The Problem of Physical Inactivity Worldwide Among Older People

  • Robert L. Hill
  • Kristiann C. Heesch


Researchers seek to learn the degree to which the people of their nations or regions are attaining levels of regular physical activity, but clarity on physical activity levels has been difficult to attain. Age, gender, and other factors produce variations in prevalence estimates within countries, and country-level differences in stages of economic development, transportation systems, and social factors produce variations of these estimates among countries. Self-reported physical activity levels are usually higher than objectively measured physical activity levels, a fact that is complicated by the strengths and weaknesses of each method for measuring physical activity. Still, within and among countries, there are well-documented, significant lessons to be learned from published data about the prevalence of physical activity.


  1. Ashe, M. C., Miller, W. C., Eng, J. J., & Noreau, L. (2009). Older adults, chronic disease and leisure-time physical activity. Gerontology, 55(1), 64–72. Scholar
  2. Australian Bureau of Statistics. (2015). Australian demographic statistics, Sept 2014 (No. 3101.0). Retrieved May 30, 2017, from
  3. Bauman, A., Phongsavan, P., Schoeppe, S., & Owen, N. (2006). Physical activity measurement – A primer for health promotion. Promotion & Education, 13(2), 92–103. Scholar
  4. Bijnen, F. C., Feskens, E. J., Caspersen, C. J., Mosterd, W. L., & Kromhout, D. (1998). Age, period, and cohort effects on physical activity among elderly men during 10 years of follow-up: The Zutphen elderly study. The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 53A(3), M235–M241. Scholar
  5. Blair, S. N., & Morris, J. N. (2009). Healthy hearts—And the universal benefits of being physically active: Physical activity and health. Annals of Epidemiology, 19(4), 253–256. Scholar
  6. Booth, F. W., Chakravarthy, M. V., Gordon, S. E., & Spangenburg, E. E. (2002). Waging war on physical inactivity: Using modern molecular ammunition against an ancient enemy. Journal of Applied Physiology, 93(1), 3–30.CrossRefGoogle Scholar
  7. Brown, W. J., McLaughlin, D., Leung, J., McCaul, K. A., Flicker, L., Almeida, O. P., et al. (2012). Physical activity and all-cause mortality in older women and men. British Journal of Sports Medicine, 46(9), 664–668. Scholar
  8. Bull, F. C., & Bauman, A. E. (2011). Physical inactivity: The “Cinderella” risk factor for noncommunicable disease prevention. Journal of Health Communication, 16(Suppl 2), 13–26.CrossRefGoogle Scholar
  9. Caspersen, C. J., Pereira, M. A., & Curran, K. M. (2000). Changes in physical activity patterns in the United States, by sex and cross-sectional age. Medicine & Science in Sports & Exercise, 32(9), 1601–1609.CrossRefGoogle Scholar
  10. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. (2017). Behavioral risk factor surveillance system. Retrieved May 30, 2017, from
  11. Centers for Disease Control and Prevention, National Center for Health Statistics. (2017a). National health and nutrition examination survey. Retrieved May 30, 2017, from
  12. Centers for Disease Control and Prevention, National Center for Health Statistics. (2017b). National health interview survey. Retrieved May 30, 2017, from
  13. Corder, K., & van Sluijs, E. M. (2010). Comparing physical activity across countries—Current strengths and weaknesses. American Journal of Epidemiology, 171(10), 1065–1068. Scholar
  14. Craig, C. L., Cameron, C. A., & Bauman, A. (2017). Utility of surveillance research to inform physical activity policy: An exemplar from Canada. Journal of Physical Activity and Health, 14, 229–239. Scholar
  15. Doherty, A., Jackson, D., Hammerla, N., Plötz, T., Olivier, P., Granat, M. H., et al. (2017). Large scale population assessment of physical activity using wrist worn accelerometers: The UK Biobank study. PLoS One, 12(2), e0169649. Scholar
