Predictors of Physical Activity Levels in Community-Dwelling Older Adults: A Multivariate Approach Based on a Socio-Ecological Framework

in Journal of Aging and Physical Activity
Restricted access

Purchase article

USD  $24.95

Student 1 year subscription

USD  $76.00

1 year subscription

USD  $101.00

Student 2 year subscription

USD  $144.00

2 year subscription

USD  $189.00

The purpose of this study was to explore cross-sectional relationships between self-reported physical activity (PA) and personal, social, and environmental factors in community-dwelling adults aged 50 years and older. Accounting for clustering by neighborhood, generalized estimating equations were used to examine associations between selected correlates and the Physical Activity Scale for the Elderly (PASE) score while adjusting for confounders. Data for 601 participants were analyzed: 79% female, 37% married, mean age 76.8 (± 8.7) years, mean PASE score 112.6 (± 64.8). Age, living in seniors’ housing, using nursing/home care services, receiving encouragement to be active, and having benches available in the neighborhood were inversely associated with PASE. Self-efficacy, SF-12 score, PA barriers, social support, and the presence of trails showed positive associations. Several personal, social, and environmental factors associated with PA were identified. The inverse association between PA and living in seniors’ housing units should be considered when developing PA programs for older adults.

Fisher is with the Dept. of Kinesiology, California State University, Fullerton, Fullerton, CA. Harrison, Lawson, Reeder, and Chad are with the University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Bruner is with Nipissing University, North Bay, Ontario, Canada. Ashworth is with the University of Alberta, Edmonton, Alberta, Canada. Sheppard is with Saskatoon Health Region, Saskatoon, Saskatchewan, Canada.

Address author correspondence to Koren L. Fisher at kofisher@fullerton.edu.
  • Berton, P., Gurrin, L., & Sly, P. (1998). Extending the simple linear regression model to account for correlated responses: An introduction to generalized estimating equations and multilevel mixed modelling. Statistics in Medicine, 17, 1261–1291. PubMed doi:10.1002/(SICI)1097-0258(19980615)17:11<1261::AID-SIM846>3.0.CO;2-Z

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bohannon, R.W., Maljanian, R., & Landes, M. (2004). Test–retest reliability of short form (SF)-12 component scores of patients with stroke. International Journal of Rehabilitation Research, 27(2), 149–150. PubMed doi:10.1097/01.mrr.0000127350.25287.08

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Booth, M., Owen, N., Bauman, A., Clavisi, O., & Leslie, E. (2000). Social-cognitive and perceived environment influences associated with physical activity in older Australians. Preventive Medicine, 31, 15–22. PubMed doi:10.1006/pmed.2000.0661

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Burton, L.C., Shapiro, S., & German, P.S. (1999). Determinants of physical activity initiation and maintenance among community-dwelling older persons. Preventive Medicine, 29, 422–430. PubMed doi:10.1006/pmed.1999.0561

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Chad, K., Reeder, B.A., Harrison, E.L., Ashworth, N.L., Sheppard, M.S., Schultz, S.L., . . . Lawson, J.A. (2005). Profile of physical activity levels in community dwelling older adults. Medicine & Science in Sport & Exercise, 37, 1774–1784. PubMed doi:10.1249/01.mss.0000181303.51937.9c

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Cerin, E., Nathan, A., van Cauwenberg, J., Barnett, D.W., & Barnett, A. (2017). The neighbourhood physical environment and active travel in older adults: A systematic review and meta-analysis. International Journal of Behavioral Nutrition & Physical Activity, 14(1), 15–37. PubMed doi:10.1186/s12966-017-0471-5

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Chaudhury, H., Campo, M., Michael, Y., & Mahmood, A. (2016). Neighbourhood environment and physical activity in older adults. Social Science & Medicine, 149, 104–113. PubMed doi:10.1016/j.socscimed.2015.12.011

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Cobb, L.K., Godino, J.G., Selvin, E., Kucharska-Newton, A., Coresh, J., & Koton, S. (2016). Spousal influence on physical activity in middle-aged and older adults: The ARIC study. American Journal of Epidemiology, 183(5), 444–451. PubMed doi:10.1093/aje/kwv104

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Copeland, J.L., & Esliger, D.W. (2009). Accelerometer assessment of physical activity in active, healthy older adults. Journal of Aging & Physical Activity, 17(1), 17–30. PubMed doi:10.1123/japa.17.1.17

