Sedentary behavior and health outcomes among older adults: a systematic review.
BACKGROUND
In the last decade, sedentary behavior has emerged as a new risk factor for health. The elderly spend most of their awake time in sedentary activities. Despite this high exposure, the impact of this sedentary behavior on the health of this population has not yet been reviewed. We systematically reviewed evidence for associations between sedentary behavior and multiple health outcomes in adults over 60 years of age.


METHODS
We searched the Medline, Embase, Web of Science, SPORTDiscus, PsycINFO, CINAHL, LILLACS, and Sedentary Research Database for observational studies published up to May 2013. Additionally, we contacted members of the Sedentary Behaviour Research Network to identify articles that were potentially eligible. After inclusion, the methodological quality of the evidence was assessed in each study.


RESULTS
We included 24 eligible articles in our systematic review, of which only 2 (8%) provided high-quality evidence. Greater sedentary time was related to an increased risk of all-cause mortality in the older adults. Some studies with a moderate quality of evidence indicated a relationship between sedentary behavior and metabolic syndrome, waist circumference, and overweightness/obesity. The findings for other outcomes such as mental health, renal cancer cells, and falls remain insufficient to draw conclusions.


CONCLUSIONS
This systematic review supports the relationship between sedentary behavior and mortality in older adults. Additional studies with high methodological quality are still needed to develop informed guidelines for addressing sedentary behavior in older adults.
Department of Preventive Medicine, University of São Paulo School of Medicine, Av, Dr Arnaldo 455 São Paulo, SP Brazil. lerezende@usp.br.
Leandro Fornias Machado
LF
de Rezende
Juan Pablo
JP
Rey-López
Victor Keihan Rodrigues
VK
Matsudo
Olinda
O
do Carmo Luiz
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D024821:Metabolic Syndrome / Q000209:etiology*; D009026:Mortality; D050177:Overweight / Q000209:etiology*; D012307:Risk Factors; D057185:Sedentary Behavior
D015415:Biomarkers