Vol.:(0123456789) 1 3
Quality of Life Research
https://doi.org/10.1007/s11136-019-02252-3
Does fitness attenuate the relationship between changes
in sitting time and health‑related quality of life over time
in community‑dwelling older adults? Evidence from the EXERNET
multicenter longitudinal study
O. López‑Torres
1,12
· B. del Pozo‑Cruz
2
· B. Maroto‑Sánchez
1
· S. Vila‑Maldonado
3,4
· A. Gómez‑Cabello
4,5,6,7,8
·
M. Martín‑García
3
· A. González‑Agüero
6,7,8,9
· N. Gusi
4,10
· L. Espino
4,11
· J. A. Casajús
6,7,8
· M. González‑Gross
1,8
·
I. Ara
3,4
· R. Pedrero‑Chamizo
1
Accepted: 21 July 2019
© Springer Nature Switzerland AG 2019
Abstract
Objective To assess the relationship between fitness levels and components, sitting time and health-related quality of life
(HRQoL), over time among community-dwelling older adults.
Methods Three different sitting trajectories were calculated: (i) no change; (ii) decrease; and (iii) increase in ST, between
baseline and follow-up. Fitness was assessed using the aerobic capacity, upper and lower limb strength, and total fitness.
Participants were classified into higher (75th percentile or above) or lower (below 75th percentile) fitness levels, using the
fitness tests. HRQoL scores at follow-up were compared to the three different sitting time trajectories within and across both
the higher and the lower fitness groups for each of the three fitness indexes.
Results Greater HRQoL scores were observed in those participants that decreased their ST as compared with those increas-
ing their sitting time over time for participants classified in the lower end of their aerobic capacity or total fitness index. No
differences were detected in HRQoL scores in people classified in the higher fitness level group for any of the fitness indexes.
Participants that increased or did not change their sitting time and who were classified in the higher fitness end of aerobic
capacity and total fitness index self-reported higher HRQoL scores when compared with those in the lower fitness end.
Conclusion Increased sitting time over time is associated with poorer HRQoL in older adults. Higher fitness levels could
help attenuate the negative impact of sitting over time.
Keywords Physical condition · Sedentary behavior · Well being · Elderly
Introduction
Health-related quality of life (HRQoL) is a multi-dimen-
sional construct that reflects the self-perception of the
impact of health status on the quality of life of an individual
[1]. Clinicians and public health officials have used HRQoL
to measure the effects of chronic diseases, treatment, and
disability. In addition, HRQoL has been used to monitor the
general health at population level or as a key measurement
in the planning and decision-making processes of health-
related policies [2, 3]. With an increasing aging popula-
tion, and the associated rises of chronic diseases and costs,
improving HRQoL is a priority [4].
There is now compelling experimental evidence [5, 6],
reviews and meta-analyses [7] providing solid arguments
that physical activity [8, 9], most likely through physical fit-
ness [10, 11], is a cost-effective health strategy in improving
the HRQoL of the older population [12]. Nonetheless, physi-
cal activity levels and physical fitness levels are worryingly
low among the older population in Spain [13].
On the other hand, sedentary behaviors, a group of wak-
ing behaviors characterized by very low energy expenditure
that occur while sitting or lying down, in combination with
the lack of moderate-to-vigorous physical activity (MVPA),
O. López-Torres and B. del Pozo-Cruz contributed equally to this
work.
* O. López-Torres
olga.lopez@upm.es
Extended author information available on the last page of the article