Table 2.
Manuscripts reporting on determinants of physical activity and exercise in healthy older adults
| Reference |
Design: Intervention study, observational study or randomized controlled trial Age: Mean (SD) or [Range]left Quality score: % |
Intervention: Content Outcome measure: Self-report or objective + instrument Outcome: unstructured physical activity (PA), structured exercise (EX) or a combination of physical activity and exercise (PA/EX) - for definitions see main text |
Determinants: Positive association (+), negative association (-) or no association (NS) | |
|---|---|---|---|---|
| [24] Boyette et al. 1997 U.S. |
Design: Intervention study Age: 71.3 (4.6) Quality score: 29 |
Intervention: Strength training intervention with considerable support from staff and program organization aimed at convenience Outcome measure: Self-report PEP Outcome: "Do you exercise for muscular strength and endurance?"/"Do you exercise for flexibility? (EX) |
Satisfaction with exercise routine (+) Satisfaction with body image (+) Age (NS) Weight (NS) BMI (NS) Easy Access to exercise location (NS) |
|
| [25] Brassington et al. 2002 U.S. |
Design: Intervention study Age: 70.2 (4.1) Quality score: 38 |
Intervention: Endurance and strengthening exercise prescription or stretching and flexibility exercise prescription combined with telephone counselling to overcome exercise barriers for the promotion of exercise adherence Outcome measure: Self-report Exercise logs, validation through class-attendance and 'vitalogs' Outcome: Adherence to prescribed exercise (EX) |
Change in exercise self-efficacy (+) Self-reported fitness outcome realizations (+) Baseline exercise self-efficacy (NS) Baseline fitness outcome expectancies (NS) Baseline psychological outcome expectancies (NS) Baseline social support for exercise (NS) Change in social support (NS) |
|
| [12] Burton et al. 1999 U.S. |
Design:Observational study Age: [65 - 85+] Quality score: 49 |
Intervention: Not applicable Outcome measure: Self-report 'how often do you perform physical activity such as walking briskly, gardening, or heavy housework?' Outcome: Performing brisk physical activity at least three times a week = active (less is considered sedentary or insufficiently active) (PA) |
Age (-) Gender (male) (+) Marital status (+) General physical health (+) Belief in importance of physical activity (+) Emotional distress (-) Advice of physician about getting more exercise (-) Ethnicity (NS) Education (NS) Self-mastery (NS) Having a confidant (NS) |
|
| [38] Cheung et al. 2006 U.S. |
Design: Randomized controlled trial Age: 75.1 (7.0) Quality score: 25 |
Intervention: Walking prescription and instruction with weekly prompting by nurse or computer Outcome measure: Self-report Exercise logs walking behaviour Outcome: Walking behaviour (miles, minutes and perceived exertion) and adherence to prescription (EX) |
Exercise self-efficacy (+) Stage of change (NS) |
|
| [39] Costanzo and Walker 2008 U.S |
Design: Randomized controlled trial Age: [50-65] Quality score: 50 |
Intervention: Behavioural counselling to increase exercise self-efficacy and social support from friends and family Outcome measure: Self-report Modified 7-day activity recall Outcome: Self-reported moderate or greater physical activities of at least 4 MET reported in minutes based on Modified 7-day activity interview, listing several common activities: "moderate" (eg, cleaning, fishing, raking); "hard" activities (eg, golf, scrubbing); and "very hard" (eg, swimming) (PA/EX) |
Change in exercise self-efficacy (+) Change in social support (family) (-) Change in social support (friends) (NS) |
|
| Cluster 1* | [42] Garcia and King 1991 U.S. |
Design: Randomized controlled trial Age: 56.4 (4.2) Quality score: 41 |
Intervention: Personalized exercise prescription class-based or home-based (home-based included regular telephone contact) Outcome measure: Self-report Exercise logs validation through 'vitalogs' Outcome: Exercise performed relative to prescription (EX) |
