Social Support and Physical Activity in Older Adults: Identifying Predictors Using Data From the Canadian Longitudinal Study on Aging

Social capital and physical activity: a literature review up to March 2024

Background

Social capital, as a multidimensional social science concept, plays a crucial role in promoting physical activity. Despite numerous studies exploring the relationship between social capital and physical activity, there is still a lack of systematic understanding of how different dimensions of social capital influence physical activity levels. This study aims to systematically review the literature up to 2024 on the relationship between social capital and physical activity, uncover the role of social capital in promoting physical activity, and identify its multidimensional impacts.

Methods

We used a combination of search terms including "social capital" and "physical activity" to search the Web of Science, PubMed, Scopus, SportDiscus, and PsychINFO databases for English literature published up to March 1, 2024.

Results

We identified 2,021 unique articles and reviewed 115 studies that met our inclusion criteria. These studies evaluated various dimensions of social capital, with key dimensions including social participation (34%), social networks (30%), social cohesion (30%), social trust (29%), overall social network (26%), social support (19%), safety (19%), norms of reciprocity (13%), social control (10%), satisfaction with the environment (8%), collective efficacy (4%), norms for physical activity (3%), and voting (1%). In studies exploring the relationship between social capital and physical activity, the majority of positive results in the hypothesized direction were observed in dimensions such as social cohesion, trust, participation, reciprocity, satisfaction with the environment, and overall social networks. In contrast, dimensions such as voting, collective efficacy, safety, control, and physical activity norms predominantly showed null or negative results. The results for social support were mixed, displaying positive, negative, and null outcomes, while findings for social networks were also predominantly mixed.

Conclusion

This study reveals the significant role of social capital in promoting physical activity, particularly in the dimensions of social cohesion, social trust, social participation, norms of reciprocity, satisfaction with environment, and overall social network. When designing public health interventions in the future, it is crucial to tailor strategies to different populations and contexts to better leverage social capital in promoting physical activity.

Effectiveness of physiotherapist-led tele-rehabilitation for older adults with chronic conditions: a systematic review and meta-analysis

BACKGROUND

Older adults live with chronic conditions worldwide. The aim of this systematic review was to determine the effectiveness of physiotherapist-led (PT-led) tele-rehabilitation on various health outcomes.

METHODS

Six databases were searched. Eligible studies were randomized controlled trials that included older adults (≥65 years) who had ≥1 chronic condition, and evaluated tele-rehabilitation (e.g., video, telephone) that was PT-led or overseen. Screening and data extraction were performed in duplicate. Meta-analyses were performed where appropriate. Cochrane's Risk of Bias 2.0 tool was used.

RESULTS

Fifteen studies were included. A meta-analysis of studies of knee osteoarthritis demonstrated that tele-rehabilitation is more effective than usual care for functional mobility (MD= -2.72, 95% CI= -3.56, -1.88, p < 0.001), quadriceps strength (MD= 15.54, 95% CI= 10.14, 20.95, p < 0.001), pain (MD= -1.2, 95% CI= -2.09, -0.39, p = 0.004) and physical function (MD= -5.95, 95% CI= -8.32, -3.58, p < 0.001). No clear differences were found between tele-rehabilitation and usual care or comparator interventions for outcomes related to physical activity level, gait speed, mental health, and quality of life.

CONCLUSIONS

PT-led tele-rehabilitation appears to be comparable to traditional methods at improving outcomes in older adults with various chronic conditions. However, high-quality trials are needed so future conclusions on the effectiveness of tele-rehabilitation can be made.

CRD42023428048.

Understanding the barriers and facilitators of urban greenway use among older and disadvantaged adults: A mixed-methods study in Québec city

Urban greenways are multipurpose and multi-user trails that provide a range of socio-ecological and health benefits, including active transportation, social interactions, and increased well-being. However, despite their numerous benefits, barriers exist that limit urban greenway access and use, particularly among older and disadvantaged adults. This study addresses a significant research gap by examining the nuanced factors that influence the choices and experiences of these specific user groups in Québec City, Canada. We use a mixed-methods' approach to explore the facilitators of and barriers to access and use of two urban greenway trails among older and disadvantaged adults. Our methods included a greenway user count, 96 observation time slots, and 15 semi-structured user interviews. The results revealed significant use of greenway trails by older adults for afternoon walks in both seasons studied (autumn and winter). We also observed variations in use patterns, such as higher levels of solitary walking, reduced levels of winter cycling, and the impracticality of the secondary greenway trail owing to snow conditions. In addition, the findings revealed a wide range of factors that influence greenway access and use, categorized as individual or personal, physical or built environment, social environment, and meteorological or climatic dimensions. Future research can build on these insights to design and assess interventions that capitalize on the facilitators and address any barriers, enhancing the value of urban greenways for older and disadvantaged adults.

