# Exercise as it relates to Disease/The better Ageing Project and sustaining mental well-being of elderly people through physical activity

This is a critical analysis of the paper: “Physical activity and mental well-being in older people participating in the Better Ageing Project” (Kenneth R. Fox, et al. 2007)

## What is the background to this research?

Growing evidence advocates for participation in physical activity amongst the elderly for the prevention of mental illnesses such as depression, Alzheimer’s disease, and dementia. The research is not limited to the prevention of mental illnesses; as undergoing regular physical activity was linked to the improvement of mood and psychological well-being in elderly people. Rise physical activity within the elderly community is also linked to an increase and preservation of muscular strength, independent living and a decrease in falls risk with an overall increase in quality of life.

## Where is the research from?

This article was published in the European journal of applied physiology, 2007­.
The primary author of this research paper, Kenneth R. Fox. Fox held an honorary position at the University of Bristol; and, although in retirement, he continues to work closely with the university as a consultant and trusted advisor. His time on projects is spent within the division of weight management and physical activity for mental health; focusing on older adults.
As the study was a self-reported account through questionnaires, participants may have a form of bias; however, any bias is unseen from Fox et al. in the original article.

## What kind of research was this?

The Better Aging Project conducted research into the quality of life of 176 older adults, aged 70 and over. Accelerometry, objectively assessed the day to day energy expenditure of differing intensities.
This study was conducted using a mixture of methods. Fox et al. utilised a combination of new and standardized questionnaires; as well as objective measurements of physical activity and interviews to obtain a quantitative and qualitative perspective.

## What did the research involve?

The study conducted was a standardised 12-month programme that consisted of structured exercise. The programme included 78 males aged between 75–79 years and 98 females aged between 75–80 years. There were 64 control participants (f=38, m=26); while 112 participants were part of the intervention. The programme was held within three different countries: UK, France, and Italy.
The research involved a selection of objectives to assess both the reliability and validity of a range of contemporary psychological evaluations for differing aspects of well-being and quality of life. The research aimed to investigate the relationship between activity completed in the daily life of elderly people; while, also assessing the link between sedentary behaviours and mental well-being. Physical activity was assessed minute-by-minute during the walking time of each participant over a duration of 7-days using an accelerometry. The amount of physical activity completed by each participant was used to determine their individual level of independency and daily mobility.
Fox. Et al. collected four variables to assess the level of physical activity being preformed by each participant. These variables included:
1. Daily physical activity and energy expenditure (in joules per day) (PAEE)
2. Minuets of light activity preformed each day (LPA)
3. Minutes of moderate activity preformed each day (MVPA)
4. Minuets spent sedentary each day (SED)

## What were the basic results?

At the end of the 12-month programme the results of the questionnaires and interviews were all positive. Participants recorded feeling a high level of enjoyment in the activity incorporated within the programme. Many participants stated that they felt empowered and used the programme to prevent themselves from falling in lethargic routines and habits. An overall increase in mental state and well-being was also observed in all participants.
Using Persons correlation coefficients, the relationship between PAEE, LPA, MVPA, SED and quality of life for both males and females was determined.
| | PAEE (Joules/day) | SED (minutes/day) | LPA (minutes/day) | MVPA (minutes/day) |
| Satisfaction with life | 0.17* | 0.07 | 0.06 | 0.15 |
| Physical health | 0.24** | -0.20* | 0.09 | 0.19** |
| Psychological health | 0.20* | -0.15 | 0.11 | 0.22** |
| Social | 0.26** | -0.16* | 0.04 | 0.21** |
| General well-being | 0.21** | -0.16* | 0.05 | 0.25** |
| Anxiety | 0.23** | -0.09 | 0.15 | 0.19* |
| Depression | 0.16* | -0.06 | 0.11 | 0.12 |
| Ageing well profile | 0.19* | -0.05 | 0.02 | 0.05 |
| Physical self-perception profile | 0.21** | -0.17* | 0.09 | 0.17* |
| Phys self-worth | 0.17* | -0.12 | 0.13 | 0.14 |
| Phys function | 0.22** | -0.16* | 0.09 | 0.19* |
| Phys strength | 0.13 | -0.14 | 0.03 | 0.07 |
* Significant at 0.05, **significant at 0.01

## What conclusions can we take from this research?

Through the Better Aging Project, a vital opportunity for the development and application of procedures used to assess psychological well-being and physical activity in elderly adults over the age of 70 has been devised. This article has facilitated important groundwork for further studies concerning physical activity and participants over the age of 70. Previously, the use of accelerometry has never been applied with this age group; appearing to be a sufficient method for assessing the amount of physical activity. Stronger associations were seen between the level of physical activity, physical self-perception, health, and wellbeing. However, further research should be conducted into the assessment of factors such as physical functions, disabilities, poor-health, and body weight with the effects these variables have on physical activity and mental health.

## Practical advice

Evidence advocates that physical activity can be the key to prevention for various types of mental illnesses; such as, depression, Alzheimer’s disease, and dementia within the elderly community. The article indicates that elderly people who spend more time being active and participate in daily physical activities experience higher levels of self-rated mental health and quality of life; compared to those who spend more time sedentary. An increase in walking has been found to be a major contributor in rising physical activity amongst elderly people. The WHO recommends that elderly people complete a minimum of 150 minuets of moderate-intensity activity like walking, or 75 minutes of high-intensity activity each week. When completed in organized social groups, higher levels of enjoyment during physical activity have been recorded.
Five Ideas for social activity groups:
* Dance classes
* Water aerobics classes
* Swimming classes
* Walking groups
* Cycle groups

## Further information/resources

The articles below can provide further information into mental health of older adults.
* Mental health of older adults
* Signs and symptoms of declining mental health
* Who can assist you in improving your mental health
* Mental health services and programs for older people

## References

* ↑ Abbott RD (2004) Walking and dementia in physically capable elderly men. JAMA 292:1447–1453
* ↑ Strawbridge WJ, Deleger S, Roberts RE, Kaplan GA (2002) Physical activity reduces the risk of subsequent depression for older adults. Am J Epidemiol 156:328–334
* ↑ Fiatarone-Singh MA (2002) Exercise comes of age: rationale and recommendations for a geriatric exercise prescription. J Ger- ontol A Biol Sci Med Sci 57:262–282
* ↑ WHOQOLGroup (1998) Development of the WHOQOL BREF quality of life assessment. Psychol Med 28:551–558
* ↑ Morris, J.N. & Hardman, A.E. Sports Med (1997) 23: 306. https://doi.org/10.2165/00007256-199723050-00004
* ↑ World Health Organisation (2002) Active ageing: a policy frame- work. World Health Organisation, Geneva
* ↑ McAuley E, Blissmer S, Marquez DX, Jerome GJ, Kramer AF, Katula J (2000b) Social relations, physical activity, and well- being in older adults. Prev Med 31:608–617