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De Luca V, Femminella GD, Patalano R, Formosa V, Lorusso G, Rivetta C, Di Lullo F, Mercurio L, Rea T, Salvatore E, Korkmaz Yaylagul N, Apostolo J, Silva RC, Dantas C, van Staalduinen WH, Liotta G, Iaccarino G, Triassi M, Illario M. Assessment Tools of Biopsychosocial Frailty Dimensions in Community-Dwelling Older Adults: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16050. [PMID: 36498125 PMCID: PMC9739796 DOI: 10.3390/ijerph192316050] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/21/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
Frailty is a complex interplay between several factors, including physiological changes in ageing, multimorbidities, malnutrition, living environment, genetics, and lifestyle. Early screening for frailty risk factors in community-dwelling older people allows for preventive interventions on the clinical and social determinants of frailty, which allows adverse events to be avoided. By conducting a narrative review of the literature employing the International Narrative Systematic Assessment tool, the authors aimed to develop an updated framework for the main measurement tools to assess frailty risks in older adults, paying attention to use in the community and primary care settings. This search focused on the biopsychosocial domains of frailty that are covered in the SUNFRAIL tool. The study selected 178 reviews (polypharmacy: 20; nutrition: 13; physical activity: 74; medical visits: 0; falls: 39; cognitive decline: 12; loneliness: 15; social support: 5; economic constraints: 0) published between January 2010 and December 2021. Within the selected reviews, 123 assessment tools were identified (polypharmacy: 15; nutrition: 15; physical activity: 25; medical visits: 0; falls: 26; cognitive decline: 18; loneliness: 9; social support: 15; economic constraints: 0). The narrative review allowed us to evaluate assessment tools of frailty domains to be adopted for multidimensional health promotion and prevention interventions in community and primary care.
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Affiliation(s)
- Vincenzo De Luca
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Grazia Daniela Femminella
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Roberta Patalano
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Valeria Formosa
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Grazia Lorusso
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Cristiano Rivetta
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Federica Di Lullo
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Lorenzo Mercurio
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Teresa Rea
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Elena Salvatore
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | | | - Joao Apostolo
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Avenida Bissaya Barreto, 3004-011 Coimbra, Portugal
| | - Rosa Carla Silva
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Avenida Bissaya Barreto, 3004-011 Coimbra, Portugal
| | | | | | - Giuseppe Liotta
- Dipartimento di Biomedicina e Prevenzione, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Guido Iaccarino
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Maria Triassi
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Maddalena Illario
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
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Tatah L, Pearce M, Goel R, Brage S, Woodcock J, Dake FAA. Physical Activity Behaviour and Comparison of GPAQ and Travel Diary Transport-Related Physical Activity in Accra, Ghana. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7346. [PMID: 35742612 PMCID: PMC9224181 DOI: 10.3390/ijerph19127346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 01/27/2023]
Abstract
There is a lack of data on physical activity (PA), active travel, and the comparison of measurement instruments in low-resource settings. The objective of this paper is to describe PA behaviour and the agreement of walking estimates from the Global Physical Activity Questionnaire (GPAQ) and the travel diary in a low-resource setting. We used a cross-sectional survey design to capture data from the residents of Accra (Ghana) between May 2020 and March 2021. Of the 863 participants aged 15+ years, 65% were females, and 86% reported PA. The median weekly PA was 18 (interquartile range: 5-75) metabolic equivalent of task hours, with 50% of females and 37% of males achieving low PA levels. In the GPAQ, 80% of participants reported weekly walking; the mean number of days walked was 3.8 (standard deviation (SD): 2.5); hence, 54% of participants reported walking on any day, and the mean daily walking duration was 51 (SD: 82) minutes. In the diary, 56% of participants reported walking for over 24 h, with a mean walking duration of 31 (SD: 65) minutes. The correlation of walking duration between instruments was weak (rho: 0.31; 95% Confidence Interval: 0.25-0.37); the mean bias was 20 min, with GPAQ estimates being 0.1 to 9 times higher than diary estimates. We concluded that low PA is prevalent in Accra, and while the travel diary and GPAQ estimate similar walking prevalence, their walking duration agreement is poor. We recommend accompanying PA questionnaires with objective measures for calibration.
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Affiliation(s)
- Lambed Tatah
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0SL, UK; (M.P.); (S.B.); (J.W.)
| | - Matthew Pearce
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0SL, UK; (M.P.); (S.B.); (J.W.)
| | - Rahul Goel
- Transportation Research and Injury Prevention Centre, Indian Institute of Technology Delhi, Hauz Khas, New Delhi 110 016, India;
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0SL, UK; (M.P.); (S.B.); (J.W.)
| | - James Woodcock
- MRC Epidemiology Unit, University of Cambridge, Cambridge CB2 0SL, UK; (M.P.); (S.B.); (J.W.)
| | - Fidelia A. A. Dake
- Regional Institute for Population Studies, The University of Ghana, Legon, Accra P.O. Box LG 96, Ghana;
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Current Evidence of Measurement Properties of Physical Activity Questionnaires for Older Adults: An Updated Systematic Review. Sports Med 2021; 50:1271-1315. [PMID: 32125670 PMCID: PMC7305082 DOI: 10.1007/s40279-020-01268-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Questionnaires provide valuable information about physical activity (PA) behaviors in older adults. Until now, no firm recommendations for the most qualified questionnaires for older adults have been provided. OBJECTIVES This review is an update of a previous systematic review, published in 2010, and aims to summarize, appraise and compare the measurement properties of all available self-administered questionnaires assessing PA in older adults. METHODS We included the articles evaluated in the previous review and conducted a new search in PubMed, Embase, and SPORTDiscus from September 2008 to December 2019, using the following inclusion criteria (1) the purpose of the study was to evaluate at least one measurement property (reliability, measurement error, hypothesis testing for construct validity, responsiveness) of a self-administered questionnaire; (2) the questionnaire intended to measure PA; (3) the questionnaire covered at least one domain of PA; (4) the study was performed in the general, healthy population of older adults; (5) the mean age of the study population was > 55 years; and (6) the article was published in English. Based on the Quality Assessment of Physical Activity Questionnaires (QAPAQ) checklist, we evaluated the quality and results of the studies. The content validity of all included questionnaires was also evaluated using the reviewers' rating. The quality of the body of evidence was evaluated for the overall construct of each questionnaire (e.g., total PA), moderate-to-vigorous physical activity (MVPA) and walking using a modified Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. RESULTS In total, 56 articles on 40 different questionnaires (14 from the previous review and 26 from the update) were included. Reliability was assessed for 22, measurement error for four and hypotheses testing for construct validity for 38 different questionnaires. Evidence for responsiveness was available for one questionnaire. For many questionnaires, only one measurement property was assessed in only a single study. Sufficient content validity was considered for 22 questionnaires. All questionnaires displayed large measurement errors. Only versions of two questionnaires showed both sufficient reliability and hypotheses testing for construct validity, namely the Physical Activity Scale for the Elderly (PASE; English version, Turkish version) for the assessment of total PA, and the Physical Activity and Sedentary Behavior Questionnaire (PASB-Q; English version) for the assessment of MVPA. The quality of evidence for these results ranged from very low to high. CONCLUSIONS Until more high-quality evidence is available, we recommend the PASE for measuring total PA and the PASB-Q for measuring MVPA in older adults. However, they are not equally qualified among different languages. Future studies on the most promising questionnaires should cover all relevant measurement properties. We recommend using and improving existing PA questionnaires-instead of developing new ones-and considering the strengths and weaknesses of each PA measurement instrument for a particular purpose.