Physical activity and functional social support in community-dwelling older adults: a scoping review

BACKGROUND

Globally, the population of older people is increasing and is estimated to reach nearly 2.1 billion by 2050. Physical activity (PA) is one of the key components for successful ageing. However, PA decreases with age and many older adults do not meet PA guidelines. Previous research has shown that social support (SOSU) is related to PA in older people. The aim of this scoping review is to identify and map all of the available evidence and to explore the association between functional SOSU and PA in older adults. Functional SOSU consists of emotional, informational, instrumental and companionship SOSU and social comparison.

METHODS

A scoping review was conducted using the Joanna-Briggs manual. Quantitative and qualitative studies investigating associations between functional SOSU and PA levels in older adults (mean age ≥ 60 years) were identified through a systematic search in seven electronic databases up to August 2023. After removing duplicates, 20,907 articles were screened for titles and abstracts. The results were analysed separately for different types of SOSU.

RESULTS

116 articles met the inclusion criteria; 72% were quantitative studies and 28% were qualitative studies. Most studies used self-reported PA measures, only 23% of the studies used objective-reported PA measures. Most studies of SOSU for PA reported positive associations but the evidence is inconclusive when the source of support is considered. PA is positively associated with general, emotional, informational, and companionship SOSU, while instrumental support may occasionally be negatively associated. Companionship support is particularly influential on PA, especially in group settings, as it promotes social connectedness. Qualitative studies show that social comparison also supports PA. Different forms of SOSU generally show positive associations with PA.

CONCLUSIONS

While the evidence on the association between functional SOSU and PA is mixed, most studies show that there is a positive association. PA may also be a strategy for improving social contact and social integration. This study offers a comprehensive overview of measures for SOSU and PA and thereby informs future research and policy-making.

Effect of Intrapersonal and Interpersonal Behavior Change Strategies on Physical Activity Among Older Adults: A Randomized Clinical Trial

Importance

Despite guidelines that recommend physical activity (PA), little is known about which types of behavior change strategies (BCSs) effectively promote sustained increases in PA in older adults who are insufficiently active.

Objective

To determine whether intrapersonal BCSs (eg, goal setting) or interpersonal BCSs (eg, peer-to-peer sharing or learning) combined with the Otago Exercise Program (17 strength and balance exercises and a walking program that are learned and individually tailored, with instruction to perform 3 times per week at home or location of choice) and a wearable PA monitor help older adults sustain increases in their PA.

Design, Setting, and Participants

This 2 × 2 factorial randomized clinical trial (Community-Based Intervention Effects on Older Adults' Physical Activity) of community-dwelling older adults 70 years or older with PA levels below minimum national PA guidelines was conducted in urban community centers. Dates of enrollment were from November 17, 2017, to June 15, 2021, with final follow-up assessments completed on September 2, 2022.

Interventions

Participants were randomized to intrapersonal (eg, goal setting) BCSs, interpersonal (eg, problem-solving with peer-to-peer sharing and learning) BCSs, intrapersonal and interpersonal BCSs, or an attention control group. All interventions included a PA monitor and 8 weekly small-group meetings with discussion, practice, and instructions to implement the exercise program and relevant BCSs independently between meetings and after the intervention.

Main Outcomes and Measures

The primary outcome was daily minutes of objectively measured total PA (light, moderate, or vigorous intensities) averaged over 7 to 10 days, measured at baseline and after the intervention at 1 week, 6 months, and 12 months.

Results

Among 309 participants (mean [SD] age, 77.4 [5.0] years; 240 women [77.7%]), 305 (98.7%) completed the intervention, and 302 (97.7%) had complete data. Participants receiving PA interventions with interpersonal BCS components exhibited greater increases in total PA than did those who did not at 1 week (204 vs 177 PA minutes per day; adjusted difference, 27.1 [95% CI, 17.2-37.0]; P < .001), 6 months (195 vs 175 PA minutes per day; adjusted difference, 20.8 [95% CI, 10.0-31.6]; P < .001), and 12 months (195 vs 168 PA minutes per day; adjusted difference, 27.5 [95% CI, 16.2-38.8]; P < .001) after the intervention. Compared with participants who did not receive interventions with intrapersonal BCS components, participants who received intrapersonal BCSs exhibited no significant changes in total PA at 1 week (192 vs 190 PA minutes per day; adjusted difference, 1.8 [95% CI, -8.6 to 12.2]; P = .73), 6 months (183 vs 187 PA minutes per day; adjusted difference, -3.9 [95% CI, -15.0 to 7.1]; P = .49), or 12 months (177 vs 186 PA minutes per day; adjusted difference, -8.8 [95% CI, -20.5 to 2.9]; P = .14) after the intervention. Interactions between intrapersonal and interpersonal BCSs were not significant.

Conclusions and Relevance

In this randomized clinical trial, older adults with low levels of PA who received interpersonal BCSs, the exercise program, and a PA monitor exhibited significant increases in their PA for up to 12 months after the intervention. Intrapersonal BCSs elicited no significant PA changes and did not interact with interpersonal BCSs. Our findings suggest that because effects of a PA intervention on sustained increases in older adults' PA were augmented with interpersonal but not intrapersonal BCSs, approaches to disseminating and implementing the intervention should be considered.

Trial Registration

ClinicalTrials.gov Identifier: NCT03326141.