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Dinger, M.K., Oman, F., Taylor, E.L., Vesely, S.K., & Able, J. (2004). Stability and convergent validity of the Physical Activity Scale for the Elderly (PASE). Journal of Sports Medicine & Physical Fitness, 44, 186–192. PubMed

    • Search Google Scholar
    • Export Citation
  • Dishman, R.K. (2008). Gene–physical activity interactions in the etiology of obesity: Behavioral considerations. Obesity, 16, 60–65. PubMed doi:10.1038/oby.2008.520

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Eyler, A., Wilcox, S., Matson-Koffman, D., Evenson, K.R., Sanderson, B., Thompson, J., . . . Rohm-Young, D. (2002). Correlates of physical activity among women from diverse racial/ethical groups. Journal of Women’s Health & Gender-Based Medicine, 11(3), 239–253. PubMed doi:10.1089/152460902753668448

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fekete, E., Stephens, M., Druley, J., & Hoyt, W., Jr. (2006). Effects of spousal control and support on older adults’ recovery from knee surgery. Journal of Family Psychology, 20(2), 302–310. PubMed doi:10.1037/0893-3200.20.2.302

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fleig, L., Ashe, M.C., Voss, C., Therrien, S., Sims-Gould, J., McKay, H.A., & Winters, M. (2016). Environmental and psychosocial correlates of objectively measured physical activity among older adults. Health Psychology, 35(12), 1364–1372. PubMed doi:10.1037/hea0000403

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fox, K. (1999). The influence of physical activity on mental well-being. Public Health Nutrition, 2, 411–418. PubMed doi:10.1017/S1368980099000567

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Franks, M., Stephens, M., Rook, K., Franklin, B., Keteyian, S., & Artinian, N. (2006). Spouses’ provision of health-related support and control to patients participating in cardiac rehabilitation. Journal of Family Psychology, 20(2), 311–318. PubMed doi:10.1037/0893-3200.20.2.311

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ghandi, S.K., Salmon, J.W., Zhao, S.Z., Lambert, B.L., Gore, P.R., & Konrad, K. (2001). Psychometric evaluation of the 12-item Short Form Health Survey (SF-12) in osteoarthritis and rheumatoid arthritis clinical trials. Clinical Therapeutics, 23(7), 1080–1098. PubMed doi:10.1016/S0149-2918(01)80093-X

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Globe, D.R., Levin, S., Chang, T.S., Mackenzie, P.J., & Azen, S. (2002). Validity of the SF-12 quality of life instrument in patients with retinal diseases. Ophthalmology, 109(10), 1793–1798. PubMed doi:10.1016/S0161-6420(02)01124-7

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Helgeson, V.S., Novak, S.A., Lepore, S.J., & Eton, D.T. (2004). Spouse social control efforts: Relations to health behavior and well-being among men with prostate cancer. Journal of Social and Personal Relationships, 21(1), 53–68. doi:10.1177/0265407504039840

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hosmer, D., & Lemeshow, S. (2000). Applied logistic regression. New York, NY: John Wiley & Sons, Inc.

  • Hummer, D.B., Silva, S.G., Yap, T.L., Toles, M., & Anderson, R.A. (2015). Implementation of an exercise program in an assisted living facility. Journal of Nursing Care Quality, 30(4), 373–379. PubMed doi:10.1097/NCQ.0000000000000125

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Jacobs, J.M., Rottenberg, Y., Cohen, A., & Stessman, J. (2013). Physical activity and health service utilization among older people. Journal of the American Medical Directors Association, 14(2), 125–129. PubMed doi:10.1016/j.jamda.2012.10.023

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kerr, J., Norman, G., Millstein, R., Adams, M.A., Morgan, C., Langer, R.D., & Allison, M. (2014). Neighborhood environment and physical activity among older women: Findings from the San Diego Cohort of the Women’s Health Initiative. Journal of Physical Activity & Health, 11(6), 1070–1077. PubMed doi:10.1123/jpah.2012-0159

    • Crossref
    • Search Google Scholar
    • Export Citation
  • King, A.C., Castro, C., Eyler, A.A., Wilcox, S., Sallis, J.F., & Brownson, R.C. (2000). Personal and environmental factors associated with physical inactivity among different racial-ethnic groups of U.S. middle-aged and older-aged women. Health Psychology, 19(4), 354–364. PubMed doi:10.1037/0278-6133.19.4.354

