Older people and sedentary behaviour: what’s the connection with the environment?

Richard Shaw of the MRC/CSO Social and Public Health Sciences Unit approached UBDC for help with a research project contrasting the relationships between sedentary behaviour measures on the one hand and neighbourhood measures on the other.

The Seniors USP (Understanding Sedentary Patterns) project, funded by the UK Medical Research Council as part of the Lifelong Health and Wellbeing Initiative (PDF 9MB), was led by Prof Dawn Skelton of Glasgow Caledonian University. While they had several established datasets to call on, UBDC was able to supply useful green space data, from our SUDS urban indicators programme. This project has made several significant contributions to the scientific literature, and guidance and intervention materials based on their findings.

The challenge

In the UK, very few older adults reach the recommended levels of activity for health. New evidence suggests that too much sitting (sedentary behaviour) is a distinct health risk, independent of other physical activity. Older people spend more time sitting than other age groups, but little research attention has been devoted to finding out what factors determine how active or sedentary older people are, and therefore what measures might mitigate this health risk. Seniors USP was an MRC-funded project which aimed to understand more about the sedentary patterns of older adults.

One particular area of interest was whether sedentary behaviour in older adults is associated with ecological factors, such as natural space, crime and fear of crime, and social cohesion. Few studies have investigated these socio-ecological factors. This project decided to investigate which aspects of the neighbourhood and social environment predict sedentary behaviour in older adults, using a more comprehensive range of measures than ever before.

The approach

The project’s multi-institutional team of researchers worked in collaboration with older people to unpick these important questions. They worked with two large groups of older people living in and around Edinburgh and Glasgow, additionally asking a sub-group of 750 people to wear a small device for a week to give an accurate measurement of how active and sedentary they were over that period. This enabled them to compare objective measurements with participants’ estimates of how active and sedentary they are.

They then investigated, among other things, the relationship between environmental factors and older people’s current sedentary and activity levels. The measures for the participants’ neighbourhoods were natural space, access to services, crime, walkability, pensioner density, population density, and availability of green spaces. While the percentage of natural space for each Scottish data zone was calculated from Scotland’s Greenspace Map obtained from Central Scotland Green Network (CSGN), and some other limited green space data was obtained from the European Environment Agency Urban Atlas, UBDC was able to provide the more fine-grained  green space data for census output areas.

The findings

Results from this study indicated that providing care to others was associated with reduced sedentary time in retired participants. Fear of crime and perceived absence of services were associated with increased sedentary time for one group of retired participants. Higher crime rates were associated with increased sedentary time in all cohorts but this was not significant after adjustment for socio-demographic characteristics. Most other neighbourhood and social participation measures (including the availability of green space) showed no association with sedentary time.

The impact

This study has made several significant contributions to the literature around older people and sedentary behaviour, which will, with the assistance of the Economic and Social Research Council in collaboration with Paths for All, translate the results from Seniors USP into new guidance and interventions to support older people to sit less, covering:

1. Developing sedentary behaviour information resources (e.g. a top tips cue card).
2. Developing and piloting training materials on reducing sedentary behaviour for integration into existing Paths for All walk-leader training courses.
3. Describing the key components and delivery mechanism of a future intervention to reduce sedentary behaviour in older adults.

There is a briefing sheet on Intervening on Sedentary Behaviour in Older Adults: From Results to Practice (PDF 4MB), from this work.

In addition to the published research paper described here, which had the support of UBDC, there are other contributions to the literature available (on BMJ Journals Volume 7, Issue 6 and BMJ Journals Volume 7, Issue 4) from Seniors USP. The team also held a webinar for researchers interested in their methods, called A Recipe for Success: Exploring the ingredients of successful data collection of objective sedentary behaviour in large scale cohort on 20th September 2017, from which a recording is available.