Using Daily Steps to Identify Older Adults with (Un)healthy Joint Profiles of Sedentary Time and Physical Activity: A Starting Point

Abstract

Herein, we investigated whether daily steps can discriminate between older adults with unhealthy and healthy joint profiles of sedentary time (ST) and moderate-to-vigorous physical activity (MVPA). Apparently healthy community-dwelling older adults aged 60–80 years were included in this cross-sectional analysis (n = 258). Daily steps, ST, and MVPA were assessed by accelerometry. Receiver Operating Characteristic (ROC) analysis was used to test the performance of daily steps in identifying older adults with unhealthy (high ST/low MVPA) and healthy (low ST/high MVPA) joint profiles of ST/MVPA. The cardiovascular disease risk of unhealthy/healthy profiles was compared using a continuous metabolic syndrome score (cMetS). Daily steps discriminated older adults with unhealthy (AUC 0.892, 0.850–0.934; cut-off: ≤5,263 steps/day; sensitivity/specificity: 82.5%/81%) and healthy (AUC 0.803, 0.738–0.868; cut-off: ≥7,134 steps/day; sensitivity/specificity: 79.5%/66.2%) joint profiles of ST/MVPA. The unhealthy profile showed a higher cMetS (β = 0.46; p = 0.008). Likewise, older adults who fell below the daily steps cut-off point to identify the unhealthy profile of ST/MVPA exhibited a higher cMetS (β = 0.34; p = 0.004). In summary, our results provide a starting point for considering daily steps as a single heuristic metric for identifying older adults with a joint profile of high ST/low MVPA, which makes them more susceptible to CVD.

Using daily steps to identify patients with peripheral artery disease with high sedentary time and low physical activity

“…Previous research has demonstrated that daily steps can be used to identify an unhealthy combined profile of ST/MVPA in older adults. 3 However, the proposed cut-off point may not be suitable for patients with peripheral artery disease and claudication symptoms. Herein, our aim was to establish specific cut-off points for distinguishing between healthy and unhealthy combined profiles of ST/ MVPA among patients with peripheral artery disease and claudication symptoms.…”

“…The combined profiles of ST/ MVPA were defined as follows: (i) unhealthy: highest tertile of ST and lowest tertile of MVPA; (ii) healthy: lowest tertile of ST and highest tertile of MVPA. 3 The remaining combinations were classified as 'neutral'.…”

“…The identified cut-off points derived from the ROC curves for healthy (⩾ 5700 steps/day) and unhealthy (⩽ 3137 steps/day) combined profiles of ST/MVPA were lower than those previously reported in older adults free of cardiovascular diseases (⩾ 7134 and ⩽ 5263 steps/day, respectively). 3 This difference may be attributed to the walking impairment of patients with peripheral artery disease and claudication symptoms, which is a major barrier to physical activity for them. 7 The patients' characteristics according to combined profiles of ST/MVPA are included in online supplemental Table 1.…”