Validity of a brief physical activity questionnaire against accelerometry in community-dwelling older adults in Greece

WHO’s Global Action Plan on Physical Activity policy recommendations include incorporating physical activity (PA) promotion in health and social services and prioritising programs for the least active, such as older adults. Easy-to-use and valid PA assessment tools are needed in this process. The General Practice Physical Activity Questionnaire (GPPAQ) is used in primary care in the UK to identify insufficiently active individuals 16-74 years, who may benefit from a brief PA promotion intervention. The GPPAQ classifies individuals as Active based on their occupational activity, physical exercise and cycling, but does not include walking in score calculation. It has not been validated for adults over 75 years. The present study aimed to assess the validity of GPPAQ and a modified version, GPPAQ-Old, which includes walking in score calculation, in a Greek sample of adults 65-90 years. The tool was translated in Greek using a standard procedure. GPPAQ and GPPAQ-Old Active/ non-Active classification was compared against meeting/not meeting the guidelines of ≥150min/week of moderate-to-vigorous PA (MVPA), accelerometer-measured. Sensitivity and specificity were calculated using a 2×2 table with accelerometer-measured MVPA as criterion. A total of 97 retired adults, mean age 73.67 ± 5.90, 82.7% women, from urban and rural areas in municipality of Rodopi, Greece, wore Actigraph accelerometers for a week and subsequently completed the GPPAQ. Based on accelerometry, 88.7% participants met the MVPA guidelines. 4.1% were classified as Active by GPPAQ and 62.9% by GPPAQ-Old. Sensitivity was 4.5% and specificity 100% for GPPAQ, 62.5% and 33.3% for GPPAQ-Old. GPPAQ showed very poor sensitivity and excellent specificity, whereas GPPAQ-Old showed good sensitivity, but poor specificity. Similar results are common when self-report PA and accelerometry are compared. GPPAQ-Old can correctly identify 6 in 10 adults as sufficiently Active, but may miss 2 in 3 insufficiently Active. It also offers insight on PA types older adults engage in their daily life. Results may be influenced by the highly active sample (only 11.3% din not meet MVPA guidelines).

A.M. Kanavaki, M. Michalopoulou, V. Gourgoulis, Ε. Kouli, Α. Gkrekidis, Η.Τ. Douda, Ι. Smilios, G. Syrakoulis, Ν., Aggelousis