  16. Fishman, E., Böcker, L., & Helbich, M. (2015). Adult active transport in the Netherlands: An analysis of its contribution to physical activity requirements. PLoS One, 10(4), e0121871. Scholar
  17. Gennuso, K. P., Gangnon, R. E., Matthews, C. E., Thraen-Borowski, K. M., & Colbert, L. H. (2013). Sedentary behavior, physical activity, and markers of health in older adults. Medicine & Science in Sports & Exercise, 45(8), 1493–1500. Scholar
  18. Guthold, R., Ono, T., Strong, K. L., Chatterji, S., & Morabia, A. (2008). Worldwide variability in physical inactivity: A 51-country survey. American Journal of Preventive Medicine, 34(6), 486–494. Scholar
  19. Guwatudde, D., Kirunda, B. E., Wesonga, R., Mutungi, G., Kajjura, R., Kasule, H., et al. (2016). Physical activity levels among adults in Uganda: Findings from a countrywide cross-sectional survey. Journal of Physical Activity and Health, 13(9), 938–945. Scholar
  20. Hagströmer, M., Troiano, R. P., Sjostrom, M., & Berrigan, D. (2010). Levels and patterns of objectively assessed physical activity—A comparison between Sweden and the United States. American Journal of Epidemiology, 171(10), 1055–1064. Scholar
  21. Hallal, P. C., Andersen, L. B., Bull, F. C., Guthold, R., Haskell, W., & Ekelund, U. (2012). Global physical activity levels: Surveillance progress, pitfalls, and prospects. The Lancet, 380(9838), 247–257. Scholar
  22. Hansen, B. H., Kolle, E., Dyrstad, S. M., Holme, I., & Anderssen, S. A. (2012). Accelerometer-determined physical activity in adults and older people. Medicine & Science in Sports & Exercise, 44(2), 266–272. Scholar
  23. Haskell, W. L., Lee, I.-M., Pate, R. R., Powell, K. E., Blair, S. N., Franklin, B. A., et al. (2007). Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation, 116(9), 1081–1093. Scholar
  24. Heesch, K. C., van Uffelen, J. G. Z., Hill, R. L., & Brown, W. (2010). What do IPAQ questions mean to older adults? Lessons from cognitive interviews. International Journal of Behavioral Nutrition and Physical Activity, 7(1), 35. Scholar
  25. Hill, R. L., & Brown, W. J. (2012). Older Australians and physical activity levels: Do we know how many are meeting guidelines? Australasian Journal on Ageing, 31(4), 208–217. Scholar
  26. Iliodromiti, S., Ghouri, N., Celis-Morales, C. A., Sattar, N., Lumsden, M. A., & Gill, J. M. (2016). Should physical activity recommendations for South Asian adults be ethnicity-specific? Evidence from a cross-sectional study of South Asian and White European men and women. PLoS One, 11(8), e0160024. Scholar
  27. Kahlmeier, S., Wijnhoven, T. M. A., Alpiger, P., Schweizer, C., Breda, J., & Martin, B. W. (2015). National physical activity recommendations: Systematic overview and analysis of the situation in European countries. BMC Public Health, 15(1), 133. Scholar
  28. Keadle, S. K., McKinnon, R., Graubard, B. I., & Troiano, R. P. (2016). Prevalence and trends in physical activity among older adults in the United States: A comparison across three national surveys. Preventive Medicine, 89, 37–43. Scholar
  29. Kohl, H. W., Craig, C. L., Lambert, E. V., Inoue, S., Alkandari, J. R., Leetongin, G., & Kahlmeier, S. (2012). The pandemic of physical inactivity: Global action for public health. The Lancet, 380(9838), 294–305. Scholar
  30. Kwapisz, J. R., Weiss, G. M., & Moore, S. A. (2011). Activity recognition using cell phone accelerometers. ACM SIGKDD Explorations Newsletter, 12(2), 74–82. Scholar
  31. Lee, S.-A., Xu, W. H., Zheng, W., Li, H., Yang, G., Xiang, Y.-B., & Shu, X. O. (2007). Physical activity patterns and their correlates among Chinese men in Shanghai. Medicine & Science in Sports & Exercise, 39(10), 1700–1707. Scholar
  32. Lee, I.-M., Shiroma, E. J., Lobelo, F., Puska, P., Blair, S. N., & Katzmarzyk, P. T. (2012). Effect of physical inactivity on major non-communicable diseases worldwide: An analysis of burden of disease and life expectancy. The Lancet, 380(9838), 219–229. Scholar
