Physical activity enhances long-term quality of life in older adults

Exercise is a lot like spinach … everybody knows it's good for you; yet many people still avoid it, forgoing its potential health benefits.

But researchers at the University of Illinois at Urbana-Champaign who study the effects of exercise on aging point to new findings that may inspire people to get up, get out and get moving on a regular basis. The research team, led by kinesiology professor Edward McAuley, found that previously sedentary seniors who incorporated exercise into their lifestyles not only improved physical function, but experienced psychological benefits as well.

"The implications of our work are that not only will physical activity potentially add years to your life as we age, but the quality of those years is likely to be improved by regular physical activity," McAuley said.

Results of the study appear in an article titled "Physical Activity Enhances Long-Term Quality of Life in Older Adults: Efficacy, Esteem and Affective Influences," published in the current issue of the Annals of Behavioral Medicine. Co-authors with McAuley on the report are UI kinesiology professor Robert W. Motl; psychology professor Ed Diener; and current and former graduate students Steriani Elavsky, Liang Hu, Gerald J. Jerome, James F. Konopack and David X. Marquez.

The UI research indicated positive psychosocial and cognitive outcomes -- in effect, significant quality-of-life gains -- among participants who remained physically active long after they began an initial randomized, six-month exercise trial consisting of walking and stretching/toning exercises. Results were gleaned from a battery of surveys and assessments administered at one- and five-year intervals following the initial exercise regimen.

McCauley said the study -- which assessed physical activity levels, quality of life, physical self-esteem, self-efficacy and affect in a large sample (174) of adults over age 65 -- is believed to be the only one to date to examine the relationship between physical activity and quality of life over such a long time. "Self-efficacy," McAuley noted, can be defined as "the belief, or self-confidence, in one's capacity to successfully carry out a task"; while "affect" refers to reported levels of happiness or contentment.

The researchers found that participants who continued to be physically active a year after baseline responses were recorded -- through engagement in leisure, occupational or home activities, such as house-cleaning or gardening -- were "fitter, had higher levels of self-efficacy and physical self-esteem, expressed more positive affect and reported, in turn, a better quality of life."

Increased physical activity over time, as indicated by results of the five-year follow-up, "was associated with greater improvements in self-esteem and affect. Enhanced affect was, in turn, associated with increases in satisfaction with life over time," the researchers noted.

"Our findings are important on several fronts," McAuley said. "First, we demonstrated that physical activity has long-term effects on important aspects of psychosocial functioning through its influences on self-efficacy, quality of life and self-esteem."

"Second, there is a growing interest in the relationship between physical activity and quality of life, especially in older adults. However, much of this work suggests a direct relationship between the two. Our work takes the approach, and the data support it, that physical activity influences more global aspects of quality of life through its influence on more proximal physical and psychological factors such as affect, self-efficacy and health status."

A related, two-year study conducted in McAuley's lab looked at the roles played by physical activity, health status and self-efficacy in determining "global quality of life," or satisfaction with life among older adults. The research focused on a different sample of 249 older black and white women. Results of that study will be published in an article titled "Physical Activity and Quality of Life in Older Adults: Influence of Health Status and Self-Efficacy" in a forthcoming edition of the Annals of Behavioral Medicine.

In that study, the researchers tested three potentially competing models of the physical activity/quality-of-life relationship and ultimately concluded that their findings "offer a strong theoretical foundation for understanding physical activity and quality-of-life relationships in older adults."

McAuley said the study's results confirm earlier findings by other researchers suggesting "changes in levels of functioning in older adults with chronic conditions were not predicted simply by health status or disease state, but also by physical activity and self-efficacy."

In other words, he said, there is a tendency among adults with lower self-expectations of their physical abilities to give up -- to reduce the number of activities they engage in as well as the degree of effort they expend toward that end.

"These reductions, in turn, provide fewer opportunities to experience successful, efficacy-enhancing behaviors leading to further reductions in efficacy," McAuley said. "Our data would suggest that such declines are likely to lead to subsequent reductions in health status and, ultimately, quality of life."

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