The Impact of Osteoporosis, Falls, Fear of Falling, and Efficacy Expectations on Exercise Among Community-Dwelling Older Adults

Abstract

Purpose The purpose of this study was to test a model delineating the factors known to influence fear of falling and exercise behavior among older adults. Design and Methods This was a secondary data analysis using baseline data from the Bone Health study. A total of 866 individuals from two online communities participated in the study, 161 (18.6%) were from SeniorNet and 683 (78.9%) were from MyHealtheVet. More than half (63%) of the participants were male with a mean age of 62.8 (SD= 8.5). The majority was white (89%), married (53%) and had some college (87%). Results Knowledge about osteoporosis and awareness one has a diagnosis of osteoporosis directly influenced fear of falling, and knowledge of osteoporosis directly and indirectly influenced exercise behavior. A diagnosis of osteoporosis indirectly influenced exercise behavior. Taken together, the hypothesized model explained 13% of the variance in exercise behavior. Implications Improving knowledge of osteoporosis and awareness of having a diagnosis of osteoporosis, decreasing fear of falling and strengthening self-efficacy and outcome expectations for exercise may help improve exercise behavior among older adults.

Outcome Expectations and Osteoarthritis: Association of Perceived Benefits of Exercise With Self‐Efficacy and Depression

“…Defined as the belief in one's ability to execute a behavior required to produce a desired outcome, self‐efficacy has been posited as a psychosocial construct operating in conjunction with outcome expectancy to influence behavior . In support of this theory, 2 cross‐sectional studies demonstrated that higher outcome expectations for exercise were significantly related to greater self‐efficacy . Our study is the first to confirm this association in people with knee OA.…”

“…Amid the limited literature, 1 study in adults with arthritis found that the average outcome expectations for exercise in their sample was below the normative value reported for similarly aged community‐dwelling adults with a higher education level . No relationship to education was found among adults with osteoporosis participating in an exercise program . Due to the collective lack of associations between race, sex, or education level and outcome expectancy, it is unlikely that these demographic factors can predict or influence the perceived benefits of exercise in the knee OA population.…”

“…The degree of the perceived physical and psychological benefits of exercise could positively or negatively influence behavior such that an individual with higher outcome expectations would be more motivated to exercise than someone who perceived less benefit . The influence of outcome expectancy on physical activity is supported by a growing body of empirical evidence across different populations and holds true in the context of chronic pain conditions , including OA. A recent study of individuals with hip OA who were enrolled in an exercise program found that outcome expectations played a major role among participants choosing to continue physical activity .…”

“…Recently, exploring variables in relation to outcome expectations has been targeted in an effort to understand exercise behavior and strengthen theoretical frameworks for improving physical activity. Research has identified mental health, self‐efficacy, fear of falling, and disease knowledge as factors . Relationships to demographic variables such as race and sex have not been consistently demonstrated , although some evidence suggests that higher education levels may be related to greater outcome expectations for exercise .…”

Environmental predictors of objectively measured out-of-home time among older adults with cognitive decline

“…Living alone (no = 0, yes = 1), gender (women = 0, men = 1), current driving status (no = 0, yes = 1) were treated as dummy variables. Because fear of falling measured with a single item in a 4-point Likert scale has been treated as a continuous variable in previous studies (e.g., Harada, Park et al, 2017, Resnick et al, 2014, we also analyzed fear of falling as a continuous variable.…”