Lifestyle

Physical activity


LASA046

Contact: Marjolein Visser

Background
Information on physical activity is obtained during each main interview of LASA (LASAB046, LASAC046, LASAD046, LASAE046, LAS2B046, LASAF046, LASAG046). The following activities are addressed: walking outdoors, bicycling, gardening, light household, heavy household, and two sports activities. In general, the respondents are asked how often and for how long in the previous two weeks they had engaged in each activity. For the sports activities additional questions are asked about sweating. Finally, questions about whether the activity pattern of the previous two weeks was representative of the rest of the year are obtained. When the activity pattern is not representative, the reason is asked (options: sick, depressed, bad weather, family affairs, vacation, other reason).

The LASA Physical Activity Questionnaire (LAPAQ) is based on the questionnaire by Voorrips et al. (1991) and Caspersen et al. (1991). The LAPAQ questionnaire has been validated against 7-day physical activity diaries and 7-day pedometer counts in a subsample of 439 LASA participants (Stel et al. 2004). The LAPAQ was highly correlated with the 7-day diary (r=0.68, P<.001), and moderately with the pedometer (r=0.56, P<.001). The repeatability of the LAPAQ is reasonably good (weighted kappa: 0.65-0.75) (Stel et al. 2004).

Previous use in LASA
The total time spent on physical activity can be calculated by multiplying the frequency and duration of each activity in the previous two weeks, and summing these values across activities. See Visser et al. (1997).

Intensity of activity
Attention should be paid to the fact that activities have different intensity levels. Therefore, the relationship of physical activity with health outcomes may differ by type of activities (for an example, see Visser et al., 1997). A simple method to take intensity into account is to distinguish sports activities from non-sports activities. A more sophisticated method is the use of MET scores.

The intensity of a specific activity can be expressed using MET scores (Caspersen et al. 1991, Ainsworth et al, 1993). One MET unit = resting energy expenditure = 1 kcal per kg body weight per hour. The MET score of a specific activity can be interpreted as an intensity measure of that specific activity. For all activities included in the LASA physical activity questionnaire a MET score has been assigned (see table 1). The MET scores were assigned based on previously published MET scores lists (Caspersen et al. 1991, Ainsworth et al, 1993) and discussions with activity experts. For young adults, activities with a MET score of 4.5 or higher are considered as ‘high-intensity’ activities. For elderly persons, activities with a MET score of 4.0 or higher are considered as ‘high-intensity’ activities.

To obtain an intensity-weighted total physical activity score, multiply the frequency and duration and MET score of each activity in the previous two weeks, and sum up these values across activities. The MET score can also be used to calculate the amount of energy used during a specific activity. Example: A person of 60 kg body weight who cycles during 40 minutes (MET score 4.0) will spend an amount of energy: (4 METs * 60 kg) * (40 min / 60 min) = 160 kcal. A similar calculation can be made for all the activities reported by the respondent, and the total sum is a measure of energy expenditure during physical activity. Please note that this value is not the total daily energy expenditure. Energy expended during sleep, at rest and during activities not included in the questionnaire, are not taken into account.

Components underlying physical activities
In 2007 we developed an alternative way to use the information of the individual activities used in the LAPAQ questionnaire. For each individual activity we developed scores for the following underlying components: muscle strength, intensity, mechanical strain, and turning actions (see table 2, Verweij et al., in preparation). By distinguishing between these underlying components we hope to obtain a better insight in the relationship between physical activities and prevalent and incident disease and functioning in old age.
The scores have been successfully applied to investigate the relationship between physical activity and incident osteoarthritis of the knee (Verweij et al. 2009). Currently, the relationship between these four physical activity component and recurrent falls is being investigated (Peeters et al, in preparation).

