cross-lagged panel models were used to test the temporal and reciprocal relationship between BST and frailty.

RESULTS

For those physically inactive (n = 126), our analyses revealed a reciprocal inverse relationship between BST and frailty, such as higher initial BST predicted lower levels of later frailty (standardized regression coefficient [β] = -0.150, 95% confidence interval [CI] = -0.281, -0.018; p < .05); as well as initial lower frailty levels predicted higher future BST (β = -0.161, 95% CI = -0.310, -0.011; p < .05). Conversely, no significant pathway was found in the active participants (n = 60).

CONCLUSIONS

In physically inactive older adults, the relationship between BST and frailty is bidirectional, while in active individuals no associations were found. This investigation provides preliminary longitudinal evidence that breaking-up sedentary time more often reduces frailty in those older adults who do not meet physical activity recommendations. Targeting frequent BST may bring a feasible approach to decrease the burden of frailty among more at-risk inactive older adults.

Association between accelerometer-measured physical activity, glucose metabolism, and waist circumference in older adults

AIMS

To examine the association of physical activity (PA) and sedentary time (ST) with glucose metabolism according to waist circumference (WC) in older people.

METHODS

A population-based sample of 702 individuals (aged 67-70 years) wore wrist-worn accelerometers for two weeks and underwent an oral glucose tolerance test. The associations between moderate-to-vigorous (MVPA) and light (LPA) PA, ST, and glucose metabolism across the tertiles of WC were analysed using general linear regression.

RESULTS

Among highest WC tertile, LPA negatively associated with fasting insulin (β =  - 0.047, 95% CI - 0.082 to - 0.012), HOMA-IR (β =  - 0.098, 95% CI - 0.184 to - 0.012), and HOMA-β (β =  - 3.367, CI - 6.570 to - 0.783). ST associated with 120 min glucose (β = 0.140, CI 0.021 to 0.260). Among lowest WC tertile, MVPA negatively associated with 30 min insulin (β =  - 0.086, 95% CI - 0.168 to - 0.004) and 120 min insulin (β =  - 0.160, 95% CI - 0.257 to - 0.063) and positively associated with Matsuda index (β = 0.076, 95% CI 0.014 to 0.139). Light PA negatively associated with 120 min insulin (β =  - 0.054, 95% CI - 0.104 to - 0.005).

CONCLUSION

With the limitation of the cross-sectional study, reducing ST and increasing LPA may be beneficial for glucose metabolism among abdominally obese older adults. Lean older adults could benefit more from increasing MVPA.

Associations of changes in neighbourhood walkability with changes in walking activity in older adults: a fixed effects analysis

Background

Supporting older adults to engage in physically active lifestyles requires supporting environments. Walkable environments may increase walking activity in older adults, but evidence for this subgroup is scarce, and longitudinal studies are lacking. This study therefore examined whether changes in neighbourhood walkability were associated with changes in walking activity in older adults, and whether this association differed by individual-level characteristics and by contextual conditions beyond the built environment.

Methods

Data from 668 participants (57.8–93.4 years at baseline) across three waves (2005/06, 2008/09 and 2011/12) of the Longitudinal Aging Study Amsterdam (LASA) were used. These individuals did not relocate during follow-up. Self-reported outdoor walking activity in minutes per week was assessed using the LASA Physical Activity Questionnaire. Composite exposure measures of neighbourhood walkability (range: 0 (low)-100 (high)) within 500-m Euclidean buffer zones around each participant’s residential address were constructed by combining objectively measured high-resolution Geographic Information System data on population density, retail and service destination density, land use mix, street connectivity, green space density, and sidewalk density. Fixed effects linear regression analyses were applied, adjusted for relevant time-varying confounders.

Results

Changes in neighbourhood walkability were not statistically significantly associated with changes in walking activity in older adults (β_500m = − 0.99, 95% CI = -6.17–4.20). The association of changes in neighbourhood walkability with changes in walking activity did not differ by any of the individual-level characteristics (i.e., age, sex, educational level, cognitive impairment, mobility disability, and season) and area-level characteristics (i.e., road traffic noise, air pollution, and socioeconomic status).

