Sedentary behavior, physical activity, and mental health in older adults: An isotemporal substitution model

Mark A. Tully, Ilona McMullan, Nicole E. Blackburn, Jason J. Wilson, Brendan Bunting, Lee Smith, Frank Kee, Manuela Deidda, Maria Giné-Garriga, Laura Coll-Planas, Dhayana Dallmeier, Michael Denkinger, Dietrich Rothenbacher, Paolo Caserotti

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Introduction Regular moderate-to-vigorous physical activity (MVPA) is associated with improved mental health, but the evidence for the effect of reducing sedentary behavior (SB) or increasing light PA (LPA) in older adults is lacking. Using isotemporal substitution (IS) models, the aim of this paper was to investigate the effect of substituting SB with LPA or MVPA on associations with mental health in older adults. 

Methods Data from 1360 older adults (mean age 75.18 years) in four countries were utilized. PA and SB was measured using ActiGraph wGT3X-BT + accelerometers worn for 7 days. Self-rated mental health was measured using the Hospital and Anxiety Depression Scale (HADS). IS models estimated cross-sectional associations when 30 minutes of one behavior was substituted with another. Models were adjusted for age, sex, marital status, and educational attainment. 

Results Substituting 30 minutes of SB with LPA (β −.37; 95% CI −0.42, −0.32) or MVPA (β −.14; 95% CI −0.21, −0.07) and substituting LPA with MVPA (β −.11; 95% CI −0.18, −0.04) were associated with improvements in anxiety. However, substituting 30 minutes of SB with LPA (β.55; 95% CI 0.49, 0.62) was associated with increased depression. 

Conclusion Replacing 30 minutes of SB with LPA or MVPA was associated with improved anxiety symptoms in older adults. Greater benefits were observed when shifting SB and LPA to MVPA.

Original languageEnglish
Pages (from-to)1957-1965
Number of pages9
JournalScandinavian Journal of Medicine and Science in Sports
Issue number10
Early online date9 Jul 2020
Publication statusPublished (in print/issue) - 1 Oct 2020

Bibliographical note

Funding Information:
The authors wish to express their appreciation for all those who volunteered for this study and Mrs Nicky Laird for her administrative support. We also thank the Northern Ireland Clinical Research Facility and the Municipality of Odense for facilitating the assessments in the United Kingdom and Danish site, respectively. The work described in this publication was part of the SITLESS project, and supported and funded by the European Union program Horizon 2020 (H2020-Grant 634270).

Publisher Copyright:
© 2020 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd

Copyright 2020 Elsevier B.V., All rights reserved.


  • isotemporal
  • light physical activity
  • mental health
  • moderate-vigorous physical activity
  • older adults


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