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Burzynska AZ, Voss MW, Fanning J, Salerno EA, Gothe NP, McAuley E, Kramer AF. Sensor-measured sedentariness and physical activity are differentially related to fluid and crystallized abilities in aging. Psychol Aging 2020; 35:1154-1169. [PMID: 32969693 PMCID: PMC8415093 DOI: 10.1037/pag0000580] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Aerobic exercise and physical activity (PA) are known to benefit cognition in adulthood. However, a typical older adult spends most of the day sedentary or in light PA, behaviors that are typically poorly captured by questionnaires. To better understand the associations between time spent in different intensities of lifestyle PA and cognition, we measured average time spent daily in sedentariness, light, and moderate to vigorous PA using hip-worn sensors (ActiGraph accelerometers). We studied baseline data from 228 cognitively normal adults (Age 60-80) who took part in a clinical trial (clinical study identifier: NCT01472744). Fluid (processing speed, memory, and reasoning) and crystallized abilities (vocabulary knowledge) were assessed with the Virginia Cognitive Aging Battery. Adjusting for age, sex, and several modifiable socioeconomic, physical and functional health factors, time spent daily in moderate to vigorous PA was positively related with fluid abilities (perceptual speed and reasoning). Furthermore, we found that those spending more time sedentary performed better on vocabulary knowledge and reasoning tasks. In contrast, time spent in light PA was not related to either fluid or crystallized abilities. Our results add to the previous literature by providing the first sensor-based evidence that crystallized and fluid abilities in older age may be associated with engagement in different intensities of daily activity. Moreover, our findings suggest that the behavior of moderate to vigorous PA is at least as important in relation to cognition as the desirable long-term physiological effects of higher intensity PA and exercise. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Agnieszka Z Burzynska
- Department of Human Development and Family Studies/Molecular, Cellular and Integrative Neurosciences
| | | | - Jason Fanning
- Department of Internal Medicine and Health and Exercise Sciences
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Cajamarca G, Herskovic V, Rossel PO. Enabling Older Adults' Health Self-Management through Self-Report and Visualization-A Systematic Literature Review. SENSORS (BASEL, SWITZERLAND) 2020; 20:E4348. [PMID: 32759801 PMCID: PMC7436010 DOI: 10.3390/s20154348] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/25/2020] [Accepted: 07/26/2020] [Indexed: 12/15/2022]
Abstract
Aging is associated with a progressive decline in health, resulting in increased medical care and costs. Mobile technology may facilitate health self-management, thus increasing the quality of care and reducing costs. Although the development of technology offers opportunities in monitoring the health of older adults, it is not clear whether these technologies allow older adults to manage their health data themselves. This paper presents a review of the literature on mobile health technologies for older adults, focusing on whether these technologies enable the visualization of monitored data and the self-reporting of additional information by the older adults. The systematic search considered studies published between 2009 and 2019 in five online databases. We screened 609 articles and identified 95 that met our inclusion and exclusion criteria. Smartphones and tablets are the most frequently reported technology for older adults to enter additional data to the one that is monitored automatically. The recorded information is displayed on the monitoring device and screens of external devices such as computers. Future designs of mobile health technology should allow older users to enter additional information and visualize data; this could enable them to understand their own data as well as improve their experience with technology.
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Affiliation(s)
- Gabriela Cajamarca
- Department of Computer Science, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile;
| | - Valeria Herskovic
- Department of Computer Science, Pontificia Universidad Católica de Chile, Santiago 7820436, Chile;
| | - Pedro O. Rossel
- Department of Computer Science, Universidad Católica de la Santísima Concepción, Concepción 4090541, Chile;
- Centro de Investigación en Biodiversidad y Ambientes Sustentables (CIBAS), Universidad Católica de la Santísima Concepción, Concepción 4090541, Chile
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Hamer M, O'Donovan G, Batty GD, Stamatakis E. Estimated cardiorespiratory fitness in childhood and cardiometabolic health in adulthood: 1970 British Cohort Study. Scand J Med Sci Sports 2020; 30:932-938. [PMID: 32037646 PMCID: PMC7187251 DOI: 10.1111/sms.13637] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/22/2020] [Accepted: 02/04/2020] [Indexed: 12/01/2022]
Abstract
Background Associations of cardiorespiratory fitness in childhood and adulthood with adult cardiometabolic risk factors are poorly understood, not least because of the paucity of studies. Objectives We investigated associations between nonexercise testing cardiorespiratory fitness (NETCRF) in childhood/adulthood and cardiometabolic risk factors in adulthood. Methods Based on an established algorithm comprising gender, age, body mass index, resting heart rate, and self‐reported physical activity at age 10, we computed NETCRF. Risk factors were assessed at age 46 in 5009 participants when NETCRF was again calculated. Linear regression was used to summarize associations between NETCRF in childhood and risk factors in adulthood and, additionally, the relationship between NETCRF in adulthood and risk factors in adulthood after adjusting for childhood NETCRF. Results Inconsistent associations were observed between childhood NETCRF and adult risk factors. NETCRF in adulthood was associated with blood pressure [−5.8 (−6.7, −4.9)], glycated hemoglobin [−3.41 (−4.06, −2.76)], total cholesterol [−0.16 (−0.24, −0.08)], HDL cholesterol [0.19 (0.16, 0.22)], triglycerides [−0.68 (−0.85, −0.50)], and C‐reactive protein [−0.29 (−0.35, −0.22)] in adult males. Similar associations were observed in adult females. Compared to those with low estimated fitness in both childhood and adulthood, participants with low fitness in childhood and high fitness in adulthood had a lower risk of two or more cardiometabolic risk factors (odds ratio: 0.25; 95% confidence interval: 0.19, 0.31). Conclusion Associations between estimated fitness and risk factors are stronger in adulthood than from childhood to adulthood. Adults with previously sedentary childhoods may still gain benefits from improving their fitness.
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Affiliation(s)
- Mark Hamer
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, Institute Sport Exercise Health, University College London, London, UK
| | - Gary O'Donovan
- Facultad de Medicina, Universidad de los Andes, Bogotá, Colombia
| | - G David Batty
- Department of Epidemiology & Public Health, University College London, London, UK.,School of Biological & Population Health Sciences, Oregon State University, Corvallis, OR, USA
| | - Emmanuel Stamatakis
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.,School of Public Health, Prevention Research Collaboration, The University of Sydney, Sydney, NSW, Australia
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Muthuri SG, Ward KA, Kuh D, Elhakeem A, Adams JE, Cooper R. Physical Activity Across Adulthood and Bone Health in Later Life: The 1946 British Birth Cohort. J Bone Miner Res 2019; 34:252-261. [PMID: 30347128 PMCID: PMC6392181 DOI: 10.1002/jbmr.3607] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 09/11/2018] [Accepted: 10/09/2018] [Indexed: 12/29/2022]
Abstract
Leisure-time physical activity (LTPA) is widely recommended for the prevention of osteoporosis and fractures in older populations. However, whether the beneficial effects of LTPA on bone accumulate across life and are maintained even after reduction or cessation of regular PA in later life is unknown. We examined whether LTPA across adulthood was cumulatively associated with volumetric and areal bone mineral density (vBMD, aBMD) at ages 60 to 64 and whether associations were mediated by lean mass. Up to 1498 participants from the Medical Research Council National Survey of Health and Development were included in analyses. LTPA was self-reported at ages 36, 43, 53, and 60 to 64, and responses summed to generate a cumulative score (range 0 = inactive at all four ages to 8 = most active at all four ages). Total and trabecular vBMD were measured at the distal radius using pQCT and aBMD at the total hip and lumbar spine (L1 to L4) using DXA. Linear regression was used to test associations of the cumulative LTPA score with each bone outcome. After adjustment for height and weight, a 1-unit increase in LTPA score (95% CI) in men was associated with differences of 1.55% (0.78% to 2.31%) in radial trabecular vBMD, 0.83% (0.41% to 1.25%) in total hip aBMD, and 0.97% (0.44% to 1.49%) in spine aBMD. Among women, positive associations were seen for radial trabecular vBMD and total hip aBMD, but only among those of greater weight (LTPA × weight interaction p ≤ 0.01). In men, there was evidence to suggest that lean mass index may partly mediate these associations. These findings suggest that there are cumulative benefits of LTPA across adulthood on BMD in early old age, especially among men. The finding of weaker associations among women suggests that promotion of specifıc types of LTPA may be needed to benefit bone health in women. © 2018 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals, Inc.
