Exercise Practice and Compliance in Community-Dwelling Older Adults
Keywords:exercise, older adults, elderly, compliance, profile, longitudinal
AbstractEXECUTIVE SUMMARY: The purpose of this study was to examine the “anatomy” of exercise in a cohort of older adults. First, the characteristics of those able to meet an exercise benchmark (i.e., five exercise events per week or more) at baseline or follow-up were also identified. Second, the exercise profile of compliers (those able to meet the exercise benchmark at baseline and follow-up) was dissected to address the question, How is compliance with an exercise standard achieved by older adults? The implications of cross-sectional and longitudinal analyses of the data were designed to provide insight into community-based exercise and physical activity programming for older adults. Subjects were derived from an archived, longitudinal data set of 2,592 adults in the United States, including an over-sampling of those aged 60 and older. This study was restricted to 1,103 subjects 60 and older at baseline and 614 subjects available at follow-up. “Regular” exercisers (those able to meet the exercise benchmark at baseline or follow-up) were compared to non-exercisers at baseline and follow-up to identify factors that discriminated between the two groups. Longitudinal analysis involved tracking those subjects who were regular exercisers at baseline and follow-up and then examining the structure of their exercise. The results suggested that older adults who regularly exercised in this cohort were clearly advantaged with respect to health-related and demographic characteristics: a little younger, better educated, less functionally limited, fewer chronic conditions, less likely to be employed, and more apt to have the support that comes with marriage or having a partner. Compliers and regular exercisers were best represented as avid walkers, with compliers characterized notably by either of two “cross-trainer” typologies; they were prone to practice more than one of physical activity option rather than persist with only one mode of exercise. Practical implications urge programs for older adult physical activity that support a variety of walking options—outdoor trails, mall walking, city circuits around neighborhoods, walking groups, walking in the water, and treadmill walking. The frequency of cross-training among compliers underscores the need for a greater diversity of physical activity choices and more varied exercise venues for seniors, such as resistance training, aquatic exercise, dancing, yoga, tai chi, balance exercises, even adapted physical education classes for older adults in pools, recreation centers, and parks.
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