Twenty-Year Trajectories of Physical Activity Types from Midlife to Old Age

Purpose Correlates of physical activity (PA) vary according to type. However, predictors of long-term patterns of PA types into old age are unknown. This study aimed to identify 20-year trajectories of PA types into old age and their predictors. Methods 7735 men (aged 40-59 years) recruited from UK towns in 1978–80 were followed up after 12, 16 and 20 years. Men reported participation in sport/exercise, recreational activity and walking, health status, lifestyle behaviours and socio-demographic characteristics. Group-based trajectory modelling (GBTM) identified the trajectories of PA types and associations with time-stable and time-varying covariates. Results Men with ≥3 measures of sport/exercise (n=5116), recreational activity (n=5085) and walking (n=5106) respectively were included in analyses. Three trajectory groups were identified for sport/exercise, four for recreational activity and three for walking. Poor health, obesity and smoking were associated with reduced odds of following a more favourable trajectory for all PA types. A range of socioeconomic, regional and lifestyle factors were also associated with PA trajectories but the magnitude and direction were specific to PA type. For example, men with manual occupations were less likely to follow a favourable sport/exercise trajectory but more likely to follow an increasing walking trajectory compared to men with non-manual occupations. Retirement was associated with increased PA but this was largely due to increased sport/exercise participation. Conclusion PA trajectories from middle to old age vary by activity type. The predictors of these trajectories and effects of major life events, such as retirement, are also specific to the type of PA. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Corresponding author: Daniel Aggio, d.aggio@ucl.ac.uk, +44 (0)207 830 2335, Department of Primary Care & Population Health, Institute of Epidemiology and Health Care, UCL Medical School, Royal Free Campus, Rowland Hill Street, London NW3 2PF UK The results of this study do not constitute endorsement by the American College of Sports Medicine, and the results of the study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. DA is funded by a British Heart Foundation PhD studentship (FS/15/70/32044). This research was also supported by an NIHR Post-Doctoral Fellowship awarded to BJJ (2010–03–023) and by a British Heart Foundation project grant (PG/13/86/30546) to BJJ. The British Regional Heart study is supported by a British Heart Foundation grant (RG/13/16/30528). Conflicts of interest: None to declare Accepted for Publication: 13 September 2018 © 2018 American College of Sports Medicine

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