Skip to main navigation menu Skip to main content Skip to site footer

Original article

Vol. 150 No. 2526 (2020)

Patterns of cross-sectional and predictive physical activity in Swiss adults aged 52+: results from the SAPALDIA cohort

Cite this as:
Swiss Med Wkly. 2020;150:w20266



Non-communicable diseases (NCDs) account for the vast majority of deaths in Switzerland. Insufficient physical activity (PA) is an established NCD risk factor and PA is known to be beneficial for physical and mental wellbeing. Sedentary behaviour (SB) is an additional, independent risk factor and associated with frailty in older adults. This study aimed at describing cross-sectional PA patterns in a general population sample of subjects aged 52 years and older (52+) from eight areas across different language regions of Switzerland. Additionally, the predictive association of self-reported PA for objectively measured PA was tested.


Participants 52+ of the Swiss Cohort Study on Air Pollution And Lung and Heart Disease In Adults (SAPALDIA) who completed accelerometer data collection at the most recent follow-up (SAPALDIA4 in 2017/18) and provided information on determinants of interest (sex, age, body mass index [BMI], language region, education, employment status, civil status, smoking) were included in the analysis (n = 1314). The accelerometer-derived average time spent in different PA intensities (SB, light PA [LPA], moderate-to-vigorous PA [MVPA]) was estimated according to participant characteristics with control for season and wear time using multiple linear regressions. In further analyses, the predictive effect of changes in self-reported PA over roughly ten years between SAPALDIA2 (2001/02) and SAPALDIA3 (2010/11) (remaining inactive [RI]; becoming inactive [BI]; becoming active [BA]; remaining active [RA]) on the objectively measured SB, LPA and MVPA obtained seven years later by accelerometry (SAPALDIA4), was assessed using multiple linear regression models.


Overall, 21.7% of 52+ participants met the Swiss recommendations for subjectively assessed PA. Obese participants, 75+ year-olds, smokers and subjects living alone spent more time in SB and less time in LPA and MVPA compared with participants with a BMI below 25 kg/m2, between 52 and 64 years old, not smoking and being married, respectively. Residents living in the French-speaking part of Switzerland were less likely to engage in MVPA compared with residents from the German-speaking part and thus were less likely to meet the PA recommendations. A trend for increasing PA and decreasing SB was observed consistently across the four groups (RI, BI, BA, RA) of predictive self-reported PA patterns with participants remaining active over the course of roughly ten years showing highest levels of PA and lowest levels of SB measured objectively at SAPALDIA4.


The high proportion of SB points to the need of physical activity promotion for the older part of the population in Switzerland. According to our data, behavioural changes in PA are possible and sustainable as we can see in the group of participants becoming active and this is essential for health promotion recommendations.


