How Can We Support Older Adults To Be Less Sedentary?
Sedentary behaviour can be seen as any waking behaviour performed at very low intensities (≤1.5 METs) whilst seated or reclined. Common sedentary behaviours include watching, reading or computer use and sedentary behaviour can account for over half of the time we are awake.
Older adults are the fastest-growing segment of the world population, and with two-thirds of older adults sitting for approximately nine hours per day, they are also the most sedentary group in society. Excessive sitting time has been associated with physical health problems such as diabetes, high blood pressure, obesity and frailty. Furthermore, sedentary behaviour in older adults can impair social opportunities, social relationships and social wellbeing. Reports have estimated that sedentary behaviour in older adults directly accounts for £103 million annually, and indirectly accounts for £723 million through associations with other health conditions such as heart disease, stroke, cancer and diabetes in older adults. The importance of reducing sedentary behaviour in older adults has been highlighted by the UK Chief Medical Officers’ Physical Activity Guidelines, the NHS Long-term Plan for Ageing Well and the World Health Organisation.
As part of my PhD, I conducted a mixed-method review which explored the existing interventions to reduce sedentary behaviour in older adults, and the experiences of older adults with these interventions and general attitudes and understanding of sedentary behaviour. Evident from the quantitative aspect of this review was the importance of social support when attempting to reduce sedentary behaviour in community-dwelling older adults. Our actions and the language we use with older adults can contribute to their sedentary behaviour, and this social influence has the potential to be either beneficial or detrimental. Both will be discussed in turn, with recommendations provided on how we can assist older adults in reducing their sitting time.
A central theme that arose from the qualitative review was that loved ones can limit the activities of older adults under the guise of respect or protection. For example, an older relative announces that they’re going to make a cup of tea and before they can get up, a family member tells them to remain where they are and that they’ll make it for them. In doing so, we are reducing the opportunities for older adults to interrupt their sedentary behaviour. Similarly, common phrases such as ‘you shouldn’t do that’, ‘you might get hurt’ or ‘you might fall’ are said from a place of concern, but can limit older adults’ reduction of sedentary behaviour and perpetuate a belief that they are incapable of performing these tasks, effectively reducing their functional independence. We should be mindful of the language we use, avoiding terms with negative connotations such as ‘senior citizens’ or ‘age-appropriate’ behaviour, instead reframing the language we use to recognise that age does not determine ability.
Also evident from the qualitative review was the positive influences of social support when trying to reduce sedentary behaviour in this population. For example, older adults reported they valued when family members would visit, as they would be on their feet the entire day. Similarly, familial obligations such as minding grandchildren can help older adults feel socially valued, and helped mitigate the loss of role following the transition to retirement in older adulthood. Providing social support can be very valuable to older adults, as the social support network for older adults often decreases following events such as the bereavement of a spouse or friend. This reduced social support network can make it difficult for older adults to motivate themselves to partake in activities they enjoy. Older adults expressed that things we can do to help include accompanying them to an activity they enjoy to help them take that initial step, and following up with them afterwards to help them maintain motivation. Additionally, even just meeting with older adults for activities which are considered sedentary, such as going for a meal, involves a considerable reduction of sedentary behaviour (getting ready and commuting over) and socialising can provide mental health benefits to reduce cognitive decline.
Small changes to our actions and the language we use can help older adults feel supported and promote the reduction of sedentary behaviour.
This blog was written by Ragy Tadrous, PhD Student, Older people with frailty theme, Yorkshire and Humber ARC.
30 August 2022