Objective Physical Activity and Cardiovascular Health in Women Aged 80 and Older (OPACH80)

Title: Objective Physical Activity and Cardiovascular Health in Women Aged 80 and Older (OPACH80)

Principal Investigator: Michael LaMonte, PhD

Funding Agency: Fred Hutchinson Cancer Research Center / National Heart, Lung and Blood Institute (NHLBI)

Period: 09/01/11 - 06/30/15

Abstract: Women aged 80 and older are emerging as a critically important demographic group for public health and public policy. The U.S. Census estimates that 6.3 million women were aged 80 and older in 2009, 5% of the total female population and 2% of the entire U.S. population. By 2040, fueled by the aging of the baby boomers who will begin to reach the age of 80 in 2026, this group will be one of the fastest growing segments of the US population representing 8% of the female population and 4% of the total population. At age 65, women’s life expectancy is 20 years, but women who survive to age 85 still have a life expectancy of 7.2 years.

The 2008 Physical Activity Guidelines for Americans states that, “regular physical activity is essential for healthy aging” [PAGAC, 2008]. The guidelines recommend that older adults should avoid inactivity and should do at least 2.5 hours a week of moderate-intensity or 1.25 hours a week of vigorous-intensity aerobic physical activity for substantial health benefits including making "the heart stronger and fitter." Regrettably, only 19.2% of women ages 65 and older report regular leisure time physical activity and among minority older women the percentages are lower (10.4% of African American women and 14.7% of Latino or Hispanic women) [Federal Interagency Forum on Aging-related Statistics, 2008].

The great majority of postmenopausal women do not meet the recommended guidelines, regardless of age. Women aged 80 and older were absent or underrepresented in the evidence reviewed to derive these guidelines. Moreover, with the exception of walking, the moderate and vigorous physical activities queried on many self-reported questionnaires used in typical epidemiologic studies are not common among older women. The authors of the 2008 Physical Activity Guidelines for Americans acknowledge that there is a "...Notable lack of evidence for frequency, duration and intensity effects on hard cardiorespiratory health outcomes (cardiovascular disease (CVD), coronary heart disease (CHD) and stroke)." The latter statement pertained to all Americans, but is especially true for older women.

The purpose of this study is to address several major gaps in the research on the health benefits of physical activity for older women. With the exception of a doubly labeled water study with a sample size of 302 older adults [Manini et al, 2006], all major prospective cohort studies have measured physical activity by self-report. While self-report measures of physical activity are useful, they lack precision, often reflect over-reporting of activity, and provide only limited information on the details and patterns of physical activity. Moreover, the report of sedentary behavior is quite difficult. By using an accelerometer to collect more precise and complete data on physical activity in a large cohort of older women already being followed for incident cardiovascular events, this study can contribute crucial new evidence on how much, how vigorous and what patterns of physical activity are necessary to maintain cardiovascular health in later life.