Sedentary Time In Older Adults Research Articles

Mapping sedentary behaviour (MAPS-B) in winter and spring using wearable sensors, indoor positioning systems, and diaries in older adults who are pre-frail and frail: A feasibility longitudinal study.

Older adults who are frail are likely to be sedentary. Prior interventions to reduce sedentary time in older adults have not been effective as there is little research about the context of sedentary behaviour (posture, location, purpose, social environment). Moreover, there is limited evidence on feasible measures to assess context of sedentary behaviour in older adults. The aim of our study was to determine the feasibility of measuring context of sedentary behaviour in older adults with pre-frailty or frailty using a combination of objective and self-report measures. We defined "feasibility process" using recruitment (20 participants within two-months), retention (85%), and refusal (20%) rates and "feasibility resource" if the measures capture context and can be linked (e.g., sitting-kitchen-eating-alone) and are all participants willing to use the measures. Context was assessed using a wearable sensor to assess posture, a smart home monitoring system for location, and an electronic or hard-copy diary for purpose and social context over three days in winter and spring. We approached 80 potential individuals, and 58 expressed interest; of the 58 individuals, 37 did not enroll due to lack of interest or medical mistrust (64% refusal). We recruited 21 older adults (72±7.3 years, 13 females, 13 frail) within two months and experienced two dropouts due to medical mistrust or worsening health (90% retention). The wearable sensor, indoor positioning system, and electronic diary accurately captured one domain of context, but the hard copy was often not completed with enough detail, so it was challenging to link it to the other devices. Although not all participants were willing to use the wearable sensor, indoor positioning system, or electronic diary, we were able to triage the measures of those who did. The use of wearable sensors and electronic diaries may be a feasible method to assess context of sedentary behaviour, but more research is needed with device-based measures in diverse groups.

Comparative effectiveness of interventions on promoting physical activity in older adults: A systematic review and network meta-analysis.

Despite the well-established health benefits of physical activity, a large population of older adults still maintain sedentary life style or physical inactivity. This network meta-analysis (NMA) aimed to compare the effectiveness of wearable activity tracker-based intervention (WAT), electronic and mobile health intervention (E&MH), structured exercise program intervention (SEP), financial incentive intervention (FI) on promoting physical activity and reducing sedentary time in older adults. The systematic review based on PRISMA guidelines, a systematic literature search of PubMed, Web of Science, Google Scholar, EMbase, Cochrane Library, Scopus were searched from inception to December 10th 2022. The randomized controlled trials (RCT) were included. Two reviewers independently conducted study selection, data extraction, risk of bias and certainty of evidence assessment. The effect measures were standard mean differences (SMD) and 95% confidence interval (CI) in daily steps, moderate-to-vigorous physical activity (MVPA) and sedentary time. A total of 69 studies with 14,120 participants were included in the NMA. Among these included studies, the results of daily steps, MVPA and sedentary time was reported by 55, 25 and 15 studies, respectively. The NMA consistency model analysis suggested that the following interventions had the highest probability (surface under the cumulative ranking, SUCRA) of being the best when compared with control: FI + WAT for daily steps (SUCRA = 96.6%; SMD = 1.32, 95% CI:0.77, 1.86), WAT + E&MH + SEP for MVPA (SUCRA = 91.2%; SMD = 0.94, 95% CI: 0.36, 1.52) and WAT + E&MH + SEP for sedentary time (SUCRA = 80.3%; SMD = -0.50, 95% CI: -0.87, -0.14). The quality of the evidences of daily steps, MVPA and sedentary time was evaluated by very low, very low and low, respectively. In this NMA, there's low quality evidence that financial incentive combined with wearable activity tracker is the most effective intervention for increasing daily steps of older adults, wearable activity tracker combined with electronic and mobile health and structured exercise program is the most effective intervention to help older adults to increase MVPA and reduce sedentary time.