    • Crossref
    • Search Google Scholar
    • Export Citation
  • King, A.C., Taylor, C.B., & Haskell, W.L. (1993). Effects of differing intensities and formats of 12 months of exercise training on psychological outcomes in older adults. Health Psychology, 12, 292–300. PubMed doi:10.1037/0278-6133.12.4.292

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Koeneman, M.A., Verheijden, M.W., Chinapaw, M.J.M., & Hopman-Rock, M. (2011). Determinants of physical activity and exercise in healthy older adults: A systematic review. International Journal of Behavioral Nutrition and Physical Activity, 8(1), 142. PubMed doi:10.1186/1479-5868-8-142

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Krueger, H., Krueger, J., & Koot, J. (2015). Variation across Canada in the economic burden attributable to excess weight, tobacco smoking, and physical inactivity. Canadian Journal of Public Health, 106(4), e171–e177. PubMed doi:10.17269/cjph.106.4994

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lox, C., Martin, K., & Petruzzello, S. (2003). The psychology of exercise: Integrating theory and practice. Scottsdale, AZ: Holcomb Hathaway Publishers Inc.

    • Search Google Scholar
    • Export Citation
  • Luo, X., Lynn George, M., Kakouras, I., Edwards, C.L., Pietrobon, R., Richardson, W., & Hey, L. (2003). Reliability, validity, and responsiveness of the Short Form 12-Item Survey (SF-12) in patients with back pain. Spine, 28(15), 1739–1745. PubMed

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McAuley, E. (1992). The role of efficacy cognitions in the prediction of exercise behavior in middle-aged adults. Journal of Behavioral Medicine, 15(1), 65–88. PubMed doi:10.1007/BF00848378

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McAuley, E., & Mihalko, S.L. (1998). Measuring exercise-related self-efficacy. In J. Duda (Ed.) Advances in sport and exercise psychology measurement (pp. 371–390). Morgantown, WV: Fitness Information Technology, Inc.

    • Search Google Scholar
    • Export Citation
  • Melville, J.L., Miller, E.A., Fialkow, M.F., Lentz, G.M., Miller, J.L., & Fenner, D.E. (2003). Relationship between patient report and physician assessment of urinary incontinence severity. American Journal of Obstetrics & Gynecology, 189(1), 76–80. PubMed doi:10.1067/mob.2003.375

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mihalko, S.L., & Wickley, K.L. (2003). Active living for assisted living: Promoting partnerships within a systems framework. American Journal of Preventive Medicine, 25, 193–203. PubMed doi:10.1016/S0749-3797(03)00184-3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Mullen, S.P., Wojcicki, T.R., Mailey, E.L., Szabo, A.N., Gothe, N.P., Olson, E.A., . . . McAuley, E. (2013). A profile for predicting attrition from exercise in older adults. Prevention Science, 14(5), 489–496.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Olsen, C.F., Telenius, E.W., Engedal, K., & Bergland, A. (2015). Increased self-efficacy: The experience of high-intensity exercise of nursing home residents with dementia– A qualitative study. BMC Health Services Research, 15(1), 1–12 . doi:10.1186/s12913-015-1041-7

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Physical Activity Scale for the Elderly administration and scoring instruction manual. (1991). Watertown, MA: New England Research Institutes, Inc.

    • Search Google Scholar
    • Export Citation
  • Prince, S.A., Reed, J.L., Martinello, N., Adamo, K.B., Fodor, J.G., Hiremath, S., . . . Reid, R.D. (2016). Why are adult women physically active? A systematic review of prospective cohort studies to identify intrapersonal, social environmental and physical environmental determinants. Obesity Reviews, 17(10), 919–944. PubMed doi:10.1111/obr.12432

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Public Health Agency of Canada. (2014). Economic burden of illness in Canada, 2005–2008. Retrieved from http://www.phac-aspc.gc.ca/publicat/ebic-femc/2005-2008/assets/pdf/ebic-femc-2005-2008-eng.pdf

    • Export Citation
  • Sallis, J.F., Grossman, R.M., Pinski, R.B., Patterson, T.L., & Nader, P.R. (1987). The development of scales to measure social support for diet and exercise behaviors. Preventive Medicine, 16, 825–836. PubMed doi:10.1016/0091-7435(87)90022-3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sallis, J.F., Johnson, M.F., Calfas, K.J., Caparosa, S., & Nichols, J.F. (1997). Assessing perceived physical environmental variables that may influence physical activity. Research Quarterly for Exercise and Sport, 68(4), 345–351. PubMed doi:10.1080/02701367.1997.10608015

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Sallis, J.F., & Owen, N. (2002). Ecological models of health behavior. In K. Glanz, F.M. Lewis, & B.K. Rimer (Eds.). Health behavior and health education: Theory, research and practice (pp. 462–484). San Francisco, CA: Jossey-Bass Publishers.

