Associations of Frailty and Physical Function with a Daily Activities Measured by a Pattern-Recognition Activity Monitor: An Isotemporal Substitution Analysis in the IMPACT65+ Study

  • Sara Higueras-FresnilloEmail author
  • M. Á. De La Cámara
  • V. Cabanas-Sánchez
  • D. Martínez-Gómez



The aims of this study were (i) to examine the independent associations of the time spent in daily activities measured by multi-sensor pattern-recognition with frailty and physical functioning (PF); and (ii) to analyze how relocating time between these daily activities is associated with frailty and PF in a sample of older adults.


Cross-sectional study.

Setting and participants

The study sample consists of 436 (287 women) high-functioning community-dwelling older adults, aged 65 to 92 years, who participated in the IMPACT65+ Study.


Frailty was calculated as a continuous measure; based on the five widely recognized Fried’s criteria. PF was assessed using the SF-12 questionnaire. The time in daily activities was assessed by the Intelligent Device for Energy expenditure and Activity (IDEEA). Independent associations of daily activities with frailty and PF were examined using linear regression models adjusting for potential confounders. The isotemporal substitution models for estimate the effect of replacing time in one activity with the same amount of time in another activity while holding wake time constant.


Time spent lying was directly associated, while time in walk at average and brisk pace was inversely associated with frailty. The independent associations for PF were similar to lying, walk at average pace and walk at brisk pace. Isotemporal substitution analyses revealed a clear beneficial effect of hypothetically replacing 30 min/day of sedentary behaviors or light physical activity by the same amount of moderate-to-vigorous physical activity for frailty and PF.


This is the first study examining the activity-specific and isotemporal association of daily activities with frailty and PF in older adults. Isotemporal substitution analyses showed that replacing sedentary behaviors (lie, recline, passive sit) by light-intensity activities (active sit, stand and walk at slow pace), as well as light-intensity activities by activities at MVPA such as walk at brisk pace, may produce theoretical improvements in frailty and PF. These findings are important for the development of effective interventions focused on reducing age-related frailty and declines in PF.

Key words

IDEEA frailty physical function sedentary behaviors physical activity walking 



This work was supported by Grants from MINECO I+D+I (DEP2013-47786-R), UAM-Santander (CEAL-AL/2015-20), and Real Madrid-UEM (P2016/RM09). SHF and MAC were supported by FPI grants from the Autonomous University of Madrid. DMG was supported by “Ramon y Cajal” contract (RYC-2016-20546). The funding organizations had no role in the study design, the collection, analysis or interpretation of the data or the decision to submit the manuscript for publication.

Conflict of interest: The authors declare that they have no conflict of interest.

Ethical standards: All procedures were performed in accordance with the principles of the Declaration of Helsinki and approved by the appropriate institutional review committee. In addition, all participants gave their informed consent to participate in the study.

Supplementary material

12603_2019_1296_MOESM1_ESM.docx (113 kb)
Supplementary material, approximately 113 KB.


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Copyright information

© Serdi and Springer-Verlag International SAS, part of Springer Nature 2019

Authors and Affiliations

  • Sara Higueras-Fresnillo
    • 1
    • 6
    Email author
  • M. Á. De La Cámara
    • 1
  • V. Cabanas-Sánchez
    • 1
    • 2
  • D. Martínez-Gómez
    • 3
    • 4
    • 5
  1. 1.Department of Physical Education, Sport and Human Movement, Faculty of Teacher Training and EducationAutonomous University of MadridMadridSpain
  2. 2.Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of SportUniversity of PortoPortoPortugal
  3. 3.Department of Preventive Medicine and Public HealthSchool of Medicine Autonomous University of Madrid/IdiPazMadridSpain
  4. 4.CIBER of Epidemiology and Public HealthMadridSpain
  5. 5.IMDEA Food Institute. CEI UAM+CSICMadridSpain
  6. 6.Department of Physical Education, Sport and Human Movement, Facultad de Formación de Profesorado y EducaciónUniversidad Autónoma de MadridMadridSpain

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