Top

European Review of Aging and Physical Activity

Published in:

Open Access 01-12-2022 | Research article

Physical activity and sedentary behavior trajectories and their associations with quality of life, disability, and all-cause mortality

Authors: Aarón Salinas-Rodríguez, Betty Manrique-Espinoza, Rosa Palazuelos-González, Ana Rivera-Almaraz, Alejandra Jáuregui

Published in: European Review of Aging and Physical Activity | Issue 1/2022

Abstract

Background

Physical activity (PA) and sedentary behavior (SB) are not stable conditions but change over time and among individuals, and both could have deleterious effects on health-related outcomes among older adults. This study aimed to identify the longitudinal trajectories of PA and SB and estimate their association with quality of life, disability, and all-cause mortality in a national sample of older Mexican adults.

Methods

Data comes from three waves of the WHO Study on global AGEing and adult health (SAGE) in Mexico (2009, 2014, 2017). In total, 3209 older adults ages 50 and above were included. PA and SB were determined by using the Global Physical Activity Questionnaire (GPAQ). Disability was measured using the WHO Disability Assessment Schedule (WHODAS 2.0), quality of life using the WHOQOL (WHO Quality of Life) instrument, and all-cause mortality using a verbal autopsy. We used growth mixture modeling (GMM) to investigate the longitudinal trajectories of PA and SB. Three-level linear mixed effect models were used to estimate the associations of PA and SB with quality of life and disability and the Cox model for the association with all-cause mortality.

Results

Three longitudinal trajectories of PA and SB were found: low-PA-decreasers, moderate-PA-decreasers, and high-PA-decreasers for PA; and low-maintainers, steep-decreasers, and steep-increasers for SB. Decreased quality of life, increased disability, and all-cause mortality were all consistently associated with worse PA and SB trajectories.

Conclusions

Our results highlight the need for health policies and prevention strategies that promote PA and limit SB in middle-aged adults. Further studies should consider these activities/behaviors as exposures that vary throughout life and work to identify vulnerable groups of older adults for whom physical activation interventions and programs would be most impactful.

Available only for authorised users

National Academies of Sciences, Engineering, and Medicine, Division of Behavioral and Social Sciences and Education, Committee on Population, Majmundar, M. K., and; Hayward, M. D. (Eds.). (2018). Future Directions for the Demography of Aging: Proceedings of a Workshop. National Academies Press (US).

Cunningham C. O' Sullivan R, Caserotti P, Tully MA. Consequences of physical inactivity in older adults: a systematic review of reviews and meta-analyses. Scand J Med Sci Sports. 2020;30(5):816–27. https://doi.org/10.1111/sms.13616.CrossRefPubMed

Ding D, Lawson KD, Kolbe-Alexander TL, Finkelstein EA, Katzmarzyk PT, van Mechelen W, et al. The economic burden of physical inactivity: a global analysis of major non-communicable diseases. Lancet. 2016;388(10051):1311–24. https://doi.org/10.1016/S0140-6736(16)30383-X.CrossRefPubMed

Ekelund U, Steene-Johannessen J, Brown WJ, Fagerland MW, Owen N, Powell KE, et al. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women [published correction appears in lancet. 2016 Sep 24;388(10051):e6]. Lancet. 2016;388(10051):1302–10. https://doi.org/10.1016/S0140-6736(16)30370-1.CrossRefPubMed

Wullems JA, Verschueren SM, Degens H, Morse CI, Onambélé GL. A review of the assessment and prevalence of sedentarism in older adults, its physiology/health impact and non-exercise mobility counter-measures. Biogerontology. 2016;17(3):547–65. https://doi.org/10.1007/s10522-016-9640-1.CrossRefPubMedPubMedCentral

Motl RW, McAuley E. Physical activity, disability, and quality of life in older adults. Phys Med Rehabil Clin N Am. 2010;21:299–308. https://doi.org/10.1016/j.pmr.2009.12.006.CrossRefPubMed

Phillips SM, Wójcicki TR, McAuley E. Physical activity and quality of life in older adults: an 18-month panel analysis. Qual Life Res. 2013;22(7):1647–54. https://doi.org/10.1007/s11136-012-0319-z.CrossRefPubMed

Kim S, Kwon YM, Park Y. I. Association between Physical Activity and Health-Related Quality of Life in Korean: Korean J Fam Med. 2014;35(3):152–9. https://doi.org/10.4082/kjfm.2014.35.3.152.CrossRefPubMedPubMedCentral

Sanchez-Sanchez JL, Izquierdo M, Carnicero-Carreño JA, García-García FJ, Rodríguez-Mañas L. Physical activity trajectories, mortality, hospitalization, and disability in the Toledo study of healthy aging. J Cachexia Sarcopenia Muscle. 2020;11(4):1007–17. https://doi.org/10.1002/jcsm.12566.CrossRefPubMedPubMedCentral

10.

