A convenience sample of 176 healthy, community-dwelling, inactive older adults (mean age 70 ± 5 years; 62 males, 114 females) were tracked for one year. The purpose was to describe the exercise modality choices older adults make one year following participation in an exercise and education intervention. Telephone follow-up contacted 137 participants (78%, men = 50, women = 87) and 62% of the men and 69% of the women reported to be “currently exercising.” Exercising independently was the most common type of exercise reported by 81% and 64% of men and women, respectively. Walking was the most commonly reported modality by both genders. The setting of exercise was most often reported to be at home or outside for both men and women. The main reason for continued participation at 12 months was for overall health (50% of men and 40% of women). Little variation was observed for exercise modality choice. Future interventions should consider a variety of exercise and physical activity opportunities for older adults.
Liza Stathokostas and Gareth R. Jones
Scott J. Strath, Ann M. Swartz and Susan E. Cashin
This study examined objectively determined walking profiles of older adults across a wide range of sociocultural backgrounds. All individuals (N = 415; 131 men age 70.5 ± 9.2 yr and 284 women age 71.5 ± 9.0 yr) underwent physiological measurements, completed pen-and-paper surveys, and wore a pedometer for 7 consecutive days. The total sample accumulated a mean of 3,987 ± 2,680 steps/day. Age (r = –.485, p < .001) and body-mass index (BMI; r = –.353, p < .001) were negatively associated with steps per day. Multivariate analysis revealed that race/ethnic category (F = 3.15, df = 3), gender (F = 2.46, df = 1), BMI (F = 6.23, df = 2), income (F = 9.86, df = 1), education (F = 43.3, df = 1), and retirement status (F = 52.3, df = 1) were significantly associated with steps per day. Collectively these categories accounted for 56% of the variance in walking activity in this independently living, community-dwelling older adult sample. Sedentary characteristics highlighted within, and step-per-day values specific to, older adults have implications for planning targeted physical activity interventions related to walking activity in this population.
Thomas R. Wójcicki, Amanda N. Szabo, Siobhan M. White, Emily L. Mailey, Arthur F. Kramer and Edward McAuley
The purpose of this study was to assess the extent to which participation in a 12-month exercise program changed the degree of importance that older adults attached to physical activity. In addition, associations among changes in physical activity importance and health-related and psychosocial outcomes were examined.
Community-dwelling older adults (N = 179) were recruited to participate in a 12-month exercise trial examining the association between changes in physical activity and fitness with changes in brain structure and psychological health. Participants were randomly assigned to a walking condition or a flexibility, toning, and balance condition. Physical, psychological, and cognitive assessments were taken at months 0, 6, and 12.
Involvement in a 12-month exercise program increased the importance that participants placed on physical activity; this positive change was similar across exercise condition and sex. Changes in importance, however, were only associated with changes in physical health status and outcome expectations for exercise midway through the intervention. There were no significant associations at the end of the program.
Regular participation in physical activity can positively influence the perceived importance of the behavior itself. Yet, the implications of such changes on physical activity-related outcomes remain equivocal and warrant further investigation.
John Cooper, Barbara Stetson, Jason Bonner, Sean Spille, Sathya Krishnasamy and Sri Prakash Mokshagundam
This study assessed physical activity (PA) in community dwelling adults with Type 2 diabetes, using multiple instruments reflecting internationally normed PA and diabetes-specific self-care behaviors.
Two hundred and fifty-three Black (44.8%) and White (55.2%) Americans [mean age = 57.93; 39.5% male] recruited at low-income clinic and community health settings. Participants completed validated PA self-report measures developed for international comparisons (International Physical Activity Questionnaire Short Form), characterization of diabetes self-care (Summary of Diabetes Self-Care Activities Measure; SDSCA) and exercise-related domains including provider recommendations and PA behaviors and barriers (Personal Diabetes Questionnaire; PDQ).
Self-reported PA and PA correlates differed by instrument. BMI was negatively correlated with PA level assessed by the PDQ in both genders, and assessed with SDSCA activity items in females. PA levels were low, comparable to previous research with community and diabetes samples. Pain was the most frequently reported barrier; females reported more frequent PA barriers overall.
When using self-report PA measures for PA evaluation of adults with diabetes in clinical settings, it is critical to consider population and setting in selecting appropriate tools. PA barriers may be an important consideration when interpreting PA levels and developing interventions. Recommendations for incorporating these measures in clinical and research settings are discussed.
K. John Fisher, Fuzhong Li, Yvonne Michael and Minot Cleveland
There is a need for greater understanding of setting-specific influences on physical activity to complement the predominant research paradigm of individual-centered influences on physical activity. In this study, the authors used a cross-sectional multilevel analysis to examine a range of neighborhood-level characteristics and the extent to which they were associated with variation in self-reported physical activity among older adults. The sample consisted of 582 community-dwelling residents age 65 years and older (M = 73.99 years, SD = 6.25) recruited from 56 neighborhoods in Portland, OR. Information collected from participants and neighborhood data from objective sources formed a two-level data structure. These hierarchical data (i.e., individuals nested within neighborhoods) were subjected to multilevel structural-equation-modeling analyses. Results showed that neighborhood social cohesion, in conjunction with other neighborhood-level factors, was significantly associated with increased levels of neighborhood physical activity. Overall, neighborhood-level variables jointly accounted for a substantial variation in neighborhood physical activity when controlling for individual-level variables.
