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.
Maarten Stiggelbout, Marijke Hopman-Rock and Willem van Mechelen
Corjena Cheung, Jean Wyman, Cynthia Gross, Jennifer Peters, Mary Findorff and Holly Stock
The transtheoretical model (TTM) was developed as a guide for understanding behavior change. Little attention has been given, however, to the appropriateness of the TTM for explaining the adoption of exercise behavior in older adults. The purposes of this study were to determine the reliability of the TTM instruments and validate TTM predictions in 86 community-dwelling older adults (mean age 75.1 ± 7.0 years, 87% women) who were participants in a 16-week walking program. TTM construct scales—self-efficacy, decisional balance (pros and cons), and processes of change (behavioral and cognitive)—were generally reliable (all α > .78). Behavioral processes of change increased from baseline to follow-up, but pros, cons, and cognitive processes did not change among participants who became regular exercisers. Stage of change did not predict exercise adoption, but baseline self-efficacy predicted walking behavior. These results lend partial support to the TTM in predicting exercise behavior.
Teresa M. Damush, Susan M. Perkins, Alan E. Mikesky, Melanie Roberts and John O’Dea
In order to provide successful interventions to increase physical activity among inactive older adults, it is imperative to understand motivational factors influencing exercise. The authors present data from 191 (baseline) and 125 (12-month) community-dwelling men and women with mean ages of 68.71 (7.47) and 67.55 (7.55) years, respectively, from a strength-training trial. Approximately 53% had diagnosed knee osteoarthritis. Using a Likert scale, participants self-reported their degree of motivation from personal, social, and environmental factors. Using multivariate analyses, the authors evaluated demographic and clinical correlates of motivational factors to join and continue with exercise. The following results were reported: Knee osteoarthritis was positively related to motivation from an organized exercise opportunity and from efficacy/outcome expectations, and knee pain was positively related to motivation from social support and experience with the exercise task. Understanding these motivators might help in targeting recruitment efforts and interventions designed to increase physical activity in older adults with lower extremity arthritis.
Minna Rasinaho, Mirja Hirvensalo, Raija Leinonen, Taru Lintunen and Taina Rantanen
The purpose of this study was to investigate what older adults with severe, moderate, or no mobility limitation consider motives for and barriers to engaging in physical exercise. Community-dwelling adults (N = 645) age 75–81 years completed a questionnaire about their motives for and barriers to physical exercise and answered interview questions on mobility limitation. Those with severely limited mobility more often reported poor health, fear and negative experiences, lack of company, and an unsuitable environment as barriers to exercise than did those with no mobility limitation. They also accentuated disease management as a motive for exercise, whereas those with no or moderate mobility limitation emphasized health promotion and positive experiences related to exercise. Information about differences in motives for and barriers to exercise among people with and without mobility limitation helps tailor support systems that support engagement in physical activity among older adults.
Maria Giné-Garriga, Míriam Guerra, Esther Pagès, Todd M. Manini, Rosario Jiménez and Viswanath B. Unnithan
The purpose of this study was to evaluate whether a 12-wk functional circuit-training program (FCT) could alter markers of physical frailty in a group of frail community-dwelling adults. Fifty-one individuals (31 women, 20 men), mean age (± SD) 84 (± 2.9) yr, met frailty criteria and were randomly assigned into groups (FCT = 26, control group [CG] = 25). FCT underwent a 12-wk exercise program. CG met once a week for health education meetings. Measures of physical frailty, function, strength, balance, and gait speed were assessed at Weeks 0, 12, and 36. Physical-frailty measures in FCT showed significant (p < .05) improvements relative to those in CG (Barthel Index at Weeks 0 and 36: 73.41 (± 2.35) and 77.0 (± 2.38) for the FCT and 70.79 (± 2.53) and 66.73 (± 2.73) for the CG. These data indicate that an FCT program is effective in improving measures of function and reducing physical frailty among frail older adults.
Po-Wen Ku, Jim McKenna and Kenneth R. Fox
Subjective well-being (SWB) and its relationship with physical activity have not been systematically investigated in older Chinese people. This study explored these issues using qualitative interviews with a purposive sample of 23 community-dwelling Chinese older adults (age 55–78 y, 12 women); 16 were physically active and 7 physically inactive. Using cross-case analyses, 7 dimensions of SWB emerged: physical, psychological, developmental, material, spiritual, sociopolitical, and social. Although elements of SWB may be shared across cultures, specific distinctions were identified. Active respondents reported the unique contributions of physical activity to the physical, psychological, developmental, and social elements of SWB. The findings suggest that physical activity could enhance the quality of life in Chinese older adults.
Elissa Burton, Gill Lewin and Duncan Boldy
The proportion of older people living in our communities is rising and, to live independently, some require assistance from home care services. Physical activity can improve and maintain function, strength, and balance, which are important for those receiving home care. This study reviewed the evidence on physical activity/exercise interventions trialed with older people receiving a home care service. A systematic review of studies published from January 1982 to September 2012, from five databases, was undertaken. Inclusion criteria were: aged 65+ years; community dwelling; no dementia diagnosis; receiving home care services; and a physical activity/exercise program. Eight articles were included and results show there were few consistencies between intervention types, groups, outcome measures, and follow-up. Study quality was mixed. Future studies should include pragmatic randomized controlled trials involving home care practitioners and their clients to gain “real-world” knowledge of what interventions are effective and can be delivered within this setting.
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.
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.
Bradley D. Hatfield, Thomas W. Spalding, Ross J. Apparies, Amy J. Haufler and D. Laine Santa Maria
Latencies and peak-to-peak amplitudes of pattern-reversal evoked-potential (PREP) components of active and inactive community-dwelling healthy 61- to 77-year-olds were compared with those of active and inactive 18- to 31-year-olds to determine whether long-term physical activity involvement was associated with attenuation of age-related changes in sensory processes. Binocular PREPs were derived for each of 2 check sizes (22 × 15 ft and 41 × 30 ft of visual angle) to provide increasing challenge of spatial resolution. Analyses of the latencies revealed significant effects for age, gender, and check size such that latencies were longer for older than for young participants, men than for women, and small than for larger check sizes. Amplitudes were larger in older adults for the P100-N150 peak-to-peak difference, but physical activity history was not associated with reduction of the observed age-related increases in component latencies and amplitude. As such, physical activity does not appear to attenuate age-related decline in visual sensory processing.