Laddu D, Parimi N, Cauley JA, Cawthon PM, Ensrud KE, Orwoll E, et al. & osteoporotic fractures in men (MrOS) study research group. The association between trajectories of physical activity and all-cause and cause-specific mortality. J Gerontol A Biol Sci Med Sci. 2018;73(12):1708–13. https://doi.org/10.1093/gerona/gly037.CrossRefPubMedPubMedCentral

11.

Susanto M, Hubbard RE, Gardiner PA. Association of 12-year trajectories of sitting time with frailty in middle-aged women. Am J Epidemiol. 2018;187(11):2387–96. https://doi.org/10.1093/aje/kwy111.CrossRefPubMed

12.

DiPietro L. Physical activity in aging: changes in patterns and their relationship to health and function. The journals of gerontology. Series A, Biological sciences and medical sciences, 56 Spec No 2, 13–22. https://doi.org/10.1093/gerona/56.suppl_2.13.

13.

He W, Muenchrath MN, Kowal P. Shades of gray: a cross-country study of health and well-being of the older populations in SAGE countries. Washington, DC: US Government Printing Office; 2007–2010.

14.

Skevington SM, Lotfy M, O'Connell KA. & WHOQOL group. The World Health Organization's WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res. 2004;13(2):299–310. https://doi.org/10.1023/B:QURE.0000018486.91360.00.CrossRefPubMed

15.

Ustün TB, Chatterji S, Kostanjsek N, Rehm J, Kennedy C, Epping-Jordan J, et al. & WHO/NIH joint project. Developing the World Health Organization disability assessment schedule 2.0. Bull World Health Organ. 2010;88(11):815–23. https://doi.org/10.2471/BLT.09.067231.CrossRefPubMedPubMedCentral

16.

World Health Organization. Verbal autopsy standards: the 2016 WHO verbal autopsy https://www.who.int/standards/classifications/other-classifications/verbal-autopsy-standards-ascertaining-and-attributing-causes-of-death-tool (accessed 2 Aug. 2021).

17.

Keating XD, Zhou K, Liu X, Hodges M, Liu J, Guan J, et al. Reliability and concurrent validity of global physical activity questionnaire (GPAQ): a systematic review. Int J Environ Res Public Health. 2019;16(21):4128. https://doi.org/10.3390/ijerph16214128.CrossRefPubMedCentral

18.

WHO. Global Physical Activity Questionnaire (GPAQ). Analysis Guide. Available online: http://www.who.int/ncds/surveillance/steps/resources/GPAQ_Analysis_Guide.pdf. Accessed Jul 2021.

19.

Aguilar-Farias N, Leppe Zamora J. Is a single question of the global physical activity questionnaire (GPAQ) valid for measuring sedentary behaviour in the Chilean population? J Sports Sci. 2017;35(16):1652–7. https://doi.org/10.1080/02640414.2016.1229010.CrossRefPubMed

20.

Metcalf KM, Baquero BI, Coronado Garcia ML, Francis SL, Janz KF, Laroche HH, et al. Calibration of the global physical activity questionnaire to Accelerometry measured physical activity and sedentary behavior. BMC public health. 18(1):412. https://doi.org/10.1186/s12889-018-5310-3.

21.

Howe LD, Galobardes B, Matijasevich A, Gordon D, Johnston D, Onwujekwe O, et al. Measuring socio-economic position for epidemiological studies in low- and middle-income countries: a methods of measurement in epidemiology paper. Int J Epidemiol. 2012;41(3):871–86. https://doi.org/10.1093/ije/dys037.CrossRefPubMedPubMedCentral

22.

