Direct and indirect measurement of physical activity in older adults: a systematic review of the literature
Open accessAbstract
BACKGROUND: Due to physiological and cognitive changes that occur with aging, accurate physical activity (PA) measurement in older adults represents a unique challenge. The primary purpose of this study was to systematically review measures of PA and their use and appropriateness with older adults. A secondary aim was to determine the level of agreement between PA measures in older adults. METHODS: Literature was identified through electronic databases. Studies were eligible if they examined the correlation and/or agreement between at least 2 measures, either indirect and/or direct, of PA in older adults (> 65 years of age). RESULTS: Thirty-six studies met eligibility criteria. The indirect and direct measures of PA across the studies differed widely in their ability to address the key dimensions (i.e., frequency, intensity, time, type) of PA in older adults. The average correlation between indirect and direct measures was moderate (r=0.38). The correlation between indirect and other indirect measures (r=0.29) was weak, while correlations between direct measures with other direct measures were high (real world: r= 0.84; controlled settings: r=0.92). Agreement was strongest between direct PA measures with other direct measures in both real world and laboratory settings. While a clear trend regarding the agreement for mean differences between other PA measures (i.e., direct with indirect, indirect with indirect) did not emerge, there were only a limited number of studies that reported comparable units. CONCLUSIONS: Despite the lack of a clear trend regarding the agreement between PA measures in older adults, the findings underscore the importance of valid, accurate and reliable measurement. To advance this field, researchers will need to approach the assessment of PA in older adults in a more standardized way (i.e., consistent reporting of results, consensus over cut-points and epoch lengths, using appropriate validation tools). Until then researchers should be cautious when choosing measures for PA that are appropriate for their research questions and when comparing PA levels across various studies.
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Generally, objective measurements of physical activity, by using accelerometers, are considered more accurate than questionnaires.
“Generally, objective measurements of physical activity, by using accelerometers, are considered more accurate than questionnaires.20”
From Effect of exercise training for five years on all cause mortality in older adults—the Generation 100 study: randomised controlled trial (2020) · cites this paper as [20]
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- Authors
- Kowalski, K., Rhodes, R., Naylor, P.-J., Tuokko, H., & MacDonald, S.
- Affiliations
- University of Victoria (CA)
- Corresponding author
- Kowalski, Kristina
- Venue
- International Journal of Behavioral Nutrition and Physical Activity
- Published
- 2012
- Volume
- 9
- Issue
- 1
- Pages
- 148
- ISSN
- 1479-5868 (ISSN-L)
- PMC
- PMC3549726
- OpenAlex
- W2149413165
- Cited by
- 212
- References
- 71
- Citations by year
- 2026: 10 · 2025: 11 · 2024: 7 · 2023: 11 · 2022: 15 · 2021: 17 · 2020: 36 · 2019: 17 · 2018: 12 · 2017: 15 · 2016: 21 · 2015: 23 · 2014: 13 · 2013: 4
- FWCI
- 1.39
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- International Journal of Behavioral Nutrition and Physical Activity (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UVic’s Research and Learning Repository (University of Victoria) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Context-Aware Activity Recognition Systems
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Keywords
- physical activity measurement, older adults, direct measurement, indirect measurement, agreement between measurement methods, reliability and validity, accelerometry, self-report questionnaire, aging
- MeSH terms
- Aged, Humans, Exercise, Geriatric Assessment
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