Abstract

INTRODUCTION

Changes in the structure of the age pyramid all over the world have highlighted ageing and old age, giving rise to actions by social and governmental agents as well as health care professionals. ⁴4 . Benedetti TRB, Borges LJ, Petroski EL, Gonçalves LHT. Atividade física e estado de saúde mental de idosos. Rev Saude Publica. 2008;42(2):302-7. DOI:10.1590/S0034-89102008005000007
https://doi.org/10.1590/S0034-8910200800...

An unprecedented change has taken place in living standards over the last few decades. Mechanization, technological advances, computerization and the constantly increasing mechanisms to avoid physical effort, such as escalators, elevators and remote controls have led to the progressive decrease in physical activities at work, within the home and in leisure time. ¹²12 . Macedo CSG, Garavello JJ. Benefícios do exercício físico para a qualidade de vida. Rev Bras Ativ Fis Saude. 2003;8(2):19-27. Such reduced levels of physical activity may increase some harmful effects of the ageing process, such as loss of muscular force. ⁶6 . Florindo AA, Guimarães VV, Cesar CLG, Barros MBA, Alves MCGP, Goldbaum M. Epidemiology of leisure, transportation, occupational and household physical activity: prevalence and associated factors. J Phys Act Health. 2009;6(5):625-32.

Physical activity or exercise is a great victory for public health as it provides many benefits to the organism; when done regularly, it has a positive influence on physiological, functional, psychological and social variables. ¹⁷17 . Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA . 1995;273(5):402-7. DOI:10.1001/jama.1995.03520290054029
https://doi.org/10.1001/jama.1995.035202...

Measuring physical activity in older adults is essential in creating interventions to minimize and control problems related with inactivity and functional decline. ¹⁸18 . Rabacow FM, Gomes MA, Marques P, Benedetti TRB. Questionários de medidas de atividade física em idosos. Rev Bras Cineantropom Desempenho Hum. 2006;8(4):99-106.

The state of Alagoas, in the Northeast of Brazil, has some of the worst social indicators in the country and high social inequality. ^aaInstituto Brasileiro de Geografia e Estatística. Pesquisa nacional por amostra de domicílio: indicadores sociodemográficos e de saúde no Brasil. Rio de Janeiro; 2009. Moreover, the older population has low levels of schooling and a poor socioeconomic level. ^bbInstituto Brasileiro de Geografia e Estatística. Síntese de indicadores sociais: uma análise das condições de vida da população brasileira. Rio de Janeiro; 2010 [cited 2010 Dec 20]. Available from: http://www.ibge.com.br/home/estatistica/populacao/condicaodevida/indicadoresminimos/sinteseindicsociais2010/default.shtm Considering the vast extent of the territory in Brazil and the peculiarities of each region, there is a lack of surveys in the Northeast identifying which aspects (sociodemographic and health indicators) may affect physical activity in the older population.

The aim of this study was to analyze the level of physical activity in older adults in the areas of commuting and leisure and associated factors.

METHODS

This was a cross-sectional population survey with a probabilistic sample of individuals aged ≥ 60 residing in the urban area of Maceió, AL, Northeastern Brazil, in 2009. Of the 320 individuals eligible for the study, one was considered as a loss due to an error in completing the questionnaire, leaving a total sample of 319 individuals.

In 2009, the municipality of Maceió, state capital, had a population of 896,965 inhabitants, of which 60,908 were aged ≥ 60. The city is composed of seven health districts, covering 50 neighborhoods and 875 census tracts, two of these census tracts are rural. ^aaInstituto Brasileiro de Geografia e Estatística. Pesquisa nacional por amostra de domicílio: indicadores sociodemográficos e de saúde no Brasil. Rio de Janeiro; 2009.

In order to calculate the sample size, a sampling error of 6.0%, 50.0% prevalence of physical inactivity and 95% confidence interval were considered. The size of the sample was 266 individuals, with 20.0% added to cover losses and refusals; the minimum needed was 320 older individuals.

A self-weighted cluster sampling model was produced in the following stages:

1) The seven health districts were classified into “better”, “intermediate” and “worse” socioeconomic level, as the heterogeneity of the city’s different socioeconomic strata was considered. They were finally order according to random selection of the districts, identifying the order in which the districts would be surveyed.

