Trajectories of self-reported physical activity and predictors during the transition to old age: a 20-year cohort study of British men

Abstract

BackgroundMaintenance of physical activity (PA) during later life is associated with optimal health; however, the long-term trajectories of PA into old age and their predictors have not been extensively researched using latent class methods. This study aimed to identify trajectories of self-reported PA and their predictors in men transitioning from midlife to old age.Methods7735 men (aged 40–59 years) recruited in 1978–80 were followed up after 12, 16 and 20 years, reporting PA, health status, lifestyle behaviours and socio-demographic characteristics. Group-based trajectory modelling identified the trajectories of PA and associations with time-stable and time-varying covariates. We considered a range of sociodemographic and health and lifestyle factors as potential covariates.Results4952 men (mean baseline age 49.1 ± 5.6 years) providing PA data at ≥3 time points were included in analyses. Three distinct 20-year trajectories were identified: low decreasing (24.6%, n = 1218), light stable (51.1%, n = 2530) and moderate increasing (24.3%, n = 1204). Being older, having a manual occupation, having never married or had children, residing in the midlands or North of England, suffering from a range of health conditions, being a smoker/ex-smoker and never consuming breakfast cereal or alcohol were independently associated with reduced odds of belonging to the moderate increasing trajectory group compared to the low decreasing group. Of the time-varying covariates considered, leaving employment was associated with a decrease in PA in the low decreasing group (β −0.306, p < 0.001) but an increase in the light stable (β 0.324, p < 0.001) and moderate increasing groups (β 0.847, p < 0.001). Developing cardiovascular-related conditions was associated with a decrease in PA in the low decreasing (β −0.408, p < 0.001) and light stable groups (β −0.118, p < 0.001) but no association was observed in the moderate increasing group (β −0.060, p = 0.313).ConclusionsThree distinct trajectories of PA were identified in men transitioning from midlife to old age, of which nearly a quarter had persistently low levels of PA. Promotion efforts may need to focus attention prior to middle age and consider a number of sociodemographic, health and lifestyle factors to sustain PA into old age. The effects of retirement and development of cardiovascular disease may vary according to PA trajectories.Electronic supplementary materialThe online version of this article (10.1186/s12966-017-0642-4) contains supplementary material, which is available to authorized users.

Association Between 20-Year Trajectories of Nonoccupational Physical Activity From Midlife to Old Age and Biomarkers of Cardiovascular Disease: A 20-Year Longitudinal Study of British Men

“…As previously described in this cohort ( 14 ), 3 trajectory groups of PA over the course of 20 years best described the data: low/decreasing (21.3%), light/stable (51.8%), and moderate/increasing (27.0%) (see Figure 1 ). Results from the model selection process are provided in Web Tables 1 and 2 .…”

“…By contrast, group-based trajectory modeling (GBTM) is a data-driven approach that has the ability “to identify rather than assume distinctive groups of trajectories” ( 12 , p. 139), thus describing the true underlying trajectories of behavior change over time ( 13 ). Previous studies have used this technique to identify trajectories of PA into old age ( 14 – 16 ), but to our knowledge it has not yet been used to examine associations with CVD biomarkers. Longitudinal studies using more repeated measures of PA and data-driven techniques are required to understand how patterns of PA into old age are associated with established and novel CVD risk factors.…”

Physical Activity Trajectories among Persons of Turkish Descent Living in Germany—A Cohort Study

“…Similar trajectories (always sedentary, fast declining, stable moderate, and always active) were reported in a study from the U.S. among a sample of older women aged 70–79 years, however, the authors found no increasing trajectory which was explained with the high age of the study participants [ 41 ]. Most studies describe three to four trajectories or patterns [ 19 , 26 , 41 ], and less often more are reported, as in a European study conducted in Spain with more than 1600 participants, reporting very diversified patterns (high PA—consistent, moderate PA—mildly decreasing, low PA—increasing, moderate PA—consistent, and low PA—decreasing) [ 12 ].…”

“…Thus, for a more detailed description of PA over a longer time period and a better understanding of its complexity, prospective trajectories including two or more time points are proposed [ 16 , 17 ]. PA trajectories can then be used to predict future health and physical functioning and are therefore a good measure for PA [ 5 , 9 , 11 , 15 , 18 , 19 , 20 , 21 ]. In addition, the identification of associated factors for specific PA trajectories is important for tailoring prevention efforts.…”

Trajectories of physical activity from midlife to old age and associations with subsequent cardiovascular disease and all-cause mortality

“…By contrast, data-driven approaches, such as group-based trajectory modelling (GBTM), allow the most naturally occurring trajectories to emerge from the data rather than assuming predetermined trajectories 21. This method has been used to identify PA trajectories in older adults,22–25 but associations with subsequent mortality and CVD events have not been fully explored.…”