Social, economic, and environmental disparities in device-measured 24-hour movement behaviours in a nationally representative cohort of older English adults
Laura Brocklebank, Andrew Steptoe, Mikaela Bloomberg, Aiden DohertyAbstract
Background
Insufficient physical activity, excessive sedentary time, and suboptimal sleep duration (i.e., not excessively short or long) are linked to morbidity and premature mortality and may contribute to health inequalities, but device-measured, nationally representative data capturing the full 24-hour movement spectrum remain scarce, particularly among older adults. This study examined social, economic, and environmental disparities in 24-hour movement behaviours in the 2021-23 English Longitudinal Study of Ageing (ELSA) accelerometry sub-study.
Methods
A subset of 5,382 ELSA participants (71.9%) was invited to wear a wrist accelerometer for eight days, with 4,354 (80.9%) agreeing. Raw data were processed using three distinct machine learning algorithms to estimate step count, sleep duration, moderate-to-vigorous and light physical activity, and sedentary time. Cross-sectional associations with sex, age, education, marital status, wealth, and urbanicity were examined using linear regression.
Results
Data from 3,648 participants (mean age 68.5 ± 9.3 years; 44.3% male) were included in the wear time analyses (median 6.6 days, IQR 6.0-6.9) and data from 3,161 (86.7%) participants with sufficient wear time were included in the 24-hour movement behaviour analyses. Older, unmarried, or lower education/wealth participants were less active, more sedentary, and slept less. Rural participants were more active than urban participants. Females accumulated fewer steps and less moderate-to-vigorous activity and sedentary time, but more light activity and longer sleep than males.
Conclusions
Social, economic, and environmental disparities exist across the full 24-hour movement spectrum, highlighting groups for targeted interventions. Follow-up will clarify how 24-hour movement behaviours influence healthy ageing and contribute to health inequalities.