Association of Self-Reported and Device-Measured Sedentary Behaviour and Physical Activity with Health-Related Quality of Life among European Older Adults

Impact of a community-based lifestyle intervention with initial sedentary reduction or physical activity increasing goals on self-reported health-related quality of life

BACKGROUND

In previous efforts, health-related quality of life (HRQoL) improved for individuals at high risk of type 2 diabetes and cardiovascular disease after participation in community-based lifestyle interventions (LI) with a moderate-to-vigorous physical activity (MVPA) movement goal.

PURPOSE

It is unknown whether HRQoL improves with LI when the primary movement goal is to reduce sedentary behavior. HRQoL changes were examined among adults with overweight and prediabetes and/or metabolic syndrome randomized to a 12-month Diabetes Prevention Program-based Group Lifestyle Balance (DPP-GLB) community LI work with goals of weight-loss and either increasing MVPA (DPP-GLB) or reducing sedentary time (GLB-SED).

METHODS

Study participants (N = 269) completed the Euroqol 5 dimension 3 long (EQ5D-3L index and EuroQol Visual Analog Scale (EQVAS)-visual analog scale) at baseline, and 6 and 12 months. Paired t-tests were used to evaluate pre-to-post-intervention changes by arm.

RESULTS

Mean EQVAS improvements for the GLB-SED arm at 6 and 12 months were +5.6 (SE = 1.3; P < .0001) and +4.6 (SE = 1.4; P = .0006), respectively. Similar mean EQVAS improvements were reported for the DPP-GLB arm; +5.9 (SE = 1.2; P < .0001) and +4.9 (SE = 1.2; P = .0001) at 6 and 12 months, respectively. Mean EQ5D index improvements were significant in the GLB-SED arm [6 months: +0.03 (SE = 0.01; P = .004); and 12 months: +0.04 (SE = 0.01; P = .006)], but not in the DPP-GLB arm.

CONCLUSIONS

Participation in community LI with a primary movement goal to reduce sedentary behavior improved HRQoL at least as well as traditional LI focused more on MVPA improvement, supporting an alternate intervention strategy for those who can't or won't engage in MVPA as the primary movement goal.

The Impacts of Engagement in Men's Sheds on Incidental Physical Activity and Wellbeing Outcomes

BACKGROUND

As a large proportion of older adults are insufficiently active, it is imperative to identify ways to increase incidental physical activity. Men's Sheds, a mutual-aid, community-based organisation appear to be a promising approach for optimising wellbeing outcomes.

OBJECTIVES

To investigate whether Men's Sheds attendance is associated with higher levels of physical activity, and the relationships between physical activity, health-related quality of life (HRQOL), and wellbeing in Men's Shed members.

METHODS

Participants (N = 45) wore a hip accelerometer (Actigraph GTX-9) for 11 days. The majority (n = 30, Mage = 72.3 ± 9.4) also consented to complete an online questionnaire investigating HRQOL and wellbeing.

RESULTS

Linear mixed models revealed members, on average, spent an additional 34 min in light physical activity, had an extra six breaks in sedentary behaviour, and took an extra 1193 steps on days they attended Men's Sheds, though, these effects were small. Physical activity was not significantly associated with HRQOL and wellbeing.

CONCLUSION

Men's Sheds appear to be a valuable approach for increasing light intensity physical activity, breaks in sedentary behaviours, and step count in older adults. However, additional Men's Shed activities specifically targeting increased movement may be required to realise greater impacts on health-related quality of life and wellbeing. SO WHAT?: Men's Sheds may provide a valuable opportunity to increase some indices of physical activity, which may contribute to better overall health. While these effects may be small for active Men's Shed members, these effects may be more appreciable for more sedentary individuals.

Validation Study of Physical Activity and Sedentary Behavior in African-American Men and Women

BACKGROUND

Self-reported data of physical activity are practical and inexpensive ways to collect data, although, subject to significant measurement errors. Most physical activity questionnaires used in the USA have been predominately validated among non-Hispanic White American populations with limited attention paid to the validity of the measures among racial/ethnic minorities. Additionally, there are limited studies that have evaluated factors related to over- and under-reporting errors linked to self-reported physical activity data, particularly among African Americans. The primary objectives of this study were to validate self-reported levels of physical activity and sedentary behavior among African-American men and women against objective measurements and to identify the factors related to under- and over-reporting.

METHODS

This study was a 7-day, cross-sectional study conducted on African-American men and women (n = 56) who were between 21-70 years of age. Participants were required to attend two study visits for the collection of self-reported and objective measurements of physical activity and sedentary behavior (VO2max, DEXA scan, anthropometrics, ActivPal accelerometer, resting metabolic rate (RMR) and International Physical Activity Questionnaire (IPAQ) questionnaire.

