Recent research suggests that despite meeting the minimum physical activity recommendations, sitting for prolonged periods (i.e., sedentary behavior) can compromise the health of adults [
Sedentary behavior is defined as any waking behavior characterized by an energy expenditure ≤1.5 METs and a sitting or reclining posture [
Beyond the influence on health, sedentary behavior may also influence overall successful aging (SA); a term used to represent the physical, psychological, and social success with which adults age. The relationship between physical activity and SA is already well established [
Recent reports indicate that 69% of waking hours of middle-aged and older adults are spent performing sedentary activities [
The Healthy Aging cycle of the Canadian Community Health Survey (CCHS-HA) was used for the current analysis. The objective of the CCHS-HA is to provide information on SA, examine healthy aging from a multidisciplinary approach, examine the effects of lifestyle on age, and better understand the aging process in those aged 45 years and older. All data contained in this survey were self-reported and all participants provided informed consent prior to participation. The total sample size of the CCHS-HA is 30,865. For purposes of the current analysis the sample was restricted to those who had complete data for all variables of interest as outlined below (
SA variables were created for all three components of SA, that is, physical, psychological, and sociological. Young et al. [
The physical component of SA generally includes both the presence of chronic disease and functional impairments; however, Strawbridge et al. [
As per Young et al. [
Engagement with life, social support, and spirituality are the main variables used to assess the sociological component of SA. Unfortunately there were no data pertaining to spirituality in the CCHS-HA. Two variables were used to classify participants as aging successfully and aging poorly, sense of belonging to the local community and the loneliness scale. Sense of belonging was a single question that classified participants as very strong, somewhat strong, somewhat weak, or very weak. The loneliness scale was based on three items: lack of companionship, feeling left out, and feeling isolated. Participants responded with either hardly ever, sometimes, or often. These scores were summed to create the loneliness scale. Those who had a strong sense of belonging and a loneliness scale score of ≤6 were classified as aging successfully, all other were classified as aging poorly.
Those who were classified as aging successfully in the physical, psychological, and sociological domains were classified as aging successfully. All other were classified as aging poorly.
Unlike the other CCHS cycles, the CCHS-HA does not contain data on energy expenditure. The PA variable for the current analysis was therefore based on the number of hours the participant walked each week. Participants who spent 1 hour or more/day walking were classified as active, those who spent 30–60 minutes/day walking were classified as moderately active and those who spent <30 minutes/day walking were classified as inactive.
The number of hours spent sitting per day were used to classify participants as sedentary (4 hours or more/day), moderately sedentary (2–4 hours/day), or least sedentary (<2 hours/day).
Middle-aged adults were those between the ages of 45 and 64 years, and older adults were those between the ages of 65 years and more. The CCHS-HA public access file does not contain age as a continuous variable for maintenance of confidentiality; therefore these data are presented in categories. Participants were classified as male or female based on self-reported biological sex. Marital status was categorized as either married/common-law, widowed/separated/divorced, or single/never married. Income was used as a proxy for socioeconomic status and was categorized as <20,000, $20–39,000, $40–59,000, $60–79,000, or >$80,000. These covariates were chosen based on previous literature [
Pearson chi-square analyses and standardized adjusted residuals that denote deviations from a normal distribution were [
Sample characteristics are described in Table
Characteristics of the sample by age group and sex.