  1. Institute for Health Metrics and Evaluation (IHME). GBD Compare. Seattle, WA: IHME, University of Washington; 2015. Available from:
  2. Gakidou E, Afshin A, Abajobir AA, Abate KH, Abbafati C, Abbas KM, et al.; GBD 2016 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1345–422. doi:.
  3. Bauman AE, Grunseit AC, Rangul V, Heitmann BL. Physical activity, obesity and mortality: does pattern of physical activity have stronger epidemiological associations? BMC Public Health. 2017;17(1):788. doi:.
  4. Demakakos P, Hamer M, Stamatakis E, Steptoe A. Low-intensity physical activity is associated with reduced risk of incident type 2 diabetes in older adults: evidence from the English Longitudinal Study of Ageing. Diabetologia. 2010;53(9):1877–85. doi:.
  5. Li J, Siegrist J. Physical activity and risk of cardiovascular disease--a meta-analysis of prospective cohort studies. Int J Environ Res Public Health. 2012;9(2):391–407. doi:.
  6. Garcia-Aymerich J, Lange P, Benet M, Schnohr P, Antó JM. Regular physical activity modifies smoking-related lung function decline and reduces risk of chronic obstructive pulmonary disease: a population-based cohort study. Am J Respir Crit Care Med. 2007;175(5):458–63. doi:.
  7. McDowell CP, Dishman RK, Vancampfort D, Hallgren M, Stubbs B, MacDonncha C, et al. Physical activity and generalized anxiety disorder: results from The Irish Longitudinal Study on Ageing (TILDA). Int J Epidemiol. 2018;47(5):1443–53. doi:.
  8. Ekelund U, Steene-Johannessen J, Brown WJ, Fagerland MW, Owen N, Powell KE, et al.; Lancet Physical Activity Series 2 Executive Committe; Lancet Sedentary Behaviour Working Group. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet. 2016;388(10051):1302–10. doi:.
  9. Peterson MJ, Giuliani C, Morey MC, Pieper CF, Evenson KR, Mercer V, et al.; Health, Aging and Body Composition Study Research Group. Physical activity as a preventative factor for frailty: the health, aging, and body composition study. J Gerontol A Biol Sci Med Sci. 2009;64A(1):61–8. doi:.
  10. Katzmarzyk PT, Church TS, Craig CL, Bouchard C. Sitting time and mortality from all causes, cardiovascular disease, and cancer. Med Sci Sports Exerc. 2009;41(5):998–1005. doi:.
  11. Chastin SFM, Buck C, Freiberger E, Murphy M, Brug J, Cardon G, et al.; DEDIPAC consortium. Systematic literature review of determinants of sedentary behaviour in older adults: a DEDIPAC study. Int J Behav Nutr Phys Act. 2015;12(1):127. doi:.
  12. Feng X, Croteau K, Kolt GS, Astell-Burt T. Does retirement mean more physical activity? A longitudinal study. BMC Public Health. 2016;16(1):605. doi:.
  13. Smith L, Gardner B, Fisher A, Hamer M. Patterns and correlates of physical activity behaviour over 10 years in older adults: prospective analyses from the English Longitudinal Study of Ageing. BMJ Open. 2015;5(4):e007423. doi:.
  14. Hills AP, Mokhtar N, Byrne NM. Assessment of physical activity and energy expenditure: an overview of objective measures. Front Nutr. 2014;1:5. doi:.
  15. Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants. Lancet Glob Health. 2018;6(10):e1077–86. doi:.
  16. McGuire S. Centers for Disease Control and Prevention. State indicator report on Physical Activity, 2014. Atlanta, GA: U.S. Department of Health and Human Services; 2014. Adv Nutr. 2014;5(6):762–3. doi:.
  17. Bundesamt für Statistik (BFS). Schweizerische Gesundheitsbefragung 2017 - Körperliche Aktivität und Gesundheit. Neuchâtel: Bundesamt für Statistik; 2019.
  18. Bundesamt für Statistik (BFS). Schweizerische Gesundheitsbefragung 2017 - Körperliche Aktivität: Bundesamt für Statistik (BFS); 2018 [cited 2020 March]. Available from:
  19. Health and Physical Activity Network Switzerland. Health-Enhancing Physical Activity in older Adults - Recommendations for Switzerland. Magglingen: Federal Office for Sports; 2013.
  20. Jefferis BJ, Sartini C, Lee IM, Choi M, Amuzu A, Gutierrez C, et al. Adherence to physical activity guidelines in older adults, using objectively measured physical activity in a population-based study. BMC Public Health. 2014;14(1):382. doi:.
