“Can Do” vs. “Do Do” in Older Adults: A Cross-Sectional Analysis of Sensor-Derived Physical Activity Patterns

Abstract

(1) Background: Identifying groups with a misaligned physical capacity (PC) and physical activity (PA) is potentially relevant for health promotion. Although an important health determinant, deeper knowledge of underlying walking behavior patterns in older adults is currently missing. We aim to identify specific PA signatures of misaligned groups and determine PA variables discriminating between groups. (2) Methods: In total, 294 community-dwelling older adults (≥70 years) were divided into four quadrants based on thresholds for PA (≥ or <5000 steps/day) and PC (≤ or >12 s, Timed Up and Go test). Kruskal–Wallis and effect sizes were calculated to compare quadrants’ PA variables and to determine the discriminative power of PA parameters on walking duration, frequency, and intensity. (3) Results: We identified quadrant-specific PA signatures. Compared with “can do–do do”, the “cannot do–do do” group performs shorter continuous and lower-intensity walks; the “can do–do not do” group takes fewer steps and walks with less intensity. The “cannot do–do not do” group presents lower values in all PA variables. “Walking duration greater or equal 3 METs” was the strongest discriminative PA variable. (4) Conclusion: We provide distinct PA signatures for four clinically different groups of older adults. Walking intensity is most useful to distinguish community-dwelling older adults, which is relevant for developing improved customized health promotion interventions.

Physical capacity and inactivity in obstructive airway diseases: a “can do, do do” analysis

“…To assess physical activity, most previous studies have used steps per day [ 6 – 8 , 14 , 21 ]. However, using a measure of physical activity intensity (MVPA) instead of volume (steps per day) has been shown to be stronger at discriminating between quadrants in a recent “can do, do do” study in community-dwelling older adults [ 22 ]. Therefore, it is possible that the discrepancy between our COPD population and previous studies is due to the physical activity measure we used MVPA to allocate people to “do, do” versus “don't do”.…”

Get a move on: physical (in)activity in people with obstructive airway disease

“…The study by U rroz G uerrero et al [ 10 ] in this issue of ERJ Open Research sought to address this gap in their secondary analysis of physical activity data from studies including participants with COPD, bronchiectasis and severe asthma. By identifying time spent in Actigraph-assessed moderate- to vigorous-intensity physical activity (MVPA), a key finding was a higher proportion of participants with COPD classified as “can't do, don't do” (59% relative to 22% and 34% in earlier work [ 6 , 8 ]), which may reflect better discrimination using classification according to duration and intensity rather than step count [ 11 ] or the long-standing challenge of applying absolute threshold values in the context of a patient group with compromised (and variable) physiological capacity [ 12 ]. The proportions of people with severe asthma and bronchiectasis in this group were similar and lower (25% and 30% respectively) but still over-represented relative to the control group (5%), a finding consistent with previous work [ 13 ].…”