Abstract
BackgroundBased on findings primarily using self-report measures, physical activity has been recommended to reduce disability in old age. Collecting objective measures of total daily physical activity in community-dwelling older adults is uncommon, but might enhance the understanding of the relationship of physical activity and disability. We examined whether greater total daily physical activity was associated with less report of disability in the elderly.MethodsData were from the Rush Memory and Aging Project, a longitudinal prospective cohort study of common, age-related, chronic conditions. Total daily physical activity was measured in community-dwelling participants with an average age of 82 using actigraphy for approximately 9 days. Disability was measured via self-reported basic activities of daily living (ADL). The odds ratio and 95% Confidence Interval (CI) were determined for the baseline association of total daily physical activity and ADL disability using a logistic regression model adjusted for age, education level, gender and self-report physical activity. In participants without initial report of ADL disability, the hazard ratio and 95% CI were determined for the relationship of baseline total daily physical activity and the development of ADL disability using a discrete time Cox proportional hazard model adjusted for demographics and self-report physical activity.ResultsIn 870 participants, the mean total daily physical activity was 2. 9 × 105 counts/day (range in 105 counts/day = 0.16, 13. 6) and the mean hours/week of self-reported physical activity was 3.2 (SD = 3.6). At baseline, 718 (82.5%) participants reported being independent in all ADLs. At baseline, total daily physical activity was protective against disability (OR per 105 counts/day difference = 0.55; 95% CI = 0.47, 0.65). Of the participants without baseline disability, 584 were followed for 3.4 years on average. Each 105 counts/day additional total daily physical activity was associated with reduced hazard of developing disability by 25% (HR = 0.75, 95% CI = 0.66, 0.84). The results were unchanged after controlling for important covariates including cognition, depressive symptoms, and chronic health conditions.ConclusionsGreater total daily physical activity is independently associated with less disability even after controlling for self-reported physical activity.
Highlights
Based on findings primarily using self-report measures, physical activity has been recommended to reduce disability in old age
As prior work in this cohort showed that greater self-report of hours of physical activity per week was associated with a lower hazard of developing activity of daily living (ADL) disability in the future [21], we examined if greater total daily physical activity still was associated with low probability of report of ADL disability after controlling for self-report physical activity
Higher total daily physical activity was associated with younger age, a lower total score for report of ADL disability, more self-reported hours of physical activity per week, better cognitive performance, fewer reports of vascular disease risk factors, fewer reports of vascular diseases, and fewer depressive symptoms (Table 1)
Summary
Based on findings primarily using self-report measures, physical activity has been recommended to reduce disability in old age. In Healthy People 2020 [1], reduction by 10-percentage points of older Americans reporting moderate to severe functional limitation over the decade is listed as a national goal. For this goal, moderate to severe functional limitation is defined as reporting difficulty in performing at least one basic activity of daily living (ADL) [2]. While almost 30% of adults 65 years and older reported functional dependence, the prevalence increases from about 20% in persons between 65 and 74 to over 55% in persons over age 85 [3]. As more Americans are living into their eighties, though, the absolute number of older Americans reporting functional limitations may increase [6]
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