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Assessing physical activity in the elderly: A comparative study of most

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 ORIGINAL ARTICLE

Trends in
Sport Sciences
2015; 3(22): 133-144
ISSN 2299-9590

Assessing physical activity in the elderly:

A comparative study of most popular questionnaires
MAGDALENA KRÓL-ZIELIŃSKA1, MONIKA CIEKOT2

Abstract 1
University School of Physical Education, Department of
Introduction. During assessing physical activity researchers Physical Activity Teaching, Poznań, Poland
often use self-reported methods which may not meet 2
University School of Physical Education, Department of
psychometric standards and can lead to false results due to the Athletics, Poznań, Poland
application of inaccurate or wrongly chosen tools. Aim of Study.
The aim of this paper was to compile a list of most popular
questionnaires used for assessing physical activity among the What is already known on this topic?
elderly and to examine their qualitative and psychometric Measurements of physical activity are usually
characteristics. Methods. An analysis of articles published
carried out using various types of questionnaires
in international scientific journals on the topic of physical
or interviews. There are many questionnaires
activity assessment among elderly people was performed
in order to select reliable and valid questionnaires. Results. assessing physical activity of the elderly which
Twenty-one papers containing information on psychometric are objective and standardized, but researchers
criteria of eleven questionnaires were analyzed. The majority still often use self-reported methods which do not
of reliability and validity studies were performed on the PASE meet psychometric standards. The use of methods
and YPAS questionnaires. In terms of objectivity, the best ones with no validity and reliability indices may, in
turned out to be the CHAMPS, IPAQ, PAQE, PASE, and YPAS consequence, lead to false results.
questionnaires. The highest reliability assessment scores were
given to the APAFOP, PAR, PAQE, and QAPSE questionnaires.
The best validation scores with objective methods assessing
physical activity were carried out for the APAFOP, PAQE, Introduction
PASE, and YPAS questionnaires. Conclusions. Among the
analyzed questionnaires, the best one in terms of objectivity,
standardization, validity, and reliability was the Yale Physical
I n the last decades, the relationship between physical
activity and health has been well documented. Study
results of elderly people who engaged in any kind of
Activity Survey (YPAS). moderate or high intensity physical activity confirmed
the role of physical activity in the prevention of
KEYWORDS: physical activity, elderly, reproducibility of
coronary heart disease [1, 2], heart attack [3, 4], and
results, questionnaires. 
respiratory diseases [5]. Profuse evidence was offered
to substantiate the importance of physical activity in
Received: 7 July 2015 maintaining one’s proper body weight [6, 7]. Research
Accepted: 22 August 2015 results concerning the influence of physical activity on
body composition confirmed its beneficial impact on
Corresponding author: [email protected]
obesity prevention and treatment [8] and on maintaining
normal cholesterol values [9]. It has been corroborated