References

  1. Ainsworth BE, Haskell WL, Leon AS, Jacobs DR, Montoye HJ, Sallis JF, Paffenbarger RS. Compedium of physical activities: classification of energy costs of human physical activities. Medicine ans Science in Sports and Exercise 1993;25:71-80.
  2. Caspersen CJ, Bloemberg BPM, Saris WHM, et al. The prevalence of selected physical activities and their relation with coronary heart disease risk factors in elderly men: The Zutphen Study, 1985. Am J Epidemiol 1991;133:1078-92.
  3. Peeters, GMEE, Verweij, LM, Van Schoor , NM, Pijnappels, M, Pluijm, SMF, Visser, M, Lips, PTA. Which types of activities are associated with risk of recurrent falling in older persons? Journal of Gerontology, Medical Sciences 2010;65 (7), 743-750.
  4. Stel VS, Smit JH, Pluijm SM, Visser M, Deeg DJ, Lips P. Comparison of the LASA Physical Activity Questionnaire with a 7-day diary and pedometer. J Clin Epidemiol 2004;57:252-8.
  5. Tromp EAM, Pluym SMF, Lips TAM. Predictors of fractures. In: Autonomy and well-being in the aging population II. Eds: Deeg DJH, Westendorp-de Serière M. Amsterdam: VU University Press, 1998; 55-62.
  6. Verweij, LM, Van Schoor , NM, Dekker, J, Visser, M. Distinguishing four components underlying physical activity: a new approach to using physical activity questionnaire data in old age. BMC Geriatrics 2010;10-20.
  7. Verweij LM, van Schoor NM, Deeg DJH, Dekker J, Visser M. Physical activity and incident clinical knee OA in older adults. Arthritis Rheum 2009;61:152-7.
  8. Visser M, Launer LJ, Deurenberg P, Deeg DJH. Total and sports activity in older men and women: relation with body fat distribution. Am J Epidemiol 1997;145:752-61.
  9. Voorrips LE, Ravelli ACJ, Dongelmans PCA et al. A physical activity questionnaire for the elderly. Med Sci Sports Exerc 1991;23:974-9.

Constructed variable physical activity

Preferred options:
a) Total time per day
b) Total amount of kcals per day

Other options, dependent on research questions:
c) Sports participation (yes / no)
d) Total time or kcals spent on sports activity
e) Total time or kcals spent on high-intensity activities (MET score ³ 4)

Imputation missing values
Values to impute certain missing values have been developed for lasaB to lasaE and can be found in a separate file (‘physical activity imputation’).

Table 1.  Assigned MET scores (in kcal/kg body weight/hour) for LASA activities

LASA ACTIVITY

MET score

GENERAL:

 

Walking outdoors

3.5

Bicycling

4.5

Gardening

4.5

Light household

2.5

Heavy household

4.5

SPORTS:

 

1.  distance walking

4.0

2.  distance cycling

6.0

3.  gym home / elderly

4.0

4.  game / sport elderly

4.0

5.  swimming

5.0

6.  (folk)dancing

5.0

7.  bowling

3.5

8.  tennis

6.0

9.  jogging / running

6.0

10. rowing

5.5

11. sailing

3.0

12. billiards

2.5

13. fishing

3.0

14. soccer/basketball/korfb

6.0

15. volleyball/baseball

5.0

16. wintersports

6.0

17. other

4.0

Table 2. The four developed physical activity component scores for the individual activities included in the LASA Physical Activity Questionnaire (LAPAQ).

LAPAQ Activity

Intensity score

Mechanical strain score

Turning actions score

Strength score

General:

       

Walking outdoors

3.5

2

1

2

Bicycling

4.5

1

1

3

Light household

2.5

1

2

2

Heavy household

4.5

2

2

4

Sports:

       

1.Distance walking

4.0

2

1

3

2.Distance cycling

6.0

1

1

4

3.Gym/Game

4.0

2

2

2

4.Home trainer

4.0

1

1

2

5.Swimming

5.0

1

2

3

6.(Folk) Dancing

5.0

3

3

2

7.Bowling/ Jeu de Boules

3.5

2

2

8.Tennis/Badminton

6.0

3

3

3

9.Jogging/Running/Speed walking

6.0

3

1

3

10.Rowing

5.5

1

1

3

11.Sailing

3.0

1

1

2

12.Billiards

2.5

1

1

3

13.Fishing

3.0

1

1

1

14.Soccer/Basketball/

Hockey

6.0

4

3

4

15.Volleyball/Baseball

5.0

4

3

4

16.Skiing

6.0

2

3

4

17. All other activities

4.0

2

2

2


Syntax Physical Activity in LASA
SyntaxPAG (pdf)