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Affiliation(s)
| | - Kate A Ward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,MRC Nutrition and Bone Health Research Group, Cambridge, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Ahmed Elhakeem
- MRC Integrative Epidemiology Unit at University of Bristol, Bristol, UK
| | - Judith E Adams
- Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, Manchester, UK
| | - Rachel Cooper
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
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De La Cámara MÁ, Higueras-Fresnillo S, Cabanas-Sánchez V, Martinez-Gomez D, Veiga OL. Criterion-related validity of self-report walking time from the EPIC questionnaire in older adults. J Sports Sci 2018; 37:1080-1087. [PMID: 30449248 DOI: 10.1080/02640414.2018.1544185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Tools for measuring walking time make use of objective and subjective methods. One subjective approach is to administer physical activity questionnaires (PAQ), mainly because they are inexpensive and easy to give to large groups. The European Prospective Investigation into Cancer and Nutrition (EPIC) study has a brief PAQ (EPIC-PAQ) and includes one question referencing walking time. The objective of this study was to assess the validity of the question about time spent walking included in the EPIC-PAQ. The sample included 200 older adults (113 women). To assess daily walking time, participants responded to the EPIC-PAQ in an interview and wore a portable gait analysis system and physical activity monitor for 48 consecutive hours in free-living condition. Results indicated that the mean of bias between the EPIC-PAQ and objetive measurement was -64.6 min/day. Also, the correlation was low compared to an objective measurement (rho = 0.196) and was positively correlated with the time spent at speeds below 2.5 mph but the correlation was low (slow walking rho = 0.154 and pace walking rho = 0.163). The EPIC-PAQ shows low correlations with the objective measurement of walking time, that suggests it may be inaccurate and affecting the estimate of the EPIC-PAQ's PA energy expenditure in this age group.
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Affiliation(s)
- M Á De La Cámara
- a Department of Physical Education, Sport and Human Movement, Faculty of Teacher Training and Education , Autonomous University of Madrid , Madrid , Spain
| | - S Higueras-Fresnillo
- a Department of Physical Education, Sport and Human Movement, Faculty of Teacher Training and Education , Autonomous University of Madrid , Madrid , Spain
| | - V Cabanas-Sánchez
- a Department of Physical Education, Sport and Human Movement, Faculty of Teacher Training and Education , Autonomous University of Madrid , Madrid , Spain
| | - D Martinez-Gomez
- a Department of Physical Education, Sport and Human Movement, Faculty of Teacher Training and Education , Autonomous University of Madrid , Madrid , Spain.,b IMDEA Food Institute , CEI UAM + CSIC , Madrid , Spain
| | - O L Veiga
- a Department of Physical Education, Sport and Human Movement, Faculty of Teacher Training and Education , Autonomous University of Madrid , Madrid , Spain
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Elhakeem A, Hardy R, Bann D, Kuh D, Cooper R. Motor performance in early life and participation in leisure-time physical activity up to age 68 years. Paediatr Perinat Epidemiol 2018; 32:327-334. [PMID: 29664176 PMCID: PMC6099324 DOI: 10.1111/ppe.12467] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study examined associations between motor performance in early life and leisure-time physical activity (LTPA) participation across adulthood, and whether these changed with age. METHODS Data were from 2526 participants from the Medical Research Council National Survey of Health and Development. Motor indicators were mother-reported ages at first standing and walking, teacher-rated games ability at age 13, and finger- and foot-tapping speed at age 15. LTPA was reported at ages 36, 43, 53, 60-64, and 68 years and classed at each age as none, moderate (1-4/mo), or regular (≥5/mo). Associations were examined using mixed-effects Poisson regression models with robust error variance. RESULTS Better ability at games and faster tapping speed were associated with more frequent participation in LTPA across adulthood, for example, fully adjusted relative risk of regular LTPA across adulthood (vs none) for above-average ability (vs below average or average) = 1.46 (95% CI 1.32, 1.61); and per 10-unit higher number of finger-taps/15 seconds = 1.04 (95% CI 1.02, 1.07). These associations did not vary by age (P ≥ .33 for interactions with age at LTPA). Ages at reaching motor milestones were not associated with LTPA (eg, fully adjusted relative risk of regular LTPA across adulthood for walking ≤10 and ≥18 months (vs 11-17 months) were 1.01 (95% CI 0.86, 1.20) and 0.89 (95% CI 0.75, 1.06) respectively. CONCLUSIONS Better ability at games and faster tapping speed in adolescence were associated with greater participation in LTPA throughout adult life; from age 36 up to age 68. Childhood motor skill interventions may therefore have the potential to promote lifelong LTPA.
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Affiliation(s)
- Ahmed Elhakeem
- MRC Unit for Lifelong Health and Ageing at UCLLondonUK,MRC Integrative Epidemiology Unit at University of BristolBristolUK
| | - Rebecca Hardy
- MRC Unit for Lifelong Health and Ageing at UCLLondonUK
| | - David Bann
- Centre for Longitudinal StudiesUCL Institute of EducationLondonUK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCLLondonUK
| | - Rachel Cooper
- MRC Unit for Lifelong Health and Ageing at UCLLondonUK
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Criterion-related validity of self-reported stair climbing in older adults. Aging Clin Exp Res 2018; 30:199-203. [PMID: 28417243 DOI: 10.1007/s40520-017-0761-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 04/10/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Stair climbing is an activity of daily living that might contribute to increase levels of physical activity (PA). To date, there is no study examining the validity of climbing stairs assessed by self-report. The aim of this study was, therefore, to examine the validity of estimated stair climbing from one question included in a common questionnaire compared to a pattern-recognition activity monitor in older adults. METHODS A total of 138 older adults (94 women), aged 65-86 years (70.9 ± 4.7 years), from the IMPACT65 + study participated in this validity study. Estimates of stair climbing were obtained from the European Prospective Investigation into Cancer and Nutrition (EPIC) PA questionnaire. An objective assessment of stair climbing was obtained with the Intelligent Device for Energy Expenditure and Activity (IDEEA) monitor. RESULTS The correlation between both methods to assess stair climbing was fair (ρ = 0.22, p = 0.008 for PA energy expenditure and ρ = 0.26, p = 0.002 for duration). Mean differences between self-report and the IDEEA were 7.96 ± 10.52 vs. 9.88 ± 3.32 METs-min/day for PA energy expenditure, and 0.99 ± 1.32 vs. 1.79 ± 2.02 min/day for duration (both Wilcoxon test p < 0.001). Results from the Bland-Altman analysis indicate that bias between both instruments were -1.91 ± 10.30 METs-min/day and -0.80 ± 1.99 min/day, and corresponding limits of agreement for the two instruments were from 18.27 to -22.10 METs-min/day and from 3.09 to -4.70 min/day, respectively. CONCLUSION Our results indicate that self-reported stair climbing has modest validity to accurately rank old age participants, and underestimates both PAEE and its duration, as compared with an objectively measured method.
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Koolhaas CM, van Rooij FJ, Cepeda M, Tiemeier H, Franco OH, Schoufour JD. Physical activity derived from questionnaires and wrist-worn accelerometers: comparability and the role of demographic, lifestyle, and health factors among a population-based sample of older adults. Clin Epidemiol 2017; 10:1-16. [PMID: 29296097 PMCID: PMC5739112 DOI: 10.2147/clep.s147613] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Agreement between questionnaires and accelerometers to measure physical activity (PA) differs between studies and might be related to demographic, lifestyle, and health characteristics, including disability and depressive symptoms. Methods We included 1,410 individuals aged 51–94 years from the population-based Rotterdam Study. Participants completed the LASA Physical Activity Questionnaire and wore a wrist-worn accelerometer on the nondominant wrist for 1 week thereafter. We compared the Spearman correlation and disagreement (level and direction) for total PA across levels of demographic, lifestyle, and health variables. The level of disagreement was defined as the absolute difference between questionnaire- and accelerometer-derived PA, whereas the direction of disagreement was defined as questionnaire PA minus accelerometer PA. We used linear regression analyses with the level and direction of disagreement as outcome, including all demographic, lifestyle, and health variables in the model. Results We observed a Spearman correlation of 0.30 between questionnaire- and accelerometer-derived PA in the total population. The level of disagreement (ie, absolute difference) was 941.9 (standard deviation [SD] 747.0) minutes/week, and the PA reported by questionnaire was on average 529.4 (SD 1,079.5) minutes/week lower than PA obtained by the accelerometer. The level of disagreement decreased with higher educational levels. Additionally, participants with obesity, higher disability scores, and more depressive symptoms underestimated their self-reported PA more than their healthier counterparts. Conclusion We observed large differences in PA time derived from the LASA Physical Activity Questionnaire and the wrist-worn accelerometer. Differences between the methods were related to body-mass index, level of disability, and presence of depressive symptoms. Future studies using questionnaires and/or accelerometers should account for these differences.
