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

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          Abstract

          Background

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

          Method

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

          Results

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

          Conclusions

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

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          Most cited references33

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          Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability.

          Functional assessment is an important part of the evaluation of elderly persons. We conducted this study to determine whether objective measures of physical function can predict subsequent disability in older persons. This prospective cohort study included men and women 71 years of age or older who were living in the community, who reported no disability in the activities of daily living, and who reported that they were able to walk one-half mile (0.8 km) and climb stairs without assistance. The subjects completed a short battery of physical-performance tests and participated in a follow-up interview four years later. The tests included an assessment of standing balance, a timed 8-ft (2.4-m) walk at a normal pace, and a timed test of five repetitions of rising from a chair and sitting down. Among the 1122 subjects who were not disabled at base line and who participated in the four-year follow-up, lower scores on the base-line performance tests were associated with a statistically significant, graduated increase in the frequency of disability in the activities of daily living and mobility-related disability at follow-up. After adjustment for age, sex, and the presence of chronic disease, those with the lowest scores on the performance tests were 4.2 to 4.9 times as likely to have disability at four years as those with the highest performance scores, and those with intermediate performance scores were 1.6 to 1.8 times as likely to have disability. Among nondisabled older persons living in the community, objective measures of lower-extremity function were highly predictive of subsequent disability. Measures of physical performance may identify older persons with a preclinical stage of disability who may benefit from interventions to prevent the development of frank disability.
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            Sedentary behaviors and subsequent health outcomes in adults a systematic review of longitudinal studies, 1996-2011.

            To systematically review and provide an informative synthesis of findings from longitudinal studies published since 1996 reporting on relationships between self-reported sedentary behavior and device-based measures of sedentary time with health-related outcomes in adults. Studies published between 1996 and January 2011 were identified by examining existing literature reviews and by systematic searches in Web of Science, MEDLINE, PubMed, and PsycINFO. English-written articles were selected according to study design, targeted behavior, and health outcome. Forty-eight articles met the inclusion criteria; of these, 46 incorporated self-reported measures including total sitting time; TV viewing time only; TV viewing time and other screen-time behaviors; and TV viewing time plus other sedentary behaviors. Findings indicate a consistent relationship of self-reported sedentary behavior with mortality and with weight gain from childhood to the adult years. However, findings were mixed for associations with disease incidence, weight gain during adulthood, and cardiometabolic risk. Of the three studies that used device-based measures of sedentary time, one showed that markers of obesity predicted sedentary time, whereas inconclusive findings have been observed for markers of insulin resistance. There is a growing body of evidence that sedentary behavior may be a distinct risk factor, independent of physical activity, for multiple adverse health outcomes in adults. Prospective studies using device-based measures are required to provide a clearer understanding of the impact of sedentary time on health outcomes. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
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              Objective vs. Self-Reported Physical Activity and Sedentary Time: Effects of Measurement Method on Relationships with Risk Biomarkers

              Purpose Imprecise measurement of physical activity variables might attenuate estimates of the beneficial effects of activity on health-related outcomes. We aimed to compare the cardiometabolic risk factor dose-response relationships for physical activity and sedentary behaviour between accelerometer- and questionnaire-based activity measures. Methods Physical activity and sedentary behaviour were assessed in 317 adults by 7-day accelerometry and International Physical Activity Questionnaire (IPAQ). Fasting blood was taken to determine insulin, glucose, triglyceride and total, LDL and HDL cholesterol concentrations and homeostasis model-estimated insulin resistance (HOMAIR). Waist circumference, BMI, body fat percentage and blood pressure were also measured. Results For both accelerometer-derived sedentary time ( 50% lower for the IPAQ-reported compared to the accelerometer-derived measure (p<0.0001 for both interactions). The relationships for moderate-to-vigorous physical activity (MVPA) and risk factors were less strong than those observed for sedentary behaviours, but significant negative relationships were observed for both accelerometer and IPAQ MVPA measures with glucose, and insulin and HOMAIR values (all p<0.05). For accelerometer-derived MVPA only, additional negative relationships were seen with triglyceride, total cholesterol and LDL cholesterol concentrations, BMI, waist circumference and percentage body fat, and a positive relationship was evident with HDL cholesterol (p = 0.0002). Regression coefficients for HOMAIR, insulin and triglyceride were 43–50% lower for the IPAQ-reported compared to the accelerometer-derived MVPA measure (all p≤0.01). Conclusion Using the IPAQ to determine sitting time and MVPA reveals some, but not all, relationships between these activity measures and metabolic and vascular disease risk factors. Using this self-report method to quantify activity can therefore underestimate the strength of some relationships with risk factors.
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                Author and article information

                Contributors
                Role: Decision Editor
                Journal
                J Gerontol A Biol Sci Med Sci
                J. Gerontol. A Biol. Sci. Med. Sci
                gerona
                The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
                Oxford University Press (US )
                1079-5006
                1758-535X
                September 2020
                14 January 2020
                14 January 2020
                : 75
                : 9
                : 1754-1762
                Affiliations
                [1 ] Department of Sport Sciences, Faculty of Psychology, Education and Sport Sciences Blanquerna, Universitat Ramon Llull , Barcelona, Spain
                [2 ] Department of Physical Therapy, Faculty of Health Sciences Blanquerna, Universitat Ramon Llull , Barcelona, Spain
                [3 ] Institute of Mental Health Sciences, School of Health Sciences, Ulster University , Newtownabbey, UK
                [4 ] Department of Sports Science and Clinical Biomechanics, Center for Active and Healthy Ageing (CAHA), University of Southern Denmark , Odense, Denmark
                [5 ] Fundació Salut i Envelliment, Universitat Autònoma de Barcelona , Spain
                [6 ] Institute of Epidemiology and Medical Biometry, Ulm University , Germany
                [7 ] Department of Epidemiology, Boston University School of Public Health , Massachusetts
                [8 ] Agaplesion Bethesda Clinic, Geriatric Research Unit Ulm University and Geriatric Center Ulm , Germany
                [9 ] Department of Health Economics, University of Glasgow , UK
                Author notes
                Address correspondence to: Maria Giné-Garriga, PhD, Faculty of Psychology, Education and Sport Sciences Blanquerna, Universitat Ramon Llull, C/Císter 34, 08022 Barcelona, Spain. E-mail: mariagg@ 123456blanquerna.url.edu
                Author information
                http://orcid.org/0000-0002-3563-2791
                Article
                glaa016
                10.1093/gerona/glaa016
                7494025
                31943000
                9ea38f04-9972-4b1c-a3e6-edd2a4d9f962
                © The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                : 26 September 2019
                : 10 January 2020
                : 06 February 2020
                Page count
                Pages: 9
                Funding
                Funded by: European Union program Horizon 2020;
                Award ID: H2020-Grant 634270
                Categories
                THE JOURNAL OF GERONTOLOGY: Medical Sciences
                Fatigue, Sedentary Time and Accelerometry - Part 1
                AcademicSubjects/MED00280
                AcademicSubjects/SCI00960

                Geriatric medicine
                compositional analysis,sedentary behavior,physical activity,sociodemographic correlates

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