Sedentary behavior and health outcomes in older adults: A systematic review

Wendell C. Taylor; Kevin Rix; Ashley Gibson; Raheem J. Paxton; Wendell C. Taylor; Kevin Rix; Ashley Gibson; Raheem J. Paxton

doi:10.3934/medsci.2020002

AIMS Medical Science

2020, Volume 7, Issue 1: 10-39. doi: 10.3934/medsci.2020002

Previous Article Next Article

Review

Sedentary behavior and health outcomes in older adults: A systematic review

1.
Institute for the Medical Humanities, Department of Preventive Medicine and Population Health, The University of Texas Medical Branch, Galveston, TX, USA
2.
Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Austin, TX, USA
3.
Department of Graduate Studies, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA
4.
Department of Community Medicine and Population Health, Institute for Rural Health Research, University of Alabama, Tuscaloosa, AL, USA

Received: 07 January 2020 Accepted: 12 February 2020 Published: 11 March 2020

Introduction Older adults (≥ 60 years old) report prolonged periods of sedentary behavior. Sedentary behavior is a potential health hazard for this priority population. Therefore, we systematically reviewed the published literature to document the relationships among sedentary behaviors and twelve health outcomes ranging from mental health to mortality.
Methods Major databases were searched from 2013 to 2019; 27 relevant articles were found and evaluated. In addition, we compared our findings to a previously published review.
Results Higher levels of sedentary behavior were related to an increased risk of all-cause mortality and adversely associated with metabolic syndrome, triglycerides/high density lipoprotein cholesterol/blood glucose, HBA1C/glucose intolerance, waist circumference, and obesity/overweight when compared to those with lower levels of sedentary behavior. Findings for blood pressure, cancer, and mental health (e.g., dementia, mild cognitive impairment, psychological well-being) were insufficient to draw conclusions or had inconsistent results. Because some sedentary behaviors were protective for mental health, we recommend a taxonomy of sedentary behaviors for older adults to provide insights into these seemingly discrepant findings. Some of our findings were similar to a prior review while other findings were different.
Conclusion This systematic review identified the health outcomes that were sufficiently, insufficiently, or not affected by sedentary behavior. To advance the field, we recommend better methodological quality. To improve the overall health and wellbeing of older adults, future studies should evaluate interventions to decrease health-compromising and increase health-promoting sedentary behaviors among older adults.
- sedentary behavior,
- health,
- elderly,
- older adults,
- physical inactivity
Citation: Wendell C. Taylor, Kevin Rix, Ashley Gibson, Raheem J. Paxton. Sedentary behavior and health outcomes in older adults: A systematic review[J]. AIMS Medical Science, 2020, 7(1): 10-39. doi: 10.3934/medsci.2020002

Related Papers:

Abstract

Introduction Older adults (≥ 60 years old) report prolonged periods of sedentary behavior. Sedentary behavior is a potential health hazard for this priority population. Therefore, we systematically reviewed the published literature to document the relationships among sedentary behaviors and twelve health outcomes ranging from mental health to mortality.

Methods Major databases were searched from 2013 to 2019; 27 relevant articles were found and evaluated. In addition, we compared our findings to a previously published review.

Results Higher levels of sedentary behavior were related to an increased risk of all-cause mortality and adversely associated with metabolic syndrome, triglycerides/high density lipoprotein cholesterol/blood glucose, HBA1C/glucose intolerance, waist circumference, and obesity/overweight when compared to those with lower levels of sedentary behavior. Findings for blood pressure, cancer, and mental health (e.g., dementia, mild cognitive impairment, psychological well-being) were insufficient to draw conclusions or had inconsistent results. Because some sedentary behaviors were protective for mental health, we recommend a taxonomy of sedentary behaviors for older adults to provide insights into these seemingly discrepant findings. Some of our findings were similar to a prior review while other findings were different.

Conclusion This systematic review identified the health outcomes that were sufficiently, insufficiently, or not affected by sedentary behavior. To advance the field, we recommend better methodological quality. To improve the overall health and wellbeing of older adults, future studies should evaluate interventions to decrease health-compromising and increase health-promoting sedentary behaviors among older adults.