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Affiliation(s)
- Chantal M Koolhaas
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Frank Ja van Rooij
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Magda Cepeda
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Josje D Schoufour
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
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12
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Elhakeem A, Murray ET, Cooper R, Kuh D, Whincup P, Hardy R. Leisure-time physical activity across adulthood and biomarkers of cardiovascular disease at age 60-64: A prospective cohort study. Atherosclerosis 2017; 269:279-287. [PMID: 29180005 PMCID: PMC5825380 DOI: 10.1016/j.atherosclerosis.2017.11.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 11/09/2017] [Accepted: 11/16/2017] [Indexed: 12/12/2022]
Abstract
Background and aims This study examined associations between leisure-time physical activity (LTPA) across adulthood (from age 36) and cardiovascular disease (CVD) biomarkers at age 60–64. Methods LTPA was reported by study participants from the MRC National Survey of Health and Development at ages 36, 43, 53 and 60–64 (n = 1754) and categorised as inactive, moderately active (1–4/month) or most active (5+/month) at each age. Linear regression was used to examine associations between a cumulative adulthood LTPA score (range = 0–8), and change in LTPA between ages 36 and 60–64 (i.e. always inactive, became inactive, became active, always active) and inflammatory [C-reactive protein (CRP), interleukin-6 (IL-6)], endothelial [tissue-Plasminogen Activator (t-PA), E-selectin] and adipokine [leptin, adiponectin] measures extracted from overnight fasting blood samples at age 60–64. Results The more active a participant was over adulthood, the better their biomarker profile, e.g. fully-adjusted difference in t-PA (both sexes) and adiponectin (women) per unit increase in the LTPA score (95% confidence interval) = −2.2% (−3.6; −0.8) and 2.0% (0.2; 3.8). Those that became active at age 60–64 showed slightly healthier biomarker profiles than those that became inactive [e.g. fully-adjusted difference in IL-6 = −9.9% (−23.9; 4.1) vs. −3.8% (−12.4; 4.8)], although the best profiles were seen for those always active [IL-6: −15.0% (−24.2; −5.7)], when compared with the always inactive group. Conclusions Greater accumulation of LTPA across adulthood was associated with a more favourable CVD biomarker profile in early old age. Earlier uptake and long-term maintenance of LTPA may provide the greatest benefits for CVD prevention. Greater LTPA over 28 years related to healthier atherosclerotic biomarker profiles. Taking up LTPA related to better biomarker levels than staying inactive over life. Differences in biomarker levels by LTPA were only partly mediated by body size. Earlier uptake and long-term maintenance of LTPA may provide greatest benefits.
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Affiliation(s)
- Ahmed Elhakeem
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK; Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Emily T Murray
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Rachel Cooper
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Peter Whincup
- Population Health Research Institute, St George's University of London, London, UK
| | - Rebecca Hardy
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
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13
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Elhakeem A, Cooper R, Bann D, Kuh D, Hardy R. Birth Weight, School Sports Ability, and Adulthood Leisure-Time Physical Activity. Med Sci Sports Exerc 2017; 49:64-70. [PMID: 27580148 PMCID: PMC5207304 DOI: 10.1249/mss.0000000000001077] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Purpose This study aimed to examine the associations of birth weight with ability in school sports in adolescence and participation in leisure-time physical activity (LTPA) across adulthood and to investigate whether associations between birth weight and LTPA change with age. Methods Study participants were British singletons born in 1946 and followed up to age 68 yr (the Medical Research Council National Survey of Health and Development). Birth weights were extracted from birth records. Teacher reports of ability in school sports were collected at age 13 yr. LTPA was self-reported at ages 36, 43, 53, 60–64, and 68 yr and categorized at each age as participating in sports, exercise, and other vigorous LTPA at least once per month versus no participation. Associations were examined using standard and mixed-effects logistic regression models. Results Relevant data were available for 2739 study participants (50.1% female). When compared with the low birth weight group (≤2.50 kg), those with heavier birth weights were more likely to be rated as above average or average at school sports (vs below average); fully adjusted odds ratio = 1.78 (95% confidence interval = 1.14–2.77). Across adulthood, those with heavier birth weights were more likely to participate in LTPA than those with low birth weight; fully adjusted odds ratio of LTPA across adulthood = 1.52 (95% confidence interval = 1.09–2.14). This association did not vary by age (P = 0.5 for birth weight by age interaction). Conclusions Low birth weight was associated with lower ability in school sports and with nonparticipation in LTPA across adulthood. Identifying the underlying developmental and social processes operating across life for low birth weight infants may inform the design of appropriate interventions to support participation in LTPA across life.
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Affiliation(s)
- Ahmed Elhakeem
- 1MRC Unit for Lifelong Health and Ageing at UCL, London, UNITED KINGDOM; and 2Centre for Longitudinal Studies, UCL Institute of Education, London, UNITED KINGDOM
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14
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Willey JZ, Voutsinas J, Sherzai A, Ma H, Bernstein L, Elkind MSV, Cheung YK, Wang SS. Trajectories in Leisure-Time Physical Activity and Risk of Stroke in Women in the California Teachers Study. Stroke 2017; 48:2346-2352. [PMID: 28794273 DOI: 10.1161/strokeaha.117.017465] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 07/18/2017] [Accepted: 07/20/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND PURPOSE Whether changes in leisure-time physical activity (LTPA) over time are associated with lower risk of stroke is not well established. We examined the association between changes in self-reported LTPA 10 years apart, with risk of incident stroke in the CTS (California Teachers Study). We hypothesized that the risk of stroke would be lowest among those who remained active. METHODS Sixty-one thousand two hundred and fifty-six CTS participants reported LTPA at 2 intensity levels (moderate and strenuous activity) at 2 time points (baseline 1995-96; 10-year follow-up 2005-2006). LTPA at each intensity level was categorized based on American Heart Association (AHA) recommendations (moderate, >150 minutes/week; strenuous, >75 minutes/week). Changes in LTPA were summarized as follows: (1) not meeting recommendations at both time points; (2) meeting recommendations only at follow-up; (3) meeting recommendations only at baseline; and (4) meeting recommendations at both time points. Incident strokes were identified through California state hospitalization records. Using multivariable Cox models, we examined the associations between changes in LTPA with incident stroke. RESULTS Nine hundred and eighty-seven women were diagnosed with stroke who completed both questionnaires. Meeting AHA recommendations at both the time points was associated with a lower risk of all stroke (adjusted hazard ratio, 0.84; 95% confidence interval, 0.72-0.98). The protective effects for stroke were driven by meeting AHA recommendations for moderate activity and largely observed for ischemic strokes (adjusted hazard ratio, 0.70; 95% confidence interval, 0.55-0.88). CONCLUSIONS Meeting AHA recommendations for moderate activity had a protective effect for reducing ischemic stroke risk. Participants who met AHA recommendations at baseline but not at follow-up, however, were not afforded reduced stroke risk.
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Affiliation(s)
- Joshua Z Willey
- From the Departments of Neurology (J.Z.W., M.S.V.E.), Epidemiology (M.S.V.E.), and Biostatistics (Y.K.C.), Columbia University, New York; Department of Population Sciences, City of Hope, Duarte, CA (J.V., H.M., L.B., S.S.W.); and Department of Neurology, Cedars Sinai Medical Center, Los Angeles, CA (A.S.).
| | - Jenna Voutsinas
- From the Departments of Neurology (J.Z.W., M.S.V.E.), Epidemiology (M.S.V.E.), and Biostatistics (Y.K.C.), Columbia University, New York; Department of Population Sciences, City of Hope, Duarte, CA (J.V., H.M., L.B., S.S.W.); and Department of Neurology, Cedars Sinai Medical Center, Los Angeles, CA (A.S.)
| | - Ayesha Sherzai
- From the Departments of Neurology (J.Z.W., M.S.V.E.), Epidemiology (M.S.V.E.), and Biostatistics (Y.K.C.), Columbia University, New York; Department of Population Sciences, City of Hope, Duarte, CA (J.V., H.M., L.B., S.S.W.); and Department of Neurology, Cedars Sinai Medical Center, Los Angeles, CA (A.S.)
| | - Huiyan Ma
- From the Departments of Neurology (J.Z.W., M.S.V.E.), Epidemiology (M.S.V.E.), and Biostatistics (Y.K.C.), Columbia University, New York; Department of Population Sciences, City of Hope, Duarte, CA (J.V., H.M., L.B., S.S.W.); and Department of Neurology, Cedars Sinai Medical Center, Los Angeles, CA (A.S.)
| | - Leslie Bernstein
- From the Departments of Neurology (J.Z.W., M.S.V.E.), Epidemiology (M.S.V.E.), and Biostatistics (Y.K.C.), Columbia University, New York; Department of Population Sciences, City of Hope, Duarte, CA (J.V., H.M., L.B., S.S.W.); and Department of Neurology, Cedars Sinai Medical Center, Los Angeles, CA (A.S.)
