ArticleEuropean review of aging and physical activity : official journal of the European Group for Research into Elderly and Physical Activity2026
Real-world walking and activity patterns in community-dwelling older adults: a cross-sectional analysis of baseline data from the SMART-AGE trial.
Article in European review of aging and physical activity : official journal of the European Group for Research into Elderly and Physical Activity, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDigital mobility outcomes (DMOs) measured under real-world conditions allow for differentiated insights into mobility patterns of older adults. This study provides an advanced description of real-world walking in community-dwelling older adults and identifies correlates of walking amount, pattern and speed.
methodsThis cross-sectional study used baseline data from the SMART-AGE intervention trial with community-dwelling older adults (age ≥ 67 years). Assessment procedures included one-week monitoring of real-world walking using a wearable device (Axivity AX6), clinical outcomes, and tablet-based questionnaires. DMOs describing the amount (steps, walking duration), pattern (e.g., number of walking bouts [WBs]) and pace (mean and 90th percentile [P90] walking speed) of real-world walking were extracted using a validated computational pipeline. Data were included with ≥ 12 h/day wear time on ≥ 3 days. Stepwise hierarchical linear mixed modelling examined associations between DMOs and sociodemographic correlates, environmental conditions, health status (Body Mass Index), locomotor capacity (Timed Up & Go [TUG]), fall-related concerns (Short FES-I) and cognitive processing speed (Symbol Search Score).
resultsThe final sample of 569 participants with a mean age of 75.0 ± 5.6 years (52% women; 56% higher education) showed a mean walking activity of 11 746 ± 5 446 steps/day, 432.3 ± 153.8 WBs / day in total, and a mean walking speed of 0.75 ± 0.13 m/s in longer (> 30s) WBs. Age was consistently related to real-world walking across all DMOs, showing non-linear trends. We found sex-related patterns of walking, as women had more WBs in total but fewer longer (> 30 s) WBs than men. Body Mass Index and locomotor capacity were consistent predictors of walking across all DMOs (β = -0.08 to -0.25, p < 0.05).
conclusionThis study provides detailed and novel insights into real-world walking in a highly active population of older adults, highlighting lower walking activity with increasing age and differences in activity patterns between men and women. Mobility data may serve as a reference for community-dwelling older adults and facilitate the identification of early changes in everyday mobility, thereby informing future mobility recommendations and preventive strategies.
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