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Understanding Sedentary Behavior in Older Adults: The Role of Lived Experience, Embodied Navigation, and Daily Physical Activity
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.ORCID iD: 0000-0001-8585-2218
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Sustainable development
SDG 3: Ensure healthy lives and promote well-being for all at all ages, SDG 8: Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all
Abstract [en]

Aim: The overarching aim of this thesis was to gain understanding of the meaning and experience of sedentary behavior, its relation to physical activity, physical function, and health in older adults.

Method: This thesis utilizes both qualitative and quantitative data. Two qualitative studies, involving in-depth interviews, investigated the lived experiences of sedentary behavior (n = 16, Study I) and the influence of lifelong physical activity experiences (n = 14, Study III) among community-dwelling older adults receiving initial support. Two quantitative studies examined physical activity and its correlates. Study II (n = 72) used questionnaires and accelerometers to measure daily step counts and its predictors in the same population as Studies I and III. Study IV (n = 819) leveraged data from the Swedish National Study on Aging and Care to investigate sit-to-stand time, a measure of lower body strength, in relation to physical function and health. Qualitative data were analyzed using a phenomenological hermeneutic approach (Study I) and qualitative content analysis (Study III). Quantitative data analysis involved descriptive statistics and multiple linear regression models (Studies II & IV).

Result: Study I showed that, for older adults, sedentary behavior is more than just sitting still. They experience it as an adaptation to an aging body, influenced by choices and a sense of frailty. Although some view it as unnatural, others see it as a necessary part of recovery and rest. Study II showed that daily step counts among older adults are influenced by a combination of predictors, including time spent in long bouts of sitting, independent outdoor walking ability, and the intention to be more active. Interestingly, the multiple linear regression model explained 47.8% of the variance in daily step counts. Of seven predictors included, time spent sitting in bouts of at least 60 minutes per day (R2 = 19.6%), independence when walking outdoors (R2 = 9.2%), and intention to become more physically active (R2 = 13.0%) explained most daily step count variance. Study III showed that a lifetime of physical activity shapes how older adults approach physical activity later in life. They rely on an embodied “activity compass” based on past experiences and their body's current limitations to navigate daily routines and make choices about activity levels and support. Study IV showed predictors explaining sit-to-stand time. The multiple linear regression model explained 26.8% of the variance in sit-to-stand time. Out of seven predictors, grip strength (R2 = 12.0%), age (R2 = 7.2%), and generic quality of life (R2 = 2.8%) explained most sit-to-stand time variance.

Conclusion: This thesis, grounded in the lived experiences of older adults, examined sedentary behavior, providing a deeper understanding of how to address sedentary behavior among older adults. Sedentary behavior is considered unnatural but still a conscious choice and sitting down for longer bouts during the day does not necessarily influence daily physical activity. Sedentary behavior among older adults can combine well-needed rest and engagement in meaningful activities. Furthermore, analyses of predictors of sit-to-stand time and daily step counts revealed potential disruptions to the natural motion of rising from a chair and walking. The findings suggest that older adults' lifelong experiences with physical activity and sedentary behavior become embodied knowledge, helping them navigate daily life.

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press, 2024. , p. 99
Series
Linnaeus University Dissertations ; 546
Keywords [en]
Life-span development theory on aging, Lived body, Older adults, Physical activity, Physical literacy, Sedentary behavior
National Category
Health Sciences
Research subject
Health and Caring Sciences, Caring Science
Identifiers
URN: urn:nbn:se:lnu:diva-133118DOI: 10.15626/LUD.546.2024ISBN: 9789180822138 (print)ISBN: 9789180822145 (electronic)OAI: oai:DiVA.org:lnu-133118DiVA, id: diva2:1908249
Public defence
2024-11-15, Azur, Hus Vita, Kalmar, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2024-10-25 Created: 2024-10-25 Last updated: 2024-10-30Bibliographically approved
List of papers
1. The meaning of sedentary behavior among older adults: a phenomenological hermeneutic study.
Open this publication in new window or tab >>The meaning of sedentary behavior among older adults: a phenomenological hermeneutic study.
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2023 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 23, no 1, article id 1134Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: A sedentary lifestyle has implications for health and well-being. For healthy ageing, it is recommended to interrupt prolonged sitting; however, little is known about the meaning of sedentary behavior among older adults. The aim of this study was to understand the meaning of sedentary behavior among older adults with initial support from community care.

METHODS: A phenomenological hermeneutics approach was used, and individual interviews were conducted with sixteen older adults aged 70 to 97 years, by phone and face to face. The older adults lived in ordinary housing in southern Sweden and received initial support from community care.

RESULTS: The interviews yielded three key themes: Being sedentary is an unnatural part of life, having an ageing body means unwanted frailty, and having a sedentary lifestyle is based on conscious choices.

