Dataset Information

Predictors of physical activity among older adults in Germany: a nationwide cohort study.

ABSTRACT: OBJECTIVES:To investigate individual, interpersonal and environmental baseline factors predicting regular aerobic physical activity (PA) participation among older adults in Germany at follow-up 12 years later. DESIGN:Population-based cohort study. SETTING:Cluster-randomised general population sample selected based on population registry address information from 130 nationally distributed sample points collected from 1997 to 1999 and re-evaluated 12 years later from 2008 to 2011. PARTICIPANTS:1184 adults, aged 65 years or older at follow-up with complete data at baseline and follow-up, were included in the final study sample. OUTCOME MEASURE:Regular 'aerobic PA ?1?day/week' assessed based on self-reported information. RESULTS:At follow-up, 53.2% of the participants engaged in aerobic PA ?1?day/week. Participants aged 50 to 60 years at baseline were more likely to engage in aerobic PA ?1?day/week than participants aged 61 to 78 years; OR 1.88, 95%?CI 1.46 to 2.40. Participants with middle and high socioeconomic status (SES) were more likely to engage in aerobic PA ?1?day/week than participants with low SES; OR middle SES 2.08, 1.33 to 3.25; high SES 3.44, 2.11 to 5.60. Participants with high social support were more likely to engage in aerobic PA ?1?day/week at follow-up than participants with low social support; OR 1.98, 1.26 to 3.12. Furthermore, participants who engaged in leisure time PA at least once per week at baseline were more likely to engage in aerobic PA ?1?day/week at follow-up than those who engaged less than once per week; OR 1.95, 1.46 to 2.60. CONCLUSIONS:Several influencing factors assessed at baseline predicted regular aerobic PA participation 12 years later. These factors should be considered when planning interventions to prevent physical inactivity in older adults. There is great potential to increase aerobic PA participation in older adults in Germany, in particular among those with low SES and low social support.

SUBMITTER: Manz K

PROVIDER: S-EPMC5942462 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Predictors of physical activity among older adults in Germany: a nationwide cohort study.

Manz Kristin K Mensink Gert B M GBM Jordan Susanne S Schienkiewitz Anja A Krug Susanne S Finger Jonas D JD

BMJ open 20180509 5

<h4>Objectives</h4>To investigate individual, interpersonal and environmental baseline factors predicting regular aerobic physical activity (PA) participation among older adults in Germany at follow-up 12 years later.<h4>Design</h4>Population-based cohort study.<h4>Setting</h4>Cluster-randomised general population sample selected based on population registry address information from 130 nationally distributed sample points collected from 1997 to 1999 and re-evaluated 12 years later from 2008 to ...[more]

PMID: 29743332

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Project description:BACKGROUND:Reduced mobility may be responsible for functional decline and acute sarcopenia in older hospitalised patients. The drivers of reduced in-hospital mobility are poorly understood, especially during the early phase of acute hospitalisation. We investigated predictors of in-hospital activity during a 24-h period in the first 48?h of hospital admission in older adults. METHODS:This was a secondary analysis of a prospective repeated measures cohort study. Participants aged 75?years or older were recruited within the first 24?h of admission. At recruitment, patients underwent a baseline assessment including measurements of pre-morbid functional mobility, cognition, frailty, falls efficacy, co-morbidity, acute illness severity, knee extension strength and grip strength, and consented to wear accelerometers to measure physical activity during the first 7?days (or until discharge if earlier). In-hospital physical activity was defined as the amount of upright time (standing or walking). To examine the predictors of physical activity, we limited the analysis to the first 24?h of recording to maximise the sample size as due to discharge from hospital there was daily attrition. We used a best subset analysis including all baseline measures. The optimal model was defined by having the lowest Bayesian information criterion in the best-subset analyses. The model specified a maximum of 5 covariates and used an exhaustive search. RESULTS:Seventy participants were recruited but eight were excluded from the final analysis due to lack of accelerometer data within the first 24?h after recruitment. Patients spent a median of 0.50?h (IQR: 0.21; 1.43) standing or walking. The optimal model selected the following covariates: functional mobility as measured by the de Morton Mobility Index and two measures of illness severity, the National Early Warning Score, and serum C-reactive protein. CONCLUSIONS:Physical activity, particularly in the acute phase of hospitalisation, is very low in older adults. The association between illness severity and physical activity may be explained by symptoms of acute illness being barriers to activity. Interdisciplinary approaches are required to identify early mobilisation opportunities.