MAPPING SEDENTARY BEHAVIOUR USING WEARABLE DEVICES AND DIARIES IN OLDER ADULTS WITH FRAILTY: A FEASIBILITY STUDY

Abstract Older adults with frailty are sedentary. Prior interventions to reduce sedentary time in older adults have not been successful as there is little research about context (posture, location, purpose, social environment). There is limited evidence on feasible measures to assess context of sedentary behaviour in older adults. Our aim was to determine feasibility of measuring context of sedentary behaviour in older adults with frailty using objective and self-report measures. We defined “feasibility process” using recruitment (20 participants within two-months), retention (85%), and refusal (20%) rates and “feasibility resource” if the measures capture context and can be linked (e.g., sitting-kitchen-eating-alone), and are all participants willing to use the measures. Context was assessed using a wearable sensor for posture, indoor positioning system [IPS] for location, and electronic or hard-copy diary for purpose and social-context over three days in winter and spring. We approached 80 individuals, and 58 expressed interest; of the 58, 37 did not enroll due to lack of interest or medical mistrust (64% refusal). We recruited 21 older adults (72±7.3 years, 13 females, 13 frail) within two months and experienced two dropouts (90% retention). The measures captured one domain of context, but the hard copy was not completed with detail making it challenging to link with the other devices. Not all participants were willing to use the wearable devices or electronic diary; but we linked the measures of those who did. Future studies will need to determine the most feasible and valid method to assess the context of sedentary behaviour.

Comparison of national and international sedentary behaviour and physical activity guidelines for older adults: A systematic review and quality appraisal with AGREE II.

Most older adults 65 years and older accumulate over 8.5 hours/day of sedentary time, which is associated with increased risk of metabolic syndromes and falls. The impact of increased sedentary time in older adults has prompted development of sedentary behaviour guidelines. The purpose of our review was to compare national and international sedentary behaviour and physical activity guidelines for older adults and appraise the quality of guidelines using AGREE II. We conducted our search in Medline, Embase, Global Health, Web of Science, CINAHL, and relevant grey literature. We included the most recent guidelines for older adults written in English. We identified 18 national and international guidelines; ten of the 18 guidelines included sedentary behaviour recommendations while all 18 included physical activity recommendations for older adults. The ten sedentary behaviour guidelines were developed using cohort studies, knowledge users' opinions, systematic reviews, or other guidelines while the physical activity guidelines were developed using randomized controlled trials, systematic reviews, meta-analysis, and overview of reviews. The definition of sedentary behaviour and the recommendations were inconsistent between the guidelines and were based on very low to low quality and certainty of evidence. All guidelines provided consistent recommendations for aerobic and resistance training; the recommendations were developed using moderate to high quality and certainty of evidence. Only eight physical activity guidelines provided recommendations for balance training and six on flexibility training; the balance training recommendations were consistent between guidelines and based on moderate quality evidence. Further work is needed to develop evidenced-based sedentary behaviour recommendations and flexibility training recommendations for older adults.

The effectiveness of wearable activity trackers for increasing physical activity and reducing sedentary time in older adults: A systematic review and meta-analysis.

Traditional interventions such as education and counseling are successful in increasing physical activity (PA) participation, but are usually labor and resource intensive. Wearable activity trackers can objectively record PA and provide feedback to help users to achieve activity goals and are an increasingly popular tool among adults used to facilitate self-monitoring of PA. However, no reviews systematically explored the roles of wearable activity trackers in older populations. We searched PubMed, Web of Science, Google Scholar, Embase, Cochrane Library, and Scopus from inception to September 10, 2022. Randomized controlled trials were included. Two reviewers independently conducted study selection, data extraction, risk of bias, and certainty of evidence assessment. A random-effects model was used to evaluate the effect size. A total of 45 studies with 7144 participants were included. A wearable activity tracker was effective in increasing daily steps (standard mean differences (SMD) = 0.59, 95% confidence interval (CI) (0.44, 0.75)), weekly moderate-to-vigorous PA (MVPA) (SMD = 0.54, 95% CI (0.36, 0.72)), and total daily PA (SMD = 0.21, 95% CI (0.01, 0.40)) and reducing sedentary time (SMD = -0.10, 95% CI (-0.19, -0.01)). Subgroup analysis showed that the effectiveness of wearable activity trackers for daily steps was not influenced by participants and intervention features. However, wearable activity trackers seemed more effective in promoting MVPA of participant's age <70 than participant's age ≥70. In addition, wearable activity trackers incorporated with traditional intervention components (e.g. telephone counseling, goal setting, and self-monitoring) could better promote MVPA than alone use. Short-term interventions potentially achieve better MVPA increase than long-term. This review showed that wearable activity trackers are an effective tool to increase PA for the old population and also favor reducing sedentary time. When used together with other interventions, wearable activity trackers can achieve better MVPA increase, especially in the short term. However, how to more effectively improve the effectiveness of wearable activity trackers is an important direction of future research.

