Predictors of attendance to group exercise: a cohort study of older adults in long-term care facilities

Abstract

BackgroundThe benefits of regular exercise and physical activity are well known. Those living in long-term care are often frail, but have the potential to benefit from physical activity; yet are less likely to be offered exercise. Promoting exercise within residential and nursing homes may reduce health risks associated with inactivity in this population. The aim of this cohort study is to identify predictors of attendance at physiotherapy led exercise groups offered to older adults residing in long-term care in the United Kingdom.MethodsOne thousand and twenty three older adults residing in residential and nursing homes, were recruited to the Older People's Exercise in Residential and nursing Accommodation (OPERA) cluster randomised controlled trial. Secondary analysis of 428 adults (aged 75 to 107) randomised to twice-weekly physiotherapy-led group exercise sessions for 12 months was undertaken. Using attendance data, linear regression analysis was utilised to separately identify individual and home-level factors predictive of attendance at exercise in the residential and nursing homes.ResultsOf 428 older adults, 326 lived in residential homes and 102 in nursing homes. Mean age of the sample was 88.0 years and the majority of residents were female (324/428, 76%). Pre-intervention assessment suggested that most residents had moderate cognitive impairment; median (range) Mini Mental State Examination scores in residential homes were 19 (0–30) and 14 (0–29) in nursing homes. Median Geriatric Depression Scale (GDS-15) scores were 3 (0–13) and 5 (0–13) respectively, indicating low levels of depressive symptoms.Over a 12-month period, 3191 exercise groups were delivered. Mean number of groups in the residential homes was 82 and 78 in the nursing homes. Number of attendances at group exercise was 11,534/21,292 (54.2%) and 3295/6436 (51.2%) respectively.Linear regression analysis revealed that depression, social engagement, and socio-economic characteristics were significantly associated with participant attendance at exercise groups in the residential homes, but none of these factors predicted attendance at group exercise in nursing homes.ConclusionsOlder people living in long-term care are receptive to participating in exercise programmes, but there are individual and home-level reasons for attendance and non-attendance.

Health Problems of Institutionalized Elderly

“…The literature suggests that women live longer than men; this has been explained by lower exposure to certain risk factors at work, lower prevalence of smoking and alcohol intake. In addition, differences are highlighted as the attitude towards disease and disability and the influence of increased coverage of the gynecological and obstetric care [2,4,9]. Other authors attribute the greater institutionalization of women, because of older women represent the major portion of this population [1].…”

“…Nowadays the family is no longer so willing to take care of their elders. Among the factors that create this difficulty can highlight women entering the labor market and the existing capitalist model, which impacts the Brazilian families, and the financial difficulties impose a family restructuring, which can create obstacles for the maintenance of elderly in their own homes [1][2].…”

“…The idea is that asylum is a care environment, recreation and socialization among seniors. For them it is a generative attitude of negative feelings, because it is expected that children or other family members are responsible for their loved aging process [2][3].…”

Força De Membros Superiores E Inferiores De Idosas Praticantes E Não Praticantes De Ginástica Funcional

“…Doenças crônicas e degenerativas aparecem com o decorrer do envelhecimento, contribuindo para a diminuição das habilidades necessárias para a vida diária e um importante marcador de um envelhecimento bem sucedido e de uma ótima qualidade de vida nos idosos é a capacidade funcional 2,4,7 . Para uma efetiva prevenção, ou mesmo para a redução das perdas funcionais que estão associadas ao envelhecimento, sugere-se a inclusão num programa regular de exercícios físicos 4,8,9 . O declínio da performance física pode ser minimizado por meio dessa prática, o que tem sido relacionado a melhoras significativas em aspectos psicológicos e físicos do idoso praticante, auxiliando positivamente na função corporal, mantendo a capacidade física, melhorando a qualidade de vida e diminuindo o risco de quedas 8,10 .…”

“…Para uma efetiva prevenção, ou mesmo para a redução das perdas funcionais que estão associadas ao envelhecimento, sugere-se a inclusão num programa regular de exercícios físicos 4,8,9 . O declínio da performance física pode ser minimizado por meio dessa prática, o que tem sido relacionado a melhoras significativas em aspectos psicológicos e físicos do idoso praticante, auxiliando positivamente na função corporal, mantendo a capacidade física, melhorando a qualidade de vida e diminuindo o risco de quedas 8,10 . O treinamento sistemático com pesos em idosos pode promover aumento da força, da massa muscular e da flexibilidade 11,12 .…”