Self-Administered Physical Activity Questionnaires for the Elderly A Systematic Review of Measurement Properties

Objective: To systematically review and appraise studies examining self-administered physical activity questionnaires (PAQ) for the elderly. This article is one of a group of four articles in Sports Medicine on the content and measurement properties of PAQs. Literature Search Methodology: Searches in PubMed, EM BASE and SportDiscus (R) (until May 2009) on self-administered PAQ. Inclusion criteria were as follows: (i) the study examined (at least one of) the measurement properties of a self-administered PAQ; (ii) the questionnaire aimed to measure physical activity (PA) in older people; (iii) the average age of the study population was >55 years; (iv) the article was written in English. We excluded PA interviews, diaries and studies that evaluated the measurement properties of a self-administered PAQ in a specific population, such as patients. We used a standard checklist (qualitative attributes and measurement properties of PA questionnaires [QAPAQ]) for appraising the measurement properties of PAQs. Findings: Eighteen articles on 13 PAQs were reviewed, including 16 reliability analyses and 25 validity analyses (of which 15 were on construct validity, seven on health/functioning associations, two on known-groups validity and one on responsiveness). Many studies suffered from methodological flaws, e.g. too small sample size or inadequate time interval between test and retest. Three PAQs received a positive rating on reliability: IPAQ-C (International Physical Activity Questionnaire Chinese), intraclass correlation coefficient (ICC) >= 0.81; WHI-PAQ (Women's Health I nitiative-PAQ), ICC = 0.76; and PASE (Physical Activity Scale for the Elderly), Pearson correlation coefficient (r)=0.84. However, PASE was negatively rated on reliability in another study (ICC=0.65). One PAQ received a positive rating on construct validity: PASE against Mini-Logger (r > 0.52), but PASE was negatively rated in another study against accelerometer and another PAQ, Spearman correlation coefficient = 0.17 and 0.48, respectively. Three of the 13 PAQs were tested for health/functioning associations and all three were positively rated in some categories of PA in many studies (r > 0.30). Conclusions: Even though several studies showed an association between the tested PAQ and health/functioning variables, the knowledge about reliability and construct validity of self-administrated PAQs for older adults is still scarce and more high-quality validation studies are needed.