The Importance of Reducing
Sedentary Behavior in Older Adults
Lisa H. Colbert, PhD, MPH
Dept. of Kinesiology
University of Wisconsin-Madison
What is Sedentary Behavior?
◦ Participation in activities that do not
substantially increase energy expenditure
above resting levels
◦ A behavior that we often have a choice about
(Credit: Science Daily/Gary Martin)
What isn’t Sedentary Behavior?
◦ A lack of physical activity or exercise
◦ Current physical activity recommendations
for older adults are 150 min/wk of moderate
intensity activity as tolerated
◦ So…you could still do adequate PA but have
substantial sedentary time
Major contexts for sedentary behaviour and their distribution over a typical adult’s waking hours.
(From Dunstan et al. 2010a, reproduced with permission of Touch Briefings, European Endocrinology, Vol. 6, p. 20, © 2010.)
Light activity throughout the day
The Evolving Definition of "Sedentary". Pate, Russell; ONeill, Jennifer; Lobelo, Felipe
Exercise & Sport Sciences Reviews. 36(4):173-178, October 2008. DOI: 10.1097/JES.0b013e3181877d1a
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Active Couch Potato
The Evolving Definition of "Sedentary". Pate, Russell; ONeill, Jennifer; Lobelo, Felipe
Exercise & Sport Sciences Reviews. 36(4):173-178, October 2008. DOI: 10.1097/JES.0b013e3181877d1a
2
(From Dunstan et al. 2010a, reproduced with permission of Touch Briefings, European Endocrinology, Vol. 6, p. 21, © 2010.)
Why should we care?
Time Spent Sedentary
Matthews et al., 2008
Sitting Time and All-Cause Mortality - Women
Patel A V et al. Am. J. Epidemiol. 2010;172:419-429
Sitting Time and All-Cause Mortality - Men
Patel A V et al. Am. J. Epidemiol. 2010;172:419-429
Sitting Time and All-Cause Mortality
KATZMARZYK, PETER; CHURCH, TIMOTHY; CRAIG, CORA; BOUCHARD, CLAUDE, Medicine & Science in Sports &
Exercise. 41(5):998-1005, May 2009., DOI: 10.1249/MSS.0b013e3181930355
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Health and Disease Outcomes
Associated with SB
•Total mortality
•Cancers (ovarian, colon, endometrial)
•Diabetes
•Obesity & Weight Gain
*even among those who do adequate PA
How can we decrease
sedentary time?
Decreasing Sedentary Time/
Increasing Breaks
•Stand up at each TV commercial
•Fold laundry while watching TV
•Stand/walk while on phone
•Modify environment…..
What do we still need to
figure out?
•Confirm relationships with disease outcomes
•Relationships with important outcomes in
older adults
•Physical Function
•Balance
•Strength
•How older adults accumulate SB
•Feasible ways to reduce sedentary time in
older adults
Work we are planning to do….

To compare the relationship between SB and
physical function in older adults

To determine the relevant domains in which SB
is accumulated most frequently

To test an intervention to reduce SB
SB & physical
function
SB & balance
testing
Pilot test
“Sit Less, Live
Better”
Madison
Rock County
X
X
X
X
Participants

30-60 adults aged ≥ 65 years
◦ Community-dwelling and able to walk unaided
Protocol

Visit 1
◦ Health history and demographics
◦ SB domain questionnaire
◦ Sent home with activity monitors

Visit 2
◦ SB domain questionnaire
◦ Physical function measurements
◦ Balance testing (in Madison)
Measures: Sedentary Behavior and
Physical Activity

Actigraph GT1M
◦ Uniaxial accelerometer
◦ Time spent in PA

ActivPal
◦ Time spent in SB and
Pattern of SB (breaks)
Self-reported sit time (hrs/day)
How well do older adults report daily
sitting time?
8+ hrs
6-7.9 hrs
3-5.9 hrs
< 3 hrs
0
2
4
6
8
10
12
Inactive time (hrs/day 0-99 cts/min)
14
ActivPAL information
Measures: self-reported SB

SB domain questionnaire
◦ Adapted from Gardiner et al. 2011
◦ Assesses time spent sitting while:






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Watching TV
Using the computer
Reading
Socializing
Driving or in public transportation
Doing hobbies
At work or volunteer
Other activities
Measures: Physical Function

Modified Short Physical Performance
Battery
◦ Standing Balance
 side-by-side, semi-tandem, & full-tandem stands
◦ Walking balance
 walk a narrow path
◦ Chair Rise Ability
 stand-up and sit-down 5 times
◦ Gait Speed
 6 meter course: usual pace
Measures: Physical Function

Hand grip strength
◦ Upper body physical function

Long Distance Corridor Walk
◦ 2 minute walk
◦ 400 meter walk

The SF-36 –self report
◦ Physical function subscale
“Sit Less, Live Better” intervention
◦ Participants
 2 groups of 10 adults from the cross-sectional
study – Rock County
◦ Protocol
 Four small group sessions held weekly
 1.5-2 hours in length
 Booster session at 8 weeks
Facilitating behavior change by
applying concepts of the selfdetermination theory
Week 1
Week 2
Week 3
Week 4
Session 1 (2 hrs)
• Program overview
• What is sitting less vs. exercising more
• Group brainstorming: why are we
Sedentary? Benefits of sitting less?
• Worksheet: how much time do I spend
Sitting?
• Action plan / goal setting
Week 8
Session 5 – “Booster” (2 hrs)
Session 3 (1.5 hrs)
• Session overview
• Share example stories and ask group to
discuss barriers and problem-solve
solutions
• Group discussion: personal barriers /
solutions / motivators
• Action plans
Session 2 (1.5 hrs)
• Session overview
• In-depth info on benefits of sitting less /
breaking up sedentary time
• Individual brainstorming: what are my
reasons for choosing to sit less?
• Group discussion: how could sitting less
benefit me personally?
• Review action plans & problem solve as
group
• Write new action plan
• Brief overview of program and session
• Individual updates, review action plans /
barriers / motivators
• Reiteration of health benefits and group
sharing of personal benefits experienced
• Create long term action plan for future
Session 4 (1.5 hrs)
• Session overview
• Review information about the benefits of
sitting less
• Review action plans / goals
• Group discussion: how has this been
difficult? How has it been rewarding? How
can we sustain the changes?
• Worksheet: Setting long-term goals
• Action plan
PA/SB –Pre Intervention; At week 4; at week 12 (one-month post-booster)
Thanks to…..
Jane Mahoney
 Rachel Smedley
 Jill Ballard
 Joyce Lubben
 Diane Lauver
 Keith Gennuso

Thoughts or Questions????