Presenter:

Jennifer L. Copeland, University of Lethbridge, Canada

Co-presenters:

Shilpa Dogra, University of Ontario Institute of Technology, Canada
Olga Theou, Dalhousie University, Canada

Abstract

Aging is associated with increasing challenges to health and wellness, including greater risks for chronic disease, poor mobility, social isolation, and cognitive decline.  Effective strategies are needed to help older adults preserve functional capacity and maintain a healthy aging trajectory.  In this symposium, we propose a novel strategy to address this issue.  We suggest that limiting prolonged periods of passive sedentary time and increasing light to moderate intensities of physical activity is essential for active and healthy aging.  Facilitating movement in the community, in assisted-living environments, and in hospitals, enables older adults to engage in life and maintain their health.

Prolonged time spent in sedentary behaviours, such as watching TV, is associated with reduced mobility, impaired physical function, frailty, risk of falls, and lower quality of life.  Frequently breaking up sedentary time, even with low intensity movement, is associated with better health outcomes and better functional capacity.  Current evidence shows that reducing sedentary time by even just 1 hour per day and increasing the number of breaks in sedentary time by as little as 10 per day would have clinically meaningful effects on health and function among older adults.   While this sounds like a simple change, sedentary behavior is a challenging problem, as it is ubiquitous across multiple domains and is normal and even encouraged in many settings.  Furthermore, many sedentary activities, such as reading a book, or socializing with friends, are enjoyable and arguably, are necessary.  To produce meaningful, long-term change in daily activity levels, the physical, organizational and social environments must support and enable older adults to choose to disrupt prolonged periods of sitting.

Throughout this symposium, the speakers will draw on evidence from community, assisted living, and hospital- based research to build a case for the importance of targeting sedentary behaviour as a modifiable determinant of health and quality of life among older adults.  We will explore novel strategies for reducing sedentary behavior in each of these different settings.

Presenter #1: Shilpa Dogra
Transportation is one of the eight dimensions in the World Health Organization handbook on Age-Friendly Communities.  However, the emphasis in this handbook is on public transportation, and fails to ignore the impact of other forms of transportation on the health and well-being of older adults.  Active transportation may be a particularly important mode of transportation for older adults as it provides the benefits of increased physical activity and reduced sedentary time.  While there are many constraints to engaging in active transportation, many of these constraints can be removed with appropriate infrastructure and age-friendly municipal policies.  The emphasis of this talk will be on the critical role that sustainable transportation plays in creating age-friendly communities, and the various impacts that accessible and inclusive forms of transportation can have on the social, cognitive, and physical health of older adults.  Data from mixed-methods studies and from an urban mobility summit will be presented to support the need for a broader approach to age-friendly transportation.  The speaker will address the implications of her research for the design of age-friendly communities that encourage active aging, and for policies that can enable this.

Presenter #2: Jennifer Copeland
Greater numbers of older adults living with chronic conditions and functional limitations means more people are seeking alternative housing options.  Assisted living allows older adults to maintain independence but provide assistance with activities of daily living.  Thus, older adults who transition to assisted living (AL) often have little need to engage in light-intensity or standing activities such as cleaning or meal preparation and as a result, they accumulate more sedentary time and less time standing and moving compared to older adults who live independently.  Unfortunately, this “low movement” environment can hasten functional decline.  This presentation will discuss the potential benefits and challenges of reducing sedentary time among residents in AL.  Stand When You Can (SWYC) is a novel intervention to reduce sedentary time in AL, developed in consultation with residents and staff.  It was designed to target change at individual, social, organizational, and environmental levels and produce a shift in habits without the need for additional staff.  A preliminary feasibility trial in two AL residences showed that SWYC is acceptable and practical; further study is warranted.  Maintaining health and function during the transition to assisted living will improve quality of life and delay the need for more intensive residential care.

Presenter #3: Olga Theou
The risk from high sedentary time is profound in hospitalized older patients who make up approximately half of all hospitalized patients.  During hospitalization, older adults are at risk for longer length of stay, greater hospital readmission rates, disability, and mortality.  These adverse outcomes appear to be related to the high levels of sedentary time among hospitalized patients.  During hospitalization, many older patients spend most of their time sedentary.  Even patients who can walk independently are highly sedentary and experience an increase in their sedentary time during hospitalization.  Health and environmental factors are main barriers associated with sedentary behaviours within hospital settings.  Reducing sedentary behaviours may allow older inpatients to recover faster and improve health outcomes during and post-hospitalization.  This presentation will summarize how to assess sedentary behaviours within clinical settings including hospitals, describe how sedentary older hospitalized patients are, and discuss how sedentary time can be reduced within clinical settings.