Skip to main content

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

From: Physical activity assessment and health outcomes in old age: how valid are dose–response relationships in epidemiologic studies?

1 2 3 4 5 6
Primary author Study design, population and health outcome Questionnaire Type and source Physical activity described Operationalizing of PA and EE Additional notes
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)
  1. Abbreviations: A adjusted for age, Co-M adjusted for co-morbidities and/or perceived health, CHD coronary heart disease, DLW doubly labeled water, EE caloric energy expenditure, F female, I interview-administered, kcal kilocalorie, kJ kilojoules, LTPA leisure time physical activity, M male, MET metabolic equivalent, MHDEE mean habitual daily energy expenditure, PA physical activity, SA self-administered