Project description:BackgroundThe health benefits of physical activity (PA) participation in later life are widely recognised. Understanding factors that can influence the participation of community-dwelling older adults in PA is crucial in an ageing society. This will be paramount in aiding the design of future interventions to effectively promote PA in this population. The main aim of this qualitative study was to explore influences on PA among community-dwelling older people, and the secondary aim was to explore gender differences.MethodsQualitative data were collected in 2014 by conducting focus group discussions using a semi-structured discussion guide with older people resident in Hertfordshire, UK. Discussions were audio-recorded, transcribed verbatim and transcripts analysed thematically.ResultsNinety-two participants were recruited to the study (47% women; 74-83 years) and a total of 11 focus groups were conducted. Findings indicated six themes that appeared to affect older adults' participation in PA: past life experiences; significant life events; getting older; PA environment; psychological/personal factors; and social capital. Overall, the findings emphasised the role of modifiable factors, namely psychological factors (such as self-efficacy, motivation, outcome expectancy) and social factors (such as social support and social engagement). These factors exerted their own influence on physical activity participation, but also appeared to mediate the effect of other largely non-modifiable background and ageing-related factors on participants' engagement with PA in later life.ConclusionIn view of these findings, intervention designers could usefully work with behavioural scientists for insight as to how to enhance psychological and social factors in older adults. Our data suggest that interventions that aim to build self-efficacy, motivation and social networks have the potential to indirectly promote PA participation in older adults. This would be best achieved by developing physical activity interventions through working with participants in an empowering and engaging way.

Project description:BackgroundEngaging in regular physical activity (PA) as an older adult has been associated with numerous physical and mental health benefits. The aim of this study is to directly compare how individual-level cognitive factors (self-efficacy for PA, self-determined motivation for PA, self-concept for PA) and neighborhood perceptions of the social factors (neighborhood satisfaction, neighborhood social life) impact moderate-to-vigorous physical activity (MVPA) longitudinally among older African American adults.MethodsData were analyzed from a sub-set of older African American adults (N = 224, M age = 63.23 years, SD = 8.74, 63.23% female, M Body Mass Index = 32.01, SD = 7.52) enrolled in the Positive Action for Today's Health trial. MVPA was assessed using 7-day accelerometry-estimates and psychosocial data (self-efficacy for PA, self-determined motivation for PA, self-concept for PA, neighborhood satisfaction, neighborhood social life) were collected at baseline, 12-, 18-, and 24-months.ResultsMultilevel growth modeling was used to examine within- and between-person effects of individual-level cognitive and social environmental factors on MVPA. At the between-person level, self-concept (b = 0.872, SE = 0.239, p < 0.001), and neighborhood social life (b = 0.826, SE = 0.176, p < 0.001) predicted greater MVPA, whereas neighborhood satisfaction predicted lower MVPA (b = -0.422, SE = 0.172, p = 0.015). Among the between-person effects, only average social life was moderated by time (b = 0.361, SE = 0.147, p = 0.014), indicating that the impact of a relatively positive social life on MVPA increased across time. At the within-person level, positive increases in self-concept (b = 0.294, SE = 0.145, p = 0.043) and neighborhood social life (b = 0.270, SE = 0.113, p = 0.017) were associated with increased MVPA.ConclusionsThese results suggest that people with a higher average self-concept for PA and a more positive social life engaged in greater average MVPA. Additionally, changes in perceptions of one's neighborhood social life and one's self-concept for PA were associated with greater MVPA over 2 years. These factors may be particularly relevant for future interventions targeting long-term change and maintenance of MVPA in older African Americans.Trial registrationClinicalTrials.Gov # NCT01025726 registered 1 December 2009.

