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Physical activity in community-dwelling older adults: which real-world accelerometry measures are robust? A systematic review

Lookup NU author(s): Dr Ríona McArdle, Dr Silvia Del DinORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Measurement of real-world physical activity (PA) data using accelerometry in older adults is informative and relevant but not without challenges. This review appraises the reliability and validity of accelerometry-based PA measures of older adults collected in real-world conditions. Eight electronic databases were systematically searched, with 13 manuscripts included. Intraclass correlation coefficient (ICC) for inter-rater reliability were: walking duration (0.94 to 0.95), lying duration (0.98 to 0.99), sitting duration (0.78 to 0.99) and standing duration (0.98 to 0.99). ICCs for relative reliability ranged from 0.24 to 0.82 for step counts and 0.48 to 0.86 for active calories. Absolute reliability ranged from 5,864 to 10,832 steps and for active calories from 289 to 597 kcal. ICCs for responsiveness for step count were 0.02 to 0.41, and for active calories 0.07 to 0.93. Criterion validity for step count ranged from 0.83 to 0.98. Percentage of agreement for walking ranged from 63.6% to 94.5%; for lying 35.6% to 100%, sitting 79.2% to 100%, and standing 38.6% to 96.1%. Construct validity between step count and criteria for moderate-to-vigorous PA was rs = 0.68 and 0.72. Inter-rater reliability and criterion validity for walking, lying, sitting and standing duration are established. Criterion validity of step count is also established. Clinicians and researchers may use these measures with a limited degree of confidence. Further work is required to establish these properties and to extend the repertoire of PA measures beyond ‘volume’ counts to include more nuanced outcomes such as intensity of movement and duration of postural transitions.

Publication metadata

Author(s): Jabbar KA, Mc Ardle R, Lord S, Kerse N, Del Din S, Teh R

Publication type: Article

Publication status: Published

Journal: Sensors

Year: 2023

Volume: 23

Issue: 17

Print publication date: 01/09/2023

Online publication date: 02/09/2023

Acceptance date: 30/08/2023

Date deposited: 02/09/2023

ISSN (electronic): 1424-8220

Publisher: MDPI AG


DOI: 10.3390/s23177615


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Funder referenceFunder name
Ageing Well National Science Challenge, New Zealand
European Unions Horizon 2020
European Federation of Pharmaceutical Industries and Associations (EFPIA)
Innovative Medicines Initiative 2 Joint Undertaking
Innovative Medicines Initiative 2 Joint Undertaking (IMI2 JU)
National Institute for Health Research (NIHR) Newcastle Biomedical Research Centre (BRC)
NIHR/Wellcome Trust Clinical Research Facility (CRF)