Validity of the International Physical Activity Questionnaire (IPAQ) for assessing moderate-to-vigorous physical activity and sedentary behaviour of older adults in the United Kingdom

Abstract

BackgroundIn order to accurately measure and monitor levels of moderate-to-vigorous physical activity (MVPA) and sedentary behaviour (SB) in older adults, cost efficient and valid instruments are required. To date, the International Physical Activity Questionnaire (IPAQ) has not been validated with older adults (aged 60 years plus) in the United Kingdom. The current study aimed to test the validity of the IPAQ in a group of older adults for both MVPA and SB.MethodsParticipants wore an Actigraph GT3X+ for seven consecutive days and following the monitor wear participants were asked to complete the IPAQ. Statistical analysis included: Kolmogorov-Smirnov tests; descriptive analyses; Spearman’s rho coefficients; and Bland-Altman analyses.ResultsA sample of 253 older adults were recruited (mean age 71.8 years (SD 6.6) and 57% male). In total, 226 had valid accelerometer and IPAQ data for MVPA and 228 had valid data for SB. Results showed the IPAQ had moderate/acceptable levels of validity (r = .430–.557) for MVPA. For SB, there was substantial levels of validity on weekdays (r = .702) and fair levels of validity (r = .257) on weekend days. Bland-Altman analysis showed inherent measurement error with the majority of participants tending to under-report both MVPA and SB. Results showed the majority of older adult’s under-report their level of MVPA and SB when completing the IPAQ and the linear relationship above the mean shows an error from under to over reporting as the mean increases.ConclusionsFindings from the current study suggest that the IPAQ is better implemented in larger surveillance studies comparing groups within or between countries rather than on an individual basis. Findings also suggest that the IPAQ validity scores could be strengthened by providing additional detail of types of activities older adults might do on a daily basis, improving recall; and it may also be necessary to provide an example of a daily break down of typical activities performed. This may enable older adults to more fully comprehend the amount of time they may spend active, sitting and/or lying during waking hours.

A comparison of self-reported and device measured sedentary behaviour in adults: a systematic review and meta-analysis

“…Additional studies examined and compared the criterion validity of self-report measures under the following conditions: nine studies (19 comparisons) on weekday/ workday (includes time at work and outside of work) vs. weekend/non-workday sedentary time [24,47,51,58,69,70,86,156,198]; 2 studies (5 comparisons) on minutes per day of self-reported television time [141,155]; nine studies (11 comparisons) on minutes per day of occupational sedentary time [61,65,75,99,101,105,122,136,181,188,193]; and, four studies (five comparisons) on the proportion of a workday spent sedentary [91,105,158,205]. In all of these studies a comparable criterion was required (e.g., self-reported occupational sitting was compared to accelerometer sedentary time during work time only).…”

Weekly recall of sedentary time: Validity of 2 weekly self‐reported measures in undergraduate students

“…Remembering sedentary time across multiple sedentary behaviors appears to be quite difficult after just 1 day, and Study 1 demonstrated that some participants were unsure up to ±5 hours over the past‐week. In previous studies, the inaccuracy of other weekly sedentary questionnaires has been demonstrated using the Bland‐Altman analysis showing very wide limits of agreement . The results of these previous studies in combination with the results of Study 2 suggest that the most accurate measures of weekly sedentary time may come from a questionnaire that has participants report daily sedentary time across multiple sedentary behaviors sequentially, in more of a “log” format, rather than retrospectively, such as the NIGHTLY‐WEEK‐U.…”

“…It is possible that continuous reporting of past‐day sedentary time over a week could make a participant aware of how much sitting they are participating in, and as a result, begin to limit their daily sedentary time. The downside of this limitation will need to be weighed against the demonstrated inaccuracies of past‐week or typical week sedentary time questionnaires . A further limitation of the NIGHTLY‐WEEK‐U is the increased burden displaced on both the participant and the researcher.…”

“…In previous studies, the inaccuracy of other weekly sedentary questionnaires has been demonstrated using the Bland-Altman analysis showing very wide limits of agreement. 7,10,20,21 The results of these previous studies in combination with the results of Study 2 suggest that the most accurate measures of weekly sedentary time may come from a questionnaire that has participants report daily sedentary time across multiple sedentary behaviors sequentially, in more of a "log" format, rather than retrospectively, such as the NIGHTLY-WEEK-U. Furthermore, to maximally reduce recall bias, the "past-day" reporting of sedentary time should be done at the end of the day in question, and not on the following day after a participant has fallen asleep.…”

“…The downside of this limitation will need to be weighed against the demonstrated inaccuracies of pastweek or typical week sedentary time questionnaires. 7,10,20,21 A further limitation of the NIGHTLY-WEEK-U is the increased burden displaced on both the participant and the researcher. More data and time are required from the participant, and as a result, there are more data to be analyzed by the researcher.…”