Sedentary time in US older adults associated with disability in activities of daily living independent of physical activity.

BACKGROUND The harmful relationship of sedentary behavior to health may reflect an exchange of sedentary activity for moderate-to-vigorous physical activity (MVPA), or sedentary behavior may be a separate risk factor. We examined whether time spent in sedentary behavior is related to disability in activities of daily living (ADL), independent of time spent in MVPA in older adults. METHODS The nationally representative 2003-2006 National Health and Nutrition Examinations Surveys (NHANES) included 2286 adults aged 60 years and older in whom physical activity was assessed by accelerometer. The association between ADL task disability and the daily percentage of sedentary time was evaluated by multiple logistic regression. RESULTS These adults on average spent 9h/d being sedentary during waking hours and 4.5% reported ADL disability. The odds of ADL disability were 46% greater (odds ratio, 1.46; 95% confidence interval, 1.07-1.98) for each daily hour spent in sedentary behavior, adjusted for MVPA and socioeconomic and health factors. CONCLUSION These US national data show a strong relationship between greater time spent in sedentary behavior and the presence of ADL disability, independent of time spent in moderate or vigorous activity. These findings support programs encouraging older adults to decrease sedentary behavior regardless of their engagement in moderate or vigorous activity.

[1]  C. Matthews,et al.  Association of Sedentary Time with Mortality Independent of Moderate to Vigorous Physical Activity , 2012, PloS one.

[2]  J. Shaw,et al.  Objectively Measured Sedentary Time, Physical Activity, and Metabolic Risk , 2007, Diabetes Care.

[3]  E. Rimm,et al.  Leisure-time physical activity, television watching, and plasma biomarkers of obesity and cardiovascular disease risk. , 2000, American journal of epidemiology.

[4]  M. Hamilton,et al.  Suppression of skeletal muscle lipoprotein lipase activity during physical inactivity: a molecular reason to maintain daily low‐intensity activity , 2003, The Journal of physiology.

[5]  M. Hirvensalo,et al.  Mobility Difficulties and Physical Activity as Predictors of Mortality and Loss of Independence in the Community‐Living Older Population , 2000, Journal of the American Geriatrics Society.

[6]  Genevieve N Healy,et al.  Feasibility of reducing older adults' sedentary time. , 2011, American journal of preventive medicine.

[7]  D. Cutler.  Disability and the future of Medicare. , 2003, The New England journal of medicine.

[8]  Rebecca E. Lee,et al.  Discretionary time among older adults: How do physical activity promotion interventions affect sedentary and active behaviors? , 2003, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[9]  L. DiPietro,et al.  ‘Sedentary behaviour counselling’: the next step in lifestyle counselling in primary care; pilot findings from the Rapid Assessment Disuse Index (RADI) study , 2012, British Journal of Sports Medicine.

[10]  M. Hamilton,et al.  Exercise Physiology versus Inactivity Physiology: An Essential Concept for Understanding Lipoprotein Lipase Regulation , 2004, Exercise and sport sciences reviews.

[11]  W. Applegate,et al.  A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). , 1997, JAMA.

[12]  D. Callahan.  Aging, death, and population health. , 1999, JAMA.

[13]  Walter C Willett,et al.  Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. , 2003, JAMA.

[14]  J. Shreffler,et al.  A randomized controlled trial of the people with arthritis can exercise program: symptoms, function, physical activity, and psychosocial outcomes. , 2008, Arthritis and rheumatism.

[15]  C. Friedenreich,et al.  Associations of objectively assessed physical activity and sedentary time with biomarkers of breast cancer risk in postmenopausal women: findings from NHANES (2003–2006) , 2011, Breast Cancer Research and Treatment.

[16]  L. Sharma,et al.  Physical activity levels and functional performance in the osteoarthritis initiative: a graded relationship. , 2011, Arthritis and rheumatism.

[17]  P. Freedson,et al.  Amount of time spent in sedentary behaviors in the United States, 2003-2004. , 2008, American journal of epidemiology.

[18]  T. Bazzarre,et al.  Best-practice physical activity programs for older adults: findings from the national impact study. , 2009, American journal of public health.

[19]  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.

[20]  S. Blair,et al.  Effects of different doses of physical activity on cardiorespiratory fitness among sedentary, overweight or obese postmenopausal women with elevated blood pressure: a randomized controlled trial. , 2007, JAMA.

[21]  Alastair Scott,et al.  On Simple Adjustments to Chi-Square Tests with Sample Survey Data , 1987 .

[22]  J. Williamson,et al.  Physical exercise and the prevention of disability in activities of daily living in older persons with osteoarthritis. , 2001, Archives of internal medicine.

[23]  Christianna S. Williams,et al.  Functional disability and health care expenditures for older persons. , 2001, Archives of internal medicine.

[24]  B. Ainsworth,et al.  Association among physical activity level, cardiorespiratory fitness, and risk of musculoskeletal injury. , 2001, American journal of epidemiology.

[25]  M. Pratt,et al.  Inactivity-Associated medical costs among US adults with arthritis. , 2001, Arthritis and rheumatism.

[26]  B. Belza,et al.  Older Adult Perspectives on Physical Activity and Exercise: Voices From Multiple Cultures , 2004, Preventing chronic disease.

[27]  Liming Cai,et al.  Health, life expectancy, and health care spending among the elderly. , 2003, The New England journal of medicine.

[28]  Timothy Waidmann,et al.  Resolving inconsistencies in trends in old-age disability: Report from a technical working group , 2004, Demography.

[29]  N. Owen,et al.  Associations of objectively-assessed physical activity and sedentary time with depression: NHANES (2005-2006). , 2011, Preventive medicine.

[30]  W. Anderson,et al.  State-Level Health Care Expenditures Associated With Disability , 2010, Public health reports.

[31]  M. Buman,et al.  Objective Light-Intensity Physical Activity Associations With Rated Health in Older Adults , 2011 .

[32]  Annemarie Koster,et al.  Sedentary Activity Associated With Metabolic Syndrome Independent of Physical Activity , 2011, Diabetes Care.