The best medicine: Promoting physical activity in older adults

Regular physical activity is a crucial part of a healthy lifestyle for people of all ages. This is especially true in older adults, who can still benefit from staying active. For a healthy lifestyle, the Centers for Disease Control and Prevention (CDC) recommends 150 minutes of moderate-to-vigorous physical activity each week. But many Americans, particularly older adults, fall short of this physical activity recommendation.

A new study by researchers from the Texas A&M School of Public Health, Texas A&M College of Architecture and Baylor Scott & White Health, published in the journal BMC Geriatrics, looked into different individual and environmental factors that might affect physical activity in older adults.

Regents and Distinguished Professor Marcia G. Ory, PhD, MPH and Samuel D. Towne Jr., PhD, assistant professor in the Texas A&M School of Public Health, both faculty affiliates in the Center for Population Health and Aging, were part of a larger research team who reviewed clinical records of Baylor Scott & White Health to identify older adults who might benefit from being more active. Study participants filled out a survey about their levels of physical activity and factors commonly related to activity levels. The study looked at 272 people between the ages of 60 and 92 in four central Texas communities: Temple, Killeen, Bryan and College Station.

Activity can be affected by several factors, so researchers looked at a number of individual and environmental variables: educational levels, age, race and ethnicity, health status, marital status and amount of human or animal companionship (in other words, having another person or a dog to walk with). The researchers also examined the median age of residents in each neighborhood and participant perceptions on matters like neighborhood safety (traffic, sidewalks, and crosswalks), risk of falling and how much they interacted with neighbors.

Most of the study participants were educated and primarily white non-Hispanic adults and in generally good health. Most had some sort of social support for walking, whether animal or human, and few had concerns about neighborhood safety or risks of falling.

“For older adults, it’s important to look at walking since it is the most common form of physical activity for that age group,” Ory said. While the majority (60 percent) reported frequent walking, defined as at least three times a week, only about a quarter (28 percent) met the CDC guidelines by walking at least 150 minutes per week.

“A major advantage of this study was the ability to examine the interaction among personal, social, and environmental factors related to physical activity among potentially at-risk older adults,” Towne said. Those less likely to meet the CDC guidelines were younger and experienced poorer mental health. Social cohesion in a neighborhood encouraged frequent walking, whereas direct social support made meeting the recommendations more likely. In addition, the average age of a neighborhood seemed to affect activity levels, with older adults living in areas where there are more young adults being more active.

“These findings highlight a need for further research into this topic,” Ory said. “One such area is the relationship between mental health issues, such as depression, and physical activity. In addition, more study is needed to examine how social support and neighborhood characteristics affect physical activity levels.”

“This study serves as another step toward understanding how to promote physical activity in older adults and shows the important role that physicians play,” added Samuel N. Forjuoh, MD, MPH, DrPH, clinical collaborator from Baylor Scott & White Health and faculty affiliate of the Center for Population Health and Aging.

This research has implications for an overall ‘exercise is medicine’ message. Ory advises that “physicians be encouraged to talk to their older patients about how to get the proper ‘dose’ of physical activity. This can be helped by finding ways to limit barriers, such as overcoming some of the mental health and environmental issues that contribute to lower physical activity levels and identifying how to enhance positive factors such as social supports.”