Accelerometer-measured Physical Activity of Older Adults with Type 2 Diabetes: A scoping review (Preprint)

Abstract

Incorporating physical activity in lifestyle routines is recommended for individuals living with type 2 diabetes. Accelerometer devices offer a promising alternative to self-report methods for measuring physical activity performance. However, the extant literature for accelerometer-measured physical activity among middle-aged/older adults with chronic conditions is lacking.

We conducted a comprehensive scoping review of the literature to capture accelerometry methodologies in older adults with type 2 diabetes, specifically in relation to cutpoints that classify physical activity into intensity categories (sedentary, light, moderate, vigorous, very vigorous).

Applying the Joanna Briggs Institute’s methodology, we searched PubMed, Web of Science, EMBASE, and Engineering Village to identify studies that used research-grade accelerometers to objectively measure physical activity intensity levels of adults with type 2 diabetes using cutpoints in participant samples of mean age 50 years and older.

We identified 46 studies that met our inclusion criteria. The ActiGraph was the most popular accelerometer among researchers, and the Freedson (1998) and Troiano (2008) cutpoints were favored the most. The Lopes (2009) cutpoints were developed by calibrating the ActiGraph accelerometer in middle-aged and older adults with overweight/ obesity and type 2 diabetes. Several studies noted limitations of accelerometry use that could lead to an underestimation or inaccurate representation of physical activity for our population of interest. Limitations included decreased accuracy due to variation in device placement and underestimation of activity intensity attributed to using cutpoints in older adults with lower fitness levels that were originally validated with younger adults.

Considering the high variability among accelerometry methodologies, more work needs to be done to understand activity intensity cut-offs for populations with a high burden of chronic disease, older age, and suboptimal physical functioning.