Acknowledgments

There were no sources of funding of this study. This systematic review protocol was not published in a repository.

Conflict of interest

All authors declare no conflicts of interest in this paper.

References

[1]	(2007) Organization, WHGlobal age-friendly cities: A guide.World Health Organization.
[2]	Matthews CE, Chen KY, Freedson PS, et al. (2008) Amount of time spent in sedentary behaviors in the United States, 2003–2004. Am J Epidemiol 167: 875-881. doi: 10.1093/aje/kwm390
[3]	Hallal PC, Andersen LB, Bull FC, et al. (2012) Global physical activity levels: surveillance progress, pitfalls, and prospects. Lancet 380: 247-257. doi: 10.1016/S0140-6736(12)60646-1
[4]	(2018) Physical Activity Guidelines Advisory Committee2018 Physical Activity Guidelines Advisory Committee Scientific Report. Washington, DC: U.S. Department of Health and Human Services.
[5]	Katzmarzyk PT (2010) Physical activity, sedentary behavior, and health: paradigm paralysis or paradigm shift? Diabetes 59: 2717-2725. doi: 10.2337/db10-0822
[6]	Dunstan DW, Howard B, Healy GN, et al. (2012) Too much sitting–a health hazard. Diabetes Res Clin Pract 97: 368-376. doi: 10.1016/j.diabres.2012.05.020
[7]	Owen N, Healy GN, Matthews CE, et al. (2010) Too much sitting: the population-health science of sedentary behavior. Exerc Sport Sci Rev 38: 105-113. doi: 10.1097/JES.0b013e3181e373a2
[8]	Tremblay MS, Colley RC, Saunders TJ, et al. (2010) Physiological and health implications of a sedentary lifestyle. Appl Physiol Nutr Metab 35: 725-740. doi: 10.1139/H10-079
[9]	Copeland JL, Ashe MC, Biddle SJH, et al. (2017) Sedentary time in older adults: A critical review of measurement, associations with health, and interventions. Br J Sports Med 51: 1539. doi: 10.1136/bjsports-2016-097210
[10]	de Rezende LFM, Rey-López JP, Matsudo VKR, et al. (2014) Sedentary behavior and health outcomes among older adults: a systematic review. BMC Public Health 14: 333. doi: 10.1186/1471-2458-14-333
[11]	Pate RR, O'Neill JR, Lobelo F (2008) The evolving definition of “sedentary”. Exerc Sport Sci Rev 36: 173-178. doi: 10.1097/JES.0b013e3181877d1a
[12]	U.S. Department of Health & Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute (2019) Study quality assessment tools. Accessed December 8, 2019. Available from: https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools .
[13]	Matthews CE, George SM, Moore SC, et al. (2012) Amount of time spent in sedentary behaviors and cause-specific mortality in US adults. Am J Clin Nutr 95: 437-445. doi: 10.3945/ajcn.111.019620
[14]	León-Muñoz LM, Martínez-Gómez D, Balboa-Castillo T, et al. (2013) Continued sedentariness, change in sitting time, and mortality in older adults. Med Sci Sports Exerc 45: 1501-1507. doi: 10.1249/MSS.0b013e3182897e87
[15]	Ensrud KE, Blackwell TL, Cauley JA, et al. (2014) Objective measures of activity level and mortality in older men. J Am Geriatr Soc 62: 2079-2087. doi: 10.1111/jgs.13101
[16]	Pavey TG, Peeters GG, Brown WJ (2015) Sitting-time and 9-year all-cause mortality in older women. Br J Sports Med 49: 95-99. doi: 10.1136/bjsports-2012-091676
[17]	Jefferis BJ, Parsons TJ, Sartini C, et al. (2019) Objectively measured physical activity, sedentary behaviour and all-cause mortality in older men: does volume of activity matter more than pattern of accumulation? Br J Sports Med 53: 1013-1020. doi: 10.1136/bjsports-2017-098733
