Physical Activity Behaviour in Middle-Aged and Older Adults

Abstract

Background: A comprehensive understanding of current physical activity (PA) behaviours and potential intervention targets is critical for promoting healthy aging and helping to alleviate the burden of preventable disease on healthcare systems. The overall aim of this work was to describe PA behaviour and its determinants in middle-aged and older adults, with a focus on generating evidence to support PA promotion in Canada. Methods: First, an umbrella review was used to systematically summarize evidence for determinants of PA in community-dwelling older adults published in systematic reviews from five databases. Second, we used data from the Canadian Longitudinal Study on Aging (CLSA), a population-based cohort of 51,000 Canadians 45-85-years old, to 1) create age-specific normative values for the Physical Activity Scale for the Elderly (PASE), and 2) describe the full spectrum of usual PA by type of activity and amount. Age and sex-specific normative PASE values were created by identifying the best-fitting models and using cross-validation. Weighted means and frequencies were used to describe Canadians by the types and amount of PA undertaken. Results: Evidence from the 11 included reviews (>300 primary papers) demonstrated consistent relationships between PA and walkability, age, gender, loneliness, and social support for PA. Using the CLSA, we created separate models for normative PASE values in men and women, and percentile ranges. Finally, our descriptive analysis highlighted the impacts of social determinants of health on PA behaviour in Canada. A higher percentage of Canadians in the lowest 20% of PASE scores were female and had lower income and education levels. Conclusions: The normative values presented increase the interpretability of PASE scores and allow for consideration of healthy variation in PA when assessing and monitoring levels over time. Future research exploring interpersonal and intrapersonal determinants and longitudinal investigations of the association between all determinants and PA trajectories are warranted.