2) Each neighborhood was ordered alphabetically and numerically to be selected according to the number of older individuals in each. Neighborhoods with more older individuals had a higher chance of being selected for the sample. Seven (one per district) were selected.

3) After identifying the residential census tracts (excluding commercial tracts), the tracts of each neighborhood were selected proportionally according to the number of older individuals in each, considering the sample calculation and size of 0.5% plus 20.0% (for losses). The sample was calculated according to the estimated population size for 2009. ^aaInstituto Brasileiro de Geografia e Estatística. Pesquisa nacional por amostra de domicílio: indicadores sociodemográficos e de saúde no Brasil. Rio de Janeiro; 2009.

4) All of the blocks and their respective sides (streets, avenues and villas) in each tract were numbered. The households were randomly selected following a clockwise selection. After visiting a specific number of residences (defined according to the total number of residences in the tract), older individuals were systematically interviewed by the researcher.

If there was no resident aged over 60 in the household, the researcher went to the next until an older individual was identified, then re·start’ing the systematic search. If there was an older resident in the household absent at the time visited, a new visit was arranged on up to two occasions, being then considered a loss if no contact was eventually possible. If there was more than one older individual in the household, it was randomly decided which one to interview. If the number of interviewees in a particular district was not attained, the researcher moved on to the next selected census tract.

The long form International Physical Activity Questionnaire (IPAQ), adapted for the older in Brazil, ³3 . Benedetti TRB, Mazo GZ, Barros MVG. Aplicação do Questionário Internacional de Atividades Físicas para avaliação do nível de atividades físicas de mulheres idosas: validade concorrente e reprodutibilidade teste-reteste. Rev Bras Cienc Mov. 2004;12(1):25-34. was used to assess the level of physical activity related to commuting and leisure time (dependent variable).

Levels of physical activity were analyzed according to the recommendation of 150 minutes per week; ^ccUnited States Department of Health and Human Services (US). 2008 Physical activity guidelines for Americans. Be active, healthy and happy. Washington (DC); 2008 [cited 2008 Oct 16]. Available from: http://www.health.gov/paguidelines/guidelines/default.aspx weekly physical activity was obtained by adding the minutes spent walking, as well as in other moderate and vigorous activities, multiplying these minutes by two. ¹¹11 . Kruger J, Ham AS, Berrigan D, Ballard-Barbash R. Prevalence of transportation and leisure walking among U.S. adults. Prev Med. 2008;47(3):329-34. DOI:10.1016/j.ypmed.2008.02.018
https://doi.org/10.1016/j.ypmed.2008.02.... The older individuals were classified into two different levels of physical activity, according to the total of minutes (0 to 149: insufficiently active; 150 or over: active). ^ccUnited States Department of Health and Human Services (US). 2008 Physical activity guidelines for Americans. Be active, healthy and happy. Washington (DC); 2008 [cited 2008 Oct 16]. Available from: http://www.health.gov/paguidelines/guidelines/default.aspx

The independent variable were: a) socioeconomic data: per capita income. (ratio between total income and number of household members); schooling (length of time at school or level of education); b) demographic data: sex, age, marital status, family composition, reported morbidities and perceived health ^ddDe Vitta A. Bem-estar físico e saúde percebida: um estudo comparativo entre homens e mulheres adultos, sedentários e ativos [tese de doutorado]. Campinas: Universidade Estadual de Campinas; 2001. (current health and physical capacity compared with that of five years ago; health and physical capacity compared to that of an individual of the same age; current mental capacity compared with that of five years ago; mental capacity compared to that of an individual of the same age).

Excel^®2003 (Windows^®) was used to produce a database. The data were transferred to the Statistics Package Social Science – SPSS^®package version 15.0, to analyze the data.