Vol. 3(22) TRENDS IN SPORT SCIENCES 133

 KRÓL-ZIELIŃSKA, CIEKOT

that physical activity may improve stability and reduce questionnaires, and quantity questionnaires.
the risk of bone fractures related to falls [10]. It has Physical activity is most frequently measured with
also been proven that physical activity helps prevent questionnaires or structured interviews.
bone density reduction in elderly people [11] and It has been observed that when assessing physical
reduce the risk of osteoporosis [12]. Existing research activity researchers often used the self-reported
confirms the beneficial effects of physical activity on methods, which did not meet psychometric standards
maintaining or improving physical fitness, and as a [31]. Scientists frequently assume that a used method
result, the functional fitness of elderly people [13-17]. is reliable, which consequently may lead to presenting
Aging entails biological, psychological, and social false results due to the application of inaccurate or
changes, which cause specific discomforts leading to wrongly chosen tools. When commencing scientific
depressive disorders. Research shows that depression studies, researchers require information on the
symptoms are more frequent in people who do not psychometric indices of a given method or measuring
undertake or rarely undertake physical activity than tool.
in physically active people, even several years after Questionnaires assessing physical activity are easily
the assessment [18-20]. Physical activity may reduce accessible and non-invasive research methods.
anxiety and depression symptoms [21, 22], and those However, similarly to the objective methods, they
effects may remain for a long period [23]. should produce reliable and valid results and comply
Even though the beneficial effects of frequent with the test criteria, which by definition constitute
physical activity are broadly documented, most an objective and standardized measurement of an
elderly people do not undertake sufficient physical individual’s behavior [32]. A subjective assessment of
activity. This is shown by data from government physical activity is expected, just as any psychological
reports from different countries. As many as 65% test, to meet certain formal criteria, called goodness
of elderly Americans [24], 65% of Canadian men criteria, such as objectivity, standardization,
and 50% of Canadian women do not undertake the reliability, and normalization, and, if necessary,
recommended dose of physical activity [25]. The adaptation.
situation is similar in 47% of elderly Australians If the formal criteria of an assessment method are
[26], 30% of elderly South Africans [27], 35% of weak, than the risk of fallacious reasoning is very
senior citizens of Austria, Belgium, Denmark, high. As it can be surmised from a survey of studies by
Finland, France, Greece, Spain, the Netherlands, Jørstad-Stein et al. [33], the knowledge of assessment
Ireland, Luxembourg, Germany, Portugal, Sweden, features was not utilized during the construction of the
the UK, Italy [28], and 49% of elderly Poles [29]. questionnaires assessing physical activity among the
Studies examining the determinants for undertaking elderly. Among the questionnaires published between
physical activity among the elderly and formulating 1966 and 2003, none met all the formal criteria of
theoretical bases for interventions aimed at promoting an assessment method. Forsén et al. [34] reviewed
a healthy lifestyle require reliable physical activity 13 questionnaires and only three received positive
measurements. According to Welk et al. [30] the recommendations, i.e. International Physical Activity
development of methods and techniques assessing Questionnaire-Chinese (IPAQ-C), Women’s Health
physical activity is one of priorities of kinesiology Initiative-PAQ (WHI-PAQ), and Physical Activity
studies. However, a reliable and valid physical activity Scale for the Elderly (PASE). The authors of both
assessment is difficult to achieve. Objective methods publications point to a constant need for validation
of assessing physical activity are costly and difficult studies of questionnaires used for physical activity
to carry out in a wider population, especially among assessment, especially those concerning the elderly
the elderly. In turn, subjective methods of assessment population.
do not require complicated technical equipment,
are not a burden for the study population and – as Aim of Study
a result – do not affect the population’s behavior. The aim of this paper was to compile a list of most
Subjective methods of assessing physical activity popular questionnaires used for assessing physical
include direct and indirect observation, interviews, activity among the elderly and to examine their
journals, protocols, general questionnaires, recall qualitative and psychometric characteristics.

134 TRENDS IN SPORT SCIENCES September 2015

Assessing physical activity in the elderly: A comparative study of most popular questionnaires