Marital status (+) Smoking status (-) Exercise self-efficacy (+) Exercise intervention condition (home-based vs class-based) (+) Age (NS) Gender (NS) Ethnicity (NS) Education (NS) Income (NS) BMI (NS) Self-motivation (NS) Exercise intervention condition (low vs high intensity) (NS) Perceived exertion, enjoyment and convenience of intervention (NS) |
| [28] King et al. 1997 U.S. |
Design: Intervention study Age: [50-65] Quality score: 40 |
Intervention: Personalized exercise prescription class-based or home- based (home-based included regular telephone contact) Outcome measure: Self-report Exercise logs validation through 'vitalogs' Outcome: Exercise adherence to at least two thirds of exercise prescription (EX) |
Exercise intervention condition (home-based vs class-based) (+) Stress (-) General physical functioning (+) Education (-) BMI (-) Age (NS) Gender (NS) Marital status (NS) Employment status (NS) Social support (NS) |
|
| [45] Oka et al. 1995 U.S. |
Design: Randomized controlled trial Age: [50-65] Quality score: 21 |
Intervention: Personalized exercise prescription group-based or home- based (home-based included telephone counselling related to meeting exercise prescription) Outcome measure: Self-report Exercise logs validation through 'vitalogs' Outcome: Exercise adherence as percentage of exercise prescription (EX) |
Smoking status (-) Exercise intervention condition (home-based vs class-based) (+) Preferring a lesser amount of social support from staff (+) Initial and continued social support (friends/family/staff) (+) Family satisfaction (-) Gender (NS) |
|
| [32] Oman and King 1998 U.S. |
Design: Intervention study Age: 56.2 (4.2) Quality score: 38 |
Intervention: Personalized exercise prescription class-based or home-based (home-based included telephone counselling related to meeting exercise prescription) Outcome measure: Self-report Exercise logs validation through 'vitalogs' Outcome: Exercise performed relative to prescription (EX) |
Exercise self-efficacy (+) Exercise intervention condition (home-based vs class-based) (+) Prior exercise adherence (+) Exercise intervention intensity (NS) Exercise self-efficacy (+) Affect (NS) |
|
| Cluster 2* | [44] McAuley et al. 2003 U.S. |
Design: Randomized controlled trial Age: 66.7 (5.4) Quality score: 38 |
Intervention: Exercise classes three times a week either walking or a stretching and toning program Outcome measure: Self-report PASE (including leisure, household, and occupational activity) Outcome: Level of activity based on PASE (PA/EX) |
Social support (NS) Prior exercise adherence (NS) Level of physical activity at 2 years after intervention (+) |
| [30] McAuley et al. 2007 U.S. |
Design: Intervention study Age: 66.7 (5.4) Quality score: 56 |
Intervention: Exercise classes three times a week either walking or a stretching and toning program Outcome measure: Self-report PASE (including leisure, household, and occupational activity) Outcome: Level of activity based on PASE (PA/EX) |
Positive affect 2 years after intervention (+) Exercise self-efficacy 2 years after intervention (+) Exercise intervention condition (Walking vs Stretching) (+) Age (NS) Gender (NS) Ethnicity (NS) Marital status (NS) Education (NS) Income (NS) |
|
| [40] Dubbert et al. 2002 U.S. |
Design: Randomized controlled trial Age: 68.7 (4.7) Quality score: 41 |
Intervention: Instruction video and individualized walking program with prompting phone calls or personalized phone calls with nurse counselling following stage of change Outcome measure: Self-report Walking diary, validation through peers and accelerometers with additional assessment using the 7-day Physical Activity Recall (PAR) Outcome: Episodes of at least 10 minutes duration walking for exercise (EX) |
Walking companion (+) BMI (reduction) (+) Change in mobility (improvement) (+) Change in general physical health (improvement) (+) Exercise intervention condition (phone calls vs. no phone calls) (+) Smoking status (NS) Change in general mental health (NS) |
|
| [26] Emery et al. 1992 U.S. |
Design: Intervention study Age: 67.0 (4.9) Quality score: 19 |
Intervention: Aerobics exercise group (3 supervised exercise sessions for 4 months), a yoga control or a waiting list control group Outcome measure: Self-report Retrospective self-report of physical activity during prior 12 months Outcome: Number of months, days per month, and minutes per day of physical activity (measure for overall activity and specific activities for which the participants were trained) converted to energy expenditure (PA/EX) |