Older adults | Middle-aged adults | |||||||
---|---|---|---|---|---|---|---|---|
Both sexes | Males | Females | Both sexes | Males | Females | |||
|
9,478 | 4,245 | 5,233 | 10,060 | 4,621 | 5,439 | ||
65–69 y | 45–49 y | 26.9 | 30.1 | 24.5 | 26.6 | 25.1 | 28.0 | |
70–74 y | 50–54 y | 19.8 | 21.2 | 18.6 | 30.8 | 34.3 | 27.5 | |
Age | 75–79 y | 55–59 y | 17.2 | 16.9 | 17.4 | 22.2 | 20.9 | 23.4 |
80–84 y | 60–64 y | 12.8 | 9.9 | 15.0 | 20.4 | 19.6 | 21.0 | |
>80 y | 23.3 | 21.8 | 24.4 | |||||
| ||||||||
>$20,000 | 24.1 | 13.7 | 32.2 | 8.3* | 7.1* | 9.5* | ||
$20,000–39,000 | 37.8 | 37.9 | 37.7 | 13.4* | 11.3* | 15.4* | ||
Income | $40,000–59,000 | 18.3 | 21.3 | 15.9 | 17.2 | 15.5* | 18.9* | |
$60,000–79,000 | 8.9 | 11.1 | 7.2 | 18.6* | 18.6* | 18.7* | ||
>$80,000 | 10.9 | 16.0 | 7.0 | 42.4* | 47.5* | 37.5* | ||
| ||||||||
Married/common law | 48.7 | 67.0 | 34.4 | 74.9* | 78.3* | 71.8* | ||
Marital status | Widowed | 38.0 | 19.7 | 52.3 | 3.5* | 1.5* | 5.3* | |
Separated/divorced | 8.4 | 8.0 | 8.7 | 12.7* | 10.6* | 14.6* | ||
Single/never married | 4.9 | 5.2 | 4.6 | 8.9* | 9.6* | 8.3* | ||
| ||||||||
Active | 33.3 | 36.4 | 30.9 | 39.3* | 42.7* | 36.2* | ||
Physical activity levels | Moderately active | 35.3 | 35.6 | 35.2 | 37.9* | 35.7 | 40.1* | |
Inactive | 31.3 | 28.0 | 33.9 | 22.7* | 21.6* | 23.8* | ||
| ||||||||
Least sedentary | 14.9 | 15.7 | 14.3 | 25.2* | 25.6* | 24.9* | ||
Sedentary behaviour | Moderately sedentary | 33.8 | 34.4 | 33.3 | 34.0 | 33.2 | 34.7 | |
Sedentary | 51.3 | 49.9 | 52.4 | 40.8* | 41.2* | 40.4* | ||
| ||||||||
Overall SA | 56.8 | 58.0 | 55.8 | 56.9 | 58.1 | 55.6 | ||
Physical SA | 87.6 | 90.4 | 85.5 | 98.4* | 98.8* | 98.1* | ||
Psychological SA | 85.3 | 84.9 | 85.7 | 86.6 | 89.2* | 84.1 | ||
Sociological SA | 70.5 | 70.8 | 70.2 | 63.2* | 63.3* | 63.2* |
*significant differences between older and middle-aged adults within sex category.
All data are weighted unless otherwise stated.
All data are a percent of the sample.
Bivariate associations (Table
Bivariate associations of successful aging with physical activity and sedentary behaviour.
Older adults | Middle-aged adults | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Overall SA | Both sexes | Males | Females | Both sexes | Males | Females | |||||||
OR | CI | OR | CI | OR | CI | OR | CI | OR | CI | OR | CI | ||
Inactive | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | |
Physical activity | Moderately active | 1.60 | 1.36–1.89 | 1.34 | 1.08–1.57 | 1.39 | 1.16–1.67 | 1.37 | 1.20–1.56 | 1.34 | 1.08–1.57 | 1.39 | 1.16–1.67 |
Active | 1.69 | 1.43–1.99 | 1.30 | 1.08–1.57 | 1.58 | 1.31–1.90 | 1.44 | 1.27–1.65 | 1.30 | 1.08–1.57 | 1.58 | 1.31–1.90 | |
| |||||||||||||
Sedentary | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | |
Sedentary |
Moderately sedentary | 1.58 | 1.36–1.84 | 0.91 | 0.77–1.07 | 1.31 | 1.11–1.54 | 1.09 | 0.97–1.23 | 0.91 | 0.77–1.07 | 1.31 | 1.11–1.54 |
Least sedentary | 1.60 | 1.31–1.95 | 1.22 | 1.02–1.46 | 1.63 | 1.36–1.94 | 1.41 | 1.24–1.61 | 1.22 | 1.02–1.46 | 1.63 | 1.36–1.94 | |
| |||||||||||||
