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J Gerontol A Biol Sci Med Sci. 2019 Mar 14;74(4):560-567. doi: 10.1093/gerona/gly243.

Active-to-Sedentary Behavior Transitions, Fatigability, and Physical Functioning in Older Adults.

Author information

1
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
2
Center on Aging and Health, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland.
3
Intramural Research Program, National Institute on Aging, Baltimore, Maryland.
4
Department of Biostatistics, Baltimore, Maryland.
5
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
6
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland.

Abstract

BACKGROUND:

With aging, daily physical activity (PA) becomes less frequent and more fragmented. Accumulation patterns of daily PA-including transitions from active-to-sedentary behaviors-may provide important insights into functional status in older, less active populations.

METHODS:

Participants of the Baltimore Longitudinal Study of Aging (n = 680, 50% male, aged 27-94 years) completed a clinical assessment and wore an Actiheart accelerometer. Transitions between active and sedentary states were modeled as a probability (Active-to-Sedentary Transition Probability [ASTP]) defined as the reciprocal of the average PA bout duration. Cross-sectional associations between ASTP and gait speed (m/s), fatigability (rating-of-perceived-exertion [RPE]), 400 m time (seconds), and expanded short physical performance battery score were modeled using linear and logistic regression, adjusted for chronic conditions. Further analyses explored the utility of ASTP over-and-above total daily PA.

RESULTS:

In continuous models, each 0.10-unit higher ASTP was associated slower gait (β = -0.06 m/s, SE = 0.01), higher fatigability (β = 0.60 RPE, SE = 0.12), slower 400 m time (β = 16.31 s, SE = 2.70), and lower functioning (β = -0.13 expanded short physical performance battery score, SE = 0.03; p < .001). In categorical analyses, those in the highest tertile of ASTP were >2 times more likely to have high fatigability (rating of perceived exertion ≥10), slow 400 m time (>300 seconds) and reduced functional performance (expanded short physical performance battery score < 3.07) than those in the lowest tertile (p < .01). Further analyses demonstrated ASTP provided additional insight into functional outcomes beyond total daily PA.

CONCLUSION:

Fragmented daily PA-as measured by ASTP-is strongly linked with measures of health and functional status and may identify those at risk of high fatigability and reduced functional performance over and above traditional PA metrics.

KEYWORDS:

Accelerometer; Fatigability; Physical activity; Physical function; Sedentary

PMID:
30357322
PMCID:
PMC6417447
DOI:
10.1093/gerona/gly243
[Indexed for MEDLINE]
Free PMC Article

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