Association between physical activity and sedentary behaviour and changes in intrinsic capacity in Spanish older adults (Seniors-ENRICA-2): a prospective population-based study

BACKGROUND: Intrinsic capacity-the composite of all the physical and mental capacities of an individual-has been proposed by WHO as a marker of healthy ageing. However, the association of movement behaviours (physical activity and sedentary behaviour) with intrinsic capacity remains largely unexplored. We aimed to prospectively analyse the association of movement behaviours with intrinsic capacity in older adults. METHODS: The Seniors-ENRICA-2 prospective, population-based study included a cohort of male and female community-dwelling older adults aged 65-94 years living in Spain. Accelerometer-based levels of sedentary, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) were assessed at baseline. An intrinsic capacity composite score (with higher scores indicating higher intrinsic capacity) was calculated at baseline and at two follow-up assessments across six domains: vitality (handgrip strength, appetite, and weight loss), cognition (Mini-Mental State Examination), psychological (Geriatric Depression Scale), locomotion (Short Physical Performance Battery), vision, and hearing. FINDINGS: Between Dec 2, 2015, and Nov 23, 2017, 3273 participants were recruited to the Seniors-ENRICA-2 study. 2477 (75·7%) of 3273 participants had complete data for movement behaviours and intrinsic capacity at baseline and were therefore included in the analyses. 1314 (53·0%) of 2477 participants were female and 1163 (47·0%) were male. 1463 (59·1%) of 2477 participants provided follow-up data over a median of 2·3 years (IQR 2·1 to 2·5) and 940 over 5·5 years (5·2 to 5·8). When analysed as a continuous variable, higher levels of MVPA (mean percentage change [MPC] per 15 min 0·63%, 95% CI 0·06 to 1·21), but not LPA (-0·39%,-0·85 to 0·07), were associated with improvements in intrinsic capacity during follow-up, whereas higher levels of sedentary behaviour were associated with declines in intrinsic capacity (-0·29%, -0·57 to -0·01). Analyses by tertiles of physical activity confirmed that the highest (MPC 4·83%, 95% CI 1·98 to 7·75) and intermediate (5·44%, 2·52 to 8·45) tertiles of MVPA were associated with improvements in intrinsic capacity compared with the lowest tertile. By contrast, compared with the highest tertile, the lowest (MPC 5·48%, 95% CI 2·88 to 8·02) and intermediate (5·73%, 3·16 to 8·22) tertiles of sedentary behaviour were associated with improvements in intrinsic capacity. INTERPRETATION: Sedentary behaviour was associated with a reduction of intrinsic capacity, and MVPA (but not LPA) was associated with an improvement in intrinsic capacity in older adults. Our findings support the importance of promoting physical activity and reducing sedentary behaviour for healthy ageing. FUNDING: Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation, French Agence Nationale de la Recherche, European Regional Development Fund/European Social Fund, Fondo de Investigaciones Sanitarias, the EU NextGenerationEU/Plan de Recuperación, and Transformación y Resiliencia.