MVPA and Sedentary Behavior In Community Dwelling Older Men Measured By Accelerometer

Purpose The 2010 physical activity (PA) guidelines for older adults in the UK include a target of 150 minutes of moderate or vigorous PA (MVPA)/week and recommend minimizing time spent being sedentary in extended periods. There are few large studies of objectively measured PA in the elderly which can estimate the prevalence and predictors of adherence to PA guidelines which are likely to provide health benefits. We therefore investigate prevalence of adherence to MVPA guidelines using two thresholds for PA bouts and describe levels of SB, among older men.

Methods In 2010-2012, 3292 British men aged 70-93 years participating in an on-going population-based cohort study recruited from primary care centres in 24 British towns were invited (by post) to wear an Actigraph GT3X accelerometer over the hip for 7 days and complete questionnaires. Uniaxial data were analysed in 60s epochs. Bouts of >120 minutes of continuous zeros with no interruptions were excluded. >=3 valid days (of >=600 minutes wear time) were required for inclusion in analyses. Cut point thresholds were <100 (sedentary behavior), 100-1951 (light) and >=1952cpm (MVPA), in bouts of 1 minute (MVPA-1) or bouts of >=10 minutes (MVPA-10+). Logistic regression models were used to model MVPA and adjusted for age, region, day order, month and accelerometer wear time.

Results 1674 (51%) men participated, mean age 78 years. 7% men did MVPA-10+, and 27% did MVPA-1. Achieving MVPA-10+ was associated with younger age, having no mobility limitations (OR 8.4, 95%CI 2.05, 34.37) and no chronic diseases (OR 2.06, 95%CI 1.38, 3.06), not being depressed (OR 4.87, 95%CI 2.10,11.25) or fearful of falling (OR 3.45, 95%CI 1.48, 8.63), having higher exercise self-efficacy (OR 2.72 95%CI 2.07, 3.56) and outcomes expectations (OR 1.88 95%CI 1.53, 2.32), leaving the house >=5 days/week (OR 3.62 95%CI 1.45,9.05), living near green spaces (OR 1.67 95%CI 1.13,2.47) and walking a dog (OR 2.28 (95%CI 1.39, 3.73). In models adjusted for all covariates, exercise self-efficacy and dog walking remained significant and little changed. The same variables were associated with achieving MVPA-1. Total daily minutes of MVPA and SB were weakly inversely correlated (r=-0.20). Mean total SB was 658 (SD 112) mins/day, of which 156 (SD 125) were spent in bouts of 60 minutes or more.

Conclusions Adherence to MVPA guidelines is low in older men (varying 7-27% depending on assumptions) and burden of SB is high, leaving room for substantial potential health gain. Poor mental and physical health were important barriers and important modifiable facilitators were dog walking and high levels of exercise self-efficacy.

Funding: NIHR Post Doctoral Fellowship