Profiles of Accelerometry-Derived Physical Activity Are Related to Perceived Physical Fatigability in Older Adults.

Jessica L Graves,Robert T Krafty,Nancy W Glynn,Eric J Shiroma,Yujia (Susanna) Qiao,Robert M Boudreau,Kyle D Moored,Jaroslaw Harezlak,Elizabeth M Venditti

doi:10.3390/s21051718

Abstract

Physical activity (PA) is associated with greater fatigability in older adults; little is known about magnitude, shape, timing and variability of the entire 24-h rest–activity rhythm (RAR) associated with fatigability. We identified which features of the 24-h RAR pattern were independently and jointly associated with greater perceived physical fatigability (Pittsburgh Fatigability Scale, PFS, 0–50) in older adults (n = 181, 71.3 ± 6.7 years). RARs were characterized using anti-logistic extended cosine models and 4-h intervals of PA means and standard deviations across days. A K-means clustering algorithm approach identified four profiles of RAR features: “Less Active/Robust”, “Earlier Risers”, “More Active/Robust” and “Later RAR”. Quantile regression tested associations of each RAR feature/profile on median PFS adjusted for age, sex, race, body mass index and depression symptomatology. Later rise times (up mesor; β = 1.38, p = 0.01) and timing of midpoint of activity (acrophase; β = 1.29, p = 0.01) were associated with higher PFS scores. Lower PA between 4 a.m. and 8 a.m. was associated with higher PFS scores (β = −4.50, p = 0.03). “Less Active/Robust” (β = 6.14, p = 0.01) and “Later RAR” (β = 3.53, p = 0.01) patterns were associated with higher PFS scores compared to “Earlier Risers”. Greater physical fatigability in older adults was associated with dampened, more variable, and later RARs. This work can guide development of interventions aimed at modifying RARs to reduce fatigability in older adults.

Highlights

Perceived physical fatigability, defined as an individual’s susceptibility to fatigue anchored to activities of specified intensity and duration [1,2], is prevalent with advanced age, such that about 25% of older adults aged 60–69 and approximately 82% of those at least 90 years of age report greater fatigability [3]
The participants in the combined sample had a mean age of 71.3 years and were predominately female (79.0%), white (73.9%), educated (79.3% had at least a high school education level), and obese
This study found that later activity patterns were associated with higher Pittsburgh Fatigability Scale (PFS) physical scores, with each hour later being associated with a

Summary

Introduction

Perceived physical fatigability, defined as an individual’s susceptibility to fatigue anchored to activities of specified intensity and duration [1,2], is prevalent with advanced age, such that about 25% of older adults aged 60–69 and approximately 82% of those at least 90 years of age report greater fatigability [3]. In addition to physical function, greater physical fatigability has been associated with other indicators of health status, such as cognition, chronic low-grade inflammation, subclinical peripheral artery disease and greater cardiovascular disease burden [2]. These findings demonstrate that physical fatigability is a key marker of phenotypic aging. Perceived physical fatigability may influence markers of phenotypic aging through a complex, bidirectional relationship with free-living activity, both contributing to decline in physical function. Wanigatunga et al [8] found that greater performance-based perceived physical fatigability was associated with lower physical activity, between the hours of 8:00 a.m. to 8:00 p.m. in the Baltimore Longitudinal

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