Leisure sedentary time and physical activity are higher in neighbourhoods with denser greenness and better built environments: an analysis of the Canadian Longitudinal Study on Aging.

Associations of environmental variables with physical activity and sedentary time using data from the Canadian Longitudinal Study on Aging, and the Canadian Urban Environmental Health Research Consortium (Canadian Active Living Environments (Can-ALE) dataset, and Normalized Difference Vegetation Index (NDVI, greenness) dataset) were assessed. The main outcome variables were physical activity and sedentary time as measured by a modified version of the Physical Activity for Elderly Scale. The sample consisted of adults aged 45 and older (n = 36 580, mean age 62.6 ± 10.2, 51% female). Adjusted ordinal regression models consistently demonstrated that those residing in neighbourhoods in the highest Can-ALE category (most well-connected built environment) reported more physical activity and sedentary time. For example, males aged 75+ in the highest Can-ALE category had 2 times higher odds of reporting more physical activity (OR = 2.0, 95%CI = 1.1-3.5) and 1.8 times higher odds of reporting more sedentary time (OR = 1.8, 95%CI = 1.0-3.4). Neighbourhoods with higher greenness scores were also associated with higher odds of reporting more physical activity and sedentary time. It appears that an environment characterized by higher Can-ALE and higher greenness may facilitate physical activity, but it also facilitates more leisure sedentary time in older adults; research using device measured total sedentary time, and consideration of the types of sedentary activities being performed is needed. Novelty: Middle-aged and older adults living in neighbourhoods with higher Can-ALE scores and more greenness report more physical activity and leisure sedentary time Greenness is important for physical activity and sedentary time in middle-aged adults.

Sedentary Time in Older Adults With Acute Cardiovascular Disease

BackgroundOlder adults may be subject to prolonged bedrest during hospitalization for acute cardiovascular disease, which can contribute to poor functional outcomes posthospitalization. Our objective was to describe mobility status in hospitalized older adults with acute cardiovascular disease. MethodsPatients aged ≥ 60 years old in the cardiac intensive care unit and cardiovascular ward at a tertiary care academic centre in Montréal, Québec were prospectively enrolled from April 2019 to March 2020. Activity levels were measured with the ActiGraph GT9X Link 3-axis accelerometer (ActiGraph, Pensacola, FL). Sedentary was defined as lying in bed or in a sitting position. Health-related quality of life (HRQOL) was measured with the Short-Form 36 (SF-36) questionnaire by telephone at 1 month posthospitalization. The primary outcome was percentage of sedentary time during hospitalization. ResultsThere were 35 patients included in the analysis (75.7 ± 6.9 years old; 45.7% female; 22.9% ischemic heart disease; 20.0% heart failure). Patients spent 91.2% ± 5.5 in a sedentary position during their hospital stay. Mean steps per minute were 1.0 ± 1.2, and mean kcals consumed per day were 116.6 ± 124.5. In the multivariable analysis, a higher percentage of sedentary time and lower steps per minute were each associated with lower total SF-36 scores at 1-month posthospitalization (both P < 0.05). ConclusionsOlder adults with acute cardiovascular disease may be sedentary for a large part of their hospital stay. Increased sedentary time is associated with worse self-reported posthospital HRQOL. Future studies are needed to determine whether interventions to increase activity during hospitalization improve posthospital HRQOL and functional outcomes.

