Sedentary behaviour, physical activity, and sarcopenia among older adults in the TSHA: isotemporal substitution model

Abstract

Background The associations between free‐living physical activity (PA) and sedentary behaviour (SB) and sarcopenia in older people and its determinants are controversial. Self‐reporting, the use of one‐size‐fits‐all cut‐points for intensity categorization when using accelerometers and the absence of a clear sarcopenia definition hampered explorations. The aim of this study is to describe the associations between objectively measured PA patterns and sarcopenia and its determinants. Methods Subjects aged >65 with valid accelerometry and sarcopenia‐related measures from Toledo Study of Healthy Aging (TSHA) were included. Muscle mass (MM) was estimated by dual‐energy X‐ray absorptiometry. Handgrip strength (HS) was measured by dynamometry. Physical performance assessment relied on gait speed (GS). Sarcopenia presence was ascertained using Foundation for the National Institutes of Health (FNIH) criteria. PA and SB were estimated by ActiTrainer worn for 1 week and classified into time spent in SB and different PA intensity bands [light PA (LPA) and moderate‐to‐vigorous PA (MVPA)] using age‐specific cut‐points. Different multivariate linear and logistic regression models [(i) single‐parameter, (ii) partition, and (iii) isotemporal substitution models] were used for estimating associations between PA, SB, and sarcopenia determinants and sarcopenia rates, respectively. All models adjusted for age, sex, co‐morbidities (Charlson index), and functional ability (Katz and Lawton indexes). Results Five hundred twelve subjects from the TSHA had available data (78.08 ± 5.71 years of age; 54.3% women). FNIH sarcopenia assessment was performed in 497 subjects (23.3% were sarcopenic). In the linear regression, the single‐parameter model showed an association between MVPA and all sarcopenia determinants. In the partition model, MVPA was associated with greater MM and GS. The isotemporal substitution showed that reallocating 1 h/day of MVPA displacing SB was associated with greater values in MM [ β = 0.014; 95% confidence interval (CI) = 0.004, 0.024; P < 0.01], GS ( β = 0.082; 95% CI = 0.054, 0.110; P < 0.001), and HS ( β = 0.888; 95% CI = 0.145, 1.631; P < 0.05). In the logistic regression, the single‐parameter model yielded a significant association between 1 h/day increase in MVPA and sarcopenia reduction [odds ratio (OR) = 0.522; 95% CI = 0.367, 0.726; P < 0.001], as did the partition model (OR = 0.555; 95% CI = 0.376, 0.799; P < 0.01). The reallocation of 1 h/day SB only yielded a significant lower sarcopenia risk by almost 50% when it was substituted with MVPA, whereas the substitution of 15 min/day yielded a significant lower sarcopenia risk by 15% ( P < 0.001) but did not show any association...

The Association Between Sedentary Behavior and Sarcopenia Among Adults Aged ≥65 Years in Low- and Middle-Income Countries

“…The present findings support previous work that also found that higher levels of sedentary behavior were associated with higher odds or risk of sarcopenia [8][9][10]26]. However, it should be noted here that previous studies show a slightly higher risk between sedentary time and sarcopenia.…”

“…First, it is possible that an increase in sedentary time may displace time in physical activity, and indeed higher levels of physical activity have been shown to be associated with lower levels of sarcopenia [5]. In support, in one study utilizing isotemporal substitution, it was found that an increase in moderate-to-vigorous physical activity replacing sedentary behavior and light physical activity were associated with a reduction in sarcopenia prevalence [26]. Therefore, it is possible that the association between sedentary behavior and sarcopenia observed in the present study is the reverse of the association between light physical activity and sarcopenia.…”

“…The covariates used for adjustment were selected based on past literature [8,9,26] and included age, sex, highest education achieved (primary, secondary, tertiary), wealth quintiles based on country-specific income, physical activity, current smoking, current drinking (alcohol consumption in the past 30 days), number of chronic physical conditions, and BMI (<18.5, 18.5-24.9, 25.0-29.9, ≥30 kg/m 2 ). Levels of physical activity were assessed with the GPAQ and were classified as low, moderate, and high based on conventional cut-offs [24].…”

More Time Spent in Sedentary Behaviors is Associated with Higher Plantar Pressures in Older Women

“…In line with that, during overloading conditions, the vertical forces and pressures generated beneath different regions of the foot contribute to the collapse of the medial longitudinal arch, causing a greater contact area of the foot with the ground [15]. Additionally, older individuals who spent more time in sedentary behaviors tend to have lower muscle mass [16], which also contributes to foot flattening [14]. In terms of foot function, previous studies have shown that obese individuals walk more slowly, with shorter and wider steps and longer stance phase duration [17], which may cause certain pain and discomfort and, in addition, higher levels of plantar pressure.…”

The Effect of Nordic Walking Training with Poles with an Integrated Resistance Shock Absorber on the Functional Fitness of Women over the Age of 60

“…The open question remains whether such a stimulus is sufficient. Sánchez-Sánchez et al [11] noted the unclear impact of walking on the health of older people. However, other studies have shown that endurance exercises can even attenuate sarcopenia [12,13].…”