The data were self-weighted; the analyses were then carried out based on the models. Analyses of the prevalence ratios of the insufficiently active older individuals in the areas of commuting and leisure were carried out using generalized linear models, with Poisson distribution with log link function and robust variance used to approximate the binomial. ²2 . Barros AJ, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BCM Med Res Methodol. 2003;(3):21. DOI:10.1186/1471-2288-3-21
https://doi.org/10.1186/1471-2288-3-21... Unadjusted analysis (separately for each characteristic) was carried out in each domain. Multiple regression analyses of the prevalence ratios for the factors in question was performed. The variables for the modelling were selected using backward elimination and grouping the most proximal factors, in the case of zeroes (or 100.0%) in the intersections between the explanatory variable and the outcome.

Two final models were evaluated for each domain. The first, containing sociodemographic explanatory variables: gender, age group, interaction between gender and age group, schooling, income, marital status, family composition; the second: number of diseases and perceived health, as well as the variables from the first model.

The study was approved by the Research Ethics Committee of the Universidade Federal de São Paulo (Process no. 0479/09, 08/05/2009). All participants were informed pf the aims of the study and signed consent forms.

RESULTS

The majority of the population studied were female (69.6%), with an average age of 69.2 (standard deviation 7.1 years), minimum 60 and maximum 90 years old ( Table 1 ).

Most of the older individuals had between one and three years of schooling (46.4%) and an income of between one and three minimum wages (41.7%) ( Table 1 ).

In the commuting domain, the prevalence of being insufficiently active was 87.5%, being greater among those aged 70 and over (97.9%). The majority had four or more years of studies (97.2%); among those with higher per capita income (five or more minimum wages) it was 96.9% ( Table 2 ).

The prevalence of insufficiently active individuals in the leisure domain was 76.2%. There was a higher proportion among women (80.6%) than men (66.0%) in the unadjusted model. The prevalence of insufficient physical activity in leisure time increased in those aged 80 and over (92.1%). The highest prevalence of inactivity was observed in those on less than one minimum wage (87.6%) and those with between four and seven years of studies (82.1%).

The sociodemographic variables age, schooling and perceived physical health compared with other individuals of the same age were associated with insufficient physical activity in commuting in both adjusted final models. For those aged 70 and over, there was a 1.22 times higher chance (PR = 1.22; 95%CI 1.13;1.32) of being insufficiently active in this domain, in the final adjusted demographic model. Those older individuals with higher levels of schooling (four or more years of studies) had a higher chance of not being sufficiently active in commuting (1.13; PR = 1.13; 95%CI 1.06;1.21; and 1.14; PR = 1.14; 95%CI 1.07;1.22, respectively, in the sociodemographic/sociodemographic and perceived health models) ( Table 3 ).

In the leisure domain, 76.2% of the older individuals were insufficiently active. There was a higher proportion of women (80.6%) than men (66.0%) in the unadjusted model. The prevalence of being insufficiently active in leisure time increased in those aged 80 and over (92.1%). A higher prevalence of inactivity was observed in those on less than one minimum wage (87.6%) and those with between four and seven years of studies (82.1%).

The prevalence of physical inactivity was higher among those with three or more diseases (93.5%), although there was no statistical significance.

Those who reported being dissatisfied with their physical health (90.2%) had a higher prevalence of inactivity ( Table 4 ).

In the two final adjusted models, differences were found regarding sex, age group, income, perceived physical compared with mental health. The profile of inactivity according to age differed between sexes. In the final demographic model, women aged between 60 and 79 years had a 1.37 times higher chance (PR = 1.37; 95%CI 1.16; 1.63) of being inactive than men, but there was no statistically significant difference between men and women in the more advanced age group of 80 to 90 years (p = 0.51). Older individuals on incomes of five or fewer minimum wages had a greater chance of being insufficiently active in leisure time (PR = 1.94; 95%CI 1.52;2.48 and PR = 1.94; 95%CI 1.53;2.48, in the respective models).

Those who evaluated their physical health as dissatisfactory compared with their mental health (PR = 1.19; 95%CI 1.07;1.32 and PR = 1.15; 95%CI 1.00;1.32, respectively) were associated with physical inactivity in leisure time, compared with those who evaluated it as satisfactory or regular ( Table 5 ).

Walking was the most commonly reported leisure time physical activity in the general sample.

