Sedentary time in older men and women: an international consensus statement and research priorities

Abstract

Sedentary time is a modifiable determinant of poor health, and in older adults, reducing sedentary time may be an important first step in adopting and maintaining a more active lifestyle. The primary purpose of this consensus statement is to provide an integrated perspective on current knowledge and expert opinion pertaining to sedentary behaviour in older adults on the topics of measurement, associations with health outcomes, and interventions. A secondary yet equally important purpose is to suggest priorities for future research and knowledge translation based on gaps identified. A five-step Delphi consensus process was used. Experts in the area of sedentary behaviour and older adults (n=15) participated in three surveys, an in-person consensus meeting, and a validation process. The surveys specifically probed measurement, health outcomes, interventions, and research priorities. The meeting was informed by a literature review and conference symposium, and it was used to create statements on each of the areas addressed in this document. Knowledge users (n=3) also participated in the consensus meeting. Statements were then sent to the experts for validation. It was agreed that self-report tools need to be developed for understanding the context in which sedentary time is accumulated. For health outcomes, it was agreed that the focus of sedentary time research in older adults needs to include geriatric-relevant health outcomes, that there is insufficient evidence to quantify the dose–response relationship, that there is a lack of evidence on sedentary time from older adults in assisted facilities, and that evidence on the association between sedentary time and sleep is lacking. For interventions, research is needed to assess the impact that reducing sedentary time, or breaking up prolonged bouts of sedentary time has on geriatric-relevant health outcomes. Research priorities listed for each of these areas should be considered by researchers and funding agencies.This consensus statement has been endorsed by the following societies: Academy of Geriatric Physical Therapy, Exercise & Sports Science Australia, Canadian Centre for Activity and Aging, Society of Behavioral Medicine, and the National Centre for Sport and Exercise Medicine.

Can physical activity attenuate the negative association between sitting time and cognitive function among older adults? A mediation analysis

“…Increasing age is associated with a decrease in physical activity and cognitive function, and sedentary behavior may be a modifiable risk factor that can reduce the risk of disease and disability among older adults 19 . Increasing physical activity is one promising strategy to promote or maintain cognitive health in later life 29 .…”

Sedentary Time and Disability in Older Adults: A Systematic Review and Meta-Analysis

“…This concern is mainly focused on older adults who spend more time in SB compared to other age groups [13]. SB, which is defined as excessive involvement in activities that require low energy expenditure (≤ 1.5 METs), typically performed in the sitting position, has been associated with reduced functional capacity and disability in older adults [12][13][14][15][16][17][18].…”

“…Specifically, studies have shown that while adults and children spend on average 7.7 hours/day in sedentary behavior, older adults spend even more time in SB (sitting or reclining), with an average of 8.0 to 11 hours per day [13,20]. This amount of time spent in SB, in older adults, may predict functional disability and also contribute to an increase in the burden of multiple chronic diseases resulting in the elevation of healthcare costs and increased risks for mortality [3,14,[21][22][23]. Both television viewing and the total time in SB are significantly associated with disability in older adults [24,25].…”

Objectively measured physical activity, sedentary behaviour and all-cause mortality in older men: does volume of activity matter more than pattern of accumulation?

“…Such data can also inform whether accruing sedentary time in prolonged bouts is associated with adverse effects on mortality, as this has been identified as an important research gap. Many studies report that higher levels of self-reported sedentary time are associated with mortality, [6][7][8][9] although self-reported sedentary behaviours may suffer from measurement error or recall bias.10-14 Experimental studies suggest benefits of breaking up sedentary time for metabolic and haemostatic markers.15 16 Hence, activity guidelines now suggest avoiding 'long' sedentary periods, but without quantifying how 'long' is detrimental. 4 Recently, prospective cohort studies using bodyworn devices to measure PA report that more time spent in MVPA is associated with lower mortality risks and sedentary behaviour with higher risks.…”

“…Such data can also inform whether accruing sedentary time in prolonged bouts is associated with adverse effects on mortality, as this has been identified as an important research gap. Many studies report that higher levels of self-reported sedentary time are associated with mortality, [6][7][8][9] although self-reported sedentary behaviours may suffer from measurement error or recall bias. [10][11][12][13][14] Experimental studies suggest benefits of breaking up sedentary time for metabolic and haemostatic markers.…”