Background: Physical activity had important role in promoting aging health. Various factors have effect in physical activity level elderly that increase the active rate.
Objectives: The current study aimed to relationship evaluated physical activity and facilitate factors in the elderly Kashan /Iran 2014.
Methods and Materials: This is descriptive cross-sectional study. Sample were 400 elderly (aged more than 60 years) living in Kashan city of Iran in 2014. The subjects selected in multistage cluster sampling. Subjects were randomly selected from healthcare centers in 3 regions Kashan. The sample size were different according gender and area living. The demographic characteristics, level of physical activity and Active Benefits/Barriers Scale recorded were in the questionnaire. Data analyzed by SPSS version 16. Descriptive statistics, chi-square test and Pearson correlation, T test, and ANOVA used in data analysis. The significance was level for all the tests considered p<0.05.
Results: The 237 (59.2%) of subjects were female. The average ages of the study population were 67.6 ±6.8 years. Average physical activity energy consumption in elderly was 326.21±364.84 according to metabolic equivalent Hours per week. The 20 subjects (5%) reported no physical activity. The 320 (80%) and 59 (14.8%) subjects had low and moderate physical activity level respectively. Only 1 subject (0.2%) had extreme physical activity. Attitude facilitates factors score were 70/82±18/27. The most facilitate factors relate to cardiovascular systems health (88 subjects). There are significant relation between facilitates factors score and physical activity levels) Chi-square=19/91, p=0/0001), age (p=0.001 r=0/01), gender (p=0.002), marital status (p=0.0001), educational status (p=0.001), personal independence (p<0.0001) and BMI status (p=0/00001).
Conclusion: Various factors related to active facility in elderly. Consideration these factors are essential in programs for physical activity elderly. In addition, the promotion of active life should be a part of health care planning in elderly.
Keywords: Physical activity, aging, facilitate, factor
1. Background
Physical activity is one infrastructure program in public health that attention has been to growing trend(1). The appropriate physical active level one of the important components of health especially in the elderly introduced World Health Organization(2). That maintained should be the time of death. (3). Physical activity is the definition every move, the activities body by skeletal muscle. The action increase total energy consumption. These activities are in aging including the workplace, taking care of their own, household, transport and leisure activities(4).The physical active role play effect in fitness, improve body balance, muscle strong and mental health function(5, 6). So relationship having with promote health and social function(3). Increase self-esteem, improving self-body image, enjoying the mobility, reducing the stress and depression is other affections on the elderly(7, 8).
Lock physical activity is one of public health problems(6). This behavior has caused common chronic diseases that threat individual’s health(9). The physical active is important early risk factor in mortality rates. (10). Reduce physical activity has effect in creating osteoporosis, diabetes type colon cancer and cardiovascular diseases during retirement aging(11). So role play in preserving the independence of the individual, reduce physical disabilities and improvement muscular disorders(12, 13). According to the Center for Disease Control and Prevention study of America in 2007, had regular physical activity only 14% of individuals aged 65- 74 years and 7% of people over 75 years old(14). Statistical differences of activity ageing level inducted role-play multiple factor in lock physical active elderly. The improvement conditions, the situation, to encourage and facilitate the physical activity(15). The physical activity facilitator factors are task, conditions and individuals affect cases to encourage and facilitate the physical activity for more energy consumption and movement skeletal muscle(7).
Rimmer et al (2008) showed the most important physical activity facilitator factors in cerebral stroke elderly were the cost financial of physical activity, the awareness of the centers physical active in the region, fitness and increase motivation(16). In the Gobbi et al study (2009) willable access to amenities, positive physical activity perceptions, and existing habit of being active were the highest impact facilitators(17). Hanley et al (2011) in US showed that supplement facilities social is one of the facilitating activities factors elderly(14). The improve condition social environment is important facility factors in the Bjorsdo et al (2012) studies(18).The most physical active facility factor among African American elderly was improved motivation and physical health(19). The study Iranian in 2010 showed the most important facility factor Tehran elderly related to meet with more people, friends, and funny(20). Another study among Swedish elderly men mentioned Enjoyment and maintaining health were important physical activity facility factors(15, 21).
The physical active among elderly is different levels according to biological factors, age, psychological status, enjoy during active, behavior characterizes, supplement social, environment factors and access physical activity equipment(5, 22). Physical activity is a crucial part of lifestyles programs in health care(23). Social, cultural and climate Conditions influence the patterns of physical activity in every region. Evaluation of physical activity facility factors in different regions can provide important data for health planners and experts interested in healthy aging issues.
2. Objectives: The current study aimed to relationship evaluated physical activity and facilitate factors in the elderly Kashan /Iran 2014.
3. Materials and Methods
3.1 Study population and sampling
In this cross-sectional study in 2014, the physical activity in elderly and its related factors studied. The study population included 400 elderly aged over 60 years who had health care records in health centers in Kashan city. Kashan is a warm and dry city located in the edge of great desert in the center of Iran and city has about 200000 populations. According to previous study and estimation of inactivity in 87% of the elderly(20), confidence level of 95% (d=0.05, p=0.87, z=1.96) the sample size was calculated to be 261 according to Cochran formula. It increased to 1.5 fold due to cluster sampling, and finally 400 Individuals investigated. Inclusion criteria were age over 60 years, the Iranian nationality, no history of recognized mental disorders (psychosis), and dementia, the ability to communicate and respond to questions and residing in Kashan city in the time of the study.