Arokiasamy P, Uttamacharya KP, Capistrant BD, et al. Chronic Noncommunicable Diseases in 6 Low- and Middle-Income Countries: Findings From Wave 1 of the World Health Organization's Study on Global Ageing and Adult Health (SAGE). Am J Epidemiol. 2017;185(6):414–28. https://doi.org/10.1093/aje/kww125.CrossRefPubMedPubMedCentral

23.

Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. & cardiovascular health study collaborative research group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56. https://doi.org/10.1093/gerona/56.3.m146.CrossRefPubMed

24.

Hoogendijk EO, Rijnhart J, Kowal P, Pérez-Zepeda MU, Cesari M, Abizanda P, et al. Socioeconomic inequalities in frailty among older adults in six low- and middle-income countries: results from the WHO study on global AGEing and adult health (SAGE). Maturitas. 2018;115:56–63. https://doi.org/10.1016/j.maturitas.2018.06.011.CrossRefPubMed

25.

Tyrovolas S, Koyanagi A, Olaya B, Ayuso-Mateos JL, Miret M, Chatterji S, et al. Factors associated with skeletal muscle mass, sarcopenia, and sarcopenic obesity in older adults: a multi-continent study. J Cachexia Sarcopenia Muscle. 2016;7(3):312–21. https://doi.org/10.1002/jcsm.12076.CrossRefPubMed

26.

Ram N, Grimm KJ. Growth Mixture Modeling: A Method for Identifying Differences in Longitudinal Change Among Unobserved Groups. Int J Behav Dev. 2009;33(6):565–76. https://doi.org/10.1177/0165025409343765.

27.

Nylund KL, Asparouhov T, Muthén BO. Deciding on the number of classes in latent class analysis and growth mixture modeling: a Monte Carlo simulation study. Struct Equ Modeling. 2014;21(2):263–79. https://doi.org/10.1080/10705510701575396.CrossRef

28.

Betensky RA, Mandel M. Recognizing the problem of delayed entry in time-to-event studies: better late than never for clinical neuroscientists. Ann Neurol. 2015;78(6):839–44. https://doi.org/10.1002/ana.24538.CrossRefPubMedPubMedCentral

29.

Matsuura M, Eguchi S. Modeling late entry bias in survival analysis. Biometrics. 2005;61(2):559–66. https://doi.org/10.1111/j.1541-0420.2005.00325.x.CrossRefPubMed

30.

Williamson JM, Satten GA, Hanson JA, Weinstock H, Datta S. Analysis of dynamic cohort data. Am J Epidemiol. 2001;154(4):366–72. https://doi.org/10.1093/aje/154.4.366.CrossRefPubMed

31.

Lamarca R, Alonso J, Gómez G, Muñoz A. Left-truncated data with age as time scale: an alternative for survival analysis in the elderly population. The journals of gerontology. Series A, Biological sciences and medical sciences. 1998;53(5):M337–43. https://doi.org/10.1093/gerona/53a.5.m337.CrossRef

32.

Muthén LK, Muthén BO. Mplus User’s Guide. Los Angeles, Ca: Eighth Edition; 1998–2017.

33.

Browning, C., Enticott, J., Thomas, S., & Kendig, H. Trajectories of ageing well among older Australians: A 16-year longitudinal study. Ageing and Society, 38(8), 1581–1602. https://doi.org/10.1017/S0144686X17000162.

34.

Jonkman NH, Del Panta V, Hoekstra T, Colpo M, van Schoor NM, Bandinelli S, et al. Predicting trajectories of functional decline in 60- to 70-year-old people. Gerontology. 2018;64(3):212–21. https://doi.org/10.1159/000485135.CrossRefPubMed

35.

Cosco TD, Stephan B, Brayne C, Muniz G, CFAS MRC. Education and Successful Aging Trajectories: A Longitudinal Population-Based Latent Variable Modelling Analysis. Can J Aging. 2017;36(4):427–34. https://doi.org/10.1017/S0714980817000344.CrossRefPubMed

36.

Vallance JK, Murray TC, Johnson ST, Elavsky S. Quality of life and psychosocial health in postmenopausal women achieving public health guidelines for physical activity. Menopause. 2010;17(1):64–71. https://doi.org/10.1097/gme.0b013e3181b6690c.CrossRefPubMed

37.

van Rijckevorsel-Scheele J, Willems R, Roelofs P, Koppelaar E, Gobbens R, Goumans M. Effects of health care interventions on quality of life among frail elderly: a systematized review. Clin Interv Aging. 2019;14:643–58. https://doi.org/10.2147/CIA.S190425.CrossRefPubMedPubMedCentral

38.