Cardiorespiratory endurance (+) Motor speed (+) Anxiety (-) Age (NS) Gender (NS) Prior exercise adherence (NS) General mental health (NS) General cognitive functioning (NS) |
|
| [41] Finkelstein et al. 2008 U.S. |
Design: Randomized controlled trial Age: [50-85] Quality score: 63 |
Intervention: Financial incentive for minutes walking, jogging or running Outcome measure: Objective Pedometer (with paper back-up logs in case of technical problems) Outcome: Minutes logged walking, jogging or running (PA/EX) |
Education (-) Income (-) Employment status (-) Exercise intervention condition (financial incentive vs. no-incentive) (+) Age (NS) Gender (NS) |
|
| [13] Hirvensalo et al. 2000 Finland |
Design: Observational study Age: [65-84] Quality score: 19 |
Intervention: Not applicable Outcome measure: Self-report The level of physical activity and its intensity was assessed using a six-point scale: 1) moving only in connection with necessary chores, 2) walking or other outdoor activities 1-2 times/week, 3) walking or other outdoors activities several times/week, 4) 1-2 times/week to the point of perspiring and heavy breathing, 5) several times/week to the point of perspiring and heavy breathing, 6) keep-fit exercise or competitive sport several times a week. Outcome: Level of physical activity based on categories of 6 point scale (PA/EX) |
Age (-) Cardiovascular/musculoskeletal diseases (-) Competitive sports early in life (+) Recreations sports in adulthood (+) |
|
| [27] Jancey et al. 2007 Australia |
Design: Intervention study Age: [65-74] Quality score: 39 |
Intervention: Prescription walking intervention (aerobic, balance, strength and flexibility components), with trained walk leaders, offering advice, reassurance, encouragement, feedback and health education. Including non-monetary incentives and gatherings to enhance social support Outcome measure: Self-report IPAQ Outcome: Level of activity based on IPAQ (including occupational, household and leisure activity) (PA/EX) |
Socioeconomic status (+) BMI (-) Loneliness (-) Walking self-efficacy (-) Baseline activity level (+) Age (NS) Gender (NS) |
|
| [14] Kahana et al. 2005 U.S. |
Design: Observational study Age: 79.1 (3.1) Quality score: 38 |
Intervention: Not applicable Outcome measure: Self-report The total number of hours per week: walking, swimming, golfing, running/jogging, aerobics, stretching or calisthenics, weight lifting, dancing, biking, and other exercises. Outcome: The total number of hours per week (PA/EX) |
Gender (male) (-) Future orientation (+) Age (NS) General physical health (NS) |
|
| [43] Li et al. 2001 U.S. |
Design Randomized controlled trial Age: 72.8 (5.1) Quality score: 25 |
Intervention: Tai Chi practice sessions twice a week Outcome measure: Class-attendance recorded by instructor Outcome: Participants practise session attendance (EX) |
Change in exercise self-efficacy (+) | |
| [15] Li et al. 2005 U.S. |
Design: Observational study Age: 73.9 (2.6) Quality score: 47 |
Intervention: Not applicable Outcome measure: Self-report Neighbourhood walking (walking or strolling though neighbourhood, walked or done physical activities with neighbours or gone to the park for walks or other physical activities) Outcome: Neighbourhood walking over the past 12 months (PA) |
Neighbourhood safety for walking (+) Access to exercise facilities (+) Education (-) Neighbourhood social cohesion (NS) Exercise self-efficacy (NS) General physical health (NS) Income (NS) |
|
| [29] Lucidi et al. 2006 Italy |
Design: Intervention study Age: [65-90] Quality score: 50 |
Intervention: Sport activity program with two sessions per week including aerobic exercise, strength training, balance and flexibility Outcome measure: Self-report Class-attendance recorded by instructor Outcome: Percentage of attended sessions divided by number of possible sessions over the three months of exercise classes (EX) |
