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Use it or lose it: a qualitative study of the maintenance of physical activity in older adults.

ABSTRACT: BACKGROUND:Lack of physical activity (PA) is a recognised global public health problem, which is increasing in prevalence with a detrimental impact on the pattern of disease worldwide. In the UK, older adults comprise the most sedentary group, with only 57% of males and 52% of females aged 65-74?years and 43% of males and 21% of females aged 75-84?years meeting PA recommendations. PA confers multiple health benefits including increased stamina, muscle, bone and joint strength, increased independence and reduced risk of falls in old age. Despite benefits experienced during time-limited PA programmes, increased PA is not always continued. This study aimed to provide a better understanding of PA maintenance behaviours in older people. METHODS:Face to face semi-structured interviews were conducted with adults who completed one of two strength and balance exercise programmes as part of the ProAct65+ trial: group (FaME) and home based (OTAGO) exercises. Five GP practices in Nottingham and Derby were recruited and invited people aged 65?years and older who met eligibility criteria. Interviews were conducted in participants' homes. Interviews explored PA levels pre and post intervention, perceived health benefits, facilitators, barriers and use of technology for PA maintenance. The interviews were transcribed verbatim and analysed using framework analysis and the software NVivo10. RESULTS:Fifteen participants from each intervention group were interviewed. The FaME group consisted of 10 females and 5 males, age range of 70-88?years. The OTAGO group consisted of 12 females and 3 males aged 72-95?years. Important themes identified were physical, social, psychological and environmental facilitators and barriers. These included increased physical autonomy, enjoyment, positive evaluation of the activity and physical benefits, importance of social interaction, positive feedback, development of behaviour considered normal or habitual, motivation and self-efficacy. Some participants used technologies not included in the original interventions, like pedometers and smart phones to motivate themselves. CONCLUSIONS:A range of modifiable factors influence continued participation in PA at the end of exercise programmes. The findings from this study will inform the commissioning and quality improvement of future PA programmes and development of an intervention to enhance continuation of PA after exercise interventions in older adults.

SUBMITTER: Maula A

PROVIDER: S-EPMC6909612 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Use it or lose it: a qualitative study of the maintenance of physical activity in older adults.

Maula Asiya A LaFond Natasher N Orton Elizabeth E Iliffe Steve S Audsley Sarah S Vedhara Kavita K Kendrick Denise D

BMC geriatrics 20191212 1

<h4>Background</h4>Lack of physical activity (PA) is a recognised global public health problem, which is increasing in prevalence with a detrimental impact on the pattern of disease worldwide. In the UK, older adults comprise the most sedentary group, with only 57% of males and 52% of females aged 65-74 years and 43% of males and 21% of females aged 75-84 years meeting PA recommendations. PA confers multiple health benefits including increased stamina, muscle, bone and joint strength, increased ...[more]

PMID: 31830900

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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:Healthcare professionals (HCPs) have a key role in promoting physical activity, particularly among populations at greatest risk of poor health due to physical inactivity. This research explored HCPs' knowledge, decision making, and routine practice of physical activity promotion with older adults. Furthermore, it aimed to enhance our understanding of the supports that HCPs need to effectively promote physical activity in routine practice across a wide range of healthcare professions, settings, and sectors. Semi-structured online interviews were completed with HCPs between November 2020-March 2021. Data were first analysed by coding instances within the transcripts, mapping onto relevant Theoretical Domains Framework (TDF) domains utilising a deductive thematic analysis approach. The data were then analysed utilising an inductive approach to thematically generate explanatory subthemes within the identified domains. Participants (n = 63) included general practitioners (15.87%), occupational therapists (30.16%), physiotherapists (38.10%), and nurses (15.87%) from the island of Ireland (Ireland and Northern Ireland). Of those interviewed, 10 (15.87%) were male and 53 (84.13%) were female. Two thirds (65.08%) were HCPs practicing in Ireland. Domains and subthemes related to the application of physical activity, and emergent themes on developing practice to support the application and integration of physical activity in routine practice are discussed. HCPs identified that focused education, appropriate training, and access to tailored resources are all essential to support the promotion of physical activity in routine practice. For such supports to be effective, a 'cultural shift' is required in HCP training and health service provision to adopt the growing evidence base that physical activity promotion must be part of disease prevention and treatment in routine practice. HCPs highlighted a range of areas for service development to support them to promote physical activity. Further research is required to explore the feasibility of implementing these recommendations in routine practice.

