Mobility is essential to maintaining independence for older adults. This systematic review aimed to summarize evidence about self-reported risk factors for self-reported mobility decline; and to provide an overview of published prognostic models for self-reported mobility decline among community-dwelling older adults. Databases were searched from inception to June 2, 2020. Studies were screened by two independent reviewers who extracted data and assessed study quality. Sixty-one studies (45,187 participants) were included, providing information on 107 risk factors. High-quality evidence and moderate/large effect sizes for the association with mobility decline were found for older age beyond 75 years, the presence of widespread pain, and mobility modifications. Moderate–high quality evidence and small effect sizes were found for a further 21 factors. Three model development studies demonstrated acceptable model performance, limited by high risk of bias. These findings should be considered in intervention development, and in developing a prediction instrument for practical application.
Philippa J.A. Nicolson, Maria T. Sanchez-Santos, Julie Bruce, Shona Kirtley, Lesley Ward, Esther Williamson, and Sarah E. Lamb
Chantelle Zimmer and Meghan H. McDonough
This study examined which of nine forms of social support were the strongest predictors of physical activity in older adults, and to what degree these associations were moderated by eight demographic indicators of groups at increased risk of social isolation. Baseline data from 21,491 adults aged 65 and older who were participants of the Canadian Longitudinal Study on Aging were analyzed using multiple regression. Greater social network size, social contact with network members, and participation in community-related activities predicted greater physical activity, whereas being in a domestic partnership and perceiving more tangible support to be available were negatively associated. The strength and direction of these associations varied by sex, living arrangement, and income. Given the findings, various forms of social support should be incorporated in physical activity interventions but tailored to meet the needs of different segments of the aging population.
Vipul Lugade, Janeesata Kuntapun, Paphawee Prupetkaew, Sirinun Boripuntakul, Eric Verner, and Patima Silsupadol
Conventional one-time gait analyses do not evaluate walking across more than a few steps, cannot monitor changes longitudinally, and do not reflect performance in real-life environments. To successfully quantify age-related gait decrement, technology that can continuously monitor gait is vital. This study examined the feasibility and validity for participant smartphones to remotely assess gait. In addition, the authors investigated whether smartphone-derived measures could differentiate between young and older adults (fallers and nonfallers). A total of 63 adults completed clinical and gait assessment in the laboratory and donned their smartphones for 3 days in the real-life environment. A custom-built Android application collected triaxial accelerations with spatiotemporal gait measures computed and compared between groups. Across 11 brands and 10 Android versions, smartphone-derived gait parameters were valid. Furthermore, results indicated age-related differences in walking during the 3-day assessment. However, no disparities were found between older adult groups. Smartphone-based evaluations may improve real-life screening of adults with gait deficits.
Yuwei Song, Momotaz Begum, Sajay Arthanat, and Dain P. LaRoche
This study tested the concurrent and construct validity of smartphone accelerometry measurement of sit-to-stand (STS) performance in individuals aged 65–89 years. Normal and fast STS times were recorded by smartphone accelerometer, force plate, and video motion systems concurrently, and isokinetic knee extension power and STS whole-body power were obtained. Normal and fast speed STS times from a smartphone accelerometer agreed closely with force plate and motion system methods (mean difference = 0.04 s). Normal and fast STS times were inversely related to isokinetic knee extension power (r = −.93, p < .001 and r = −.82, p < .001, respectively) and STS whole-body power (r = −.76, p < .001 and r = −.70, p < .001, respectively). The STS time obtained from a smartphone accelerometer was equivalent to the established, precise measures of STS time and was related to lower-extremity power, making it a potentially useful metric of lower-extremity function.