Determinants of physical activity behavior among older adults with subjective cognitive decline based on the capability, opportunity, motivation, and behavior model: mediating and moderating effects

Background

PA is vital for secondary prevention in older adults with subjective cognitive decline (SCD), but their physical activity (PA) levels are low, and the underlying interaction pathways among associated factors are poorly understood. This study aims to identify mediating and moderating effects of determinants on PA behavior in older adults with SCD using the capability, opportunity, motivation, and behavior model.

Methods

Following the STROBE checklist, we conducted a cross-sectional survey among 289 older adults with SCD. Path regression, mediation effects, and moderation effects were used to explore the associated factors of PA behavior and the associations among these variables.

Results

The prevalence of physical inactivity among older adults with SCD was high (40.3%). The path model fit indices were χ2/df = 1.145, GFI = 0.968, CFI = 0.988, and RMSEA = 0.022. Path regression revealed that frailty, physical and social support, PA motivation, and fall history had significant direct association with PA behavior. PA motivation not only partially mediates between frailty and PA behavior but also partially mediates between physical and social support and PA behavior. Additionally, fall history moderated the relationship between frailty and PA behavior.

Conclusion

PA behavior in older adults with SCD requires improvement. Healthcare professionals should devise more effective interventions to boost PA behavior by enhancing motivation. Screening for frailty and addressing fall history, while providing sufficient physical and social support, is crucial.

Determinants of Physical Activity in Older Adults in South-Eastern Poland

The aim of our study is to assess factors determining the uptake of physical activity (PA) by older people living in south-eastern Poland. This is a cross-sectional study. The study included 858 older people aged 75 and over living in south-eastern Poland. PA was assessed by asking about the time spent on any at least moderate PA per week and about doing planned strengthening exercises to improve muscle strength and muscular endurance. Functional status, disability and quality of life in older people were also assessed. Logistic regression models were used to identify the factors related to PA. In the study group, only 25.64% performed a minimum of 150 min of moderate-intensity exercise, while strengthening exercises were performed by 22.49%. The most important factors influencing the uptake of PA were age, number of chronic diseases, place of residence, education, social activity, housing conditions, quality of life and health status. In summary, the study population represents a low level of PA uptake, with the majority not meeting the World Health Organization recommendations for PA uptake by older people. Our findings suggest individualized efforts to promote public health and increase PA among older people over 75 years of age.

Physical Activity and Social Support to Promote a Health-Promoting Lifestyle in Older Adults: An Intervention Study

The purpose of this study was to understand the effect of intervention in the form of physical activity and social support while co-exercising to promote a health-promoting lifestyle in older adults. This study openly recruited 60 healthy male older adults, all of whom wore a wrist-worn Garmin device walker. Experimental group A was monitored by a special person and walked together as a group, experimental group B walked independently outdoors, and the control group went about their daily routine as normal. All participants recorded daily steps and calorie consumption data for eight weeks. The results of the study showed that when walking together in experimental group A, the number of daily walks and calories consumed could be maintained at a high level due to the effect of group and social support. The number of daily walks in experimental group B was inconsistent due to the lack of motivation to walk on their own. The control group consumed the lowest number of calories in their daily routine. The results show that physical activity and social support have positive explanatory power for a health-promoting lifestyle. Finally, physical activity in older adults should be promoted, and social support for interaction with peers can effectively promote a healthy lifestyle and respond to the arrival of the super-aged society in advance.

Chinese Translation and Psychometric Testing of the Simplified Version of Social Support Scale for Physical Activity

Purpose

Sallis et al’s social support scale for physical activity (SSSPH) is one of the most widely used scales to measure exercise-related social support yet has never been translated and validated in Chinese. The current study aims to simplify, translate, and validate a short form of SSSPH in a Chinese population.

Patients and Methods

A simplified Chinese version of the SSSPH (SSSPH-SC) retaining 6 items was achieved after the translation and back-translation process, which showed good content validity. The scale was then assessed among a convenience sample of 266 Chinese adults from various backgrounds. Internal consistency was tested by calculating Cronbach’s α. The a priori two-factor structure was tested with confirmatory factor analysis (CFA). Concurrent validity was examined by investigating the correlation of the SSSPH-SC with general social support, quality of life, and self-rated health.

Results

The SSSPH-SC full scale and subscales showed good internal consistency with Cronbach’s alpha ranging from 0.87 to 0.92. The CFA supported the a priori two-factor structure: family support and friend support, with χ2/df=2.93, CFI = 0.98, TLI = 0.98, RMSEA = 0.07, SRMR = 0.035. The concurrent validity of the SSSPH-CS was further supported by its significant positive correlations with social support (r=0.26, p<0.001), quality of life (r=0.25, p<0.001), and self-rated general health depression (r=0.23, p<0.001).

Conclusion

The SSSPH-SC had good reliability and validity and could be used as a simple and effective tool for assessing social support for physical activity in Chinese adults. The scale can be used as an effective tool to guide future health promotion programs as well as an evaluation tool to assess intervention effects.