Restricted accessResearch articleFirst published online 2024-10
How Perceptions of Aging Influence Physical Activity and Exercise in Older Age: Exploring the Behavior of People Aged 70+ Years Engaged in Fall Prevention Activities
For older people, physical inactivity increases fall risk as well as other preventable health conditions. Despite the well-documented benefits of physical activity, uptake and adherence continue to challenge efforts aimed at increasing physical activity and reducing falls. Nested within a randomized controlled trial, this study reports on the factors influencing the physical activity behavior of people, aged between 70 and 90 years, engaged in StandingTall, a home-based balance exercise program proven to reduce falls in the community. The perception of aging, physical activity in older age, and the delivery of exercise were identified as major themes, with the perception of aging an overarching theme influencing both preferences for physical activity in older age and exercise delivery. Findings demonstrate the importance of considering the role of aging, the influence aging has on physical activity and exercise behavior, and how aging influences the delivery and design of exercise programs including falls prevention activities for older people.
AhmedH. M.BlahaM. J.NasirK.RiveraJ. J.BlumenthalR. S. (2012). Effects of physical activity on Cardiovascular disease. The American Journal of Cardiology, 109(2), 288–295. https://doi.org/10.1016/j.amjcard.2011.08.042
2.
AmbrensM.StannersM.ValenzuelaT.RazeeH.ChowJ.van SchootenK. S.CloseJ. C. T.ClemsonL.ZijlstraG. A. R.LordS. R.TiedemannA.AlleyS. J.VandelanotteC.DelbaereK. (2021). Exploring older adults’ experiences of a home-based, technology-driven balance training exercise program designed to reduce fall risk: A qualitative research study within a randomized controlled trial. Journal of Geriatric Physical Therapy, 46(2), 139–148. https://doi.org/10.1519/JPT.0000000000000321
3.
AndoS.HiguchiY.KitagawaT.MurakamiT.TodoE. (2020). Custom-made daily routine increases the number of steps taken by frail older adults. Journal of Aging and Physical Activity, 28(3), 343–351. https://doi.org/10.1123/japa.2019-0099
4.
AndrewsS. C.ParekhD.BradyB.DelbaereK.Hamidul HuqueM.KillcrossS.AnsteyK. J. (2021). Associations between planned exercise, walking, incidental physical activity, and habit strength in older people: A cross-sectional study. Journal of Aging and Physical Activity, 30(5), 813–823. https://doi.org/10.1123/japa.2021-0284
5.
ArlinghausK. R.JohnstonC. A. (2018). The importance of creating habits and routine. American Journal of Lifestyle Medicine, 13(2), 142–144. https://doi.org/10.1177/1559827618818044
6.
ArnautovskaU.FleigL.O’CallaghanF.HamiltonK. (2017). A longitudinal investigation of older adults’ physical activity: Testing an integrated dual-process model. Psychology and Health, 32(2), 166–185. https://doi.org/10.1080/08870446.2016.1250273
BeckerC.WooJ.ToddC. (2018). Falls. In MichelJ. P.BeattieB. L.MartinF. C.WalstonJ. (Eds.), Oxford textbook of geriatric medicine (3rd ed.). Oxford University Press.
11.
BerkmanN. D.SheridanS.DonahueK. E.HalpernD. J.VieraA.CrottyK.HollandA.BrasureM.LohrK. N.HardenE.TantE.WallaceI.ViswanathanM. (2011). Health literacy interventions and outcomes: An updated systematic review. E. r. t. Assessment.
12.
BeyerA. K.WolffJ. K.WarnerL. M.SchüzB.WurmS. (2015). The role of physical activity in the relationship between self-perceptions of ageing and self-rated health in older adults. Psychology and Health, 30(6), 671–685. https://doi.org/10.1080/08870446.2015.1014370
13.
BlondellS. J.Hammersley-MatherR.VeermanJ. L. (2014). Does physical activity prevent cognitive decline and dementia? A systematic review and meta-analysis of longitudinal studies. BMC Public Health, 14(510), 510. https://doi.org/10.1186/1471-2458-14-510
14.
BostockS.SteptoeA. (2012). Association between low functional health literacy and mortality in older adults: Longitudinal cohort study. BMJ, 344(e1602), e1602–e1610. https://doi.org/10.1136/bmj.e1602
15.
CaspersenC. J.PowellK. E.ChristensonG. (1985). Physical activity, exercise, and physical fitness: Definitions and distinctions for health-related research. Public health reports (Washington, D.C, 1974), 100(2), 126–131.
16.
