Characterising patterns and changes in physical activity in older people and their determinants and consequences

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Non-communicable diseases such as diabetes, heart disease, cancer and mental health problems account for 60% of deaths globally. Poor diet and lack of physical activity play an important role in increasing the chance of developing these diseases. Physical inactivity is estimated to account for around 1 in 10 deaths worldwide, comparable to the impact of smoking. In the face of these statistics it would seem intuitive that everyone should strive to make individual choices to adopt an active lifestyle. However, we do not make such choices in isolation and our activity levels are believed to be driven as much by the broader social, cultural, economic and physical environment in which we live by as our personal knowledge, attitudes and beliefs.One of the main challenges that will face health services, and society, in the foreseeable future is the care of older people with limitations to their independent living. The promotion of physical activity among the middle-aged and elderly may make this challenge more manageable. Unfortunately, the majority of research on levels and patterns of physical activity, why some people are more active than others, and the links between physical activity and health outcomes has been undertaken among individuals less than 60 years of age, and has relied on imprecise questionnaire measures.Our existing collaboration of scientists includes expertise in a range of disciplines from Public Health and Epidemiology, Health Geography and Health Economics to Social and Behavioural Science. We have worked effectively together for several years as part of a national Public Health Centre of Excellence called CEDAR (Centre of Excellence in Diet and Activity Research). CEDAR is a collaboration between Medical Research Council (MRC) Units in Cambridge, the University of Cambridge, the University of East Anglia (UEA) and non-academic partners including the East of England Public Health Observatory (ERPHO). CEDAR researches the determinants of diet and activity at the population level and develops and evaluates potential preventive interventions (see http://www.cedar.iph.cam.ac.uk/).We have expertise in the causes of chronic disease, in physical activity and its measurement and in the development and evaluation of interventions to promote physical activity among individuals with or at high risk of disease. We also have access to a large population-based sample of older people participating in the EPIC-Norfolk study. In this project we will describe the levels and patterns of physical activity and also of sedentary behaviour (such as television viewing). We will study how these behaviours change over time using self-report and objective measures among volunteers in the EPIC-Norfolk study. We will also improve knowledge about the sorts of activities that might reduce risk of disease and be feasible for older people, the personal and environmental factors that influence physical activity in older people, and to what extent changes in physical activity might reduce disease risk and health service costs. These are important steps in developing interventions and policy to help populations adopt sustainable healthy behaviours.In order to achieve our aims we will use a range of quantitative and qualitative research methods within the context of a large ongoing study. The evidence we gather will help politicians, health professionals and society at large make better decisions about how to improve health for the whole population, whether it is through direct public health interventions, or wider ways that influence how we live. It will also help scientists and research funders to focus efforts into areas in which reducing uncertainty through further research would provide the greatest benefit.