Project description:BackgroundMaintaining or initiating regular physical activity (PA) is important for successful aging. Technology-based systems may support and stimulate older adults to initiate and persevere in performing PA. The aim of the current study was to assess to which extent a customised Kinect system is 1) a credible tool to increase PA in older adults, 2) motivating to perform PA by older adults, and 3) easy to be used in older adults.MethodsA mixed-method cross-sectional feasibility study was performed in 5 aged care facilities in Flanders, Belgium. Aged participants were asked to perform a 20-30?min test with the intelligent Activity-based Client-centred Training (i-ACT) system. After the test, the 'Credibility and Expectancy Questionnaire' (CEQ), the 'Intrinsic Motivation Inventory'(IMI), the System Usability Scale (SUS), and semi-structured interviews were conducted in the older adults. Feedback was gathered using the thinking aloud method in both aged participants and healthcare professionals.ResultsA total of 48 older adults (20 males and 28 females, mean age?=?81.19 (SD?=?8.10)), were included. The scores pertaining to system credibility and expectancy, system usability, and motivation towards use were moderate to good. Participants reported that they liked using the i-ACT system, but that the context could be more attractive by adding more visualisations. Twelve professionals stated that they observed involvement in older adults but think that i-ACT is better used in day care centres.ConclusionsThis study indicates that i-ACT is a usable and motivational system to engage older adults to perform PA and therefore supports successful aging. Future research is necessary to investigate the efficacy of i-ACT to perform PA and the transfer to regain and/or maintain engagement in ADLs that older adults find meaningful and purposeful at an older age. Also, further development of i-ACT is advisable to adapt the i-ACT system towards implementation at the home of older adults.Trial registrationClinicalTrial.gov ID NCT04489563 , 23 July 2020 - Retrospectively registered.

Project description:Dysfunctional neutrophils with advanced age are a hallmark of immunosenescence. Reduced migration and bactericidal activity increase the risk of infection. It remains unclear why neutrophil dysfunction occurs with age. Physical activity and structured exercise have been suggested to improve immune function in the elderly. The aim of this study was to assess a comprehensive range of neutrophil functions and determine their association with habitual physical activity.Physical activity levels were determined in 211 elderly (67±5years) individuals by 7-days of accelerometry wear. Twenty of the most physically active men and women were matched for age and gender to twenty of the least physically active individuals. Groups were compared for neutrophil migration, phagocytosis, oxidative burst, cell surface receptor expression, metabolic health parameters and systemic inflammation. Groups were also compared against ten young participants (23±4years).The most active group completed over twice as many steps/day as the least active group (p<0.001), had lower BMI's (p=0.007) and body fat percentages (p=0.029). Neutrophils migrated towards IL-8 better in the most active group compared to the least active (p<0.05) and was comparable to that of the young (p>0.05). These differences remained after adjusting for BMI, body fat and plasma metabolic markers which were different between groups. Correlations revealed that steps/day, higher adiponectin and lower insulin were positively associated with migratory ability (p<0.05). There was no difference in expression of the chemokine receptors CXCR1 or CXCR2 (p>0.05 for both). CD11b was higher in the most active group compared to the least active (p=0.048). No differences between activity groups or young controls were observed for neutrophil phagocytosis or oxidative burst in response to Escherichia coli (p>0.05). The young group had lower concentrations of IL-6, IL-8, MCP-1, CRP, IL-10 and IL-13 (p<0.05 for all) with no differences between the two older groups.These data suggest that impaired neutrophil migration, but not bactericidal function, in older adults may be, in part, the result of reduced physical activity. A 2-fold difference in physical activity is associated with better preserved neutrophil migratory dynamics in healthy older people. As a consequence increasing habitual physical activity may be beneficial for neutrophil mediated immunity.

Dataset Information

Use it or lose it: a qualitative study of the maintenance of physical activity in older adults.

Publications

Use it or lose it: a qualitative study of the maintenance of physical activity in older adults.

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