| | - Mitchell S V Elkind
- From the Departments of Neurology (J.Z.W., M.S.V.E.), Epidemiology (M.S.V.E.), and Biostatistics (Y.K.C.), Columbia University, New York; Department of Population Sciences, City of Hope, Duarte, CA (J.V., H.M., L.B., S.S.W.); and Department of Neurology, Cedars Sinai Medical Center, Los Angeles, CA (A.S.)
| | - Ying K Cheung
- From the Departments of Neurology (J.Z.W., M.S.V.E.), Epidemiology (M.S.V.E.), and Biostatistics (Y.K.C.), Columbia University, New York; Department of Population Sciences, City of Hope, Duarte, CA (J.V., H.M., L.B., S.S.W.); and Department of Neurology, Cedars Sinai Medical Center, Los Angeles, CA (A.S.)
| | - Sophia S Wang
- From the Departments of Neurology (J.Z.W., M.S.V.E.), Epidemiology (M.S.V.E.), and Biostatistics (Y.K.C.), Columbia University, New York; Department of Population Sciences, City of Hope, Duarte, CA (J.V., H.M., L.B., S.S.W.); and Department of Neurology, Cedars Sinai Medical Center, Los Angeles, CA (A.S.)
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15
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Copeland JL, Ashe MC, Biddle SJ, Brown WJ, Buman MP, Chastin S, Gardiner PA, Inoue S, Jefferis BJ, Oka K, Owen N, Sardinha LB, Skelton DA, Sugiyama T, Dogra S. Sedentary time in older adults: a critical review of measurement, associations with health, and interventions. Br J Sports Med 2017; 51:1539. [PMID: 28724714 DOI: 10.1136/bjsports-2016-097210] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 06/21/2017] [Accepted: 06/21/2017] [Indexed: 12/21/2022]
Abstract
Sedentary time (ST) is an important risk factor for a variety of health outcomes in older adults. Consensus is needed on future research directions so that collaborative and timely efforts can be made globally to address this modifiable risk factor. In this review, we examined current literature to identify gaps and inform future research priorities on ST and healthy ageing. We reviewed three primary topics:(1) the validity/reliability of self-report measurement tools, (2) the consequences of prolonged ST on geriatric-relevant health outcomes (physical function, cognitive function, mental health, incontinence and quality of life) and(3) the effectiveness of interventions to reduce ST in older adults. METHODS A trained librarian created a search strategy that was peer reviewed for completeness. RESULTS Self-report assessment of the context and type of ST is important but the tools tend to underestimate total ST. There appears to be an association between ST and geriatric-relevant health outcomes, although there is insufficient longitudinal evidence to determine a dose-response relationship or a threshold for clinically relevant risk. The type of ST may also affect health; some cognitively engaging sedentary behaviours appear to benefit health, while time spent in more passive activities may be detrimental. Short-term feasibility studies of individual-level ST interventions have been conducted; however, few studies have appropriately assessed the impact of these interventions on geriatric-relevant health outcomes, nor have they addressed organisation or environment level changes. Research is specifically needed to inform evidence-based interventions that help maintain functional autonomy among older adults.This consensus statement has been endorsed by the following societies: Academy of Geriatric Physical Therapy, Exercise & Sports Science Australia, Canadian Centre for Activity and Aging, Society of Behavioral Medicine, and the National Centre for Sport and Exercise Medicine.
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Affiliation(s)
| | - Maureen C Ashe
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | | | | | | | | | | | - Neville Owen
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Swinburne University of Technology, Melbourne, Australia
| | - Luís B Sardinha
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal
| | | | | | - Shilpa Dogra
- University of Ontario Institute of Technology, Oshawa, Ontario, Canada
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16
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Dogra S, Ashe MC, Biddle SJH, Brown WJ, Buman MP, Chastin S, Gardiner PA, Inoue S, Jefferis BJ, Oka K, Owen N, Sardinha LB, Skelton DA, Sugiyama T, Copeland JL. Sedentary time in older men and women: an international consensus statement and research priorities. Br J Sports Med 2017; 51:1526-1532. [PMID: 28724710 PMCID: PMC5738599 DOI: 10.1136/bjsports-2016-097209] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2017] [Indexed: 01/12/2023]
Abstract
Sedentary time is a modifiable determinant of poor health, and in older adults, reducing sedentary time may be an important first step in adopting and maintaining a more active lifestyle. The primary purpose of this consensus statement is to provide an integrated perspective on current knowledge and expert opinion pertaining to sedentary behaviour in older adults on the topics of measurement, associations with health outcomes, and interventions. A secondary yet equally important purpose is to suggest priorities for future research and knowledge translation based on gaps identified. A five-step Delphi consensus process was used. Experts in the area of sedentary behaviour and older adults (n=15) participated in three surveys, an in-person consensus meeting, and a validation process. The surveys specifically probed measurement, health outcomes, interventions, and research priorities. The meeting was informed by a literature review and conference symposium, and it was used to create statements on each of the areas addressed in this document. Knowledge users (n=3) also participated in the consensus meeting. Statements were then sent to the experts for validation. It was agreed that self-report tools need to be developed for understanding the context in which sedentary time is accumulated. For health outcomes, it was agreed that the focus of sedentary time research in older adults needs to include geriatric-relevant health outcomes, that there is insufficient evidence to quantify the dose–response relationship, that there is a lack of evidence on sedentary time from older adults in assisted facilities, and that evidence on the association between sedentary time and sleep is lacking. For interventions, research is needed to assess the impact that reducing sedentary time, or breaking up prolonged bouts of sedentary time has on geriatric-relevant health outcomes. Research priorities listed for each of these areas should be considered by researchers and funding agencies. This consensus statement has been endorsed by the following societies: Academy of Geriatric Physical Therapy, Exercise & Sports Science Australia, Canadian Centre for Activity and Aging, Society of Behavioral Medicine, and the National Centre for Sport and Exercise Medicine.
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Affiliation(s)
- Shilpa Dogra
- University of Ontario Institute of Technology, Oshawa, Ontario, Canada
| | - Maureen C Ashe
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Stuart J H Biddle
- Victoria University, Melbourne, Australia.,University of Southern Queensland, Springfield, Australia
| | | | | | - Sebastien Chastin
- Glasgow Caledonian University, Glasgow, UK.,Ghent University, Ghent, Belgium
| | | | | | | | | | - Neville Owen
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Swinburne University of Technology, Melbourne, Australia
| | - Luís B Sardinha
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
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17
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Physical activity levels objectively measured among older adults: a population-based study in a Southern city of Brazil. Int J Behav Nutr Phys Act 2017; 14:13. [PMID: 28153018 PMCID: PMC5289039 DOI: 10.1186/s12966-017-0465-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 01/06/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Low levels of physical activity are currently observed in all age groups around the world. Among older adults physical activity is even lower, potentially influencing quality of life, incidence of diseases and premature mortality. The aim of this study was to describe objectively measured physical activity levels among older adults residents in a Southern city of Brazil. METHODS A population-based study was carried out including people aged 60+ years living in the urban area of Pelotas. Face-to-face interviews, anthropometric measures and triaxial accelerometry (non-dominant wrist) were used to collect sociodemographic, anthropometric and physical activity, respectively. For descriptive purposes, overall physical activity was expressed as daily averages of acceleration. Time spent in light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) using different bout criteria (non-bouted, and in 1-, 5- and 10-min bouts) were calculated. Crude and adjusted analyses were performed using simple linear regression to examine the association between physical activity and exposure variables. RESULTS Overall, 971 individuals provided valid accelerometry data. Women spent on average more time on LPA (136.2 vs. 127.6 min per day). Men and women respectively accumulated, in average, 64.5 and 56.7 min per day of non-bouted MVPA, while these daily averages were 14.9 and 9.46 min using 5-min, and 8.1 and 4.5 min using 10-min bout MVPA. In adjusted analyses, men aged 80 years or more spent in average 45 min less LPA per day when compared to men 60-69 years and, among women, this difference was 65 min. Considering time in 5-min MVPA bouts, the youngest age group and those with a better self-perceived health accumulated more MVPA. Specifically among men, socioeconomic status was inversely associated with 5-min bout MVPA. CONCLUSION The present study showed low levels of physical activity among Brazilian older adults, even lower in more advanced ages, and a different pattern for physical activity intensity between men and women.
