Determinants of physical activity initiation and maintenance among community-dwelling older persons

Background. Understanding determinants of initiation and maintenance of an active lifestyle among older individuals is of great concern to public health because of the increasing evidence that lifestyle may alter the course of frequently occurring chronic diseases. Method. Two thousand five hundred seven community-dwelling Medicare beneficiaries age 65 and over were interviewed at three points over 4 years regarding their physical activity, defined as a self-report of walking briskly, gardening, or heavy housework at least three times a week. Extensive data were also collected on health status, health services use, sociodemographics, and, at the final interview, self-mastery, importance of various factors in the decision to be physically active, and interaction with their physician regarding physical activity. Determinants of initiation and maintenance of physical activity were identified using logistic regressions. Results. Forty-one percent maintained an active lifestyle; 12% initiated an active lifestyle; 22% declined to become sedentary; 25% were sedentary at all observation. Predictors of both initiation and maintenance of physical activity were younger age, moderate to excellent health, and the patient's belief that physical activity was important to his/her health. Among the 301 patients who initiated activity, 40% said their physician was a very important influence. Conclusions. Strengthening the belief of older individuals in the benefits to their health of physical activity holds promise for increasing the proportion of community-dwelling older persons who move from a sedentary lifestyle to a more physically active lifestyle and for maintaining such activity.