Moderate-to-vigorous Physical Activity May Offset Harms Of Sedentary Time On An Older Adult’s Functional Fitness

The ability to maintain functional fitness is important for preserving quality of life and promoting a healthy aging process. Habitual physical activity, especially that of moderate-to-vigorous intensity, has been associated with improvements in functional fitness resulting in enhanced functioning and reduced risk of disability, morbidity and mortality of older adults, whereas high amounts of sedentary time (ST) have been inversely associated with functional fitness and related with detrimental effects on several health-related outcomes. PURPOSE: We aimed to assess if moderate-to-vigorous physical activity (MVPA) can moderate the relationship between ST and functional fitness and, thus, offset the adverse effects of ST in older adults. METHODS: Older adults (≥65 years old) from the national surveillance system in Portugal (n = 564) had their MVPA and ST assessed using accelerometers. Functional fitness was assessed using the Senior Fitness Test battery and an overall z-score based on the individual scores for each fitness item was created. Multiple linear regression was used to model the outcomes, while adjusting for age, sex, BMI, and accelerometer wear-time. RESULTS: Higher ST was related with lower functional fitness (β = -0.01, p < 0.0001), whereas increases in MVPA were related to a higher fitness level (β = 0.02, p = 0.001). There was a moderating effect of MVPA on the relationship of ST with functional fitness (p < 0.0001), where MVPA ≥34.66 min/d ameliorated the significant inverse relationship between ST and functional fitness, whereas, engaging in ≥68.60 min/d of MVPA resulted in ST having a significant positive relationship with functional fitness. CONCLUSION: MVPA was found to be a moderator of the relationship between ST and functional fitness in older adults, such that engaging in at least 35 min/day of MVPA may offset the negative associations related with ST. Moreover, with higher levels of MVPA (≥69 min/d), having some ST may provide some benefit to an older adult’s ability to maintain functional fitness. This investigation was funded by the Portuguese Foundation for Science and Technology (UIDB/00447/2020). IRC is supported by the Portuguese Foundation for Science and Technology (IRC: SFRH/BD/149394/2019).

Interventions for reducing sedentary behaviour in community-dwelling older adults.

Older adults are the most sedentary segment of society, often spending in excess of 8.5 hours a day sitting. Large amounts of time spent sedentary, defined as time spend sitting or in a reclining posture without spending energy, has been linked to an increased risk of chronic diseases, frailty, loss of function, disablement, social isolation, and premature death. To evaluate the effectiveness of interventions aimed at reducing sedentary behaviour amongst older adults living independently in the community compared to control conditions involving either no intervention or interventions that do not target sedentary behaviour. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, PsycINFO, PEDro, EPPI-Centre databases (Trials Register of Promoting Health Interventions (TRoPHI) and the Obesity and Sedentary behaviour Database), WHO ICTRP, and ClinicalTrials.gov up to 18 January 2021. We also screened the reference lists of included articles and contacted authors to identify additional studies. We included randomised controlled trials (RCTs) and cluster-RCTs. We included interventions purposefully designed to reduce sedentary time in older adults (aged 60 or over) living independently in the community. We included studies if some of the participants had multiple comorbidities, but excluded interventions that recruited clinical populations specifically (e.g. stroke survivors). Two review authors independently screened titles and abstracts and full-text articles to determine study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted authors for additional data where required. Any disagreements in study screening or data extraction were settled by a third review author. We included seven studies in the review, six RCTs and one cluster-RCT, with a total of 397 participants. The majority of participants were female (n = 284), white, and highly educated. All trials were conducted in high-income countries. All studies evaluated individually based behaviour change interventions using a combination of behaviour change techniques such as goal setting, education, and behaviour monitoring or feedback. Four of the seven studies also measured secondary outcomes. The main sources of bias were related to selection bias (N = 2), performance bias (N = 6), blinding of outcome assessment (N = 2), and incomplete outcome data (N = 2) and selective reporting (N=1). The overall risk of bias was judged as unclear. Primary outcomes The evidence suggests that interventions to change sedentary behaviour in community-dwelling older adults may reduce sedentary time (mean difference (MD) -44.91 min/day, 95% confidence interval (CI) -93.13 to 3.32; 397 participants; 7 studies; I2 = 73%; low-certainty evidence). We could not pool evidence on the effect of interventions on breaks in sedentary behaviour or time spent in specific domains such as TV time, as data from only one study were available for these outcomes. Secondary outcomes We are uncertain whether interventions to reduce sedentary behaviour have any impact on the physical or mental health outcomes of community-dwelling older adults. We were able to pool change data for the following outcomes. • Physical function (MD 0.14 Short Physical Performance Battery (SPPB) score, 95% CI -0.38 to 0.66; higher score is favourable; 98 participants; 2 studies; I2 = 26%; low-certainty evidence). • Waist circumference (MD 1.14 cm, 95% CI -1.64 to 3.93; 100 participants; 2 studies; I2 = 0%; low-certainty evidence). • Fitness (MD -5.16 m in the 6-minute walk test, 95% CI -36.49 to 26.17; higher score is favourable; 80 participants; 2 studies; I2 = 29%; low-certainty evidence). • Blood pressure: systolic (MD -3.91 mmHg, 95% CI -10.95 to 3.13; 138 participants; 3 studies; I2 = 73%; very low-certainty evidence) and diastolic (MD -0.06 mmHg, 95% CI -5.72 to 5.60; 138 participants; 3 studies; I2 = 97%; very low-certainty evidence). • Glucose blood levels (MD 2.20 mg/dL, 95% CI -6.46 to 10.86; 100 participants; 2 studies; I2 = 0%; low-certainty evidence). No data were available on cognitive function, cost-effectiveness or adverse effects. It is not clear whether interventions to reduce sedentary behaviour are effective at reducing sedentary time in community-dwelling older adults. We are uncertain if these interventions have any impact on the physical or mental health of community-dwelling older adults. There were few studies, and the certainty of the evidence is very low to low, mainly due to inconsistency in findings and imprecision. Future studies should consider interventions aimed at modifying the environment, policy, and social and cultural norms. Future studies should also use device-based measures of sedentary time, recruit larger samples, and gather information about quality of life, cost-effectiveness, and adverse event data.