Zhang Y, Zhang Y, Du S, Wang Q, Xia H, Sun R. Exercise interventions for improving physical function, daily living activities and quality of life in community-dwelling frail older adults: a systematic review and meta-analysis of randomized controlled trials. Geriatr Nurs. 2020;41(3):261–73. https://doi.org/10.1016/j.gerinurse.2019.10.006.CrossRefPubMed

39.

de Rezende LF, Rey-López JP, Matsudo VK, do Carmo Luiz O. Sedentary behavior and health outcomes among older adults: a systematic review. BMC Public Health. 2014;14:333. https://doi.org/10.1186/1471-2458-14-333.CrossRefPubMedPubMedCentral

40.

Withall J, Stathi A, Davis M, Coulson J, Thompson JL, Fox KR. Objective indicators of physical activity and sedentary time and associations with subjective well-being in adults aged 70 and over. Int J Environ Res Public Health. 2014;11(1):643–56. https://doi.org/10.3390/ijerph110100643.CrossRefPubMedPubMedCentral

41.

Balboa-Castillo T, León-Muñoz LM, Graciani A, Rodríguez-Artalejo F, Guallar-Castillón P. Longitudinal association of physical activity and sedentary behavior during leisure time with health-related quality of life in community-dwelling older adults. Health Qual Life Outcomes. 2011;9(1):47. https://doi.org/10.1186/1477-7525-9-47.CrossRefPubMedPubMedCentral

42.

Dunlop DD, Song J, Arnston EK, Semanik PA, Lee J, Chang RW, et al. Sedentary time in US older adults associated with disability in activities of daily living independent of physical activity. J Phys Act Health. 2015;12(1):93–101. https://doi.org/10.1123/jpah.2013-0311.CrossRefPubMed

43.

Woods JA, Wilund KR, Martin SA, Kistler BM. Exercise, inflammation and aging. Martin SA, Kistler BM. Exercise, inflammation and aging. Aging Dis. 2012;3(1):130–40.PubMed

44.

Simpson RJ, Lowder TW, Spielmann G, Bigley AB, LaVoy EC, Kunz H. Exercise and the aging immune system. Ageing Res Rev. 2012;11(3):404–20. https://doi.org/10.1016/j.arr.2012.03.003.CrossRefPubMed

45.

Neilson HK, Friedenreich CM, Brockton NT, Millikan RC. Physical activity and postmenopausal breast cancer: proposed biologic mechanisms and areas for future research. Cancer Epidemiol Biomark Prev. 2009;18(1):11–27. https://doi.org/10.1158/1055-9965.EPI-08-0756.CrossRef

46.

Parker L, McGuckin TA, Leicht AS. Influence of exercise intensity on systemic oxidative stress and antioxidant capacity. Clin Physiol Funct Imaging. 2014;34(5):377–83. https://doi.org/10.1111/cpf.12108.CrossRefPubMed

47.

Garcia Meneguci CA, Meneguci J, Sasaki JE, Tribess S, Júnior J. Physical activity, sedentary behavior and functionality in older adults: a cross-sectional path analysis. PLoS One. 2021;16(1):e0246275. https://doi.org/10.1371/journal.pone.0246275.CrossRefPubMedPubMedCentral

48.

Zamani Sani SH, Fathirezaie Z, Brand S, Pühse U, Holsboer-Trachsler E, Gerber M, et al. Physical activity and self-esteem: testing direct and indirect relationships associated with psychological and physical mechanisms. Neuropsychiatr Dis Treat. 2016;12:2617–25. https://doi.org/10.2147/NDT.S116811.CrossRefPubMedPubMedCentral

49.

Bey L, Hamilton MT. Suppression of skeletal muscle lipoprotein lipase activity during physical inactivity: a molecular reason to maintain daily low-intensity activity. J Physiol. 2003;551(Pt 2):673–82. https://doi.org/10.1113/jphysiol.2003.045591.CrossRefPubMedPubMedCentral

50.

Biswas A, Oh PI, Faulkner GE, Bajaj RR, Silver MA, Mitchell MS, et al. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Ann Intern Med. 2015;162(2):123–32. https://doi.org/10.7326/M14-1651.CrossRefPubMed

51.

