Sex differences in habitual physical activity of the elderly: Issues of measurement, activity patterns, barriers and health response

Roy J. Shephard, Yukitoshi Aoyagi

Abstract


A systematic review of sex differences in the habitual physical activity of the elderly covers articles published between 1966 and 2012. Both subject sampling and assessments of physical activity are liable to sex biases. Questionnaires have large systematic errors; often. they were designed for male populations, so that the common activities of many elderly women may be ignored. Pedometer/accelerometers generally give more accurate information on activity patterns tha questionnaires. But again, there are sex differences in the minimum periods of recording to overcome effects of the weekly routine, adverse weather conditions and seasonal variations. Men and women also differ in the times that they allocate to activities that are not well recorded by personal monitors. Doubly-labelled water (DLW) studies provide the gold standard of metabolic measurement, but particularly in elderly women, the daily intensity of physical activity rises so little above the resting state that DLW estimates of leisure activity lack precision. When sex differences in patterns of physical activity are analyzed on a geographic basis, there seem few differences between the developed societies of North America, Japan, Europe and other parts of the world. All regions show substantial sex differences in the types of physical activity performed, with men focussed more upon sport, and women devoting more time to housework and walking; however, such differences seem attenuated in the very old. The overall weekly volume of physical activity is some 10% greater in elderly men than in women of similar age, and moderate or vigorous activity, although limited in both sexes, is more likely to be reported and/or observed in men. Involvement in Masters competition demonstrates sex differences in the choice of activities and participation rates that parellel those seen in the general elderly population. Attempts to demonstrate secular trends in habitual activity have to date had limited success because observations have covered relatively short periods, and comparisons have often been vitiated by year-to-year changes in measurement procedures. Studies of factors encouraging and inhibiting physical activity have often been hampered by failure to use sound behavioural models. Many older men are still attracted by the competitive aspects of physical activity, but valued aspects for women are companionship, and the aesthetic and health benefits of physical activity. Women report more barriers to exercise than men, emphasizing such issues as the perceived dangers of physical activity, costs and the lack of a companion and transport. The active elderly gain many health advantages over their sedentary peers, including higher levels of fitness, a later onset of dependency, and reduced risks of all-cause mortality, an adverse metabolic risk profile, cardiovascular disease, peptic ulcers, benign and malignant neoplasms, osteoporosis and sarcopenia. Outcomes sometimes differ between men and women, because women start from a poorer level of health, and they are less likely to engage in the moderate to vigorous physical activity needed for certain improvements in health. From the standpoint of policy, a large proportion of the elderly, both men and women, take much less than the minimum weekly volume of activity that has been recommended for their health. There is thus great scope to find new ways of stimulating a greater interest in physical activity among the elderly, taking account of sex-specific preferences and perceived barriers to exercise. There remains a need to explore ways in which currently available information about habitual activity patterns may have been distorted by sex-specific sampling and sex-related differences in responses to questionnaires and personal monitors. It will be particularly interesting to obtain accurate longitudinal data, exploring how far physical activity patterns are changing in response to both health promotional efforts and changes in the social status of elderly women.

Keywords


Accelerometer; Activity patterns; All-cause death rates; Cardiovascular disease; Dependency; Fitness levels; Health outcomes; Intensity; Masters athletes; Metabolic risk factors; Neoplasms; Osteoporosis; Pedometer; Perceived barriers; Physical Activity Qu

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ISSN: 19206216