Longitudinal association of physical activity and sedentary behavior during leisure time with health-related quality of life in community-dwelling older adults

Background: Evidence on the relation between leisure-time physical activity (LTPA) and health-related quality of life (HRQoL) in older adults is based primarily on clinical trials of physical exercise programs in institutionalized persons and on cross-sectional studies of community-dwelling persons. Moreover, there is no evidence on whether leisure-time sedentary behavior (LTSB) is associated with HRQoL independently of LTPA. This study examined the longitudinal association between LTPA, LTSB, and HRQoL in older community-dwelling adults in Spain. Methods: Prospective cohort study of 1,097 persons aged 62 and over. In 2003 LTPA in MET-hr/week was measured with a validated questionnaire, and LTSB was estimated by the number of sitting hours per week. In 2009 HRQoL was measured with the SF-36 questionnaire. Analyses were done with linear regression and adjusted for the main confounders. Results: Compared with those who did no LTPA, subjects in the upper quartile of LTPA had better scores on the SF-36 scales of physical functioning (beta 5.65; 95% confidence interval [CI] 1.32-9.98; p linear trend < 0.001), physical role (beta 7.38; 95% CI 0.16-14.93; p linear trend < 0.001), bodily pain (beta 6.92; 95% CI 1.86-11.98; p linear trend < 0.01), vitality (beta 5.09; 95% CI 0.76-9.41; p linear trend < 0.004) social functioning (beta 7.83; 95% CI 2.89-12.75; p linear trend < 0.001), emotional role (beta 8.59; 95% CI 1.97-15.21; p linear trend < 0.02) and mental health (beta 4.20; 95% CI 0.26-8.13; p linear trend < 0.06). As suggested by previous work in this field, these associations were clinically relevant because the beta regression coefficients were higher than 3 points. Finally, the number of sitting hours showed a gradual and inverse relation with the scores on most of the SF-36 scales, which was also clinically relevant. Conclusions: Greater LTPA and less LTSB were independently associated with better long-term HRQoL in older adults.