DISCUSSION

In the domains of physical activity in commuting and leisure, there was a high prevalence of physical inactivity in the older population. These domains were evaluated separately, as, when dealing with this population, it was necessary to consider their peculiarities (part of this population suffer from chronic, degenerative diseases and are retired). Moreover, these domains are relevant in categorizing physical activity at a population level. ⁸8 . Hallal PC, Tenório MCM, Tassitano RM, Reis RS, Carvalho YM, Cruz DKA, et al. Avaliação do programa de promoção da atividade física Academia da cidade de Recife, Pernambuco, Brasil: percepções de usuários e não usuários. Cad Saude Publica 2010; 26(1):70-8. DOI:10.1590/S0102-311X2010000100008
https://doi.org/10.1590/S0102-311X201000...

The proportion of insufficiently active older individuals in commuting was high (87.5%). A similar result was found in an international survey, which indicated that 80.0% of the older population in the USA are inactive in commuting. ¹¹11 . Kruger J, Ham AS, Berrigan D, Ballard-Barbash R. Prevalence of transportation and leisure walking among U.S. adults. Prev Med. 2008;47(3):329-34. DOI:10.1016/j.ypmed.2008.02.018
https://doi.org/10.1016/j.ypmed.2008.02.... The high prevalence in this study is possibly the result of biological factors, added to environmental factors, such as most older individuals being retired and having no need to travel to work.

National studies show different results. Research described by Florindo et al ⁶6 . Florindo AA, Guimarães VV, Cesar CLG, Barros MBA, Alves MCGP, Goldbaum M. Epidemiology of leisure, transportation, occupational and household physical activity: prevalence and associated factors. J Phys Act Health. 2009;6(5):625-32. (2009) showed a higher prevalence of the older adults inactive in commuting (93.7%) in the city of Sao Paulo, SP, Southeastern Brazil, probably explained by the availability of free public transport, such as the bus and metro. A recent population based study, with a sample of 6,624 older individuals in 100 municipalities in 23 states in Brazil, showed a lower prevalence of insufficiently active older individuals in commuting (73.9%). ¹³13 . Madeira MC, Siqueira FCV, Facchini LA, Silveira DS, Tomasi E, Thumé E, et al. Atividade física no deslocamento em adultos e idosos do Brasil: prevalências e fatores associados. Cad Saude Publica. 2013;29(1):165-74. DOI:10.1590/S0102-311X2013000100019
https://doi.org/10.1590/S0102-311X201300...

Lower per capita income was associated with a lower prevalence of older individuals insufficiently active in commuting (82.9%). A similar result was found in a study by Salvador et al ²⁰20 . Salvador EP, Reis RS, Florindo AA. A prática de caminhada como forma de deslocamento e suas associações com a percepção do ambiente em idosos. Rev Bras Ativ Fis Saude. 2009;14(3):197-205. (2009) with 385 older individuals in the municipality of Ermelino Matarazzo, SP. This region is characterized by low to mid socioeconomic levels and the prevalence of older individuals who did not do more than 150 min/week of walking as commuting was 65.2%. Those with poorer socioeconomic conditions probably did not use individual means of transport (car) to get around. ²⁰20 . Salvador EP, Reis RS, Florindo AA. A prática de caminhada como forma de deslocamento e suas associações com a percepção do ambiente em idosos. Rev Bras Ativ Fis Saude. 2009;14(3):197-205.

Age was positively associated with inactivity in commuting. A similar result was found by Madeira et al ¹³13 . Madeira MC, Siqueira FCV, Facchini LA, Silveira DS, Tomasi E, Thumé E, et al. Atividade física no deslocamento em adultos e idosos do Brasil: prevalências e fatores associados. Cad Saude Publica. 2013;29(1):165-74. DOI:10.1590/S0102-311X2013000100019
https://doi.org/10.1590/S0102-311X201300... (2013) in an older population, among whom a trend was observed of insufficient levels of movement with increased age. Morbidities limited getting around in this age group.