Centers for Disease Control and Prevention [CDC]. (2017, May 5, 2021). Healthy Aging: Promoting well-being in older adults. Centers for Disease Control and Prevention.
17.
ClemsonL.FiataroneS.M. A.BundyA.CummingR. G.ManollarasK.O'LoughlinP.BlackD. (2012). Integration of balance and strength training into daily life activity to reduce rate of falls in older people (the LiFE study): Randomised parallel trial. BMJ, 345(e4547). https://doi.org/10.1136/bmj.e4547, <Go to ISI> ://WOS:000307496500001.
18.
CreswellJ. W.MillerD. L. (2000). Getting good qualitative data to improve educational practice. Theory Into Practice, 39(3), 124–130. https://doi.org/10.1207/s15430421tip3903_2
19.
DelbaereK.ValenzuelaT.LordS. R.ClemsonL.ZijlstraG. A. R.CloseJ. C. T.LungT.WoodburyA.ChowJ.McInerneyG.MilesL.TosonB.BriggsN.van SchootenK. S. (2021). e-Health StandingTall balance exercise for fall prevention in older people: Results of a two-year randomised controlled trial. BMJ, 373(n740). https://doi.org/10.1136/bmj.n740
20.
FarranceC.TsofliouF.ClarkC. (2016). Adherence to community based group exercise interventions for older people: A mixed-methods systematic review. Preventive Medicine, 87, 155–166. https://doi.org/10.1016/j.ypmed.2016.02.037
21.
FastameM. C.HitchcottP. K.PennaM. P. (2018). The impact of leisure on mental health of Sardinian elderly from the ‘blue zone’: Evidence for ageing well. Aging Clinical and Experimental Research, 30(2), 169–180. https://doi.org/10.1007/s40520-017-0768-x
22.
FinneganS.BruceJ.SeersK. (2021). Life after falls prevention exercise – experiences of older people taking part in a clinical trial: A phenomenological study. BMC Geriatrics, 21(1), 91. https://doi.org/10.1186/s12877-021-02037-9
23.
FrancoM. R.TongA.HowardK.SherringtonC.FerreiraP. H.PintoR. Z.FerreiraM. L. (2015). Older people’s perspectives on participation in physical activity: A systematic review and thematic synthesis of qualitative literature. British Journal of Sports Medicine, 49(19), 1268–1276. https://doi.org/10.1136/bjsports-2014-094015
24.
FrenchD. P.OlanderE.ChisholmA.McSharryJ. (2014). Which behaviour change techniques are most effective at increasing older adults’ self-efficacy and physical activity behaviour? A systematic review. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 48(2), 225–234. https://doi.org/10.1007/s12160-014-9593-z
25.
GolaszewskiN. M.LaCroixA. Z.HookerS.BartholomewJ. B. (2021). Group exercise membership is associated with forms of social support, exercise identity, and amount of physical activity. International Journal of Sport and Exercise Psychology, 20(2), 630–643. https://doi.org/10.1080/1612197x.2021.1891121
26.
GutholdR.StevensG. A.RileyL. M.BullF. C. (2018). Worldwide trends in insufficient physical activity from 2001 to 2016: A pooled analysis of 358 population-based surveys with 1·9 million participants. Lancet Global Health, 6(10), e1077–e1086. https://doi.org/10.1016/S2214-109X(18)30357-7
27.
HanJ. (2018). Chronic illness and depressive symptoms among older people: Functional limitations as a mediator and self-perceptions of ageing as a moderator. Journal of Aging and Health, 30(8), 1188–1204. https://doi.org/10.1177/0898264317711609
28.
Hawley-HagueH.SkeltonD.HorneM.ToddC. (2016). Review of how we should define (and measure) adherence in studies examining older adults’ participation in exercise classes?BMJ Open, 6(e011560), Article e011560. https://doi.org/10.1136/bmjopen-2016-011560
29.
IshikawaH.YanoE. (2008). Patient health literacy and participation in the health-care process. Health Expectations: An International Journal of Public Participation in Health Care and Health Policy, 11(2), 113–122. https://doi.org/10.1111/j.1369-7625.2008.00497.x
30.
KalichmanS.RamachandranB.CatzS. (1999). Adherence to combination antiretroviral therapies in HIV patients of low health literacy. Journal of General Internal Medicine, 14(5), 267–273. https://doi.org/10.1046/j.1525-1497.1999.00334.x
31.
LaneN. E. (2006). Epidemiology, etiology, and diagnosis of osteoporosis. American Journal of Obstetrics and Gynecology, 194(2 Suppl), S3–S11. https://doi.org/10.1016/j.ajog.2005.08.047
32.