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18
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Doma K, Speyer R, Leicht AS, Cordier R. Comparison of psychometric properties between usual-week and past-week self-reported physical activity questionnaires: a systematic review. Int J Behav Nutr Phys Act 2017; 14:10. [PMID: 28137268 PMCID: PMC5282723 DOI: 10.1186/s12966-017-0470-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Accepted: 01/23/2017] [Indexed: 12/15/2022] Open
Abstract
The aim was to critically appraise the methodological quality of studies and determine the psychometric qualities of Past-week and Usual-week Physical Activity Questionnaires (PAQs). Data sources were obtained from Pubmed and Embase. The eligibility criteria for selecting studies included: 1) at least one psychometric property of PAQs was examined in adults; 2) the PAQs either had a recall period of usual 7-days (Usual-week PAQs) within the past 12 months or during the past 7-days (Past-week PAQs); and 3) PAQs were self-administered. Study quality was evaluated using the COSMIN taxonomy and the overall psychometric qualities evaluated using pre-established psychometric criteria. Overall, 45 studies were reviewed to assess the psychometric properties of 21 PAQs with the methodological quality of most studies showing good to excellent ratings. When the relationship between PAQs and other instruments (i.e., convergent validity) were compared between recall methods, Past-week PAQs appeared to have stronger correlations than Usual-week PAQs. For the overall psychometric quality, the Incidental and Planned Exercise Questionnaire for the Usual-week (IPEQ-WA) and for the Past-week (IPEQ-W) had the greatest number of positive ratings. For all included PAQs, very few psychometric properties were assessed with poor ratings for the majority of the overall qualities of psychometric properties indicating the limitation of current PAQs. More research that covers a greater spectrum of psychometric properties is required to gain a better understanding of the qualities of current PAQs.
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Affiliation(s)
- Kenji Doma
- College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia.
| | - Renée Speyer
- College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia.,Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Anthony S Leicht
- College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia
| | - Reinie Cordier
- School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia
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Nicolaou M, Gademan MGJ, Snijder MB, Engelbert RHH, Dijkshoorn H, Terwee CB, Stronks K. Validation of the SQUASH Physical Activity Questionnaire in a Multi-Ethnic Population: The HELIUS Study. PLoS One 2016; 11:e0161066. [PMID: 27575490 PMCID: PMC5004804 DOI: 10.1371/journal.pone.0161066] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 07/30/2016] [Indexed: 02/02/2023] Open
Abstract
PURPOSE To investigate the reliability and validity of the SQUASH physical activity (PA) questionnaire in a multi-ethnic population living in the Netherlands. METHODS We included participants from the HELIUS study, a population-based cohort study. In this study we included Dutch (n = 114), Turkish (n = 88), Moroccan (n = 74), South-Asian Surinamese (n = 98) and African Surinamese (n = 91) adults, aged 18-70 years. The SQUASH was self-administered twice to assess test-re-test reliability (mean interval 6-7 weeks) and participants wore an accelerometer and heart rate monitor (Actiheart) to enable assessment of construct validity. RESULTS We observed low test-re-test reliability; Intra class correlation coefficients ranged from low (0.05 for moderate/high intensity PA in African Surinamese women) to acceptable (0.78 for light intensity PA in Moroccan women). The discrepancy between self-reported and measured PA differed on the basis of the intensity of activity: self-reported light intensity PA was lower than measured but self-reported moderate/high intensity PA was higher than measured, with wide limits of agreement. The discrepancy between questionnaire and Actiheart measures of moderate intensity PA did not differ between ethnic minority and Dutch participants with correction for relevant confounders. Additionally, the SQUASH overestimated the number of participants meeting the Dutch PA norm; Cohen's kappas for the agreement were poor, the highest being 0.30 in Dutch women. CONCLUSION We found considerable variation in the test-re-test reliability and validity of self-reported PA with no consistency based on ethnic origin. Our findings imply that the SQUASH does not provide a valid basis for comparison of PA between ethnic groups.
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Affiliation(s)
- M. Nicolaou
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- * E-mail:
| | - M. G. J. Gademan
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - M. B. Snijder
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - R. H. H. Engelbert
- Education of Physical Therapy, Amsterdam School of Health Professions (ASHP), University of Applied Sciences, Amsterdam, The Netherlands
- Department of Rehabilitation, Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - H. Dijkshoorn
- Department of Epidemiology and Health Promotion, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - C. B. Terwee
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - K. Stronks
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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20
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Lachman S, Peters RJ, Lentjes MA, Mulligan AA, Luben RN, Wareham NJ, Khaw KT, Boekholdt SM. Ideal cardiovascular health and risk of cardiovascular events in the EPIC-Norfolk prospective population study. Eur J Prev Cardiol 2016; 23:986-94. [PMID: 26336197 PMCID: PMC6215703 DOI: 10.1177/2047487315602015] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 07/31/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND The American Heart Association has prioritised seven cardiovascular health metrics to reduce the cardiovascular burden, including: body mass index, healthy diet, physical activity, smoking status, blood pressure, glycated haemoglobin A1c and total cholesterol. The aim of the current study was to assess the association between the American Heart Association-defined health metrics and the risk of cardiovascular events in the EPIC-Norfolk prospective study. DESIGN Prospective cohort study. METHODS An overall cardiovascular health score was calculated based on the number of health metrics including ideal, intermediate or poor. Cox proportional hazards models were used to describe the association of the seven metrics separately and the overall health score with risk of coronary heart disease, stroke and cardiovascular disease. A total of 10,043 participants was included in the analysis (follow-up 1993-2008). For all individual health metrics a more ideal status was associated with a lower risk of cardiovascular events. RESULTS AND CONCLUSION As for the overall cardiovascular health score, those in the highest (i.e. healthiest) category (score 12-14) had an adjusted hazard ratio for coronary heart disease of 0.07 (95% confidence interval (CI) 0.02-0.29, P < 0.001), for stroke of 0.16 (95% CI 0.02-1.37, P = 0.09) and for cardiovascular disease of 0.07 (95% CI 0.02-0.23, P < 0.001), compared to people in the lowest (i.e. unhealthiest) category (score 0-2). The overall cardiovascular health score was strongly and inversely associated with risk of coronary heart disease, stroke and cardiovascular disease. Our data suggest that even small improvements in modifiable risk factors may lead to substantial reductions in the risks of cardiovascular events.
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Affiliation(s)
- Sangeeta Lachman
- Department of Cardiology, Academic Medical Centre, The Netherlands
| | - Ron Jg Peters
- Department of Cardiology, Academic Medical Centre, The Netherlands
| | - Marleen Ah Lentjes
- Department of Public Health and Primary Care, University of Cambridge, UK
| | - Angela A Mulligan
- Department of Public Health and Primary Care, University of Cambridge, UK
| | - Robert N Luben
- Department of Public Health and Primary Care, University of Cambridge, UK
| | | | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, UK
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Black SV, Cooper R, Martin KR, Brage S, Kuh D, Stafford M. Physical Activity and Mental Well-being in a Cohort Aged 60-64 Years. Am J Prev Med 2015; 49:172-80. [PMID: 26070782 PMCID: PMC4518501 DOI: 10.1016/j.amepre.2015.03.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 03/06/2015] [Accepted: 03/18/2015] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Although evidence suggests physical activity (PA) may be associated with mental well-being at older ages, it is unclear whether some types of PA are more important than others. The purpose of this study is to investigate associations of monitored total PA under free-living conditions, self-reported leisure-time PA (LTPA), and walking for pleasure with mental well-being at age 60-64 years. METHODS Data on 930 (47%) men and 1,046 (53%) women from the United Kingdom Medical Research Council (MRC) National Survey of Health and Development collected in 2006-2011 at age 60-64 were used in 2013-2014 to test the associations of PA (PA energy expenditure and time spent in different intensities of activity assessed using combined heart rate and acceleration monitors worn for 5 days, self-reported LTPA, and walking for pleasure) with the Warwick-Edinburgh Mental Well-being Scale (WEMWBS; range, 14-70). RESULTS In linear regression models adjusted for gender, long-term limiting illness, smoking, employment, socioeconomic position, personality, and prior PA, those who walked for >1 hour/week had mean WEMWBS scores 1.47 (95% CI=0.60, 2.34) points higher than those who reported no walking. Those who participated in LTPA at least five times/month had WEMWBS scores 1.25 (95% CI=0.34, 2.16) points higher than those who did not engage in LTPA. There were no statistically significant associations between free-living PA and WEMWBS scores. CONCLUSIONS In adults aged 60-64 years, participation in self-selected activities such as LTPA and walking are positively related to mental well-being, whereas total levels of free-living PA are not.
