Validity of the International Physical Activity Questionnaire (IPAQ) for assessing moderate-to-vigorous physical activity and sedentary behaviour of older adults in the United Kingdom

Claire Cleland, Sara Ferguson, Geraint Ellis, Ruth F Hunter, Claire Cleland, Sara Ferguson, Geraint Ellis, Ruth F Hunter

Abstract

Background: In order to accurately measure and monitor levels of moderate-to-vigorous physical activity (MVPA) and sedentary behaviour (SB) in older adults, cost efficient and valid instruments are required. To date, the International Physical Activity Questionnaire (IPAQ) has not been validated with older adults (aged 60 years plus) in the United Kingdom. The current study aimed to test the validity of the IPAQ in a group of older adults for both MVPA and SB.

Methods: Participants wore an Actigraph GT3X+ for seven consecutive days and following the monitor wear participants were asked to complete the IPAQ. Statistical analysis included: Kolmogorov-Smirnov tests; descriptive analyses; Spearman's rho coefficients; and Bland-Altman analyses.

Results: A sample of 253 older adults were recruited (mean age 71.8 years (SD 6.6) and 57% male). In total, 226 had valid accelerometer and IPAQ data for MVPA and 228 had valid data for SB. Results showed the IPAQ had moderate/acceptable levels of validity (r = .430-.557) for MVPA. For SB, there was substantial levels of validity on weekdays (r = .702) and fair levels of validity (r = .257) on weekend days. Bland-Altman analysis showed inherent measurement error with the majority of participants tending to under-report both MVPA and SB. Results showed the majority of older adult's under-report their level of MVPA and SB when completing the IPAQ and the linear relationship above the mean shows an error from under to over reporting as the mean increases.

Conclusions: Findings from the current study suggest that the IPAQ is better implemented in larger surveillance studies comparing groups within or between countries rather than on an individual basis. Findings also suggest that the IPAQ validity scores could be strengthened by providing additional detail of types of activities older adults might do on a daily basis, improving recall; and it may also be necessary to provide an example of a daily break down of typical activities performed. This may enable older adults to more fully comprehend the amount of time they may spend active, sitting and/or lying during waking hours.

Keywords: Accelerometry; IPAQ; International physical activity questionnaire; MVPA; Moderate-to-vigorous physical activity; Objective measurement; Physical activity; Sedentary behaviour; Self-report; Validity.

Conflict of interest statement

Ethics approval and consent to participate

Ethical approval was obtained from the School of Medicine Dentistry and Biomedical Sciences Research Ethics Committee, Queen’s University Belfast (reference number: 16.30v2). Each participant provided written informed consent to participate in the current study for accelerometry wear and survey completion.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow Diagram of Participant Recruitment
Fig. 2
Fig. 2
Bland-Altman plot for moderate-to-vigorous physical activity
Fig. 3
Fig. 3
Bland-Altman plot for sedentary behaviour – week day
Fig. 4
Fig. 4
Bland-Altman plot for sedentary behaviour – weekend day