After coordination with the Department of Health and Medical Education and obtaining necessary permissions, the Kashan city divided into 5 regions (center, north, south, west, and east) based on health map. The 3 regions selected randomly. All health care centers in these areas entered to the study. In each health care centers, the elderly were determined from family records and the subjects selected randomly based on the population covered by the center. The selected subjects evaluated by telephone calls. If did not meet the inclusion criteria or were reluctant to participate in the study, another subject replaced randomly. If the questionnaire had some missing data, the researchers contacted to the subject to complete the items and if it was not possible, another subject replaced randomly. Then the researchers went to the houses of the subjects and after explaining the objectives of the study, the questionnaire completed. In elderly who did not have the ability to read and write the questionnaire completed through interview.
3.2. Questionnaire
The first part of the questionnaire contained demographic data including variables (such as age, sex, education, marital status, occupational status, location, and income). Ability of mobility, chronic diseases, and history of participation in regular physical activity also recorded. The second part of the questionnaire contained 24 items about different physical activities and duration of these activities that elderly usually perform in a week. The Iranian version of International Physical Activity Questionnaire (IPAQ) was used in this part (24). The energy consumption of every subject calculated according to the type of the activities and duration of the activities during a week in minutes. The activities divided to light (equivalent 1.3 units of energy per minute), walking (the equivalent of 3.3 units of energy per minute), moderate (equivalent to 4 units of energy per minute), and vigorous (equivalent to 8 units of energy per minute). The energy consumption of activities added to calculate the whole energy consumption in a week.
(The energy consumed amount based on the type of activities × minutes × days)= The amount of energy consumed within a week
For example, a person who spends 30-minutes a day for 5 day in week in walking and in moderate, vigorous physical activities has the total amount of energy consumption of 2295 [(8×30×5)+(3/3×30×5)+(4×30×5)] Unit Energy per week or metabolic equivalent rate (MET). The lowest possible score of the questionnaire is zero and the highest possible score is when someone practices the non-stop vigorous physical activity the whole of the week that is not attainable, so the upper limit is wide and has not defined.
There were four classes of physical activity. The Lack of physical activity, means reporting no activity during the week. The Moderate physical activity means having 600-1500 Unit Energy consumption per week. Vigorous physical activity means having more than 1,500 Unit Energy consumption per week and Low physical activity are people who cannot be classified in other groups(25).The IPAQ is a standard questionnaire. the mean of CVI and CVR of this questionnaire(26), has been reported 0.85 and 0.77 respectively, and its Cronbach’s Alpha coefficient had been 0.7(24). Its use was for elderly confirmed by 10 experts and in a pilot study in 30 elderly people the alpha-cronbach calculated 0.83.
Tree part of the questionnaire-contained questionnaire contained Active Benefits/Barriers Scale provided by Sechrist et al. The Active Benefits/Barriers Scale (ABBS) had 43 questions. The ABBS determine benefits and barriers to participating in physical activity from the literature and interviews. The instrument scored Likert-type format with response. This tool can be completed with the options strongly agree (score 4), agree (score 3), strongly agree (score 4), disagree (score 2) and strongly disagree (score 1). The total score ABBS is range from 43 to 172. The tool has not cut point. The Benefite score range is, 29 to 116. Missing data concluded if the items not answered more than five percent, recommended that the response discarded. The questionnaire result evaluated by test-retest reliability. The Iranian version of ABBS is a standard questionnaire, the mean of CVI and CVR of this questionnaire has been reported 0.81 and 0.76 respectively, and its Cronbach’s Alpha coefficient had been 0.87(27, 28). Its use was for elderly confirmed in 30 elderly people the alpha-cronbach was calculated 0.79. The Cronbach’s Alpha coefficient physical active facility factors questions had been 0.85.
3.3. Ethical considerations
The study proposal confirmed the research council university medical Sciences of kashan. The code of ethical was 197 in 25/5/2014. After receiving the necessary authorizations, oral and written consent obtained from participants. They assured that the data would remain confidential and used for the research purposes only. The participants were also given an unconditional an absolute right to withdraw from study at any time. All the subjects received explanation about the objectives of the study and they signed the informed consent.
3.4. Data analysis
The data analyzed by SPSS version 16. The normality of the data analyzed by Kolmogorov-Smirnov test and Q-Q normality plot. The variables of MET, age, facility score and BMI were not normally distributed, the non-parametric tests used for data analysis. The relationship between age, facility score and MET determined with Spearman correlation test. The qualitative variables relationship such as gender, marital status, education, physical activity level, facility factors and the disease evaluated chi-square test. The relationship between facility score and qualitative variables relationship such as gender, marital status, education, physical activity level evaluated ANOVA and T test. The significance level in all the tests considered p<0.05.
4. Results
Most participants were female (n = 237) (59.2 %). The mean age of the study population was 67.6 ± 6.8 years (range 60-90 years, median=65, Interquartile R (IQR) =8). Majority of participants were married (n = 291) (72.8 %).The 188 (28.5 %) subjects were illiterate. Most of the elderly (n = 199) reported hous