The adjusted models showed a positive association between being insufficiently active in commuting and higher levels of education. On the other hand, a nationwide study of the older people ¹³13 . Madeira MC, Siqueira FCV, Facchini LA, Silveira DS, Tomasi E, Thumé E, et al. Atividade física no deslocamento em adultos e idosos do Brasil: prevalências e fatores associados. Cad Saude Publica. 2013;29(1):165-74. DOI:10.1590/S0102-311X2013000100019
https://doi.org/10.1590/S0102-311X201300... showed that, the higher the level of schooling, the greater the activity in getting around. One explanation is the fact that the sample analyzed different populations in several cities (n = 100) of different sizes.

The older people were shown to get around less, which could be associated with factors such as health and social conditions as, in the municipality of Maceió, these indicators are precarious.

There was a high prevalence, 76.2%, of being insufficiently active in leisure time, which is in agreement with other Brazilian studies. ⁶6 . Florindo AA, Guimarães VV, Cesar CLG, Barros MBA, Alves MCGP, Goldbaum M. Epidemiology of leisure, transportation, occupational and household physical activity: prevalence and associated factors. J Phys Act Health. 2009;6(5):625-32. ^{, 7}7 . Gilhl MW, Schneider IJC, Corseuil HX, Benedetti TRB, d´Orsi E. Atividade física e percepção do ambiente em idosos: estudo populacional em Florianópolis. Rev Saude Publica . 2012;46(3):516-25. DOI:10.1590/S0034-89102012005000026
https://doi.org/10.1590/S0034-8910201200... ^{, 25}25 . Zaitune MPA, Barros MBA, César CLG, Carandina L, Goldbaum M. Fatores associados ao sedentarismo no lazer em idosos, Campinas, São Paulo, Brasil. Cad Saude Publica. 2007;23(6):1329-38. DOI:10.1590/S0102-311X200700060000
https://doi.org/10.1590/S0102-311X200700... A population survey of the older population in the United States (n = 5,589), showed a proportion of 73.1% inactive. ¹⁰10 . Hughes JP, Mc Dowell MA, Brody DJ. Leisure-time physical activity among US adults 60 or more years of age: results from NHANES 1999-2004. J Phys Act Health. 2008;5(3):347-58. This domain received greater attention from researchers as it deals with activities carried out in free time, which can be affected by campaigns promoting health and by public policies.

There is growing interest in assessing the Brazilian population’s levels of physical activity. The study “ Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico – Telephone Survey Monitoring Risk and Protection Factors for Chronic Disease”, Brazil, 2012 (VIGITEL), ¹⁵15 . Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Análise de Situação de Saúde. Plano de ações estratégicas para o enfretamento das doenças crônicas não transmissíveis (DCNT) no Brasil 2011-2022. Brasília (DF); 2011. p.148. in the Brazilian state capitals and the Federal District, showed 70.8% of those aged 18 and over in Maceió who did not do the recommended weekly 150 minutes of physical activity.

A study of the areas covered by primary health care units in municipalities in the South and Northeast, including two municipalities in Alagoas, observed a lower prevalence of inactivity in the population that that in this study. The authors of that study ²⁴24 . Siqueira FV, Facchini LA, Piccini RX, Tomasi E, Thumé E, Silveira DS, et al. Atividade física em adultos e idosos residentes em áreas de abrangência de unidades básicas de saúde de municípios das regiões Sul e Nordeste do Brasil. Cad Saude Publica. 2008;24(1):39-54. DOI:10.1590/S0102-311X2008000100005
https://doi.org/10.1590/S0102-311X200800... investigated the older adults (n = 4,003) in 41 municipalities and presented data that differed by region, with a prevalence of inactivity from 47.3% to 67.5%, respectively, in the South and Northeast. The South having the best socioeconomic indicators in the country may explain these results. The prevalence in the Northeast was lower than that found in this study, possibly because those older individuals ²⁴24 . Siqueira FV, Facchini LA, Piccini RX, Tomasi E, Thumé E, Silveira DS, et al. Atividade física em adultos e idosos residentes em áreas de abrangência de unidades básicas de saúde de municípios das regiões Sul e Nordeste do Brasil. Cad Saude Publica. 2008;24(1):39-54. DOI:10.1590/S0102-311X2008000100005
https://doi.org/10.1590/S0102-311X200800... had some type of access to health promotion in the Primary Health Care Units.

