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Jack M. Guralnik, Suzanne Leveille, Stefano Volpato, Marcia S. Marx and Jiska Cohen-Mansfield

Epidemiological studies have demonstrated that, using objective performance measures of physical functioning, disability risk can be predicted in nondisabled older adults. This makes it possible to recruit a nondisabled but at-risk population for clinical trials of disability prevention. Successful disability prevention in this population, for example through an exercise program, would have a major public health impact. To enhance the development of exercise interventions in this group it would be valuable to have additional information not available from existing epidemiologic studies. This report examines the evidence that functional limitations preceding disability can be identified in a community-dwelling population and that it is feasible to recruit these people into studies. It introduces a series of articles examining the characteristics of this population: motivators and barriers to exercise, exercise habits and preferences, the impact of positive and negative affect, and the impact of pain and functional limitations on attitudes toward exercise.

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Glenn V. Ostir, Jiska Cohen-Mansfield, Suzanne Leveille, Stefano Volpato and Jack M. Guralnik

This study investigated whether positive or negative affect has an independent association with exercise self-efficacy. Participants (N = 324) age 75-85 were classified as high or at-risk performers, and three exercise-self-efficacy items (scored 1-10) were assessed. For at-risk performers, positive affect was significantly associated with confidence in the ability to perform strength and flexibility (b = 0.83, SE = 0.23, p = .001) and aerobic exercise (b = 0.59, SE = 0.28, p = .04) and with the perception that exercise would not worsen preexisting symptoms (b = 0.73, SE = 0.24, p = .001). Among high performers, nonsignificant associations were found for positive and negative affect and exercise-self-efficacy. For at-risk performers, higher positive affect was associated with an increased odds ratio of 2.72 for scoring 10 on the muscle strength and flexibility item, 4.08 on the aerobic item, and 2.94 on the item assessing preexisting symptoms. The results suggest that improving at-risk older adults’ positive affect might increase their participation in exercise.