• Urho M Kujala, Pekka Hautasaari, Henri Vähä-Ypyä, Katja Waller, Noora Lindgren, Paula Iso-Markku, Kauko Heikkilä, Juha Rinne, Jaakko Kaprio, and Harri Sievänen.
• a Faculty of Sport and Health Sciences , University of Jyväskylä , Jyväskylä , Finland.
• Ann. Med. 2019 Feb 1; 51 (1): 78-87.

IntroductionHigh physical activity (PA) at old age indicates good functional capacity enabling independent living. We investigated how different disease conditions are associated with measured PA indicators in old women and men, and whether they recognize this association.Materials And MethodsThis cross-sectional twin cohort study in Finland comprised 779 individuals (276 complete twin pairs, including 117 monozygotic pairs), who participated in hip-worn accelerometer monitoring of PA and responded to questions on diseases and mobility limitations at mean age of 73 (range 71-75).ResultsOf the participants, 23.2% reported having a disease restricting mobility. With sex and age in the regression model, the reported disease restricting mobility explained 11.8% of the variation in moderate-to-vigorous PA (MVPA) and 10.4% of the variation in daily steps. Adding stepwise other self-reported diseases and body mass index to the model increased the explanatory power for MVPA up to 18.5% and 25.5%, and for daily steps up to 16.0% and 20.7%, respectively. In the co-twin control analysis the PA differences were smaller in disease-discordant monozygotic than dizygotic pairs.ConclusionsChronic disease conditions are associated with low PA, which individuals may not always recognize. Shared genetic factors may explain part of the associations. Key messages Among community-dwelling older men and women one-fourth of the variation in objectively measured moderate-to-vigorous physical activity is accounted for by age, sex, body mass index and self-reported diseases. Occurrence of chronic diseases is associated with low physical activity and individuals do not always recognize this. Healthcare professionals should pay attention to the low physical activity and mobility of individuals with chronic disease conditions before these result in limitations in independent living.

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