RESULTS

Overall, energy expenditure measured by ActivPal was 24.1 MET/hr/week whereas self-reported (IPAQ) energy expenditure was 52.66 MET/hr/week. Self-reported sedentary time was 40.37 h/week, whereas sedentary time measured by ActivPal was 63.03 h/week. Obese participants tended to over-report their physical activity levels more so than non-obese participants (Obese, Activpal-23.89 MET/hr/week vs IPAQ-58.98 MET/hr/week; Non-obese, Activpal - 24.48 MET/hr/week vs IPAQ - 42.55 MET/hr/week). Both obese and non-obese participants underestimated their sedentary time (Obese, Activpal - 66.89 h/week vs IPAQ-43.92 h/week; Non-obese, Activpal -56.07 h/week vs IPAQ - 33.98 h/week).

CONCLUSIONS

The results of this study found that the ActivPal validated physical activity and sedentary behavior among African-Americans. Self-reported data were found to be highly variable, whereas the objective assessments of physical activity and sedentary behavior had limited variability. It was also found that obese individuals over-estimated their self-reported physical activity levels and under-estimated sedentary behavior in comparison to the ActivPal. These findings strongly support the need to measure physical activity and sedentary behaviors objectively, particularly among African-Americans.

Physical activity from the perspective of older adults: a convergent mixed-method study

BACKGROUND

Older adults are insufficiently physically active, despite its importance for healthy aging. To develop appropriate physical activity interventions, it is necessary to understand their physical activity. This study applies a theoretical perspective, the COM-B model, and a mixed-method design to examine what influences older adults' physical activity levels with three questions: (1) What individual and external factors predict older adults' physical activity levels? (2) What do older adults perceive as influencing their levels of physical activity? (3) To what extent do the quantitative results on older adults' physical activity levels agree and disagree with the qualitative findings on older adults' physical activity levels?

METHODS

A convergent mixed-method design was used with questionnaire (n = 334) and interview (n = 14) data from adults 65 years and older. Regression analyses were used for quantitative measurements: physical activity, age, subjective socioeconomic status, health status, capability, opportunity, motivation, and depression. Content analysis was applied to the qualitative data. The two forms of data were then integrated to provide greater insights than would be obtained by either dataset separately.

RESULTS

The regression analyses showed that previous physical activity, current motivation, health status, and age significantly predicted older adults' physical activity levels. The content analysis revealed that participants addressed all subcomponents of the COM-B model, indicating its pertinence in understanding how older adults discuss their current physical activity levels. The integrated findings showed convergent and divergent results. Overall results indicated that previous physical activity engagement, present motivation, capability, and opportunity influenced older adults' physical activity levels.

CONCLUSIONS

This study is the first to use this mixed-methods design to examine factors influencing physical activity levels among older adults living in rental apartments with community hosts. The integrated result reveals convergence for findings on motivation and physical capability but divergence on psychological capability, opportunity, and previous physical activity. The findings underscore a complex interplay of factors influencing older adults' physical activity levels and indicate relevance for the COM-B model. The results can guide future research on theoretically informed interventions to promote physical activity and healthy aging. Future research should clarify the role of opportunity for older adults' physical activity.

Sedentarism in Recreational Marathon Runners

Aim

Although it has been previously observed that sedentary behavior (SB) was not related to training duration in marathon runners, little information existed about the relationship of SB with training, anthropometric and physiological characteristics in this population. This study aimed to investigate the prevalence of SB and its correlation with performance parameters (such as body fat percentage, maximal oxygen uptake and weekly training volume) as well as its variation by sex and day (ie, weekdays versus weekend) in recreational marathon runners.

Methods

A total of 151 finishers (women, n = 29; men, n = 122; age 43.1 (8.7) years, mean (standard deviation)) in the Athens marathon 2017 performed a series of anthropometric and physiological tests, and completed the Multi-context sitting time questionnaire.

Results

SB did not correlate with anthropometric and physiological characteristics and no difference in these characteristics was shown between low and high sedentary participants (p > 0.05). SB did not differ between women and men (p > 0.05), but differed between working and non-working days (p < 0.05).

Conclusion

In contrast to previous findings on the general population indicating an association of a high SB with a low cardiorespiratory and muscular fitness, our finding of no correlation between SB and physical fitness in marathon runners suggested that endurance exercise might offset the negative effects of SB.

Objectively and subjectively measured physical activity levels in individuals with whiplash associated disorder and aged-matched healthy controls

BACKGROUND

Whiplash associated disorders (WAD) are the most common non-hospitalised injuries resulting from a motor vehicle crash. Half of individuals with WAD experience ongoing pain and disability. Furthermore, individuals with persistent WAD have lower levels of aerobic capacity and isometric strength compared with age-matched controls. It is not known whether these differences are associated with increased levels of pain and disability, or with reduced physical activity (PA) participation.

OBJECTIVE

Our primary aim was to compare PA levels in individuals with persistent WAD with healthy controls. Secondary aims were to: compare objective and subjective measurements of PA; explore factors that may influence PA; and describe proportions of these populations meeting World Health Organisation PA guidelines.

METHODS

Objective (ActiGraph accelerometer; seven days) and subjective (International Physical Activity Questionnaire (IPAQ)) PA data were collected for n = 53 age-matched participants (WAD n = 28; controls n = 25).