CONCLUSION: Being sedentary means having a lack of physical activity and social interactions, resulting in wanting to be more physically active than sometimes possible. Clinical practitioners should bear in mind that becoming more sedentary is inevitable with an ageing body, but that older adults may have an innate desire to be as physically active as possible. A lifelong exposure to physical activity, the possibility of well-being found in sedentary activities and the impact of social networks should not be overlooked when creating clinical interventions to break unhealthy sedentary behavior among older adults. To increase the understanding of sedentary behavior among older adults, future research could focus on the impact of physical impairment on sedentary behavior and the relationship between sedentary behavior and physical activity throughout life.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Ageing, Frailty, Lived experience, Ordinary housing, Physical activity sedentary behavior
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-122014 (URN)10.1186/s12889-023-16052-5 (DOI)001009432100002 ()37312149 (PubMedID)2-s2.0-85161830861 (Scopus ID)
Available from: 2023-06-16 Created: 2023-06-16 Last updated: 2024-10-25Bibliographically approved
2. Daily activity patterns in older adults receiving initial support: the association between daily steps and sitting in bouts of at least 60 min
Open this publication in new window or tab >>Daily activity patterns in older adults receiving initial support: the association between daily steps and sitting in bouts of at least 60 min
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2024 (English)In: BMC Geriatrics, E-ISSN 1471-2318, Vol. 24, no 1, article id 88Article in journal (Refereed) Published
Abstract [en]

Background

Aging has a significant impact on health, underlining the importance of maintaining physical function and reducing time spent sitting among older adults. To understand how to reduce prolonged sitting or increase physical activity, factors related to the daily living and observed daily activity patterns should be explored. This study aimed to investigate the association between daily steps, self-rated health, physical activity, sedentary behavior, motivation to exercise and fear of falling among older adults receiving initial support.

Method

Cross-sectional design with total population questionnaire data from adults aged ≥ 60 years (n = 917), living at home with initial support from municipal care in southern Sweden. The older adults were offered to participate in a follow-up study measuring daily activity patterns with accelerometers (n = 72). Linear regression was used to analyze associations between daily steps and possible predictors.

Results

The linear model (

0.478) showed that sitting in unbroken bouts of > 60 min (β = -0.313, p < 0.05), walking independently outdoors (β = 0.301, p < 0.05), intending to increase physical activity (β = -0.294, p < 0.05), sex (β = 0.279, p < 0.05), relative autonomy index (β = 0.258, p < 0.05), fear of falling (β = -0.238, p < 0.05), and self-rated health (β = 0.213, p < 0.05) predicted daily steps.

Conclusion

The model of predictors brings new understanding regarding daily steps among community-dwelling older adults. The association between sitting in bouts of > 60 min and daily steps is interesting as 35% of participants had a number of sitting bouts that on average, showed 30% less steps taken. Minimizing long sitting bouts and maintaining physical functioning to promote independence when walking outdoors can be tools for clinical practitioners devising interventions to break prolonged sitting among community-dwelling older adults. Future research should prioritize studying older adults’ outdoor walking independence, including its relation to walking with or without assistive devices and its impact on physical activity and sedentary behavior.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
Keywords
Accelerometer Aging Physical activity Sedentary behavior Sitting Walking independence
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-127281 (URN)10.1186/s12877-024-04681-3 (DOI)001148301500001 ()2-s2.0-85182847415 (Scopus ID)
Funder
Linnaeus University
Available from: 2024-01-30 Created: 2024-01-30 Last updated: 2024-10-25Bibliographically approved
3. Embodied navigation: the influence of lived experience on physical activity and sedentary behavior among older adults
Open this publication in new window or tab >>Embodied navigation: the influence of lived experience on physical activity and sedentary behavior among older adults
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2024 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 19, no 1, article id 2313657Article in journal (Refereed) Published
Abstract [en]

PurposeThe impact of a sedentary lifestyle on health and well-being is well recognized. However, there is limited understanding of how a lifetime of physical activity and sedentary behaviour influences an active lifestyle in older adults. The aim of this study was to describe how lived experience of physical activity and sedentary behaviour impacts daily activities among older adults, from a life course perspective.MethodsQualitative content analysis was used; individual telephone interviews were conducted with fourteen older adults aged 71 to 92 years. The participants received initial support from community care and lived in ordinary housing in southern Sweden.ResultsThe interviews yielded one theme, “Navigating with an embodied activity compass,” and two sub-themes: “Being guided by the past” and “Unveiling pathways through body awareness.”ConclusionsOur study highlights how older adults’ lived experiences of physical activity, with their connections to body awareness and acceptance, impact daily physical activity. These findings offer new knowledge for clinical practitioners balancing recommendations of sedentary behaviour and physical activity, to promote healthy daily physical activity among older adults. Future research and policies should consider the lived experiences of older adults when addressing public health matters related to sedentary behaviour and physical activity.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2024
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing; Medicine, Gerontology
Identifiers
urn:nbn:se:lnu:diva-127765 (URN)10.1080/17482631.2024.2313657 (DOI)001161297400001 ()2-s2.0-85185205340 (Scopus ID)
Funder
Linnaeus University
Available from: 2024-02-14 Created: 2024-02-14 Last updated: 2024-10-25Bibliographically approved

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