Objectively Measured Physical Activity Levels and Associated Factors in Older US Women During the COVID-19 Pandemic: A Quantitative Cross‐sectional Study (Preprint)

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BACKGROUND Physical activity (PA) is vital for attenuating the aging-related physiological and functional declines in women aged 60 years or above. However, little is known about the objectively assessed PA behavior in older women during the COVID-19 pandemic and its association with socio-demographics, health and physical function. OBJECTIVE This study aims to examine the objectively measured PA levels and associated factors among older US women, who were living under the physical distancing guidelines during the second year of the pandemic. METHODS In this cross-sectional study, we collected free-living PA data from 94 community-dwelling older women aged between 60 and 96 years (mean 75.1 years, SD 7.3 years) using wrist-worn ActiGraph GT9X accelerometers between February 2021 and August 2021. We examined if their daily duration spent in sedentary behavior (SB), light-intensity PA (LPA), and moderate-to-vigorous-intensity PA (MVPA) varied by sociodemographic characteristics, health and physical function, and COVID-19 related factors. RESULTS On average, participants accumulated 12.4 (SD=1.9) hours/day in SB, 218.6 (SD=64.3) min/day in LPA and 42.4 (SD=31.0) min/day in MVPA - exhibiting overall reduced PA levels than previously published pre-COVID norms of older women. Among participants aged≥80 years, sedentary time was 7.5% (P=.003) higher, and time spent in LPA and MVPA was, respectively, 13.3% (P=.03) and 44.9% (P<.001) lower than those aged 60-79 years. More MVPA participation and less sedentary lifestyle was observed in those who had higher self-rated health score (MVPA: P=.001, SB: P=.04) and lower fear of falling (FOF) (MVPA: P=.003, SB: P=.04). Poorer performance in 30-second sit-to-stand (STS) test was independently associated with more SB (P=.001) and less LPA (P=.011) and MVPA (P=.002) time among participants. Also, living alone was independently associated with less MVPA participation (P=.03). In addition, sedentary time was 5.0% higher (P=.03) in frail and prefrail participants than their healthy counterparts. CONCLUSIONS During the pandemic, older women spent the majority of their waking time being sedentary, while LPA accounted for a larger portion of their daily PA. Therefore, replacing SB with LPA (rather than MVPA) might provide a more feasible PA target for older women, particularly those aged≥80 years and who have reduced physical function. Also, targeted interventions might be beneficial in promoting an active lifestyle for those who live alone, are pre-frail or frail, and have high FOF in older age. INTERNATIONAL REGISTERED REPORT RR2-10.2196/27381