Abstract
BackgroundProlonged daily sedentary time is associated with increased risk of cardiometabolic diseases, impaired physical function, and mortality. Older adults are more sedentary than any other age group and those in assisted living residences accumulate more sedentary time as they often have little need to engage in light-intensity or standing activities such as cleaning or meal preparation. This “low movement” environment can hasten functional decline. Thus, the purpose of this study was to develop a multi-level intervention to reduce and interrupt sedentary time within assisted living residences and conduct a pilot study to determine if the intervention is feasible and if further testing is warranted.Methods“Stand When You Can” (SWYC) was developed using a Social Ecological framework based on a review of literature and consultation with residents and staff at assisted living residences. After development, a six-week pilot study was conducted in two different residences with 10 older adults (82.2 ± 8.7 years). Before and after the 6 weeks, ActivPAL™ inclinometers were used to measure daily movement behaviours and self-report questionnaires assessed time spent in different sedentary behaviours and quality of life. Physical function was assessed using the Short Physical Performance Battery. Paired sample t-tests examined pre-post differences for pooled data and individual sites. At the end of the pilot study, feedback on the intervention was gathered from both residents and staff to examine feasibility.ResultsThere was a trend towards a decrease in self-reported sitting time (142 min/day; p = 0.09), although device-measured sedentary time did not change significantly. Participants with lower physical function at baseline showed clinically meaningful improvements in physical function after the 6 weeks (p = 0.04, Cohen’s d = 0.89). There was no change in quality of life. Residents and staff reported that the intervention strategies were acceptable and practical.ConclusionThis study suggests that a multi-level intervention for reducing prolonged sedentary time is feasible for implementation at assisted living residences. The intervention could potentially help delay functional decline among older adults when they transition to a supportive living environment. Longer and larger trials to test the efficacy of SWYC are necessary.Trial registrationName of Clinical Trial Registry: clinicaltrials.govTrial Registration number: NCT04458896.Date of registration: July 8, 2020. (Retrospectively registered).
Highlights
Prolonged daily sedentary time is associated with increased risk of cardiometabolic diseases, impaired physical function, and mortality
Since both strategies have been successful at reducing sedentary time and slowing declines in physical function, they were referenced as a starting point for Stand When You Can (SWYC)
The post-intervention reduction in device-measured sedentary time observed at Site A was consistent with findings in communitydwelling older adults that have reported reductions in sitting of approximately 30-min per day [18, 21, 22] and a decrease of this magnitude could have a meaningful impact on physical function and mobility [48, 49]
Summary
Prolonged daily sedentary time is associated with increased risk of cardiometabolic diseases, impaired physical function, and mortality. Older adults are more sedentary than any other age group and those in assisted living residences accumulate more sedentary time as they often have little need to engage in light-intensity or standing activities such as cleaning or meal preparation. This “low movement” environment can hasten functional decline. There is no standard definition of assisted living and it can include a range of services; most have at minimum 24-h emergency assistance, meal service, and housekeeping support With these supports in place, older adults who transition to assisted-living often have little need to engage in light-intensity or standing activities such as household chores or meal preparation. Older adults in assisted living accumulate more sitting time and less time standing and walking compared to their peers who live independently [3,4,5]
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