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Affiliation(s)
| | - Rachel Cooper
- MRC Unit for Lifelong Health and Ageing at UCL, London
| | - Kathryn R Martin
- Epidemiology Group, University of Aberdeen, School of Medicine and Dentistry, Aberdeen
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London
| | - Mai Stafford
- MRC Unit for Lifelong Health and Ageing at UCL, London
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Heseltine R, Skelton DA, Kendrick D, Morris RW, Griffin M, Haworth D, Masud T, Iliffe S. "Keeping Moving": factors associated with sedentary behaviour among older people recruited to an exercise promotion trial in general practice. BMC FAMILY PRACTICE 2015; 16:67. [PMID: 26018127 PMCID: PMC4446807 DOI: 10.1186/s12875-015-0284-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 05/20/2015] [Indexed: 12/31/2022]
Abstract
Background Sedentary behaviour is detrimental to health, even in those who achieve recommended levels of physical activity. Efforts to increase physical activity in older people so that they reach beneficial levels have been disappointing. Reducing sedentary behaviour may improve health and be less demanding of older people, but it is not clear how to achieve this. We explored the characteristics of sedentary older people enrolled into an exercise promotion trial to gain insights about those who were sedentary but wanted to increase activity. Method Participants in the ProAct65+ trial (2009–2013) were categorised as sedentary or not using a self-report questionnaire. Demographic data, health status, self-rated function and physical test performance were examined for each group. 1104 participants aged 65 & over were included in the secondary analysis of trial data from older people recruited via general practice. Results were analysed using logistic regression with stepwise backward elimination. Results Three hundred eighty seven (35 %) of the study sample were characterised as sedentary. The likelihood of being categorised as sedentary increased with an abnormal BMI (<18.5 or >25 kg/m2) (Odds Ratio 1.740, CI 1.248–2.425), ever smoking (OR 1.420, CI 1.042–1.934) and with every additional medication prescribed (OR 1.069, CI 1.016–1.124). Participants reporting better self-rated physical health (SF-12) were less likely to be sedentary; (OR 0.961, 0.936–0.987). Participants’ sedentary behaviour was not associated with gender, age, income, education, falls, functional fitness, quality of life or number of co-morbidities. Conclusion Some sedentary older adults will respond positively to an invitation to join an exercise study. Those who did so in this study had poor self-rated health, abnormal BMI, a history of smoking, and multiple medication use, and are therefore likely to benefit from an exercise intervention. Trial registration ISRCTN reference: ISRCTN43453770
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Affiliation(s)
- Ruth Heseltine
- Department of Primary Care & Population Health, University College London, Royal Free Campus, Rowland Hill St., London, NW3 2PF, UK.
| | - Dawn A Skelton
- School of Health & Life Sciences, Glasgow Caledonian University, Cowcaddens Rd, Glasgow, Lanarkshire, G4 0BA, UK.
| | - Denise Kendrick
- Division of Primary Care, University of Nottingham, Floor 13, Tower Building, University Park, Nottingham, NG7 2RD, UK.
| | - Richard W Morris
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Mark Griffin
- Department of Primary Care & Population Health, University College London, Royal Free Campus, Rowland Hill St., London, NW3 2PF, UK.
| | - Deborah Haworth
- Department of Primary Care & Population Health, University College London, Royal Free Campus, Rowland Hill St., London, NW3 2PF, UK.
| | - Tahir Masud
- Nottingham University Hospital NHS Trust, Derby Rd, Nottingham, NG7 2UH, UK.
| | - Steve Iliffe
- Department of Primary Care & Population Health, University College London, Royal Free Campus, Rowland Hill St., London, NW3 2PF, UK.
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23
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Cooper AJM, Simmons RK, Kuh D, Brage S, Cooper R. Physical activity, sedentary time and physical capability in early old age: British birth cohort study. PLoS One 2015; 10:e0126465. [PMID: 25961736 PMCID: PMC4427100 DOI: 10.1371/journal.pone.0126465] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 04/02/2015] [Indexed: 01/25/2023] Open
Abstract
PURPOSE To investigate the associations of time spent sedentary, in moderate-to-vigorous-intensity physical activity (MVPA) and physical activity energy expenditure (PAEE) with physical capability measures at age 60-64 years. METHODS Time spent sedentary and in MVPA and, PAEE were assessed using individually calibrated combined heart rate and movement sensing among 1727 participants from the MRC National Survey of Health and Development in England, Scotland and Wales as part of a detailed clinical assessment undertaken in 2006-2010. Multivariable linear regression models were used to examine the cross-sectional associations between standardised measures of each of these behavioural variables with grip strength, chair rise and timed up-&-go (TUG) speed and standing balance time. RESULTS Greater time spent in MVPA was associated with higher levels of physical capability; adjusted mean differences in each capability measure per 1 standard deviation increase in MVPA time were: grip strength (0.477 kg, 95% confidence interval (CI): 0.015 to 0.939), chair rise speed (0.429 stands/min, 95% CI: 0.093 to 0.764), standing balance time (0.028 s, 95% CI: 0.003 to 0.053) and TUG speed (0.019 m/s, 95% CI: 0.011 to 0.026). In contrast, time spent sedentary was associated with lower grip strength (-0.540 kg, 95% CI: -1.013 to -0.066) and TUG speed (-0.011 m/s, 95% CI: -0.019 to -0.004). Associations for PAEE were similar to those for MVPA. CONCLUSION Higher levels of MVPA and overall physical activity (PAEE) are associated with greater levels of physical capability whereas time spent sedentary is associated with lower levels of capability. Future intervention studies in older adults should focus on both the promotion of physical activity and reduction in time spent sedentary.
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Affiliation(s)
- Andrew J. M. Cooper
- MRC Epidemiology Unit, University of Cambridge, Institute of Metabolic Science, Box 285, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 0QQ, United Kingdom
| | - Rebecca K. Simmons
- MRC Epidemiology Unit, University of Cambridge, Institute of Metabolic Science, Box 285, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 0QQ, United Kingdom
| | - Diana Kuh
- MRC Unit for Lifelong Health & Ageing at UCL, 33 Bedford Place, London, WC1B 5JU, United Kingdom
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Institute of Metabolic Science, Box 285, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 0QQ, United Kingdom
| | - Rachel Cooper
- MRC Unit for Lifelong Health & Ageing at UCL, 33 Bedford Place, London, WC1B 5JU, United Kingdom
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Bann D, Hire D, Manini T, Cooper R, Botoseneanu A, McDermott MM, Pahor M, Glynn NW, Fielding R, King AC, Church T, Ambrosius WT, Gill T. Light Intensity physical activity and sedentary behavior in relation to body mass index and grip strength in older adults: cross-sectional findings from the Lifestyle Interventions and Independence for Elders (LIFE) study. PLoS One 2015; 10:e0116058. [PMID: 25647685 PMCID: PMC4315494 DOI: 10.1371/journal.pone.0116058] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 12/01/2014] [Indexed: 02/04/2023] Open
Abstract
Background Identifying modifiable determinants of fat mass and muscle strength in older adults is important given their impact on physical functioning and health. Light intensity physical activity and sedentary behavior are potential determinants, but their relations to these outcomes are poorly understood. We evaluated associations of light intensity physical activity and sedentary time—assessed both objectively and by self-report—with body mass index (BMI) and grip strength in a large sample of older adults. Methods We used cross-sectional baseline data from 1130 participants of the Lifestyle Interventions and Independence for Elders (LIFE) study, a community-dwelling sample of relatively sedentary older adults (70-89 years) at heightened risk of mobility disability. Time spent sedentary and in light intensity activity were assessed using an accelerometer worn for 3–7 days (Actigraph GT3X) and by self-report. Associations between these exposures and measured BMI and grip strength were evaluated using linear regression. Results Greater time spent in light intensity activity and lower sedentary times were both associated with lower BMI. This was evident using objective measures of lower-light intensity, and both objective and self-reported measures of higher-light intensity activity. Time spent watching television was positively associated with BMI, while reading and computer use were not. Greater time spent in higher but not lower intensities of light activity (assessed objectively) was associated with greater grip strength in men but not women, while neither objectively assessed nor self-reported sedentary time was associated with grip strength. Conclusions In this cross-sectional study, greater time spent in light intensity activity and lower sedentary times were associated with lower BMI. These results are consistent with the hypothesis that replacing sedentary activities with light intensity activities could lead to lower BMI levels and obesity prevalence among the population of older adults. However, longitudinal and experimental studies are needed to strengthen causal inferences.