    • Search Google Scholar
    • Export Citation
  • Salyers, M.P., Bosworth, H.B., Swanson, J.W., Lamb-Pagone, J., & Osher, F.C. (2000). Reliability and validity of the SF-12 health survey among people with severe mental illness. Medical Care, 38(11), 1141–1150. PubMed doi:10.1097/00005650-200011000-00008

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Samsa, G., Edelman, D., Rothman, M.L., Williams, G.R., Lipscomb, J., & Matchar, D. (1999). Determining clinically important differences in health status measures: A general approach with illustration to the Health Utilities Index Mark II. Parmacoeconomics, 15(2), 141–155. PubMed doi:10.2165/00019053-199915020-00003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Schulz, R., & Sherwood, P.R. (2008). Physical and mental health effects of family caregiving. The American Journal of Nursing, 108(Suppl. 9), 23–27. PubMed doi:10.1097/01.NAJ.0000336406.45248.4c

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Shaw, S., Bonen, A., & McCabe, J. (1991). Do more constraints mean less leisure? Examining the relationship between constraints and participation. Journal of Leisure Research, 21, 286–300.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Siddique, R., Ricci, J.A., Stewart, W.F., Sloan, S., & Farup, C.E. (2002). Quality of life in a US national sample of adults with diabetes and motility-related upper gastrointestinal symptoms. Digestive Diseases and Sciences, 47(4), 683–689. PubMed doi:10.1023/A:1014723525911

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Stathi, A., Gilbert, H., Fox, K.R., Coulson, J., Davis, M., & Thompson, J.L. (2012). Determinants of neighbourhood activity of adults age 70 and over: A mixed methods study. Journal of Aging & Physical Activity, 20(2), 148–170. PubMed doi:10.1123/japa.20.2.148

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Statistics Canada. (1996). 1996 census questionnaire (Report No. 96-2b-en). Ottawa, ON: Statistics Canada. Retrieved from http://www12.statcan.gc.ca/english/census01/info/question2.cfm

    • Search Google Scholar
    • Export Citation
  • Statistics Canada. (2001). 1998 national population health survey. Ottawa, ON: Statistics Canada. Retrieved from http://www23.statcan.gc.ca/imdb-bmdi/instrument/3236_Q1_V3-eng.pdf

    • Search Google Scholar
    • Export Citation
  • Trost, S.G., Owen, N., Bauman, A.E., Sallis, J.F., & Brown, W. (2002). Correlates of adults’ participation in physical activity: Review and update. Medicine & Science in Sport & Exercise, 34(12), 1996–2001. PubMed doi:10.1097/00005768-200212000-00020

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ware, J., Jr., Kosinski, M., & Keller, S.D. (1996). A 12-Item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220–233. PubMed doi:10.1097/00005650-199603000-00003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ware, J., Jr., Kosinski, M., Turner-Bowker, D.M., & Gandek, B. (2002). How to score version 2 of the SF-12 Health Survey (with a supplement documenting version 1). Lincoln, RI: QualityMetric Incorporated.

    • Search Google Scholar
    • Export Citation
  • Washburn, R.A., Smith, K.W., Jette, A.M., & Janney, C.A. (1993). The Physical Activity Scale for the Elderly (PASE): Development and evaluation. Journal of Clinical Epidemiology, 46(2), 153–162. PubMed doi:10.1016/0895-4356(93)90053-4

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Wu, Y.T., Jones, N.R., van Sluijs, E.M.F., Griffin, S.J., Wareham, N.J., & Jones, A.P. (2016). Perceived and objectively measured environmental correlates of domain-specific physical activity in older English adults. Journal of Aging & Physical Activity, 24, 599–616. PubMed doi:10.1123/japa.2015-0241

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 192 192 22
Full Text Views 16 16 2
PDF Downloads 4 4 1