Physical activity

Physical activity

LASA filenames:
LASA046
LASEs812

Contact: Natasja van Schoor

Background
Physical activity is an important determinant of health in older age. Higher levels of physical activity have been associated with decreased mortality risk, disability, fractures, depressive symptoms etc. (Llamas-Velasco S et al. 2016, Manini TM et al. 2017, Gregg EW et al. 2000, Ku PW et al. 2012).

According to the recent Dutch guidelines for physical activity (Gezondheidsraad, 2017), physical activity is categorised as follow based on the intensity:

  • Light physical activity consist of activities that involve standing or moving while upright. Examples include cooking, grocery shopping and playing darts. Energy consumption ranges from 1.6-2.9 METs (Metabolic Equivalent of Task scores – see below).
  • Moderate physical activity relates to activities performed at an intensity that requires effort, but during which conversation remains possible, such as hiking, cycling and swimming. Energy consumption ranges from 3.0 to 5.9 METs.Vigorous physical activity causes rapid breathing or shortness of breath depending of fitness levels. Examples include aerobics, running, speed cycling and certain competitive sports. Energy consumption is 6 MET or more.


Measurement instruments in LASA
Information on physical activity has been obtained during the main interview of each wave using the LASA Physical Activity Questionnaire (LAPAQ). Respondents were asked how often and for how long they performed each of the following activities in the last two weeks: walking outdoors, biking, gardening, light household activities, heavy household activities and two of their most frequently performed sports activities. For the sports activities, additional questions are asked about sweating. Respondents were also asked if the activity pattern of the previous two weeks was representative for the rest of the year. When the activity pattern was not representative, the reason was asked (options: sick, depressed, bad weather, family affairs, vacation, other reason).

LAPAQ is based on the questionnaire by Voorrips et al. (1991) and Caspersen et al. (1991). It 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).

Physical activity assessment in the migrant cohort
The migrant cohort (2013-2014) uses a similar but less extensive questionnaire. Respondents were asked how often and for how long they did each of the following activities in the past two weeks: walking outdoors, biking, heavy household activities and the most intense sport activity. Different from the LAPAQ there were no questions available for light households activities or gardening, and only the most intense sport activity was asked instead of 2 most frequent sport activities in LAPAQ. Also, there was no information whether the activity pattern in the last two weeks was different from the rest of the year and if so, for what reason.

Questionnaires
LASAB046 / LASAC046 / LASAC246* / LASAD046 / LASAE046 / LAS2B046 / LASAF046 / LASAG046 / LASAH046 / LAS3B046 / LASMB046 / LASAI046 / LASAJ046 / LASAK046 (main interview, in Dutch)

Interim measurement:
Questions PHY07, PHY11, PHY17, PHY21, PHY32, PHY36 and PHY39 in LASEs812 (self-admin. questionnaire, in Dutch)

Variable information
LASAB046 / LASAC046 / LASAD046 / LASAE046 / LAS2B046 / LASAF046 / LASAG046 / LASAH046 / LAS3B046 / LASMB046 / LASAI046 / LASAJ046 / LASAK046;
LASAC246* (activity by age period)
(pdf)

Interim measurement:
LASEs812
(pdf)

* See for more information topic Early life physical activity)

Components underlying physical activities
In 2007, an alternative way was developed to use the information of the individual activities used in the LAPAQ questionnaire. For each individual activity, scores for the following underlying components were constructed: muscle strength, intensity, mechanical strain, and turning actions (Verweij et al. 2010). By distinguishing between these underlying components, we hoped to obtain a better insight into the relationship of physical activities with prevalent and incident disease and functioning in old age.

The underlying component scores have been successfully applied to investigate the relationship between physical activity and incident osteoarthritis of the knee (Verweij et al. 2009). The relationship between these four physical activity component and recurrent falls was also investigated (Peeters et al. 2010).

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 activity (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 Metabolic Equivalent of Task (MET) scores.

The intensity of a specific activity can be expressed using MET scores (Caspersen et al. 1991, Ainsworth et al, 2011). 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 LAPAQ a MET score has been assigned. For a list of sport activities and corresponding MET scores, please click here. MET scores of the general activities are listed below. Scores for both general activities and sport activities were assigned based on previously published MET scores lists (Caspersen et al. 1991, Ainsworth et al, 2011) and in discussions with activity experts.

The MET scores assigned to each general activity are as follow:

Walking outdoors = 3.5 METs
Biking = 4.5 METs
Light household activities = 2.5 METs
Heavy household activities = 4.5METs
Gardening* = 4.5 METs

* Please note that gardening is not included in the total physical activity score as calculated in the syntaxes hereunder!

To obtain an intensity-weighted total physical activity score, multiply the frequency, duration and MET score of each activity were multiplied and these values were summed up 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 for 40 minutes (MET score 4.0) will spend the following 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 total energy expenditure resulting from physical activity.

Please note that this value is not the total daily energy expenditure. Energy expended during sleep, at rest and during other activities that are not included in the LAPAQ, are not taken into account.
Please note that using kcals/day may result in more missing data (smaller sample size) due to missing values in the measured body weight variable!