Material and Methods In terms of objectivity, the best questionnaires were

An analysis of international scientific journals on CHAMPS, IPAQ, PAQE, PASE, and YPAS. These
the topic of physical activity assessment among the questionnaires contain the precise instructions how
elderly was performed in order to select reliable and to fill them, and the procedure for calculation and
valid questionnaires. The search of the SPORTDiscus, interpretation of results. All of these questionnaires
MEDLINE, and Health Source – Consumer Edition were easy to understand. The PASE questionnaire
(until April 2013) databases was carried out following required the shortest time to fill. The IPAQ had the
the algorithm: SU (“motor activity*” OR “physical lowest number of items.
activity*” OR exercise*) AND SU (questionnaire* Access to properly designed research tools is important
OR test* OR scale* OR measure* OR method* OR for investigators, therefore we also checked the
assess*) AND SU (old* OR eld* OR aged OR aging) availability of the questionnaires. Full versions of
AND (psychometr* OR valid* OR reliab* OR norm* APAFOP, CHAMPS, PAQE, YPAS questionnaires
OR standard* OR objective*). Initially, 12,979 records can be found as attachments to papers demonstrating
were found and after limiting the search only to their theoretical assumptions [35, 39, 51]. IPAQ and
studies on people, the number of records was reduced PASE are available on the Internet. Access to the other
to 402. Articles concerning questionnaires measuring questionnaires can be obtained upon written request to
physical activity levels in English, French, Spanish, their authors or managing institutions.
and Chinese, and their adaptations were included in A review of scientific journals allowed us to collect
these databases. Next, using an analysis of abstracts, the results of studies by different authors on the
two independent reviewers excluded a number of reliability and validity of questionnaires assessing
articles on the grounds of some complex criteria. physical activity among the elderly. We considered the
Finally, papers and questionnaires in other languages methodology of assessing reliability and validity, and
than English targeted at people with certain diseases the obtained measures; time between the study and the
were excluded as well. repetition of the study; and the number of participants.
Particular questionnaires were subject to different
Results numbers of validation studies. We also considered the
The study results indicated 11 questionnaires from time from the publication of a given method, since the
among 21 papers, which were examined with respect longer a questionnaire was available, the better it was
to goodness criteria: Assessment of Physical Activity disseminated among the researchers.
in Frail Older People (APAFOP) [35], Community Our review of the databases showed that the most
Healthy Activities Model Program for Seniors studies on reliability and validity were performed for
(CHAMPS) [36-38], Physical Activity Questionnaire the YPAS [37, 40, 41, 46, 49, 51, 52] and PASE [37, 43,
for the Elderly: Modified Baecke Questionnaire for 44, 53, 54] questionnaires.
Older Adults (PAQE) [39, 40], 7-Day Physical Activity In all the studied questionnaires, reliability (overall
Recall (PAR) [41, 42], Physical Activity Scale for consistency of measurement) was tested with a test-
the Elderly (PASE) [37, 40, 43, 44], Questionnaire retest technique, which is based on performing an
d’Activite Physique Saint-Etienne (QAPSE) [45], The assessment twice on one study group at different
International Physical Activity Questionnaire (IPAQ) times. The time from the first test to the retest
[46], The International Physical Activity Questionnaire should be long enough, so that the study population
for the Elderly (IPAQ-E) [47], The Older Adult Exercise does not recall their answers given the first time.
Status Inventory (OA-ESI) [48], Yale Physical Activity However, the time between the two tests cannot be
Survey (YPAS) [37, 40, 41, 46, 49], and Zutphen too long, because the volume of physical activity
Physical Activity Questionnaire [40, 50]. might change substantially. The time between the
The examined qualitative features of each questionnaire test and the retest depends on the activity period
included the aim, target population, assessed areas of assessed by a given questionnaire. In order to assess
physical activity, number of items, completion time, weekly physical activity, the time between the test
and the interpretation of results. Table 1 summarizes and the retest can vary from one week to several
the qualitative features of the analyzed questionnaires. months [55].

Vol. 3(22) TRENDS IN SPORT SCIENCES 135

 Table 1. Quality characteristics of physical activity questionnaires for older adults

136
Target No. of Recall
Questionnaire Purpose Areas Time Mode of administration Scores
population items period
APAFOP to measure PA in older frail > 65 y walking, 24’±5’ interview 10 past MET
or impaired people outdoor, indoor, 24 h
sitting, lying, sport
CHAMPS to evaluate effectively 65–90 y exercise, household, 15’ self-administered, 41 typical wk MET
interventions to increase PA recreation interviewer-administered in the past summary
among older persons (by telephone or 4 wk frequency/wk
face to face)
PAQE to classify apparently healthy 60–83 y household, sport, 30’ interview 12 past PAQE
elderly people in a consistent leisure 1y activity score
way into extremes of the
distribution of PA
PAR to assess PA in older people 60–80 y household, leisure, ? interview ? past EE
occupation 7d (kcal x kg/d)
PASE to assess PA in large scale ≥ 65 y household, leisure, 5’ self-administered, 11 past PASE
epidemiologic studies where occupation interviewer-administered 7d activity score
limited time is available (by telephone or face to face)
QAPSE to provide a complete 65–84 y occupation, 20’–30’ self-administered, 35 1 wk EE (kJ/d)
measure of daily PA and leisure, household, interviewer-administered
daily EE in population of basic, moving,
elderly subjects sport
IPAQ for cross-cultural > 60 y moderate, ? self-administered, 7 past MET
surveillance to assess PA in vigorous, interviewer-administered 7d
a comparable manner walking (by telephone or
face to face)
KRÓL-ZIELIŃSKA, CIEKOT

