Table 1 Prospective cohort studies in the elderly: population characteristics, methods of assessing physical activity and energy expenditure, and dose–response relationships

Kaplan 1987

17-year follow-up.

Questionnaire Alameda Country Study (SA)

LTPA (e.g. walking, gardening, fishing), sport, exercise.

Low vs. high

Negative response based on low LTPA index.

4,174 F and M. Age 60–94 years.

Index (often, sometimes, never)

Co-M

Mortality risk

Lee 1990

8-year follow-up. 508 W and M aged ≥ 60 years.

10-item scale on PA (I)

LTPA, performed during past 2 weeks (1976, 1980, 1984)

Total scale score from sum of all items

Dose–response: No.

Risk of all cause mortality

Co-M;

Rakowski 1992

4-year follow-up. 3,679 F, 2,222 M aged ≥70 year.

Longitudinal Study of Aging

Baseline LTPA: Questions:

Walking 1 mile:

Dose–response: yes, based on ≥4 days/week.

Risk of all cause mortality

Questionnaire (I)

“How often do you walk a mile or more at a time?”

Never; <1; 2–3; ≥4 days/week

Co-M; A

“Are physically more active, less active or the same active as other persons?”

Bijnen 1996

30-year follow-up.

Questionnaire of the Zutphen Elderly Study (I)

Walking, cycling (previous week).

Total PA level (min/week).

Questionnaire

1,402 M aged 60–90 year.

Hobbies, gardening in summer/winter.

Intensity level: 3-point ordinal scale: moderate PA (2–4 kcal/kg/h); heavy PA (≥4 kcal/kg/h).

-Designed for older populations

Prevalence of cardiovascular risk factors

Odd job and sports (min/week)

Walking, cycling ≥20 min ≥3 times weekly at intensity 60% max ex. performance

-Validated among the elderly (age 70–89)

-Direct validity: DLW r = 0.61

-Reliability r = 0.98.

Dose–response: yes, based on both total and heavy PA, and for cycling (only for some risk factors)

La Croix 1996

4.2-year follow-up. 1,645 F and M aged ≥65 year.

Questionnaire adapted from Minnesota Leisure Time Physical Activity Questionnaire (SA)

5 categories of walking: for exercise, work, errands, pleasure, hiking (h/week)

Hours walked per week

Questionnaire

<1; 1–4; >4 h/week

-Designed for younger and older populations

Mortality risk from CHD

-Validated among elderly (mean age 73)

-Direct validity: DLW r = 0.23

Dose–response: yes, based on walking >4 h/week.

Co-M

Morgan 1997

10-year follow-up.

Questionnaire of the Nottingham Longitudinal Study of Activity and Aging (I)

Walking. Indoor activities incl. housework (min/week)

Tertile grouping of PA level:

Questionnaire

1,042 individuals aged ≥65 year.

High activity (1st); intermediate activity (2nd); low activity (3rd)

-Designed for older populations

Mortality risk

-Reliability α ≥ 0.7.

Dose–response: yes, inversely related to activity level.

Co-M; A

Bath 1998

12-year follow-up.

Questionnaire of Nottingham Longitudinal Study of Activity and Ageing (I)

Outdoor PA; indoor productive PA incl. housework; walking; shopping; leisure activities; strength a/o joint flexibility activity (min/week)

Tertiles of PA:

Questionnaire

1,042 individuals aged ≥65 year.

Light, moderate vigorous.

-Designed for older populations

Risk of all cause and disease specific mortality

Walking: <10 vs. ≥10 min/day

-Reliability α ≥ 0.7

Dose–response inversely related to tertiles of PA.

A

Bjinen 1998

10-year follow-up.

Questionnaire of the Zutphen Elderly Study (SA)

Walking, cycling, hobbies, odd jobs, sport, gardening, (min/week).

Total PA score (min/week) converted in tertiles

Questionnaire

802 M aged 64–84 year.

-Designed for older populations

Risk of all cause and cardiovascular mortality

1985 and 1995

-Validated among the elderly (mean age 74)

-Direct validity: DLW r = 0.61

-Reliability r = 0.93.

Inverse dose–response relationship across tertiles.

Co-M

Fried 1998

5-year follow-up. 658 F and 5,201 M aged ≥65 year. (range 65–101 year at baseline).

Questionnaire from Cardiovascular Health Study (I)

Moderate and vigorous LTPA (estimated kcal/week)

5-point ordinal scale: from <67.5 to >1,890 kcal/week

Inverse dose–response relationship across tertiles.

Mortality risk

Hakim 1998

12-year follow-up.

Questionnaire adapted to Framingham Heart Study (I)

Daily distance walked (miles/day) at baseline

3-point ordinal scale for walking distance per day (miles/day):

Framingham Questionnaire

707 M aged 61–81 year.

0.0–0.9; 1.0–2.0, and 2.1–8.0

-Validated among men aged 45–64

Risk of all cause mortality and mortality from CHD and cancer

-Direct validity (MET) r = 0.63 and r = 0.55

-Reliability r = 0.30–0.59

Dose–response inversely related to miles/day.