Conclusions

This study did not show evidence for an association between changes in neighbourhood walkability and changes in walking activity in older adults. If neighbourhood walkability and walking activity are causally linked, then changes in neighbourhood walkability between 2005/06 and 2011/12 might have been not substantial enough to produce meaningful changes in walking activity in older adults.

Endothelial-derived cardiovascular disease-related microRNAs elevated with prolonged sitting pattern among postmenopausal women

Time spent sitting is positively correlated with endothelial dysfunction and cardiovascular disease risk. The underlying molecular mechanisms are unknown. MicroRNAs contained in extracellular vesicles (EVs) reflect cell/tissue status and mediate intercellular communication. We explored the association between sitting patterns and microRNAs isolated from endothelial cell (EC)-derived EVs. Using extant actigraphy based sitting behavior data on a cohort of 518 postmenopausal overweight/obese women, we grouped the woman as Interrupted Sitters (IS; N = 18) or Super Sitters (SS; N = 53) if they were in the shortest or longest sitting pattern quartile, respectively. The cargo microRNA in EC-EVs from the IS and SS women were compared. MicroRNA data were weighted by age, physical functioning, MVPA, device wear days, device wear time, waist circumference, and body mass index. Screening of CVD-related microRNAs demonstrated that miR-199a-5p, let-7d-5p, miR-140-5p, miR-142-3p, miR-133b level were significantly elevated in SS compared to IS groups. Group differences in let-7d-5p, miR-133b, and miR-142-3p were validated in expanded groups. Pathway enrichment analyses show that mucin-type O-glycan biosynthesis and cardiomyocyte adrenergic signaling (P < 0.001) are downstream of the three validated microRNAs. This proof-of-concept study supports the possibility that CVD-related microRNAs in EC-EVs may be molecular transducers of sitting pattern-associated CVD risk in overweight postmenopausal women.

Accelerometer-Measured Daily Step Counts and Adiposity Indicators among Latin American Adults: A Multi-Country Study

The aim of the present study was to examine the sex-related associations between accelerometer-measured daily step counts and adiposity indicators in adults from eight Latin American countries. We analyzed data from 2524 adults (aged 18–65 years) from the Latin American Study of Nutrition and Health. Device-measured daily step counts were measured by accelerometers (ActiGraph GT3X). The outcomes were body mass index (BMI; (kg/m2), waist and neck circumference (in cm). Overall, the mean of daily steps counts, BMI, waist and neck circumference were 10699.8, 27.3, 89.6, and 35.8. Weak and negative associations were observed between daily steps counts and BMI (r = −0.17; p < 0.05) and waist circumference (r = −0.16; p < 0.05); however, step counts was not associated with neck circumference. Daily steps counts were negatively associated with BMI (β: −0.054; 95%CI: −0.077; −0.012) and waist circumference (−0.098; −0.165; −0.030) independently of age and socioeconomic level. In men, there were significant negative associations between daily steps counts with BMI (−0.075; −0.119; −0.031) and waist circumference (−0.140; −0.233; −0.048), and in women, there was no significant association with either of the body composition indicators. The findings from this study need to be examined in prospective settings that use device-measured from Latin America.

An Exploratory Analysis of Accelerometer-Measured Physical Activity and Emotional Functioning in Patients With Chronic Pain

BACKGROUND

Physical activity (PA) can benefit pain and emotional functioning for patients with chronic pain. However, associations between different intensities of PA (moderate-to-vigorous PA, light PA, and sedentary behavior), pain, and emotional functioning are not well understood in patients with chronic pain.

OBJECTIVE

The goals of this study were to (1) describe PA patterns of adult patients with chronic pain using accelerometers and (2) explore preliminary associations between PA intensities, pain, and emotional functioning.

METHODS

Thirteen patients with chronic pain completed self-report measures of pain, cognitive and emotional reactions to pain, depression and anxiety, and wore ActiGraph accelerometers for 1 week before participating in a pilot mind-body PA intervention.

