Abstract
BackgroundPhysical activity questionnaires (PAQ) have been extensively used to determine physical activity (PA) levels. Most PAQ are derived from an energy expenditure-based perspective and assess activities with a certain intensity level. Activities with a moderate or vigorous intensity level are predominantly used to determine a person’s PA level in terms of quantity. Studies show that the time spent engaging in moderate and vigorous intensity PA does not appropriately reflect the actual PA behavior of older people because they perform more functional, everyday activities. Those functional activities are more likely to be considered low-intense and represent an important qualitative health-promoting activity. For the elderly, functional, light intensity activities are of special interest but are assessed differently in terms of quantity and quality. The aim was to analyze the content of PAQ for the elderly.MethodsN = 18 sufficiently validated PAQ applicable to adults (60+) were included. Each item (N = 414) was linked to the corresponding code of the International Classification of Functioning, Disability and Health (ICF) using established linking rules. Kappa statistics were calculated to determine rater agreement.ResultsItems were linked to 598 ICF codes and 62 different ICF categories. A total of 43.72% of the codes were for sports-related activities and 14.25% for walking-related activities. Only 9.18% of all codes were related to household tasks. Light intensity, functional activities are emphasized differently and are underrepresented in most cases. Additionally, sedentary activities are underrepresented (5.55%). κ coefficients were acceptable for n = 16 questionnaires (0.48-1.00).ConclusionsThere is a large inconsistency in the understandings of PA in elderly. Further research should focus (1) on a conceptual understanding of PA in terms of the behavior of the elderly and (2) on developing questionnaires that inquire functional, light intensity PA, as well as sedentary activities more explicitly.
Highlights
Physical activity questionnaires (PAQ) have been extensively used to determine physical activity (PA) levels
We searched for PAQ using the following keywords with Boolean operators (AND, OR) in titles and abstracts: “questionnaire”, “scale”, “index”, “physical activity”, “activity”, “sport”, “exercise”, “adults”, “adolescents”, “older” and “elderly”. 784 articles were identified through the database search and an additional 22 articles through independent web research (N = 806)
Three PAQ were excluded, the Occupational Physical Activity Questionnaire (OPAC) [19], the Occupational Sitting and Physical Activity Questionnaire (OSPAQ) [20] and the Tecumseh Occupational Physical Activity Questionnaire (Tecumseh OPAQ) [21] because they were only applicable in occupational contexts
Summary
Physical activity questionnaires (PAQ) have been extensively used to determine physical activity (PA) levels. Most existing questionnaires are derived from an energy expenditure-based perspective and assess activities with a certain intensity level because evidence connects higher levels of energy expenditure with a variety of health-promoting effects [8] The consequence of this emphasis is that activities with a moderate or vigorous intensity level, e.g., sports activities, are predominantly used to determine a person’s physical activity level in terms of quantity [5]. Studies show that the time spent engaging in moderate and vigorous intensity physical activity does not appropriately reflect the actual physical activity behavior of older people because they perform more functional, everyday activities [6,9] Those functional activities are more likely to be considered lowintensity physical activity and represent an important qualitative health-promoting activity [10,11]. Sedentary behavior has emerged as an independent risk factor for health among older adults [14], but is not sufficiently covered by most of the questionnaires
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