The International Physical Activity Questionnaire modified for the elderly: aspects of validity and feasibility

Abstract

Objective: To modify the self-administered, short version of the International Physical Activity Questionnaire (IPAQ) for adults to be used in the elderly (aged 65 years and above), and to validate this modified IPAQ for the elderly (IPAQ-E). Design: A direct validity study using accelerometer-measured physical activity (PA) as the criterion measure, and an indirect criterion validity study using highsensitivity C-reactive protein (hs-CRP) as a biological marker of activity. Setting: Organisations for retired persons in Sweden. Subjects: The direct validity study consisted of fifty-four participants and the indirect criterion validity study consisted of 359 participants. All participants were retired persons (66-91 years) living independently. Results: All self-reported activity domains (sitting, walking, moderate and vigorous) were positively correlated with the corresponding variable objectively assessed by an accelerometer (r 5 0?277-0?471), but a systematic error was observed. The specificity of IPAQ-E to identify low-active participants was 85 %, and the sensitivity to identify the more active participants was 81 %. A main effect of IPAQ-E category (Low, Moderate or High) was observed for hs-CRP (P 5 0?041). Conclusions: We found this modified version of IPAQ, the IPAQ-E, to be well accepted by our sample of socially active elderly. It provided acceptable estimates of PA, well in line with other questionnaires, even though it had a systematic error. The IPAQ-E was able to identify an expected response of a biomarker (hs-CRP) to PA. We recommend the use of the IPAQ-E to classify participants aged 65 years and above into PA categories, to rank individuals or to identify individuals meeting certain PA criteria. Keywords AccelerometryElderly International Physical Activity Questionnaire Physical activityTo promote and maintain health, regular physical activity (PA) is essential. In both men and women, individuals with a high level of PA have been shown to have a longer life expectancy than more sedentary individuals (1,2) . More recently, positive effects of PA have also been reported on cognitive functions (3,4) as well as on depression and anxiety disorders (5) . The level and pattern of PA and various health markers have been extensively studied in young and middle-aged groups, but not to the same extent in older adults (6) . The elderly (aged 65 years and above) are a rapidly growing age group in many countries, and therefore merit special attention with regard to PA behaviour and its effect on health.Most PA assessment methods have been developed for young-to-middle-aged participants, and just a few activity questionnaires have been developed specifically for the elderly participants (7) . This holds true also for the International Physical Activity Questionnaire (IPAQ, available at www.ipaq.ki.se (8) ), which was developed by an international consensus group in 1998, primarily for international surveillance studies of PA in adults aged 18-65 years (9) . The short-format IPAQ (10) and the long-form...

Adherence to physical activity guidelines and functional fitness of elderly women, using objective measurement

“…Different results were obtained by Hurtig-Wennlof and Hagstromer [20], who observed the recommended physical activity in up to 87% of seniors in Sweden; the research, however, concerned a much smaller group (n = 54) compared to other presented analyses in which the number of examined ranged from 200 -900 seniors. Moreover, in all the abovequoted studies, different criteria were used to verify the activity of the various levels of intensity.…”

“…Moreover, in all the abovequoted studies, different criteria were used to verify the activity of the various levels of intensity. Tucker and Welk [21], for the level of MVPA accepted values of >2020 counts/ min, while Harrisand Owen [17] >2,000 counts/min, Davis and Fox [18] >1,952 counts/min, Colley and Garriguet [19] >1,535 count/min, and Hurtig-Wennlof and Hagstromer [20] > 760 count/min. The inclusion of such low value probably contributed to the high proportion of Swedish seniors meeting the criteria for health-enhancing physical activity.…”

Impact of different physical activities on executive functioning

“…To determine the physical activity of each participant, two questionnaires were usedInternational Physical Activity Questionnaire for Elderly (IPAQ-E) [14] and a modified version of Social Determinants of Health Behaviours [15]. IPAQ-E questionnaire consists of four questions regarding the physical activity in the last seven days -time spent sitting, time spent walking, time spent doing moderate physical activities and time spent doing vigorous physical activities.…”

Factors Associated with Poor Muscle Mass and Strength in A Community-Dwelling Elderly Population: A Cross-Sectional Study

“…Of 3 measurements made for each participant the highest value was used for this study. The main study factors were as follows: (a) physical exercise, assessed by the International Physical Activity Questionnaire and daily hours walked outdoors (www.ipaq.ki.se) [13]; (b) nutritional status, assessed by anthropometric measurements (weight, height, body mass index), recent weight loss and the short-form Mini Nutritional Assessment questionnaire; (c) comorbidities (arthrosis, diabetes, ischaemic heart disease, heart failure, stroke, chronic obstructive pulmonary disease, chronic kidney failure, chronic liver disease, Parkinson disease, depression, etc); (d) anabolic hormone levels, namely, fasting plasma levels of total ghrelin, insulin-like growth factor 1 (IGF-1), testosterone and insulin determined using validated commercial kits; (e) inflammatory markers, namely, fasting plasma levels of interleukin-6 (IL-6) and C-reactive protein, determined using validated commercial kits; and (f) frailty phenotype, whereby participants were classified as robust, pre-frail or frail if they fulfilled 0, 1-2 or ≥3, respectively, of the following five Fried criteria: unintentional weight loss, exhaustion, low physical activity, slow walking speed and poor grip strength [5]. Other study variables included sociodemographic characteristics (age, sex, education level); chronic medication; appetite and satiety assessed by means of a visual analogue scale; functional capacity assessed by the Barthel index, timed up-and-go test, single-leg stance test, falls and gait speed; and, finally, a complete blood count and basic blood biochemical analyses for glucose, creatinine, albumin and lipid profile.…”