Comparison of the EPIC Physical Activity Questionnaire with Combined Heart Rate and Movement Sensing in a Nationally Representative Sample of Older British Adults

Objectives To compare physical activity (PA) subcomponents from EPIC Physical Activity Questionnaire (EPAQ2) and combined heart rate and movement sensing in older adults. Methods Participants aged 60–64y from the MRC National Survey of Health and Development in Great Britain completed EPAQ2, which assesses self-report PA in 4 domains (leisure time, occupation, transportation and domestic life) during the past year and wore a combined sensor for 5 consecutive days. Estimates of PA energy expenditure (PAEE), sedentary behaviour, light (LPA) and moderate-to-vigorous PA (MVPA) were obtained from EPAQ2 and combined sensing and compared. Complete data were available in 1689 participants (52% women). Results EPAQ2 estimates of PAEE and MVPA were higher than objective estimates and sedentary time and LPA estimates were lower [bias (95% limits of agreement) in men and women were 32.3 (−61.5 to 122.6) and 29.0 (−39.2 to 94.6) kJ/kg/day for PAEE; −4.6 (−10.6 to 1.3) and −6.0 (−10.9 to −1.0) h/day for sedentary time; −171.8 (−454.5 to 110.8) and −60.4 (−367.5 to 246.6) min/day for LPA; 91.1 (−159.5 to 341.8) and 55.4 (−117.2 to 228.0) min/day for MVPA]. There were significant positive correlations between all self-reported and objectively assessed PA subcomponents (rho  = 0.12 to 0.36); the strongest were observed for MVPA (rho = 0.30 men; rho = 0.36 women) and PAEE (rho = 0.26 men; rho = 0.25 women). Conclusion EPAQ2 produces higher estimates of PAEE and MVPA and lower estimates of sedentary and LPA than objective assessment. However, both methodologies rank individuals similarly, suggesting that EPAQ2 may be used in etiological studies in this population.

[1]  N. Day,et al.  Vitamin C and hyperglycemia in the European Prospective Investigation into Cancer--Norfolk (EPIC-Norfolk) study: a population-based study. , 2000, Diabetes care.

[2]  D. Bassett,et al.  Accuracy of the Actiheart for the assessment of energy expenditure in adults , 2008, European Journal of Clinical Nutrition.

[3]  U. Ekelund,et al.  Branched equation modeling of simultaneous accelerometry and heart rate monitoring improves estimate of directly measured physical activity energy expenditure. , 2004, Journal of applied physiology.

[4]  H. Kemper,et al.  Repeatability and relative validity of two physical activity questionnaires in elderly women. , 1996, Medicine and science in sports and exercise.

[5]  I‐Min Lee Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy , 2012, BDJ.

[6]  Ulf Ekelund,et al.  Moderate to vigorous physical activity and sedentary time and cardiometabolic risk factors in children and adolescents. , 2012, JAMA.

[7]  Ulf Ekelund,et al.  Accuracy and validity of a combined heart rate and motion sensor for the measurement of free-living physical activity energy expenditure in adults in Cameroon. , 2011, International journal of epidemiology.

[8]  A. Wong,et al.  Using a birth cohort to study ageing: representativeness and response rates in the National Survey of Health and Development , 2013, European journal of ageing.

[9]  P. Marano,et al.  Clinical radiology. , 2004, Rays.

[10]  Claude Bouchard,et al.  Maintaining a high physical activity level over 20 years and weight gain. , 2010, JAMA.

[11]  J. Sallis,et al.  Assessment of Physical Activity by Self-Report: Status, Limitations, and Future Directions , 2000, Research quarterly for exercise and sport.

[12]  Ulf Ekelund,et al.  Estimating physical activity energy expenditure, sedentary time, and physical activity intensity by self-report in adults. , 2010, The American journal of clinical nutrition.

[13]  Martine Thomis,et al.  Reliability and Validity of the Flemish Physical Activity Computerized Questionnaire in Adults , 2007, Research quarterly for exercise and sport.

[14]  F. Togo,et al.  Development and evaluation of the physical activity questionnaire for elderly Japanese: the Nakanojo study. , 2007, Journal of aging and physical activity.