Walking was the preferred leisure activity, other authors have identified the same trend. ¹⁰10 . Hughes JP, Mc Dowell MA, Brody DJ. Leisure-time physical activity among US adults 60 or more years of age: results from NHANES 1999-2004. J Phys Act Health. 2008;5(3):347-58. ^{, 21}21 . Santos PL, Foroni PM, Chaves MCF. Atividades físicas e de lazer e seu impacto sobre a cognição no envelhecimento. Medicina (Ribeirão Preto). 2009; 42(1):54-60. ^{, 25}25 . Zaitune MPA, Barros MBA, César CLG, Carandina L, Goldbaum M. Fatores associados ao sedentarismo no lazer em idosos, Campinas, São Paulo, Brasil. Cad Saude Publica. 2007;23(6):1329-38. DOI:10.1590/S0102-311X200700060000
https://doi.org/10.1590/S0102-311X200700... This physical activity is better adapted to the older population, as well as being a natural, low impact activity, of low cost. ²¹21 . Santos PL, Foroni PM, Chaves MCF. Atividades físicas e de lazer e seu impacto sobre a cognição no envelhecimento. Medicina (Ribeirão Preto). 2009; 42(1):54-60.

More older women than older men were insufficiently active in leisure time, as found in other studies. ⁶6 . Florindo AA, Guimarães VV, Cesar CLG, Barros MBA, Alves MCGP, Goldbaum M. Epidemiology of leisure, transportation, occupational and household physical activity: prevalence and associated factors. J Phys Act Health. 2009;6(5):625-32. ^{, 19}19 . Salvador EP, Florindo AA, Reis RS, Costa, EF. Percepção do ambiente e prática de atividade física no lazer entre idosos. Rev Saude Publica. 2009; 43(6):972-80. DOI:10.1590/S0034-89102009005000082
https://doi.org/10.1590/S0034-8910200900... ^{, 22}22 . Shibata A, Koichiro O, Nakamura Y, Muraoka I. Prevalence and demographic correlates of meeting the physical activity recommendation among japanese adults. J Phys ActHealth. 2009;6(1):24-32. DOI:10.1186/1479-5868-6-60
https://doi.org/10.1186/1479-5868-6-60... Women had less free time, which was filled with domestic chores and caring for families, as well as cultural issues that restrict their participation is leisure activities from becoming adults, and which may extend into old age. ⁴4 . Benedetti TRB, Borges LJ, Petroski EL, Gonçalves LHT. Atividade física e estado de saúde mental de idosos. Rev Saude Publica. 2008;42(2):302-7. DOI:10.1590/S0034-89102008005000007
https://doi.org/10.1590/S0034-8910200800... ^{, 22}22 . Shibata A, Koichiro O, Nakamura Y, Muraoka I. Prevalence and demographic correlates of meeting the physical activity recommendation among japanese adults. J Phys ActHealth. 2009;6(1):24-32. DOI:10.1186/1479-5868-6-60
https://doi.org/10.1186/1479-5868-6-60... Men retire, increasing their free time, which encourages their participation in leisure activities. ⁴4 . Benedetti TRB, Borges LJ, Petroski EL, Gonçalves LHT. Atividade física e estado de saúde mental de idosos. Rev Saude Publica. 2008;42(2):302-7. DOI:10.1590/S0034-89102008005000007
https://doi.org/10.1590/S0034-8910200800...

Cross-sectional and longitudinal studies indicate a reduction in physical activity of between 1.0% and 20.0% per year, with a trend for the proportion of inactive individuals to increase with age. ¹1 . Alves CL, Leimann BCQ, Vasconcelos MEL, Carvalho MS, Vasconcelos AGG, Fonseca TCO, et al. A influência das doenças crônicas na capacidade funcional dos idosos do Município de São Paulo, Brasil. Cad Saude Publica. 2007;23(8):1924-30. DOI:10.1590/S0102-311X2007000800019
https://doi.org/10.1590/S0102-311X200700... This is mainly due to progressive loss of functional aptitude and physical capacity. ⁹9 . Hirvensalo M., Lintunen T. Life-course perspective for physical activity and sports participation. Eur Rev Aging Phys Act. 2011;8(1):13-22. DOI:10.1007/s11556-010-0076-3
https://doi.org/10.1007/s11556-010-0076-... According to Vigitel data, physical activity decreases with increased age, reaching 77.8% in those aged 65 and over. ¹⁵15 . Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Análise de Situação de Saúde. Plano de ações estratégicas para o enfretamento das doenças crônicas não transmissíveis (DCNT) no Brasil 2011-2022. Brasília (DF); 2011. p.148.

