Physical activity and psychological well-being among people aged 65 to 84 years

Age and Ageing, July, 1995 by J.M. Ruuskanen, I. Ruopilla

Introduction

Findings in gerontology and sport sciences suggest that regular physical activity and exercise can help to maintain and enhance functioning, health and psychological well-being among elderly people. Many studies have demonstrated benefits of physical exercise on physiological functioning in older adults. Some recent studies have shown that physical exercise may have broader significance for the overall well-being of elderly people. These studies indicate improvement or positive associations of mood [1] or lower occurrence of depressive symptoms [2, 3] as well as positive effects on body-image [4], cognitive functioning [1, 5, 6] and self-esteem [7] with increases in physical activity. Physical exercise also seems to lead to greater life-satisfaction [8]. Despite these findings, little is known about the relationship between physical activity and psychological well-being among elderly persons in different age groups. One reason for this is that current findings have not been based on large populations. In addition, there have been weaknesses in the methodological basis of some experimental studies, for example, lack of randomization in the allocation of subjects into experimental and control groups or insufficient control over the actual exercise intervention programmes.

Many reviewers have suggested that physical exercise is beneficial for elderly people in terms of promoting psychological well-being or in specifically treating depressive disorders. Social interaction [9], cognitive-based achievements (self-efficacy theory) [10] and an increased sense of mastery over physical tasks [11] are explanations for improved psychological well-being through physical exercise. It is therefore relevant to investigate the associations between physical exercise and psychological well-being in a larger population. Such information would be needed to translate the research findings into intervention programmes aimed at promoting the health and functioning of elderly populations.

This study focuses on the associations between physical activity and psychological well-being and their significance among elderly individuals. The main purpose of the study was to find out to what extent physical activity level is associated with indicators of psychological well-being among representative samples of elderly people.

Materials and Methods

This study is a part of an interdisciplinary gerontological research programme, the Evergreen Project [12], the aim of which is to support and promote physical, psychological and social functioning and health among elderly residents in the city of Jyvaskyla, central Finland. The total population of Jyvaskyla on 1 February 1988 was 65 000, of whom 7600 or 11.6% were aged 65 and over. The majority of the elderly people were women (67.3%). The proportion aged 75 or more in the population aged over 64 years was 38.9%.

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The samples were selected from persons resident in Jyvaskyla on 1 February 1988 and born during the periods 1904-13, and 1914-23. Two systematic random samples consisting of 1000 people for each age group were drawn from the population register. For financial reasons these samples were then randomly reduced to the final sample size of 800 for each age group. Institutionalized persons (n = 33) were not interviewed in this study.

Consenting participants were interviewed twice at their homes, each interview lasting 2 hours. The interviews were conducted by 28 female university students, who underwent 40 hours of training. The response rate (80.2%) was calculated after excluding institutionalized persons, the deceased and those who had moved out of Jyvaskyla. A total of 1224 persons responded to the interview questionnaire (Table).

The structured interview included questions about the respondent's demographic status, social network, health and functional status and physical activity. Physical activity consisted of several items. Walking, the practice of home gymnastics, participation in organized physical exercise and intensity of physical exercise were chosen to describe physical activity in this report. Respondents were asked to assess their practice of these forms of activity on a six-point scale from daily exercise to no exercise at all. The intensity of physical exercise was assessed on a seven-point scale from the performance of daily living activities only to intensive regular training. Self-ratings of functional capacity and health as well as self-perceived meaningfulness of life, memory and mental agility were elicited on a five-point scale from very good to very poor. Information about the prevalence of chronic diseases was obtained by the following question: `Have you any chronic disease which has been diagnosed by a physician?'.

The screening instrument for depression was modified from the 13-item scale by Beck et al. [13] and Raitasalo [14]. Each item was scored 0-3, a high score indicating a high occurrence of depressive symptoms. For the statistical analyses a dichotomized variable was created so that 0-4 points indicated no depressive symptoms and 5-39 points depressive symptoms. The screening instrument for cognitive capacity was the Mini-D test based on Luria's theory [15]. The test included items concerned with orientation, memory, learning, visualization, problem-solving and reasoning. A high score showed better cognitive functioning.