Intention (+) Perceived behavioural control (NS) Exercise self-efficacy (NS) Exercise attitude (NS) Subjective norm (NS) |
|
| [16] Michael et al. 2010 U.S. |
Design: Observational study Age: [65+] Quality score: 75 |
Intervention: Not applicable Outcome measure: Self-report 2 questions of the PASE "Over the past 7 days, how often did you walk outside your home or yard for any reason. For example for fun or exercise, walking to work, walking the dog, etc.?" "On average, how many hours per day did you spend walking?" Outcome: Walking behaviour (PA/EX) |
Proximity of parks and trails (+) Proximity of recreational facilities (NS) |
|
| [31] Morey et al. 2003 U.S. |
Design: Intervention study Age: 71.5 (4.9) Quality score: 32 |
Intervention: Exercise intervention to improve physical functioning supervised phase (followed by home-based phase for one of the two randomized groups) Outcome measure: Self-report validation through measured oxygen uptake Outcome: Following exercise prescription (EX). Participants were classified as adherent if their exercise averaged 20 minutes or more, 3 or more days a week, over six months |
Gender (male) (+) Depression (-) BMI (-) General physical functioning (+) Chronic diseases (-) Pain (-) Prior exercise adherence (weekend exercise home-work) (+) Age (NS) Ethnicity (NS) General physical health (NS) Exercise self-efficacy (NS) Locus of Control (NS) Social support (NS) Exercise intervention condition (aerobic only vs aerobic + flexibility) (NS) |
|
| [17] Nitz and Choy 2007 Australia |
Design: Observational study Age: [40-80] Quality score: 15 |
Intervention: Not applicable Outcome measure: Self-report The level of physical activity and its intensity was assessed using a six-point scale: 1) moving only in connection with necessary chores, 2) walking or other outdoor activities 1-2 times/week, 3) walking or other outdoors activities several times/week, 4) 1-2 times/week to the point of perspiring and heavy breathing, 5) several times/week to the point of perspiring and heavy breathing, 6) keep-fit exercise or competitive sport several times a week. Outcome: Level of physical activity based on categories of 6 point scale (PA/EX) |
BMI (-) Baseline activity level (+) Change in BMI (NS) Age (NS) Number of falls (NS) Number of falls since baseline (NS) Stability (NS) Number of medical conditions (NS) Increase in number of medical conditions (NS) Number of medications (NS) Change in number of medications (NS) |
|
| [33] Oman and King 2000 U.S. |
Design: Intervention study Age: 65.5 (4.3) Quality score: 25 |
Intervention: Personalized exercise prescription class-based or home-based (home-based included telephone counselling related to meeting exercise prescription) Outcome measure: Exercise logs validation through 'vitalogs' Outcome: Exercise performed relative to prescription (EX) |
Major life events (-) | |
| [34] Rhodes et al. 2001 Canada |
Design: Intervention study Age: 76.4 (1.6) Quality score: 25 |
Intervention: Three weekly sessions of progressive resistance training Outcome measure: Class-attendance Outcome: Adherence measured through attendance (EX) |
Prior exercise adherence (+) Baseline exercise self-efficacy (+) Initial general social support (+) Continued general and program social support (NS) |
|
| [35] Sarkisian et al. 2007 U.S. |
Design: Intervention study Age: [65+] Quality score: 50 |
Intervention: Attribution retraining followed by physical activity class including strength, endurance and flexibility Outcome measure: Objective Pedometer Outcome: Weekly step count (PA) |
Positive age expectations (+) | |
| [18] Shaw and Spokane 2008 U.S. |
Design: Observational study Age: [54-72] Quality score: 48 |
Intervention: Not applicable Outcome measure: Self-report Single item, vigorous physical activity or exercise, 3 times a week or more, over the past 12 months (PA/EX) Outcome: Vigorous physical activity or exercise 3 times a week or more, over the past 12 months (yes or no) (PA/EX) |
Age (-) Education (+) Employment status (+) Change in employment status (+) Chronic conditions (-) Change in chronic conditions (increase) (-) General physical functioning (+) General physical functioning (increase in limitations)(+) Depressive symptoms (-) Change in depressive symptoms (increase) (-) |