Considerations in Processing Accelerometry Data to Explore Physical Activity and Sedentary Time in Older Adults.

Processing decisions for accelerometry data can have important implications for outcome measures, yet little evidence exists exploring these in older adults. The aim of the current study was to investigate the impact of three potentially important criteria on older adults, physical activity, and sedentary time. Participants (n = 222: mean age 71.75 years [SD = 6.58], 57% male) wore ActiGraph GT3X+ for 7 days. Eight data processing combinations from three criteria were explored: low-frequency extension (on/off), nonwear time (90/120min), and intensity cut points (moderate-to-vigorous physical activity ≥1,041 and >2,000counts/min). Analyses included Wilcoxon signed-rank test, paired t tests, and correlation coefficients (significance, p < .05). Results for low-frequency extension on 90-min nonwear time and >1,041counts/min showed significantly higher light and moderate-to-vigorous physical activity and lower sedentary time. Cut points had the greatest impact on physical activity and sedentary time. Processing criteria can significantly impact physical activity and/or sedentary time, potentially leading to data inaccuracies, preventing cross-study comparisons and influencing the accuracy of population surveillance.

Sit Less for Successful Aging Pilot Study: Feasibility of an Intervention to Reduce Sedentary Time in Older Adults in Independent Living Communities.

Purpose: Older adults are the most sedentary of all age groups, which is concerning given the association of sedentary time with adverse health outcomes. The purpose of this study was to pilot test a 12-week sedentary behavior intervention in older adults in independent living communities. Methods: Individuals older than 60 years, who could walk &gt;100 feet, were recruited. The intervention targeted a reduction in sedentary behavior using an activity prompter and weekly behavioral group sessions. Sedentary time, steps/day, physical function, mobility, and blood pressure were measured. Twelve-week changes in outcomes were compared using paired t tests. Results: Twenty-one older adults (82.2 ± 7.1 years) completed the study. Sedentary minutes accumulated in 30-minute bouts decreased (−27.7 ± 12.9 min/d, P = .0471). There were no changes in total number of sedentary minutes or steps/day. Physical function and mobility improved (all P &lt; .05). The intervention strategy was feasible and acceptable among older adults in independent living communities. Conclusions: An intervention targeting a reduction in sedentary behavior is feasible and acceptable in older adults and shows promise for reducing minutes spent in bouts of prolonged sitting and for improving physical function and mobility.