Older adults | Middle-aged adults | ||||||||||||
Physical SA | Both sexes | Males | Females | Both sexes | Males | Females | |||||||
OR | CI | OR | CI | OR | CI | OR | CI | OR | CI | OR | CI | ||
| |||||||||||||
Inactive | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | |
Physical activity | Moderately active | 2.64 | 1.66–4.17 | 3.22 | 1.51–6.84 | 2.34 | 1.30–4.19 | 2.64 | 1.66–4.17 | 3.22 | 1.51–6.84 | 2.34 | 1.30–4.19 |
Active | 4.03 | 2.4–6.78 | 5.81 | 2.44–13.86 | 3.07 | 1.60–5.90 | 4.03 | 2.4–6.78 | 5.81 | 2.44–13.86 | 3.07 | 1.60–5.90 | |
| |||||||||||||
Sedentary | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | |
Sedentary |
Moderately sedentary | 1.91 | 1.20–3.05 | 2.83 | 1.19–6.73 | 1.61 | 0.92–2.82 | 1.91 | 1.20–3.05 | 2.83 | 1.19–6.73 | 1.61 | 0.92–2.82 |
Least sedentary | 2.61 | 1.45–4.68 | 1.90 | 0.83–4.34 | 3.44 | 1.48–7.97 | 2.61 | 1.45–4.68 | 1.90 | 0.83–4.34 | 3.44 | 1.48–7.97 | |
| |||||||||||||
Older adults | Middle-aged adults | ||||||||||||
Psychological SA | Both sexes | Males | Females | Both sexes | Males | Females | |||||||
OR | CI | OR | CI | OR | CI | OR | CI | OR | CI | OR | CI | ||
| |||||||||||||
Inactive | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | |
Physical activity | Moderately active | 1.47 | 1.23–1.75 | 1.30 | 0.98–1.72 | 1.59 | 1.27–200 | 1.47 | 1.23–1.75 | 1.30 | 0.98–1.72 | 1.59 | 1.27–200 |
Active | 2.18 | 1.81–2.63 | 2.13 | 1.58–2.86 | 2.13 | 1.66–2.72 | 2.18 | 1.81–2.63 | 2.13 | 1.58–2.86 | 2.13 | 1.66–2.72 | |
| |||||||||||||
Sedentary | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | |
Sedentary |
Moderately sedentary | 1.08 | 0.92–1.27 | 0.90 | 0.69–1.97 | 1.24 | 1.00–1.53 | 1.08 | 0.92–1.27 | 0.90 | 0.69–1.97 | 1.24 | 1.00–1.53 |
Least sedentary | 1.53 | 1.26–1.86 | 1.44 | 1.06–1.97 | 1.59 | 1.24–2.05 | 1.53 | 1.26–1.86 | 1.44 | 1.06–1.97 | 1.59 | 1.24–2.05 | |
| |||||||||||||
Older adults | Middle-aged adults | ||||||||||||
Sociological SA | Both sexes | Males | Females | Both sexes | Males | Females | |||||||
OR | CI | OR | CI | OR | CI | OR | CI | OR | CI | OR | CI | ||
| |||||||||||||
Inactive | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | |
Physical activity | Moderately active | 1.32 | 1.15–1.51 | 1.19 | 0.98–1.46 | 1.44 | 1.20–1.73 | 1.32 | 1.15–1.51 | 1.19 | 0.98–1.46 | 1.44 | 1.20–1.73 |
Active | 1.32 | 1.15–1.51 | 1.14 | 0.94–1.38 | 1.51 | 1.25–1.83 | 1.32 | 1.15–1.51 | 1.14 | 0.94–1.38 | 1.51 | 1.25–1.83 | |
| |||||||||||||
Sedentary | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | |
Sedentary |
Moderately sedentary | 1.03 | 0.92–1.16 | 0.89 | 0.75–1.05 | 1.19 | 1.01–1.41 | 1.03 | 0.92–1.16 | 0.89 | 0.75–1.05 | 1.19 | 1.01–1.41 |
Least sedentary | 1.37 | 1.20–1.56 | 1.25 | 1.03–1.51 | 1.50 | 1.24–1.80 | 1.37 | 1.20–1.56 | 1.25 | 1.03–1.51 | 1.50 | 1.24–1.80 |
SA: successful aging; OR: odds ratio; CI: confidence interval.
Regressions adjusted for age, income, and marital status showed similar trends as bivariate regression (Table
Adjusted regressions of successful aging with physical activity and sedentary behaviour.
