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

Abstract

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.

Keywords

aging self-perceptions physical activity fall prevention older people

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References

Ahmed

H. M.

Blaha

M. J.

Nasir

Rivera

J. J.

Blumenthal

R. 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

Ambrens

Stanners

Valenzuela

Razee

Chow

van Schooten

K. S.

J. C. T.

Clemson

Zijlstra

G. A. R.

Lord

S. R.

Tiedemann

Alley

S. J.

Vandelanotte

Delbaere

(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

Ando

Higuchi

Kitagawa

Murakami

Todo

(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

Andrews

S. C.

Parekh

Brady

Delbaere

Hamidul Huque

Killcross

Anstey

K. 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

Arlinghaus

K. R.

Johnston

C. A.

(2018). The importance of creating habits and routine. American Journal of Lifestyle Medicine, 13(2), 142–144. https://doi.org/10.1177/1559827618818044

Arnautovska

Fleig

O’Callaghan

Hamilton

(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

Australian Institute of Health & Welfare [AIHW] . (2020). Insufficient physical activity. Australian Government. https://www.aihw.gov.au/reports/risk-factors/insufficient-physical-activity/contents/insufficient-physical-activity

Australian Institute of Health & Welfare [AIHW] . (2021). Australian burden of disease study 2018 - key findings. Australian Government. ttps://www.aihw.gov.au/reports/burden-of-disease/burden-of-disease-study-2018-key-findings/contents/key-findings

Bazeley

(2013). Qualitative data analysis practical strategies (1st ed.). Sage Publications Ltd.

10.

Becker

Woo

Todd

(2018). Falls. In Michel

J. P.

Beattie

B. L.

Martin

F. C.

Walston

(Eds.), Oxford textbook of geriatric medicine (3rd ed.). Oxford University Press.

11.

Berkman

N. D.

Sheridan

Donahue

K. E.

Halpern

D. J.

Viera

Crotty

Holland

Brasure

Lohr

K. N.

Harden

Tant

Wallace

Viswanathan

(2011). Health literacy interventions and outcomes: An updated systematic review. E. r. t. Assessment.

12.

Beyer

A. K.

Wolff

J. K.

Warner

L. M.

Schüz

Wurm

(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.

Blondell

S. J.

Hammersley-Mather

Veerman

J. 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.

Bostock

Steptoe

(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.

Caspersen

C. J.

Powell

K. E.

Christenson

(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.

Clemson

Fiatarone

S.M. A.

Bundy

Cumming

R. G.

Manollaras

O'Loughlin

Black

(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.

Creswell

J. W.

Miller

D. 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.

Delbaere

Valenzuela

Lord

S. R.

Clemson

Zijlstra

G. A. R.

J. C. T.

Lung

Woodbury

Chow

McInerney

Miles

Toson

Briggs

van Schooten

K. 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.

Farrance

Tsofliou

Clark

(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.

Fastame

M. C.

Hitchcott

P. K.

Penna

M. 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.

Finnegan

Bruce

Seers

(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.

Franco

M. R.

Tong

Howard

Sherrington

Ferreira

P. H.

Pinto

R. Z.

Ferreira

M. 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.

French

D. P.

Olander

Chisholm

McSharry

(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.

Golaszewski

N. M.

LaCroix

A. Z.

Hooker

Bartholomew

J. 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.

Guthold

Stevens

G. A.

Riley

L. M.

Bull

F. 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.

Han

(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-Hague

Skelton

Horne

Todd

(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.

Ishikawa

Yano

(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.

Kalichman

Ramachandran

Catz

(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.

Lane

N. 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.

Lee

(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

33.

Levy

(2009). Stereotype embodiment: A psychosocial approach to aging. Current Directions in Psychological Science, 18(6), 332–336. https://doi.org/10.1111/j.1467-8721.2009.01662.x

34.

Levy

B. R.

Slade

M. D.

Kasl

S. 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.

Lincoln

Y. S.

Guba

E. 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.

Maxwell

J. A.

(2005). Qualitative research design: An interactive approach (2nd ed.). Sage.

37.

McGarrigle

Boulton

Todd

(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

38.

McTiernan

(2008). Mechanisms linking physical activity with cancer. Nature Reviews Cancer, 8(3), 205–211. https://doi.org/10.1038/nrc2325

39.

Merom

Pye

Macniven

Ploeg

H. V. D.

Milat

Sherrington

Lord

Bauman

(2012). Prevalence and correlates of participation in fall prevention exercises/physical activity by older adults. Preventive Medicine, 55(6), 613–617.

40.

Moser

Spagnoli

Santos-Eggimann

(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

41.

QSR International Pty Ltd . (2021). NVivo. In (Version 12.6.1). QSR International Pty Ltd. https://www.qsrinternational.com/nvivo-qualitative-data-analysis-software/home

42.

Rhodes

R. E.

Dean

R. 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

43.

Sandelowski

(2000). Whatever happened to qualitative description? Research in Nursing & Health, 23(4), 334–340. https://doi.org/10.1002/1098-240x(200008)23:4<334::aid-nur9>3.0.co;2-g

44.

Sandelowski

(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.

Sherrington

Fairhall

Kwok

Wallbank

Tiedemann

Michaleff

Z. A.

C. A. C. M.

Bauman

(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.

Sherrington

Fairhall

N. J.

Wallbank

G. K.

Tiedemann

Michaleff

Z. A.

Howard

Clemson

Hopewell

Lamb

S. 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.

Strawbridge

W. J.

Deleger

Roberts

R. E.

Kaplan

G. 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.

Tong

Sainsbury

Craig

(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.

Tuomilehto

Lindstrom

Eriksson

J. G.

Valle

T. T.

Hamalainen

Ilanne-Parikka

Keinanen-Kiukaanniemi

Laakso

Louheranta

Rastas

Salminen

Uusitupa

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

50.

ustralian Institute of Health & Welfare . (2022). Older people. Australian Government. Retrieved 19/09/22 from.https://www.aihw.gov.au/reports-data/population-groups/older-people/overview

51.

van Bree

R. J.

van Stralen

M. M.

Bolman

Mudde

A. N.

de Vries

Lechner

(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 Bree

R. J.

van Stralen

M. M.

Mudde

A. N.

Bolman

de Vries

Lechner

(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

53.

World Health Organization [WHO] . (2022). Physical inactivity. https://www.who.int/data/gho/indicator-metadata-registry/imr-details/3416

54.

Zhang

Kamin

S. T.

Liu

Fung

H. H.

Lang

F. 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

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