April 8, 2015

Older people can learn to spend less time sitting down

Coaching helped Group Health patients sit half hour less per day in pilot study

SEATTLE—“I feel lethargic when I sit all day,” said Gerald Alexander, an 82-year-old retired social service worker among the 25 Group Health patients who participated in the Take Active Breaks from Sitting (TABS) pilot study. “I feel much peppier when I stand and take walks.”

Retirement may be more golden if less of it is spent in a resting position. Yet older adults spend an average of 8.5 waking hours a day sitting or lying down, according to TABS study leader Dori Rosenberg, PhD, MPH, an assistant scientific investigator at Group Health Research Institute. More of this kind of time has been linked to obesity, heart disease, diabetes, and death—even if people are physically active at other times of the day.

“We’re not sure whether older people can improve their health by reducing the time they spend sitting,” Dr. Rosenberg said. “To prove that, we need randomized trials—and none have been done yet in older adults.” As a first step toward such a trial, she conducted the TABS study, which showed that it was feasible to coach adults aged 60 and older to spend less time sitting: an average of 27 minutes less per day. They reported feeling more able to accomplish everyday tasks. And data suggested that after coaching, they also walked faster and had fewer symptoms of depression.

Health Education & Behavior published the new study’s quantitative results: “The Feasibility of Reducing Sitting Time in Overweight and Obese Older Adults.” And The Gerontologist published its results from interviews with participants: “Motivators and Barriers to Reducing Sedentary Behavior Among Overweight and Obese Older Adults.”

How coaching worked

In the TABS study, health coaches talked by phone with each participant five times during eight weeks. The coaches used motivational interviewing to engage participants in setting personalized goals to sit less by standing and moving more—and to take more breaks from sitting throughout the day. Participants tracked how much they thought they were sitting. And at baseline, midway through the study, and at its end, participants used two devices for a week to measure how much they were sitting. They also received charts showing feedback from these measurements. Participants found the feedback charts most helpful, followed by the coaching phone calls.

“The feedback was like a reward for standing up and moving,” Mr. Alexander said. Read more of his story in a blog post: “Standing up for my health.”

The Group Health Research Institute’s development fund supported this study. Dr. Rosenberg is continuing her research on the effects of sitting time in older adults through her recently funded career development award from the National Heart, Lung, and Blood Institute of the National Institutes of Health (K23HL119352).

Dr. Rosenberg’s coauthors are David Arterburn, MD, MPH, an associate investigator, Salene Jones, PhD, a research fellow, and Anne Renz, MPH, a project manager, all at Group Health Research Institute; Nancy Gell, PhD, MPH, PT, an assistant professor of rehabilitation and movement science at the University of Vermont School of Nursing and Health Sciences; Jaqueline Kerr, PhD, an associate professor of family medicine and public health at the University of California San Diego, in La Jolla; and Paul Gardiner, PhD, one of Dr. Rosenberg’s coauthors. Dr. Gardiner is a postdoctoral research fellow in public health at the University of Queensland, in Brisbane, Australia.

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David E. Arterburn, MD, MPH

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Kaiser Permanente Washington Health Research Institute


Healthy Findings blog


Standing up for my health

by Gerald Alexander