Running head: PHYSICAL ACTIVITY PROMOTION AMONG THE ELDERLY

Health Promotion: Physical Activity Promotion Among the Elderly

Megan Cottrell, RN and Amber Dykstra, RN
Ferris State University

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Abstract

For many years now it has been neglected to promote physical activity in the elderly. Now to
promote physical activity in the elderly we have to look at barriers, outcomes and benefits,
interventions and ways nurses can promote physical activity. Some barriers that affect the elderly
from physical activity are disability, fear for injury, attitude and self-efficiency. The importance
for nurses to promote physical activity is increasing. This can be performed in any nursing
setting. Outcomes and benefits that have been found are important to educate the patient on. The
patient may understand the benefits but it is a good reminder. Finally, finding ways to promote
physical activity is different for every patient and needs to be tailored to their needs.

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Health Promotion: Physical Activity Promotion Among the Elderly

The goal of this paper is to identify barriers to physical activity in the elderly, describe
ways to promote physical activity, identify benefits and outcomes of physical activity, and its
importance among this population.
Barriers to Physical Activity
According to HealthTrust.org (2013), only a small percentage (16%) of adults across the
age continuum engage in the recommended frequency and amount of physical activity (para.
5). There are many internal and external barriers to physical activity that the elderly encounter.
Some of these barriers include disabilities, fear of injury, attitude, illness, motivation and self
efficacy, physical and environmental discomfort, and cognitive decline (Green, 2013). According
to a study performed by Azizan, Hussan, Justine, Salleh, and Manef (2013) aimed to identify
barriers to physical activity and participation among elderly individuals, the most common
external barriers to physical activity were not enough time, no one to exercise with, and
lack of facilities. The most common internal barriers in this study were too tired, lack of
motivation, and already active enough.
It is important for health care professionals to identify these barriers in this population so
these individuals may benefit from physical activity and exercise.
Importance of Nurses in Promoting Physical Activity
Community nurses are in an ideal position to positively influence the general population,
including older adults. Nurses are able to help identify barriers to physical activity and health
promotion, as well as offer advice and provide resources to individuals. According to Davies,
Dinan, Goodman, Iliffe, and Tai (2010), older people who recalled being given activity advice

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given by health care professionals or who received structured input were more likely to start
participating in exercise classes than those who did not recall having received such advice(p. 6).
Outcomes and Benefits of Physical Activity
Similar to young adults, older adults benefit greatly from increased physical activity. As
an adult ages their risk for increased Coronary Heart Disease increases as well. According to Tai
et al, the amount of exercise that is enough is still in debate but the risk for CHD can be
decreased with regular, brisk walking.
As adults grow older, their bones become more fragile and their balance becomes less
stable. This leads to an increased risk for falls and fractured bones. Tai states that with moderate
exercise the risk for a hip fracture decreases by 40-50%. In higher levels of activity the risk is
reduced by 70%. This rate occurs when the performer also eats a well-balanced diet and takes
calcium supplements.
Depression and anxiety are common in older adults. Dysphoric or demoralization
syndrome is often found in depressed adults and is associated with disability. Exercises can be
effective in assisting in treating these disorders. It has been well known for many years that
exercise increases endorphins which lead to a happier person. As for having anxiety, many adults
use working out as a way to relax and release their worries. This method of relaxation can be
used in older adults as well. This would in turn, reduce the use of anxiolytics in the elderly which
is not highly recommended in the elderly anyways.
Another benefit of physical activity is the performer has more social interaction. Work
places and churches put together challenges for employees to compete in to see who is more
active. According to King, churches and work sites also put together walking groups. This can be
found in community settings as well.

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The benefits received from physical activity in the elderly are important to educate. Not
only does physical activity prevent CHD, and hip fracture but it reduces other risks as well.
Other health related issues that physical activity reduces is thromboembolic stroke, hypertension,
type 2 diabetes mellitus, obesity, colon cancer, and breast cancer.
Physical Activity Promotion
To promote activity in the elderly we have to assess each person first on an individual
basis. Physicians are urged to tailor exercises programs per patients needs. This could include
but is not limited to, assessing whether the patient prefers working out in a public environment or
at home in a personal atmosphere. If the patient states that they prefer public, choosing a place
with different activity options will help the person to remain active. It is also important to assess
how motivated the person is to change his or her sedentary life. The last part of tailoring a
patients exercise program is to educate them on what types of exercises are appropriate for their
needs and how long they should do it for.
The American College of Sports Medicine (ACSM) and the American Heart Association
(AHA) recommend moderate-intensity aerobic exercise 30 minutes a day, five days a week or 20
minutes of vigorous activity three days a week. To access whether the adult is achieving
moderate or vigorous exercise, the ACSP and AHA use a scale from 0-10, with 10 being the most
intense. Moderate intensity rates from 5-6 and vigorous intensity is 7-8.
For patients who should focus on preventing or slowing osteoporosis, the AHA
recommends activities that will maintain or increase muscle strength for at least two days a
week. The AHA also recommends performing 8-10 exercises that will focus on major muscle
groups. The American College of Sports Medicine recommends a resistant weight with 10-15

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repetitions for each exercise. Again, the 0-10 point intensity schedule is used with 5-6 being
moderate effort and 7-8 being intense.
As mentioned earlier, a risk of falling increases with a persons age. Doing physical
activity on a regular basis decreases fall injuries by 35-45%. To increase this number, add
balance exercises into a regular routine three days a week.
It is also important to assess the support the elderly person is receiving from home.
According to King, studies have shown that a person with support from family, friends and
program staff have been more successful in maintaining physical activity. Other factors
contributing to lower success rates were smokers and divorced people. Studies suggest divorcees
have a lower success rate because they have less support from family and friends.

Conclusion
In conclusion, there are many barriers to physical activity that the elderly population must
overcome. It is important for nurses as health care professionals to identify these barriers and
encourage regular exercise. The benefits of regular physical activity in the elderly are numerous
and can help improve the quality of life for these individuals. As nurses we have to promote
physical activity and encourage the elderly to overcome barriers that may be keeping them from
performing these activities.

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References

Azizan, A., Hussan, V., Justine, M., Manef, H., Salleh, Z. (2013). Barriers to participation in
physical activity and exercise among middle-aged and elderly individuals. Singapore
Medical Journal. 54(10). Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24154584
Goodman, C., Davies, S. L., Dinan, S., Tai, S. S., & Iliffe, S. (2011). Activity promotion for
community-dwelling older people: A survey of the contribution of primary care
nurses. British journal of community nursing, 16(1), 12-17.
Green, J. (2013). Addressing barriers to exercise with older adults. Retrieved from
http://www.ncpad.org/786/4168/Addressing~Barriers~to~Exercise~with~Older~Adults
Health Trust. (2013). Healthy aging: Facts & statistics. Retrieved from
http://www.healthtrust.org/initiatives/aging/facts.php
King, A.C. (2001). Interventions to promote physical activity by older adults. Journals of
Gerontology,56(2), 36-43.
Nelson, M., Rejeski, W.J., and Blair,S.N. (2007). Physical activity and public health in older
adults: recommendation from the American college of sports medicine and the American
heart association. American College of Sport Medicine, (1435-1445).
Tai, S.S., Gould, M. and Iliffe, S. (1997). Promoting healthy exercise amog older people in
general practice: issues in designing and evaluating therapeutic interventions. British
Journal of General Practice 47, 119-122.