References

    1. Lee IM, Shiroma EJ, Lobelo F, et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380:219–229. doi: 10.1016/S0140-6736(12)61031-9.
    1. Jefferis BJ, Sartini C, Lee IM, Choi M, Amuzu A, Gutierrez C, et al. Adherence to physical activity guidelines in older adults, using objectively measured physical activity in a population-based study. BMC Public Health. 2014;14:382. doi: 10.1186/1471-2458-14-382.
    1. DiPietro L, Caspersen CJ, Ostfeld AM, Nadel ER. A survey for assessing physical activity among older adults. Med Sci Sports Exerc. 1993;25:628–642. doi: 10.1249/00005768-199305000-00016.
    1. Kowalski K, Rhodes R, Naylor PJ, Tuokko H, MacDonald S. Direct and indirect measurement of physical activity in older adults: a systematic review of the literature. Int J Behav Nutr Phys Act. 2012;9:148–110. doi: 10.1186/1479-5868-9-148.
    1. Washburn RA, Smith KW, Jette AM, Janney CA. The physical activity scale for the elderly (PASE): development and evaluation. J Clin Epidemiol. 1993;46:153–162. doi: 10.1016/0895-4356(93)90053-4.
    1. Sallis JF, Saelens BE. Assessment of physical activity by self-report: status, limitations, and future directions. Res Q Exerc Sport. 2000;71:1–14. doi: 10.1080/02701367.2000.11082780.
    1. Washburn RA, Heath GW, Jackson AW. Reliability and validity issues concerning large-scale surveillance of physical activity. Res Q Exerc Sport. 2000;71(2):104–113. doi: 10.1080/02701367.2000.11082793.
    1. Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King AC, et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116:1094–1105. doi: 10.1161/CIRCULATIONAHA.107.185650.
    1. Seymour DG, Ball AE, Russell EM, Primrose WR, Garratt AM, Crawford JR. Problems in using health survey questionnaires in older patients with physical disabilities. The reliability and validity of the SF-36 and the effect of cognitive impairment. J Eval Clin Practice. 2001;7(4):411–418. doi: 10.1046/j.1365-2753.2001.00296.x.
    1. Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008;40:181–188. doi: 10.1249/mss.0b013e31815a51b3.
    1. Hutto B, Howard VJ, Blair SN, Colabianchi N, Vena JE, Rhodes D, Hooker SP. Identifying accelerometer nonwear and wear time in older adults. Int J Behav Nutr Phys Activ. 2013;10:120–110. doi: 10.1186/1479-5868-10-120.
    1. Adams SW, Matthews CE, Ebbeling CB, et al. The effect of social desirability and social approval on self-reports of physical activity. Am J Epidemiol. 2005;161:389–398. doi: 10.1093/aje/kwi054.
    1. Ferrari P, Friedenreich C, Matthews CE. The role of measurement error in estimating levels of physical activity. Am J Epidemiol. 2007;166:832–840. doi: 10.1093/aje/kwm148.
    1. Shephard RJ. Limits to the measurement of habitual physical activity by questionnaires. Br J Sports Med. 2003;37:197–206. doi: 10.1136/bjsm.37.3.197.
    1. Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE. International physical activity questionnaire: 12 country reliability and validity. Med Sci Sports Exerc. 2003;35:1381–1395. doi: 10.1249/01.MSS.0000078924.61453.FB.
    1. IPAQ, 2005. Guidelines for Data Processing and Analysis of the International Physical Activity Questionnaire (IPAQ). [Online] The International Physical Activity Questionnaire.
    1. Maddison R, Mhurchu CN, Jiang Y, Vander Hoorn S, Rodgers A, Lawes CMM, Rush E. International physical activity questionnaire (IPAQ) and New Zealand physical activity questionnaire (NZPAQ): a doubly labeled water validation. Int J Behav Nutr Phys. 2007;4:62.
    1. Booth ML. Assessment of physical activity: an international perspective. Res Q Exerc Sport. 2000;71:114–120. doi: 10.1080/02701367.2000.11082794.
    1. Cerin E, Barnett A, Cheung MC, Sit CHP, Macfarlane DJ, Chan WM. Reliability and validity of the IPAQ-L in a sample of Hong Kong urban older adults: does neighborhood of residence matter? J Aging Phys Act. 2012;20:402–420. doi: 10.1123/japa.20.4.402.
    1. Van Holle V, De Bourdeaudhuij I, Deforche B, Van Cauwenberg J, Van Dyck D. Assessment of physical activity in older Belgian adults: validity and reliability of an adapted interview version of the long international physical activity questionnaire (IPAQ-L) BMC Public Health. 2015;15:1–14. doi: 10.1186/1471-2458-15-1.
    1. Tomioka K, Iwamoto J, Saeki K, Okamoto N. Reliability and validity of the international physical activity questionnaire (IPAQ) in elderly adults: the Fujiwara-kyo Study. J Epidemiol. 2011;21:459–465. doi: 10.2188/jea.JE20110003.
    1. Ellis G, Hunter R, Hino AA, Cleland CL, Ferguson S, Murtagh B, Anez CRR, Meo S, Reis R. Study Protocol: Healthy urban living and ageing in place (HULAP Study): physical activity, built and social environments for older adults the UK and Brazil. BMC Public Health. 2018;18(1):1135. doi: 10.1186/s12889-018-6018-0.