Older adults | Middle-aged adults | ||||||||||||
Overall SA | Both sexes | Males | Females | Both sexes | Males | Females | |||||||
OR | CI | OR | CI | OR | CI | OR | CI | OR | CI | OR | CI | ||
| |||||||||||||
Inactive | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | |
Physical activity | Moderately active | 1.41* | 1.19–1.67 | 1.62* | 1.24–2.10 | 1.27* | 1.02–1.58 | 1.35* | 1.18–1.54 | 1.36* | 1.11–1.66 | 1.33* | 1.10–1.59 |
Active | 1.42* | 1.20–1.69 | 1.57* | 1.21–2.05 | 1.33* | 1.06–1.68 | 1.45* | 1.27–1.66 | 1.35* | 1.12–1.64 | 1.54* | 1.28–1.86 | |
| |||||||||||||
Sedentary | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | |
Sedentary |
Moderately sedentary | 1.38* | 1.12–1.69 | 1.36* | 1.08–1.72 | 1.49* | 1.22–1.83 | 1.08 | 0.96–1.21 | 0.90 | 0.76–1.07 | 1.27* | 1.08–1.50 |
Least sedentary | 1.43* | 1.23–1.67 | 1.20 | 0.88–1.62 | 1.56* | 1.18–2.07 | 1.43* | 1.25–1.63 | 1.23* | 1.01–1.48 | 1.65* | 1.37–1.98 | |
| |||||||||||||
Older adults | Middle-aged adults | ||||||||||||
Physical SA | Both sexes | Males | Females | Both sexes | Males | Females | |||||||
OR | CI | OR | CI | OR | CI | OR | CI | OR | CI | OR | CI | ||
| |||||||||||||
Inactive | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | |
Physical activity | Moderately active | 1.62* | 1.26–1.08 | 1.65* | 1.09–2.51 | 1.61* | 1.18–2.21 | 2.46* | 1.53–3.94 | 2.90* | 1.34–6.30 | 2.24* | 1.35–7.55 |
Active | 1.80* | 1.37–2.37 | 1.96* | 1.25–3.07 | 1.75* | 1.24–2.48 | 3.87* | 2.28–6.58 | 5.63* | 2.33–13.63 | 3.18* | 1.62–6.22 | |
| |||||||||||||
Sedentary | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | |
Sedentary |
Moderately sedentary | 1.75* | 1.37–2.24 | 1.85* | 1.22–2.79 | 1.69* | 1.24–2.31 | 1.68* | 1.04–2.72 | 2.28 | 0.93–5.56 | 1.50 | 0.84–2.66 |
Least sedentary | 2.44* | 1.64–3.65 | 2.48* | 1.28–4.79 | 2.45* | 1.47–4.07 | 2.15* | 1.18–3.92 | 1.27* | 0.54–3.02 | 3.20* | 1.62–6.22 | |
| |||||||||||||
Older adults | Middle-aged adults | ||||||||||||
Psychological SA | Both sexes | Males | Females | Both sexes | Males | Females | |||||||
OR | CI | OR | CI | OR | CI | OR | CI | OR | CI | OR | CI | ||
| |||||||||||||
Inactive | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | |
Physical activity | Moderately active | 1.53* | 1.22–1.91 | 1.96* | 1.40–2.76 | 1.26 | 0.93–1.70 | 1.40* | 1.17–1.68 | 1.27 | 0.95–1.71 | 1.46* | 1.15–1.85 |
Active | 1.74* | 1.37–2.21 | 2.47* | 1.73–3.54 | 1.33 | 0.96–1.83 | 2.16* | 1.78–2.63 | 2.29* | 1.69–3.12 | 2.03* | 1.58–2.62 | |
| |||||||||||||
Sedentary | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | |
Sedentary |
Moderately sedentary | 1.08 | 0.82–1.44 | 1.03 | 0.75–1.42 | 1.40* | 1.05–1.88 | 1.02 | 0.86–1.21 | 0.82 | 0.62–1.07 | 1.15 | 0.92–1.44 |
Least sedentary | 1.21 | 0.98–1.50 | 0.89 | 0.59–1.35 | 1.28 | 0.86–1.91 | 1.51* | 1.23–1.85 | 1.30* | 0.94–1.80 | 1.60* | 1.23–2.08 | |
| |||||||||||||
Older adults | Middle-aged adults | ||||||||||||
Sociological SA | Both sexes | Males | Females | Both sexes | Males | Females | |||||||
OR | CI | OR | CI | OR | CI | OR | CI | OR | CI | OR | CI | ||
| |||||||||||||
Inactive | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | |
Physical activity | Moderately active | 1.19* | 1.00–1.43 | 1.30 | 0.98–1.72 | 1.11 | 0.88–1.40 | 1.30* | 1.14–1.49 | 1.21 | 0.99–1.48 | 1.39* | 1.15–1.67 |
Active | 1.21* | 1.01–1.46 | 1.23 | 0.93–1.63 | 1.21 | 0.94–1.55 | 1.33* | 1.16–1.52 | 1.17 | 0.96–1.43 | 1.49* | 1.23–1.80 | |
| |||||||||||||
Sedentary | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | 1.00 | Ref. | |
Sedentary |
Moderately sedentary | 1.32* | 1.12–1.56 | 1.17 | 0.85–1.62 | 1.30* | 1.04–1.61 | 1.03 | 0.91–1.16 | 0.90 | 0.76–1.08 | 1.17 | 0.99–1.38 |
Least sedentary | 1.25* | 1.00–1.55 | 1.35* | 1.05–1.74 | 1.32 | 0.98–1.78 | 1.39* | 1.22–1.59 | 1.28* | 1.05–1.55 | 1.52* | 1.26–1.84 |
SA: successful aging; OR: odds ratio; CI: confidence interval.