RESULTS

Sedentary behavior and light activity were strongly inversely correlated (r = -0.93, P < 0.01). Greater sedentary behavior was associated with lower pain during activity (r = -0.55, P = 0.05), and greater light activity was correlated with higher pain during activity (r = 0.63, P = 0.02) and pain at rest (r = 0.54, P = 0.06). However, greater moderate-to-vigorous PA was correlated with lower pain at rest (r = -0.66, P = 0.01), pain catastrophizing (r = -0.53, P = 0.06), depression (r = -0.44, P = 0.14), and anxiety (r = -0.57, P = 0.04).

CONCLUSIONS

Objective accelerometer-measured PA has the potential to reveal differential associations between PA intensities, pain, and emotional functioning. Findings here suggest preliminary recommendations to focus on interconnections between moderate-to-vigorous PA, pain at rest, pain catastrophizing, anxiety, and depression for patients with chronic pain.

Accelerometer-Measured Sedentary and Physical Activity Time and Their Correlates in European Older Adults: The SITLESS Study

Background

Sedentary behavior (SB) and physical activity (PA) are important determinants of health in older adults. This study aimed to describe the composition of accelerometer-measured SB and PA in older adults, to explore self-reported context-specific SB, and to assess sociodemographic and functional correlates of engaging in higher levels of SB in participants of a multicenter study including four European countries.

Method

One thousand three hundred and sixty community-dwelling older adults from the SITLESS study (61.8% women; 75.3 ± 6.3 years) completed a self-reported SB questionnaire and wore an ActiGraph accelerometer for 7 days. Accelerometer-determined compositional descriptive statistics were calculated. A fixed-effects regression analysis was conducted to assess the sociodemographic (country, age, sex, civil status, education, and medications) and functional (body mass index and gait speed) correlates.

Results

Older adults spent 78.8% of waking time in SB, 18.6% in light-intensity PA, and 2.6% in moderate-to-vigorous PA. Accelerometry showed that women engaged in more light-intensity PA and walking and men engaged in higher amounts of moderate-to-vigorous PA. Watching television and reading accounted for 47.2% of waking time. Older age, being a man, single, taking more medications, being obese and overweight, and having a slower gait speed were statistically significant correlates of more sedentary time.

Conclusions

The high amount of SB of our participants justifies the need to develop and evaluate interventions to reduce sitting time. A clinically relevant change in gait speed can decrease almost 0.45 percentage points of sedentary time. The distribution of context-specific sedentary activities by country and sex showed minor differences, albeit worth noting.

Levels of Physical Activity Among Older Adults in the European Union

The study aimed to ascertain the levels of older European people's physical activity according to sociodemographic variables. The sample size was 7,893 citizens aged 65 and over from the European Union. The participants were classified as physically inactive, adequately active, or highly active, according to the World Health Organization. The total metabolic equivalents of task minutes per week were also calculated. In the results, 55.5% of older people were adequately active, and 43.8% were highly active, especially in the North and West. The average metabolic equivalents of task minutes per week was 1,313 metabolic equivalents of task minutes, with walking as the main activity, followed by moderate physical activity and vigorous activity. Male older people of a lower age from the North and West, with a higher level of education and less difficulty in paying bills, were more likely to be physically active. As a conclusion, only slightly more than half the population were adequately active. These sociodemographic inequalities show the necessity of implementing specific measures.

Energy intake and expenditure in patients with Alzheimer's disease and mild cognitive impairment: the NUDAD project

Background

Malnutrition is common in patients with Alzheimer’s disease (AD) dementia and mild cognitive impairment (MCI) and is associated with institutionalization and increased mortality. Malnutrition is the result of a negative energy balance, which could be due to reduced dietary intake and/or higher energy expenditure. To study underlying mechanisms for malnutrition, we investigated dietary intake and resting energy expenditure (REE) of patients with AD dementia, MCI, and controls. In addition, we studied associations of global cognition (Mini-Mental State Examination (MMSE)) and AD biomarkers with dietary intake and REE.