  33. Lin, Y.-P., Huang, Y.-H., Lu, F.-H., Wu, J.-S., Chang, C.-J., & Yang, Y.-C. (2011). Non-leisure time physical activity is an independent predictor of longevity for a Taiwanese elderly population: An eight-year follow-up study. BMC Public Health, 11(1), 428. Scholar
  34. Loyen, A., Clarke-Cornwell, A. M., Anderssen, S. A., Hagströmer, M., Sardinha, L. B., Sundquist, K., et al. (2016). Sedentary time and physical activity surveillance through accelerometer: Pooling in four European countries. Sports Medicine.
  35. Lyon, D., Haggerty, K. D., & Ball, K. (2012). Introducing surveillance studies. In K. Ball, K. Haggerty, & D. Lyon (Eds.), Routledge handbook of surveillance studies (pp. 15–18). New York: Routledge.Google Scholar
  36. Macniven, R., Bauman, A., & Abouzeid, M. (2012). A review of population-based prevalence studies of physical activity in adults in the Asia-Pacific region. BMC Public Health, 12, 41. Scholar
  37. Mâsse, L. C., Fuemmeler, B. F., Anderson, C. B., Matthews, C. E., Trost, S. G., Catellier, D. J., & Treuth, M. (2005). Accelerometer data reduction: A comparison of four reduction algorithms on select outcome variables. Medicine and Science in Sports and Exercise, 37(11), S544–S554.CrossRefGoogle Scholar
  38. Pate, R. R., Pratt, M., Blair, S. N., Haskell, W. L., Macera, C. A., Bouchard, C., et al. (1995). Physical activity and public health. JAMA, 273(5), 402–407. Scholar
  39. Pucher, J., & Buehler, R. (2008). Making cycling irresistible: Lessons from the Netherlands, Denmark and Germany. Transport Reviews, 28(4), 495–528. Scholar
  40. Sims, J., Birrell, C. L., Hunt, S., Browning, C., Burns, R. A., & Mitchell, P. (2014). Prevalence of physical activity behaviour in older people: Findings from the dynamic analyses to optimise ageing (DYNOPTA) project and Australian national survey data. Australasian Journal on Ageing, 33(2), 105–113. Scholar
  41. Sparling, P. B., Howard, B. J., Dunstan, D. W., & Owen, N. (2015). Recommendations for physical activity in older adults. BMJ, 350, h100. Scholar
  42. Stel, V. S., Smit, J. H., Pluijm, S. M., Visser, M., Deeg, D. J., & Lips, P. (2004). Comparison of the LASA physical activity questionnaire with a 7-day diary and pedometer. Journal of Clinical Epidemiology, 57(3), 252–258. Scholar
  43. Sun, F., Norman, I. J., & While, A. E. (2013). Physical activity in older people: A systematic review. BMC Public Health, 13, 449. Scholar
  44. Sundquist, K., Qvist, J., Sundquist, J., & Johansson, S.-E. (2004). Frequent and occasional physical activity in the elderly. American Journal of Preventive Medicine, 27(1), 22–27. Scholar
  45. Tak, E., Kuiper, R., Chorus, A., & Hopman-Rock, M. (2013). Prevention of onset and progression of basic ADL disability by physical activity in community dwelling older adults: A meta-analysis. Ageing Research Reviews, 12(1), 329–338. Scholar
  46. Troiano, R. P., Berrigan, D., Dodd, K. W., Mâsse, L. C., Tilert, T., & McDowell, M. (2008). Physical activity in the United States measured by accelerometer. Medicine and Science in Sports and Exercise, 40(1), 181–188.CrossRefGoogle Scholar
  47. Warburton, D. E. R., Nicol, C. W., & Bredin, S. S. D. (2006). Health benefits of physical activity: The evidence. Canadian Medical Association Journal, 174(6), 801–809. Scholar
  48. Washburn, R. A. (2000). Assessment of physical activity in older adults. Research Quarterly for Exercise and Sport, 71(2), 79–88. Scholar

Copyright information

© The Author(s) 2018

Authors and Affiliations

  • Robert L. Hill
    • 1
  • Kristiann C. Heesch
    • 2
  1. 1.School of Public Health and Social WorkQueensland University of TechnologyKelvin GroveAustralia
  2. 2.School of Public Health and Social Work and Institute of Health and Biomedical InnovationQueensland University of TechnologyKelvin GroveAustralia

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