[15]  Yves Schutz,et al.  Metabolic equivalent: one size does not fit all. , 2005, Journal of applied physiology.

[16]  C. Cooper,et al.  Physical activity at 36 years: patterns and childhood predictors in a longitudinal study. , 1992, Journal of epidemiology and community health.

[17]  The InterAct Consortium,et al.  Validity of a short questionnaire to assess physical activity in 10 European countries , 2012 .

[18]  Charles E Matthews,et al.  Comparative validity of physical activity measures in older adults. , 2011, Medicine and science in sports and exercise.

[19]  A. Marshall,et al.  Repeatability and accuracy of CHAMPS as a measure of physical activity in a community sample of older Australian adults. , 2009, Journal of physical activity & health.

[20]  Hirofumi Tanaka,et al.  Age-predicted maximal heart rate revisited. , 2001, Journal of the American College of Cardiology.

[21]  S. Brage,et al.  Validity of the international physical activity questionnaire in the arctic. , 2013, Medicine and science in sports and exercise.

[22]  F. Rodríguez‐Artalejo,et al.  Sleep Duration and Mortality According to Health Status in Older Adults , 2010, Journal of the American Geriatrics Society.

[23]  Karsten Froberg,et al.  Hierarchy of individual calibration levels for heart rate and accelerometry to measure physical activity. , 2007, Journal of applied physiology.

[24]  Heather K. Neilson,et al.  Estimating activity energy expenditure: how valid are physical activity questionnaires? , 2008, The American journal of clinical nutrition.

[25]  Shigeru Inoue,et al.  The pandemic of physical inactivity: global action for public health , 2012, The Lancet.

[26]  Bruce K Armstrong,et al.  International Journal of Behavioral Nutrition and Physical Activity Validity and Repeatability of the Epic Physical Activity Questionnaire: a Validation Study Using Accelerometers as an Objective Measure , 2007 .

[27]  Maria Hagströmer,et al.  The International Physical Activity Questionnaire modified for the elderly: aspects of validity and feasibility , 2010, Public Health Nutrition.

[28]  U. Ekelund,et al.  Global physical activity levels: surveillance progress, pitfalls, and prospects , 2012, The Lancet.

[29]  X. Lao,et al.  Reliability and validity of the IPAQ-Chinese: the Guangzhou Biobank Cohort study. , 2008, Medicine and science in sports and exercise.

[30]  U. Ekelund,et al.  Criterion validity of a 10-category scale for ranking physical activity in Norwegian women , 2012, International Journal of Behavioral Nutrition and Physical Activity.

[31]  K. Kazuma,et al.  Validity and reliability of the Physical Activity Scale for the Elderly (PASE) in Japanese elderly people , 2008, Geriatrics & gerontology international.

[32]  H J Montoye,et al.  Assessment of the accuracy of physical activity questionnaire occupational data. , 1993, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[33]  U. Ekelund,et al.  Reliability and validity of the combined heart rate and movement sensor Actiheart , 2005, European Journal of Clinical Nutrition.

[34]  N. Day,et al.  EPIC-Norfolk: study design and characteristics of the cohort. European Prospective Investigation of Cancer. , 1999, British journal of cancer.

[35]  S. Blair,et al.  Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy , 2012, BDJ.

[36]  A. Beckett,et al.  AKUFO AND IBARAPA. , 1965, Lancet.

[37]  Jo Mitchell,et al.  Validity and repeatability of a simple index derived from the short physical activity questionnaire used in the European Prospective Investigation into Cancer and Nutrition (EPIC) study , 2003, Public Health Nutrition.

[38]  J F Sallis,et al.  Assessment of physical activity by self-report: status, limitations, and future directions. , 2000, Research quarterly for exercise and sport.

[39]  U. Ekelund,et al.  Integration of physiological and accelerometer data to improve physical activity assessment. , 2005, Medicine and science in sports and exercise.

[40]  B E Ainsworth,et al.  Comprehensive evaluation of the Minnesota Leisure Time Physical Activity Questionnaire. , 1994, Journal of clinical epidemiology.

