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
Kristiann C. Heesch, Jannique van Uffelen and Wendy J. Brown
The aim of this study was to examine older adults’ understanding and interpretation of a validated questionnaire for physical activity surveillance, the Active Australia Survey (AAS). To address this aim, cognitive interviewing techniques were used during face-to-face semistructured interviews with 44 adults age 65–89 years. Qualitative data analysis revealed that participants were confused with questionnaire phrasing, misunderstood the scope of activities to include in answers, and misunderstood the time frame of activities to report. They also struggled to accurately estimate the frequency and duration of their activities. Our findings suggest that AAS questions may be interpreted differently by older adults than intended by survey developers. Findings also suggest that older adults use a range of methods for calculating PA frequency and duration. The issues revealed in this study may be useful for adapting AAS for use in older community-dwelling adults.
Joe R. Nocera, Keith M. McGregor, Chris J. Hass and Bruce Crosson
Studies suggest improvements of neurocognitive function among older adults who undergo aerobic exercise training. This study sought to examine the impact of an aerobic exercise intervention on verbal fluency in sedentary older adults. Twenty community-dwelling older adults were recruited and enrolled in either a spin exercise group or a control condition. Participants were evaluated with an estimated V02max test and on measures of letter, category, and switching verbal fluency both before and after a 12-week intervention period. Spin exercise resulted in a significant improvement in category (semantic) verbal fluency when compared with the control group (15% vs. 2% increase, respectively; P = .001). Spin exercise also resulted in a significant improvement in estimated V02max (P = .005). Also important, the spin exercise group demonstrated a high level of adherence (mean adherence = 82.5%). Spin exercise can be an effective mode of aerobic exercise to improve semantic fluency in previously sedentary older adults.
Koen A.P.M. Lemmink, Han C.G. Kemper, Mathieu H.G. de Greef, Piet Rispens and Martin Stevens
This article focuses on the validity of the circumduction test for measuring shoulder flexibility in older adults. Participants included 137 community-dwelling older adults. Equipment consisted of a cord with a fixed handle on one end and a sliding handle on the other. The sliding handle was adjusted so that the cord length between the 2 handles equaled the participant’s shoulder width. Holding the 2 handles, the participant must pass the cord from the front of the body over the head and as far back as possible with extended arms. The score is the fanning-out angle. Forward flexion, abduction, horizontal retroflexion, and outward rotation were also measured. The test and criterion measurements were administered within 1 wk. The criterion-related validity of the circumduction test as a measure of forward flexion and horizontal retroflexion received support from moderate correlations. Its use as a measure of abduction and outward rotation, however, received no support from the data.
Tamar Semerjian and Dawn Stephens
This study examined the relationships between older women’s comparison styles, physical self-perceptions, and functional fitness. Participants were community-dwelling women (N = 102, age 65-99) living in the mid-Atlantic region of the United States. Individuals were categorized as relying primarily on social comparisons, temporal comparisons, or a combination of both styles. Also of interest was whether individuals evaluated themselves positively or negatively when making comparisons. Participants who evaluated themselves positively as compared with others were found to have higher levels of physical self-perception. Analyses revealed that women who relied primarily on temporal comparisons had higher self-perceptions of their functional ability than those who relied on a combination of comparison styles. An avoidance of both temporal and social comparisons was also related to higher levels of physical self-perception.
Kenneth E. Mobily and Paula R. Mobily
The primary purpose of this investigation was to determine the internal consistency of the 60+ functional fitness test battery for older adults. A secondary purpose was to determine whether the number of trials recommended in the testing manual was optimal. Subjects were used from an ongoing study of a fitness program for community-dwelling older adults. Internal consistency coefficients for subtests of flexibility, agility, coordination, and strength were excellent. Post hoc analysis across trials indicated significant differences in means between early trials and later trials. Mean scores stabilized after two or three trials, depending on the subtest of interest. Data provided insight into the number of practice trials and amount of warm-up necessary to implement the 60+ functional fitness test battery in field settings.
Michelle Y. Martin, M. Paige Powell, Claire Peel, Sha Zhu and Richard Allman
This study examined whether leisure-time physical activity (LTPA) was associated with health-care utilization in a racially diverse sample of rural and urban older adults. Community-dwelling adults (N = 1,000, 75.32 ± 6.72 years old) self-reported participating in LTPA and their use of the health-care system (physician visits, number and length of hospitalizations, and emergency-room visits). After controlling for variables associated with health and health-care utilization, older adults who reported lower levels of LTPA also reported a greater number of nights in the hospital in the preceding year. There was no support, however, for a relationship between LTPA and the other indicators of health-care utilization. Our findings suggest that being physically active might translate to a quicker recovery for older adults who are hospitalized. Being physically active might not only have health benefits for older persons but also lead to lower health-care costs.
Maarten Stiggelbout, Marijke Hopman-Rock and Willem van Mechelen
This study reports entry correlates and motivations of older adults participating in organized exercise programs in the Netherlands, as determined in a descriptive explorative study (N = 2,350, response rate 86%). Participants were community-dwelling older adults (50+ years) who enrolled and started in 10 different exercise programs. Entry features were analyzed for differences in age, sex, marital status, education, living situation, body-mass index, lifestyle, and health status. Motivations for entering an exercise program were determined using homogeneity analyses. More Exercise for Seniors (MBvO) attracted relatively older seniors, whereas organized sports mainly attracted younger ones. Walking, MBvO, and gymnastics attracted more women, whereas skating and table tennis were reported to attract more male participants. Badminton and cycling attracted relatively higher educated participants, whereas MBvO attracted relatively lower educated participants. Three distinct motivational constructs were found: relax and enjoy, care and cure, and competition. Public health and recruitment implications of these findings are discussed.
David E. Vance, Virginia G. Wadley, Karlene K. Ball, Daniel L. Roenker and Matthew Rizzo
Physical activity has been shown to be positively associated with cognitive health, but the mechanisms underlying the benefits of physical activity on cognitive health are unclear. The present study simultaneously examined two hypotheses using structural equation modeling (SEM). The depression-reduction hypothesis states that depression suppresses cognitive ability and that physical activity alleviates dysphoric mood and thereby improves cognitive ability. The social-stimulation hypothesis posits that social contact, which is often facilitated by socially laden physical activities, improves cognitive functioning by stimulating the nervous system. Sedentary behavior in the absence of physical activity is expected to exert an inverse relationship on cognitive health through each of these hypotheses. Community-dwelling elders (N = 158) were administered a variety of measures of cognition, depression, social support, and physical activity. SEM techniques provided partial support for the social-stimulation hypothesis and depression-reduction hypothesis. Implications for treating depression and improving cognitive functioning are discussed.
Priscilla Gilliam MacRae, Michael E. Feltner and Sibylle Reinsch
This study examined the effects of a 1-year low intensity exercise program in community dwelling older women on falls, injuries, and risk factors for falls such as poor balance, muscular weakness, and gait abnormalities. Eighty older women were assigned to an exercise (Ex, n = 42) or attention control (Co, n = 38) group. During the 1-year study, 36% of the Ex group experienced a fall compared to 45% of the Co group (χ2 = 0.22, p ≥ 0.05). None of the 10 fallers in the Ex group suffered an injury that required medical attention, compared with 3 of the 14 fallers (21%) in the Co group. Further analyses indicated that the Co group declined significantly in isometric strength of the knee extensors and ankle dorsiflexors while the Ex group did not change significantly across the 1-year study. On measures of hip abductor strength, balance, and gait, the groups were not significantly different from each other pre- to post intervention.