Those in the most advanced age group had a higher prevalence of being insufficiently active. Although women aged between 60 and 79 were less active than men, from the age of 80 onwards, the results are similar. Similar data were verified by Zaitune et al ²⁵25 . Zaitune MPA, Barros MBA, César CLG, Carandina L, Goldbaum M. Fatores associados ao sedentarismo no lazer em idosos, Campinas, São Paulo, Brasil. Cad Saude Publica. 2007;23(6):1329-38. DOI:10.1590/S0102-311X200700060000
https://doi.org/10.1590/S0102-311X200700... (2007) with older individuals in Campinas, SP, Southeastern Brazil, finding a prevalence of 83.8% of those aged 80 and over being inactive in leisure time.

Many of the older individuals had low purchasing power, and there was an association between being on a lower income and not being sufficiently active in leisure time, which has also been found in other studies. ⁹9 . Hirvensalo M., Lintunen T. Life-course perspective for physical activity and sports participation. Eur Rev Aging Phys Act. 2011;8(1):13-22. DOI:10.1007/s11556-010-0076-3
https://doi.org/10.1007/s11556-010-0076-... ^{, 14}14 . Mazo GZ, Benedetti TB, Sacomori C. Association between participation in community groups and being more physically active among older adults from Florianópolis, Brazil. Clinics . 2011;66(11):1861-6. DOI:10.1590/S1807-59322011001100003
https://doi.org/10.1590/S1807-5932201100... ^{, 24}24 . Siqueira FV, Facchini LA, Piccini RX, Tomasi E, Thumé E, Silveira DS, et al. Atividade física em adultos e idosos residentes em áreas de abrangência de unidades básicas de saúde de municípios das regiões Sul e Nordeste do Brasil. Cad Saude Publica. 2008;24(1):39-54. DOI:10.1590/S0102-311X2008000100005
https://doi.org/10.1590/S0102-311X200800... Socioeconomic activity influences doing regular physical activity: those with higher purchasing power tend to be more physically active than those with lower purchasing power. ⁹9 . Hirvensalo M., Lintunen T. Life-course perspective for physical activity and sports participation. Eur Rev Aging Phys Act. 2011;8(1):13-22. DOI:10.1007/s11556-010-0076-3
https://doi.org/10.1007/s11556-010-0076-... In Brazil, this can be attributed to cultural issues related to physical activity or the lack of policies promoting health and access. Individuals on higher income have more facility and opportunity to do physical activity, as well as inhabiting a society in which it is recognized by their peers. ¹⁶16 . Pan SY, Cameron C, Desmeules M, Morrison H, Craig CL, Jiang XH. Individual, social, environmental, and physical environmental correlates with physical activity among Canadians: a cross-sectional study. BMC Public Health. 2009;9:21. DOI:10.1186/1471-2458-9-21
https://doi.org/10.1186/1471-2458-9-21...

Self-perceived health is reflected in the level of physical activity. Those who report their own health as good do more physical activity than those who rate it as poor or regular. ⁹9 . Hirvensalo M., Lintunen T. Life-course perspective for physical activity and sports participation. Eur Rev Aging Phys Act. 2011;8(1):13-22. DOI:10.1007/s11556-010-0076-3
https://doi.org/10.1007/s11556-010-0076-... There is an association between being insufficiently active in commuting and rating health as regular. Being insufficiently active in the leisure time domain or dissatisfied with physical health was associated with dissatisfaction with mental health. This trend was consistent with the results of other studies. ⁵5 . Chipperfield JG, Newall NE, Chuchmach LP, Swift AU, Haynes TL. Differential determinants of men’s and women’s everyday physical activity in later life. J Gerontol B Phychol Sci Soc Sci. 2008;63(4):211-8. DOI:10.1093/geronb/63.4.S211
https://doi.org/10.1093/geronb/63.4.S211... ^{, 25}25 . Zaitune MPA, Barros MBA, César CLG, Carandina L, Goldbaum M. Fatores associados ao sedentarismo no lazer em idosos, Campinas, São Paulo, Brasil. Cad Saude Publica. 2007;23(6):1329-38. DOI:10.1590/S0102-311X200700060000
https://doi.org/10.1590/S0102-311X200700...

