Measuring physical activity over the life course: cross-cultural validation and measurement properties of the lifetime total physical activity questionnaire for Brazilian older adults

Abstract

Abstract Introduction Assessing lifetime physical activity is essential for understanding its cumulative impact on health and ageing; however, no validated instrument is available in Brazilian Portuguese to capture these long-term patterns. The Lifetime Total Physical Activity Questionnaire (LTPAQ) records physical activity across multiple domains and intensities throughout the life course. Objective To translate the LTPAQ into Brazilian Portuguese, perform a cross cultural validation and evaluate its measurement properties in a population of Brazilian older adults. Methods This methodological study was conducted in two phases: (1) translation and cross-cultural validation following the Beaton guidelines, and (2) measurement properties according to COSMIN standards. The pre-final version was tested in 30 older adults to assess comprehensibility, and the measurement property analyses were conducted in 80 community-dwelling older adults aged 60–80 years. Test-retest reliability, measurement error (standard error of measurement, Bland–Altman limits of agreement), interpretability (minimum detectable difference, floor and ceiling effects), and hypothesis testing and known-groups analyses for construct validity were evaluated. The calendar method was used to improve lifetime activity recall. Results The Brazilian Portuguese version of the LTPAQ required minimal cultural adaptation and achieved excellent clarity (content validity index > 0.90). Test-retest reliability was excellent (ICC = 0.89–0.96), with minimal measurement error (SEM = 1%) and low minimum detectable difference values. Narrow limits of agreement were observed for transportation and exercise/sports, while light-to-moderate activities showed wider variability. Floor effects were present in some domains, but no ceiling effects were identified. No significant correlations were observed between the LTPAQ-Brazil and the EuroQol 5-Dimension questionnaire (EQ-5D), the EuroQol Visual Analogue Scale (EQ-VAS), and the International Physical Activity Questionnaire – Short Form (IPAQ-SF). However, significant differences in lifetime physical activity scores were found according to sex, educational attainment, and socioeconomic status, supporting construct validity. Conclusion The LTPAQ-Brazil demonstrated evidence of cross-cultural validity, reliability, measurement precision, interpretability, and construct validity for assessing lifetime physical activity in Brazilian older adults. The instrument enables the characterization of physical activity exposure across the life course and may be useful for epidemiological and healthy ageing research.