Advertisement

Can Physical Activity Offset the Detrimental Consequences of Sedentary Time on Frailty? A Moderation Analysis in 749 Older Adults Measured With Accelerometers

Published:February 06, 2019DOI:https://doi.org/10.1016/j.jamda.2018.12.012

      Abstract

      Objectives

      To determine whether or not and to what extent the association between sedentary time and frailty was moderated by moderate-to-vigorous physical activity in older adults.

      Design

      Cross-sectional.

      Setting

      Community-dwelling individuals.

      Participants

      749 (403 females and 346 males) white older adults.

      Measurements

      Sedentary time and moderate-to-vigorous physical activity were measured with accelerometers. Frailty was objectively measured using the Frailty Trait Scale. All models were adjusted for age, sex, education, income, marital status, body mass index, moderate-to-vigorous physical activity, and accelerometer wear time.

      Results

      The regression model reported a significant effect of sedentary time on frailty (P < .05). Nevertheless, the results indicated that moderate-to-vigorous physical activity moderates the relationship between frailty status and sedentary time. The Johnson-Neyman technique determined that the estimated moderate-to-vigorous physical activity point was 27.25 minutes/d, from which sedentary time has no significant effect on frailty.

      Conclusions

      Moderate-to-vigorous physical activity is a moderator in the relationship between sedentary time and frailty in older adults, offsetting the harmful effects of sedentary behavior with 27 minutes/d of moderate-to-vigorous activity. Engaging in moderate-to-vigorous physical activities should be encouraged. Reducing sedentary behavior may also be beneficial, particularly among inactive older adults.

      Keywords

      To read this article in full you will need to make a payment

      Subscribe:

      Subscribe to Journal of the American Medical Directors Association
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Morley J.E.
        • Vellas B.
        • van Kan G.A.
        • et al.
        Frailty consensus: A call to action.
        J Am Med Dir Assoc. 2013; 14: 392-397
        • Clegg A.
        • Young J.
        • Iliffe S.
        • et al.
        Frailty in elderly people.
        Lancet. 2013; 381: 752-762
        • Izquierdo M.
        • Rodriguez-Manas L.
        • Casas-Herrero A.
        • et al.
        Is it ethical not to prescribe physical activity for the elderly frail?.
        J Am Med Dir Assoc. 2016; 17: 779-781
        • de Rezende L.F.
        • Rey-Lopez J.P.
        • Matsudo V.K.
        • do Carmo Luiz O.
        Sedentary behavior and health outcomes among older adults: A systematic review.
        BMC Public Health. 2014; 14: 333
        • Dogra S.
        • Stathokostas L.
        Sedentary behavior and physical activity are independent predictors of successful aging in middle-aged and older adults.
        J Aging Res. 2012; 2012: 190654
        • Manas A.
        • Del Pozo-Cruz B.
        • Garcia-Garcia F.J.
        • et al.
        Role of objectively measured sedentary behaviour in physical performance, frailty and mortality among older adults: A short systematic review.
        Eur J Sport Sci. 2017; 17: 940-953
        • Song J.
        • Lindquist L.A.
        • Chang R.W.
        • et al.
        Sedentary behavior as a risk factor for physical frailty independent of moderate activity: Results from the Osteoarthritis Initiative.
        Am J Public Health. 2015; 105: 1439-1445
        • Blodgett J.
        • Theou O.
        • Kirkland S.
        • et al.
        The association between sedentary behaviour, moderate-vigorous physical activity and frailty in NHANES cohorts.
        Maturitas. 2015; 80: 187-191
        • Garcia-Hermoso A.
        • Ramirez-Velez R.
        • Celis-Morales C.A.
        • et al.
        Can physical activity attenuate the negative association between sitting time and cognitive function among older adults? A mediation analysis.
        Exp Gerontol. 2018; 106: 173-177
        • Ekelund U.
        • Steene-Johannessen J.
        • Brown W.J.
        • et al.
        Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women.
        Lancet. 2016; 388: 1302-1310
        • Garcia-Garcia F.J.
        • Avila G.G.
        • Alfaro-Acha A.
        • et al.
        The prevalence of frailty syndrome in an older population from Spain. The Toledo Study for Healthy Aging.
        J Nutr Health Aging. 2011; 15: 852-856
        • Garcia-Garcia F.J.
        • Carcaillon L.
        • Fernandez-Tresguerres J.
        • et al.
        A new operational definition of frailty: The Frailty Trait Scale.
        J Am Med Dir Assoc. 2014; 15: 371.e7-371.e13
        • Colley R.
        • Connor Gorber S.
        • Tremblay M.S.
        Quality control and data reduction procedures for accelerometry-derived measures of physical activity.
        Health Rep. 2010; 21: 63-69
        • Freedson P.S.
        • Melanson E.
        • Sirard J.
        Calibration of the Computer Science and Applications, Inc. accelerometer.
        Med Sci Sports Exerc. 1998; 30: 777-781
        • Johnson P.O.
        • Fay L.C.
        The Johnson-Neyman technique, its theory and application.
        Psychometrika. 1950; 15: 349-367
        • Anderson J.R.
        • Calvo D.
        • Glickman E.
        • et al.
        The moderating role of insulin-like growth factor 1 in the relationship between cognitive and aerobic endurance change.
        J Geriatr Psychiatry Neurol. 2017; 30: 84-89
        • Gao X.
        • Nelson M.E.
        • Tucker K.L.
        Television viewing is associated with prevalence of metabolic syndrome in Hispanic elders.
        Diabetes Care. 2007; 30: 694-700
        • Gennuso K.P.
        • Gangnon R.E.
        • Matthews C.E.
        • et al.
        Sedentary behavior, physical activity, and markers of health in older adults.
        Med Sci Sports Exerc. 2013; 45: 1493-1500
        • Del Pozo-Cruz B.
        • Manas A.
        • Martin-Garcia M.
        • et al.
        Frailty is associated with objectively assessed sedentary behaviour patterns in older adults: Evidence from the Toledo Study for Healthy Aging (TSHA).
        PLoS One. 2017; 12: e0183911
        • Kehler D.S.
        • Clara I.
        • Hiebert B.
        • et al.
        The association between bouts of moderate to vigorous physical activity and patterns of sedentary behavior with frailty.
        Exp Gerontol. 2018; 104: 28-34
        • Thyfault J.P.
        • Du M.
        • Kraus W.E.
        • et al.
        Physiology of sedentary behavior and its relationship to health outcomes.
        Med Sci Sports Exerc. 2015; 47: 1301-1305
        • Theou O.
        • Blodgett J.M.
        • Godin J.
        • Rockwood K.
        Association between sedentary time and mortality across levels of frailty.
        Can Med Assoc J. 2017; 189: E1056-E1064
        • Lee I.M.
        • Shiroma E.J.
        • Lobelo F.
        • et al.
        Effect of physical inactivity on major non-communicable diseases worldwide: An analysis of burden of disease and life expectancy.
        Lancet. 2012; 380: 219-229
        • Wen C.P.
        • Wu X.
        Stressing harms of physical inactivity to promote exercise.
        Lancet. 2012; 380: 192-193
        • Del Pozo-Cruz J.
        • Garcia-Hermoso A.
        • Alfonso-Rosa R.M.
        • et al.
        Replacing sedentary time: Meta-analysis of objective-assessment studies.
        Am J Prev Med. 2018; 55: 395-402
        • Manas A.
        • Del Pozo-Cruz B.
        • Guadalupe-Grau A.
        • et al.
        Reallocating accelerometer-assessed sedentary time to light or moderate- to vigorous-intensity physical activity reduces frailty levels in older adults: An isotemporal substitution approach in the TSHA Study.
        J Am Med Dir Assoc. 2018; 19: 185.e1-185.e6
        • Gardiner P.A.
        • Eakin E.G.
        • Healy G.N.
        • Owen N.
        Feasibility of reducing older adults' sedentary time.
        Am J Prev Med. 2011; 41: 174-177
        • Sardinha L.B.
        • Santos D.A.
        • Silva A.M.
        • et al.
        Breaking-up sedentary time is associated with physical function in older adults.
        J Gerontol A Biol Sci Med Sci. 2015; 70: 119-124
        • Buman M.P.
        • Hekler E.B.
        • Haskell W.L.
        • et al.
        Objective light-intensity physical activity associations with rated health in older adults.
        Am J Epidemiol. 2010; 172: 1155-1165
        • Tse A.C.Y.
        • Wong T.W.L.
        • Lee P.H.
        Effect of low-intensity exercise on physical and cognitive health in older adults: A systematic review.
        Sports Medicine Open. 2015; 1: 37
        • Brach J.S.
        • FitzGerald S.
        • Newman A.B.
        • et al.
        Physical activity and functional status in community-dwelling older women: A 14-year prospective study.
        Arch Intern Med. 2003; 163: 2565-2571
        • Fried L.P.
        • Tangen C.M.
        • Walston J.
        • et al.
        Frailty in older adults: Evidence for a phenotype.
        J Gerontol A Biol Sci Med Sci. 2001; 56: M146-M156
        • Rockwood K.
        • Song X.
        • MacKnight C.
        • et al.
        A global clinical measure of fitness and frailty in elderly people.
        Can Med Assoc J. 2005; 173: 489-495
        • An H.S.
        • Kim Y.
        • Lee J.M.
        Accuracy of inclinometer functions of the activPAL and ActiGraph GT3X+: A focus on physical activity.
        Gait Posture. 2017; 51: 174-180