Screen and Non-screen Sedentary Time in Older Adults Living in a Retirement Community

Screen and Non-screen Sedentary Time in Older Adults Living in a Retirement Community

Sedentary Time in Older Adults: Sitting Is Not the New Smoking

A growing body of literature suggests that excessive sedentary time may have deleterious health consequences, particularly among inactive individuals. Given that older adults are the least physically active and most sedentary of any demographic group, research on active, healthy aging must consider both the cause and the consequences of prolonged time spent sitting. Current evidence suggests that reducing sedentary time may be beneficial to older adults and allow them to better maintain their functional capacity and autonomy, but more research is needed to enable the development of evidence-based behavioral goals that will improve health outcomes. There is also a need to consider sedentary behavior from an organizational and societal perspective that moves beyond workplace and school settings to be inclusive of older adults, the fastest growing population in the world.

Cognitive ability does not predict objectively measured sedentary behavior: Evidence from three older cohorts.

Higher cognitive ability is associated with being more physically active. Much less is known about the associations between cognitive ability and sedentary behavior. Ours is the first study to examine whether historic and contemporaneous cognitive ability predicts objectively measured sedentary behavior in older age. Participants were drawn from 3 cohorts (Lothian Birth Cohort, 1936 [LBC1936] [n = 271]; and 2 West of Scotland Twenty-07 cohorts: 1950s [n = 310] and 1930s [n = 119]). Regression models were used to assess the associations between a range of cognitive tests measured at different points in the life course, with sedentary behavior in older age recorded over 7 days. Prior simple reaction time (RT) was significantly related to later sedentary time in the youngest, Twenty-07 1950s cohort (p = .04). The relationship was nonsignificant after controlling for long-standing illness or employment status, or after correcting for multiple comparisons in the initial model. None of the cognitive measures were related to sedentary behavior in either of the 2 older cohorts (LBC1936, Twenty-07 1930s). There was no association between any of the cognitive tests and the number of sit-to-stand transitions in any of the 3 cohorts. The meta-analytic estimates for the measures of simple and choice RT that were identical in all cohorts (n = 700) were also not significant. In conclusion, we found no evidence that objectively measured sedentary time in older adults is associated with measures of cognitive ability at different time points in life, including cognitive change from childhood to older age.

Why Older Adults Spend Time Sedentary and Break Their Sedentary Behavior: A Mixed-Methods Approach Using Life-Logging Equipment.

Older adults are recommended to reduce their sedentary time to promote healthy ageing. To develop effective interventions identifying when, why, and how older adults are able to change their sitting habits is important. The aim of this mixed-method study was to improve our understanding of reasons for (breaking) sedentary behavior in older adults. Thirty older adults (74.0 [±5.3] years old, 73% women) were asked about their believed reasons for (breaking) sedentary behavior, and about their actual reasons when looking at a personal storyboard with objective records of activPAL monitor data and time-lapse camera pictures showing all their periods of sedentary time in a day. The most often mentioned believed reason for remaining sedentary was television/radio (mentioned by 48.3%), while eating/drinking was most often mentioned as actual reason (96.6%). Only 17.2% believed that food/tea preparation was a reason to break up sitting, while this was an actual reason for 82.8% of the study sample. Results of this study show that there is a discrepancy between believed and actual reasons for (breaking) sedentary behavior. These findings suggest developing interventions utilizing the actual reasons for breaking sedentary behavior to reduce sedentary time in older adults.