Project description:Maintaining physical activity in later life is important for maintaining health and function. Activity outdoors, such as walking, jogging and cycling, may provide an accessible, sociable and practical solution, but maintaining outdoor mobility may be a challenge in later life. Providing green environments which are supportive of physical activity may facilitate this, yet research into how greenspace could be best used is inconclusive. This study evaluates the role of greenspace in protecting against decline in physical activity over time in older adults. Data from the European Prospective Investigation of Cancer Norfolk, UK, cohort 1993-2009 (N=15,672) was used. Linear regression modelling was used to examine the association between exposure to greenspace in the home neighbourhood and change in overall, recreational and outdoor physical activity measured in terms of metabolic equivalent cost (MET) in hours/week. Mediation analysis was conducted to assess if dog walking explained the relationship between greenspace and physical activity change. Models were adjusted for known and hypothesised confounders. People living in greener neighbourhoods experienced less of a decline in physical activity than those living in less green areas. Comparing change for those living in the greenest versus least green quartiles, participants showed a difference in overall physical activity of 4.21 MET hours/week (trend P=0.001), adjusted for baseline physical activity, age, sex, BMI, social class and marital status. This difference was 4.03 MET hours/week for recreational physical activity (trend P<0.001) and 1.28 MET hours/week for outdoor physical activity (trend P=0.007). Dog walking partially mediated the association between greenspace and physical activity change, by 22.6% for overall, 28.1% for recreational and 50.0% for outdoor physical activity (all P<0.001). Greenspace in the home neighbourhood may be protective against decline in physical activity among older people as they age. Dog walking is a potential mechanism in this relationship, and warrants further investigation as a way of maintaining physical activity in later life.

Project description:BackgroundThe evidence for the prospective relationships between specific physical activities (PA), sedentary behaviours (SB) and sleep on subsequent total PA levels is scarce. The purpose of this study was to examine prospective associations of self-reported PA, SB and sleep, and changes in these with subsequent accelerometer-measured PA.MethodsA sub-sample of 91,648 UK Biobank participants reported moderate-to-vigorous PA (MVPA), lifestyle activities, TV viewing, computer use and sleep through screen-based questionnaires at baseline (2006-2010), and provided valid accelerometry data (dominant wrist-worn for 7 days between 2013 and 2015). A further sub-sample of 7709 participants repeated the screen-based questionnaires between 2012 and 2013.ResultsIn both women (n = 51,545) and men (n = 40,103), positive associations were observed between all self-reported measures of PA at baseline (MVPA, lifestyle/job-related activities, active transporting modes) and accelerometer-measured PA levels at follow-up (median 5.7 years); an exception was 'walking/standing at work' in women. Sedentary time at work, TV viewing and computer use were inversely associated with PA at follow-up. Sleeping either more or less than 7 h/day at baseline was associated with lower PA at follow-up (except for ≤6 h/day in men). In the repeat self-report sub-sample (median 4.3 years), relatively higher physical activity at follow-up was observed in those who maintained or achieved favourable levels of MVPA, walking for pleasure, strenuous sports, other exercises, heavy DIY (in women), heavy physical work, and walking/standing at work (in women), sedentary time at work, getting about methods (in women), commuting methods (in women), TV viewing, computer use or sleep.ConclusionsInitial levels of PA, SB and sleep, and changes in these variables were generally associated with subsequent accelerometer-measured PA in the expected directions, suggesting these specific behaviours all contribute to the total volume of physical activity over time and could thus be targets for intervention.

Project description:Healthy ageing is an important concern for many societies facing the challenge of an ageing population. Physical activity (PA) is a major contributor to healthy ageing; however insufficient PA levels are prevalent in old age in Germany. Community capacity building and community involvement are often recommended as key strategies to improve equitable access to prevention and health promotion. However, evidence for the effectiveness of these strategies is scarce. This study aims to assess the community readiness for PA promotion in local environments and to analyse the utility of strategies to increase community readiness for reaching vulnerable groups.We designed a mixed method intervention trial comprising three study modules. The first module includes an assessment of community readiness for PA interventions in older adults. The assessment is carried out in a sample of 24 municipalities in the Northwest of Germany using structured key informant interviews. In the second module, eight municipalities with the low community readiness are selected from the sample and randomly assigned to one of two study groups: active enhancement of community readiness (intervention) versus no enhancement (control). After enhancing community readiness in the active enhancement group, older adults in both study groups will be recruited for participation in a PA intervention. Participation rates are compared between the study groups to evaluate the effects of the intervention. In addition, a cost-effectiveness analysis is carried out calculating recruitment costs per person reached in the two study groups. In the third module, qualitative interviews are conducted with participants and non-participants of the PA intervention exploring reasons for participation or non-participation.This study offers the potential to contribute to the evidence base of reaching vulnerable older adults for PA interventions and provide ideas on how to reduce participation barriers. Its findings will inform governmental authorities, professionals, academics, and NGOs with an estimate of resources necessary to achieve equitable access to physical activity programs for vulnerable older adults.German Clinical Trials Register DRKS00009564 (Date of registration 03-11-2015).

Dataset Information

Predictors of physical activity among older adults in Germany: a nationwide cohort study.

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Predictors of physical activity among older adults in Germany: a nationwide cohort study.

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