Methods

We included 219 participants from the NUDAD project, 71 patients with AD dementia (age 68 ± 8 years, 58% female, MMSE 24 ± 3), 52 with MCI (67 ± 8 years, 42% female, MMSE 26 ± 2), and 96 controls (62 ± 7 years, 52% female, MMSE 28 ± 2). We used a 238-item food frequency questionnaire to assess dietary intake (energy, protein, carbohydrate, and fat). In a subgroup of 92 participants (30 patients with AD dementia, 22 with MCI, and 40 controls) we measured REE with indirect calorimetry. Between-group differences in dietary intake and REE were tested with ANOVAs. In the total sample, linear regression analyses were used to explore potential associations of MMSE score and AD biomarkers with dietary intake and REE. All analyses were adjusted for age, sex, education, and body mass index or fat-free mass.

Results

Patients with AD dementia and MCI did not differ from controls in total energy intake (1991 ± 71 and 2172 ± 80 vs 2022 ± 61 kcal/day, p > 0.05) nor in protein, carbohydrate, or fat intake. Patients with AD dementia and MCI had a higher REE than controls (1704 ± 41 and 1754 ± 47 vs 1569 ± 34 kcal/day, p < 0.05). We did not find any association of MMSE score or AD biomarkers with dietary intake or REE.

Conclusions

We found a higher REE, despite similar energy intake in patients with AD and MCI compared to controls. These findings suggest that elevated metabolism rather than reduced energy intake explains malnutrition in AD. These results could be useful to optimize dietary advice for patients with AD dementia and MCI.

Application of Activity Trackers among Nursing Home Residents-A Pilot and Feasibility Study on Physical Activity Behavior, Usage Behavior, Acceptance, Usability and Motivational Impact

The aim of this study was to assess physical activity and sedentary behavior, as well as the usage behavior, usability, acceptance, and motivational impact of an applied activity tracker among nursing home residents. Physical activity and usage behavior were measured among 22 residents (68 to 102 years) by use of a commercial activity tracker worn during waking hours for 77 days on average. Usability, acceptance, and motivational impact of the tracker were examined using an adapted questionnaire. Participants walked, on average, 1007 ± 806 steps per day and spent, on average, more than 9 h (77.2% of their waking time) sedentary. The average steps/day increased significantly within the first five weeks of wearing the activity tracker. The acceptance rate was high (94.4%). The tracker was used for 65.4% of the individual study period, and usage behavior did not significantly change during the first five wearing weeks. Participants with a usage time of ≥50% walked significantly more steps per day than those with a lower usage. Overall, we were able to reveal that the residents were highly inactive and sedentary. The results support the feasibility of a long-term application of activity trackers to assess or even increase physical activity behavior.

Device-measured sedentary behavior and physical activity in older adults differ by demographic and health-related factors

Background

Our aim was to describe and explore older adults' device-measured sedentary behavior and physical activity (PA) pattern by sex, age, education, marital status, body mass index, and physical function; and to assess agreement regarding fulfillment of PA recommendations, i.e. 150 min/week of moderate-to-vigorous intensity PA (MVPA), between device-measured and self-reported PA.

Method

We included 656 older adults (64% women), aged 66, 81-87 or ≥ 90 years from a Swedish population-based cohort study. The activPAL3 accelerometer provided information on sedentary behavior (sedentary time, sedentary bouts, sit-to-stand transitions) and PA. Stepping ≥100 steps/min was considered MVPA; standing and stepping < 100 steps/min were considered light-intensity PA (LPA). Self-reported PA was compared with min/week in MVPA and steps/day.

Results

On average, 60% of wear time was spent sedentary, 36% in LPA, and 4% in MVPA. Relative to men, women, had significantly (p < 0.05) more sit-to-stand transitions, spent 33 min/day less sedentary and 27 min/day more in LPA, and were more likely to report meeting PA recommendations, but showed no difference in steps/day, MVPA, or sedentary bout duration. Older age was associated with more sedentary time, lower MVPA and fewer steps/day. The prevalence of meeting PA recommendations was 59% device-measured and 88% by self-report with limited agreement between methods (Cohen's Kappa = 0.21, Spearman's rho = 0.28). Age differences were much more pronounced with objective measures than by self-report.

Conclusions

We found significant sex differences in sedentary behavior and time in LPA in older adults, but not in MVPA, in contrast to previous findings. Sedentary time increased with age, with small differences in accumulation pattern. MVPA time was lower with older age, obesity, and poor physical function. A majority of the participants > 80 years did not meet the PA recommendations. Given the strong relationships between sedentary behavior, PA and health in older adults, programs are needed to address these behaviors. Agreement between device-measured and self-reported fulfillment of PA recommendations was limited. Device-based measurement adds value to PA studies, providing richer and different data than self-report.