IPAQ-E to classify old people into PA ≥ 65 y low, moderate, ? self-administered ? past moderate act. (min/d)

TRENDS IN SPORT SCIENCES

categories vigorous, walking 7d vigorous act. (min/d)
walking (min/d)
OA-ESI to capture information occupation, few self-administered 38 past MET
about PA patterns without 65–90 y leisure, sport min 7d total time (h/wk)
markedly increasing
respondent burden
YPAS to measure PA in 60–86 y household, 20’ interviewer- 36 typical wk total time (h/wk)
epidemiological studies yard work, administered in the past EE (kcal/wk)
care giving, (by telephone mth act. dimensions
exercise, or face to face) index
recreation
Zutphen PAQ to assess PA in retired men 65–84 y leisure ? self-administered 15 past wk EE (kcal/kg/day)
past mth

act. – activity, d – day, EE – energy expenditure, h – hours, MET – Metabolic Equivalent, min – minutes, mth – month, PA – physical activity, wk – week, y – year, ? – no
information

September 2015
Assessing physical activity in the elderly: A comparative study of most popular questionnaires

Table 2. Reliability of physical activity questionnaires for older adults

Questionnaire Reliability method Reliability results

APAFOP [35] Test-retest after 24 h, N = 30, aged > 65 (82 ± 7 y) from a geriatric ICC = 0.91L–0.97L
rehabilitation ward and a community-dwelling population
CHAMPS [36] Test-retest after 6 mth, N = 147, aged 65–90 (74 ± 6 y) ICC = 0.58L–0.67L
CHAMPS [37] Test-retest after 2 wk with the use of e-mail, N = 80, aged 65–89 (75 ± 6 y) r = 0.62L–0.76L
from community centers and retirement homes ICC = 0.62L–0.76L
CHAMPS [38] Test-retest after 1 wk, N = 43, aged 65–96 from independent-living ICC = 0.34*–0.88***
retirement villages
PAQE [39] Test-retest after 20 d, N = 29, aged 63–80, free-living people, No differences between pairs,
unrepresentative sample rS = 0.89L,
72% of results in the same tercile,
rB = 0.74L
PAR [42] Test-retest after 2–4 wk, N = 220, M aged 60–80 (69 ± 5 y) from ICC = 0.80***–0.90***
The Veterans Affairs Medical Center
PASE [43] Test-retest after 3–7 wk, N = 254, representative sample of community- r = 0.75L
dwelling aged ≥65 (mean age 73 y)
–  mail administration r = 0.84L
–  telephone administration r = 0.68L
QAPSE [45] Test-retest after 6 wk, r = 0.65***–0.97***
N = 44, aged 65–84 (71 ± 4 y) NS a paired t-test
IPAQ [46] Test-retest after 3–5 d, N = 122, W = 70 (66 ± 6 y), M = 52 (68 ± 5 y) rS = 0.29*–0.77***
OA-ESI [48] Test-retest after 4 wk, N = 17, W aged 58–80 (mean age 67 y), athletic sample r = 0.34
Test-retest after 1 wk, N = 29, W = 22, M = 7 aged 65–90 (mean age 71 y) r = 0.77***
YPAS [49] Test-retest of Spanish version after 2 wk, N = 108, aged 61–80, 70 women ICC = 0.12–0.66***
(68 ± 6 y) and 38 men (70 ± 7 y)
YPAS [51] Test-retest after 2 wk, N = 76, aged 60–86, W = 56 (71 ± 7 y), M = 20 (71 ± 6 y) r = 0.42***–0.65***

YPAS [46] Test-retest after 3–5 d, N = 122, W = 70 (66 ± 6 y), M = 52 (68 ± 5 y) rS = 0.44***–0.99***

Zutphen PAQ [40] Test-retest after 4 mth, N = 21, M aged 65–84 (mean age 74 y) rL = 0.93***

*p < 0.05, **p < 0.01, ***p < 0.001, d – day, h – hours, ICC – Intraclass correlation coefficient, L – lack of information about the level of
significance, M – men, mth – month, NS – non significant, PA – physical activity, r – Pearson’s correlation coefficient, rB – tau-b Kendall’s
correlation coefficient, rL – unknown type of correlation, rS – Spearman’s correlation coefficient, y – year, W – women, wk – week

