Current Evidence of Measurement Properties of Physical Activity Questionnaires for Older Adults: An Updated Systematic Review

Abstract

Background Questionnaires provide valuable information about physical activity (PA) behaviors in older adults. Until now, no firm recommendations for the most qualified questionnaires for older adults have been provided. Objectives This review is an update of a previous systematic review, published in 2010, and aims to summarize, appraise and compare the measurement properties of all available self-administered questionnaires assessing PA in older adults. Methods We included the articles evaluated in the previous review and conducted a new search in PubMed, Embase, and SPORTDiscus from September 2008 to December 2019, using the following inclusion criteria (1) the purpose of the study was to evaluate at least one measurement property (reliability, measurement error, hypothesis testing for construct validity, responsiveness) of a self-administered questionnaire; (2) the questionnaire intended to measure PA; (3) the questionnaire covered at least one domain of PA; (4) the study was performed in the general, healthy population of older adults; (5) the mean age of the study population was > 55 years; and (6) the article was published in English. Based on the Quality Assessment of Physical Activity Questionnaires (QAPAQ) checklist, we evaluated the quality and results of the studies. The content validity of all included questionnaires was also evaluated using the reviewers' rating. The quality of the body of evidence was evaluated for the overall construct of each questionnaire (e.g., total PA), moderate-to-vigorous physical activity (MVPA) and walking using a modified Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. Results In total, 56 articles on 40 different questionnaires (14 from the previous review and 26 from the update) were included. Reliability was assessed for 22, measurement error for four and hypotheses testing for construct validity for 38 different questionnaires. Evidence for responsiveness was available for one questionnaire. For many questionnaires, only one measurement property was assessed in only a single study. Sufficient content validity was considered for 22 questionnaires. All questionnaires displayed large measurement errors. Only versions of two questionnaires showed both sufficient reliability and hypotheses testing for construct validity, namely the Physical Activity Scale for the Elderly (PASE; English version, Turkish version) for the assessment of total PA, and the Physical Activity and Sedentary Behavior Questionnaire (PASB-Q; English version) for the assessment of MVPA. The quality of evidence for these results ranged from very low to high. Conclusions Until more high-quality evidence is available, we recommend the PASE for measuring total PA and the PASB-Q for measuring MVPA in older adults. However, they are not equally qualified among different languages. Future studies on the most promising questionnaires should cover all relevant measurement properties. We recommend using and improving existing PA questionnaires-instead of developing new ones-...

Validity and Reliability of International Physical Activity Questionnaires for Adults across EU Countries: Systematic Review and Meta Analysis

“…GPAQ uses a typical week to assess PA data; however, a typical week can be different in many European countries due to weather conditions yielding different PA levels. (iii) The season of the assessed PA was not taken into account, and therefore different results could be reported from studies since the EU has four seasons; (iv) even though the quality of each study was assessed, findings from studies of a lower quality were given no less importance than the other findings; (v) sample type might have a potential impact on the results of the study, since 13 out of 20 used convenience sampling; (vi) meta-analysis included only 17 studies, whereas the systematic review included 20 studies; (vii) coefficients of associations were reported whether or not they were significant or insignificant in initial studies, potentially leading to different results if only significant results were used; (viii) according to the PROSPERO register we left Eurobarometer out of the manuscript since we did not find any validation studies; (ix) this review includes studies from the UK, although at the time of publication, the UK is no longer a part of the EU; (x) although there exist other widely used PA questionnaires, targeting specific parts of the populations, such as Physical Activity Scale for the Elderly [ 85 ], we focused only on the questionnaires targeting the general adult population; and (xi) results of the present meta-analysis refers only to the adult population and are not necessarily valid in other populations such as the elderly, children and patients.…”

The Quick Physical Activity Rating (QPAR) scale: A brief assessment of physical activity in older adults with and without cognitive impairment

“…Other scales include the Community Health Activities Model Program for Seniors [ 71 ], General Practice Physical Activity Questionnaire [ 72 ], Modified Leisure Time Physical Activity Questionnaire [ 73 ], Stanford Brief Activity Survey [ 74 ], and Physical Activity and Sedentary Behavior Questionnaire (PASB) [ 73 ]. In a systematic review, most scales except for the PASE and PASB suffered from large measurement errors, low-quality evidence, and the lack of tests of reliability and construct validity [ 75 ]. Few of these scales were tested in individuals with cognitive impairment.…”

Identification of Tools for the Functional and Subjective Assessment of Patients in an Aquatic Environment: A Systematic Review

“…Likewise, the direct impact of the disease on the person can be assessed by means of the Arthritis Self-Efficacy Scale, Berg Balance Scale, Chronic Venous Insufficiency Questionnaire or, to evaluate the functional capacity of the patient, the Assessment of Motor and Process Skills or the Physical Activity Scale for the Elderly, among other instruments (see Table S4 ( Supplementary Materials )). Therefore, the application of a set of questionnaires with chosen criteria provides a comprehensive view of the patient’s health status and will facilitate a therapeutic approach [ 32 ]. The application time of the instrument must be regulated; instruments such as the Child Health Assessment Questionnaire, Assessment of Motor and Process Skills or Short Form-36 (30–40 min) ( Table S3 ( Supplementary Materials )) may be of excessive duration and can be difficult to integrate into an evaluation process within a clinical consultation.…”

“…The psychometric properties of the questionnaires are fundamental as they allow us to identify the validity and reliability to apply the best instrument on each occasion [ 33 ] ( Table S4 ( Supplementary Materials )). The highest test-retest reliability identified was in the Berg Balance Scale 0.99 [ 32 ] and the Chronic Venous Insufficiency Questionnaire 0.98 [ 34 ]. However, the lowest values were observed in the Assessment of Quality of Life Scale 0.78 [ 35 ].…”

“…However, the lowest values were observed in the Assessment of Quality of Life Scale 0.78 [ 35 ]. Inter-observer reliability was only identified in two questionnaires: Falls Efficacy Scale; 0.72 [ 36 ] and Berg Balance Scale 0.98 [ 32 ]. The minimal detectable change of the included questionnaires was only identified in the Activities-specific Balance Confidence Scale [ 37 ], Arthritis Impact Measurement Scale [ 38 ] and the Berg Balance Scale [ 39 ].…”