    1. Hagstromer M, Oja P, Sjostrom M. The international physical activity questionnaire (IPAQ): a study of concurrent and construct validity. Public Health Nutr. 2006;9:755–762. doi: 10.1079/PHN2005898.
    1. Plasqui G, Westerterp KR. Physical activity assessment with accelerometers: an evaluation against double labeled water. Obesity. 2007;15:2371–2379. doi: 10.1038/oby.2007.281.
    1. Kelly LA, McMillan DG, Anderson A, Fippinger M, Fillerup G, Rider J. Validity of actigraphs uniaxial and triaxial accelerometers for assessment of physical activity in adults in laboratory conditions. BMC Med Phys. 2013;13:5. doi: 10.1186/1756-6649-13-5.
    1. Santos-Lozano A, Santı’n-Medeiros F, Cardon G, et al. Actigraph GT3X: validation and determination of physical activity intensity cut points. Int J Sports Med. 2013;34:975–982. doi: 10.1055/s-0033-1337945.
    1. Copeland JL, Esliger DW. Accelerometer assessment of physical activity in active, healthy older adults. J Aging Phys Act. 2009;17:17–30. doi: 10.1123/japa.17.1.17.
    1. Davis MG, Fox KR, Hillsdon M, Sharp DJ, Coulson JC, Thompson JL. Objectively measured physical activity in a diverse sample of older urban UK adults. Med Sci Sports Exerc. 2011;43:647–654. doi: 10.1249/MSS.0b013e3181f36196.
    1. Hart TL, Swartz AM, Cashin SE, Strath SJ. How many days of monitoring predict physical activity and sedentary behaviour in older adults? Int J Behav Nutr Phys Act. 2011;8:62. doi: 10.1186/1479-5868-8-62.
    1. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–174. doi: 10.2307/2529310.
    1. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307–310. doi: 10.1016/S0140-6736(86)90837-8.
    1. Liu J, Tang W, Chen G, Lu Y, Feng C, Tu XM. Correlation and Agreement: overview and clarification of competing concepts and measures. Shanghai Arch Psychiatry. 2016;28(2):6.
    1. Pate RR, Pratt M, Blair SN, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273:402–407. doi: 10.1001/jama.1995.03520290054029.
    1. Ainsworth BE, Haskell WL, Whitt MC, et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000;32(9):498–504. doi: 10.1097/00005768-200009001-00009.
    1. Kwan M, Woo J, Kwok T. The standard oxygen consumption value equivalent to one metabolic equivalent (3.5 ml/min/kg) is not appropriate for elderly people. Int J Food Sci Nutr. 2004;55:179–182. doi: 10.1080/09637480410001725201.
    1. Freedson PS, Melanson E, Sirard J. Calibration of the computer science and applications, Inc. accelerometer. Med Sci Sports Exerc. 1998;30:777–781. doi: 10.1097/00005768-199805000-00021.
    1. Grimm EK, Swartz AM, Hart T, Miller NE, Strath SJ. Comparison of the IPAQ-short form and accelerometry predictions of physical activity in older adults. J Aging Phys Act. 2012;20:64–79. doi: 10.1123/japa.20.1.64.
    1. Cleland C, Hunter R, Kee F, Cupples M, Sallis J, Tully M. Validity of the global physical activity questionnaire (GPAQ) in assessing levels and change in moderate-vigorous physical activity and sedentary behaviour. BMC Public Health. 2014;14(1):1255. doi: 10.1186/1471-2458-14-1255.
    1. Ekelund U, Sepp H, Brage S, Becker W, Jakes R, Hennings M, Wareham NJ. Criterion-related validity of the last 7-day, short form of the international physical activity questionnaire in Swedish adults. Public Health Nutr. 2005;9:258–265.
    1. Prince SA, Adamo KB, Hamel ME, Hardt J, Gorber SC, Tremblay M. A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review. Int J Behav Nutr Phys Act. 2008;5:56–10. doi: 10.1186/1479-5868-5-56.
    1. Harada ND, Chiu V, King AC, Stewart AL. An evaluation of three self-report physical activity instruments for older adults. Med Sci Sports Exerc. 2001;33:962–970. doi: 10.1097/00005768-200106000-00016.
    1. Heesch KC, van Uffelen JGZ, Hill RL, Brown WJ. What do IPAQ questions mean to older adults? Lessons from cognitive interviews. Int J Behav Nutr Phys Act. 2010;7:35. doi: 10.1186/1479-5868-7-35.
    1. Amagasa S, Fukushima N, Kikuchi H, Takamiya T, Oka K, Inoue S. Light and sporadic physical activity overlooked by current guidelines makes older women more active than older men. Int J Behav Nutr Phys Act. 2017;14:59. doi: 10.1186/s12966-017-0519-6.
    1. Fuzeki E, Engeroff T, Banzer W. Health benefits of light-intensity physical activity: a systematic review of accelerometer data of the National Health and nutrition examination survey (NHANES) Sports Med. 2017;47(9):1769–1793. doi: 10.1007/s40279-017-0724-0.
    1. Rosenberg DE, Bull FC, Marshall AL, Sallis JF, Bauman AE. Assessment of sedentary behavior with the international physical activity questionnaire. J Phys Act Health. 2008;5(1):30–44. doi: 10.1123/jpah.5.s1.s30.
    1. Harrison CL, Thompson RG, Teede HJ, Lombard CB. Measuring physical activity during pregnancy. Int J Behav Nutr Phys Act. 2011;8:19. doi: 10.1186/1479-5868-8-19.

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