Vol. 3(22) TRENDS IN SPORT SCIENCES 137

 KRÓL-ZIELIŃSKA, CIEKOT

Table 3. Validity of physical activity questionnaires for older adults

Questionnaire Validity method Validity results Study population

APAFOP [35] –  Physilog System r = 0.65*** N = 108, aged >65 (82 ± 7 y) from a geriatric
–  PAQE r = 0.70*** rehabilitation ward and a community-dwelling
–  Sensitivity to change (N = 81) effect size = 0.84–0.90 population
–  Change during intervention effect size = 1.01
(N = 98)
CHAMPS [36] –  BMI r = 0.04–(–0.21)* N = 249, aged 65–90 (74 ± 6 y)
–  Elements of physical fitness r = 0.10–0.30*** (87–experimental group, 86–control group and
–  Psychological well-being r = 0.05–0.14* 76–active group)
–  Sensibility to change effect size =0.38 –0.64
CHAMPS [37] –  Mini-Logger Recorder r = 0.36**–0.48*** N = 87, aged 65–89 (75 ± 6 y) from community
–  EPESE-lower body parts r = 0.44**–0.46** centers (51) and retirement homes (38)
functioning
–  6 min walk test r = 0.46**–0.54**
–  SF-36 r = 0.25**–0.42**
–  PASE r = 0.58***–0.64***
– YPAS r = 0.64***–0.68***
–  BMI NS
CHAMPS [38] –  Senior Fitness Test (3 tests) rS = 0.14–0.32* N = 167, aged 65–96 (79 ± 6 y) from
–  SF-12 (physical) rS = 0.12–0.24** independent-living retirement villages
–  SF-12 (mental) NS
PAQE [39] –  A repeated 24-hour PA recall rS = 0.78L; rB = 0.66L N = 31, aged 63–80, unrepresentative sample
–  Pedometers for 3 d (N = 30) rS = 0.72L; rB = 0.68L
PAR [42] –  6 min walk test rS = 0.21**–0.22** N = 220, aged 60–80 (69 ± 5 y) M from The
–  Accelerometer rS = 0.33**–0.52** Veterans Affairs Medical Center
–  H sitting per d rS = –0.24–(–0.45)**
–  Min walking per d rS = 0.02–(–0.40)**
–  SF-36 rS = 0.17–0.36**
–  Tinetti gait score rS = –0.01–0.23**
–  Basic activities of daily living rS = –0.08–(–0.25)**
score
–  Mobility activities of daily rS = –0.01–(–0.24)*
living
–  Instrumental activities of daily rS = –0.04–(–0.37)**
living
–  Sensitivity to change inconclusive
–  Tinetti balance score NS
PAR [41] –  VO2max rS = 0.11–0.34** N = 59, aged 60–80 (67 ± 5 y)
– YPAS rS = 0.09–0.51***
–  Resting HR, BMI NS
PASE [37] –  Mini-Logger recorder r = 0.52***–0.59*** N = 87, aged 65–89 (75 ± 6 y) from community
–  EPESE–lower body r = 0.57** centers (51) and retirement homes (38)
functioning
–  6-min walk test r = 0.68**
–  SF-36 r = 0.17–0.30*
–  CHAMPS r = 0.58***–0.64***
– YPAS r = 0.61***
–  BMI NS

138 TRENDS IN SPORT SCIENCES September 2015

Assessing physical activity in the elderly: A comparative study of most popular questionnaires

Cont. Tab. 3

Questionnaire Validity method Validity results Study population

PASE [53] –  PA measured with the double rS = –0.58* N = 21, aged 60–80 from intervention study
labeled water method
PASE [44] Accelerometer for 3 days r = 0.49* N = 20, aged 69–89 recruited from a university
supervised PA program for older adults
PASE [43] –  Resting HR r = –0.13* N = 222, representative sample of community-
–  Sickness Impact Profile r = –0.42** dwelling aged ≥ 65 (mean age 73)
–  Perceived health status r = –0.34**
–  Grip strength r = 0.37*
–  Static balance r = 0.33**
–  Leg strength r = 0.25**–0.28**
–  Age r = –0.34*
–  BMI, BP NS
PASE [54] –  VO2peak r = 0.20** N = 190 (W = 134, M = 56) mean age 67 ± 5
–  Systolic BP, r = –0.18*
–  Balance score r = 0.20**
–  Diastolic BP, Resting HR, NS
Body fat