Gregory J. Welk, Pedro F. Saint-Maurice, Philip M. Dixon, Paul R. Hibbing, Yang Bai, Gabriella M. McLoughlin, and Michael Pereira da Silva
A balance between the feasibility and validity of measures is an important consideration for physical activity (PA) research—particularly in school-based research with youth. The present study extends previously tested calibration methods to develop and test new equations for an online version of the youth activity profile (YAP) tool, a self-report tool designed for school applications. Data were collected across different regions and seasons to develop more robust, generalizable equations. The study involved a total of 717 youth from 33 schools (374 elementary [ages 9–11 years], 224 middle [ages 11–14 years], and 119 high school [ages 14–18 years]) in two different states in the United States. Participants wore a Sensewear monitor for a full week and then completed the online YAP at school to report PA and sedentary behaviors in school and at home. Accelerometer data were processed using an R-based segmentation program to compute PA and sedentary behavior levels. Quantile regression models were used with half of the sample to develop item-specific YAP calibration equations, and these were cross validated with the remaining half of the sample. Computed values of mean absolute percentage error ranged from 15 to 25% with slightly lower error observed for the middle school sample. The new equations had improved precision compared with the previous versions when tested on the same sample. The online version of the YAP provides an efficient and effective way to capture school level estimates of PA and sedentary behaviors in youth.
Andrew P. Kingsnorth, Mhairi Patience, Elena Moltchanova, Dale W. Esliger, Nicola J. Paine, and Matthew Hobbs
The response to COVID-19 resulted in behavioral restrictions to tackle the spread of infection. Initial data indicates that step counts were impacted by lockdown restrictions; however, there is little evidence regarding changes of light and moderate to vigorous physical activity (MVPA) behavioral intensities. In this study, participants were asked to provide longitudinal wearable data from Fitbit devices over a period of 30 weeks, from December 2019 to June 2020. Self-assessed key worker status was captured, along with wearable estimates of steps, light activity, and MVPA. Bayesian change point analyses of data from 97 individuals found that there was a sharp decrease of 1,473 steps (95% credible interval [CI] [−2,218, −709]) and light activity minutes (41.9; 95% CI [−54.3, −29.3]), but an increase in MVPA minutes (11.7; 95% CI [2.9, 19.4]) in the mean weekly totals for nonkey workers. For the key workers, the total number of steps (207; 95% CI [−788, 1,456]) and MVPA minutes increased (20.5; 95% CI [12.6, 28.3]) but light activity decreased by an average of 46.9 min (95% CI [−61.2, −31.8]). Interestingly, the change in steps was commensurate with that observed during Christmas (1,458; 95% CI [−2,286, −554]) for nonkey workers and behavioral changes occurred at different time points and rates depending on key worker status. Results indicate that there were clear behavioral modifications before and during the initial COVID-19 lockdown period, and future research should assess whether any behavioral modifications were sustained over time.
Pedro F. Saint-Maurice, David Berrigan, Geoffrey P. Whitfield, Kathleen B. Watson, Shreya Patel, Erikka Loftfield, Joshua N. Sampson, Janet E. Fulton, and Charles E. Matthews
Background: Surveillance of domain-specific physical activity in the United States is lacking. Thus, the authors describe domain-specific moderate to vigorous physical activity (MVPA) in a nationwide sample of US adults. Methods: Participants from the AmeriSpeak panel (n = 2649; 20–75 y; 50% female) completed the Activities Completed Over Time in 24-Hours previous-day recall. The authors estimated average MVPA duration (in hours per day) overall and in major life domains by sex, age, race/ethnicity, and education. They also described the most commonly reported MVPAs and timing of MVPA during the day. Results: Across all life domains, participants reported an average of 2.5 hours per day in MVPA. Most MVPA was accumulated during work (50% of total, 1.2 h/d) and household activities (28%, 0.7 h/d) with less MVPA reported in leisure time (15%, 0.4 h/d). Time reported in MVPA varied by sex, and race/ethnicity (P < .05). Walking at work and for exercise, childcare, and walking for transportation were the most commonly reported domain-specific MVPAs. A greater proportion of MVPA took place in the morning (∼06:00 h) and evening (∼18:00 h). Conclusions: Work and household activities accounted for 78% of overall MVPA reported, while leisure-time MVPA accounted for only 15% of the total. Encouraging MVPA during leisure time and transportation remain important targets for promoting MVPA in US adults.