Objective Measures of Activity in the Elderly: Distribution and Associations With Demographic and Health Factors

Abstract

Background: Little is known about the distribution of activity over the full 24-hour spectrum in late old age and its association with demographic and health factors. Therefore, we aimed to evaluate the distribution of physical activity (PA), sedentary behavior, and sleep, and associated factors in the elderly population.

Methods: Our study included 1210 participants (51.9% women) aged 70-94 years [mean age 77.5 years, standard deviation (SD) 5.0] from the population-based Rotterdam Study. Participants wore a triaxial accelerometer (GENEActiv) around the wrist for 7 days between July 2014 and June 2016. We examined if PA, sedentary behavior, and sleep differed by age, sex, body mass index (BMI), smoking status, alcohol consumption, education, season, functional capacity, marital status, presence of chronic disease, and use of sleep medication.

Results: Mean total PA, expressed in milli-gravity (mg) units, was slightly higher for women (20.3, SD 5.6) than for men (19.3, SD 5.2, P < .01). Mean (SD) daily duration spent in sedentary behavior and light and moderate-to-vigorous PA was 13.3 (1.5) h/d, 147.5 (31.5) min/d, and 75.0 (25.5) min/d, respectively, among women; and 13.8 (1.6) h/d, 140.5 (31.1) min/d, and 71.5 (24.5) min/d, respectively, among men. Women spent on average 6.7 (SD 1.1) h/d sleeping and men 6.6 (1.4) h/d. Across increasing categories of age and BMI and in participants with chronic disease and disability, time spent in light and moderate-to-vigorous PA was decreased. Higher age and BMI were associated with more sedentary time. In addition, obese men spent slightly more time sleeping than their normal weight counterparts and women spent slightly less time sleeping in the summer than in spring.

Conclusions: PA and sedentary behavior in the elderly differed by sex, age, BMI, prevalence of chronic disease, and disability, whereas there were no clear patterns for sleep. On average, our participants spent up to 79.5% of their time awake being sedentary and 7%-8% in moderate-to-vigorous PA. Replacing sedentary behavior with light PA would be a good starting point for those with the lowest level of PA. Older adults, those with high BMI and worse health could benefit from targeted interventions to increase PA.

Keywords: Physical activity; Rotterdam Study; accelerometer; elderly.

Figure 1

Flow chart of participant inclusion for the Rotterdam Study.

Figure 2

Activity distribution of time spent in acceleration (mg) categories (intensity) stratified by sex. Abbreviations: ENMO, The Euclidean norm minus 1 g with negative numbers rounded to zero; IQR, interquartile range.

Figure 3

Activity distribution of time spent in acceleration (mg) categories (intensity) stratified by age-group. Abbreviations: ENMO, The Euclidean norm minus 1 g with negative numbers rounded to zero; IQR, interquartile range.

Figure 4

Distribution of activity across the 24-hour period in men and women, according to age-group Abbreviations: PA, physical activity

Figure 5

Distribution of activity across the 24-hour period in men and women, according to normal weight, overweight and obesity Abbreviations: PA, physical activity. Body mass index was calculated as weight in kilograms divided by height in meters squared. Categories were defined as normal weight: 18.5 < 25 kg/m², overweight: 25 < 30 kg/m² and obese: ≥ 30 kg/m². The average time spent in each activity level was adjusted for age.