LeeS.LeeC.AnJ. (2020). Psycho-social correlates of leisure-time physical activity (LTPA) among older adults: A multivariate analysis. European review of aging and physical activity: Official Journal of the European Group for Research Into Elderly and Physical Activity, 17(6), 6. https://doi.org/10.1186/s11556-020-00238-6
LevyB. R.SladeM. D.KaslS. V. (2002). Longitudinal benefit of positive self-perceptions of ageing on functional health. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 57(5), P409–P417. https://doi.org/10.1093/geronb/57.5.p409
35.
LincolnY. S.GubaE. G. (1986). But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. In New Directions for Program Evaluation (Vol. 30, pp. 73–84). Jossey-Bass.
36.
MaxwellJ. A. (2005). Qualitative research design: An interactive approach (2nd ed.). Sage.
37.
McGarrigleL.BoultonE.ToddC. (2020). Map the apps: A rapid review of digital approaches to support the engagement of older adults in strength and balance exercises. BMC Geriatrics, 20(1), 483. https://doi.org/10.1186/s12877-020-01880-6
MeromD.PyeV.MacnivenR.PloegH. V. D.MilatA.SherringtonC.LordS.BaumanA. (2012). Prevalence and correlates of participation in fall prevention exercises/physical activity by older adults. Preventive Medicine, 55(6), 613–617.
40.
MoserC.SpagnoliJ.Santos-EggimannB. (2011). Self-perception of aging and vulnerability to adverse outcomes at the age of 65-70 years. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 66(6), 675–680. https://doi.org/10.1093/geronb/gbr052
RhodesR. E.DeanR. N (2016). Is physical activity a part of who I am? A review and meta-analysis of identity, schema and physical activity. Health Psychology Review, 10(2), 204–225. https://doi.org/10.1080/17437199.2016.1143334
SandelowskiM. (2010). What's in a name? Qualitative description revisited. Research in Nursing & Health, 33(1), 77–84. https://doi.org/10.1002/nur.20362
45.
SherringtonC.FairhallN.KwokW.WallbankG.TiedemannA.MichaleffZ. A.NgC. A. C. M.BaumanA. (2020). Evidence on physical activity and falls prevention for people aged 65+ years: Systematic review to inform the WHO guidelines on physical activity and sedentary behaviour. International Journal of Behavioral Nutrition and Physical Activity, 17(1), 144. https://doi.org/10.1186/s12966-020-01041-3
46.
SherringtonC.FairhallN. J.WallbankG. K.TiedemannA.MichaleffZ. A.HowardK.ClemsonL.HopewellS.LambS. E. (2019). Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 1(1), CD012424. https://doi.org/10.1002/14651858.CD012424.pub2
47.
StrawbridgeW. J.DelegerS.RobertsR. E.KaplanG. A. (2002). Physical activity reduces the risk of subsequent depression for older adults. American Journal of Epidemiology, 156(4), 328–334. https://doi.org/10.1093/aje/kwf047
48.
TongA.SainsburyP.CraigJ. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care: Journal of the International Society for Quality in Health Care, 19(6), 349–357. https://doi.org/10.1093/intqhc/mzm042
49.
TuomilehtoJ.LindstromJ.ErikssonJ. G.ValleT. T.HamalainenH.Ilanne-ParikkaP.Keinanen-KiukaanniemiS.LaaksoM.LouherantaA.RastasM.SalminenV.UusitupaM.Finnish Diabetes Prevention Study Group. (2001). Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. New England Journal of Medicine, 344(18), 1343–1350. https://doi.org/10.1056/NEJM200105033441801
van BreeR. J.van StralenM. M.BolmanC.MuddeA. N.de VriesH.LechnerL. (2013). Habit as moderator of the intention-physical activity relationship in older adults: A longitudinal study. Psychology and Health, 28(5), 514–532. https://doi.org/10.1080/08870446.2012.749476
52.
van BreeR. J.van StralenM. M.MuddeA. N.BolmanC.de VriesH.LechnerL. (2015). Habit as mediator of the relationship between prior and later physical activity: A longitudinal study in older adults. Psychology of Sport and Exercise, 19, 95–102. https://doi.org/10.1016/j.psychsport.2015.03.006
ZhangX.KaminS. T.LiuS.FungH. H.LangF. R. (2020). Negative self-perception of aging and mortality on very old Chinese adults: The mediation role of healthy lifestyle. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 75(5), 1001–1009. https://doi.org/10.1093/geronb/gby136
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