*p < 0.05, **p < 0.01, ***p < 0.001, BP – blood pressure, d – day, EPESE – Established Populations for Epidemiologic Studies of the
Elderly, h – hour, HR – heart rate, M – men, min – minute, NS–non significant, L – lack of information about the level of significance,
PA – physical activity, r – Pearson’s correlation coefficient, rS – Spearman’s correlation coefficient, SF-12 – The 12-Item Short Form
Health Survey, SF-36 – The Short Form (36) Health Survey, W – women, y – year

The correlation coefficient between the test and retest validity should obtain at least r = 0.7 for doubly labelled
results was considered the coefficient of reliability water and step-counters, r ≥ 0.6 for VO2max, r ≥ 0.5 for
for a given questionnaire. The authors of the papers accelerometers, diaries, and other questionnaires, and
analyzing the reliability of the questionnaires used the r ≥ 0.3 for fitness and health variables [34].
Pearson correlation coefficient, intraclass correlation The most validation studies of questionnaires among
coefficient, and Spearman’s rank correlation coefficient. the elderly, using objective methods assessing physical
The acceptance criteria for reliability assessment of a activity (doubly labelled water, accelerometers,
research questionnaire should reach r = 0.7, optimally and step-counters), were carried out for the YPAS
r = 0.8, with the minimal value of r = 0.5 [34]. Most questionnaire [37, 46, 49, 52] and PASE [37, 44, 53].
of the assessed questionnaires on physical activity The results for YPAS and doubly labelled water in
obtained satisfactory results (Table 2). The APAFOP conjunction with indirect calorimetry collected from
[35], PAR [42], PAQE [39], QAPSE [45] questionnaires among 67 subjects between 45 and 84 years of age did
achieved the highest scores. not differ [52], and in the case of PASE correlation with
The questionnaire validity is the degree to which a physical activity measured with the double labelled
questionnaire assesses behavior that can by definition water method amounted to r = 0.58 [53].
be assessed. In order to study the validity of adapted The highest correlation coefficients were found
physical activity questionnaires, investigators usually between PAQE results and pedometer: r = 0.72 [39],
compare the findings from a given questionnaire with APAFOP and Physilog System: r = 0.65 [35], and
the results from another tool assessing physical activity YPAS and Mini-Logger Recorder: r = 0.46 – 0.61
among the elderly, and with other variables aimed at [37]. Some authors tested the validity of an analyzed
the assessed theoretical construct (Tables 3 and 4). The questionnaire assessing physical activity among the

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 KRÓL-ZIELIŃSKA, CIEKOT

Table 4. Validity of physical activity questionnaires for older adults (continued)

Questionnaire Validity method Validity results Study population

QAPSE [45] –  VO₂max r = –0.02–0.56*** N = 65 (W = 34, M = 31) aged 65–84 (71 ± 4 y)
–  BMI r = 0.10–0.46***
–  Fat-free mass r = 0.13–0.64***
–  Body fat r = 0.07–(–0.64)***
–  Skinfold thickness NS

IPAQ-E [47] –  Accelerometer rS = 0.28*–0.47*** N = 54 (W = 31, aged 66–85, M = 23, aged 66–82)
living independently
IPAQ [46] –  Accelerometer rS = 0.05–0.57*** N = 122 participants, W = 70 (66 ± 6 yr.), M = 52
(68 ± 5 y)
OA-ESI [48] –  Self-efficacy for PA r = 0.32*** N = 327 (W), aged 70–98 (mean age 77) from
–  Social support for PA r = 0.33*** different community facilities
–  Risk related to PA r = –0.19**
–  Age r = –0.26***
–  Positive health self-rating r = 0.22***
–  Lifelong activity involvement in PA r = 0.45**
–  Number of active d reported per r = 0.49***
wk
–  PAST4MON r = 0.41***
YPAS [49] –  Caltrac r = –0.01–0.26** N = 108, aged 61–80, W = 70 (68 ± 6 y), M = 38 (70 ± 7 y)
–  BMI r = –0.02–(–0.29)***
–  Body fat r = –0.05–(–0.27)***
YPAS [51] –  VO₂max rS = –0.20–0.60*** N = 25 (W = 11, M = 14) aged 62–76
–  Diastolic BP rS = –0.47**–0.53**
–  Body fat rS = –0.01–(–0.43)*
–  BMI, Caltrac NS