A

Bijnen 1999

5-year follow-up.

Questionnaire of the Zutphen Elderly Study

Walking, cycling, hobbies, odd jobs, sports, gardening (min week⁻¹).

Total PA score (min/week) converted in tertiles.

Questionnaire

472 M, aged 70–79 year.

(SA)

LTPA: EE estimation for walking, stair climbing, sports/ recreation.

Intensity: “heavy” (≥ 4 kcal/kg/h) vs. “non-heavy” (<4 kcal/kg/h)

-Designed for older populations

Mortality risk

1985 und 1995.

-Validated among the elderly (age 70–89; mean age 74)

-Direct validity: DLW r = 0.61

-Reliability r = 0.93.

Dose–response: yes, based on 2nd and 3rd tertiles of total PA; no, based on intensity.

Co-M; A

Hakim 1999

2–4 year follow-up.

Questionnaire adapted to Framingham Heart Study (I)

Walking (miles per day) (baseline)

3-point ordinal scale for

Framingham Questionnaire

2,678 M, aged 71–93 year.

Miles/day (<0.25 vs. >1.5; 0.25–1.5 vs. >1.5; <0.25 vs. 0.25–1.5)

-Validated among men aged 45–64

Risk of CHD

-Direct validity (MET) r = 0.63 and r = 0.55

-Reliability r = 0.30–0.59.

Dose–response: yes, based on higher miles/day each.

A

Kostka 1999

0.5-year follow-up.

Questionnaire d`Activité Physique Saint Etienne (I)

Sports, gardening, housework, walking corresponding to intensity ≥ 3 METS

Mean habitual daily EE (kJ/day)

Questionnaire

-Designed for older populations

21 F and 17 M, aged 65–84 year.

-Validated among the elderly (mean age 71)

Change of risk factors (blood lipids and lipoproteins)

-Direct validity: DLW r = 0.32

-Reliability: low/moderate

-Responsiveness: low.

Dose–response: no relationship referring MHDEE for 6 months

Stessman 2000

6-year follow-up.

Jerusalem 70-year Old-Longitudinal Study

LTPA (walking, sport)

-No activity (walking <4 h/week)

Questionnaire designed for older populations.

456 subjects aged ≥70 year.

Questionnaire adapted from Gothenburg population study of 70-year olds (I)

-Moderate PA (walking around 4 h/week)

Dose response: yes, based on moderate and regular PA

Mortality risk

-Sports (sport activity at least 2 times per week.

-Regular PA (walking ≥1 h/day)

Van Dam 2002

5-year follow-up 424 M, age

Questionnaire of the Zutphen Elderly Study (SA)

Walking, cycling time hobbies, odd jobs, sport, gardening (min/week).

Duration of moderate PA (≥4 kcal/kg/h): none; > 0–29; 30–59; ≥60 min/day)

Questionnaire

69–89 year, mean 75 year.

1985 and 1990

Cycling, walking, gardening: none; >0–19; 20 (min/day)

-Designed for older populations

Prevalence of glucose tolerance

-Validated among the elderly (mean age 74)

-Direct validity: DLW r = 0.61

-Re-test reliability r = 0.93.

Dose–response: yes, based on moderate PA ≥30 min/day and cycling >19 min/day.

A

Gregg 2003

12.5-year follow-up.

Modified Paffenbarger PA Questionnaire (SA)

Stairs climbed, blocks walked, sports, recreation. EE (kcal/week)

Quintile for kcal week⁻¹ for

Paffenbarger PA Questionnaire

9,518 F, aged >65 year.

-Total PA: <163 (1st) to ≥1,907 (5th);

-Designed for older and younger populations

Risk of all cause mortality

(baseline, after 5.7 years and 12.5 years)

-Walking: <70 (1st) to ≥898 (5th)

-Validated among older people

-Direct validity: DLW r = 0.39

-Reliability: low

-Responsiveness: low.

Inverse dose–response based across kcal/week for all-cause and CVD

Co-M

Lan 2006

2 years follow-up.

Questionnaire Elderly Nutrition and Health Survey (I)

13 activities (e.g. walking, race walking, Chinese-style exercise, sports, weight lifting, indoor exercises (baseline).

5-point ordinal indices on total amount of EE: from sedentary and <500 to ≥2,000 (kcal/week)

Questionnaire

2,113 F and M age ≥65 years.

Estimation of EE (kcal/week)

-Designed for older populations

Mortality risk

-Validated among older people (age 65–≥80)

-Internal consistency α = 0.88

-Repeated measures kappa 0.41–0.46.

Dose–response: yes, based on based (kcal/week), with benefit

>1,000 kcal/week).

Co-M

Manini 2006

Population-based study of EE over 2 weeks. 6.15-year follow-up. 302 community-dwelling F (aged 70–82).

DLW and unspecified questionnaire (I)

Free-living activities.

Tertiles for kcal/day:

DLW: validity and repeatability: high.

Risk of all cause mortality

Measured EE.

<521 (low)

Dose–response relation based on highest tertile

521–770 (medium)

>770 (high)