[41]  C J K Henry,et al.  Basal metabolic rate studies in humans: measurement and development of new equations. , 2005, Public health nutrition.

[42]  Charles E Matthews,et al.  The role of measurement error in estimating levels of physical activity. , 2007, American journal of epidemiology.

[43]  Ulf Ekelund,et al.  A systematic review of reliability and objective criterion-related validity of physical activity questionnaires , 2012, International Journal of Behavioral Nutrition and Physical Activity.

[44]  R. Shephard Limits to the measurement of habitual physical activity by questionnaires , 2003, British journal of sports medicine.

[45]  Marcus Richards,et al.  Cohort Profile: Updating the cohort profile for the MRC National Survey of Health and Development: a new clinic-based data collection for ageing research , 2011, International journal of epidemiology.

[46]  U. Ekelund,et al.  Validity of a physical activity questionnaire in Shanghai. , 2010, Medicine and science in sports and exercise.

[47]  M. Tremblay,et al.  A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review , 2008, The international journal of behavioral nutrition and physical activity.

[48]  G. A. Rose The diagnosis of ischaemic heart pain and intermittent claudication in field surveys. , 1962, Bulletin of the World Health Organization.

[49]  J. Manson,et al.  Physical activity, including walking, and cognitive function in older women. , 2004, JAMA.

[50]  A. Stewart,et al.  An evaluation of three self-report physical activity instruments for older adults. , 2001, Medicine and science in sports and exercise.

[51]  Caroline B. Terwee,et al.  Qualitative Attributes and Measurement Properties of Physical Activity Questionnaires , 2010, Sports medicine.

[52]  U. Ekelund,et al.  Effect of combined movement and heart rate monitor placement on physical activity estimates during treadmill locomotion and free-living , 2006, European Journal of Applied Physiology.

[53]  Felipe Montes,et al.  Evidence-based intervention in physical activity: lessons from around the world , 2012, The Lancet.

[54]  Salvatore Panico,et al.  Validity of a short questionnaire to assess physical activity in 10 European countries , 2011, European Journal of Epidemiology.

[55]  Sung Gyoo Park Medicine and Science in Sports and Exercise , 1981 .

[56]  A. Stewart,et al.  CHAMPS physical activity questionnaire for older adults: outcomes for interventions. , 2001, Medicine and science in sports and exercise.

[57]  K. Westerterp,et al.  Validity of the Physical Activity Scale for the Elderly (PASE): according to energy expenditure assessed by the doubly labeled water method. , 1997, Journal of clinical epidemiology.

[58]  G. Somes,et al.  The accuracy of self-reports of physical activity. , 1990, Medicine and science in sports and exercise.

[59]  R. Chatburn,et al.  Evaluation of instrument error and method agreement. , 1996, AANA journal.

[60]  N. Okamoto,et al.  Reliability and Validity of the International Physical Activity Questionnaire (IPAQ) in Elderly Adults: The Fujiwara-kyo Study , 2011, Journal of epidemiology.

[61]  R S Paffenbarger,et al.  Measurement of physical activity to assess health effects in free-living populations. , 1993, Medicine and science in sports and exercise.

[62]  N. Day,et al.  Validity and repeatability of the EPIC-Norfolk Physical Activity Questionnaire. , 2002, International journal of epidemiology.

[63]  B E Ainsworth,et al.  Compendium of physical activities: an update of activity codes and MET intensities. , 2000, Medicine and science in sports and exercise.

[64]  Oliver Stegle,et al.  Gaussian Process Robust Regression for Noisy Heart Rate Data , 2008, IEEE Transactions on Biomedical Engineering.

[65]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[66]  S. Stewart,et al.  Performance of the international physical activity questionnaire (short form) in subgroups of the Hong Kong chinese population , 2011, The international journal of behavioral nutrition and physical activity.

[67]  W. Mechelen,et al.  Self-Administered Physical Activity Questionnaires for the Elderly , 2010, Sports medicine.

[68]  M. Pagano,et al.  Validity of self-reported total physical activity questionnaire among older women , 2008, European Journal of Epidemiology.