[18]	Klenk J, Dallmeier D, Denkinger MD, et al. (2016) Objectively measured walking duration and sedentary behaviour and four-year mortality in older people. Plos ONE 11: e0153779. doi: 10.1371/journal.pone.0153779
[19]	Cabanas-Sánchez V, Guallar-Castillón P, Higueras-Fresnillo S, et al. (2018) Physical activity, sitting time and mortality from inflammatory diseases in older adults. Front Physiol 9: 898. doi: 10.3389/fphys.2018.00898
[20]	Ekblom Ö, Ekblom-Bak E, Rosengren A, et al. (2015) Cardiorespiratory fitness, sedentary behaviour and physical activity are independently associated with the metabolic syndrome, results from the SCAPIS pilot study. Plos ONE 10: e0131586. doi: 10.1371/journal.pone.0131586
[21]	Gennuso KP, Gangnon RE, Thraen-Borowski KM, et al. (2015) Dose–response relationships between sedentary behaviour and the metabolic syndrome and its components. Diabetologia 58: 485-492. doi: 10.1007/s00125-014-3453-z
[22]	Figueiró TH, Arins GCB, dos Santos CES, et al. (2019) Association of objectively measured sedentary behavior and physical activity with cardio-metabolic risk markers in older adults. Plos ONE 14: e0210861. doi: 10.1371/journal.pone.0210861
[23]	Aadahl M, Linneberg A, Møller TC, et al. (2014) Motivational counseling to reduce sitting time: a community-based randomized controlled trial in adults. Am J Prev Med 47: 576-586. doi: 10.1016/j.amepre.2014.06.020
[24]	Chang AK, Sok SR (2015) Predictors of sedentary behavior in elderly Koreans with hypertension. J Nurs Res 23: 262-270. doi: 10.1097/JNR.0000000000000094
[25]	Joseph JJ, Echouffo-Tcheugui JB, Golden SH, et al. (2016) Physical activity, sedentary behaviors and the incidence of type 2 diabetes mellitus: the Multi-Ethnic Study of Atherosclerosis (MESA). BMJ Open Diabetes Res Care 4: e000185. doi: 10.1136/bmjdrc-2015-000185
[26]	Wirth K, Klenk J, Brefka S, et al. (2017) Biomarkers associated with sedentary behaviour in older adults: a systematic review. Ageing Res Rev 35: 87-111. doi: 10.1016/j.arr.2016.12.002
[27]	Gennuso KP, Gangnon RE, Matthews CE, et al. (2013) Sedentary behavior, physical activity, and markers of health in older adults. Med Sci Sports Exerc 45: 1493-1500. doi: 10.1249/MSS.0b013e318288a1e5
[28]	Bann D, Hire D, Manini T, et al. (2015) Light intensity physical activity and sedentary behavior in relation to body mass index and grip strength in older adults: cross-sectional findings from the Lifestyle Interventions and Independence for Elders (LIFE) study. Plos ONE 10: e0116058. doi: 10.1371/journal.pone.0116058
[29]	Thorp AA, Owen N, Neuhaus M, et al. (2011) Sedentary behaviors and subsequent health outcomes in adults: a systematic review of longitudinal studies, 1996–2011. Am J Prev Med 41: 207-215. doi: 10.1016/j.amepre.2011.05.004
[30]	Judice P, Silva A, Sardinha LB (2015) Sedentary bout durations are associated with abdominal obesity in older adults. J Nutr Health Aging 19: 798-804. doi: 10.1007/s12603-015-0501-4
[31]	van Alphen HJ, Volkers KM, Blankevoort CG, et al. (2016) Older adults with dementia are sedentary for most of the day. Plos ONE 11: e0152457. doi: 10.1371/journal.pone.0152457
[32]	Hartman YA, Karssemeijer EG, van Diepen LA, et al. (2018) Dementia patients are more sedentary and less physically active than age-and sex-matched cognitively healthy older adults. Dement Geriatr Cogn Disord 46: 81-89. doi: 10.1159/000491995
