Need to Revise Classification of Physical Activity Intensity in Older Adults? The Use of Estimated METs, Measured METs, and V̇O2 Reserve

Author:

Skjødt Mathias12ORCID,Tully Mark A3ORCID,Tsai Li-Tang4ORCID,Gejl Kasper Degn1,Ørtenblad Niels1,Jensen Kurt1,Koster Annemarie5ORCID,Visser Marjolein6ORCID,Andersen Marianne Skovsager7,Caserotti Paolo12

Affiliation:

1. Department of Sports Science and Clinical Biomechanics, University of Southern Denmark , Odense , Denmark

2. Center for Active and Healthy Ageing (CAHA), Department of Sports Science and Clinical Biomechanics, University of Southern Denmark , Odense , Denmark

3. School of Medicine, Ulster University , Londonderry , UK

4. Research Unit for ORL—Head and Neck Surgery and Audiology, Odense University Hospital & University of Southern Denmark , Odense , Denmark

5. Department of Social Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University , Maastricht , The Netherlands

6. Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam , Amsterdam , The Netherlands

7. Department of Endocrinology, Odense University Hospital, University of Southern Denmark , Odense , Denmark

Abstract

Abstract Background Multiples of resting metabolic rate (RMR) are often used to classify physical activity intensity, a concept known as the metabolic equivalent of task (MET). However, the METs metrics may misclassify physical activity intensity in older adults because of age-related changes in RMR and maximal aerobic capacity (V˙O2max). This study aimed to (i) compare classifications of activity intensity by estimated (METsestimated) and measured (METsmeasured) METs and (ii) compare physical activity classified by absolute (METsmeasured) versus relative intensity (%V˙O2Reserve) in older adults. Methods Ninety-eight adults aged 75–90 years participated in the study. RMR and V˙O2 during sitting, standing, daily activities, and 6-minute walking test were measured. V˙O2Reserve was defined as the difference between V˙O2max and RMR. Moderate and vigorous intensity was classified as 3 and 6 METs and 40% and 60% of V˙O2Reserve, respectively. Paired t tests and a confusion matrix were used to investigate aims 1 and 2, respectively. Results METsmeasured was 24% lower than the standard 1 MET of 3.5 mL O2·min−1·kg−1. METsestimated underestimated the intensity during daily and walking activities when compared to METsmeasured. Nevertheless, when comparing METsmeasured to percentages of V˙O2Reserve, a mismatch was shown for moderate intensity in 47%–67% of the participants during daily activities and 21% of the participants during self-selected gait speed. Conclusions Applying METsestimated for older adults leads to potential underestimation of physical activity intensity, suggesting that current classification metrics should be revised for older adults. V˙O2Reserve is a candidate metric for establishing precise physical activity intensity cut points for older adults. Clinical Trials Registration Number: NCT04821713

Funder

National Institutes of Health

Publisher

Oxford University Press (OUP)

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