Step counts superior to physical activity scale for identifying health markers in older adults

Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Callaghan, NSW 2308, Australia.
British Journal of Sports Medicine (Impact Factor: 5.03). 08/2008; 44(10):756-61. DOI: 10.1136/bjsm.2008.048827
Source: PubMed


Measuring physical activity is a key part of studying its health effects. Questionnaires and pedometers each have weaknesses but are the cheapest and easiest to use measurement methods for large-scale studies. We examined their capacity to detect expected associations between physical activity and a range of surrogate health measures.
Cross-sectional analysis of 669 community-dwelling participants (mean age 63.3 (7.7) years) who completed the Physical Activity Scale for the Elderly (PASE) questionnaire and who, within 2 weeks, wore a pedometer for 7 days.
PASE score and step count were only poorly correlated (r = 0.37 in women, r = 0.30 in men). Of 12 expected associations examined between activity and surrogate markers of health, 10 were detected as statistically significant by step counts but only 3 by PASE scores. Significant associations in the expected direction were found between step counts and high-density lipoprotein, body mass index, waist circumference, waist-to-hip ratio, blood glucose level, white cell count and fibrinogen. There was no association with either systolic or diastolic blood pressure. The association between PASE score and these markers was detected as significant only for body mass index and waist circumference in women and waist-to-hip ratio in both sexes. Associations were stronger for steps multiplied by stride length than for raw step count.
Pedometer-derived step counts are a more valid measurement of overall physical activity in this sample than PASE score. Researchers should use objective measures of physical activity whenever possible.

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    • "Some studies did use objective measures such as motion sensor devices (accelerometer and/or pedometer) (22, 24, 28, 31, 33, 38, 41). However, self-reported physical activity scales do lack validity in measuring physical activity and were found to be inferior to the motion sensor devices (45, 46). This would lead to less precise measurement and misclassification of the level of physical activity. "
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    ABSTRACT: Introduction: Type 2 diabetes mellitus (T2DM) among people aged 60 years and above is a growing public health problem. Regular physical activity is one of the key elements in the management of T2DM. Recommendations suggest that older people with T2DM will benefit from regular physical activity for better disease control and delaying complications. Despite the known benefits, many remain sedentary. Hence, this review assessed interventions for promoting physical activity in persons aged 65 years and older with T2DM. Methods: A literature search was conducted using Ovid MEDLINE, PubMed, EMBASE, SPORTDiscus, and CINAHL databases to retrieve articles published between January 2000 and December 2012. Randomized controlled trials and quasi-experimental designs comparing different strategies to increase physical activity level in persons aged 65 years and older with T2DM were included. The methodological quality of studies was assessed. Results: Twenty-one eligible studies were reviewed, only six studies were rated as good quality and only one study specifically targeted persons aged 65 years and older. Personalized coaching, goal setting, peer support groups, use of technology, and physical activity monitors were proven to increase the level of physical activity. Incorporation of health behavior theories and follow-up supports also were successful strategies. However, the methodological quality and type of interventions promoting physical activity of the included studies in this review varied widely across the eligible studies. Conclusion: Strategies that increased level of physical activity in persons with T2DM are evident but most studies focused on middle-aged persons and there was a lack of well-designed trials. Hence, more studies of satisfactory methodological quality with interventions promoting physical activity in older people are required.
    Full-text · Article · Dec 2013 · Frontiers in Public Health
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    • "Investigations dating back to the 1990s have admonish the careful use of the PASE instrument, because, for example, " PASE questionnaire overestimates women's physical activity as compared to men, due to an incorrect weighing of heavy housework and caring for others " [7]. Alternate measures physical performance measures like pedometer-derived steep counts have been compared with PASE more recently and found to be a " more valid measurement of overall physical activity " than PASE scoring [8]. Others have argued that " PASE is not recommended as a valid tool to examine [physical activity] level for patients with hip [osteoarthritis] " [9]. "
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    ABSTRACT: Studies assessing physical functioning with the Physical Activity Scale for the Elderly (PASE) should be aware that the instrument may be age and culture insensitive. To asses "classical" PASE scoring in a sample of aged (mean age 74) Mexican origin Latinos in the Southwestern United States and provide a new scoring algorithm. Information from a cross sectional study of 2438 community-dwelling minority subjects who completed the PASE scale was scored with the classical and a new scoring approach to compare their similarity and predictive power on three items of functional ability. The classical and new scoring procedures for PASE items render different total scores. The classical approach for scoring PASE in aged minorities may fail to capture the age and culture insensitivity of the instrument. The new approach, or a derivation of it, should be used to compute the total PASE score for minority aged populations as further research continues.
    Full-text · Article · Jun 2012 · Maturitas
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    ABSTRACT: To established population norms for pedometer determined step counts in older Australians. A representative sample of 684 participants over the age of 55 years wore a pedometer for a week in Newcastle, Australia. Response rate was 32%. Median daily step count was 8605 in those aged 55-59 years declining to 3778 in those over 80 years old. The proportion who reached 8000 steps per day was 62% in those 55-59 years and 12% in those over 80 years. Daily step counts were highest on Thursdays and Fridays and least on Sundays. Weekend days had on average 620 less steps than weekdays. After adjusting for age, there was a negative association of step count with body mass index >30, and with a history of arthritis but no significant association with other demographic variables. Pedometry is feasible in an elderly sample, and research involving pedometers must take days of the week into account.
    Full-text · Article · Sep 2009 · Australasian Journal on Ageing
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