  21. Kehler DS, Theou O. The impact of physical activity and sedentary behaviors on frailty levels. Mech Ageing Dev. 2019;180:29–41. doi:.
  22. Tudor-Locke C, Brashear MM, Johnson WD, Katzmarzyk PT. Accelerometer profiles of physical activity and inactivity in normal weight, overweight, and obese U.S. men and women. Int J Behav Nutr Phys Act. 2010;7(1):60. doi:.
  23. Faeh D, Minder C, Gutzwiller F, Bopp M ; Swiss National Cohort Study Group. Culture, risk factors and mortality: can Switzerland add missing pieces to the European puzzle? J Epidemiol Community Health. 2009;63(8):639–45. doi:.
  24. Martin BW, Ackermann-Liebrich U, Leuenberger P, Künzli N, Stutz EZ, Keller R, et al. SAPALDIA: methods and participation in the cross-sectional part of the Swiss Study on Air Pollution and Lung Diseases in Adults. Soz Praventivmed. 1997;42(2):67–84. doi:.
  25. ActiGraph LLC. User Guide: ActiGraph wGT3X-BT + ActiLife. 2019. Available from:
  26. Hansen BH, Kolle E, Steene-Johannessen J, Dalene KE, Ekelund U, Anderssen SA. Monitoring population levels of physical activity and sedentary time in Norway across the lifespan. Scand J Med Sci Sports. 2019;29(1):105–12. doi:.
  27. Troiano RP. Large-scale applications of accelerometers: new frontiers and new questions. Med Sci Sports Exerc. 2007;39(9):1501. doi:.
  28. Troiano RP, Berrigan D, Dodd KW, Mâsse LC, Tilert T, McDowell M. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008;40(1):181–8. doi:.
  29. US Department of Health and Human Services. Physical activity and health: a report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion; 1996. 292 p.
  30. Trost SG, McIver KL, Pate RR. Conducting accelerometer-based activity assessments in field-based research. Med Sci Sports Exerc. 2005;37(11, Suppl):S531–43. doi:.
  31. Wanner M, Probst-Hensch N, Kriemler S, Meier F, Autenrieth C, Martin BW. Validation of the long international physical activity questionnaire: Influence of age and language region. Prev Med Rep. 2016;3:250–6. doi:.
  32. Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95. doi:.
  33. Endes S, Schaffner E, Caviezel S, Dratva J, Autenrieth CS, Wanner M, et al. Long-term physical activity is associated with reduced arterial stiffness in older adults: longitudinal results of the SAPALDIA cohort study. Age Ageing. 2016;45(1):110–5. doi:.
  34. Kirkwood B, Sterne J. Essential Medical Statistics. Hoboken, NJ: Wiley; 2003. 516 p.
  35. Prince SA, Adamo KB, Hamel ME, Hardt J, Connor Gorber S, Tremblay M. A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review. Int J Behav Nutr Phys Act. 2008;5(1):56. doi:.
  36. Grimm EK, Swartz AM, Hart T, Miller NE, Strath SJ. Comparison of the IPAQ-Short Form and accelerometry predictions of physical activity in older adults. J Aging Phys Act. 2012;20(1):64–79. doi:.
  37. Bringolf-Isler B, Probst-Hensch N, Kayser B, Suggs S. Schlussbericht zur SOPHYA-Studie. Basel: Swiss Tropical and Public Health Institute; 2016.
  38. Slootmaker SM, Schuit AJ, Chinapaw MJ, Seidell JC, van Mechelen W. Disagreement in physical activity assessed by accelerometer and self-report in subgroups of age, gender, education and weight status. Int J Behav Nutr Phys Act. 2009;6(1):17. doi:.
  39. Baptista F, Santos DA, Silva AM, Mota J, Santos R, Vale S, et al. Prevalence of the Portuguese population attaining sufficient physical activity. Med Sci Sports Exerc. 2012;44(3):466–73. doi:.
  40. Luzak A, Heier M, Thorand B, Laxy M, Nowak D, Peters A, et al.; KORA-Study Group. Physical activity levels, duration pattern and adherence to WHO recommendations in German adults. PLoS One. 2017;12(2):e0172503. doi:.
  41. Hagströmer M, Oja P, Sjöström M. Physical activity and inactivity in an adult population assessed by accelerometry. Med Sci Sports Exerc. 2007;39(9):1502–8. doi:.
  42. Warburton DER, Bredin SSD. Health benefits of physical activity: a systematic review of current systematic reviews. Curr Opin Cardiol. 2017;32(5):541–56. doi:.