Interventions for reducing sedentary behaviour in community-dwelling older adults

Background: Older adults are the most sedentary segment of society, often spending in excess of 8.5 hours a day sitting. Large amounts of time spent sedentary, defined as time spend sitting or in a reclining posture without spending energy, has been linked to an increased risk of chronic diseases, frailty, loss of function, disablement, social isolation, and premature death. Objectives: To evaluate the effectiveness of interventions aimed at reducing sedentary behaviour amongst older adults living independently in the community compared to control conditions involving either no intervention or interventions that do not target sedentary behaviour. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, PsycINFO, PEDro, EPPI-Centre databases (Trials Register of Promoting Health Interventions (TRoPHI) and the Obesity and Sedentary behaviour Database), WHO ICTRP, and ClinicalTrials.gov up to 18 January 2021. We also screened the reference lists of included articles and contacted authors to identify additional studies. Selection criteria: We included randomised controlled trials (RCTs) and cluster-RCTs. We included interventions purposefully designed to reduce sedentary time in older adults (aged 60 or over) living independently in the community. We included studies if some of the participants had multiple comorbidities, but excluded interventions that recruited clinical populations specifically (e.g. stroke survivors). Data collection and analysis: Two review authors independently screened titles and abstracts and full-text articles to determine study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted authors for additional data where required. Any disagreements in study screening or data extraction were settled by a third review author. Main results: We included seven studies in the review, six RCTs and one cluster-RCT, with a total of 397 participants. The majority of participants were female (n = 284), white, and highly educated. All trials were conducted in high-income countries. All studies evaluated individually based behaviour change interventions using a combination of behaviour change techniques such as goal setting, education, and behaviour monitoring or feedback. Four of the seven studies also measured secondary outcomes. The main sources of bias were related to selection bias (N = 2), performance bias (N = 6), blinding of outcome assessment (N = 2), and incomplete outcome data (N = 2) and selective reporting (N=1). The overall risk of bias was judged as unclear. Primary outcomes. The evidence suggests that interventions to change sedentary behaviour in community-dwelling older adults may reduce sedentary time (mean difference (MD) −44.91 min/day, 95% confidence interval (CI) −93.13 to 3.32; 397 participants; 7 studies; I = 73%; low-certainty evidence). We could not pool evidence on the effect of interventions on breaks in sedentary behaviour or time spent in specific domains such as TV time, as data from only one study were available for these outcomes. Secondary outcomes. We are uncertain whether interventions to reduce sedentary behaviour have any impact on the physical or mental health outcomes of community-dwelling older adults. We were able to pool change data for the following outcomes. • Physical function (MD 0.14 Short Physical Performance Battery (SPPB) score, 95% CI −0.38 to 0.66; higher score is favourable; 98 participants; 2 studies; I = 26%; low-certainty evidence). • Waist circumference (MD 1.14 cm, 95% CI −1.64 to 3.93; 100 participants; 2 studies; I = 0%; low-certainty evidence). • Fitness (MD -5.16 m in the 6-minute walk test, 95% CI −36.49 to 26.17; higher score is favourable; 80 participants; 2 studies; I = 29%; low-certainty evidence). • Blood pressure: systolic (MD −3.91 mmHg, 95% CI -10.95 to 3.13; 138 participants; 3 studies; I = 73%; very low-certainty evidence) and diastolic (MD −0.06 mmHg, 95% CI −5.72 to 5.60; 138 participants; 3 studies; I = 97%; very low-certainty evidence). • Glucose blood levels (MD 2.20 mg/dL, 95% CI −6.46 to 10.86; 100 participants; 2 studies; I = 0%; low-certainty evidence). No data were available on cognitive function, cost-effectiveness or adverse effects. Authors' conclusions: It is not clear whether interventions to reduce sedentary behaviour are effective at reducing sedentary time in community-dwelling older adults. We are uncertain if these interventions have any impact on the physical or mental health of community-dwelling older adults. There were few studies, and the certainty of the evidence is very low to low, mainly due to inconsistency in findings and imprecision. Future studies should consider interventions aimed at modifying the environment, policy, and social and cultural norms. Future studies should also use device-based measures of sedentary time, recruit larger samples, and gather information about quality of life, cost-effectiveness, and adverse event data.

Association Between Structured Physical Activity and Sedentary Time in Older Adults

This post hoc exploratory analysis of Lifestyle Interventions and Independence for Elders (LIFE) trial data examines the association between the trial’s physical activity intervention and sedentary time in older adults.

