Contrasting characteristics of daily physical activity in older adults by cancer history

Abstract

Introduction: Using objectively-collected physical activity (PA) data from the Baltimore Longitudinal Study of Aging, we tested whether patterns of daily activity and sedentary time differed by cancer survivorship in older adults. Methods: 659 participants (mean age 71 ± 10 years, 51% women) were instructed to wear an accelerometer for 7 consecutive days and had self-reported information on cancer history. Accelerometer data were summarized into: 1) PA volume and 2) activity fragmentation (interrupted activity), both expressed as continuous and as dichotomized (low and high) variables. Participants were categorized into four groups by cross-classification of dichotomous PA volume and fragmentation. Multiple regression models were used to estimate differences in PA patterns by cancer history. Results: Cancer survivors averaged 0.12 (SE=0.05, p=0.02) fewer log-transformed activity counts per day than those reporting no cancer history after adjusting for demographics, behavioral factors, and comorbidities. Although fragmentation did not differ by cancer survivorship in the continuous model (p=0.13), cancer survivorship was associated with a 77% (odds ratio (OR): 1.77, 95% confidence interval (CI): 1.11–2.82) higher odds of having high (versus low) fragmentation and a 94% (OR: 1.94, 95% CI: 1.13–3.33) higher odds of having combined low PA/high fragmentation (versus high PA/low fragmentation) relative to no cancer history. Discussion: Findings suggest that cancer survivors engage in lower total daily PA and that this activity is performed in a more fragmented manner. These results may reflect the onset and progression of a low activity phenotype that is more vulnerable to heightened levels of fatigue and functional decline with aging.

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

“…Bout length was defined as the number of consecutive minutes spent in either an active or sedentary state and a daily activity profile was created for each participant to detect alternating bouts of sedentary and active states. ASTP was defined as the probability of transitioning from an active to a sedentary state and calculated as the reciprocal of the average active bout duration (14,15). ASTP was calculated for each day and averaged across valid days to derive a single measure of ASTP for each participant.…”

“…Although both individuals may accrue similar amounts of active and sedentary time over a typical day or week, the number of transitions between active and sedentary states, or degree of activity fragmentation, differs dramatically. Extracting information on activity fragmentation from accelerometry data may thus provide a new and more informative criterion to identify individuals earlier in their transition from moderately active to largely sedentary (14,15).…”

“…The purpose of this article is to introduce an index of activity fragmentation, the Active-to-Sedentary Transition Probability (ASTP) (14,15), as an early marker of fragmented PA, diminished reserve capacity, and declining functional status in older adults. ASTP is easy to calculate, interpret, and translate across accelerometer devices and studies, which may improve cohesiveness across accelerometer-based research.…”

Association of Total Daily Physical Activity and Fragmented Physical Activity With Mortality in Older Adults

“…With aging and disease, activity becomes less frequent and shorter in duration, or more fragmented, 7 as physiological capacity declines. Fragmented patterns of activity are associated with poorer physical functioning, 7,8 a precursor of disability and frailty, 9,10 and have been detected in cancer survivors with high fatigability and low endurance performance, 11,12 factors consistent with accelerated aging. Thus, activity fragmentation may be a marker of a compromised physiological state and impending decline in health and functional status, making it a potential early target for intervention.…”

Physical activity fragmentation as a potential phenotype of accelerated aging

“…In Wanigatunga, et al's recent publication, activity fragmentation was coupled with total physical activity amount to create a physical activity phenotype that was assessed among older adults participating in the Baltimore Longitudinal Study of Aging by cancer history [9]. Together, the joint effects of physical activity quantity and accumulation patterns detected greater differences in physical activity than each independent characteristic alone, suggesting the combined physical activity phenotype may be more sensitive for detecting emerging physiological impairment resulting from cancer and related therapeutics.…”