  43. Cooper AR, Page A, Fox KR, Misson J. Physical activity patterns in normal, overweight and obese individuals using minute-by-minute accelerometry. Eur J Clin Nutr. 2000;54(12):887–94. doi:.
  44. Wanner M, Martin BW, Autenrieth CS, Schaffner E, Meier F, Brombach C, et al. Associations between domains of physical activity, sitting time, and different measures of overweight and obesity. Prev Med Rep. 2016;3:177–84. doi:.
  45. Kaczynski AT, Manske SR, Mannell RC, Grewal K. Smoking and physical activity: a systematic review. Am J Health Behav. 2008;32(1):93–110. doi:.
  46. Papathanasiou G, Papandreou M, Galanos A, Kortianou E, Tsepis E, Kalfakakou V, et al. Smoking and physical activity interrelations in health science students. Is smoking associated with physical inactivity in young adults? Hellenic J Cardiol. 2012;53(1):17–25.
  47. Sattelmair J, Pertman J, Ding EL, Kohl HW, 3rd, Haskell W, Lee IM. Dose response between physical activity and risk of coronary heart disease: a meta-analysis. Circulation. 2011;124(7):789–95. doi:.
  48. Ambrose AF, Paul G, Hausdorff JM. Risk factors for falls among older adults: a review of the literature. Maturitas. 2013;75(1):51–61. doi:.
  49. Moschny A, Platen P, Klaassen-Mielke R, Trampisch U, Hinrichs T. Barriers to physical activity in older adults in Germany: a cross-sectional study. Int J Behav Nutr Phys Act. 2011;8(1):121. doi:.
  50. Lohne-Seiler H, Hansen BH, Kolle E, Anderssen SA. Accelerometer-determined physical activity and self-reported health in a population of older adults (65-85 years): a cross-sectional study. BMC Public Health. 2014;14(1):284. doi:.
  51. Alkerwi A, Schuh B, Sauvageot N, Zannad F, Olivier A, Guillaume M, et al. Adherence to physical activity recommendations and its associated factors: an interregional population-based study. J Public Health Res. 2015;4(1):406. doi:.
  52. Pettee KK, Brach JS, Kriska AM, Boudreau R, Richardson CR, Colbert LH, et al. Influence of marital status on physical activity levels among older adults. Med Sci Sports Exerc. 2006;38(3):541–6. doi:.
  53. Cobb LK, Godino JG, Selvin E, Kucharska-Newton A, Coresh J, Koton S. Spousal Influence on Physical Activity in Middle-Aged and Older Adults: The ARIC Study. Am J Epidemiol. 2016;183(5):444–51. doi:.
  54. Bedell G. Lonely people need local connections – don’t make a song and dance of it. The Guardian. 2018 October 16.
  55. Frei A, Dalla Lana K, Radtke T, Stone E, Knöpfli N, Puhan MA. A novel approach to increase physical activity in older adults in the community using citizen science: a mixed-methods study. Int J Public Health. 2019;64(5):669–78. doi:.
  56. Bringolf-Isler B, Mäder U, Dössegger A, Hofmann H, Puder JJ, Braun-Fahrländer C, et al. Regional differences of physical activity and sedentary behaviour in Swiss children are not explained by socio-demographics or the built environment. Int J Public Health. 2015;60(3):291–300. doi:.
  57. Leeger-Aschmann CS, Schmutz EA, Radtke T, Kakebeeke TH, Zysset AE, Messerli-Bürgy N, et al. Regional sociocultural differences as important correlate of physical activity and sedentary behaviour in Swiss preschool children. Swiss Med Wkly. 2016;146:w14377. doi:.
  58. Bringolf-Isler B, Grize L, Mäder U, Ruch N, Sennhauser FH, Braun-Fahrländer C ; SCARPOL team. Built environment, parents’ perception, and children’s vigorous outdoor play. Prev Med. 2010;50(5-6):251–6. doi:.
  59. Bringolf-Isler B, Grize L, Mäder U, Ruch N, Sennhauser FH, Braun-Fahrländer C ; SCARPOL team. Personal and environmental factors associated with active commuting to school in Switzerland. Prev Med. 2008;46(1):67–73. doi:.
  60. Directorate - General for Education Y. Sport and Culture (European Commission), Social TO. Sport and physical activity: report. 2018. Available from:
  61. Santos-Lozano A, Torres-Luque G, Marín PJ, Ruiz JR, Lucia A, Garatachea N. Intermonitor variability of GT3X accelerometer. Int J Sports Med. 2012;33(12):994–9. doi:.

Most read articles by the same author(s)