YPAS [40] –  Total ability score rL = 0.02*** N = 1189, aged 70–79 from the MacArthur Study
of Successful Aging cohort
YPAS [37] –  Mini-Logger Recorder r = 0.46***–0.61*** N = 87, aged 65–89 from community centers (51)
–  EPESE - lower body parts r = 0.49** and retirement homes (38)
functioning
–  6 min walk test r = 0.58**
–  SF-36 r = 0.23*–0.31**
–  CHAMPS r = 0.64***–0.68***
–  PASE r = 0.61***
–  BMI NS
YPAS [46] –  Accelerometer rS = –0.01–0.54*** N = 122, W = 70 (66 ± 6 y)
M = 52 (68 ± 5 y)
YPAS [52] –  Doubly labeled water in NS N = 67, W = 35, M = 32, aged 45–84
conjunction with indirect
calorimetry
YPAS [41] –  VO₂max rS = 0.06–0.36** N = 59, aged 60–80 (67 ± 5 y)
–  BMI rS = 0.02–(–0.31)*
–  PAR rS = 0.09–0.51***
–  Sensitivity to change inconclusive
–  Resting pulse rate NS

140 TRENDS IN SPORT SCIENCES September 2015

Assessing physical activity in the elderly: A comparative study of most popular questionnaires

Cont. Tab. 4

Questionnaire Validity method Validity results Study population

Zutphen PAQ –  Age rS = –0.28*** N = 863, M aged 65–84, representative sample
[50] –  Total cholesterol rS = 0.08**
–  HDL cholesterol rS = 0.13***
–  Daily alcohol rS = 0.11***
–  BMI, Daily cigarettes, Diastolic NS
BP, Subscapular skinfold,
Systolic BP
Zutphen PAQ –  HR rS = –0.11*** N = 1271, M aged 69–90 participated in the 30-year
[56] –  HDL cholesterol rS = 0.08** follow-up survey
–  Alcohol consumption, BMI, NS
Diastolic BP, Non-HDL
cholesterol, Smoking, Systolic
BP, Total cholesterol
Zutphen PAQ –  PA index by double labeled water rL = 0.61** N = 21,M aged 65–84 (mean age 74 y)
[40] method

*p < 0.05, **p < 0.01, ***p < 0.001, BP – blood pressure, d – day, EPESE – Established Populations for Epidemiologic Studies of
the Elderly, h – hour, HR – heart rate, M – men, min – minute, NS – non significant, PA – physical activity, PAST4MON – Gaston
Godin’s survey instrument: “Participation in the Past 4 Months”, r – Pearson’s correlation coefficient, rL – unknown type of correlation,
rS – Spearman’s correlation coefficient, SF-36 – The Short Form (36) Health Survey, W – women, y – year

elderly by comparing it with a different questionnaire questionnaires assessing physical activity, without
and performing the same assessment [35, 37, 41]. verifying the criteria for research methods, which
The highest correlation coefficients were obtained by resulted in drawing inaccurate conclusions [31].
Hauer et al. [35] for APAFOP and PAQE: r = 0.70, and In order to provide methodological reliability of a
Harada et al. [37], who compared CHAMPS and PASE: physical activity study, questionnaires used to assess
r = 0.58 – 0.64, YPAS and PASE: r = 0.61, and CHAMPS physical activity should have clearly stated terms and
and YPAS: r = 0.64 – 0.68. conditions of use. Uniform assessment criteria are
Researchers used different methods in order to necessary for any future comparisons of study results.
assess the validity of a given questionnaire. The most Proper instruction, scope of assistance in explaining the
frequently shown correlation were those between the questions, terms and conditions of using the research tool
results obtained from a physical activity questionnaire (duration, season, whether the tool should be used with
and the results of fitness tests [36-38, 40, 42, 43], individuals or groups), and the procedure for calculating
health condition [37, 42, 43, 48], and VO2max [41, and interpreting results are of key importance for
45, 51]. All methods assessing the validity of selected questionnaires assessing physical activity. Moreover, a
questionnaires and obtained results are presented in questionnaire should be objective, i.e. with constant,
Tables 3 and 4. clearly established procedures for calculating results,
which do not allow for subjective interpretation.
Discussion The analyzed questionnaires used for measuring
The present paper is a review of 21 papers containing physical activity among the elderly differed in terms
information on assessment criteria of 11 questionnaires of assessment aims. Most of the physical activity
assessing physical activity among the elderly. During questionnaires were created for assessing physical
the initial selection procedure, especially in studies activity in epidemiological and comparative studies,
on the elderly population of Poland, we noticed for ascertaining whether or not the elderly meet certain
that very frequently investigators created their own health criteria, or for classifying them based on their