[33]	Falck RS, Davis JC, Liu-Ambrose T (2017) What is the association between sedentary behaviour and cognitive function? A systematic review. Br J Sports Med 51: 800-811. doi: 10.1136/bjsports-2015-095551
[34]	Engeroff T, Füzéki E, Vogt L, et al. (2018) Is objectively assessed sedentary behavior, physical activity and cardiorespiratory fitness linked to brain plasticity outcomes in old age? Neuroscience 388: 384-392. doi: 10.1016/j.neuroscience.2018.07.050
[35]	Benka Wallén M, Franzén E, Nero H, et al. (2015) Levels and patterns of physical activity and sedentary behavior in elderly people with mild to moderate Parkinson's disease. Phys Ther 95: 1135-1141. doi: 10.2522/ptj.20140374
[36]	Nemoto Y, Sato S, Takahashi M, et al. (2018) The association of single and combined factors of sedentary behavior and physical activity with subjective cognitive complaints among community-dwelling older adults: Cross-sectional study. Plos ONE 13: e0195384. doi: 10.1371/journal.pone.0195384
[37]	Ku PW, Fox KR, Chen LJ (2015) Leisure-time physical activity, sedentary behaviors and subjective well-being in older adults: An eight-year longitudinal research. Soc Indic Res 127: 1349-1361.
[38]	Okely JA, Čukić I, Shaw RJ, et al. (2019) Positive and negative well-being and objectively measured sedentary behaviour in older adults: evidence from three cohorts. BMC Geriatr 19: 28. doi: 10.1186/s12877-019-1026-1
[39]	Maréchal R, Fontvieille A, Parent-Roberge H, et al. (2019) Effect of a mixed-exercise program on physical capacity and sedentary behavior in older adults during cancer treatments. Aging Clin Exp Res 31: 1583-1589. doi: 10.1007/s40520-018-1097-4
[40]	Trends G (2003) Public health and aging: trends in aging—United States and worldwide. Public Health 347: 921-925.
[41]	Harvey J, Chastin S, Skelton D (2013) Prevalence of sedentary behavior in older adults: a systematic review. Int J Env Res Public Health 10: 6645-6661. doi: 10.3390/ijerph10126645
[42]	de Magalhães JP (2013) How ageing processes influence cancer. Nat Rev Cancer 13: 357-365. doi: 10.1038/nrc3497
[43]	Balducci L, Fossa SD (2013) Rehabilitation of older cancer patients. Acta Oncol 52: 233-238. doi: 10.3109/0284186X.2012.744142
[44]	Pinto BM, Eakin E, Maruyama NC (2000) Health behavior changes after a cancer diagnosis: what do we know and where do we go from here? Ann Behav Med 22: 38-52. doi: 10.1007/BF02895166
[45]	Dewys WD, Begg C, Lavin PT, et al. (1980) Prognostic effect of weight loss prior to chemotherapy in cancer patients. Am J Med 69: 491-497. doi: 10.1016/S0149-2918(05)80001-3
[46]	Mohile SG, Velarde C, Hurria A, et al. (2015) Geriatric assessment guided care processes for older adults: A delphi consensus of geriatric oncology experts. J Natl Compr Canc Netw 13: 1120-1130. doi: 10.6004/jnccn.2015.0137
[47]	Jones LW, Eves ND, Haykowsky M, et al. (2009) Exercise intolerance in cancer and the role of exercise therapy to reverse dysfunction. Lancet Oncol 10: 598-605. doi: 10.1016/S1470-2045(09)70031-2
[48]	Jones LW, Courneya KS (2002) Exercise discussions during cancer treatment consultations. Cancer Pract 10: 66-74. doi: 10.1046/j.1523-5394.2002.102004.x
[49]	Lynch BM (2010) Sedentary behavior and cancer: a systematic review of the literature and proposed biological mechanisms. Cancer Epidemiol Biomarkers Prev 19: 2691-2709. doi: 10.1158/1055-9965.EPI-10-0815

Reader Comments

Your name:*

Email:*
© 2020 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)