The International Physical Activity Questionnaire modified for the elderly: aspects of validity and feasibility

Abstract Objective To modify the self-administered, short version of the International Physical Activity Questionnaire (IPAQ) for adults to be used in the elderly (aged 65 years and above), and to validate this modified IPAQ for the elderly (IPAQ-E). Design A direct validity study using accelerometer-measured physical activity (PA) as the criterion measure, and an indirect criterion validity study using high-sensitivity C-reactive protein (hs-CRP) as a biological marker of activity. Setting Organisations for retired persons in Sweden. Subjects The direct validity study consisted of fifty-four participants and the indirect criterion validity study consisted of 359 participants. All participants were retired persons (66–91 years) living independently. Results All self-reported activity domains (sitting, walking, moderate and vigorous) were positively correlated with the corresponding variable objectively assessed by an accelerometer (ρ = 0·277–0·471), but a systematic error was observed. The specificity of IPAQ-E to identify low-active participants was 85 %, and the sensitivity to identify the more active participants was 81 %. A main effect of IPAQ-E category (Low, Moderate or High) was observed for hs-CRP (P = 0·041). Conclusions We found this modified version of IPAQ, the IPAQ-E, to be well accepted by our sample of socially active elderly. It provided acceptable estimates of PA, well in line with other questionnaires, even though it had a systematic error. The IPAQ-E was able to identify an expected response of a biomarker (hs-CRP) to PA. We recommend the use of the IPAQ-E to classify participants aged 65 years and above into PA categories, to rank individuals or to identify individuals meeting certain PA criteria.

[1]  J. Sallis,et al.  American Heart Association guide for improving cardiovascular health at the community level: a statement for public health practitioners, healthcare providers, and health policy makers from the American Heart Association Expert Panel on Population and Prevention Science. , 2003, Circulation.

[2]  B. Ainsworth,et al.  Estimation of energy expenditure using CSA accelerometers at hip and wrist sites. , 2000, Medicine and science in sports and exercise.

[3]  Kenneth R Fox,et al.  Physical activity patterns assessed by accelerometry in older people , 2007, European Journal of Applied Physiology.

[4]  Luc Vanhees,et al.  Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment. , 2008, The Cochrane database of systematic reviews.

[5]  Heikki Kyröläinen,et al.  International Physical Activity Questionnaire: Validity against fitness. , 2006, Medicine and science in sports and exercise.

[6]  L. Mâsse,et al.  Physical activity in the United States measured by accelerometer. , 2008, Medicine and science in sports and exercise.

[7]  A. King,et al.  Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. , 2007, Medicine and science in sports and exercise.

[8]  Rongwei Fu,et al.  C-Reactive Protein as a Risk Factor for Coronary Heart Disease: A Systematic Review and Meta-analyses for the U.S. Preventive Services Task Force , 2009, Annals of Internal Medicine.

[9]  B. Ainsworth,et al.  Comparison of a subjective and an objective measure of physical activity in a population sample. , 2010, Journal of physical activity & health.

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

[11]  T. Robinson,et al.  Estimating physical activity from incomplete accelerometer data in field studies. , 2007, Journal of physical activity & health.

[12]  Kelly R Evenson,et al.  Accelerometer use in physical activity: best practices and research recommendations. , 2005, Medicine and science in sports and exercise.

[13]  P. Thompson,et al.  The effects of physical activity on serum C-reactive protein and inflammatory markers: a systematic review. , 2005, Journal of the American College of Cardiology.

[14]  R S Paffenbarger,et al.  The association of changes in physical-activity level and other lifestyle characteristics with mortality among men. , 1993, The New England journal of medicine.

[15]  R A Washburn,et al.  Assessment of Physical Activity in Older Adults , 2000, Research quarterly for exercise and sport.

[16]  P S Freedson,et al.  Calibration of the Computer Science and Applications, Inc. accelerometer. , 1998, Medicine and science in sports and exercise.

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

[18]  E. Plaisance,et al.  Physical Activity and High-Sensitivity C-Reactive Protein , 2006, Sports medicine.

[19]  U. Ekelund,et al.  Comparison of two methods of measuring physical activity in South African older adults. , 2006, Journal of aging and physical activity.

[20]  S. Hooker,et al.  The effect of question order on reporting physical activity and walking behavior. , 2008, Journal of physical activity & health.

[21]  J. Manson,et al.  Physical activity and mortality: a prospective study among women. , 2001, American journal of public health.

[22]  B. Ainsworth,et al.  Guidelines for data processing analysis of the International Physical Activity Questionnaire (IPAQ) - Short and long forms , 2005 .

[23]  Karin Mack,et al.  Walking trends among U.S. adults: the Behavioral Risk Factor Surveillance System, 1987-2000. , 2003, American journal of preventive medicine.

[24]  B. Ainsworth,et al.  International physical activity questionnaire: 12-country reliability and validity. , 2003, Medicine and science in sports and exercise.

[25]  I. Bourdeaudhuij,et al.  The effect of item order on physical activity estimates using the IPAQ , 2007 .

[26]  Michael N. Sawka,et al.  ACSM's advanced exercise physiology , 2006 .

[27]  J. Foster,et al.  Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease: a randomized trial. , 2008, JAMA.

[28]  Charles E Matthew,et al.  Calibration of accelerometer output for adults. , 2005, Medicine and science in sports and exercise.

[29]  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.

[30]  M. Hagströmer,et al.  The International Physical Activity Questionnaire (IPAQ): a study of concurrent and construct validity , 2006, Public Health Nutrition.

[31]  Ross C Brownson,et al.  The epidemiology of walking for physical activity in the United States. , 2003, Medicine and science in sports and exercise.

[32]  A. Ströhle Physical activity, exercise, depression and anxiety disorders , 2009, Journal of Neural Transmission.

[33]  G. Dalsky,et al.  Economy of mobility in older adults. , 1997, The Journal of orthopaedic and sports physical therapy.

[34]  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.

[35]  U. Ekelund,et al.  Criterion-related validity of the last 7-day, short form of the International Physical Activity Questionnaire in Swedish adults , 2006, Public Health Nutrition.

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

[37]  L. Lechner,et al.  Question order in the assessment of misperception of physical activity , 2007, The international journal of behavioral nutrition and physical activity.