Older individuals with lower levels of schooling, representing the majority of this sample, had a higher prevalence of being insufficiently active in leisure time, although not statistically significant in the unadjusted analysis. A similar result was found in older individuals in Campinas. ²⁵25 . Zaitune MPA, Barros MBA, César CLG, Carandina L, Goldbaum M. Fatores associados ao sedentarismo no lazer em idosos, Campinas, São Paulo, Brasil. Cad Saude Publica. 2007;23(6):1329-38. DOI:10.1590/S0102-311X200700060000
https://doi.org/10.1590/S0102-311X200700... Those with higher levels of schooling tended to have better health conditions and social support, and better assimilated the benefits of regularly doing physical activity. ¹⁶16 . Pan SY, Cameron C, Desmeules M, Morrison H, Craig CL, Jiang XH. Individual, social, environmental, and physical environmental correlates with physical activity among Canadians: a cross-sectional study. BMC Public Health. 2009;9:21. DOI:10.1186/1471-2458-9-21
https://doi.org/10.1186/1471-2458-9-21... The PRs showed no association with inactivity in leisure time in the adjusted models.

Public policies aiming to promote better quality of life should encourage the disadvantaged segments of society. This would prevent social inequalities in morbidity and mortality from growing and guarantee more equality in adopting behavior favorable to health. ²⁵25 . Zaitune MPA, Barros MBA, César CLG, Carandina L, Goldbaum M. Fatores associados ao sedentarismo no lazer em idosos, Campinas, São Paulo, Brasil. Cad Saude Publica. 2007;23(6):1329-38. DOI:10.1590/S0102-311X200700060000
https://doi.org/10.1590/S0102-311X200700...

Public health care policies should be established to promote and sustain active and health ageing. Recife, PE, Northeastern Brazil, stands out due to its City Gym program – Programa Academia da Cidade, which enables better adherence to exercise in public places with equipment for doing physical activity. This program was groundbreaking in that it encouraged women living where the equipment was installed, including older women of lower purchasing power, to have access to physical activities. ²³23 . Simões EJ, Hallal P, Pratt M, Ramos L, Munk M, Damasceno W, et al. Effects of a community-based, professionally supervised intervention on physical activity levels among residents of Recife, Brazil. Am J Public Health. 2009;99(1):68-75. DOI:10.2105/AJPH.2008.141978
https://doi.org/10.2105/AJPH.2008.141978...

The Brazilian Ministry of Health launched a strategic action plan to tackle non-communicable chronic diseases affecting the poorest levels of society and vulnerable groups. Faced with this reality, the Ministry of Health established public policies promoting health, prioritizing various activities, including physical activity. Thus, the Health Gym program – Programa Academia da Saúde was created in April 2011. This program aimed to encourage physical activity by constructing healthy spaces, favoring activities aimed at active ageing by implementing comprehensive health care and incentivizing the older individuals in this practice. ¹⁵15 . Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Análise de Situação de Saúde. Plano de ações estratégicas para o enfretamento das doenças crônicas não transmissíveis (DCNT) no Brasil 2011-2022. Brasília (DF); 2011. p.148.

In the literature, there are few studies specifically in physical activity in the older adults, especially in a state capital of the Northeast.

There are some limitations to this study. As it is a cross-sectional study, the relationship between cause and effect cannot be evaluated. Information presented herein on factors associated with physical activity in the commuting and leisure time domains may help future studies assess accessibility and obstacles to the older population using walking as a means of transport and in leisure time in Maceió.

The results show a high prevalence of physical inactivity in commuting and leisure time in older adults. Public policies should be drawn up that promote the development of physical activity, especially in the older elderly, females, those on lower income and those reporting poor perceived health.

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