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.
Jack M. Guralnik, Suzanne Leveille, Stefano Volpato, Marcia S. Marx and Jiska Cohen-Mansfield
Silvia Aranda-García, Albert Iricibar, Antoni Planas, Joan A. Prat-Subirana and Rosa M. Angulo-Barroso
This study evaluates the separate effect and retention of 12-week traditional (TE) and horse (HE) exercise programs on physical function in healthy older participants (61 to 87 years old). Thirty-eight participants were randomly assigned to three groups: TE (n = 17), HE (n = 10), and control group (n = 11). TE and HE underwent a supervised exercise program (3 day/week). Maximal gait speed, muscle strength, and body balance were assessed at weeks 0, 12, and 16. Only TE and HE displayed significant improvements (P < .05) in knee extensor strength, and only HE had faster gait speed. Marginal balance improvements were found only in HE in the medial-lateral direction. However, TE showed larger improvements in handgrip than HE. The largest retention was in knee extensor strength but most of the exercise effects were lost in the follow-up. Besides TE, exercise with a horse may be an alternative option to older adults, provided that they want to interact with the animal.
Jitka Jancova-Vseteckova, Martin Bobak, Ruzena Kubinova, Nada Capkova, Anne Peasey, Michael G. Marmot and Hynek Pikhart
The aim was to examine the association of objective measures of physical functioning (PF) with education and material circumstances and the decline in PF with age by socioeconomic position (SEP).
In 3,205 subjects (60–75 years) from the Czech Republic, we assessed relationship between PF, SEP, and age. Linear regression was used to assess PF measures and SEP measures.
Cross-sectional decline in PF by age was similar in all individuals. Differences between SEP groups were similar across age groups, except for the difference in walk speed by material circumstances in men—bigger at older ages (p = .004). Men and women with the highest education were about 2 s faster at the chair rise test than those with the lowest education.
Findings suggest strong educational gradient in PF, an inconsistent role of self-assessed material circumstances, and virtually no interaction of SEP with the cross-sectional decline in PF by age.
Carrie S. Baker, Jennifer M. Medina McKeon and Ellen L. Usher
Self-efficacy of balance, a psychological characteristic, may provide information regarding psychological risk factors for lower-extremity injury. Validated instruments to assess self-efficacy of balance do not currently exist. The objective of this study was to determine the face and content validity of the Self-Efficacy of Balance Scale (SEBS) for an adolescent population, as well as content validity, construct and convergent validity of the overall instrument. A series of panelists (n = 11) assessed proposed items for face and content validity for self-efficacy of balance. Construct and convergent validity were assessed with active college individuals (n = 74) and female high school basketball athletes (n = 57). Original items were revised to 21 items. Panelists validated both face and content validity of the SEBS. All items were assessed to have the construct of self-efficacy. Evidence of convergent validity supported the proposed construct of self-efficacy, and was found to be relevant to the physical functioning of a young, active population.
Lisa M. Warner, Jochen P. Ziegelmann, Benjamin Schüz, Susanne Wurm and Ralf Schwarzer
The purpose of the current study was to examine whether the effects of social support on physical exercise in older adults depend on individual perceptions of self-efficacy. Three hundred nine older German adults (age 65–85) were assessed at 3 points in time (3 months apart). In hierarchical-regression analyses, support received from friends and exercise self-efficacy were specified as predictors of exercise frequency while baseline exercise, sex, age, and physical functioning were controlled for. Besides main effects of self-efficacy and social support, an interaction between social support and self-efficacy emerged. People with low self-efficacy were less likely to be active in spite of having social support. People with low support were less likely to be active even if they were high in self-efficacy. This points to the importance of both social support and self-efficacy and implies that these resources could be targets of interventions to increase older adults’ exercise.
L. Jerome Brandon, Lisa W. Boyette, Adreinne Lloyd and Deborah A. Gaasch
The purpose of this study was to evaluate the effects of a 24-month moderate-intensity resistive-training intervention on strength and function in older adults. A repeated-measures experimental research design was employed as a sample of 55 apparently healthy, older, community-dwelling volunteers (30 exercisers—25 women and 5 men; 25 comparisons—16 women and 9 men) were evaluated for strength of 5 muscle groups that influence lower extremity movement and physical function. Strength and function were evaluated at 6-month intervals. The findings from this study indicate that a moderate-intensity resistive-training program increases strength in older adults and that the strength benefits are retained for the duration of the intervention. Furthermore, a long-term strength-training program can increase independent-function skills in older adults and might therefore aid in prolonging functional independence.
Lorraine J. Phillips and Marcia Flesner
This qualitative study investigated individual and situational factors influencing physical activity (PA) practices of elders in residential-care/assisted-living (RC/ AL) communities. This article describes the results of focus-group interviews involving 47 residents across 6 RC/AL settings. Thematic analysis revealed 6 themes: staying active, past PA experiences, value of PA, barriers to PA, strategies to facilitate PA, and support needs to promote PA. Staying active meant walking indoors and out, attending chair-exercise programs, performing professionally prescribed home exercises, and using available exercise equipment. Past PA experiences shaped current preferences and practices. Participants agreed that exercise helped maintain physical functioning but recounted cognitive and situational barriers to PA. Lack of dedicated exercise space and short corridors hampered efforts to stay active. Participants wished for individualized home exercise programs and supervised exercise sessions. Future research should examine the extent to which the physical environment and PA programming in RC/AL communities affect elders’ PA.
Kathleen Benjamin, Nancy C. Edwards and Virendra K. Bharti
For seniors, an inactive lifestyle can result in declines in mental and physical functioning, loss of independence, and poorer quality of life. This cross-sectional descriptive study examined theory-of-planned-behavior, health-status, and sociodemographic predictors on exercise intention and behavior among 109 older and physically frail adults. Significant predictors of being a high versus a low active were a strong intention to continue exercising, positive indirect attitudes about exercise, and having been advised by a doctor to exercise. Findings indicate that a strong intention to continue exercising differentiates between those who report low levels and those who report high levels of physical activity. The results also highlight the salience of physician’s advice for seniors to exercise.
Joanna S. Kostka, Jan W. Czernicki and Tomasz J. Kostka
We assessed the relative association of quadriceps muscle strength and power as well as optimal shortening velocity (υopt) to physical functioning in 28 women aged 50–87 years with chronic osteoarthritis participating in a three-week multimodal exercise program. Quadriceps muscle strength, power, υopt, and functional performance using the Activities of Daily Living (ADL) scale, Timed Up & Go (TUG) test, Tinetti test, and 6-Minute Walking Test (6-MWT) were assessed pre- and postrehabilitation. With rehabilitation, patients improved the values of strength, power, and the results of all functional tests. Both at baseline and postrehabilitation, functional status was more strongly related to power and υopt than to strength. Functional gains obtained with rehabilitation were not related to changes in power or υopt, and only very modestly related to changes in strength. Future studies should assess the benefits and feasibility of power- and velocity-oriented training in patients with osteoarthritis.
Jennifer J. Heisz and Ana Kovacevic
Age-related changes in the brain can compromise cognitive function. However, in some cases, the brain is able to functionally reorganize to compensate for some of this loss. The present paper reviews the benefits of exercise on executive functions in older adults and discusses a potential mechanism through which exercise may change the way the brain processes information for better cognitive outcomes. Specifically, older adults who are more physically active demonstrate a shift toward local neural processing that is associated with better executive functions. We discuss the use of neural complexity as a sensitive measure of the neural network plasticity that is enhanced through exercise. We conclude by highlighting the future work needed to improve exercise prescriptions that help older adults maintain their cognitive and physical functions for longer into their lifespan.