|
| [19] Shimada et al. 2007 Japan |
Design: Observational study Age: [70+] Quality score: 54 |
Intervention: Not applicable Outcome measure: Self-report Regular physical activity (yes/no, frequency and nature of activity: golf, ball games, hiking, home-based or group exercise, dancing, swimming, martial arts, jogging, walking, other exercise) Outcome: Regular physical activity was defined as carrying out any type of physical activity 5 times or more per week (PA/EX) |
Gender (male) (+) Smoking status (-) Physical functioning (slow walking speed) (-) Fear of falling (-) Age (NS) General physical health (NS) |
|
| [20] Stiggelbout et al. 2006 The Netherlands |
Design: Observational study Age: 60.9 (8.4) Quality score: 50 |
Intervention: Not applicable Outcome measure: Self-report Part of the Dutch Monitor on Physical Activity and Health to assess compliance with Dutch public-health guidelines Outcome: Norm-active is defined as performing 30 minutes or more of moderate-intensity physical activity on most, and preferably all, days - either in a single session or accumulated in multiple bouts of al least 10 minutes (PA/EX) |
Prior exercise adherence (+) Perceived quality of the program (+) Exercise attitude (+) Exercise barriers (-) Exercise intention (+) Exercise self-efficacy (NS) Coping (NS) Social influences and support (NS) |
|
| [21] Touvier et al. 2010 France |
Design: Observational study Age:[45-64] Quality score:46 |
Intervention: Not applicable Outcome measure: Self-report MAQ Past 12 month physical activity during leisure time and at work Outcome: Subjects were considered to meet overall PA recommendations if their overall PA was ≥ 60 min per week of vigorous activities with at least 20 min per session or ≥ 150 min per week of moderate activities (PA/EX) |
Retirement (+) Gender (NS) Occupation physical demand level (NS) |
|
| [22] Tu et al. 2004 U.S. |
Design: Observational study Age: 63.7 (7.3) Quality score: 52 |
Intervention: Not applicable Outcome measure: Class-attendance recorded by research assistant Outcome: Measured attendance (EX) |
Weather conditions (good) (+) High blood pressure (-) Age (NS) Ethnicity (NS) General physical health (NS) Perceived barriers (NS) Pain as exercise barrier (NS) Exercise self-efficacy (NS) Workers going to work on foot in neighbourhood (NS) |
|
| [36] Wilcox and King 2004 U.S. |
Design: Intervention study Age: 70.2 (4.1) Quality score: 25 |
Intervention: Exercise classes aerobic and strength training or stretching and relaxation combined with home-work with telephone counselling to encourage participation in the program Outcome measure: Self-report Exercise logs validation through class-attendance and 'vitalogs' Outcome: Participation calculated as percentage of exercise sessions completed divided by sessions prescribed (EX) |
Number of life events (-) Interpersonal loss (-) |
|
| [37] Williams and Lord 1995 Australia |
Design: Intervention study Age: 71.6 (5.5) Quality score: 16 |
Intervention: Exercise to improve balance, coordination, strength and cardiorespiratory fitness Outcome measure: Class-attendance and activities outside the program Outcome: Adherence was defined as number of exercise classes attended (EX) |
Age (-) Reaction time (+) Psychoactive drug use (-) Physical strength (+) Cognitive reasoning ability (+) Depression (-) Self reported general physical health outcome realizations (+) Self reported physical functioning outcome realizations (+) Self reported cognitive functioning outcome realizations (+) Self reported psychological outcome realizations (+) Education (NS) BMI (NS) General physical health (NS) General mental health (NS) General cognitive functioning (NS) Baseline activity level (NS) Locus of control (NS) |
|
| [23] Yasunaga et al. 2008 Japan |
Design: Observational study Age: [65-83] Quality score: 88 |
Intervention: Not applicable Outcome measure: Objective Pedometer/accelerometer Outcome: Number of steps taken and the intensity of physical activity (PA) |
Age (-) Gender (male) (+) Weather conditions (good) (+) |
|
* Cluster of multiple manuscripts reporting on the same original data set