Constructed variables physical activity
Preferred options:
a) Total time (minutes) per day
b) Total amount of kcals per day
c) Total MET hours per week
Other options, dependent on research questions:
d) Sports participation (yes/no)
e) Total time or kcals or MET hours/week spent on sports activity
f) Total time or kcals or MET hours/week spent on high-intensity activities (MET score > 4)


Syntaxes to calculate total physical activity score
It is up to the researcher to choose which physical activity variable is the best option to answer their research question. However, since physical activity is often used as a confounder in many analyses, a syntax that calculates the most used variables (total minutes per day, total amount of kcals/day, total MET hours/week) has been prepared.

Important to know:

  • The syntax includes the following general activities in the physical activity variables: walking outdoors, biking, light household activities, heavy household activities and 2 most frequently performed sports. It calculates total physical activity for people who are not bedridden or in a wheelchair (mechanical or electrical).
  • For participants who reported doing a specific type of activity from the ones mentioned above and also reported either frequency or duration of the activity,  the missing duration or frequency was imputed with the sex-specific mean of the people who reported to do that activity and reported both duration and intensity. A table with the values to be imputed for each wave from wave B to 3B can be found here (pdf). Also, an example (for wave H) on how to calculate these values is given here (pdf).
  • Gardening is not included in the syntax calculations. It is possible to add it to the total score but before doing so please take into account that:
    • LASA participants come from 3 different regions: Amsterdam, Zwolle and Oss. People living in the urban areas of Amsterdam are less likely to own a garden and therefore do gardening.
    • There are different tools used for gardening (electrical vs mechanical) which cannot be assigned the same intensity (MET score).
    • Gardening depends on the season and therefore the time of the interview.
  • From wave H onwards, the list of sports used during the interview changed and also their coding system. Please check carefully the sport variables and their labels. MET scores for the new and old classification are described above.
  • For wave 3B, an extra session is added about the most intense sport activity (What is the most intense sport you did in the last 2 weeks? How many times did you do this sport in the last 2 weeks? For how long did you do the following sport activity?) This session is not taken into account when calculating the PA variables in the syntax but can be used to make the data of wave 3B comparable with the data from the migrant study.

The syntaxes of total physical activity variables from wave B to 3B can be found  below.

Availability of information per wave ¹

BCDEIM*
2B*		FGH

3B*		MB*IJK
Physical activity

MaMaMaMaSaMaMaMaMaMaMaMaMaMa

¹ More information about the LASA data collection waves is available here.

* IM=interim measurement between E and F (first cohort only);
2B=baseline second cohort;
3B=baseline third cohort;
MB=migrants: baseline first cohort

Ma=data collected in main interview;
Sa=data collected in self-admin. questionnaire

Previous use in LASA


References

  1. Ainsworth BE, Haskell WL, Herrmann SD, et al. 2011 Compendium of Physical Activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011;43(8):1575-1581.
  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. Gezondheidsraad. Beweegrichtlijnen 2017. Den Haag, 2017, 2017/08.
  4. Gregg EW, Pereira MA, Caspersen CJ. Physical activity, falls, and fractures among older adults: a review of the epidemiologic evidence. J Am Geriatr Soc. 2000; 48(8):883–93.
  5. Llamas-Velasco S, Villarejo-Galende A, Contador I,  Lora-Pablos D, et al. Physical activity and long term mortality risk in older adults: A prospective population-based study (NEDICES). Prev. Med. Rep. 2016; 4:546–550.
  6. Ku PW, Fox KR, Chen LJ, Chou P. Physical activity and depressive symptoms in older adults: 11 year follow-up. Am J Prev Med. 2012; 42(4):355–62.
  7. Manini TM, Beavers DP, Pahor M, et al. Effect of physical Activity on Self-Reported Disability in Older Adults: Results from the LIFE Study. J Am Geriatr Soc. 2017; 65(5):980–988.
  8. 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.
  9. 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.
  10. Verweij, L.M., Van Schoor , N.M., 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.
  11. 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.
  12. Voorrips LE, Ravelli ACJ, Dongelmans PCA et al. A physical activity questionnaire for the elderly. Med Sci Sports Exerc 1991;23:974-9.
  13. Timmermans, E.J., de Koning, E.J., van Schoor, N.M., van der Pas, S., Denkinger, M.D., Dennison, E.M., Maggi, S., Pedersen, N.L., Otero, A., Peter, R., Cooper C., Siviero, P., Castell, M.V., Herbolsheimer, F., Edwards, M., Limongi, F., Deeg, D.J.H., Schaap, L.A. (2019) Within-person pain variability and physical activity in older adults with osteoarthritis from six European countries. BMC Musculoskeletal Disorders, 20(12), https://doi.org/10.1186/s12891-018-2392-0.

Syntax information Physical activity (PDF)

Note: In order to run the following syntaxes you will need file Z004 (sex) and file 161 (weight, bmweight for LASA-B and *med153 for other waves)

Syntax wave B
Syntax wave C
Syntax wave D
Syntax wave E
Syntax wave 2B
Syntax wave F
Syntax wave G
Syntax wave H
Syntax wave 3B
Syntax wave I 
Syntax wave J

Date of last update: April 24, 2020 (LenaS)