Adjusted for age, marital status, and income.
Using a sample of middle-aged and older adults from the CCHS-HA, we analyzed the relationship of SA with physical activity and sedentary behavior. Similar to previous research, we found that physical activity is strongly related to SA and each of its components. The novel findings of this study pertain to the association between sedentary behavior and SA. Our primary finding is that sedentary behavior is associated with SA such that those who spend less time in sedentary activities are more likely to age successfully, regardless of their physical activity levels. Our secondary finding is that the relationship between the physical component of SA with physical activity and sedentary behavior was stronger and occurred in a dose-response manner. Finally, for the psychological and sociological components of SA, it seems that sedentary behavior lasting <2 hours/day is required for SA. The present study is one of the first to highlight the adverse role of sedentary behavior in SA. These findings have implications for the development of sedentary guidelines for middle-aged and older adults.
Our finding that there is a strong association between physical activity and SA was as expected based on research pertaining to physical activity and SA. A direct association between SA and physical activity was noted by Baker et al. [
Physical activity is an established determinant of SA [
In addition to a strong association between the physical component of SA and sedentary behavior, we also noted a dose-response relationship, that is, less time spent in sedentary activities was associated with higher odds of SA. In a recent review conducted on physical activity and functional limitations, a similar dose-response relationship was displayed such that those with higher levels of physical activity were less likely to develop functional limitations as compared to a sedentary group [
The possibility of a threshold for sedentary behavior was also observed for the psychological and sociological components of SA. Among older adults, the psychological component was not influenced by sedentary behavior whereas the sociological component was only influenced by sedentary behavior lasting less than two hours. Among the middle-aged adults, only those who were sedentary for less than two hours per day were more likely to age successfully, that is, those engaging in sedentary activities for 2–4 hours per day were not more likely to age successfully in these domains than those sedentary for 4 hours or more per day. In other words, less than two hours of sedentary activity per day may serve as a minimum duration (threshold) that must be achieved in order to age successfully in these two domains. This idea of a dose-dependent relationship or a threshold has been assessed in studies using physical inactivity and the psychological component of SA. Pietrelli et al. [
The current analysis has two limitations that are noteworthy. First, the CCHS-HA uses self-reported data; as such it is difficult to truly know how much time participants were spending in sedentary activities or being physically active. Therefore some participants may have been misclassified. Social desirability would dictate that physical activity was overreported and sedentary behavior was underreported. Given the broad categories used in the current analysis, it is less likely that such misclassification occurred. Second, the CCHS is a cross-sectional data set, so reverse causality cannot be ruled out. In other words, it cannot be said with certainty that sedentary behavior is causing poor outcomes as it is possible that poor outcomes are leading to sedentary lifestyles.
In conclusion, using a large database of middle-aged and older adults we found that similar to previous research, physical activity is strongly associated with SA. The novel finding of the current study is that sedentary behavior is significantly associated with lower odds of SA independent of physical activity levels, that is, sedentary behavior and physical activity may be independent risk factors for poor health among aging populations. We also found evidence for a dose-dependent relationship between sedentary behavior and each of the components of SA. Results of the present analysis are novel and have implications for the development of sedentary guidelines for middle-aged and older adults.