Physical Performance and Physical Activity in Older Adults: Associated but Separate Domains of Physical Function in Old Age

Abstract

BackgroundPhysical function is a crucial factor in the prevention and treatment of health conditions in older adults and is usually measured objectively with physical performance tests and/or physical activity monitoring.ObjectiveTo examine whether 1) physical performance (PP) and physical activity (PA) constitute separate domains of physical function; 2) differentiation of PA classes is more informative than overall PA.DesignCross-sectional study to explore the relationships within and among PP and PA measures.MethodsIn 49 older participants (83±7 years; M±SD), performance-based tests were conducted and PA was measured for one week. Activity monitor data were reduced in terms of duration, periods, and mean duration of periods of lying, sitting, standing and locomotion. The relation between and within PP scores and PA outcomes were analysed using rank order correlation and factor analysis.ResultsFactor structure after varimax rotation revealed two orthogonal factors explaining 78% of the variance in the data: one comprising all PA variables and one comprising all PP variables. PP scores correlated moderately with PA in daily life. Differentiation of activity types and quantification of their duration, intensity and frequency of occurrence provided stronger associations with PP, as compared to a single measure of acceleration expressing overall PA.LimitationsFor independent validation, the conclusions about the validity of the presented conceptual framework and its clinical implications need to be confirmed in other studies.ConclusionsPP and PA represent associated but separate domains of physical function, suggesting that an improvement of PP does not automatically imply an increase of PA, i.e. a change to a more active lifestyle. Differentiation of activity classes in the analysis of PA provides more insights into PA and its association with PP than using a single overall measure of acceleration.

Untitled

“…The lack of association between volumes of activity and physical performance measures concurs with earlier reports (van Lummel et al, 2015;Weiss et al, 2013). Others have found associations between laboratory-based gait speed measures (Giannouli et al, 2016;Hall et al, 2017) (which we did not measure) and step count, although comparisons are limited due to methodological differences.…”

“…Step and Dynamic Gait Index) for those aged 70 -80+ (van Lummel et al, 2015;Weiss et al, 2013). Stronger associations were reported for selected micro gait characteristics and physical performance measures in a study comparing physical activity in fallers and non-fallers (Weiss et al, 2013).…”

Poor Physical Performance Predicts Future Onset of Depression in Elderly People: Progetto Veneto Anziani Longitudinal Study

“…Physical performance is a multidimensional concept, including several subdomains: muscle strength, mobility (lower extremity function), dexterity (upper extremity function), axial ability (neck and back function), and ability to carry out instrumental activities of daily living. 8 Some cross-sectional studies showed a significant relationship between low physical performance and depression. 9,10 However, there is a lack of clarity about these results, due to the cross sectional nature and the directionality of the association, since depression is characterized by fatigue and asthenia, which may themselves lead to a decrease in activity.…”

A clinical view on the development of technology-based tools in managing Parkinson's disease

“…Among others (see below), a particular downside of when PD patients visit doctors in professional environments is that this does not provide an accurate assessment of patient physical activity. Office‐based tests preferentially assess physical performance, which is closer to a stress test than to physical activity, and it has recently been shown that an assessment of physical performance does not automatically allow one to draw conclusions about physical activity status, that is, a valid evaluation of (the activity level of) patient lifestyle . Therefore, complementary assessment strategies are needed.…”