RESULTS

Independent sample t-tests showed no significant difference in objectively measured PA (p>0.05) between WAD and controls. For the subjective measure (IPAQ), controls reported more overall weekly PA (t = 0.219, p<0.05), while WAD participants reported more weekly walking minutes (t = -0.712, p<0.05). Linear regression showed mental health quality-of-life predicted objectively measured moderate intensity PA (R2 = 0.225, F (2, 44) = 6.379, p<0.004) and subjectively reported overall PA (R2 = 0.132, F (1, 41) = 6.226, p<0.017). Bland-Altman analyses indicated that subjects over-reported MVPA and under-reported sedentary time using the IPAQ.

CONCLUSIONS

Individuals with WAD had levels of physical and mental health quality-of-life significantly lower than controls and below population norms yet participated in similar levels of PA. Given that increased perceptions of mental health quality-of-life were positively associated with objectively measured MVPA and subjectively reported overall PA, strategies to help people with WAD achieve adequate doses of MVPA may be beneficial. ActiGraph-measured and IPAQ-reported PA were discordant. Hence, IPAQ may not be a reliable measure of habitual PA in WAD.

A systematic review examining associations between physical activity, sedentary behaviour, and sleep duration with quality of life in older adults aged 65 years and above

This systematic review examined the associations between movement behaviours (i.e., physical activity, sedentary behaviour, and sleep duration) and quality of life (QOL) in adults ≥65 years of age. Four databases were searched in June 2021. Studies were eligible for inclusion if published within the last 20 years, peer-reviewed, examined apparently healthy older adults, and analysed ≥2 movement behaviours together. QOL was represented by the World Health Organization Quality of Life measure which conceptualizes QOL by distinct domains. Study results were categorized and presented by domain. Risk of bias was completed for all included studies using methods described in the Cochrane Handbook. Thirty-one studies with 307 292 participants were included that examined QOL outcomes across seven domains: superdomain (composite measures), perceived physical health, mental and psychological states, level of independence, social relationships, environment, and general health. Findings indicated that moderate-to-vigorous intensity physical activity was favourably associated with QOL. Time re-allocation studies that showed moving time into physical activity from sedentary behaviour were associated with favourable QOL changes. The evidence regarding sedentary behaviour and sleep duration was inconsistent. The quality of evidence was very low for all domains. In conclusion, there is consistent evidence that physical activity improves QOL in adults ≥65 years of age. International Prospective Register of Ongoing Systematic Reviews (PROSPERO) registration No.: CRD42021260566.

Individual and country-level factors associated with self-reported and accelerometer-based physical activity in old age: a cross-national analysis of European countries

This study aimed to investigate associations between individual-level (personality traits, quality of life) and country-level (gross domestic product per capita, number of policies and action plans for physical activity) factors with self-reported and accelerometer-based physical activity and cross-level interactions among European countries. Based on the Survey of Health, Ageing and Retirement in Europe (SHARE) from 2019-2020, self-reported physical activity (N = 46,617 from 27 countries) and accelerometer-based average acceleration and intensity gradient (N = 855 from 10 countries) were analyzed. Mixed-model regressions with two levels (individuals nested within countries) were used for analyses. Between countries differences accounted for relatively small portions of the variability in self-reported physical activity (intraclass correlation, ICC = 7.5%), average acceleration (ICC = 3.5%), and intensity gradient (ICC = 1.9%). There were more associations between individual- and country-level factors and self-reported physical activity than with accelerometer-based physical activity. The association between individual-level variables and accelerometer-based physical activity did not differ between countries. Cross-level interactions suggested that associations between some personality traits and self-reported physical activity were stronger in countries with lower GDP. Both individual- and country-level factors are related to participation in more intensive physical activities. Adults with less resilient personality traits living in countries with lower resources are at the highest risk for physical inactivity.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10433-022-00737-8.

New Strategies to Improve the Quality of Life for Normal Aging versus Pathological Aging

In the context of the manifestation of the phenomenon of normal aging and functional decline at older adults with neurodegenerative pathology, the development of physical activities and healthy lifestyle has become a priority that involves many decisions and responsibilities. Therefore, the study of the quality of life of the elderly in terms of delaying early aging and improving the lifestyle of patients with neurodegenerative diseases is a scientific challenge representing research of great interest and relevance. By promoting physical activity based on telerehabilitation programs or performed according to coordinated training either in the community or at home for both study groups, significant improvements have been obtained. The aim of this paper was to evaluate the intervention suitable patterns, surveys delivered through variables online platforms and tools to reflect the stagnation of early aging and the evolution of patients with PD and dementia. Our study involved selected original studies, intensively processed, which demonstrated through intervention specific tools, such as quantitative, qualitative, socio-economics, physical, and cognitive indicators, that significant improvements can be achieved in the process of early aging, but also significant progress in patients with neurodegenerative diseases. By searching the last five years of papers, our review, presents the importance of intervention by telerehabilitation or by scheduled physical exercises quantified by specific indicators.