Physical Activity in SeniorsDoes perception match reality?

Deborah Weiss, Mark Yaffe, Christina Wolfson

Physical Activity is Associated With…

Reductions in All-cause and CVD mortality Risk of dementia Risk of Type II diabetes Risk of incident CVD Risk of falls and fractures

Improvements in function

Lee and Skerrett 2001, Franco et al. 2005, Larson et al. 2006, Gilles et al. 2007, Gregg et al. 2000, Carter et al. 2001, Keysor and Jette 2001.

Prevalence of Inactivity

Older adults are least active of any age group

Figure 1: Prevalence of Physical Inactivity in Canada, 2000-2001 and 2005

0

10

20

30

40

50

60

70

80

90

100

Under 12 12 to 19 20 to 34 35 to 44 45 to 64 65 and older

Age

2000-2001

2005

Statistics Canada

% in

activ

e

Can we do better?

Physical inactivity in older adults shown to be associated with Poor health and pain Environmental factors (safety, presence of

sidewalks, etc) Poor self-efficacy Lack of knowledge about physical activity

Schutzer and Graves 2006

Is Physical Activity Being Misunderstood?

From a qualitative study of 33 people aged 75 and older “Physical Activity” was considered too vague

for most people This led participants to “perceive their level of

physical activity to be relatively high despite varying activity levels.”

Grossman and Stewart 2003

Research Question

Given the benefits older adults may experience with being physically active, why do the majority remain inactive?

How do older adults perceive their levels of physical activity?

Qualitative Study

Qualitative Methods

6 Focus Groups with adults aged 65 + (3 in French, 3 in English)

Source validation 5 physician interviews 2 additional focus groups, adults aged 65 + from

“Nifty 50’s” group at YMCA Downtown

Transcripts analyzed using Grounded Theory

Results

“…you can sit and do hobbies and different things, a cooking class, a crafts class, be in a choir, you’re being physical, you’re doing something with your own self, it doesn’t always have to be strenuous…certainly that’s being physically active to me.”

Cross-Sectional Survey

Includes Validated tool for measuring physical activity in older

adults Rapid Assessment for Physical Activity (RAPA)©

Validated tool for measuring nutritional risk in older adults

Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN)©

Health behaviour questions Questions assessing sources of physical activity

information, barriers, etc.

Questionnaire Design

Topolski et al. 2006

Keller, H. et al. 2001, 2005, 2006

Simple Physical Activity Question

“Regarding physical activity and exercise, do you consider yourself to be:

Very physically active Somewhat physically active A little physically active Generally not very physically active Not at all physically active”

Data Collection

Using newspaper advertisements placed in Métro The Suburban The Senior Times

Interested participants contacted Study Coordinator, were informed of the study and screened for cognitive impairment Survey mailed to participants with return envelope

Preliminary ResultsVariable

Age, Mean (SD) 73.6 (7.1)

Sex, Female, % (n) 61.9 (26)

Education, University 55.0 (22)

Physically Active, % (n), RAPA© 50.0 (21)

Elevated Nutritional Risk, % (n), SCREEN © 66.0 (31)

Self-Rated Health, Very Good or Excellent, % (n) 66.7 (28)

Physically Active (Somewhat or very), % (n), simple question 77.5 (31)

The RAPA vs. the Simple Question

RAPA Sedentary or

Insufficiently active Active

Sedentary or Insufficiently active

9 0 Simple Question

Active

11 20

27.5% (11/40) are over-reporting their physical activity

When not dichotomized…

RAPA

Sedentary Under-active light

Under-active regular

Active

Not very active 1 1 1 0 A little active 0 2 4 0 Somewhat active

0 3 1 9

Simple Question

Very active 0 3 4 11

It really depends on what cut-offs we use to define “active” and “inactive”, and how the questions are asked!

11 who are “over-reporting”

Discussion

The qualitative results indicate that the term “physical activity” might not be well-understood in older adults

Could it be that dichotomizing into “active” and “inactive” is part of the problem? Those who feel they are “doing enough” will

not be as receptive to messages to “do more” Particularly important if in fact they are not

sufficiently active!

Conclusions

Our public health messages might need clarification

How? Should focus on physical activity as a continuous

measure, and not in terms of achieving a recommended level, adding labels of “active” and “inactive”

Promote “adding a bit more” instead of “doing a minimum amount”

A person’s perception of their activity level won’t matter as much!

Questions?

deborah.weiss@mail.mcgill.ca