Association of Maximum Temperature With Sedentary Time in Older British Men.

BackgroundSedentary behavior is very common in older adults and a risk factor for mortality. Understanding determinants of sedentary behavior may help in defining strategies aimed to reduce the time spent sedentary. The degree of difference in sedentary time attributable to varying temperatures has not been yet estimated in older men.MethodsMen aged 71 to 91 years participating in an established UK population-based cohort study were invited to wear an Actigraph GT3X accelerometer for 1 week in 2010–12. Outcome was sedentary time (<1.5 Metabolic Equivalent of Task) in minutes per day. Associations between daily outdoor maximum temperature and accelerometer-measured sedentary time were estimated using multilevel models.Results43% (1361/3137) of invited men participated in the study and provided adequate data. Men spent on average 615 minutes in sedentary time per day (72% of the total accelerometer-wear time). After adjusting for covariates, men spent 26 minutes more per day (P < .001) in sedentary time when temperatures were in the lowest (–3.5; 9.2°C) versus highest quintile (19.1; 29.5°C).ConclusionsSedentary time in older adults is highest at lowest temperatures, typically recorded in winter. Findings are relevant for guidelines: interventions may consider targeting older men in winter providing recommendations for minimizing sedentariness on daily basis.

Sedentary Behavior and Cardiovascular Risk in Older Adults: a Scoping Review.

Sedentary behavior is an emerging risk factor for cardiovascular disease (CVD) and may be particularly relevant to the cardiovascular health of older adults. This scoping review describes the existing literature examining the prevalence of sedentary time in older adults with CVD and the association of sedentary behavior with cardiovascular risk in older adults. We found that older adults with CVD spend >75 % of their waking day sedentary, and that sedentary time is higher among older adults with CVD than among older adults without CVD. High sedentary behavior is consistently associated with worse cardiac lipid profiles and increased cardiac risk scores in older adults; the associations of sedentary behavior with blood pressure, CVD incidence, and CVD-related mortality among older adults are less clear. Future research with larger sample sizes using validated methods to measure sedentary behavior are needed to clarify the association between sedentary behavior and cardiovascular outcomes in older adults.

Gender and Age Differences in Hourly and Daily Patterns of Sedentary Time in Older Adults Living in Retirement Communities.

BackgroundTotal sedentary time varies across population groups with important health consequences. Patterns of sedentary time accumulation may vary and have differential health risks. The purpose of this study is to describe sedentary patterns of older adults living in retirement communities and illustrate gender and age differences in those patterns.MethodsBaseline accelerometer data from 307 men and women (mean age = 84±6 years) who wore ActiGraph GT3X+ accelerometers for ≥ 4 days as part of a physical activity intervention were classified into bouts of sedentary time (<100 counts per minute). Linear mixed models were used to account for intra-person and site-level clustering. Daily and hourly summaries were examined in mutually non-exclusive bouts of sedentary time that were 1+, 5+, 10+, 20+, 30+, 40+, 50+, 60+, 90+ and 120+ minutes in duration. Variations by time of day, age and gender were explored.ResultsMen accumulated more sedentary time than women in 1+, 5+, 10+, 20+, 30+, 40+, 50+ and 60+ minute bouts; the largest gender-differences were observed in 10+ and 20+ minute bouts. Age was positively associated with sedentary time, but only in bouts of 10+, 20+, 30+, and 40+ minutes. Women had more daily 1+ minute sedentary bouts than men (71.8 vs. 65.2), indicating they break up sedentary time more often. For men and women, a greater proportion of time was spent being sedentary during later hours of the day than earlier. Gender differences in intra-day sedentary time were observed during morning hours with women accumulating less sedentary time overall and having more 1+ minute bouts.ConclusionsPatterns identified using bouts of sedentary time revealed gender and age differences in the way in which sedentary time was accumulated by older adults in retirement communities. Awareness of these patterns can help interventionists better target sedentary time and may aid in the identification of health risks associated with sedentary behavior. Future studies should investigate the impact of patterns of sedentary time on healthy aging, disease, and mortality.