Reducing sedentary behaviour in older adults with mobility limitations.

My doctoral research, conducted at the University of Birmingham (2017–2020) within the PANINI Marie Skłodowska-Curie Innovative Training Network, asked how we can help older adults who struggle to move spend less time sitting — and whether it matters for their health. As part of this work, I became Chief Investigator of a behaviour change trial embedded within NHS orthopaedic surgery services.

Sedentary behaviour — time spent sitting or lying while awake — is strongly associated with poor cardiometabolic health, frailty, and early mortality. These risks are especially pronounced for older adults with limited mobility, who may have few opportunities to be physically active and face structural barriers to reducing sitting time. Yet at the time this PhD began, almost no behaviour change trials had specifically targeted sedentary time in this population — research had focused on physical activity in healthier older adults, leaving people with mobility limitations underserved by the evidence base.

The PhD proceeded in three phases: a systematic review of existing interventions; development and measurement work to design a targeted behaviour change programme; and a randomised controlled trial — the INTEREST (INTErvention to REduce Sitting Time) study — which recruited older adults with osteoarthritis from NHS orthopaedic surgery services. I was Chief Investigator of the trial, which ran in complex real-world NHS conditions. The findings are reported in my 2020 thesis and a series of peer-reviewed papers.

“The systematic review found no published trials that had specifically targeted sedentary behaviour in older adults with mobility limitations — a gap this PhD was designed to fill.”

From evidence gap to randomised trial

1 Systematic review 2 Intervention development 3 INTEREST trial

Publications from this work

Objective and subjective measurement of sedentary behavior in human adults: a toolkitJoint first author
2022 · Aunger J*, Wagnild J* · American Journal of Human Biology
Interventions to reduce sedentary time in older adults with and without mobility limitationFirst author
2020 · Aunger JA · Doctoral thesis, University of Birmingham
A novel behavioural INTErvention to REduce Sitting Time in older adults undergoing orthopaedic surgery (INTEREST): results of a randomised controlled trialFirst author
2020 · Aunger JA, Greaves CJ, Davis ET, Asamane EA, et al. · Aging Clinical and Experimental Research
A randomised feasibility study to reduce sitting in older adults undergoing orthopaedic surgeryFirst author
2019 · Aunger JA, Greaves CT, Asamane EA, et al. · Innovation in Aging
Interventions targeting sedentary behavior in non-working older adults: a systematic reviewFirst author
2018 · Aunger JA, Doody P, Greig CA · Maturitas

About PANINI

This PhD was supported by PANINI — Physical Activity and Nutrition Influences in Ageing — a Marie Skłodowska-Curie Innovative Training Network funded under the European Commission's Horizon 2020 programme. The network funding was secured by my supervisors; I was one of the early-career researchers it supported.

Selected presentations

  • Nov 2019
    Gerontological Society of America Annual Meeting
    "A randomised feasibility study to reduce sitting in older adults undergoing orthopaedic surgery"
  • Jul 2019
    European College of Sports Science (ECSS), Prague
    Debated poster — INTEREST randomised controlled feasibility study