Jochen Klenk, Gisela Büchele, Ulrich Lindemann, Sabrina Kaufmann, Raphael Peter, Roman Laszlo, Susanne Kobel and Dietrich Rothenbacher
The aim of this study was to assess concurrent validity between activPAL and activPAL3 accelerometers in a sample of 53 community-dwelling older adults ≥ 65 years. Physical activity (PA) was measured simultaneously with activPAL and activPAL3 while performing scripted activities. The level of agreement between both devices was calculated for sitting/lying, standing, and walking. In addition, PA was measured over one week using activPAL to estimate the expected agreement with activPAL3 in real life. Overall agreement between activPAL and activPAL3 was 97%. Compared with activPAL, the largest disagreement was seen for standing, with 5% categorized as walking by activPAL3. For walking and sitting/lying, the disagreement was 2%, respectively. The expected daily differences between activPAL3 and activPAL were +15.0 min (95% CI: 11.3ߝ18.8) for walking and +29.5 min (95% CI: 6.2–52.7) for standing. ActivPAL and activPAL3 showed good agreement in older adults. However, if using these devices interchangeably, observed differences might still bias results.
Johanna Eronen, Mikaela von Bonsdorff, Merja Rantakokko, Erja Portegijs, Anne Viljanen and Taina Rantanen
Life-space mobility describes the extent of community mobility of older persons. The aim of this cross-sectional study was to examine the relationship between socioeconomic status (SES) and life-space mobility and to investigate whether associations might be explained by SES-related disparities in health and functioning. The participants (n = 848) were community-dwelling adults aged 75–90. Education and occupation were used to indicate SES. Life-space assessment (range 0–120) was used to indicate distance and frequency of moving and assistance needed in moving. People with low education had lower life-space mobility scores than those with intermediate or high education: marginal means 63.5, 64.8, and 70.0 (p = .003), respectively. SES-related health disparities, i.e., higher body mass index, poorer cognitive capacity, and poorer physical performance explained the association, rendering it nonsignificant (marginal means 65.2, 65.3, and 67.5, p = .390). Low SES and restricted life-space mobility often coexist with overweight, reduced cognition, and poorer physical performance.
Lena Fleig, Megan M. McAllister, Penny Brasher, Wendy L. Cook, Pierre Guy, Joseph H. Puyat, Karim M. Khan, Heather A. McKay and Maureen C. Ashe
To characterize patterns of sedentary behavior and physical activity in older adults recovering from hip fracture and to determine characteristics associated with activity.
Community-dwelling, Canadian adults (65 years+) who sustained hip fracture wore an accelerometer at the waist for seven days and provided information on quality of life, falls self-efficacy, cognitive functioning, and mobility.
There were 53 older adults (mean age [SD] 79.5 [7.8] years) enrolled in the study; 49 had valid data and demonstrated high levels of sedentary time (median [p10, p90] 591.3 [482.2, 707.2] minutes/day), low levels of light activity (186.6 [72.6, 293.7]), and MVPA (2 [0.1, 27.6]), as well as few daily steps (2467.7 [617.1, 6820.4]). Regression analyses showed that age, gender, gait speed, and time since fracture were associated with outcomes.
Older adults have long periods of sedentary time with minimal activity. Results are a call to action to encourage people to sit less and move more.
Addie Middleton, George D. Fulk, Michael W. Beets, Troy M. Herter and Stacy L. Fritz
Daily ambulatory activity is associated with health and functional status in older adults; however, assessment requires multiple days of activity monitoring. The objective of this study was to determine the relative capabilities of self-selected walking speed (SSWS), maximal walking speed (MWS), and walking speed reserve (WSR) to provide insight into daily ambulatory activity (steps per day) in community-dwelling older adults. Sixty-seven older adults completed testing and activity monitoring (age 80.39 [6.73] years). SSWS (R 2 = .51), MWS (R 2 = .35), and WSR calculated as a ratio (R 2 = .06) were significant predictors of daily ambulatory activity in unadjusted linear regression. Cutpoints for participants achieving < 8,000 steps/day were identified for SSWS (≤ 0.97 m/s, 44.2% sensitivity, 95.7% specificity, 10.28 +LR, 0.58 −LR) and MWS (≤ 1.39 m/s, 60.5% sensitivity, 78.3% specificity, 2.79 +LR, 0.50 −LR). SSWS may be a feasible proxy for assessing and monitoring daily ambulatory activity in older adults.
Fuzhong Li, Peter Harmer, K. John Fisher, Junheng Xu, Kathleen Fitzgerald and Naruepon Vongjaturapat
The primary objective of this study was to provide preliminary evaluation of the feasibility, safety, and efficacy of a newly developed Tai Chi-based exercise program for older adults with Parkinson’s disease (PD). Using a one-group pretest-posttest design, 17 community-dwelling adults (mean age 71.51 years) with mild to moderate idiopathic PD (Stage I, II, or III on the Hoehn and Yahr scale) and stable medication use completed a 5-day, 90-min/day Tai Chi exercise-evaluation program. Outcome measures included face-to-face exit interviews on appropriateness and safety and physical performance (i.e., 50-ft speed walk, up-and-go, functional reach). At the end of this brief intervention, exercise adherence was 100% and the program was shown to be safe. Exit interviews indicated that the program was well received by all participants with respect to program appropriateness, participant satisfaction and enjoyment, and intentions to continue. Furthermore, a significant pretest-to-posttest change was observed at the end of the 5-day program in all three physical-performance measures (p < .05). The results of this pilot evaluation suggest that Tai Chi is an appropriate physical activity for older adults with PD and might also be useful as a therapeutic exercise modality for improving and maintaining physical function. These preliminary findings warrant further investigation.