Focused Review
Motivating elders to initiate and maintain exercise1

https://doi.org/10.1016/j.apmr.2004.03.012Get rights and content

Abstract

Phillips EM, Schneider JC, Mercer GR. Motivating elders to initiate exercise. Arch Phys Med Rehabil 2004;85(Suppl 3):S52–7.

This article addresses the motivation of elders to initiate exercise. It is part of the study guide on geriatric rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation and geriatric medicine. This article specifically focuses on the health benefits of exercise, describes a theoretical model for assessing and improving an individual’s motivation to pursue exercise, details the particular challenges elders face in initiating and adhering to an exercise program, and outlines professional interventions to address these obstacles.

Overall article objective

To explore the particular challenges elders face in motivation to exercise and to develop a systematic approach for counseling elders toward greater activity.

Section snippets

Importance of exercise in the elderly

In the geriatric population, physical activity is beneficial. Physical activity promotes health, slows disease progression, and prolongs functional independence.1, 9, 10, 11 Researchers have identified an inverse relationship between total physical activity and mortality.12 In fact, physical activity initiated late in life positively affects mortality, effectively delaying death, even after statistics are corrected for comorbidities such as smoking, obesity, and hypertension.13 Physical

Motivation

Motivation is defined as the forces acting on or within a person to initiate a behavior.22 This definition provides a framework that includes both intrinsic and extrinsic factors. Understanding motivation as more than an inert part of an individual’s personality may strengthen care providers’ efforts to motivate their elderly patients and can provide elderly persons with the tools to empower themselves to become self-directed about exercise participation. Multiple motivational models have been

Obstacles to motivation

It is helpful to organize obstacles to exercise motivation according to the 4 elements of the motivation equation: odds of success, importance of goal, costs, and inclination to remain sedentary.

Methods of motivation

To overcome the common obstacles to initiating exercise, it is incumbent on physicians to counsel their elderly patients to exercise. Interestingly, those encouraged by a physician to exercise report fewer barriers and exercise more than those without such support,52 underscoring the large potential benefit inherent in a physician’s intervention to assist elderly patients to become more active.

Conclusions

Although the health benefits of physical activity for elderly persons are well established, exercise is an underused form of health promotion, especially in the elderly population. Physicians must play a more active role in motivating their patients to exercise. Clinicians historically have not actively promoted physical activity and sometimes have even actively discouraged activity. Motivation is not simply a static description of an individual’s personality; rather, it is comprised of many

References (60)

  • Surveillance for selected public health indicators affecting older adults—United States

    MMWR Morb Mortal Wkly Rep

    (1999)
  • D Ash

    Exercises for older adults

  • J.O Judge

    Exercise programs for older personswriting an exercise prescription

    Conn Med

    (1993)
  • S.S Paist

    Screening and preventive interventions in older patientswhich ones are useful?

    Hosp Med

    (1999)
  • I.M Lee et al.

    Do physical activity and physical fitness avert premature mortality?

    Exerc Sport Sci Rev

    (1996)
  • S.N Blair et al.

    Changes in physical fitness and all-cause mortalitya prospective study of healthy and unhealthy men

    JAMA

    (1995)
  • S.G Leveille et al.

    Aging successfully until death in old ageopportunities for increasing active life expectancy

    Am J Epidemiol

    (1999)
  • J.F Bean et al.

    The benefits of exercise for community-dwelling older adults

    Arch Phys Med Rehabil

    (2004)
  • R Kaplan

    Health and aging in Alameda County Study

  • R Sheppard

    Determinants of exercise in people aged 65 and older

  • Physical activity and cardiovascular health

    JAMA

    (1996)

  • Exercise and physical activity for older adults

    Med Sci Sports Exerc

    (1998)

  • Physical activity and healtha report of the Surgeon General

    (1996)
  • J.F Sallis et al.
  • M.L Fogel et al.

    Correlation of psychological variables and progress in rehabilitation

    Dis Nerv Syst

    (1969)
  • M.E Tinetti et al.

    Fear of falling and low self-efficacya cause of dependence in elderly persons

    J Gerontol

    (1993)
  • E McAuley et al.

    Mode of physical activity and self-efficacy in older adultsa latent growth curve analysis

    J Gerontol B Psychol Sci Soc Sci

    (1999)
  • M.E Simonsick et al.

    Who walks? Factors associated with walking behavior in disabled older women with and without self-reported walking difficulty

    J Am Geriatr Soc

    (1999)

    • Cited by (0)

    1

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors(s) or upon any organization with which the author(s) is/are associated.

    View full text
    Copyright © 2004 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.