This study is aimed to evaluate whether circulating adiponectin concentration is associated with physical activity (PA) level in healthy older females. To date, daily PA in older adults (> or = 65 years) has primarily relied on self-report. This study used accelerometry, which objectively measured minute-by-minute movement to assess PA volume and intensity performed by elderly females. In addition, body composition, leptin and insulin resistance values were measured to assess the influence of these parameters on the possible relationship between adiponectin and PA levels in this specific age group of older women. On 49 women (mean age: 73.6 +/- 4.2 years), adiponectin, leptin, insulin resistance, body composition and 7-day PA parameters were measured. Average daily accelerometer step counts and time spent in different PA levels were obtained from 7-day PA measurement. Average daily accelerometer step-count was 7,722 +/- 3,069 steps day(-1) and the recommended 150 min weekly of at least moderate/vigorous PA in bouts of at least 10 min was achieved by 71.4% (35/49) of the participants. Correlation analysis showed that plasma adiponectin concentration (16.0 +/- 6.1 microg ml(-1) ) was related (P < 0.001) to steps per day (r = 0.438) and leptin (r = -0.443) values. Multivariate regression analysis further revealed that only steps per day and leptin were independent predictors of circulating adiponectin concentration in healthy elderly females. In conclusion, these data support the hypothesis that being physically active is associated with better adiponectin concentration and a reduced risk of having metabolic disease risk in the specific group of healthy elderly females.