Calibration of an Accelerometer Activity Index Among Older Women and Its Association With Cardiometabolic Risk Factors

Purpose: Traditional summary metrics provided by accelerometer device manufacturers, known as counts, are proprietary and manufacturer specific, making it difficult to compare studies using different devices. Alternative summary metrics based on raw accelerometry data have been introduced in recent years. However, they were often not calibrated on ground truth measures of activity-related energy expenditure for direct translation into continuous activity intensity levels. Our purpose is to calibrate, derive, and validate thresholds among women 60 years and older based on a recently proposed transparent raw data-based accelerometer activity index (AAI) and to demonstrate its application in association with cardiometabolic risk factors. Methods: We first built calibration equations for estimating metabolic equivalents continuously using AAI and personal characteristics using internal calibration data (N = 199). We then derived AAI cutpoints to classify epochs into sedentary behavior and physical activity intensity categories. The AAI cutpoints were applied to 4,655 data units in the main study. We then utilized linear models to investigate associations of AAI sedentary behavior and physical activity intensity with cardiometabolic risk factors. Results: We found that AAI demonstrated great predictive accuracy for estimating metabolic equivalents (R² = .74). AAI-Based physical activity measures were associated in the expected directions with body mass index, blood glucose, and high-density lipoprotein cholesterol. Conclusion: The calibration framework for AAI and the cutpoints derived for women older than 60 years can be applied to ongoing epidemiologic studies to more accurately define sedentary behavior and physical activity intensity exposures, which could improve accuracy of estimated associations with health outcomes.