Impact of dopamine-related genetic variants on physical activity in old age - a cohort study

OBJECTIVES

The beneficial effects of a physically active lifestyle in aging are well documented. Understanding the factors of importance for physical activity in older adults are therefore essential. Informed by animal and human data linking the dopamine system to motivation and reward processes, we investigated the associations between variations in dopamine genes and objectively measured physical activity and sedentary behaviour. Further, we aimed to verify whether higher age may exacerbate the impact of dopamine genes on physical activity.

METHODS

We analyzed data from 504 older adults, 66-87 years, from the population-based Swedish National study on Aging and Care in Kungsholmen (SNAC-K). Physical activity was measured with activPAL accelerometers and DNA was extracted from blood samples for genotyping. We assessed the effects of three dopamine relevant genetic variations (DRD1, DRD2, and DRD3) on daily time in sedentary behavior, light-intensity physical activity and moderate-to-vigorous physical activity using analyses of covariance, adjusting for sex, age and physical function.

RESULTS

Higher dopamine receptor efficacy was related to moderate-to-vigorous physical activity, but not to light-intensity physical activity or sedentary time. DRD1 explained 2.7% of variance in moderate-to-vigorous physical activity, with more pronounced effect in people aged ≥80 years, about 10% of explained variance.

CONCLUSION

Stronger genetic effects in older adults are in line with the well-established nonlinear effects of dopamine signaling on performance, expected to be exacerbated with aging. Individuals over 80 years, genetically predisposed to lower dopamine receptor efficacy, engaged on average 100 min/week in moderate-to-high physical activity, below the recommended levels beneficial for healthy aging. Our findings highlight that some individuals might need extra support to maintain a physically active lifestyle.

Movement behavior remains stable in stroke survivors within the first two months after returning home

BACKGROUND AND PURPOSE

The aim of this study is to investigate changes in movement behaviors, sedentary behavior and physical activity, and to identify potential movement behavior trajectory subgroups within the first two months after discharge from the hospital to the home setting in first-time stroke patients.

METHODS

A total of 140 participants were included. Within three weeks after discharge, participants received an accelerometer, which they wore continuously for five weeks to objectively measure movement behavior outcomes. The movement behavior outcomes of interest were the mean time spent in sedentary behavior (SB), light physical activity (LPA) and moderate to vigorous physical activity (MVPA); the mean time spent in MVPA bouts ≥ 10 minutes; and the weighted median sedentary bout. Generalized estimation equation analyses were performed to investigate overall changes in movement behavior outcomes. Latent class growth analyses were performed to identify patient subgroups of movement behavior outcome trajectories.

RESULTS

In the first week, the participants spent an average, of 9.22 hours (67.03%) per day in SB, 3.87 hours (27.95%) per day in LPA and 0.70 hours (5.02%) per day in MVPA. Within the entire sample, a small but significant decrease in SB and increase in LPA were found in the first weeks in the home setting. For each movement behavior outcome variable, two or three distinctive subgroup trajectories were found. Although subgroup trajectories for each movement behavior outcome were identified, no relevant changes over time were found.

CONCLUSION

Overall, the majority of stroke survivors are highly sedentary and a substantial part is inactive in the period immediately after discharge from hospital care. Movement behavior outcomes remain fairly stable during this period, although distinctive subgroup trajectories were found for each movement behavior outcome. Future research should investigate whether movement behavior outcomes cluster in patterns.

Movement Behavior Patterns in People With First-Ever Stroke

Supplemental Digital Content is available in the text.

Movement behaviors, that is, both physical activity and sedentary behavior, are independently associated with health risks. Although both behaviors have been investigated separately in people after stroke, little is known about the combined movement behavior patterns, differences in these patterns between individuals, or the factors associated with these patterns. Therefore, the objectives of this study are (1) to identify movement behavior patterns in people with first-ever stroke discharged to the home setting and (2) to explore factors associated with the identified patterns.