Krogh-Madsen R, Thyfault JP, Broholm C, Mortensen OH, Olsen RH, Mounier R, et al. A 2-wk reduction of ambulatory activity attenuates peripheral insulin sensitivity. J Appl Physiol (1985). 2010;108(5):1034–40. https://doi.org/10.1152/japplphysiol.00977.2009.CrossRef

52.

Knaeps S, Bourgois JG, Charlier R, Mertens E, Lefevre J, Wijndaele K. Ten-year change in sedentary behaviour, moderate-to-vigorous physical activity, cardiorespiratory fitness and cardiometabolic risk: independent associations and mediation analysis. Br J Sports Med. 2018;52(16):1063–8. https://doi.org/10.1136/bjsports-2016-096083.CrossRefPubMed

53.

Visser M, Koster A. Development of a questionnaire to assess sedentary time in older persons--a comparative study using accelerometry. BMC Geriatr. 2013;13(1):80. https://doi.org/10.1186/1471-2318-13-80.CrossRefPubMedPubMedCentral

54.

Schmid D, Ricci C, Leitzmann MF. Associations of objectively assessed physical activity and sedentary time with all-cause mortality in US adults: the NHANES study. PLoS One. 2015;10(3):e0119591. https://doi.org/10.1371/journal.pone.0119591.CrossRefPubMedPubMedCentral

55.

Harvey JA, Chastin SF, Skelton DA. How sedentary are older people? A systematic review of the amount of sedentary behavior. J Aging Phys Act. 2015;23(3):471–87. https://doi.org/10.1123/japa.2014-0164.CrossRefPubMed

56.

Vancampfort D, Stubbs B, Koyanagi A. Physical chronic conditions, multimorbidity and sedentary behavior amongst middle-aged and older adults in six low- and middle-income countries. Int J Behav Nutr Phys Act. 2017;14(1):147. https://doi.org/10.1186/s12966-017-0602-z.CrossRefPubMedPubMedCentral

57.

Gaskin CJ, Orellana L. Factors associated with physical activity and sedentary behavior in older adults from six low- and middle-income countries. Int J Environ Res Public Health. 2018;15(5):908. https://doi.org/10.3390/ijerph15050908.CrossRefPubMedCentral

58.

Gardiner PA, Clark BK, Healy GN, Eakin EG, Winkler EA, Owen N. Measuring older adults' sedentary time: reliability, validity, and responsiveness. Med Sci Sports Exerc. 2011;43(11):2127–33. https://doi.org/10.1249/MSS.0b013e31821b94f7.CrossRefPubMed

59.

Clark BK, Winkler E, Healy GN, Gardiner PG, Dunstan DW, Owen N, et al. Adults' past-day recall of sedentary time: reliability, validity, and responsiveness. Med Sci Sports Exerc. 2013;45(6):1198–207. https://doi.org/10.1249/MSS.0b013e3182837f57.CrossRefPubMed

Title: Physical activity and sedentary behavior trajectories and their associations with quality of life, disability, and all-cause mortality
Authors: Aarón Salinas-Rodríguez
Betty Manrique-Espinoza
Rosa Palazuelos-González
Ana Rivera-Almaraz
Alejandra Jáuregui
Publication date: 01-12-2022
Publisher: BioMed Central
Published in: European Review of Aging and Physical Activity / Issue 1/2022
Print ISSN: 1813-7253
Electronic ISSN: 1861-6909
DOI: https://doi.org/10.1186/s11556-022-00291-3

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Physical activity and sedentary behavior trajectories and their associations with quality of life, disability, and all-cause mortality

Abstract

Background

Methods

Results

Conclusions

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2022

The effects of virtual reality training in stroke and Parkinson’s disease rehabilitation: a systematic review and a perspective on usability

Going digital – a commentary on the terminology used at the intersection of physical activity and digital health

The value of walking: a systematic review on mobility and healthcare costs

Effects of functional training with blood occlusion on the irisin, follistatin, and myostatin myokines in elderly men

Correction to: Being active with a total hip or knee prosthesis: a systematic review into physical activity and sports recommendations and interventions to improve physical activity behavior

Correction: Physical activity and recurrent fall risk in community-dwelling Japanese people aged 40–74 years: the Murakami cohort study

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page