Adherence to Exercise and the Older Adult

I always knew I wanted to work in the health field. The medical field was fascinating, but I wanted a closer relationship with patients than most doctors have. The fitness industry was also appealing to me, but I couldn’t face working out 6 hours a day for the rest of my life. So, I put myself on the path to becoming a physical therapist, getting my undergraduate degree in exercise physiology and a master’s in Sport Psychology. During this time I worked my way through school with physical therapy and personal training jobs. Then I discovered health psychology. During this time, I also began work with older adult populations and fell in love with them. Health psychology deals with a wide range of issues related to health, including the biological, behavioral and social contexts important to older adult populations.

What I enjoy most about working with older adults is their desire to learn and improve their well being. The problem is that 40 percent of older adults have a chronic illness that limits mobility (Blocker, 1992). Limitations in mobility can make exercise or therapy painful, which can impact adherence and compliance to a prescribed training regimen. This is why I began researching different methods of increasing exercise adherence and compliance of older populations. In addition to potentially painful exercise experiences, I also knew that in general Americans are not as active as they should be. This is evident in that obesity affects approximately 58 million Americans and accounts for 300,000 preventable deaths each year (Moore & Koop, 1998). Given these facts, it is surprising that researchers have reported a 50% dropout rate between 3 and 6 months after the initiation of an exercise program (Dishman, 1994). The issues of adherence and compliance are perplexing to professionals in both the psychology and health industries.

The health practices of older adults are important to the field of psychology and society at large because they are the fastest growing population. It is projected that in the year 2010 there will be 40.2 million people over the age of 65 and 6.1 million people over the ages of 85 in the United States (FIFARS, 2006). This population increase is a growing concern for health care practitioners. In my personal experience, I have found the older population especially engaging to work with because they have different motivations for exercising than other populations. For example, older people tend to exercise to feel better, to easily pick up their grandchildren or maintain their independence as they age. It is very empowering and rewarding to know that psychological research is making a difference in the quality of life of our elderly.

Psychology has been a component of the health industry from the beginning of the 20th century. For the first half of the century most psychological study in medicine was primarily focused on psychiatry. In the 1960’s behavioral science became part of the curriculum in most medical schools. Health psychology became the 38th established division of the APA in 1978 after a task force report envisioned a future where psychologists could enhance health and prevent disease. Today, the field of health psychology is flourishing with more educational, research, and career opportunities than ever before. (Brannon and Feist, 2004)

Currently, one of the main focuses of health psychology is looking at behavioral risk factors that lead to mortality, such as a sedentary lifestyle. Health psychologists are in a unique position in the health care community to address these issues. They can provide support not only to the individual but also to the physicians, nurses, therapists, trainers and government care providers.

APS has also taken an active interest in this area. In 2007, the APS Student Caucus (APSSC) group for Research on Socially and Economically Underrepresented Populations (RiSE-UP) created the weight issues subcommittee. The Weight Issues subcommittee is for graduate and undergraduate students interested in uncovering, researching and promoting research on various subjects in health and fitness psychology. If you are interested in learning more about health psychology, older populations and/or exercise research please email me at riseup.weight.issues@gmail.com or the RiSE-UP Coordinator at riseup.coordinator@gmail.com. In addition, the American Geriatrics Society has published a valuable position statement about geriatric research and funding, which can be found on their website at http://www.americangeriatrics.org/products/positionpapers/research.shtml. ♦

References

Brannon, L., & Feist, J. (2004). Health psychology: An introduction to behavior and health (5th Ed). Wadsworth Publishing: Belmont, CA.

Dishman, R., & Sallis, J. (1994). Determinants and interventions for physical activity and exercise. In C. Bouchard, R. Shepard & T. Stephens (Eds), Physical activity, fitness and health: International preceding and consensus statement. Champaign, Il. Human Kinetics. 214-238.

Federal Interagency Forum on Aging Related Statistics (FIFARS). (2006). Data sources on older Americans. Washington, D.C.: National Center for Health Statistics. Retrieved on May 4, 2007 from http://www.agingstats.gov/agingstatsdotnet/Main_Site/Data/Data_2006.aspx.

Moore, B., & Koop, C. (1998). Obesity is no laughing matter. Journal of Women’s Health, 7(2), 183-185.