Promoting physical activity in older adults by education of home visitors.

The objectives were to investigate in older adults (1) whether regular preventive home visits are associated with change or stability in physical activity and (2) whether education of home visitors influences stability and change in physical activity. The design was a prospective controlled randomised follow-up study with randomization at municipality level (17 intervention and 17 control municipalities) and outcomes measured at individual level. Visitors in the intervention-municipalities received regular education during 3 years. The effect of the intervention was measured by a questionnaire survey among 1,913 old persons living in the 34 municipalities at baseline and 4½-year follow-up. Changes in physical activity were measured through self-reported frequencies of vigorous physical activity. All logistic regression analyses were stratified by sex and age group (75 and 80 years old). There was no effect of receiving preventive home visits on change in physical activity among the men and among the 75-year-old women. Among the physically active 80-year-old women those who accepted and received more than four preventive home visits were more likely to go on being physically active compared to women who did not receive preventive home visits. Among the sedentary 80-year-old women those living in the intervention municipalities tended to increase their physical activity compared to the control women. These results were not seen in the old men. Preventive home visits as part of daily routine in primary care and education of home visitors and general practitioners may promote physical activity in older women.

Stability and change in physical activity in old age: the role of changes in disability.

The objective was to examine whether stability and change in physical activity in older men and women are influenced by (1) changes in disability and by (2) social relations and psychological well-being. The study is based on baseline, 3 and 4.5 year follow-up data on 917 older men and women. Changes in physical activity were measured through self-reported frequencies of vigorous physical activity at the three measurement points. The analyses were carried out for two outcomes-decline in physical activity versus sustained high level of physical activity (from high to low) and sustained low physical activity versus improvement in physical activity (from low to high). The main results were: older adults with onset of tiredness or continuous tiredness in daily activities during 4.5 years are more likely to have a concurrent decline in their physical activities during the same period. Older adults with onset of need of help and sustained need of help are more likely to have a decline in physical activities or to sustain a low level of physical activities during the same period. The associations between the psychosocial factors and change in physical activity are attenuated by the concurrent changes in disability. The present study supports that health promotion projects should be aware that development of tiredness and continuous tiredness are strongly related to a decline in physical activity and that onset of and sustained need of help are strongly associated with both a decline in and sustained low physical activity.