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Affiliation(s)
- David Bann
- MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom
- * E-mail:
| | - Don Hire
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Todd Manini
- Department of Aging & Geriatric Research, University of Florida, Gainesville, Florida, United States of America
| | - Rachel Cooper
- MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom
| | - Anda Botoseneanu
- Department of Health Policy Studies and Institute of Gerontology, University of Michigan—Dearborn/Ann Arbor, Ann Arbor, Michigan, United States of America
| | - Mary M. McDermott
- Northwestern University, Feinberg School of Medicine, Chicago, United States of America
| | - Marco Pahor
- Department of Aging & Geriatric Research, University of Florida, Gainesville, Florida, United States of America
| | - Nancy W. Glynn
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, United States of America
| | - Roger Fielding
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, United States of America
| | - Abby C. King
- Stanford University School of Medicine, Stanford, CA, United States of America
| | - Timothy Church
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States of America
| | - Walter T. Ambrosius
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Thomas Gill
- Yale School of Medicine, New Haven, Connecticut, United States of America
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Van Cauwenberg J, Van Holle V, De Bourdeaudhuij I, Owen N, Deforche B. Older adults' reporting of specific sedentary behaviors: validity and reliability. BMC Public Health 2014; 14:734. [PMID: 25042423 PMCID: PMC4223385 DOI: 10.1186/1471-2458-14-734] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 07/10/2014] [Indexed: 11/10/2022] Open
Abstract
Background Previous questionnaires targeting older adults’ sedentary time have underestimated total sedentary time, possibly by not including all relevant specific sedentary behaviors. The current study aimed to investigate the criterion validity and test-retest reliability of a new questionnaire assessing a comprehensive set of sedentary behaviors. Additionally, we examined whether the criterion validity of the questionnaire differed according to age, gender and educational level. Methods A sample of home-dwelling Belgian older adults (>64 years, n = 508) completed a newly-developed questionnaire assessing twelve specific sedentary behaviors and wore an accelerometer for seven consecutive days as criterion measure. A subsample (n = 28) completed the questionnaire a second time to examine test-retest reliability. Data collection occurred between September 2010 and October 2012. Results Correlational analyses examining self-reported total sitting time and accelerometer-derived sedentary time yielded a Spearman’s ρ of 0.30. Using the Bland-Altman regression procedure, self-reported total sitting time underestimated accelerometer-derived sedentary time by -82 minutes/day for a participant with an average level of sedentary time (539 minutes/day). Corresponding 95% limits of agreement were wide (-364, 200 minutes/day). Better, but still not ideal, validity findings were observed in the younger, male and tertiary-educated subgroups. Acceptable test-retest reliability (ICC > 0.70) was found for total sitting time, TV viewing, computer use, and driving a car. Conclusion Validity for older adults’ self-reported total sitting time against accelerometer-derived sedentary time was not strong, but comparable to previous studies. However, underestimation of total sedentary time was lower compared to previous studies, possibly explained by the inclusion of additional specific sedentary behaviors. Further research is needed to develop self-report tools and objective criterion measures that accurately measure engagement in (specific) sedentary behavior(s) among different subgroups of the older population.
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Affiliation(s)
- Jelle Van Cauwenberg
- Department of Human Biometry and Biomechanics, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium.
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Martin KR, Cooper R, Harris TB, Brage S, Hardy R, Kuh D. Patterns of leisure-time physical activity participation in a British birth cohort at early old age. PLoS One 2014; 9:e98901. [PMID: 24911018 PMCID: PMC4049596 DOI: 10.1371/journal.pone.0098901] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 05/03/2014] [Indexed: 11/18/2022] Open
Abstract
Using data from a nationally representative British birth cohort we characterized the type and diversity of leisure-time physical activity that 2,188 participants (age 60–64 years) engaged in throughout the year by gender and obesity. Participants most commonly reported walking (71%), swimming (33%), floor exercises (24%) and cycling (15%). Sixty-two percent of participants reported ≥2 activities in the past year and 40% reported diversity on a regular basis. Regular engagement in different types of activity (cardio-respiratory, balance/flexibility and strength) was reported by 67%, 19% and 11% of participants, respectively. We found gender differences, as well as differences by obesity status, in the activities reported, the levels of activity diversity and activity type. Non-obese participants had greater activity diversity, and more often reported activities beneficial for cardio-respiratory health and balance/flexibility than obese participants. These findings may be used to inform the development of trials of physical activity interventions targeting older adults, and those older adults with high body mass index.
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Affiliation(s)
- Kathryn R. Martin
- Epidemiology Group, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, United Kingdom
- Medical Research Council Unit for Lifelong Health and Ageing at University College London, London, United Kingdom
- Laboratory of Epidemiology and Population Sciences, National Institute of Aging, National Institutes of Health, Bethesda, Maryland United States of America
- * E-mail:
| | - Rachel Cooper
- Medical Research Council Unit for Lifelong Health and Ageing at University College London, London, United Kingdom
| | - Tamara B. Harris
- Laboratory of Epidemiology and Population Sciences, National Institute of Aging, National Institutes of Health, Bethesda, Maryland United States of America
| | - Soren Brage
- Medical Research Council Epidemiology Unit, School of Clinical Medicine, Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
| | - Rebecca Hardy
- Medical Research Council Unit for Lifelong Health and Ageing at University College London, London, United Kingdom
| | - Diana Kuh
- Medical Research Council Unit for Lifelong Health and Ageing at University College London, London, United Kingdom
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Golubic R, Martin KR, Ekelund U, Hardy R, Kuh D, Wareham N, Cooper R, Brage S. Levels of physical activity among a nationally representative sample of people in early old age: results of objective and self-reported assessments. Int J Behav Nutr Phys Act 2014; 11:58. [PMID: 24885497 PMCID: PMC4038114 DOI: 10.1186/1479-5868-11-58] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 04/02/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Detailed assessment of physical activity (PA) in older adults is required to comprehensively describe habitual PA-levels in this growing population segment. Current evidence of population PA-levels is predominantly based on self-report. METHODS We examined PA and sedentary behaviour in a nationally representative sample of British people aged 60-64, using individually-calibrated combined heart-rate and movement sensing and a validated questionnaire (EPAQ2), and the socio-demographic and behavioural factors that may explain between-individual variation in PA. RESULTS Between 2006-2010, 2224 participants completed EPAQ2 capturing the past year's activity in four domains (leisure, work, transportation and domestic life) and 1787 participants provided 2-5 days of combined-sensing data. According to objective estimates, median(IQR) physical activity energy expenditure (PAEE) was 33.5 (25.3-42.2) and 35.5 (26.6- 47.3) kJ/kg/day for women and men, respectively. Median (IQR) time spent in moderate-to-vigorous PA (MVPA; >3MET), light-intensity PA (1.5-3 MET) and sedentary (<1.5 MET) was 26.0 (12.3-48.1) min/day, 5.4 (4.2-6.7) h/day and 18.0 (16.6-19.4) h/day, respectively, in women; and 41.0 (18.8-73.0) min/day, 5.2 (4.0-6.5) h/day and 17.9 (16.3-19.4) h/day in men. PAEE and time spent in MVPA were lower and sedentary time was greater in obese individuals, those with poor health, and those with lower educational attainment (women only). Questionnaire-derived PAEE and MVPA tended to have similar patterns of variation across socio-demographic strata. In the whole sample, domestic PA had the greatest relative contribution to total questionnaire-derived PAEE (58%), whereas occupational PA was the main driver among employed participants (54%). Only 2.2% of participants achieved an average of >30 min MVPA per day combined with >60 min strength-training per week. CONCLUSIONS The use of both self-report and objective monitoring to assess PA in early old age provides important information on the domains of PA, PAEE and time spent at different intensity levels. Our findings suggest PA levels are generally low and observed patterns of variation indicate specific subgroups who might benefit from targeted interventions to increase PA.
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Affiliation(s)
- Rajna Golubic
- Medical Research Council Epidemiology Unit, University of Cambridge, Institute of Metabolic Science, Addenbrooke's Hospital, Hills Road, Box 285, Cambridge CB2 0QQ, United Kingdom.
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