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 KRÓL-ZIELIŃSKA, CIEKOT

physical activity. Only the CHAMPS questionnaire 4. Lee IM, Paffenbarger RS, Jr. Associations of light,
[36-38] was aimed at assessing the effects of moderate, and vigorous intensity physical activity with
longevity. The Harvard Alumni Health Study. Am J
interventions which were meant to change the physical
Epidemiol. 2000; 151(3): 293-299.
activity habits. The results of physical activity
5. Manson JE, Greenland P, LaCroix AZ, et al. Walking
questionnaires were most frequently presented as
compared with vigorous exercise for the prevention
metabolic equivalent (MET), and the frequency or
of cardiovascular events in women. New Engl J Med.
duration of physical activity in a unit of time. 2002; 347(10): 716-725.
Most reliability and validity studies of the reviewed
6. Parkkari J, Natri A. A controlled trial of the health
questionnaires on physical activity were based on benefits of regular walking on a golf course. Am J Med.
research conducted among volunteers or participants 2000; 109(2): 102-108.
in programs for the elderly. This problem was already 7. Voorrips LE, Lemmink KA, Van Heuvelen M, et al.
pointed out by Forsén et al. [34]. Therefore, there is a The physical condition of elderly women differing in
need for future validation studies on physical activity habitual physical activity. Med Sci Sport Exer. 1993;
questionnaires on more representative groups. 25(10): 1152-1157.
8. Szeklicki R, Stemplewski R, Osiński W. Relations
Conclusions between habitual physical activity and BMI, WHR
From among the analyzed questionnaires, the most and body composition in elderly men. Hum Movement.
highly assessed in objectivity, standardization, validity, 2006; 7(1): 31-35.
and reliability were achieved was the Yale Physical 9. Kelley GA, Kelley KS, Tran ZV. Exercise, lipids, and
Activity Survey (YPAS). lipoproteins in older adults: a meta-analysis. Prev
Cardiol. 2005; 8(4): 206-214.
10. Carter ND, Kannus P, Khan KM. Exercise in the
What this study adds? prevention of falls in older people: a systematic
When conducting scientific studies, researchers literature review examining the rationale and the
require information on the psychometric indicators evidence. Sports Med. 2001; 31(6): 427-438.
of their methods and measuring tools. This 11. Katsuta S, Kuno Sy, Maukai N. Physiological
paper gives information on the qualitative and characteristics of elderly elite athletes. Bulletin of
psychometric characteristics of the most popular Institute of Health and Sport Sciences, University of
questionnaires measuring the levels of physical Tsukuba. 2000; 23: 81-88.
activity among the elderly. 12. Goldspink G. Age-related loss of skeletal muscle
function; impairment of gene expression. J Musculoskelet
Neuronal Interact. 2004; 4(2): 143-147.
This study was supported by a Polish National Science 13. Brach JS, Simonsick EM, Kritchevsky S, et al. The
association between physical function and lifestyle
Centre grant no. 2013/09/B/HS6/02622 “Reliability
activity and exercise in the health, aging and body
and validity of Polish adaptations of CHAMPS, PAQE,
composition study. J Am Geriatr Soc. 2004; 52(4): 502-509.
YPAS tools for measurement of physical activity
14. Ramsbottom R, Ambler A, Potter J, et al. The effect of
among elderly people”.
6 months training on leg power, balance, and functional
mobility of independently living adults over 70 years
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