Physical Activity Patterns and Multimorbidity Burden of Older Adults with Different Levels of Functional Status: NHANES 2003-2006

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Background: Physical function and physical activity decrease with age, but differences in physical activity patterns within different physical functioning groups are unknown.

Objectives: To describe physical activity patterns and multimorbidity burden by physical function group and age.

Methods: Actigraph accelerometer-derived physical activity patterns were compared by physical function (high functioning, activity limitations, activity of daily living disabled) determined by questionnaire and age among 2174 older adults (mean age = 70.9, sd = 0.2 years) from the cross-sectional 2003-2006 National Health and Nutrition Examination Survey. Associations between physical function, physical activity, and multimorbidity were examined.

Results: Reduced physical function and increased age were associated with lower physical activity,increased sedentary time and a compressed activity profile. During the most active hour of the day(11:00 a.m.), the oldest, lowest physical functioning group was 82% less active than the youngest, highest physical functioning group. High functioning had over 30% more total activity counts, over 56% more time in moderate-to-vigorous activity, about 8% less time sedentary and took approximately one more sedentary break/hour than lower physical functioning groups. Gender differences in physical activity variables were prevalent for high functioning, but limited within reduced physical functioning groups. Physical function, age, total activity counts/day, and breaks in sedentary time/day were independently associated with multimorbidity (p<0.005).

Conclusions: Reduced physical function and increased age are associated with physical activity levels, and all three are associated with multimorbidity. Understanding physical activity differences by physical function is important for designing interventions for older individuals at increased risk for mobility disability.